AUTHOR INDEX for Volume 12

BBEIChun Hua ,LUOYi,LIGuang Lian ,PANYi Zhi,andZENGChong .　TheEffectofPercutaniousCoronaryInterventiononQTDispersionandItsClinicalImplicationinPatientswithAcuteMyocardialInfarction (6 ) :72 3…………………………………　　CCHENBing ,SONGJian Nan ,NIUXiao     

South China Journal of Cardiology Subject Index Volume 9,2008

AAcute Coronary SyndromeElevated Inflammation Markers are Negatively Associ-ated With Plasma Free Testosterone Level in MalePatients With Acute Coronary Syndrome,1:26Inhibitory Effect of Clopidogrel on Release of SolubleCD40Ligand by ADP-activated Platele…     

South China Journal of Cardiology Subject Index Volume 8,2007

AAcute coronary Syndrome(ACS) The Value of PAPP-A and MMP-9in Diagnosis andOutcome of ACS Patients,72Acute Myocardial Infarction Patient Delay in Patients WithST-elevation Acute My-ocardial Infarction,12 Atorvastatin Reduces the Expression of COX-2mRNAin …     

South China Journal of Cardiology Author Index Volume 8,2007

Aiqun Ma,87 Biao Yang,43 Bijuan Kuang,133 Bin Liang,198 Binquan You,43 Bo Xu,1 Chang Fang,82 Chaofeng Sun,87 Chengjun Yan,63 Chuanshi Xiao,198 Congxin Huang,107 Cuilian Dai,92 Dan Zhang,135 Daogang Zha,138 Dingli Xu,8 Dongbao Li,12 Dongxia Liu,12 D.Eli…     

Native T1 and Extracellular Volume in Transthyretin Amyloidosis

ObjectivesThis study evaluated the prognostic potential of native myocardial T1 in cardiac transthyretin amyloidosis (ATTR) and compared native T1 with extracellular volume (ECV) in terms of diagnostic accuracy and prognosis.BackgroundATTR is an increasingly recognized cause of heart failure that has an overlapping clinical phenotype with hypertrophic cardiomyopathy (HCM). Native T1 mapping by cardiac magnetic resonance (CMR) is useful for diagnosis in cardiac amyloidosis but its prognostic potential has never been assessed.MethodsA total of 134 patients with wild-type ATTR (ATTRwt) (122 men; age 76 ± 7 years), 81 patients with hereditary-type ATTR (ATTRm) (60 men; age 69 ± 11 years), 44 patients with HCM (32 men; age 51 ± 13 years), and 12 asymptomatic mutation carriers (4 men; age 47 ± 10 years) were studied. All subjects underwent CMR with T1 mapping and ECV measurement. ATTR patients also underwent ^99mTc-3,3-diphosphono-1,2-propanodicarboxylic acid (^99mTc-DPD) scintigraphy.ResultsNative T1 and ECV were elevated in ATTR compared with HCM (p < 0.001) and were both associated with a high diagnostic accuracy (area under the curve [AUC]: 0.87; 95% confidence interval [CI]: 0.82 to 0.91) for T1 and an AUC of 0.91 (95% CI: 0.87 to 0.94) for ECV. No significant difference in native T1 and ECV was found between ATTRwt and ATTRm, and ECV correlated well with ^99mTc-DPD scintigraphy. During follow-up of a mean of 32 ± 17 months, 55 ATTRwt and 40 ATTRm patients died. Native T1 and ECV predicted death (T1: hazard ratio [HR]: 1.225 for each 59-ms increase; 95% CI: 1.010 to 1.486; p < 0.05; ECV: HR: 1.155 for each 3% increase; 95% CI: 1.097 to 1.216; p < 0.001), but only ECV remained independently predictive after adjustment for age, N-terminal pro?B-type natriuretic peptide, left ventricular ejection fraction, E/E′, left ventricular mass index, DPD grade, and late gadolinium enhancement.ConclusionsNative T1 mapping and ECV are good diagnostic techniques for cardiac ATTR that are associated with prognosis. Both parameters correlated with mortality, but only ECV remained independently predictive of prognosis, suggesting that it is a more robust marker in cardiac ATTR.     

