Debt and primary care physicians' career satisfaction.
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Education, Medical↗
Biomedical subjects
G Xu
Publications and source records attributed to G Xu.
Physician parents' influence over their children's choices of careers in generalist specialties.
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Career Choice↗
Board certification: associations with physicians' demographics and performances during medical school and residency.
PURPOSE: To examine the associations between board certification and both physicians' demographics and their performances during medical school and residency. METHOD: Data were prospectively collected for 1,186 medical students in three major specialty areas for the Jefferson Medical College's graduating classes of 1976 through 1985. RESULTS: Older students and underrepresented minorities were less likely to achieve certification. Overall, physicians who achieved board certification had performed better during medical school and residency than had those without certification. The prediction of board certification using academic performance indicators is limited, particularly for older and minority groups. CONCLUSIONS: This study demonstrated an overall positive relationship between physicians' board certification status and their past academic performances. The potential impact of the increases of both older students and minority physicians on rates of board certification needs to be considered by specialty boards and other policymakers.
Adult↗
Medical students' personal values and their career choices a quarter-century later.
A longitudinal study of 391 physicians tested two hypotheses regarding personal values and career choices: that higher preference for social values would be associated with physicians' being more interested in "people-oriented" rather than "technology-oriented" specialties and that higher preference for economic values would be associated with expectations of high income. The physicians (344 men, 47 women) were graduates of Jefferson Medical College in 1974 and 1975 who completed the Allport-Vernon-Lindzey Study of Values during medical school. Analysis showed that physicians currently in the "people-oriented" specialties scored significantly higher on the Social Value scale than their peers in "technology-oriented" specialties. A moderate but statistically significant correlation was found between scores on the Economic Value scale and expectations of higher income. The findings suggest that physicians' personal values are relevant to their career decisions such as specialty choice and expectations of income. The findings have implications with regard to two major issues in the evolving health care system, namely, the distribution of physicians by specialty and cost containment.
Adult↗
[Adjuvant chemotherapy following radical surgery for non-small cell lung cancer: a randomized study].
OBJECTIVE: To evaluate the efficacy of adjuvant chemotherapy after radical surgery for non-small cell lung cancer (NSCLC). METHODS: Seventy patients with NSCLC(stage I-III) undergone radical surgery were randomized into two groups: 35 patients received adjuvant chemotherapy with cyclophosphamide (CTX) 300 mg/m2, vincristine(VCR) 1.4 mg/m2, adriamycin(ADM) 50 mg/m2, d1; cisplatin (PDD) 20 mg/m2, d1-5, for 4 cycles, and followed by oral ftorafur (FT-207) 600-900 mg/d for 1 year (adjuvant chemotherapy group). The other 35 patients received surgical treatment only (surgery group). RESULTS: The overall 5-year survival rate was 48.6% in the adjuvant chemotherapy group, and 31.4% in the surgery group, respectively. The difference between the two groups was not statistically significant (P > 0.05). The 5-year survival rate of patients in atage III was 44.0% and 20.8% (5/24) received surgery with and without adjuvant chemotherapy, respectively. The difference between the two groups was statistically significant (P < 0.025). The 5-year survival rate of patients in stage I-II in the two group was 60.0% and 54.5%, respectively (P > 0.75). CONCLUSION: Postoperative adjuvant chemotherapy in NSCLC improves survival but only in patients in stage III, it results in significantly higher 5-year susvival rate than surgery alone.
Adult↗
[Comparative studies of the pharmacokinetics of 131I-3H11 after different routes of administration].
OBJECTIVE: To study the pharmacokinetics of 131I-3H11, a mAb to gastric cancer, by different routes of administration. METHODS: Three groups of rabbits were injected with 131I-3H11 through ear vein(i.v.), portal vein(pv) and into the peritoneal cavity(i.p.), respectively. At various time intervals, blood samples from the ear vein and portal vein, and the peritoneal fluid were collected and their radioactivities determined. RESULTS: (1) The radioactivity of ear vein blood and portal vein blood was the same in the i.v. group. In the peritoneal cavity, it was 1/3 of that in the blood. (2) In pv group, radioactivity of the portal vein blood was higher than that of the ear vein blood, but the difference became insignificant 30 min later. In the peritoneal cavity, it was 1/3 of that in the blood. (3) In i.p. group, radioactivity in the peritoneal cavity was highest, its peak activity was 37.2-fold and 5.4-fold as high as that of the venous blood, respectively. That in the portal vein blood was 6.9 times higher than in the ear vein blood. CONCLUSION: There is a significant pharmacokinetic advantage for i.p. over i.v. and pv routes of administration for the prevention and treatment of peritoneal recurrence and liver metastsis of gastrointestinal cancers after surgical resection.
