Objective To systematically evaluate the efficacy and safety of iris-registration in wavefront-guided LASIK (IR+WG LASIK) versus conventional LASIK for correction of myopia accompanied with astigmatism. Methods Such databases as PubMed, EMbase, The Cochrane library (Issue 2, 2012), CBM, CNKI, VIP, and WangFang Data were searched to collect the randomized controlled trials (RCTs) and quasi-RCTs about IR+WG LASIK versus conventional LASIK for correction of myopia accompanied with astigmatism. The retrieval time was from inception to February 2012, and the language was in both Chinese and English. Two reviewers independently screened the literature, extracted the data and assessed the quality of the included studies. Then the meta-analysis was performed by using RevMan 5.1 software. Results A total of 9 studies involving 3 903 eyes were included. The results of meta-analysis showed that, compared with the conventional LASIK group, the IR+WG LASIK group had a higher ratio in patients with postoperative uncorrected visual acuity no less than 1.0 (RR=1.03, 95%CI 1.01 to 1.05, P=0.002), as well as in patients with best-corrected visual acuity gained over 1 line (RR=1.75, 95%CI 1.49 to 2.16, Plt;0.000 01); it was smaller in the postoperative high order aberration RMS (WMD=−0.16, 95%CI −0.21 to −0.11, Plt;0.000 01), coma-like RMS (WMD=−0.05, 95%CI −0.11 to 0.00, P=0.07), spherical-like RMS (WMD=−0.15, 95%CI −0.23 to −0.07, P=0.000 2), and residual astigmatism (WMD=0.14, 95%CI 0.10 to 0.18, Plt;0.000 01); moreover, it was lower in the incidence of postoperative glare (RR=0.27, 95%CI 0.15 to 0.50, Plt;0.000 1), and it was higher in the subjective satisfaction of patients (RR=1.08, 95%CI 1.04 to 1.13, P=0.000 3). Conclusion Compared with conventional LASIK, IR+WG LASIK can more effectively reduce astigmatism, postoperative high order aberration RMS and spherical-like RMS. It can also get visual function including uncorrected visual acuity and best-corrected visual acuity, consequently increase patient’s satisfaction. But further studies are still required for its long-term effect.
Objective The baseline, clinical characteristics, and risk factors were analyzed in the stroke registry program of the Xinjiang Production Constraction Corp’s Hospital aimed to aid the clinical management and stroke prevention. Method A single center prospective method based on Lausanne Stroke Registry was used in this study. Patients generally, past history, living conditions, onset to treatment time, the stroke scale were collected with 1 year follow up. The investigators of follow up were single blinded. Result Eight hundred and ten ischemic stroke patients were included, of which 478 (59.01%) were male, 332 (40.99%) were female. The average age of these patients was 66.50±10.66 years. One year loss rate of follow up was 4.64%. Seven hundred and sixty-nine patients were diagnosis as acute cerebral infarction, 41 patients were TIA. The median time from onset to treatment was 15 hours. Lacunar infarction was the most common type with 334 (43.43%) patients. The average score of the National Institutes of Heath Stroke Scale was 5.55±7.24. The incidence of carotid artery plaque was 82.2%. Conclution Xinjiang region has its own characteristics of stroke with a higher carotid artery plaque rate and thrombolytic therapy ratio. Good stroke registration system could standardize the clinical behavior and promote the continuous improvement of medical quality.
Objective To know the current status of multinational clinical trials (MNCTs) in East Asia, and to find the characters of MNCTs in countries/regions. Methods We downloaded the trial records of East Asia on May 8, 2008 from ClinicalTrials.gov and analyzed the data. Results The number of clinical trials sponsored by industry was 125 in China Mainland, 196 in Taiwan, 134 in Hong Kong, 264 in Korea, and 231 in Japan, respectively. Of the total 654 clinical trials in East Asia, 307 (47%) trials were MNCTs, most of which were conducted by Euro-American pharmaceutical companies, such as Pfizer, AstraZeneca, GlaxoSmithKline, Sanofi-Aventis and Bristol-Myers Squibb. Main therapeutic areas were cancer, followed by CNS diseases, cardiovascular diseases, infectious diseases, diabetes mellitus and respiratory diseases. Trials in phaseⅢwere 198 (65%), in phaseⅣ32 (10%), others in phaseⅡorⅠ. One hundred and ninety trials (62%) were double-blind clinical trials, about half of them using placebo. The characters of clinical trials in China were: ① Most of MNCTs were large scale trials with big sample size and many study sites; ② Most of local trials were phase Ⅲ trials; ③ There were no phase Ⅰ trials. The characters in Taiwan, Hong Kong and Korea were: 1) Most of the trials (84% in Taiwan and 93% in Hong Kong, 72% in Korea) were MNCTs, 2) A lot of large scale trials were conducted with each other. The characters of clinical trials in Japan were: ① MNCTs were only 17%, ② Large scale trials were fewer. Conclusion In East Asia, MNCTs are developing because of the initiation of the Europe and America pharmaceutical giants. It seems that the regulation in each country influence the development pattern of East Asia.
