1.The relationship between hyperuricaemia and clinic pathology of IgA nephropathy
Mingji CUI ; Baohong ZHANG ; Qingfei XIAO ; Fulian ZHU ; Hongyue WANG
Chinese Journal of Internal Medicine 2011;50(8):659-663
objective To analyze the correlation between the level of serum uric acid and the clinical and pathological features of IgA nephropathy.Methods Totally 148 patients diagnosed as IgA nephropathy by renal biopsy in our hospital from January 2007 to December 2010 were divided into hyperuricaemic group(41 cases)and non-hyperuricaemic group(107 cases)according to the level of serum uric acid.The clinical parameters and renal pathology grade were compared.Results There were significant differences between hyperuricaemic group and non-hyperuricaemic group in the incidences of hypertension(63.4%vs 38.3%),disease duration[(18.90±10.12)months vs(9.46±3.91)months]and body mass index[(22.81±3.60)kg/m2vs(15.32±2.54)kg/m2](all P<0.05),while no differences in age and sex(both P>0.05).The blood urea nitrogen(BUN)[(8.93±4.28)mmol/L vs (5.21±2.18)mmol/L],creatinine(Cr)[(155.96±107.72)μmol/L vs(79.52±40.01)μmol/L],serum triglycerides[(2.11±1.06)mmoVL vs(1.86±1.20)mmol/L]and 24-hour urine protein amount [(4328.16±1434.25)mg/24 h vs(2885.10±1388.15)mg/24 h]were significantly different between the two groups(all P<0.05).The percentage of Lee's grade I+Ⅱin hyperuricaemic group was 12.2%,and IV+V grade was 39.0%,while percentage of Lee's grade I+Ⅱin non-hyperuricaemic group was 25.2%,and IV+V grade was 16.9%(P<0.05).Tubulointerstitial lesions(TIL)gradeⅢ+IV was more in hyperuricaemic group,which was 68.3%,while TIL grade II was more in non-hyperuricaemic group,which was 76.6%.Renal artery damage grade II+Ⅲ was more in hyperuricaemic group.which was 73.2%,while renal artery damage grade 0+1 was more in non-hyperuricaemic group,which was 69.2%.Conclusion The level of serum uric acid was related with 24-hour urine protein amount,blood pressure and kidney function in IgA nephropathy,and Lee's grade,TIL grade and renal artery damage grade were severe in hyperuricaemic group.
2.Relationship of PTSD after hypertensive intracerebral hemorrhage and rs806377 polymorphism of CNR1 gene in elderly patients
Fulian ZHU ; Fuyue YE ; Peiri LIANG ; Chuangliang ZHANG
Chinese Journal of Geriatric Heart Brain and Vessel Diseases 2023;25(10):1060-1064
Objective To construct a risk prediction model of post-traumatic stress disorder(PTSD)after hypertensive intracerebral hemorrhage in elderly patients and analyze the correla-tion of PTSD with rs806377 polymorphism of cannabinoid receptor 1(CNR1)gene.Methods A total of 215 elderly patients with hypertensive cerebral hemorrhage admitted to the Department of Neurology of Geriatric Hospital of Hainan and Department of Neurosurgery of the First Affiliated Hospital of Hainan Medical University from January 2020 to August 2022 were enrolled in this study.According to the results of PTSD scale(scoring>50 or 0~50)after surgical treatment,they were divided into PTSD group(43 cases)and non-PTSD group(172 cases).The rs806377 polymorphism of CNR1 gene was detected in both groups by gene sequencing.Univariate and mul-tivariate logistic regression analyses were used to analyze the susceptibility to PTSD among the elderly after hypertensive intracerebral hemorrhage.Another 103 elderly patients with hyperten-sive intracerebral hemorrhage during the same period were also subjected and served as verifica-tion set.A prediction model was constructed.Results There were significant differences in age,family annual income,blood loss amount,psychological resilience score and social support score between the PTSD group and non-PTSD group(P<0.05,P<0.01).The PTSD group had obvi-ously larger proportion of TT genotype carriers and higher T allele frequency than the non-PTSD group(P<0.05,P<0.01).Logistic regression analysis showed that age(OR=2.020,95%CI:1.115-3.658),family annual income(OR=1.799,95%CI:1.232-2.626),blood loss(OR=1.507,95%CI:1.243-1.826),psychological resilience score(OR=2.059,95%CI:1.068-3.969),social support score(OR=1.664,95%CI:1.122-2.467),rs806377 TT genotype(OR=1.861,95%CI:1.485-2.331)and rs806377 T allele(OR=3.777,95%CI:2.049-6.962)were the influencing fac-tors of postoperative PTSD in these patients(P<0.05,P<0.01).ROC curve analysis indicated that the sensitivity was 69.57%,the specificity was 71.25%,and the AUC value was 0.762(95%CI:0.708-0.813)in the verification group,indicating a certain accuracy of our model.Conclusion CNR1 gene rs806377 locus polymorphism is an influencing factor for PTSD susceptibility,and rs806377 TT genotype and rs806377 T allele can predict PTSD in elderly patients after hyperten-sive intracerebral hemorrhage.
