简介：AbstractObjective:The prevalence of midline birth defects, such as gastroschisis, has increased worldwide, over the last few decades. This study aims to explore the prevalence, maternal epidemiological characteristics, and natural history of neonates affected by gastroschisis at the University Hospital of León city, Nicaragua.Methods:Data were collected from the birth defect surveillance system of the Hospital Oscar Danilo Rosales (HEODRA). The analysis included all pregnancies that had gastroschisis complications between January 1 and December 31, 2020. The prevalence of gastroschisis was calculated according to maternal age. The mothers were interviewed, and the clinical records of the newborns were reviewed.Results:Among the 4,460 deliveries included in this study, four cases of gastroschisis were identified, including three live births and one stillbirth. The gastroschisis rate was 8.9 per 10,000 live births (95% confidence interval [CI]: 0.18-17.8). The prevalence among mothers younger than 20 years and those older than 20 years was 26.4 (95% CI: -3.43 to 56.25) and 3.01 (95% CI: 2.89-8.90)/10,000 births, respectively. Mothers of gastroschisis-affected fetuses were of rural origin (n = 3), had normal body mass indexes (n = 3), were exposed to tobacco and wood smoke (n = 2), and one was exposed to pesticides during the periconceptional period. Primary closure of the gastroschisis was performed on one patient, and complex gastroschisis for intestinal perforation was observed in another patient. The mean hospitalization duration was 33 days, and two patients were discharged alive.Conclusions:Gastroschisis was a significant birth defect among children delivered at HEODRA in 2020. Its prevalence in Nicaragua was higher than that in other countries in the region. All complicated pregnancies were young women with unplanned pregnancies, from rural areas, with exposure to secondhand smoke, and without vitamin supplements before or during the first trimester of pregnancy. Only 67% of infants survived after hospital discharge.

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简介：AbstractObjective:No ideal training system exists for pancreaticoduodenectomy (PD). We developed an educational system that uses an objective structured assessment of technical skills.Methods:This retrospective observational study was conducted using the data of consecutive trainees and patients who underwent PD from 2007 to 2013 in Kansai Medical University Hospital. The total score on the task checklist (21 parameters) for measuring technical performance during PD by self assessment and instructor assessment was compared between junior (JN) and hepatobiliary pancreatic (HBP) trainees at a university hospital. Surgical outcomes of 303 PDs (2007-2013) were also compared among JN trainees, HBP trainees, and instructors, and the present position of the trainees was investigated. This study was approved by the institutional review board of Kansai Medical University on May 26, 2020.Results:The self-assessment score on the task checklist was significantly higher for the HBP trainees than for the JN trainees on all parts of PD (P <.001). The discrepancy between self-assessment and instructor assessment improved in 3 JN trainees after experience with the first 5 PDs. Although total score curves rose to the right in the JN group, scores in the HBP group were stable, at 70 or higher, which correlated with the instructor assessment. The 90-day and 30-day mortality rates were 1.6% and 0.3%, respectively. Mortality and morbidity after PD did not differ between the JN and HBP trainees or between the instructors and the trainees. Four of 10 trainees became board-certified expert surgeons of the Japanese Society of Hepatobiliary Pancreatic Surgery.Conclusion:These results indicated good construct validity of the task checklist system. This program was safely and effectively implemented in terms of surgical outcomes and final outcomes of trainees becoming board-certified expert surgeons.

简介：《ChinaNewsofTCM》reportedthatrecently,HongKongUniversityaccomplishedaresearchonacupuncturetreatmentofhoarseness.Findingsof54cases(27casesreceivingacupuncturetreatmentandother27casesreceivingroutine

简介：AbstractObjective:Awareness regarding the negative effects of ultraviolet radiation are commonly neglected in Asian countries. This study sought to evaluate the ultraviolet radiation knowledge and photoprotective behaviors of university students in Indonesia.Methods:This observational cross-sectional was conducted at Pelita Harapan University, Indonesia.Results:A total of 89 (45.4%) medical students and 107 (54.6%) nonmedical students participated in this study. Their mean age was 21.03 ± 2.03 years, and 46.4% of them had Fitzpatrick type III skin. Medical students as well as older students exhibited a higher level of knowledge regarding photoprotection (P ≤ 0.05). Factors related to good photoprotective behaviors were sex, older age, and average expenditure on skincare. Further analysis revealed that a high level of knowledge regarding photoprotection was related to acceptable photoprotective behaviors (P = 0.01; odds ratio = 1.97; 95% confidence interval = 1.13-3.54).Conclusions:Knowledge regarding sun-related damage and practice of photoprotective behaviors were low among the participants. The results indicate that formal education and academic subjects should incorporate the topic of sun-related damage and promote the practice of photoprotective behaviors early on to increase awareness among populations.