Animals↗
[Preoperative radiotherapy reduces cervical metastasis of supraglottic carcinoma: a prospective randomized trial in 201 patients].
OBJECTIVE: To evaluate the effectiveness of preoperative radiotherapy in the control of overall cervical lymph node metastasis from supraglottic carcinoma. METHODS: A prospective randomized study on 210 patients with supraglottic carcinoma was performed. Nine patients were lost from follow-up and therefore excluded. The analysis was based on the remained 201 patients including fifteen who did not complete the treatment protocol. Surgery alone(S) was carried out in 102 patients and radiotherapy(40 Gy) followed by surgery (R + S) in 99 patients. All the patients were followed up for more than three years. RESULTS: No statistically significant difference in survival rates between S and R + S groups was found by using the Kaplan-Meier analysis. However, relative risk of overall cervical recurrence had a trend of reduction for patients in R + S group, versus patients in S group. There was a statistically significant reduction of lymph node metastasis in R + S group compared to S group in stage I-III(P = 0.0198) while in stage IV no such difference was observed. Patients with stage I-III disease who did not receive preoperative radiation were 1.766 times more likely to develop neck recurrence compared to patients who did. Among all the factors, only TNM stage and histological nodal status were found to be independent risk factors for regional control. Contralateral neck failure occurred more frequently in patients with advanced lesion(P = 0.020) and in patients without preoperative radiation(P = 0.018). CONCLUSION: There may be a trend towards improved control of cervical lymph node metastasis with preoperative radiation of 40 Gy dose in patients with supraglottic cancer in stage I-III of the disease.
Combined Modality Therapy↗
[Arterial plasma nitric oxide and lactate level in hemorrhagic shock patients].
OBJECTIVE: To investigate the relationship between arterial plasma nitric oxide(NO), lactate (LA) concentration and prognosis of hemorrhagic shock patients. METHODS: The blood levels of a NO and LA were measured with fluoropholometry and colorimetry in 48 hemorrhagic shock patients, and other 30 patients for selective surgery served as controls. RESULTS: NO level was significantly lower and LA level was significantly higher in the hemorrhagic shock group than that of the control group respectively. NO level had a negative correlation with LA level and trauma index. NO level in the patients complicated by sepsis was still lower than that of the control group. CONCLUSION: Decrease of NO level may be a main cause of disturbance of microcirculation and increase of LA. The lower the NO level, the higher the LA level, the worse the prognosis. So NO and LA level play an important role in forecasting progress of hemorrhagic shock patients.
Adolescent↗
[Resources investigation of Actinidia in Hunan Province].
Based on the resources investigation and taxonomic research on the plants of Actinidia in Hunan Province, 15 species and 5 varieties together with their distribution and utilization are reported. A key is set forth according to the differences among the above species and varieties.
China↗
Supraglottic carcinoma: does preoperative radiotherapy reduce the incidence of cervical metastasis?
OBJECTIVE: To compare surgery (S) alone with combined radiotherapy and surgery (R + S) in the management of patients with supraglottic laryngeal cancer. METHODS: Between 1981 and 1994, patients were stratified according to stage and randomised to either surgery (S) or 4000cGy of radiotherapy and surgery. There were 102 patients in the S group and 99 in the R + S group who completed at least 3-year follow-up. RESULTS: Using Kaplan-Meier survival method showed no significant difference between the two groups. When the patients were grouped according to tumour stage, a significant reduction in the regional recurrence was noted in the R + S group for stage I-III disease (Cox multivariate analysis, P < 0.02). They had an increased relative risk of 1.8 (95% confidence 1.1-2.9) for neck recurrence. There was no significant difference in neck recurrence rates in the two groups for stage IV disease. When Cox proportional hazard model was used, only TNM stage (P < 0.02) and histological nodal status (positive lymph nodes, P < 0.01) were found to be independent risk factors for regional control. CONCLUSION: Preoperative radiotherapy can improve regional cervical control of stage I-III supraglottic cancer as compared with surgery alone.
Adult↗
[Advances in the chemoprophylaxis of tuberculosis].
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Animals↗
[Exploration of evaluating way of curative effect in transnasal endoscopic sinus surgery for treating chronic sinusitis].
OBJECTIVE: To explore the evaluating way of curative effect in transnasal endoscopic sinus surgery for treating chronic sinusitis. METHODS: 725 cases who suffered from chronic sinusitis and undergone the endoscopic sinus surgery in 1991-1995 were analyzed according to the index that set up by ourselves. RESULTS: The difference of properties, limits and extents of pathological changes in sinuses affected directly the surgical result. CONCLUSION: It is very important to build up a staging system and a criterion of treating effect on chronic sinusitis for appraising properly the endoscopic sinus surgery.
Adolescent↗
[Energy metabolism of men in full pressure suit with additional pressure].
