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ABSTRACT: Translational medicine is a fashionable term describing the inclination of basic science and clinical researchers to ultimately help patients through facilitating the incorporation of basic research findings into clinical practice. The development of translational medicine in recent years has been rapid-focusing on a new medical research model advocating "patient-centered" clinical work. Starting with clinical questions regarding patient problems, conducting basic research, and then turning the results of basic research quickly into clinical applications to improve clinical care is the heart of this new model. In this article, we examine the incorporation of and experience with translational medicine at Peking Union Medical College Hospital (PUMCH) in Beijing, China.
Science China. Life sciences 08/2012; · 2.02 Impact Factor
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Postgraduate medical journal 07/2012; 88(1043):554-5. · 1.38 Impact Factor
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ABSTRACT: The application of main methodologies for clinical decision-making by residents in emergency medical practice was assessed, and issues in this area were investigated. The treatments provided to 2 611 critical patients by the Emergency Department of Peking Union Medical College Hospital were analyzed by independent investigators who evaluated the main clinical decision-making processes applied by the hospital residents. The application of decision-making strategies by PG1 and PG3 groups, which means the residents in first year and the third year, were compared. The patients were treated according to pattern recognition (43.0%), hypothetico-deductive reasoning (23.4%), event-driven models (19.3%), and rule-using algorithms (5.9%). A significant difference was found between PG1 and PG3 groups (χ(2)= 498.01, P < 0.001). Pattern recognition and hypothetic-deductive methods were the most common techniques applied by emergency physicians in evaluating critically ill patients. The decision-making processes applied by junior and senior residents were significantly different, although neither group adequately applied rule-using algorithms. Inclusion of clinical decision-making in medical curricula is needed to improve decision-making in critical care.
Frontiers of medicine. 03/2012; 6(1):89-93.
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The journal of trauma and acute care surgery. 03/2012; 72(3):E114.
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Resuscitation 07/2011; 82(7):959. · 3.60 Impact Factor
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Postgraduate medical journal 03/2011; 87(1028):438-9. · 1.38 Impact Factor
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The Journal of trauma 02/2011; 70(2):496-7. · 2.48 Impact Factor
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The Journal of trauma 07/2009; 66(6):1747-8. · 2.48 Impact Factor
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ABSTRACT: Recent global estimates of deaths from poisoning suggest that more than 150,000 deaths occur each year in China from pesticide poisoning alone. One response from the Chinese government has been to set up Poison Control Centers in each province to improve management. Unfortunately, the epidemiology of poisoning in China is still unclear and there are no specialist clinical toxicologists to take the lead in dealing with the massive loss of life. The objective of this article is to survey the situation of clinical toxicology in China and give some suggestions for its development.
Clinical Toxicology 05/2009; 47(4):263-9. · 2.22 Impact Factor
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ABSTRACT: Organophosphorus pesticide poisoning occurs frequently in China and can be diagnosed easily based on the history of ingestion and the cholinergic toxic syndrome. Yet, when combined with other toxins, organophosphorus poisoning may appear different.
Here, we present a case of acute ethanol poisoning together with a dermal organophosphorus exposure.
Based on the history and a misinterpretation of the physical examination, the patient was treated as an organophosphorus poisoning. Ultimately, serum analysis helped clarify the diagnosis.
Toxicologist should be aware of the error known as anchoring and take appropriate precautions to limit its occurrence.
Alcohol and Alcoholism 09/2008; 43(6):650-2. · 2.95 Impact Factor
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ABSTRACT: Organophosphorus (OP) pesticide poisoning is the most common form of pesticide poisoning in many Asian countries. Guidelines in western countries for management of poisoning indicate that gastric lavage should be performed only if two criteria are met: within one hour of poison ingestion and substantial ingested amount. But the evidence on which these guidelines are based is from medicine overdoses in developed countries and may be irrelevant to OP poisoning in Asia. Chinese clinical experience suggests that OP remains in the stomach for several hours or even days after ingestion. Thus, there may be reasons for doing single or multiple gastric lavages for OP poisoning. There have been no randomised controlled trials (RCTs) to assess this practice of multiple lavages. Since it is currently standard therapy in China, we cannot perform a RCT of no lavage vs. a single lavage vs. multiple lavages. We will compare a single gastric lavage with three gastric lavages as the first stage to assess the role of gastric lavage in OP poisoning.
We have designed an RCT assessing the effectiveness of multiple gastric lavages in adult OP self-poisoning patients admitted to three Chinese hospitals within 12 hrs of ingestion. Patients will be randomised to standard treatment plus either a single gastric lavage on admission or three gastric lavages at four hour intervals. The primary outcome is in-hospital mortality. Analysis will be on an intention-to-treat basis. On the basis of the historical incidence of OP at the study sites, we expect to enroll 908 patients over three years. This projected sample size provides sufficient power to evaluate the death rate; and a variety of other exposure and outcome variables, including particular OPs and ingestion time. Changes of OP level will be analyzed in order to provide some toxic kinetic data.
the GLAOP study is a novel, prospective cohort study that will explore to the toxic kinetics of OP and effects of gastric lavage on it. Given the poor information about the impact of gastric lavage on clinical outcomes for OP patients, this study can provide important information to inform clinical practice.
BMC Emergency Medicine 02/2006; 6:10.