3.FACE-Q scale assessment of surgical outcomes in robot-assisted mandibular angle osteotomy
Xuran ZHU ; Gang LI ; Gang CHAI ; Baoxi MENG ; Fulian MA
Chinese Journal of Plastic Surgery 2024;40(10):1073-1079
Objective:To assess the effectiveness of robot-assisted mandibular angle osteotomy using the FACE-Q questionnaire.Methods:A randomized controlled clinical study was conducted in the Second Affiliated Hospital of Zhengzhou University from January 2022 to June 2023. Patients with mandibular angle hypertrophy aged 18 to 40 years old were recruited as research objects, and a randomization and supply management system (Clinflash IRT 2.0) was used to randomly assign the experimental group and control groups in a 1∶1 ratio. Before surgery, Mimics 21.0 software was used to plan the surgical approach and determine the osteotomy plane based on the head CT data of the two groups. The experimental group underwent robot-assisted mandibular angle osteotomy according to the preoperative osteotomy plan, while the control group underwent traditional manual mandibular angle osteotomy according to the preoperative design. Six months after surgery, patients filled in the FACE-Q craniofacial module scale to evaluate the surgical effect, covering 12 indicators in four aspects: appearance satisfaction (including face, jaw and smile), health-related quality of life (including appearance anxiety, psychology, social interaction and speech), postoperative function (including breathing, diet, face and pronunciation), and adverse reactions. Each indicator was scored from 0 to 100 points, with higher scores indicating better evaluation. SPSS 27.0 software was used to process the data, and the measurement data of normal distribution were expressed by Mean±SD, and t-test was used for comparison between groups. The measurement data of non-normal distribution were expressed by M ( Q1, Q3), and Mann-Whitney U test was used for the comparison between groups. P<0.05 was considered statistically significant. Results:The experimental group included 20 patients, 3 males and 17 females, with an age of (27.6±4.4) years (19 to 38 years); the control group included 20 patients, 4 males and 16 females, with an age of (27.4±3.9) years (19 to 35 years). Six months postoperatively, all patients in both groups had good wound healing, and the mandibular hypertrophy was improved to varying degrees. There were no complications such as facial paralysis, facial deviation, or pain. The FACE-Q questionnaire results showed that in terms of appearance satisfaction, the scores for the three indicators of face, mandible, and smile in the experimental group were (72.2±11.7), 86(77, 92), and (63.2±9.5) points, respectively, all higher than those in the control group, which were (49.2±9.9), 43(35.5, 50), and (48.0±7.7) points, respectively, with statistically significant differences ( P<0.01 for all); in terms of health-related quality of life, except for speech, the scores for the three indicators of appearance anxiety, psychology, and social interaction in the experimental group were higher than those in the control group [(71.0±11.5) points vs.(49.1±10.3) points, (66.7±11.7) points vs.(45.4±10.5) points, (75.0±9.7)points vs.(56.4±8.5) points], with statistically significant differences ( P<0.01 for all); in terms of postoperative function, the score for eating in the experimental group was higher than that in the control group [(83.4±10.7) points vs.(71.0±14.9) points] ( P<0.01), but there were no statistically significant differences in the other three indicators ( P>0.05 for all); in terms of adverse reaction, there was no statistically significant difference between the two groups ( P>0.05). Conclusion:The result of the FACE-Q questionnaire assessment confirmed that robot-assisted mandibular angle osteotomy can significantly improve patients’ postoperative appearance satisfaction, psychological state, social adaptability, and eating function without increasing the incidence of complications.
