1.Clinical efficacy of bowel obstruction treated by octreotide
Chinese Journal of Postgraduates of Medicine 2011;34(8):19-21
Objective To observe the clinical efficacy of octreotide for treatment of bowel obstruction. Methods Ninety-five cases of bowel obstruction treated from January 2007 to July 2010 were divided into study group (48 cases) and control group (47 cases) by random digits table. Patients in control group received the conventional therapy including fasting, gastrointestinal decompression, total parenteral nutrition, sufficient fluid infusion, water-electrolyte and acetic-alkali equilibrium maintenance and infection prevention, while patients in study group received octreotide 0.1 mg by subcutaneous injection on the base of above conventional therapy, the clinical symptomatic relief time, gastrointestinal decompression volume,anus exhaust time, hospitalization time and effective power of both groups were observed and compared.Results The clinical symptomatic relief time, gastrointestinal decompression volume, anus exhaust time and hospitalization time in study group were all significantly lower than those in control group, the differences was statistically significant (P < 0.05); the effective power in study group was 97.9%(47/48),which was significantly higher than that in control group(87.2% ,41/47), the difference was statistically significant(P <0.05). There was no obvious adverse reactions occurred, the patients of treatment futility were therapied by surgery later. Conclusion Octreotide used to treat bowel obstruction has a reliable efficacy with low reverse reaction and deserves general application.
2.Reflection on enhancing medical humanitarian activities in clinical teaching
Changyan LU ; Guozhong JI ; Jinfan WANG
Chinese Journal of Medical Education Research 2013;(2):187-190
Enhancing medical humanitarian activities in clinical teaching is demanded by modern medicine and education.It contains the modern values of constructing a harmonious doctor-patientrelationship and adjusting to medical education and modern medical model development.We put forward several countermeasures such as establishing concept of respect for people,improving teachers'humanistic caring ability,strengthening management to enhance students' sense of responsibility,enhancing students' doctor-patient communication skills,and abiding by relevant laws and regulations in the current situation which lacks humanistic care,doctor-patient communication and legal concept.
3.Advances in antiradiation drugs
Kunping WANG ; Yong XU ; Changyan LI
Military Medical Sciences 2015;(6):464-467
Antiradiation drugs, also known as radioprotective agents, can prevent humans from radiation injury,reduce the clinical symptoms of radiation sickness,promote early recovery and reduce morbidity or mortality.Early developments of such agents focused on thiol synthetic compounds, such as amifostine (WR 2721).This compound reduced mortality, but its disadvantages, such as large use and high toxicity, limited its use in clinical practice.To find a suitable radioprotective agent is crucial to reducing side effects induced by ionizing radiation and increasing survival rate in patients during radiotherapy.In this paper, the classification and mechanism of radioprotective agents are reviewed and future developments in this field are predicted.
4.The early nutritional support strategies and postnatal growth in extremely low birth weight infants——trends of the last decade
Meiying QUAN ; Changyan WANG ; Yu ZHANG ; Zhenghong LI ; Danhua WANG
Chinese Journal of Neonatology 2017;32(3):180-184
Objective To evaluate the nutritional status of extremely low birth weight (ELBW) infants and the effects of nutritional support strategy alterations on their growth during hospitalization.Method From 2005 to 2014,clinical data of ELBW infants admitted to the neonatal intensive care unit (NICU) in our hospital were retrospectively analyzed.The clinical data included their general status,enteral and parental nutritional support strategy and complications during hospitalization The patients were assigned into pre5 group and late5 group.Those who survived and discharged from 2005 to 2009 were the pre5 group,and those who survived and discharged fromn 2010 to 2014 were the late5 group.The independent t test and chi square test were used for statistical analysis.Result A total of 58 ELBW infants were enrolled in the study,including 18 patients in the pre5 group and 40 in the late5 group.No statistically significant differences existed between the two groups on gestational age,birth weight,Z score (weight for length and gender),birth length,head circumference and main complications during hospitalization (P >0.05).Pre5 group had higher incidence of small for gestational age (SGA) than late5 group (16/18 vs.25/40,P =0.037),while the EUGR ratio at discharge (14/18 vs.21/40,P =0.061) was similar.When compared with pre5 group,late5 group had larger amount of initial enteral feeding volume [4.4 ml/(kg · d) vs.2.4 ml/(kg · d),P =0.014] and feeding volume at the end of the first week [(19.8 ± 16.0) ml/(kg · d) vs.(12.2 ±9.5) ml/(kg · d),P =0.036].Similarly,the starting dose of amino acids in parenteral nutrition [2.0g/(kg· d) vs.1.0 g/(kg· d),P<0.001],maximum dose of amino acids [4.0g/(kg.d) vs.3.5 g/(kg · d),P < 0.001],total calories at the end of the first week [(82.6 ± 12.6) kcal/(kg · d) vs.