简介：为了加强国内外心脑血管专业高新科技信息交流，提高老年医学领域的基础研究与临床治疗水平，促进年轻医务工作者专业技能的快速成长与发展，《中华老年心脑血管病杂志》作为学术前沿的交流平台，于2013年12月5日与位于美国旧金山硅谷的CaliforniaSouthBayUniversity（CSBU）即美国加州南湾大学商定，双方坦诚牵手开展长期协作。

简介：ModelunitofShanghaicity;Onlygrade3-firstclassgeneralhospitalofintegratedChineseandWesternmedicineinShanghaiawardedbyNationalAdministrationofTCM;Oneofthemedicalinstitutionsforforeignersappointedby

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简介：AbstractVaccination is crucial in controlling the spread of the coronavirus disease 2019 (COVID-19) that triggered the pandemic, but herd immunity can only work with high vaccination coverage in the population. This study aims to measure the COVID-19 knowledge level and determine the factors influencing COVID-19 vaccination intention among university students in Malaysia. A cross-sectional online survey was carried out with 1,274 Malaysian university students in July 2021. Univariate and multivariate analyses were employed to examine the relationships between the study variables. Results showed that the majority of university students had an acceptable level of knowledge of COVID-19. The knowledge, risk perception of COVID-19, social norms, and perceived benefit of COVID-19 vaccination were positively associated with vaccination intention. However, perceived trust in information sources of COVID-19 vaccination and the government's response to COVID-19 did not affect the university students’ desire to receive the vaccination. These findings are essential for health policymakers and healthcare providers to implement evidence-based interventions to increase COVID-19 vaccination uptake among university students.

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简介：AbstractBackground:Radical nephrectomy and thrombectomy is the standard surgical procedure for the treatment of renal cell carcinoma (RCC) with tumor thrombus (TT). But the estimation of intra-operative blood loss is only based on the surgeon’s experience. Therefore, our study aimed to develop Peking University Third Hospital score (PKUTH score) for the prediction of intra-operative blood loss volume in radical nephrectomy and thrombectomy.Methods:The clinical data of 153 cases of renal mass with renal vein (RV) or inferior vena cava tumor thrombus admitted to Department of Urology, Peking University Third Hospital from January 2015 to May 2018 were retrospectively analyzed. The total amount of blood loss during operation is equal to the amount of blood sucked out by the aspirator plus the amount of blood in the blood-soaked gauze. Univariate linear analysis was used to analyze risk factors for intra-operative blood loss, then significant factors were included in subsequent multivariable linear regression analysis.Results:The final multivariable model included the following three factors: open operative approach (P < 0.001), Neves classification IV (P < 0.001), inferior vena cava resection (P = 0.001). The PKUTH score (0-3) was calculated according to the number of aforementioned risk factors. A significant increase of blood loss was noticed along with higher risk score. The estimated median blood loss from PKUTH score 0 to 3 was 280 mL (interquartile range [IQR] 100-600 mL), 1250 mL (IQR 575-2700 mL), 2000 mL (IQR 1250-2900 mL), and 5000 mL (IQR 4250-8000 mL), respectively. Meanwhile, the higher PKUTH score was, the more chance of post-operative complications (P = 0.004) occurred. A tendency but not significant overall survival difference was found between PKUTH risk score 0 vs. 1 to 3 (P = 0.098).Conclusion:We present a structured and quantitative scoring system, PKUTH score, to predict intra-operative blood loss volume in radical nephrectomy and thrombectomy.

简介：瞄准：为了在煽动性的肠疾病(IBD)评估肝炎B(HBV)感染的流行，在我们的医院和尝试里列在后面在上面到的病人识别涉及这感染传播的可能的风险因素。方法：这是176个病人为医药会见根据他们的到达为被选择的代表性的研究。所有这些病人已经有IBD诊断。病人被会见，一张问询表被填写。结果：在我们检查了的176个病人的组，我们发现(30)17%是anti-HBc积极。从有积极anti-HBc的30个病人，(4)2.3%有积极HBsAg和否定HBV-DNA。在里面识别可能的HBV感染传播的一次尝试在IBD病人冒因素的风险，117个病人被提交了到某种外科的过程，而是仅仅24个病人，这被观察有的积极anti-HBc(P=0.085)。对待IBD复杂并发症的外科不是为HBV感染传播的一个风险因素，这也被观察，自从我们没得到静态地重要的P价值。然而，被提交了到外科对待IBD复杂并发症的IBD病人然后收到了更多的输血提交到另外的外科的干预的病人(P=0.015)。结论：在IBD病人有积极anti-HBc(17%)和积极HBsAg(2.3%)的高发生什么时候与全面人口(7.9%)相比。