Irrigation Volume Determines the Efficacy of “Rectal Washout”

PURPOSE Rectal stump washout has been recommended to prevent implantation of exfoliated malignant cells in the anastomosis after anterior resection for rectal cancer. The aim of this study was to investigate its efficacy, particularly the extent to which the volume of irrigation fluid might influence the efficacy of tumor cell elimination and whether tumor characteristics might influence the result.METHODS The study comprised 30 consecutive patients operated on by anterior resection for rectal cancer. After cross-clamping the rectum below the tumor, a washout sample was collected for examination after every incremental 500 ml of saline irrigation up to 2 liters. The presence of shed cancer cells was correlated with the washout volume and tumor characteristics.RESULTS Cancer cells were found in 29 of 30 patients (97 percent) in the first sample of irrigation fluid and decreased gradually in frequency and number with increasing irrigation volumes. No cancer cells were demonstrated after 1.5 liters of irrigation in patients with tumor below the peritoneal reflection, whereas cancer cells were still present in one-fourth of the patients with tumor located above the peritoneal reflection. Finally, only a small number of cancer cells was confirmed in one patient after 2 liters of irrigation.CONCLUSIONS The irrigation volume determined the efficacy of rectal washout. With our method, 1 1/2 liters of saline irrigation appears to clear contents from cancer cells in patients with tumors below the peritoneal reflection whereas at least 2 liters is recommended for patients with tumor above the peritoneal reflection.     

Is High‐Volume Online Hemodiafiltration Associated With Malnutrition?

Chronic malnutrition is a common problem in patients with end‐stage renal disease on hemodialysis. Some studies have reported albumin loss into dialysis fluid during postdilution online hemodiafiltration (OL‐HDF). The aim of the study was to assess the nutritional status of patients on high‐volume OL‐HDF and to demonstrate that higher convective clearances are not associated with malnutrition due to possible loss of nutrients with ultrafiltration. Demographic and clinical data, corporal composition with bioimpedance spectroscopy, dialysis features, albumin loss into dialysis fluid and laboratory parameters were collected in twenty‐eight patients with ESRD undergoing postdilution OL‐HDF with stable convective volumes over 28 L/session. Convective volume (CV) in the last six months was 32.51 ± 3.52 L per session. Cross‐sectional analysis of dialysis features showed 32.7 ± 3.34 L of CV and high reduction rates of beta‐2‐microglobulin (84.2 ± 3.8%) and cystatin‐C (81.6 ± 3.47%). Beta‐2‐microglobulin reduction showed a positive correlation with prealbumin levels (P = 0.048). CV was only correlated with cystatin‐C reduction (P = 0.025). Estimated albumin loss into dialysis fluid (1.82 ± 1.05 g/session) was not related to laboratory or bioimpedance nutritional parameters, or to CV. Among patients with higher CV, serum albumin levels maintained more stability during the observational period. High volume OL‐HDF results in better convective clearances and is not associated with malnutrition. Albumin and nutrients loss into dialysis fluid should not be a limiting factor of the substitution volume.     

Association of Volume of Patient Encounters with Residents’ In-Training Examination Performance

BACKGROUND

Patient care and medical knowledge are Accreditation Council for Graduate Medical Education (ACGME) core competencies. The correlation between amount of patient contact and knowledge acquisition is not known.

OBJECTIVE

To determine if a correlation exists between the number of patient encounters and in-training exam (ITE) scores in internal medicine (IM) and pediatric residents at a large academic medical center.

DESIGN

Retrospective cohort study

PARTICIPANTS

Resident physicians at Mayo Clinic from July 2006 to June 2010 in IM (318 resident-years) and pediatrics (66 resident-years).

