It is vital for disciplines to introduce their glossary in a standardized manner, and Evidence-Based Medicine is no exception. Unification and standardization for evidence-based medicine glossary are indispensable and urgent. This paper will introduce what is evidence-based medicine glossary and why it is important.
Objective To explore the clinical epidemiologic characteristics and tendency of gastric cancer during recently ten years in northern Henan province. Methods The clinical data of 1 090 patients with gastric cancer in our department were collected from January 1998 to May 2008. The ten-year period was divided into two groups: previous 5 years group (n=433) and post 5 years group (n=657). The age, gender, pathologic characteristics and the relationship between age and pathologic features were analyzed retrospectively. Results ①The patient’s age was 15-83 years old 〔mean （57.60±10.84） years old〕 and men-momen ratio was 3.71∶1 in previous 5-year group. The patient’s age was 18-82 years old 〔mean （58.95±10.81）years old〕 and men-momen ratio was 2.84∶1 in post 5-year group. There was no significant difference in age or gender between two groups （Pgt;0.05）. ②Gastric cancer arised in cardia and gastric fundus more common and for the incidence of the site no change was found in two groups. The incidence of gastric antrum cancer descended but that of gastric body arised. ③The mean age of patients with gastrocardiac cancer was significantly different (Plt;0.05) between two groups. No significant difference occurred on the mean age of patients with gastric antrum (Pgt;0.05) or gastric body cancer (Pgt;0.05). The mean age of patients with highly malignant tumor (signet ring cell cancer, poorly differentiated adenocarcinoma and undifferentiated carcinoma) was significantly different compared with that of patients with lowly malignant tumor (well differentiated and moderately differentiated adenocarcinoma) (Plt;0.05). ④The proportion of patients with highly and lowly malignant tumor presented significantly different between the previous 5 years and the post 5 years (Plt;0.05). ⑤The proportion of early gastric cancer was very low and no correlation was found between infiltrating depth and age in all patients (Pgt;0.05). Conclusion Cardia and gastric fundus is the most common site of gastric cancer in northern Henan province. The patients with gastrocardiac cancer are often older but gastric antrum and gastric body cancer patients are younger. Highly malignant gastric cancer is often found in youths, however, lowly malignant gastric cancer occurred predominantly in elderly. The proportion of gastric cancer found early is very low in northern Henan province.
Objective To analyze the clinical and etiological characteristics and bacterial susceptibility in patients with ventilator-associated pneumonia (VAP) in Guangzhou area.Methods A retrospective study was conducted on VAP patients in four hospital of Guangzhou from Jan 2004 to Oct 2005.Totally 157 patients were enrolled in this study，whose flora was identified and tested by Kirby Bauer disk diffusion susceptibility test.The univariate analysis method was used to analyze the prognostic parameters.Results The average onset time of VAP was 7.7 days after mechanical ventilation with a mortality rate of 38.2%.The proportion of Gram-negative bacilli，Gram-positive cocci and eumycete was 68.0%，23.4% and 8.7% respectively in 184 isolated strains.The most common pathogens were Pseudomonas aeruginosa (18.5%)，Stenotrophomonas maltophilia (14.1％)，Burkholderia cepacia (10.9%)，Staphylococcus aureus (10.3%) and Acinetobacter baumannii (8.7%).Pseudomonas aeruginosa，Stenotrophomonas maltophilia，and Acinetobacter baumannii were resistant to most common antibacterials such as cephalosporin and imipenem.18 strains oxacillin resistant Staphylococcus aureus，7 strains oxacillin resistant Staphylococcus simulans and one vancomycin resistant Staphylococcus aureus were isolated.Expect for vancomycin，teicoplanin and fusidic acid，the resistance of Gram-positive cocci were above 50% to other 9 antibacterials.Conclusions The antibiotic resistance situation of VAP in Guangzhou is very serious with high mortality.It is important to reinforce the prevention and guidance on the proper treatment of VAP.
