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Objective:To explore the external factors of the development of cancer hospitals under normalized epidemic prevention and control, and to propose targeted strategies in accordance with existing practice.Methods:PEST model was used to analyze the political, economic, social and technological environment of specialized cancer hospitals, with an overall strategy proposed based on the specific analysis of a cancer hospital.Results:In the era of normalized epidemic prevention and control, cancer hospitals were facing a new environment that was common or unique to other types of medical institutions. In response, the case hospital had adopted such strategies as integrating prevention and control with medical services, integrating offline with online services, and integrating internal and external resources to promote its recovery and development.Conclusions:Cancer hospitals and government should fully leverage the environmental changes incurred by the normalization of prevention and control, and formulate a more integrated development strategy covering short, medium up to long term conditions, based on the two major objectives of epidemic prevention and control and cancer prevention and medical services.
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Objective@#To analyze the characteristics of the second primary tumor affecting the survival of patients with lymphoma, and to explore the risk factors of death from the second primary tumor.@*Methods@#The medical records and related death information of 1 173 lymphoma patients who had already died with known causes were collected. The basic causes of death and the characteristics of patients who died of the second primary tumor were analyzed. Cox regression model was used to analyze the risk factors of lymphoma patients who died of the second primary tumor.@*Results@#Among the 1 173 patients who had died, 94 (8.0%) died of the second primary tumor, 935 (79.7%) died of the primary lymphoma and 144 (12.3%) died of other diseases. The second primary tumor accounted for 17.5% (38/217) of all causes of death in patients with the survival period of more than 5 years, and the second primary tumor accounted for 28.3% (17/60) of all causes of death in patients with the survival period of more than 10 years. Among 94 cases who died of second primary tumors, 31 died of lung cancer, 15 died of gastric cancer, 13 died of liver cancer, 9 died of pancreatic cancer, 6 died of colorectal cancer, 6 died of second primary lymphoma and 14 died of other types of tumors. Univariate Cox regression analysis showed that age, first-line treatment effect, and chest or mediastinal radiotherapy were associated with the death from second primary tumors for lymphoma patients (all P<0.05). Multivariate Cox regression analysis showed that the effect of first-line treatment (P=0.030) and the chest or mediastinal radiotherapy (P=0.039) were independent factors for the death of lymphoma patients from the second primary tumor.@*Conclusions@#The second primary tumor is an important factor affecting the survival of lymphoma patients, and the risk of death from second primary tumors increases significantly over time. The effect of first-line treatment and radiotherapy in the chest or mediastinum are independent factors for the death of lymphoma patients from the second primary tumor.
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Objective: To understand the causes of death and long-term prognosis of lymphoma patients. Methods: Data from 6 200 patients with lymphoma admitted to the Department of Lymphoma, Peking University Cancer Hospital, from January 1995 to Decem-ber 2017, were collected. Those who had died and whose causes of death were known were selected. Clinical records and information on death were collected. Results: A total of 1,173 patients were selected, 742 of whom were male (63.3% ), and 431 were female (36.7%). The median age was 56 (8-92) years. There were 77 cases (6.6%) of Hodgkin's lymphoma, 1,095 cases (93.4%) of non-Hodg-kin's lymphoma, and 1 case of unclear pathological classification. Overall population survival was 0-253 months, with a median surviv-al rate of 20 months. The direct causes of death included lymphoma in 688 (58.7%), various infectious diseases in 119 (10.1%), cardio-vascular diseases in 96 (8.2%), secondary primary tumors in 68 (5.8%), and other diseases in 202 cases (17.2%). The underlying causes of death included lymphoma in 936 (79.8%), secondary primary tumors in 94 (8.0%), cardiovascular diseases in 75 (6.4%), respiratory diseases in 32 (2.7%) and other diseases in 36 cases (3.1%). The underlying causes of death in cases wherein survival time exceeded 5 years included lymphoma in 129 (59.4%), secondary primary tumors in 38 (17.5%), cardiovascular diseases in 35 (16.1%), and other dis-eases in 15 cases (6.9%). The underlying causes of death in cases wherein survival time exceeded 10 years included lymphoma in 28 (46.7%), secondary primary tumors in 17 (28.3%), cardiovascular diseases in 7 (11.7%), and other diseases in 8 cases (13.3%). Conclu-sions: Primary tumors remain the main cause of death in patients with lymphoma. After primary tumors, secondary primary tumors and cardiovascular diseases are the most common causes of death, and with the prolongation of survival, the risk of death caused by these factors increases significantly.