METHODS

We tabulated patient encounters through review of clinical notes in an electronic medical record during post graduate year (PGY)-1 and PGY-2. Using linear regression models, we investigated associations between ITE score and number of notes during the previous PGY, adjusted for previous ITE score, gender, medical school origin, and conference attendance.

KEY RESULTS

For IM, PGY-2 admission and consult encounters in the hospital and specialty clinics had a positive linear association with ITE-3 % score (β?=?0.02; p?=?0.004). For IM, PGY-1 conference attendance is positively associated with PGY-2 ITE performance. We did not detect a correlation between PGY-1 patient encounters and subsequent ITE scores for IM or pediatric residents. No association was found between IM PGY-2 ITE score and inpatient, outpatient, or total encounters in the first year of training. Resident continuity clinic and total encounters were not associated with change in PGY-3 ITE score.

CONCLUSIONS

We identified a positive association between hospital and subspecialty encounters during the second year of IM training and subsequent ITE score, such that each additional 50 encounters were associated with an increase of 1 % correct in PGY-3 ITE score after controlling for previous ITE performance and continuity clinic encounters. We did not find a correlation for volume of encounters and medical knowledge for IM PGY-1 residents or the pediatric cohort.     

Aquilion One Volume低剂量扫描在急诊膝关节检查中的应用研究

目的探讨东芝320排CT Aquilion One Volume低剂量扫描在急诊膝关节检查中的应用,并联合软组织和骨算法进行MPR、VR等重建方法辅助诊断。方法2018年11月起始,截止2019年6月,针对性选取我院接受诊治的146例急诊膝关节损伤患者作为研究对象,根据扫描方式将研究对象分为实验组和常规组,实验组采用东芝320排CT Aquilion One Volume低剂量扫描,常规组采用相同设备螺旋CT常规扫描,观察并对比两组患者的图像质量与射线剂量。结果实验组和对照组图像合格率分别为91.8%和100.0%,两组图像质量对比无明显差异(P>0.05);两组患者的扫描范围相同,实验组CTDLvol平均值、DLP平均值、有效辐射剂量(ED)均显著优于常规组,两组射线剂量、平均值数据差异突出,对比结果有意义(P<0.05)。结论东芝320排CT Aquilion One Volume低管电压及低剂量扫描技术在急诊膝关节检查中的应用价值观突出,扫描速度快且图像质量较高,剂量明显低于常规螺旋CT扫描,有利于患者的辐射防护,同时可以保护球管延长其使用寿命,值得在临床中推广。     

Does Physicians’ Case Volume Impact Inpatient Care Costs for Pneumonia Cases?

Summary Background Increasing physician case volumes are documented to reduce costs and improve outcomes for many surgical procedures but not for medical conditions such as pneumonia that consume significant health care resources. Objective This study explored the association between physicians’ inpatient pneumonia case volume and cost per discharge. Design The design was a retrospective, population-based, cross-sectional study, using National Health Insurance administrative claims data. Setting The setting was Taiwan. Participants The participants were a universal sample of 270,002 adult, acute pneumonia hospitalizations, during 2002–2004, excluding transferred cases and readmissions. Measurements Hierarchical linear regression modeling was used to examine the association of physician’s volume (three volume groups, designed to classify patients into approximately equal sized groups) with cost, adjusting for hospital random effects, case severity, physician demographics and specialty, hospital characteristics, and geographic location. Results Mean cost was NT$2,255 (US$1 = NT$33 in 2004) for low-volume physicians (≤100 cases) and NT$1,707 for high-volume physicians (≥316 cases). The adjusted patient costs for low-volume physicians were higher (US$264 and US$235 than high- and medium-volume physicians, respectively; both P < .001), with no difference between high- and medium-volume physicians. High-volume physicians had lower in-hospital mortality and 14-day readmission rates than low-volume physicians. Conclusions Data support an inverse volume–cost relationship for pneumonia care. Decision processes and clinical care of high-volume physicians versus low-volume physicians should be studied to develop effective care algorithms to improve pneumonia outcomes and reduce costs.