Bioscience trends
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Advances in the study of the medical humanities and medical humanities education have been made over the past few decades. Many influential journals have published articles examining the role of medical humanities and medical humanities education, the development and evaluation of medical humanities, and the design of a curriculum for medical humanities education in Western countries. ⋯ The six companion articles featured in this issue describe the current status and challenge of medical humanities and medical humanities education in China in the hope of providing international readers with a novel and meaningful glimpse into medical humanities in China. This Journal is calling for greater publication of research on medical humanities and medical humanities education to propel medical humanities in China.
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The purpose of this study is to determine the prevalence of burnout among different grade hospitals and to examine if a relation exists between burnout and medical mistakes. A multi-center cross-sectional survey was conducted. Physicians were interviewed in hospitals from 10 provinces in China. ⋯ In conclusion, Chinese physicians reported high workloads, high rates of burnout and high medical mistakes. Physicians in tertiary hospitals were especially overworked and suffered the most serious burnout. Longer work hours per week, and burnout were the independent risk factors for medical mistakes.
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Review Meta Analysis Comparative Study
A systematic review and meta-analysis of feasibility, safety and efficacy of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) versus two-stage hepatectomy (TSH).
This meta-analysis aimed to review the regeneration rate of future liver remnant (FLR) and perioperative outcomes after associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) and two-stage hepatectomy (TSH). A web search was performed in "MEDLINE", "EMBASE", and "SCIENCE DIRECT" databases using both subject headings (MeSH) and truncated word to identify all the articles published that related to this topic. Pooled risk ratios were calculated for categorical variables and mean differences for continuous variables using the fixed-effects and random-effects models for meta-analysis. ⋯ There was no statistical difference (95% CI, p = 0.34). So from the outcome of this meta-analysis, TSH had a similar remnant liver regeneration ability compared to ALPPS while the morbidity and mortality rates were relatively low. Cancer progression while waiting for the staged liver resection after portal vein embolization was a drawback for TSH.
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Observational Study
The impact of intra-abdominal pressure on the stroke volume variation and plethysmographic variability index in patients undergoing laparoscopic cholecystectomy.
The purpose of the present study was to evaluate the effect of increasing intra-abdominal pressure (IAP) on stroke volume variation (SVV) and plethysmographic variability index (PVI) in patients undergoing laparoscopic cholecystectomy. PVI examined by Masimo Radical 7 pulse oximeter and SVV determined using FloTrac/Vigileo were monitored simultaneously in forty-five patients undergoing laparoscopic cholecystectomy (LC). Mean arterial blood pressure (MAP), heart rate (HR), cardiac index (CI), perfusion index (PI), airway pressures (P), SVV, and PVI were also recorded at the following predetermined time: 5 min after endotracheal intubation (T1), 5 min after pneumoperitoneum at 5 mmHg (T2), 5 min after pneumoperitoneum at 10 mmHg (T3), 5 min after pneumoperitoneum at 15 mmHg (T4), and 5 min after the termination of pneumoperitoneum (T5). ⋯ No significant difference was found when the pneumoperitoneum was terminated at T5. Further regressive analysis indicated strong relationships between SVV and IAP (r = 0.8118, p < 0.001), PVI and IAP(r = 0.8876, p < 0.001) respectively. Both PVI and SVV showed rapid and IAP correlative changes with increasing intra-abdominal pressure in patients undergoing laparoscopic cholecystectomy.
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Preterm premature rupture of the membranes (PPROM) remains the leading cause of preterm deliveries and neonatal mortality and morbidity. The current cohort study sought to retrospectively examine perinatal outcomes in cases of PPROM < 34 weeks' gestation that were managed conservatively from 2010 to 2012 and to identify risk factors for short-term neonatal outcomes. Subjects were 510 pregnancies consisting of 114 twin and 396 singleton pregnancies. ⋯ Multivariate logistic regression analysis revealed that weeks of gestation at PPROM (OR: 0.953, 95% CI: 0.939-0.966, p < 0.001) and a latency period (OR: 0.948, 95%CI: 0.926-0.970, p < 0.001) were associated with neonatal mortality or morbidity. A twin pregnancy (OR: 0.319, 95% CI: 0.17-0.6, p < 0.001) and weeks of gestation at PPROM (OR: 0.737, 95% CI: 0.66-0.822, p < 0.001) were associated with the latency period. Gestational age at PPROM, a twin pregnancy, and the latency period are associated with neonatal mortality and morbidity.