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Objective:To describe the clinical characteristics , overall survival as well as to evaluate the prognostic factors in Chinese diffuse large B cell lymphoma ( DLBCL) patients.Methods: DLBCL pa-tients who were initially diagnosed and treated in Peking University Cancer Hospital from January 1995 to December 2008 were identified and analyzed ,retrospectively .The 5-year OS rates were estimated with Ka-plan-Meier.Log-rank test was used to compare the survival curves of the different groups .The multivari-ate analysis of prognostic factors was conducted with Cox regression model , which included all statistically significant prognostic factors in the univariate analyses .Results:A total of 525 DLBCL patients were in-cluded in this retrospective analysis , of whom , 294 were male and 231 female ( male∶female=1 .27∶1 ) . The median age at the initial diagnosis was 55 (range 16-90) years, and 37.0% (n=194) were 60 years and above .Regarding the clinical staging at the initial diagnosis , 54 patients (10.3%) were diag-nosed as Stage Ⅰ of the disease, 152 (28.9%) as Stage Ⅱ, 117 (22.3%) as Stage Ⅲ and 202 (38.5%) as Stage Ⅳ.The ‘B symptoms’ and increased serum LDH were presented in 206 (39.2%) and 192 (36.6%) patients, respectively.A total of 197 (37.5%) patients were treated with rituximab (R).The survival follow-up continued till 31 January 2014 with a median follow-up time of 77.5 ( range:0-205) months.A total of 267 patients (50.9%) died during the follow-up period.The medi-al overall survival ( OS) time was 84 months, and 5-year OS rate was 52.3%.There were six statistically significant prognostic factors that were identified in both univariate and multivariate analyses : gender, Ann Arbor stage, B symptom, serum LDH, age at initial diagnosis and rituximab treatment .The relative risk ( RR) of these prognostic factors in the multivariate analyses were: age >60 years /≤60 years=1.380 (95%CI 1.078 -1.765), male /female =1.315 (95%CI 1.025 -1.687), stage Ⅲ/stageⅠ=3.034(95%CI 1.667-5.522), stage Ⅳ/Ⅰ=3.748(95%CI 2.102 -6.681), with B symp-toms/without B symptoms=1.278(95%CI 0.999-1.636),serum LDH increased/LDH not increased=1.351(95%CI 1.057 -1.726), without R treatment /with R treatment =1.543(95%CI 1.182 -2 .015 ) .Compared with the IPI , age >50 years/≤50 years was a statistically significant factor in both univariate and multivariate analyses RR =1.478 (95%CI 1.148-1.902), P=0.002.Conclusion:Six factors were related to DLBCL survival:gender, Ann Arbor stage, B symptom, serum LDH, age at initial diagnosis and rituximab treatment .Compared with the IPI , several specific factors may predict a poor prognosis in Chinese DLBCL patients:male , age>50 years and the presence of ‘B symptoms ’ .But this result is not conclusive until these factors are further tested .
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In order to summarize the experience in physician recruitment and training process,an investigation was carried out on young physicians recruited from campus from 2007 to 2011.The results showed that the assessments of departments of the young physician's on theirs' medical ethics,professional values,theoretical knowledge,clinical competence and other aspects were higher.This indicated that these young physicians have higher overall quality.In addition,compared with the above-described abilities,the results also showed that the assessments on theirs' foreign language oral communication skills,research capacity,innovation capability,and so on,were lower.Therefore the hospital should continue to increase assessments to the candidates during the campus recruitment stage,and to develop targeted training plans so as to strengthen the ability of young physicians continually.
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To promote sustainable development of the hospital,Peking University Cancer Hospital adopted a series of measures to help advance the health professionals,which include a favorable recruiting and training systemsto attract high-level talents,recruit qualified graduates,supporting outstanding young asholars to studying abroad,etc.. These measures have achieved remarkable results,and have in turn greatly promoted the continuous development of medical practice and scientific research work of the hospital.
