1.Superconducting MRI Signal Intensity in Pallidum in Neonatal Hyperbilirubinemia
Lijuan CHEN ; Xiaoming WANG ; Yuzhen WAN ; Weihai LI ; Yonggeng JIA ; Caihong YUN ; Tianhu CHEN
Chinese Journal of Rehabilitation Theory and Practice 2016;22(7):838-840
Objective To explore the relationship between MRI signal intensity in pallidum and levels of total bilirubin in neonatal hy-perbilirubinemia. Methods From July, 2014 to October, 2015, sixty neonates were divided into three groups according to the levels of total serum bilirubin (TSB), that were group I (TSB 17.1~34.2μmol/L, n=16), group II (TSB>34.2~340μmol/L, n=34), and group III (TSB>340μmol/L, n=10). They were screened with 3.0 T MRI, and the T1WI signal intensity of bilateral pallidum was measured. Results The bi-lateral signal intensity was higher in group III than in group II and group I. There was positive correlation between signal intensity and TSB levels. Conclusion The MRI signal intensity in pallidum may help for diagnosis of neonatal bilirubin encephalopathy.
2.Findings of MRI in Cervical Spinal Cord Injury without Fracture and Dislocation and Correlation between Apparent Diffusion Coefficient of Foci and Severity of Injuries
Xiaoming WANG ; Lijuan CHEN ; Yonggeng JIA ; Yuzhen WAN ; Caihong YUN ; Liang ZHOU ; Shengwei WANG
Chinese Journal of Rehabilitation Theory and Practice 2015;21(4):394-396
Objective To study the MRI of cervical spinal cord injury without fracture and dislocation and explore of the apparent diffusion coefficient (ADC) of injured site related to the severity of injury. Methods 46 patients with cervical spinal cord injury without fracture and dislocation and 20 healthy controls were scaned with routine MRI and diffusion weighted imaging. The ADC value of site of injury and grades of Frankel's classification were analyze with the correlation. Results There were 22 cases with spinal cord edema, 8 cases with intramedullary hemorrhage, 14 cases with edema and hemorrhage, 2 cases without abnormal finding. The ADC of controls and patients were (1.05±0.12)×10-3 mm2/s, (1.21±0.23)×10-3 mm2/s (t=0.704, P<0.05). The ADC values positively correlated with the grades of Frankel's classification (r=0.407, P<0.05). Conclusion MRI may help to find the cervical cord injury in those without fracture and dislocation, and the ADC may be resposible to the severity of injury.
3.The pilot observation of cerebral blood flow during aortic arch reconstruction surgery in piglet's animal model
Qian WANG ; Sihua LIU ; Hao YANG ; Caihong WAN ; Shigang WANG ; Jiuguang YANG ; Peng SUN ; Yulong GUAN ; Cun LONG
Chinese Journal of Thoracic and Cardiovascular Surgery 2012;28(3):161-164
ObjectiveA single pump and double arterial lines piglet model was established in this piglet's experiment.The preliminary study of cerebral blood flow proportion and distribution was performed continuously during the procedure.MethodsEight female piglets were utilized in this study.The body weight ranged from 18 kg to 22 kg.The right atrium was carmulated for venous drainage.Double arterial lines were established through cannulating into right carotid artery and ascending aortic aorta.Selective antegrade cerebral perfusion (SACP) through right carotid artery started after bladder temperature was decreased to 20℃ and the perfusion from ascending aortic aorta was interrupted.The perfusion through ascending aortic aorta resumed following 60 minutes of circulatory arrest.Traditional rewarming strategy was adopted and the experiment ended when bladder temperature attained 36℃.The real-time blood flow in the double arterial lines was monitored using a TS410 transit-time tubing flowmeter (Transonic Systems Inc.,Ithaca,NY).Blood pressure in femoral artery,intra-circuit pressure was recorded every five minutes interval.Regional cerebral oxygen saturation ( rSO2 ) was assessed with NIRO-200 oximeter using Near-infrared spectroscopy (Hamamatsu Photonics,Hamamatsu City,Japan )and mixed venous oxygen saturation ( SvO2 ).Blood samples were drawn for blood chemistry measurement prior to extracorporeal circulation,before circulatory arrest and at the end of experiment.ResultsArterial blood pressure was maintained at (60 ± 20) mm Hg.Total blood flow perfusion was(85.30 ±6.81)ml · kg-1 · min-1 and(14.42 ±1.76) ml · kg-1 · min-1 in right carotid artery.The proportion of cerebral blood flow was (16.72 ± 2.77 )% of total perfusion.Cerebral blood perfusion was controlled with( 15.11 ± 0.44)ml · kg - 1 · min - 1 during SACP.Compared to SvO2,rSO2 remained stable during the procedure.The plasma concentration of
4.Effect of high-flow nasal cannula oxygen therapy and non-invasive ventilation on patients with acute respiratory failure after gastrointestinal operation under general anesthesia: a prospective randomized controlled trial
Caihong GU ; Shuxia LIU ; Kexi LIU ; Yongpeng XIE ; Xiaobin CHEN ; Caiyun XU ; Wan WANG
Chinese Journal of Emergency Medicine 2020;29(2):262-267