(71.1±15.2) kcal/(kg· d),P=0.004] and the second week [(103.7 ±19.8) kcal/(kg· d) vs.(92.3 ± 17.9) kcal/(kg · d),P =0.041],the weight gain velocity from birth to discharge [(18.7 ± 2.9) g/(kg.d) vs.(16.9±2.8) g/(kg· d),P=0.031] and change of Z scores (AZ) [-0.6 (-1.0,-0.4) vs.-1.2 (-1.6,-0.8),P =0.004] showed significantl differences between the two groups,with better outcomes in late5 group.However,the duration of parenteral nutrition,the total amount of amino acids,the time reaching total enteral feeding,the length of hospital stay were similar between the two groups.Ten cases(61.1%)of infants in pre5 group were breastfed,and four of them used human milk fortifier (HMF) (fortified rate was 22%).32 cases (80%) in late5 group were breastfed and 23 cases used HMF (fortified rate was 57.5%).The time to initiate HMF in the late5 group was at (30.2 ± 13.2) days,and human milk amount was (89.9 ± 34.5) ml/kg,fortified duration was (32.8 ± 15.7) days.Conclusion The enteral feeding strategy were more vigorous in the last 5 years than before,the initial feeding volume,the increasing rate,the initial dosage of amino acid,and maximum dosage of amino acid had been increased.Human milk and HMF of preterm infants were preferred.The vigorous nutritional support strategy were effective for the weight gain of ELBW infants without obvious side effects during hospitalization.
5.Simultaneous Determination of Phenolic and Salicylanilide Anthelmintics Multi-residues in Cattle and Ovine Tissues by HPLC-MS/MS
Shuaipeng LI ; Xianhui HUANG ; Wei WANG ; Changyan YAN ; Xiangkai KONG
Chinese Journal of Analytical Chemistry 2014;(3):423-428
A high performance liquid chromatography-tandem mass spectrometric( HPLC-MS/MS) method was developed for the simultaneous determination of four phenolic and salicylanilide anthelmintics including nitroxinil, oxyclozanide, closantel and rafoxanide in cattle and ovine tissues. Muscle, liverand kidney were extracted with acetonitrile-acetone(60:40, V/V)and fat with 1% triethylamine in acetonitrile, then the extract was purified with MAX solid-phase extraction column. Qualitative and quantitative analysiswas achieved by HPLC-MS/MS undernegative multiple reaction monitoring ( MRM) mode. Good correlation coefficients were obtained (R>0. 99) in the concentration range of 1-100 μg/L. The limits of detection (LOD) and limits of qualification (LOQ) for the four compounds were 1 and 2. 5 μg/kg, respectively. The mean recoveries at the four levels of LOQ, 0. 5 maximum residue limit (MRL), MRL, 2MRL were between 71% and 112%,with the intra-day relative standard deviation(RSD)in the range of 1. 1%-14. 0%and inter-day RSD in the range of 6. 4%-14. 7%. Forty samples from the market were analyzed with the method, only two samples were found to show phenolic and salicylanilide anthelmintics residues.
6.One neonate with bullae of lung whose mother diagnosed with Goodpasture's syndrome during pregnancy:case report and review of the literatures
Lejia ZHANG ; Guofang DING ; Changyan WANG ; Jing SHEN ; Zhenghong LI
Chinese Journal of Perinatal Medicine 2015;(7):527-532
Objective To summarize the clinical features and possible impacts of Goodpasture's syndrome in pregnancy on the pulmonary and kidney of the newborn and the mothers. Methods One patient diagnosed Goodpasture's syndrome in pregnancy hospitalized in Peking Union Medical College Hospital on August 23 in 2011 delivered a neonate with bullae of lung. And literatures including 8 cases of pregnancy complicated by Goodpasture's syndrome worldwide through Medline were reviewed. Results (1) Case report:one 31-year-old women presented with acute renal failure at 30+6 weeks of gestation and delivered a male infant with birth weight 1 900 g by caesarean section at 31+1 weeks of gestation. Diagnosis was confirmed as Goodpasture's syndrome with anti-glomerular basement membrane(GBM) antibodies in serum and renal biopsy after delivery. Then she was treated with methylprednisolone, cyclophosphamide, plasmapheresis and dialysis. The neonate showed the lung bullae in the right middle lobe and bilateral intraventricular hemorrhage but renal function was transient normal with anti-GBM as 113.1 EU/ml. The baby was treated by glucocorticoid for two months and clinical symptoms were improved. Anti-GBM antibodies and chest CT showed normal. After been followed up for two years, the baby was normal. (2) Literatures review:the main manifestations of Goodpasture's syndrome in pregnancy were malignant hypertension and renal failure but respiratory symptoms were not obvious. Treated with plasmapheresis, hematodialysis and glucocorticoid maybe have good effects. Most cases had premature delivery. Neonatal anti-GBM antibodies coming from mothers could result to cerebral, renal and pulmonary injury which could be treated by glucocorticoid. Conclusions The Clinical features of pregnancy complicating the Goodpasture's syndrome are malignant hypertension and renal failure. Diagnosis was depended on positive anti-GBM antibodies and renal pathological changes and treatment were depended on plasmapheresis, hematodialysis and glucocorticoid. Neonatal cerebral, renal and pulmonary injury resulting from anti-GBM antibodies coming from mothers should be followed up, and glucocorticoid should be taken if necessary.