Objective To understand the outpatients, evaluation and demands of the real-name registration system. To implement the new medical reform program deeply. Methods We used the questionnaire named registration questionnaire of West China Hospital designed by ourselves to survey the outpatients and their family members and were filled in the questionnaire by themselves. Results Firstly, real-name registration system in West China Hospital made major contribution to alleviate the difficulties of registration and medical treatment. It achieved a major breakthrough and created a good social benefit. Secondly, patients the most favourite way of registration was by phone. They were satisfied with the platform of the social welfare services very much. Thirdly, the number of appointment registration arrived year by year, while the number of the day registration fell year by year. Conclusion Firstly, we innovate the form of the realname registration system, refine service and do scientific management at the needs of the patient-oriented. Secondly, we strengthen the track of the failure of appointment registration and analyze the causes. We should take measures timely to reduce the rate of the event and improve the real-name registration system. Thirdly, we strengthen the management of the out-patient doctor visiting program and credit services, to improve medical compliance rate and protect the interests of the patients. Fourthly, we explore a scientific research of out-patient real-name registration system to establish a modern hospital out-patient services model.
Objective To evaluate the quality of the registration information for trials sponsored by China registered in the WHO International Clinical Trial Registration Platform (ICTRP) primary registries or other registries that meet the requirements of the International Committee Medical Journal Editor (ICMJE). Methods We assessed the registration information for trials registered in the 9 WHO primary registries and one other registry that met the requirements of ICJME as of 15 October 2008. We analyzed the trial registration data set in each registry and assessed the registration quality against the WHO Trial Registration Data Set (TRDS). We also evaluated the quality of the information in the Source(s) of Monetary or Material Support section, using a specially prepared scale. Results The entries in four registries met the 20 items of the WHO TRDS. These were the Chinese Clinical Trial Registration Center (ChiCR), Australian New Zealand Clinical Trials Registry (NZCTR), Clinical Trials Registry – India (CTRI), and Sri Lanka Clinical Trials Registry (SLCTR). Registration quality varied among the different registries. For example, using the Scale of TRDS, the NZCTR scoreda median of 19 points, ChiCTR (median = 18 points), ISRCTN.org (median = 17 points), and Clinical trials.org (median = 12 points). The data on monetary or material support for ChiCTR and ISRCTN.org were relatively complete and the score on our Scale for the Completeness of Funding Registration Quality ranged from ChiCTR (median = 7 points), ISRCTN.org (median = 6 points), NZCTR (median = 3 points) to clinicaltrials.gov (median = 2 points). Conclusion Further improvements are needed in both the quantity and quality of trial registration. This could be achieved by full completion of the 20 items of the WHO TRDS. Future research should assess ways to ensure the quality and scope of research registration and the role of mandatory registration of funded research.
Objective To investigate the number of Chinese clinical trials and the completeness of registered information on the source of their funding. Methods We searched the five primary registers in the World Health Organization’s International Clinical Trial Registration Platform to identify Chinese clinical trials, calculated the number Chinese clinical trials with specific funding and evaluated the completeness of the information on the source of this funding. Results We identified 383 registered Chinese clinical trials, of which 219 (27 trials per year on average) were registered in clinicaltrials.gov, 94 in the Chinese Clinical Trial Register Center (113 per year on average), 62 in controlled-trials.com (12.4 per year on average) and 8 (1.6 per year on average) in the Australian and New Zealand Clinical Trials Registry. 360 trials had some information on their source of funding: 230 from the mainland of China (62 funded by colleges/universities, 47 by national/local organizations, 47 by the Ministry of Science and Technology, 34 by hospitals, 28 by commercial organizations, 9 by international foundations, and 3 by the Ministry of Health), 117 from Hongkong and 13 from Taiwan. The information in the registers on the source of funding was incomplete. Conclusion The number of funded Chinese clinical trials in these registers is too small. The registrations should be improved to improve the completeness of information on the source of funding. It is important to disseminate the importance of registering clinical trials and doing so in a local register to promote the transparency and accessibility of trial registration.
ObjectiveTo explore the function of information system platform in the management of outpatient registration source. MethodsOn the basis of registration appointment system, we surveyed again on outpatients traffic between February 6th and 10th in 2012 to find out find out the disadvantages of outpatient service procedures. Certain measures were taken for improvement, especially the management of registration source. ResultsAfter improvement by certain measures, queuing phenomenon and the degree of congestion in the waiting area were improved. To some extent, the satisfaction of patients and doctors was raised from 91% to 93%. ConclusionStandardizing outpatient administration and behavior of patients by information system platform has a good effect and is worth promoting.
We applied Demons and accelerated Demons elastic registration algorithm in radiotherapy cone beam CT (CBCT) images, We provided software support for real-time understanding of organ changes during radiotherapy. We wrote a 3D CBCT image elastic registration program using Matlab software, and we tested and verified the images of two patients with cervical cancer 3D CBCT images for elastic registration, based on the classic Demons algorithm, minimum mean square error (MSE) decreased 59.7%, correlation coefficient (CC) increased 11.0%. While for the accelerated demons algorithm, MSE decreased 40.1%, CC increased 7.2%. The experimental verification with two methods of demons algorithm obtained the desired results, but the small difference appeared to be lack of precision, and the total registration time was a little long. All these problems need to be further improved for accuracy and reducing of time.
Non-rigid medical image registration is a popular subject in the research areas of the medical image and has an important clinical value. In this paper we put forward an improved algorithm of Demons, together with the conservation of gray model and local structure tensor conservation model, to construct a new energy function processing multi-modal registration problem. We then applied the L-BFGS algorithm to optimize the energy function and solve complex three-dimensional data optimization problem. And finally we used the multi-scale hierarchical refinement ideas to solve large deformation registration. The experimental results showed that the proposed algorithm for large deformation and multi-modal three-dimensional medical image registration had good effects.