4.Preoperative emergency nursing in the patients with mechanical prosthetic valve dysfunction
Jianmei FANG ; Meilan WANG ; Fulian WU ; Peilan ZHU
Chinese Journal of Modern Nursing 2014;20(8):926-928
Objective To explore the key points of preoperative emergency nursing in the patients with mechanical pros thetic valve dysfunction .Methods The clinical data from five patients with mechanical prosthetic valve dysfunction from March 2010 to November 2012 were retrospectively analyzed , and the key points of preoperative emergency nursing were summarized in the course of the disease .Results Four patients were recovered and discharged after they got the positive and effective rescue and accepted the valve replacement operation;one patient gave up further treatment because of serious condition .Conclusions The mechanical prosthetic valve dysfunction can lead to acute hemodynamic instability and eventually cause death of patients , and the valve replacement operation as the effective treatment should be carried out as early as possible .The preoperative intensive monitor and targeted emergency nursing can help patients to win the operative time and increase the chance of survival .
5.FACE-Q scale assessment of surgical outcomes in robot-assisted mandibular angle osteotomy
Xuran ZHU ; Gang LI ; Gang CHAI ; Baoxi MENG ; Fulian MA
Chinese Journal of Plastic Surgery 2024;40(10):1073-1079
Objective:To assess the effectiveness of robot-assisted mandibular angle osteotomy using the FACE-Q questionnaire.Methods:A randomized controlled clinical study was conducted in the Second Affiliated Hospital of Zhengzhou University from January 2022 to June 2023. Patients with mandibular angle hypertrophy aged 18 to 40 years old were recruited as research objects, and a randomization and supply management system (Clinflash IRT 2.0) was used to randomly assign the experimental group and control groups in a 1∶1 ratio. Before surgery, Mimics 21.0 software was used to plan the surgical approach and determine the osteotomy plane based on the head CT data of the two groups. The experimental group underwent robot-assisted mandibular angle osteotomy according to the preoperative osteotomy plan, while the control group underwent traditional manual mandibular angle osteotomy according to the preoperative design. Six months after surgery, patients filled in the FACE-Q craniofacial module scale to evaluate the surgical effect, covering 12 indicators in four aspects: appearance satisfaction (including face, jaw and smile), health-related quality of life (including appearance anxiety, psychology, social interaction and speech), postoperative function (including breathing, diet, face and pronunciation), and adverse reactions. Each indicator was scored from 0 to 100 points, with higher scores indicating better evaluation. SPSS 27.0 software was used to process the data, and the measurement data of normal distribution were expressed by Mean±SD, and t-test was used for comparison between groups. The measurement data of non-normal distribution were expressed by M ( Q1, Q3), and Mann-Whitney U test was used for the comparison between groups. P<0.05 was considered statistically significant. Results:The experimental group included 20 patients, 3 males and 17 females, with an age of (27.6±4.4) years (19 to 38 years); the control group included 20 patients, 4 males and 16 females, with an age of (27.4±3.9) years (19 to 35 years). Six months postoperatively, all patients in both groups had good wound healing, and the mandibular hypertrophy was improved to varying degrees. There were no complications such as facial paralysis, facial deviation, or pain. The FACE-Q questionnaire results showed that in terms of appearance satisfaction, the scores for the three indicators of face, mandible, and smile in the experimental group were (72.2±11.7), 86(77, 92), and (63.2±9.5) points, respectively, all higher than those in the control group, which were (49.2±9.9), 43(35.5, 50), and (48.0±7.7) points, respectively, with statistically significant differences ( P<0.01 for all); in terms of health-related quality of life, except for speech, the scores for the three indicators of appearance anxiety, psychology, and social interaction in the experimental group were higher than those in the control group [(71.0±11.5) points vs.(49.1±10.3) points, (66.7±11.7) points vs.(45.4±10.5) points, (75.0±9.7)points vs.(56.4±8.5) points], with statistically significant differences ( P<0.01 for all); in terms of postoperative function, the score for eating in the experimental group was higher than that in the control group [(83.4±10.7) points vs.(71.0±14.9) points] ( P<0.01), but there were no statistically significant differences in the other three indicators ( P>0.05 for all); in terms of adverse reaction, there was no statistically significant difference between the two groups ( P>0.05). Conclusion:The result of the FACE-Q questionnaire assessment confirmed that robot-assisted mandibular angle osteotomy can significantly improve patients’ postoperative appearance satisfaction, psychological state, social adaptability, and eating function without increasing the incidence of complications.