Objective To investigate gastroenterologists’ evidence-based medicine (EBM) practice regarding awareness and application and relevant factors as well. Methods Gastroenterologists in hospitals with the level above other districts and counties in Jiangxi province were requested to take part in the survey using questionnaires from December 2010 to February 2011. Results a) Questionnaires were returned by 414 doctors with a response rate of 84.7%, among whom 55.1% respondents were males with the age of 43.2±15.9 years. b) Sixty-four percent respondents were familiar with EBM, which was independently correlated with working experience no less than 10 years (OR=2.32, 95%CI 1.47 to 3.67), from tertiary hospital (OR=1.81, 95%CI 1.12 to 2.93), specialists in gastroenterology (OR=1.74, 95%CI 1.06 to 2.85) and capability of manipulating endoscopy (OR=1.88, 95%CI 1.11 to 3.17). c) Of all the respondents, 53.1% accumulated clinical experience mainly from consensus/guideline, which was independently correlated with the age (OR=2.09, 95%CI 1.83 to 3.24), education level (OR=2.36, 95%CI 1.28 to 4.34) and capability of manipulating endoscopy (OR=2.10, 95%CI 1.29 to 3.42). d) Only 39.4% of doctors mainly depended on EBM to make clinical decision, which was independently correlated with the position (OR=2.38, 95%CI 1.57 to 3.61) and capability of making medical research (OR=1.63, 95%CI 1.05 to 2.55). Conclusion The awareness of EBM in gastroenterologists is fairly good while the practice of medicine is actually influenced by empirical medicine, especially in doctors with younger age, lower education level and lower position.
Fibroblast growth factor 21 (FGF21) is a multi-effect endocrine factor, mainly secreted in liver and adipose tissue, with the properties of lipid-lowering, anti-inflammatory, anti-oxidant and anti-atherosclerosis. Recent studies found that FGF21 can induce protective effect in cardiovascular disease, and plasma FGF21 levels in patients with disease cardiovascular are elevated. These studies have suggested the use of FGF21 as a biomarker for subclinical atherosclerosis and its potential role in the treatment of established atherosclerotic cardiovascular disease. This article will review the recent advances in the anti-atherosclerosis effect of FGF21.
Objective To explore the allocation of necessary living goods for the emergency medical rescue teams at Lushan earthquake sites. Methods The living goods requirements of 59 emergency medical rescue members at Lushan earthquake sites were investigated using a questionnaire and then analyzed, in order to provide references for the allocation of necessary living goods for emergency medical rescue teams in future. Results The top five necessary living goods for emergency medical rescue members at earthquake sites were food, drinking water, toilet, communication product, and bedclothe. The needs of bath of the members who stayed longer than 3 days were more than the members who stayed shorter than 3 days, with a significant difference (Plt;0.05). The number of living goods that female members need were more than that male members need (Plt;0.05). Conclusion For improving the work efficiency and quality of life, emergency medical rescue teams need to be equipped with not only the medical supplies, but also necessary living goods based on the length of stay and the ratio between male and female.
目的 观察噻托溴铵治疗慢性阻塞性肺疾病急性加重期（AECOPD）临床疗效与安全性。 方法 选取 2010 年 1 月－2011年12月入院的69例AECOPD 患者随机分为试验组（A组，n=36）和对照组（B组，n=33），A组在B组常规治疗的基础上吸入噻托溴铵。治疗起始及结束分别观察两组肺功能指标、慢性阻塞性肺疾病评估测试（CAT）评分、血气分析、6分钟步行距离、住院时间及药物不良反应。 结果 两组均显示出一定的临床效果，A组治疗后肺功能指标、CAT评分、血气分析、6分钟步行距离均优于B组，差异均具有统计学意义（P＜0.05）。A组住院时间短于B组（P＜0.05），且无严重不良反应。 结论 AECOPD患者在常规治疗同时吸入噻托溴铵，疗效显著且临床安全性较高。
Objective To explore the effect of multi-disciplinary treatment of the Graves’ disease (GD) with huge-size thyroid during perioperative period. Methods Retrospectively analyzed the clinical data of 8 GD patients with huge-size thyroid who got treatment in Pekin Union Medical College Hospital during Jan. 2006 to Dec. 2016. All patients underwent comprehensive preparation before operation and underwent total thyroidectomy. To explore the changes of thyroid function and culture after anti-thyroid drug (ATD)/iodine preparation/arterial embolization before operation, and to summarize situation of the bleeding loss intraoperation, neck-drainage, thyroid function, and relapses after operation. Results All cases got a satisfactory operation result after standard ATD, iodine preparation (Lugol’s solution 10–15 drops for 3–4 weeks, combined with ATDs for 2–3 weeks ), and main arterial embolization of thyroid in 24 h preoperation. They got shorter operative time (2.5–4.5 h), less bleeding intraoperation (4 cases≤100 mL), less neck-drainage, and almost normal retention time. No severe or permanent complications, for example thyroid storm, abnormal voice, and hypoparathyroid occurred. They were followed as outpatients for 18–133 months, and were found a perfect long-term effect without complication and relapse. Conclusions Perioperative period management is very important to those GD patients with huge-sized thyroid, and multi-disciplinary treatment can decrease theintraoperation bleeding, as well as occurrence of thyroid storm effectively. In addition, operated subtly during surgery can protect the recurrent laryngeal nerve and parathyroid effectively.
Objective To investigate drug usage and costs of children inpatients with bronchopneumonia in Karamay Central Hospital in 2014 and to provide baseline for evidence-based pharmacy study of single disease in respiratory system. Methods The information of drug use and expenditure of children inpatients with bronchopneumonia were collected from the hospital information system (HIS). We analyzed the data including frequency, proportion and cumulative proportion by Excel 2007 software. Results A total of 890 children inpatients were included, the average age was 1.00±2.17 years old. Among the antibiotics of single therapy, the frequency of amoxicillin and clavulanate potassium for injection was highest. Among the antibiotics of combination therapy, the frequency of macrolides was highest. Conclusion The mainly drugs for treatment of children inpatients with bronchopneumonia in Karamay Central Hospital in 2014 is amoxicillin and clavulanate potassium for injection.