Latest Issue
Volume 36 ， Issue 2 ， 2021
- Abstract：Objectives To validate the reliability of the Chinese version of the Consultation and Relational Empathy (CARE) in physician-standardized patient (SP) encounter. We also tried to examine the agreement between video-based ratings and in-room ratings, as well as the agreement between the faculty ratings and SP ratings. Methods The CARE was translated into Chinese. Forty-eight anesthesia residents were recruited to make preoperative interview in SP-counter. Performance of each resident was graded by in-room raters, video raters and SP raters. Consistency between different raters was examined. Results The Chinese-CARE measure demonstrated high scale reliability with a Cronbach’s alpha value of 0.95 and high consistency in the in-room ratings in intraclass correlation (coefficient=0.888,P<0.001). Despite a good consistency in intraclass correlation, video ratings were significantly higher than in-room ratings (39.6±7.1vs. 24.0±10.0,P<0.001), and Wilcoxon signed-rank test indicated that the pass/fail rate was significantly higher based on video ratings than based on in-room ratings (45/48vs. 22/48, P<0.001). SP ratings had a moderate consistency with in-room faculty ratings (coefficient=0.568,P<0.001), and there was no significant difference between the pass/fail rates based on the in-room ratings and SP ratings (22/48vs. 28/48, P=0.12). Conclusions The Chinese-CARE measure is reliable in the assessment of empathy during preoperative anesthesia interview. In-room and video ratings are not equivalent, while SP may provide a feasible alternative for the faculty rater in the assessment of communication skills with an appropriate measure.Keywords：empathy;standardized patient encounter;assessment;rating modality44|489|1Updated：2024-04-10
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Abstract：Objective To describe the epidemiologic, clinical, laboratory, and radiological characteristics and prognoses of COVID-19 confirmed patients in a single center in Beijing, China. Methods The study retrospectively included 19 patients with nucleic acid-confirmed SARS-CoV-2 infection at our hospital from January 20 to March 5, 2020. The final follow-up date was March 14, 2020. The epidemiologic and clinical information was obtained through direct communication with the patients or their family members. Laboratory results retrieved from medical records and radiological images were analyzed both qualitatively by two senior chest radiologists as well as quantitatively via an artificial intelligence software. Results We identified 5 family clusters (13/19, 68.4%) from the study cohort. All cases had good clinical prognoses and were either mild (3/19) or moderate (16/19) clinical types. Fever (15/19, 78.9%) and dry cough (11/19, 57.9%) were common symptoms. Two patients received negative results for more than three consecutive viral nucleic acid tests. The longest interval between an initial CT abnormal finding and a confirmed diagnosis was 30 days. One patient’s nucleic acid test turned positive on the follow-up examination after discharge. The presence of radiological abnormalities was non-specific for the diagnosis of COVID-19. Conclusions COVID-19 patients with mild or no clinical symptoms are common in Beijing, China. Radiological abnormalities are mostly non-specific and massive CT examinations for COVID-19 screening should be avoided. Analyses of the contact histories of diagnosed cases in combination with clinical, radiological and laboratory findings are crucial for the early detection of COVID-19. Close monitoring after discharge is also recommended.Keywords：coronavirus;SARS-CoV-2;COVID-19;tomography;X-ray computed;follow-up37|506|0Updated：2024-04-10 -
Abstract：Objective Burnout is a triad of emotional exhaustion, depersonalization, and reduced personal accomplishment resulting from job stress. Although with distinct regional and cultural characteristics, burnout among anesthesiologists in the Tibet has not been described. This study aimed to explore the prevalence of burnout among anesthesiologists in Tibet and its associated factors. Methods A cross-sectional survey was conducted in Tibet, China, with an anonymous questionnaire. Social-demographic characteristics, work status, three dimensions of burnout assessed by the Maslach Burnout Inventory-Human Service Survey were collected and analyzed. Results A total of 133 individuals from 17 hospitals completed the survey from March to June 2018. The prevalence of moderate- to high-level of emotional exhaustion, depersonalization, and burnout in personal accomplishment was 65.4% (95%CI, 57.0%-72.9%), 66.9% (95%CI, 58.5%-74.3%), and 83.5% (95%CI, 76.2%-88.8%), respectively. An annual caseload ≥500, frequent overtime work and fair to poor sleep quality were significantly associated with a higher level of emotional exhaustion ( P<0.001,P=0.001, and P<0.0001, respectively). 5-9 years in anesthesiology experience was significantly associated with a high level of emotional exhaustion and depersonalization (P=0.002 and P=0.003, respectively). Conclusions More than half of anesthesiologists working in Tibet experience a moderate- to high- level of burnout in at least one dimensional scale. Anesthesiologists having 5-9 years of experience are more prone to emotional exhaustion and depersonalization. Efforts to decrease burnout through reducing the working load and raising the social recognition of anesthesiologists in Tibet should be considered.Keywords：anesthesia;burnout;personal accomplishment;Tibet23|371|0Updated：2024-04-10 -