7.Clinical significance of IL-17 in peripheral blood of patients with rheumatoid ar-thritis
Changyan CHE ; Guohua ZHANG ; Junping LIU ; Mingliang WANG
Chinese Journal of Immunology 2014;(10):1405-1407
Objective:To explore the role and significance of IL-17 on the pathogenesis of rheumatoid arthritis ( RA).Methods:The levels of IL-17 mRNA in peripheral blood mononuclear cell ( PBMC) of 66 RA patients (32 active,34 inactive) and 44 healthy controls were detected by reverse transcription-polymerase chain reaction ( RT-PCR ).The levels of serum IL-17 were detected by enzyme-linked immunosorbent assay ( ELISA).The levels of RF were detected by immunoturbidimetric assay.The correlations of serum IL-17 and RF were analyzed.Results: In RA patients the levels of IL-17 mRNA in PBMC were significantly higher than those in healthy controls ( P<0.05 ) , but there was no difference between the active and inactive RA ( P>0.05 ).The serum IL-17 levels in active RA patients were significantly higher than those in inactive RA patients and healthy controls ( P<0.05 ).The levels of serum IL-17 were positively correlated with RF in RA patients.Conclusion: IL-17 and RF play an important role in the pathogenesis and pathology process of RA ,and IL-17 may be associated with RA activity.
8.Blood compatibility of an axial-flow blood pump made in China:Verifying observation
Changyan LIN ; Guanghui WU ; Bingyi LI ; Xiaotong HOU ; Jing WANG ; Xiangyue ZHOU ; Hongjiu PAN
Chinese Journal of Tissue Engineering Research 2007;11(48):9809-9812
BACKGROUND: Axial-flow blood pump is a main pump for ventricle assistance. Previous researches demonstrate that poor hemocompatibility of blood pump is an important factor for hemolysis and thrombus.OBJ ECTTVE: To design an axial-flow blood pump based on previous kinds of blood pumps through changing whole appearance and impeller shape of the pump by using Computer-Aided Design CAD) and Computational Fluid Dynamics (CFD), and manufacture it successfully.DESIGN: Rationality of theoretical design was verified by practical tests.SETTTNG: Beijing Anzhen Hospital of Capital University of Medical Sciences Department of Biomedical Engineering,Beijing Institute of Heart, lung and Blood Vessel Diseases; the Faurteenth Institute of China-Aerospace Science and Industry Corporation.MATERIALS: Body of blood pump and impeller were titanium alligation, and shaft bearing was ceramic. Test in vitro was accorded to artificial ventricular assist device which was provided by Department of Biomedical Engineering, Beijing Anzhen Hospital of Capital University of Medical Sciences. Experimental goats were provided by Experimental Animal Center, Beijing Anzhen Hospital of Capital University of Medical Sciences.METHODS: Since the beginning of 2005, a model of axial flow blood pump was designed in the 14th Institute of China-Aerospace Science and Industry Corporation base on decreasing shearing force and circulating dead bands. In the process, CAD and CFD were used to generate the geometrical data document of pump's structure, which included the figures of pump's body, shape and number of impeller's vanes, the structure and position of the guide vanes, and the size of impeller's screw-pitch. And then, NC machine tool was used for shaping. Finally, axial-flow blood pump was fixed on artificial ventricular assist device which was provided by Department of Biomedical Engineering, Beijing Anzhen Hospital of Capital University of Medical Sciences. The pump's hemodynamic output was 5 L/min and the average pressure was 13.3 kPa under the mixture of glycerin and water and fresh anticoagulation goat blood. The samples were collected at every one half hour during pumps being pumping for 4 hours. According to testing pressure output of blood pump, normalized index of hemolysis (NIH) was used to reflect content of free hemoglobin in plasma, observe thrombogenesis in pump and verify pump's hemodynamic output and vascular damaging degree.RESULTS: Shaped axial-flow blood pump included body, impeller, guide vanes, ceramic shaft bearing, export and import. The volume was 63 mL. Experimental results in vitro indicated that when the rotation speed of blood pump was 10 000 r/min, its pressure and flow output were 21.01 kPa and 6.0 L/min. The hemodynamic output might satisfy for left ventricular assistance. Surface temperature did not change obviously during successive rotation. The calculation indicated that most parts in blood pump showed a streaming flow. The mean NIH was (0.047±0.017) g/100 L, which was less than that of previous pumps; while, thrombogenesis was not observed in blood pump.CONCLUSTON: Axial-flow blood pump designed by using CAD and CFD can not only satisfy for the hemodynamics of a left ventricular assistant devices, but also the blood damage is milder than previous pumps. Therefore, axial-flow blood pump improves blood compatibility.