Objective To investigate the constituent ratio and clinical features of diffuse interstitial lung disease（DILD） in Chongqing city.Methods Data was collected from all patients diagnosed as DILD in five comprehensive teaching hospitals in Chongqing from 2002 to 2006.The disease constituent ratio of DILD in the respiratory department or in the whole hospital was analysised.Meanwhile the clinical manifestation and the laboratory examination such as lung function and biopsy were also analysised.Results Mean age of DILD patients is （61.65±13.31）years with a ratio male to female of 1.83.The constituent ratio of DILD were 2.83‰ in respiratory department and 0.30‰ in hospital in 2002，and increased to 8.29‰ and 0.48‰ respectively in 2006.Graticule（62.20%）and honeycombing（24.50%） were predominant imaging manifestations.47.55% patients had restrictive lung function impairment，and 51.05% had mixed lung function impairment.Pathologic examination revealed UIP as the most common type，however，81.82% cases could not be classified to any category pathologically.Conclusions The prevalence of DILD increased progressively from 2002 to 2006.A definite diagnosis of DILD demands cooperation of physicians，radiologists and pathologists.
Objective To study the prevalence and risk factors of chronic obstructive pulmonary disease ( COPD) and provide reliable data for COPD prevention and management. Methods By cluster-random-sampling survey, the residents aged 40 yrs or older in a community in South Bank District of Chongqing were investigated.The post-bronchodilator FEV1 /FVC lt; 0. 7 was defined as COPD. Those individuals with FEV1 /FVC lower than 0. 7 would received history inquiry, X-ray of chest and ECG to exclude other disease that could impair pulmonary function. Results 1518 residents were enrolled( 517 male and 1001 female) . The prevalence of COPD was 12. 78% ( male 23. 02% and female 7. 49% ) . The major risk factors were cigarettes smoke( OR: 2. 88, 95% CI:2. 118-3. 928) and indoor cooking smoke( OR: 1. 98, 95% CI: 1. 685-3. 317) . There were 22.06% smokers were diagnosed as COPD. Only 9. 30% patients had known themselves disease condition about chronic bronchitis,emphysema or COPD. Conclusion The prevalence of COPD in Chongqing city is significant higher than average level of the whole country and the patients have poor knowledge about the disease.
【Abstract】Objective To investigate the contribution of occupational exposure to dusts / gases / fumes to chronic obstructive pulmonary disease( COPD) and respiratory symptoms in China. Methods Based on the crosssectional survey of COPD which was conducted in urban and rural areas of Beijing, Shanghai, Guangdong,Liaoning, Tianjin, Chongqing and Shanxi for residents aged 40 years or older, the association between the occupational exposure to dusts/ gases/ fumes and COPD and respiratory symptoms was analyzed. The recruited populations were interviewed with questionnaire and were tested with spirometry. The post-bronchodilators FEV1 /FVC lt; 70% was used as diagnostic criteria of COPD. Having any cough, sputum, wheezing and dyspnea was defined as having respiratory symptoms. Results The prevalence of occupational exposure to dusts/ gases /fumes was 20. 5% . As shown by multiple-variables Logistic regression analyses, occupational exposure to dusts / fumes /gases [ OR = 1. 20 ( 1. 04, 1. 39) ] and dusts of grain [ 1. 48 ( 1. 18, 1. 86) ] were associated with COPD;occupational exposure to dusts / fumes / gases [ OR = 1. 37( 1. 25, 1. 49) ] , hard-rock mining [ OR = 2. 31( 1. 67,3. 20) ] , coal mining [ OR = 1. 71( 1. 09, 2. 70) ] , dusts of cement [ OR = 1. 92( 1. 47, 2. 52) ] , chemical or plastics manufacturing [ OR =1. 58( 1. 37, 1. 83) ] , spray painting [ OR= 1. 46( 1. 16, 1. 84) ] , and other dusts or fumes [ OR = 1. 46 ( 1. 29, 1. 64 ) ] were associated with the respiratory symptoms. Smoking and occupational exposure to dusts / gases / fumes had synergic effects on the increasing risk of respiratory symptoms. The populationattributable risk ( PAR) of exposure to dusts / gases / fumes was 3. 94% and 7. 05% for COPD and respiratory symptoms respectively. Conclusions Occupational exposure to dusts /gases /fumes is associated with COPD and respiratory symptoms. Smoking and occupational exposure to dusts/ gases /fumes may have synergic effects on respiratory symptoms.