Abstract：Objective Chronic cardiovascular diseases induced by long-term poor blood glucose control are the main cause of death in patients with type 2 diabetes mellitus (T2DM). Previous researches report that methylenetetrahydrofolate reductase gene (MTHFR) polymorphisms might influence the occurrence of coronary heart disease (CHD) in T2DM patients. The purpose of this study was to evaluate whether MTHFR C677T and A1298C mutations are associated with the risk of CHD in T2DM patients. Methods A total of 197 subjects with T2DM were studied, of which 95 patients with CHD. The genotypes of MTHFR C677T and A1298C were analyzed by using dideoxy chain-termination method, and compared between patients with CHD and those without CHD. Results We found that the frequency of the 677T allele was significantly higher in T2DM patients with CHD than those without CHD (P=0.011). However, there was no significant difference in any of the examined haplotypes between T2DM patients with and without CHD. Furthermore, the 677T allele was associated with a higher risk of CHD development in diabetic patients with lower homocysteine (Hcy) levels (≤15 μmol/L) (P=0.006), while no effect of MTHFR gene polymorphism on the incidence of CHD was found in patients with higher Hcy levels (>15 μmol/L) (P=0.491). Conclusion The MTHFR C677T gene polymorphism is associated with the risk of CHD of diabetic patients and could be used as an effective marker for CHD in Chinese diabetic populations with normal Hcy levels.Keywords：methylenetetrahydrofolate reductase;gene polymorphism;type 2 diabetes mellitus;coronary heart diseases;homocysteine23|272|0Updated：2024-04-10 -
Abstract：Objectives To investigate whether a longer time period of gadolinium ethoxybenzyl diethylenetriaminepen-taacetic acid (Gd-EOB-DTPA)-enhanced T1 mapping scanning, as well as dynamic contrast-enhanced (DCE) and multiple hepatobiliary phase magnetic resonance imaging (MRI) have the potential to provide information about liver function in rats with liver fibrosis. Methods Forty rats were divided into the carbon tetrachloride-induced hepatic injury groups [carbon tetrachloride for four (n=14), eight (n=8), or twelve (n=8) weeks] and the control group (n=10). Gd-EOB-DTPA-enhanced MRI was performed including T1-mapping (delayed to 50 min), DCE, and multiple hepatobiliary phases. Indocyanine green retention rate at 15 min (ICG-R15) was determined. Parameters such as T1 reduction rate (ΔT1), elimination half-life of ΔT1 (TΔT1 1/2), relative enhancement (RE), time to maximum RE (Tmax), and perfusion parameters were calculated. Pearson correlation analysis was used for correlation analysis between ICG-R15 and each MRI indices. Results ΔT1 at 30, 40, and 50 min showed significant positive correlations with ICG-R15 ( r=0.784, 0.653, 0.757, P=0.007, 0.041, 0.030). TΔT1 1/2 showed a significant positive correlation with ICG-R15 (r=0.685, P=0.029). Tmaxshowed a significant positive correlation with ICG-R15 (r=0.532, P=0.019). Conclusions ΔT1 in the late hepatobiliary phase and T ΔT1 1/2 exhibited moderate correlations with liver function. The longer time period of Gd-EOB-DTPA-enhanced T1 mapping scanning, as well as DCE and multiple hepatobiliary phases, may be of some value for estimating liver function in rats with liver fibrosis.Keywords：liver function;T1 mapping;Gd-EOB-DTPA;magnetic resonance imaging26|327|0Updated：2024-04-10 -
Abstract：Objective Complications after transsphenoidal surgery for pituitary adenoma have been well documented in the literatures, but the occurrence of delayed sudden sensorineural hearing loss (SNHL) after pituitary adenoma resection is extremely rare. In this study three cases who developed sudden SNHL 3 to 7 days after pituitary adenoma surgery without experiencing cerebrospinal fluid leak or meningitis were presented, and the possible causes of SNHL were discussed. Methods Three cases with sudden hearing loss after transsphenoidal surgery for pituitary adenoma were reviewed. The past medical history, onset of sudden hearing loss, accompanying symptoms such as headache, tinnitus, dizziness and aural fullness, and the post-operative MRI images, therapy, and hearing results were reported. Results Three cases developed profound sudden SNHL on the 3rd to 7th post-operative day, all accompanied by prior headache, tinnitus and dizziness. One patient developed episodic vertigo, ear fullness accompanying with fluctuating hearing loss in the first post-operative month. Two patients had past medical history of arteriosclerosis and coronary heart disease or cerebral infarction. Two of three demonstrated obstructive hydrocephalus on MRI on the first post-operative day. Under treatment with prednisone orally, dexamethasone intratympanic injection, neurotrophic and vasodilatation drugs for 3 to 8 months, hearing of all three improved partially. Obstructive hydrocephalus and ischemia might be responsible for the hearing loss. Conclusion Post-operative obstructive hydrocephalus and ischemia of labyrinthine arteries might lead to the delayed SNHL after transsphenoidal surgery for pituitary adenoma.Keywords：transsphenoidal surgery for pituitary adenoma;obstructive hydrocephalus;ischemia of internal auditory arteries;sudden sensorineural hearing loss;tinnitus23|764|0Updated：2024-04-10 -