9.An investigation of coal-burning type endemic fluorosis in Fuyuan County of Yunnan Province
Kailian HUANG ; Anwei WANG ; Changyan PENG ; Liangjing SHI ; Zhihua ZHAO ; Yuxi GUO ; Haitao ZHANG
Chinese Journal of Endemiology 2016;(1):38-42
Objectives To study the prevailing status of coal-burning type endemic fluorosis in Fuyuan County of Yunnan Province, and to provide a scientific basis for fluorosis control and prevention. Methods In 2013, five towns were selected from the villages and towns which the defluoridation stove project was implemented and by the end of 2007 defluoridation stove rate was higher than 95%(including 95%), and two natural villages were selected in each township to carry out the investigation. Dental fluorosis was examined of all children aged 8 to 12 of survey points. At least 20 people were selected in each village. At the same time, 20 copies of instant urine samples were collected from these children of half male and half female, and urinary fluoride was determined. Then five natural villages were sampled from all survey points, and permanent residents were divided into25-,35-,45-,55-and≥65groups according to age. Six people were selected from each group with male and female in half who were conducted examination of adult skeletal fluorosis by X-ray. Dental fluorosis diagnosis was based on theDental Fluorosis Diagnosis(WS/T 208-2011). Urinary fluoride determination was done in accordance withUrine-Determination of Fluoride-Ion Specific Electrode Method(WS/T 30-1996). Skeletal fluorosis diagnosis was carried out according to Diagnostic Criteria for Endemic Skeletal Fluorosis (WS 192-2008). Results A total of 556 children aged 8 to 12 were monitored, the detection rate of dental fluorosis was 41.55%(231/556), the dental fluorosis index was 0.78. The very mild, mild, moderate and severe proportions of children's dental fluorosis were 20.50%(114/556), 17.09%(95/556), 3.60%(20/556) and 0.36%(2/556), respectively, given priority to very mild. The prevalence of dental fluorosis in children was increased with increasing age (χ2=74.27, P<0.05). One hundred and ninety-three copies of child urine samples were tested, the geometric mean of urinary fluoride was 0.62 mg/L, and the urinary fluoride contents were between 0.10-2.93 mg/L. A total of 116 adults were examined, and the detection rate of skeletal fluorosis was 9.48%(11/116). Detected cases of skeletal fluorosis was given priority to mild (9 cases, accounted for 81.81%), more men cases [16.36% (9/55)] than those of women [3.28% (2/61), χ2 = 5.77, P< 0.05]. Conclusion The hazard of coal-burning type fluorosis has been reduced in Fuyuan County , the affect of defluoridation stove project is obvious.
10.Blood cell and electrolyte change in diagnosis and surgical treatment of Cushing's disease
Xiuhua SHI ; Changyan FAN ; Qingfang SUN ; Liuguan BIAN ; Weiguo ZHAO ; Fukang SUN ; Weiqing WANG ; Guang NING
Journal of Endocrine Surgery 2011;05(5):323-326
Objective To evaluate the diagnostic significance of blood cells and electrolyte in preoperative diagnosis and surgical treatment of Cushing's disease (CD).Methods 116 csses of CD and 21 cases of adrenocortical adenoma (ACA) patients pathologically proven adrenocorticotropic hormone (ACTH) adenoma from Jan.2003 to Dec.2010 were enrolled into the study.They were given transsphenoidal surgery (TSS) and laparoscopic resection of adrenal adenoma (LRAA).Patients were divided into remission group ( group A),non-remission group (group B) and ACA group (group C) according to the remission criteria of CD.The preoperative and postoperative level of blood cells and electrolyte were determined.Results TSS treatment improved the abnormal level of blood cells and electrolyte in patients with CD.Group A had significant change in preoperative and postoperative level of blood cells and electrolyte,while group B and group C didn't.Conclusions Compared with the endocrine examination items which need huge expense and harsh conditions,the change of blood cells and electrolyte level is more superior in assessing diagnostic and cruative effects on CD patients.