The energy metabolism of men in full pressure suit with additional pressure and without additional pressure were measured during rest and exercise. Results show that the rates of energy metabolism of men in full pressure suit with additional 28 kPa pressure and without additional pressure increased as the exercise load increased. The rates of energy metabolism of men in full pressure suit with additional 28kPa pressure had no significant difference during rest and 0.9W exercise, but significantly increased during 8.5 W exercise, as compared with that without additional pressure. It suggested that full pressure suit with 28 kPa did not affect human energy metabolism during rest, but affected during exercise.
Aerospace Medicine↗
[Observation on changes of heart rate and energy metabolic rate and their regression under upper and lower limb exercise].
Energy metabolic rate and heart rate were observed in 8 healthy young men during exercise on a bicycle ergometer. The results showed that there is a linear relationship between heart rate and metabolic rate during both upper and lower exercise, only that the metabolic rate is higher during upper limb exercise than during lower limb exercise under the same work load. It suggests that work efficiency may be influenced by mode of exercise.
Adolescent↗
[Identification of 12 species of hailong and haima by HPCE].
Twelve species of Hailong and Haima were analyzed by HPCE(high performance capillary electrophoresis) and significant differences among the species were found. The method is rapid, highly efficient and reproducible, thus providing experimental criteria for the qualitative identification of these two crude drugs.
Animals↗
[Identification of commercial Chinese medicine ziwan].
OBJECTIVE: Commercial samples of Ziwan have been investigated and identified to find out the original species in circulation. METHOD: Comparative histological and morphological identification. RESULT: The main original plant species are Aster tataricus, Ligularia fischeri, L. hodgsonii, L. intermedia, L. wilsoniana, L. sibirica var. araneosa, L. veitchiana and L. caloxantha. CONCLUSION: The root and rhizome of A. tataricus are used as Ziwan in most areas of China; but those of Ligularia species are used as Ziwan(named Shanziwan) in southwest, and part of northwest and northeast areas of China.
Asteraceae↗
[Squamous cell carcinoma of temporal bone: an analysis of long-term treatment results in 33 patients].
OBJECTIVE: To evaluate the long-term results in patients with squamous cell carcinoma of the temporal bone and treated by of mastoidectomy combined with perioperative radiation therapy. METHODS: Thirty-three patients with squamous cell carcinoma invading the temporal bone were reviewed retrospectively. According to the tumor extent, the patients were staged into three subgroups, 3 with lesions confined to the auditory canal(Group I), 17 with involvement of the middle ear or mastoid(Group II) and 13 with more extensive disease(Group III). Two patients were treated by surgery, 11 by irradiation and the remaining 20 by the combined surgery and perioperative radiotherapy. The surgical procedures included sleeve resection for group I patients, mastoidectomy for all other patients except one who had subtotal temporal bone resection. The radiation doses were in the range of 3,500 to 10,000 cGy, with an average dose of 6,560 cGy. RESULTS: The 5-year survival rate for the whole series was 51.7% by the life table analysis. The estimated 5-year survival rates for 3 subgroups were 100%, 68.8%, and 19.6%, respectively (P = 0.012). Radiation alone had a 28.7% survival rate and combined therapy 59.6% (P = 0.80). For patients treated with planned combined therapy, the actual 5-year survival rates were 72.7% (8/11) for Group II and 12.5% (1/8) for Group III (P = 0.02). Twelve patients died of local recurrence (10 cases), cervical metastases(1 case) and liver metastases (1 case) with 67.0% (8/12) succumbed to their diseases within two years. Complications included osteonecrosis (n = 1), osteitis (n = 3), radiation dermatitis (n = 2), facial palsy (n = 2), and delayed healing (n = 2). CONCLUSION: The 5-year survival rates in patients with mastoidectomy with removal of gross tumor, combined with planned perioperative irradiation therapy, are similar or higher than those from literature. This protocol can be used in patients with squamous cell carcinoma confined to the middle ear or the mastoid.
Adult↗
[Research of optic canal decompression by transnasal endoscopic approach].
OBJECTIVE: To find a better method to treat traumatic optic neuropathy. METHODS: Fourteen cases were treated by transnasal endoscopic sphenoethmoidal optic canal decompression in clinic. RESULTS: Nine of them had their visual acuity improved from NLP, HM, FC/50 cm, HM, NLP, LP, NLP, HM, NLP to 0.2, 0.3, 0.3(+2), 0.4, 0.06, 0.3, 0.1, 0.7, 0.12 after the operation. The clinical anatomy, attentions during operation, merits of operative approaches were discussed. CONCLUSION: Transnasal endoscopic sphenoethmoidal optic canal decompression is a good method for treatment of post-traumatic optic neuropathy.
Adolescent↗