Abstract：Objective To identify new genes that correlate with prognosis of clear-cell renal cell carcinoma (ccRCC) via bioinformatics analysis. Methods The gene expression profiles of 62 ccRCC and 54 normal kidney tissues were available from the Gene Expression Omnibus database: GSE12606, GSE36895 and GSE66272. The differentially expressed genes were screened with GEO2R and J Venn online tools. Functional annotation including Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) was applied to identify the possible function of the hub genes involved in prognosis of ccRCC. In protein protein interaction network (PPI network), the STRING online tool was used to visualize the network of the differentially expressed genes, and the core gene was selected by MCODE App in Cytoscape software. Finally, GEPIA Survival Plot was performed to assess genes associated with worse survival. Results We totally found 648 differentially expressed genes, including 222 up-regulated genes and 426 down-regulated genes. PPI network showed that in 28 up-regulated genes 7 (CCNE2, CDK1, CDC6, CCNB2, BUB1, TTK and PTTG1) enriched in cell cycle and 4 genes (CCNE2, CDK1, CCNB2 and RRM2) enriched in p53 signaling pathway. GEPIA Survival Plot assay revealed that ccRCC patients carrying CDK1, CCNB2, RRM2, BUB1, and PTTG1 had a worse survival. GEPIA Box Plot showed that BUB1, CCNB2, PTTG1, and RRM2 were over expressed in the ccRCC tissues in contrast to the normal tissues (P<0.05). Conclusion ccRCC patients with the four up-regulated differentially expressed genes including BUB1,CCNB2,PTTG1, and RRM2might manifest a poor prognosis.Keywords：clear-cell renal cell carcinoma;bioinformatical analysis;differentially expressed genes15|444|0Updated：2024-04-10
Original Article
- Abstract：Osteoporosis as a systemic chronic skeletal disease is characterized by low bone mineral density and increased risk to osteoporotic fractures. Osteoporosis is prevalent in the middle-aged and elderly population, especially in the postmenopausal women. With population aging, osteoporosis has become a world-wide serious public health problem. Early recognition of the high-risk population followed by timely and efficient intervention and/or treatment is important for preventing osteoporotic fractures. In light of the high heritability and complex pathogenesis of osteoporosis, comprehensive consideration of vital biological/biochemical factors is necessary for accurate risk evaluation of fractures. For this purpose, we review recent research progress on molecules which can be applied to assess risk for osteoporotic fractures. Future integrative analyses and systematic evaluation of these molecules may facilitate developing novel methodologies and/or test strategies, i.e., biochips, for early recognition of osteoporosis, hence contributing to preventing osteoporotic fractures.Keywords：osteoporotic fracture;molecules;predictive;diagnostic17|369|0Updated：2024-04-10
Review
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Abstract：Alternating hemiplegia of childhood is a rare neurodevelopmental disorder. Most cases are reported as sporadic disorder due to de novo variants, and few with family members involved. Two boys were hospitalized due to epileptic seizures occurred initially at age of six to seven months. During the course of the disease, there were repeated episodes of paroxysmal weakness or paralysis affecting one side of the body. Genetic testing showed that both patients carried heterozygous missense mutations in theATP1A3 gene (OMIM: 614820): c.3025 (exon 22) A>G (p.K1009E) and c.2443 (exon 18) G>A (p.E815K). Flunarizine can significantly improve the paroxysmal motor symptoms of pediatric patients with alternating hemiplegia.Keywords：ATP1A3 gene;alternating hemiplegia of childhood;epilepsy40|586|0Updated：2024-04-10 -
Abstract：Pheochromocytomas or paragangliomas are rare and the diagnosis remains a challenge for clinicians. We present a woman suffering from recurrent myocardial infarction and cardiomyopathy, who was finally diagnosed with paraganglioma. Pheochromocytomas or paraganglioma should be considered in the differential diagnosis of a patient with symptoms possibly referring to acute coronary syndrome and cardiomyopathy.Keywords：pheochromocytomas;paragangliomas;cardiomyopathy;myocardial infarction21|292|0Updated：2024-04-10 -
Abstract：Cornual heterotopic pregnancy is an extremely rare, life-threatening complication during pregnancy. Here, we report a 33-year-old woman who suffered cornual heterotopic pregnancy afterin vitro fertilization embryo transfer. To prevent rupture during heterotopic pregnancy, she received laparoscopic surgery to remove the ectopic gestational sac at 7+2weeks of gestation. Ultimately, she delivered a healthy boy at 38+3 weeks of gestation. Here, we also review the clinical presentations, risk factors, treatment options and outcomes of cornual heterotopic pregnancy.Keywords：cornual heterotopic pregnancy;transvaginal ultrasonography;laparoscopy;reproduction technique35|480|1Updated：2024-04-10
Case Reports
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