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Due to factors such as an aging population, the Hospital Authority(HA) of Hong Kong is facing a contradiction between limited health resource supply and continuously increasing demand. In order to effectively address challenges, the HA prompted three measures to bridging the demand-supply gap. The HA relied on its management system advantages to continuously increase its capital construction to enhance the service capacity of public health institutions; transformed service delivery mode so as to improve the experience, quality, and efficiency of service delivery; established cooperation with private service providers and communities to shunt population health demand. The practices of HA can provide reference for public hospitals and their sponsors in other regions of China.
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Objective:To research the occurrence regularity and influencing factor of acute moderate and severe abdominal pain after radiofrequency ablation (RFA).Methods:Cross-sectional study was used to collect patients with primary liver cancer treated by RFA from January 2019 to July 2020 in a hospital. The patients were divided into abdominal pain group ( n=35) and non -pain group ( n=133). The data of 2 groups was analyzed by univariate analysis. The statistically significant factors were analyzed by multivariate Logistic regression analysis, and to explore the risk factors. Results:A total of 168 patients were enrolled in this study; Multiple liver tumors (the number of tumors≥3), lager focus diameters (diameter≥3cm) and a history of pain after RFA were independent predictors of acute moderate and severe abdominal pain ( χ2 values were 21.713, 17.454, 7.953, P<0.01). Conclusion:The incidence of acute moderate and severe abdominal pain after RFA is high. Evaluating risk factors can provide reference for postoperative pain management.
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Objective To study the expression of microRNA-100 ( miR-100 ) in hepatocellular carcinoma ( HCC) tissues and cells, and further explore the function of miR-100 on invasion and metastasis of HCC. Methods A total of 50 patients with HCC from December 2016 to October 2018 in Department of Hepatobiliary Pancreatic Surgery, Henan Provincial People's Hospital were selected, including 32 males and 18 females, aged 20~78 years. PCR was used to detect the expression of miR-100 in HCC tissues, adjacent tissues and HCC cells. HCC cells were transfected with miR-100 sequence, inhibition sequence and corre-sponding negative control sequence to detect the migration and invasion ability of HCC cells after transfec-tion. Results The expression of miR-100 was lowest in SMMC-7721 and MHCC-97H. The relative expres-sion level of miR-100 in HCC tissues was significantly lower than that in normal adjacent liver tissues [(0. 39 ± 0. 03) vs. (0. 56 ± 0. 06)], and the difference was statistically significant (P<0. 05). Compared with the negative control HCC cells, the migration and invasion of HCC cells with overexpression of miR-100 decreased, while the inhibition of miR-100 expression increased the migration and invasion of HCC cells. Conclusions The expression of miR-100 is low in human HCC tissues and cells. miR-100 inhibits the invasion and migration of HCC cells and plays an important role in the occurrence and development of HCC.
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Objective@#To study the expression of microRNA-100 (miR-100) in hepatocellular carcinoma (HCC) tissues and cells, and further explore the function of miR-100 on invasion and metastasis of HCC.@*Methods@#A total of 50 patients with HCC from December 2016 to October 2018 in Department of Hepatobiliary Pancreatic Surgery, Henan Provincial People's Hospital were selected, including 32 males and 18 females, aged 20~78 years. PCR was used to detect the expression of miR-100 in HCC tissues, adjacent tissues and HCC cells. HCC cells were transfected with miR-100 sequence, inhibition sequence and corresponding negative control sequence to detect the migration and invasion ability of HCC cells after transfection.@*Results@#The expression of miR-100 was lowest in SMMC-7721 and MHCC-97H. The relative expression level of miR-100 in HCC tissues was significantly lower than that in normal adjacent liver tissues [(0.39±0.03) vs. (0.56±0.06)], and the difference was statistically significant (P<0.05). Compared with the negative control HCC cells, the migration and invasion of HCC cells with overexpression of miR-100 decreased, while the inhibition of miR-100 expression increased the migration and invasion of HCC cells.@*Conclusions@#The expression of miR-100 is low in human HCC tissues and cells. miR-100 inhibits the invasion and migration of HCC cells and plays an important role in the occurrence and development of HCC.