【Abstract】 Objective To survey the prevalence and risk factors of chronic obstructive pulmonary disease ( COPD) , and establish database for community intervention of COPD.Methods A cluster-randomsampling survey was carried out. The population aged over 40 years old in eight communities of Chengdu were investigated from August 2007 to August 2009 using the standard protocol and questionnaire. The spirometry was performed for each participant. Results A total of 4315 residents were enrolled in this survey and 3687 case reports were analyzed, including 1529 males and 2148 females, with an average age of 60. 35 ±13. 21 years old. Total prevalence of COPD was 9. 6% . The prevalence of COPD in the males was significantly higher than that in the females ( 14. 0% vs. 6. 4%, P lt;0. 01) . The prevalence of COPD increased with the age. The major risk factors were cigarettes smoking ( OR = 3. 012, 95% CI 2. 390-3. 797, P lt; 0. 01) and indoor cooking smoking ( OR = 2. 546, 95% CI 1. 734-3. 425, P lt; 0. 01) . Conclusion The prevalence of COPD in Chengdu city is significantly higher than average level of the whole country, which warrant moreattention to better prevention and treatment of COPD in communities.
Objective To review the research progress of alcohol-induced osteonecrosis of the femoral head (ONFH). Methods Recent literature concerning alcohol-induced ONFH was reviewed and summarized. Results Alcohol-induced ONFH accounte for approximately 1/3 of total ONFH. Alcohol intake and the incidence of ONFH has a significant dose-effect relationship. There are some correlations between alcohol-induced ONFH and lipid metabolism, secretion of corticosteroid, and some gene of alcohol or lipid metabolism. Conclusion The relationships between alcohol and lipid metabolism, and between alcohol and steroid are still the main direction of the research of ONFH. Gene level researches can not demonstrate the pathogenesis, therefore further research should be carried on.
Objective To investigate the clinical manifestation and radiological features of unknownetiology ostearthritic disease in Shigeng village of Chongzhou city in Sichuan province so as to lay a basis for further study. Methods The data were analyzed retrospectively. The epidemiology investigation, physical examination, movement functional assessment, lab test and X-ray examination were performed on 116 villagers of 3 years and more than. Quantitative analysis on roentgenography was conducted. Results Sixty-four villagers had unknown ostearthritic disease，the prevalence was 55.2%；17 patients were limp, the prevalence of limp was 26.6%，onset age mainly focused under 40 years. Main manifestation of osteoarthritic disease was fixed pain of knee joint or hip joint, and bilateral pain was significantly more than single pain, but local fever and swelling were not obvious. Mild or moderate pain account for 73.5% of patients, and pain was aggravated after physical labor or movement and could be relieved after rest. Joint pain had no influence on joint movement function for long time, leading to a limp due to the joint functional disorders at late stage. Physical examination illustrated the flexion contracture of the hip and limitation of internal and external rotation. The Harris scores were 86.5±17.1(left hip) and 86.3±17.2. 46 (right hip), and the excellent or good result was achieved in 46 patients, fair and poor results in 18 patients. The average HSS scores were 88.4±9.3(left knee) and 88.2±11.0(right knee). The excellent or good result was achieved in 61 patients, fair and poor results in 3 patients. The X-ray films showed degenerative disorders of hip joint such as narrowing of the joint space (47.6%)，articular surface sclerosis and deformation (30.2%), shallow and increased density acetabulum, increased obliquity and insuffi cient coverage of the femoral head by the acetabulum, and increased femoral neck-shaft angles. Radiological features of knee joint were bony spur or bony bridge，osteoporosis，incomplete and thickening articular surface with sclerosis and deformation，degenerative disorders. Conclusion Main clinical manifestation of unknown osteoarthritic disease in Chongzhou city was fixed pain of bilateral knee joint or combined with hip joint pain at early stage，and functional limitation in hip joint at late stage. Main radiological feature was hip joint degeneration. To effectively control the osteoarthritic disease ofthis area, much more etiology researches should be done.
Objective To analyze the epidemiological features of clavicle fractures.Methods A total of 363 cases of clavicle fractures were treated from February 1993 to November 2002, their case history data were reviewed and evaluated by epidemiological method.Results Out of 363 cases, there were 269 males and 94 females, aged from new born to 96 years. The locations of fractures were on left side in 159 cases and on right side in 204 cases. Neonatal clavicle fracture occurred in the case of delivery (0.28%). The causes of disease for adult clavicle fractures were traffic injury (52.1%) and daily falling injury(31.1%). There were232 cases of simple fractures and 131 cases of comminuted fractures. The fracture positions included inner(6 cases), middle(328 cases) and outer parts(29 cases). Multiinjuries occurred in 78 cases, the rib fractures concomitant with clavicle fractures were the commonest(31 cases).Conclusion The clavicle fractures are the common injury. Of them, traffic injury and daily falling injury arethe most common. The rib fractures are always accompanied with clavicle fractures.The main position of fracture is on the middle part.