objective:To observe the effect of high-flow nasal cannula (HFNC) oxygen therapy on patients with acute respiratory failure after gastrointestinal operation under general anesthesia and its efficacy on prognosis.Methods:Totally 107 patients with acute respiratory failure after gastrointestinal operation under general anesthesia in ICU of our hospital were selected from January 2017 to June 2019. Patients were randomly divided into the HFNC group ( n=57) and non-invasive ventilation (NIV) group ( n=50). The changes of pH, PaO 2, PaCO 2, PaO 2/FiO 2, SpO 2, heart rate (HR), respiration rate (RR), and intra-abdominal pressure (IAP) before and after oxygen treatment were compared. The differences of comfort level, duration of oxygen treatment, re-intubation rate, 48-h pulmonary infection rate, incidence of anastomotic fistula, length of stay in ICU, length of hospital stay, hospitalization cost, and 28-day mortality were compared between the two groups. The t test of two independent samples was used for the comparison of normal measurement data. Non-normal data were expressed by median (quartile), fractional count data by case number (percentage), and comparison between the two groups by Chi-square test. Results:PaO 2, PaCO 2, PaO 2/FiO 2 and SpO 2 were not significantly different after 2-h oxygen therapy. PH of the HFNC group was lower than that of the NIV group (7.39 ± 0.04 vs. 7.42 ± 0.03), PaO 2, PaCO 2, PaO 2/FiO 2 and SpO 2 were higher than that of the NIV group [ (89.22 ± 8.70) vs. (84.99± 9.76) mmHg, (41.3 ± 3.43) vs. (39.34 ± 4.21) mmHg, (250.07 ± 18.34) vs. (237.89±19.38) mmHg, (96.14 ± 2.19) vs. (94.78 ± 2.76)%, P <0.05]; pH, PaO 2, PaCO 2, PaO 2 /FiO 2 and SpO 2 were significantly higher in the HFNC group than those in the NIV group [ (7.39 ± 0.04) vs. (7.36 ± 0.04) ; (97.2 ± 12.45) vs. (93.82 ± 12.54) mmHg; (40.84 ± 5.22) vs. (45.10 ± 6.40) mmHg; (277.16 ± 13.98) vs. (248.86 ± 12.81) mmHg, (98.14 ± 1.64)% vs. (95.48 ± 2.71) %] after 12 h oxygen treatment. The HR, RR and IAP of the HFNC group were lower than those of the NIV group, and the differences were statistically significant ( P <0.05). The duration of oxygen therapy in the HFNC group was shorter than that in the NIV group [(32.01 ± 7.57) vs. (40.88 ± 8.89) h], the reintubation rate was lower than that in the NIV group (1.75% vs. 12%), the pulmonary infection rate within 48 h oxygen therapy was lower than that in the NIV group (8.78% vs.30%), and the length of stay in ICU was shorter than that in the NIV group [(5.61 ± 1.73) vs. (7.60 ± 2.31) d], and the hospitalization cost was lower than that in the NIV group ( t = 4.822, P <0. 05). Conclusions:HFNC can improve the oxygenation index of patients with hypoxemia after gastrointestinal operation under general anesthesia, reduce oxygen treatment time, reduced reintubation rate, reduce pulmonary infection rate within 48 h, and improve the prognosis.
5.Evaluation of the applicability of the Zhang′s diagnostic criteria for atopic dermatitis in adolescents and adults from southern Jiangsu
Wen XU ; Xin LING ; Xin SHI ; Congchong WAN ; Caihong DAI ; Zhigang YANG ; Lingling CHEN
Chinese Journal of Dermatology 2022;55(12):1084-1088
Objective:To evaluate the applicability of the Zhang′s diagnostic criteria for atopic dermatitis (AD) in adolescents and adults from southern Jiangsu.Methods:A total of 1 769 patients were collected, who were newly diagnosed with eczema or AD in departments of dermatology of 7 hospitals in southern Jiangsu from May 2019 to May 2021. A standardized survey interview was conducted with patients by dermatologists using a self-designed questionnaire, which included patient′s personal information, relevant medical history, clinical characteristics, laboratory tests, etc. Using Hanifin-Rajka criteria as the gold standard, the sensitivity and specificity of the Williams criteria, Zhang′s criteria and Japanese Dermatological Association (JDA) criteria were evaluated, separately.Results:Among the 1 769 patients, there were 759 (42.9%) males and 1 010 (57.1%) females, aged 32.2 ± 8.2 years (range, 12 - 79 years) . Pruritus was the most common clinical feature among the AD patients (883/913, 96.7%) . When using the Hanifin-Rajka criteria as the gold standard, 913 (51.6%) subjects were diagnosed with AD; the sensitivity of Zhang′s criteria reached 92.6% (845/913) , and its specificity was 73.2% (627/856) ; the sensitivity of Williams′ criteria was 87.8% (802/913) , and its specificity was 81.3% (696/856) ; the sensitivity of JDA criteria reached 96.9% (885/913) , and its specificity was 68.9% (590/856) . The consistency in the diagnosis of AD was moderate between the Zhang′s criteria and Williams criteria (Kappa = 0.61, P = 0.009) , was relatively high between the Zhang′s criteria and JDA criteria (Kappa = 0.85, P = 0.001) , and was moderate between the Williams criteria and JDA criteria (Kappa = 0.51, P = 0.013) . Conclusions:Compared with the Hanifin-Rajka criteria, the Zhang′s criteria exhibit good sensitivity and specificity for the diagnosis of AD among adolescents and adults in southern Jiangsu. However, pruritus remains important for the diagnosis of AD.