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Objective To investigate the influence of diameter of liver outflow vein on portal hypertension and artificial blood vessel (ABV) patency rate in Budd-Chiari syndrome (BCS) patients undergoing atrial caval shunting (ACS).Methods We recruited 209 patients,who had undergone ACS for Ⅱ type of BCS.Those patients with unobstructed liver outflow vein were included into group A and the patients with stenosed liver outflow vein into group B.Free portal pressure (FPP) was measured before and after ABV opening.Portal vein velocity (Vpv),liver function,spleen volume and function,esophagogastric varices and ABV patency were evaluated postoperatively.Results After ABV opening,FPP decreased significantly in group A than group B (t =10.45,P < 0.05).Vpv accelerated significantly in group A 2 weeks after operation than group B (t =12.81,P < 0.05).Apparent improvement of liver function,spleen function and esophagogastric varices and reduction of spleen volume were observed in group A patients than group B patients (P < 0.05).Reduction of esophagogastric varices in group A was better than in group B (x2 =44.73,P < 0.05).By postoperative follow up,ABV patency of group A was higher than group B (P < 0.05).Conclusions Patency status of liver outflow vein significantly influences postoperative portal vein pressure and closely correlats to ABV patency rate after ACS.
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Objective:This study aims to determine the efficacy of chemotherapy and to identify potential chemotherapy agents for advanced primary duodenal carcinoma (PDC). Methods:Fifty-six patients with advanced PDC, who did and did not receive chemo-therapy, were involved in this study. Response rates (RR), disease control rates (DCR), progression-free survival (PFS), and overall sur-vival (OS) were analyzed. Results:The overall RR and DCR of 43 patients were 19.04%and 71.42%, respectively. The patients who re-ceived chemotherapy agents fluorourzcil and oxaliplatin exhibited higher RR compared with patients who received other chemotherapy combinations (35.29%vs. 7.69%, P=0.010 9). Palliative chemotherapy improved the OS of patients with advanced PDC compared with patients who did not receive chemotherapy (13.35 months vs. 5.65 months, HR=0.203, 95%CI:0.083 to 0.497, P=0.000 5). Compared with the use of other chemotherapy regimens, treatment with a fluorourzcil-based chemotherapy agent resulted in a longer PFS (5.08 months vs. 1.08 months, HR=0.004, 95%CI:0.000 to 0.315, P=0.013 2). Multivariate analysis indicated mucinous histology and lymph mode metastasis as factors predictive of poor prognosis in patients with advanced PDC. Conclusion:Palliative chemotherapy may im-prove the OS of patients with advanced PDC.
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Objective To investigate the change of inferior vena cava pressure (IVCP) in type Ⅱ Budd-Chiari syndrome patients undergoing atrial caval shunting and its relationship with postoperative artificial blood vessel (ABV) patency rate.Methods We recruited 209 patients who had undergone atrial caval shunting for type Ⅱ Budd-Chiari syndrome and evaluated IVCP,right atrial pressure (RAP) and free portal vein pressure (PFP) before and after ABV opening.Presure changes were compared by t-test.These patients were followed up by color Doppler ultrasonograthy for ABV patency.The correlation between IVCP and postoperative ABV patency were analyzed By Kaplan-Meier test.Results IVCP (t =0.56,P < 0.05)and PFP (t =0.72,P < 0.05) decreased and RAP increased significantly after ABV opening (t =0.52,P < 0.05).Follow up result showed that ABV patency rate was lower in patients with IVCP descent < 1 kPa than those with IVCP descent > 1 kPa (P < 0.05).Conclusions Significant IVCP descent correlates with high ABV patency rate after atrial caval shunting in type Ⅱ Budd-Chiari syndrome patients.