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Objective To evaluate the effects and safety of uterine artery embolization for uterine leiomyoma. Methods Total of 185 patients with uterine leiomyoma were treated by UAE. They were followed for one to 6 years to observe the changes of leiomyoma size and improvement in clinical symptoms. Ovarian function was evaluated in 44 cases. Results Bilateral embolization of uterine arteries was performed in 185 patients. Follow-up of 1 ～6 years for 292 leiomyoma indicated that one to 9 months after embolization, shrinkage of leiomyoma size was the most significant factor. One year after embolization, leiomyoma sizes decreased a little. Shrinkage of submucous leiomyoma was more significant than that of intratumoral one, and the latter was more significant than subserous one. Shrinkage of leiomyoma with large size ( volume ≥ 150cm~3) was less than that of small one. Menorrhagia, anemia and pressure symptoms were all resolved. There was no significant difference between pre- and post embolization ovarian hormone level. Conclusions The significant reduction in leiomyoma volume and resolution of clinical symptoms confirmed that the treatment validity of symptomatic leiomyomas by UAE. UAE is an effective therapeutic procedure which has no adverse effect on the ovarian function.
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Objective To assess preoperative value of serum CA125 determination for uterine endometrial carcinoma including myometrial invasion, lymph node metastasis, surveillance and recurrence of the carcinoma. To explore the relationship between serum CA125 levels and pathological grades of endometrial carcinoma. Methods Serum CA125 levels were determined by ELISA test in 67 cases of postmenopausal endometrial carcinoma. Results There were significant differences in CA125 levels between patients with clinical stage Ⅲ、 Ⅳ cases and clinical stage Ⅰ, Ⅱ (P<0.01). Serum CA125 levels of 10 cases with recurrent carcinoma were positive. Serum CA125 levels of patients with papillary serous adenocarcinoma were significantly higher than those of adenocarcinoma. No relation was found between pathological grades and serum CA125 levels. Conclusions Serum CA125 levels was a useful clinical parameter for determination of postmenopausal endometrial carcinoma preoperatively.
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Objective To investigate the effect of combining use of methotrexate and mifepristone on treating unruptured tubal pregnancy.Methods Treatment consisted of 300mg of mifepristone administered orally one time and 20mg of methotrexate injected intravenously consecutively for 5 days.The previous cases who received only 20mg methotrexate injected intravenously were selected as control group.Results The success rate of the combination group was 87.5% which was significantly higher than that of the control group.The effect of treatment was related to serum β-hcG levels and whether there was embryos with cardiac activity or not.Conclusion The treatment of unruptured tubal pregnancy with the combination of methotrexate and mifepristone is safe and effective.It is suitable for the unruptured tubal pregnancy with stable vital signs,but without acute abdominal pain or embryonic cardiac activity and β-hCG＜30μg/L.
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AIM: To explore the possible changes in cell adhesion molecules and composition of complement activation in patients with acute myocardial infarction (AMI). METHODS: The expression of leukocyte CD18, soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular-cell adhesion molecule-1 (sVCAM-1) and composition of complement activation (sC5b-9) concentrations of patients with AMI (67 cases), old myocardial infarction (OMI, 42 cases) and 38 healthy volunteers were measured using enzyme-linked immunosorbent assay(ELISA). RESULTS: The expression of leukocyte CD18, sICAM-1,sVCAM -1 and sC5b-9 were significantly higher in AMI patients than that in normal controls and OMI patients(P
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Objective To assess preoperative value of serum CA 125 determination for uterine endometrial carcinoma including myometrial invasion, lymph node metastasis, surveillance and recurrence of the carcinoma. To explore the relationship between serum CA 125 levels and pathological grades of endometrial carcinoma. Methods Serum CA 125 levels were determined by ELISA test in 67 cases of postmenopausal endometrial carcinoma. Results There were significant differences in CA 125 levels between patients with clinical stage Ⅲ、 Ⅳ cases and clinical stage Ⅰ, Ⅱ ( P
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To explore the mechanism of protecting erythrocyte deformability (ED) of polysaccharide sulfate(PSS)and propyllene glycolmannurate sulfate(PGMS) in patients with acute myocardial infarction (AMI). The erythrocyte filtration index(EFI),erythrocgte membrane Na+,K+-ATPase .glutathione peroxidase(GSH-Px)activity and lipid peroxide(LPO) were measured in 52 patients with AMI. Meanwhile the effects of PSS and PGMS on EFI, Na+,K+-ATPase ,GSH-Px and LPO in AMI patients were observed in vitro. The results showed that the EFI and LPO were markedly higher ,Na+ ,K+-ATP ase and GSH-Px were si-hnificantly lower in patients than those in control(P0. 05). These results indicate that PSS and PGMS could improve the ED in patients ,and the efficacy of PSS or PGMS was related to enchancement of erythrocyte membrane ATP-ase anci GSH-Px activity.