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Objective To describe the profile of probiotics utilization in hospitalized pneumonia children and evaluate the ef -fectiveness of probiotics in the treatment of pneumonia in hospitalized children combined with antibiotics. Methods Descriptive data a-nalysis was obtained from the medical records in one children′s hospital in one year period. The clinical data including patient charac-teristics, drug prescribed time, drug use duration, and length of stay was reviewed. Ridit analysis was used to compare the data. Re-sults Data of 2 974 children hospitalized for pneumonia was accessed. Antibiotics were prescribed to 99.1 % ( n=2 948) of pa-tients, probiotics were prescribed to 42.1%(n=1 252) of patients, and both antibiotics and probiotics were prescribed to 41.9%(n=1 246 ). The median of the time to start administration of probiotics was the second day of hospitalization and the mode was the first day of hospitalization. For those patients who were prescribed antibiotics combined with probiotics, the median of the duration of ad-ministration of antibiotics before accepting probiotics was 3 days and the mode was 1 day.After administrating probiotics, the median of the duration of accepting of antibiotics was 5 days, the mode was 4 days, and the median and the mode of the duration of administration of probiotics were 4 days.21%(n=626) of all hospitalized patients were administrated anti-diarrheals.The most common age group of them were neonates and infants (82.3%, n=515).The patients with anti-diarrheal who was administrated antibiotics with or with-out probiotics were 585(47.0%), 34(2.0%), respectively (P<0.05).The median of duration of anti-diarrheals in those adminis-trated antibiotics with probiotics was 4 days, the mode was 3 days and the interquartile range was 2-6 days.For those administrated an-tibiotics without probiotics, the median of duration of anti-diarrheals was 3 days, the mode was 1 day and the interquartile range was 1-6 days (P>0.05).The median of the length of stay in those administrated antibiotics with probiotics was 7 days, the mode was 6 days and the interquartile range was 6-9 days.For those administrated antibiotics without probiotics, the median and the mode of the length of stay were 7 days and the interquartile range was 6-9 days(P>0.05).Conclusion The time of starting to administrate probiotics was mainly within 2 days combined with antibiotics. The aim of prescribed probiotics was prevention of antibiotic-associated diarrhea. There was no significant difference in the duration of the following antibiotic therapy, the duration of anti-diarrhea therapy, the length of stay between those administrated antibiotics combination with or without probiotics.
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Objective:This retrospective study aims to determine the efficacy of chemotherapy and improve a salvage chemother-apy agent for metastatic colorectal cancer (MCRC) after failure of treatment with irinotecan and oxaliplatin. Methods:Between Janu-ary 2002 and March 2013, 37 patients with metastatic MCRC who had progressed after treatment with irinotecan and oxaliplatin were analyzed for their response rate (RR) and progression-free survival (PFS). Results:The overall RR of the 37 patients was 13.51%, with 5 cases of partial response (PR), 12 cases of disease stabilization (SD), and 20 cases of progression (PD). Compared with other chemo-therapy regimens, treatment with a pemetrexed-based chemotherapy agent had a higher RR (17.64%vs. 10.00%, P=0.64) without a lon-ger PFS (2.00 months vs. 1.63 months, HR=0.79, 95%, CI:0.35 to 1.78, P=0.58). Compared with other chemotherapy regimens, treat-ment with a raltirexed-based chemotherapy agent had a higher RR (16.67%vs. 12.00%, P=0.34) without a longer PFS (1.58 months vs. 1.90 months, HR=2.24, 95%, CI:0.98 to 5.12, P=0.06).Conclusion:In patients with MCRC after failure of treatment with irinotecan and oxaliplatin, a pemetrexed-based or raltirexed-based chemotherapy agent may beneficial during salvage treatment and is therefore worthy of further study.
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ObjectiveTo analyze the relationship between expressions of Indoleamine 2,3-dioxygenase (IDO) and B7-H1 with clinico-pathological features and their prognostic significance in pancreatic cancer (PC).Method95 patients who underwent radical pancreaticoduodenectomy for PC were studied.The IDO and B7-H1 expressions in tissue specimens were determined by immunohistochemistry.ResultsIDO and B7-H1 expressions were higher in pancreatic carcinoma tissues than in normal pancreatic tissues (P<0.05).IDO and B7-H1 expressions positively and significantly correlated with pathological grades and tumour-node-metastasis (TNM) stages (P<0.05).They were prognostic of poor cancer-specific survival.After adjusting by the Cox proportional hazards regression models (P<0.05),only a combined IDO/B7-H1 expression served as an independent prognostic marker.ConclusionsIDO and B7-H1 were expressed in PC,and they were important markers for malignant progression of PC.A combined IDO/B7-H1 expression served as an independent prognostic marker for PC.