1.The reform and practice in teaching anesthetic pharmacology
Chinese Journal of Medical Education Research 2003;0(04):-
Anesthetic pharmacology is a bridge subject that connects preclinical medicine with clinical medicine,and multiple methods of teaching in this subject would play an vital role in training student’s idea of scientific research and creativity.Combining modern teaching means with clinical medicine is an evaluative tendency for education of anesthetic pharmacology in the future.
2.The effects of glucocorticoid on myocardial apoptosis in septic rats
Hanyu ZHANG ; Lipei YANG ; Miaorong XIE
Chinese Journal of Emergency Medicine 2014;23(10):1105-1108
Objective To observe the occurrence of myocardial apoptosis and discussing the mechanism of the effects of glucocorticoid on myocardial apoptosis in septic rats in order to provide the rationale for clinical strategy.Methods A total of 60 Wistar rats weighing 230-280 g were randomly (random number) divided into control group and experimental group (n =30 in each group).Cecal ligation and puncture (CLP) was performed in rats to induce sepsis,and Cefoperazone Sodium/Sulbactam Sodium (200 mg/kg) was injected into caudal vein 4 hours after CLP,twice a day.In addition,glucocorticoid was given to rats of experimental group.After rats sacrificed,their left ventricular myocardia were rapidly taken out and myocardial apoptosis rate was measured and the level of Bcl-2 was assayed at 6 h,24 h,and 72 h after CLP.Measured data were analyzed with independent-samples t-test and One-Way ANOVA.Results The rates of myocardial apoptosis in experimental group were obviously lower than those in control groups respectively (F=9.11,t=5.681,P<0.01) (6ht=11.416,P<0.01; 24ht=6.217,P<0.01; 72 h t =3.76,P <0.01).The rates of myocardial apoptosis in 24 h in control and 72 h control groups were distinctively higher than those in 6 h control group,respectively (F =13.254,sig =0.000,P <0.01 ; sig =0.004,P < 0.01).The rates ofmyocardial apoptosis in group 24 h control were higher than those in 72 h control group (sig =0.039,P < 0.05).The rates of myocardial apoptosis make no difference among experimental group (F =2.488,6/24 h sig =0.132,P > 0.05 ; 24/72 h sig =0.549,P > 0.05 ; 6/72 h sig =0.053,P > 0.05).Conclusions The rate of myocardial apoptosis is peaked at 24 h in sepsis rat,and the rate of myocardial apoptosis can be obviously decreased by administration of glucocorticoid.
3.Efficacy ofα-Lipoic Acid Treatment on Sepsis-induced Acute Kidney Injury in Rats and Its Mechanisms
Guofu LI ; Yang ZHAO ; Mengjie ZHU ; Hanyu QIN ; Bin ZANG
Journal of China Medical University 2015;(7):577-580
Objective To investigate the impact ofα?lipoic acid(ALA)treatment on sepsis?induced acute kidney injury in rats and explore the mechanisms. Methods A total of 32 male SD rats were randomized into 4 groups:normal control group(group A),ALA?treated control group (group B),sepsis group(group C)and sepsis with ALA treated group(group D). Group A and B underwent sham operation,while CLP operations were conducted in group C and D. Rats in both group B and group D were then administered with 200 mg/kg ALA by oral gavage immediately after the surgical procedure. Twenty?four hours after the surgical procedure blood samples were obtained for the evaluation of creatinine,BUN,TNF?α,IL?6 and IL?1β. Rat kidneys were rapidly removed for PAS stain. Western blot was employed to determine the expression of NF?κB. Results Pathologi?cal changes of kidney were induced by sepsis and the level of creatinine,BUN,TNF?α,IL?6 and IL?1βwere significantly increased by 178%,66%, 55%,114%and 110%(P<0.01). respectively;simultaneously the phosphorylation and nuclear expression of NF?κB p65 in kidney tissues were significantly increased by 144%and 102%(P<0.01). Sepsis?induced acute kidney injury also significantly reduced the expression of IκBαby 61%(P<0.01). These changes were significantly suppressed by early ALA treatment. Compared with C group,the level of creatinine,BUN,TNF?α,IL?6 and IL?1βwere significantly decreased by 48%,26%,25%,37%and 40%(P<0.05),respectively,and the relative expression of IκBαwas increased by 103%(P<0.05). Conclusion The present study demonstrated that ALA can suppress the activation of NF?κB,thus ameliorat?ing sepsis?related acute kidney injury.
4.Comparison of clinical features and prognosis between patients with early-stage NK/T-cell lymphoma originating from nasal cavity and Waldeyer's ring
Shaoqing NIU ; Yujing ZHANG ; Yong YANG ; Qing XIA ; Ge WEN ; Hanyu WANG ; Yunfei XIA
Chinese Journal of Radiation Oncology 2013;22(5):352-356
Objective To investigate the differences in clinical features and prognosis between patients with stage Ⅰ E-Ⅱ E nasal cavity natural killer (NK)/T-cell lymphoma (NC-NKTL) and Waldeyer's ring NK/T-cell lymphoma (WR-NKTL).Methods A retrospective analysis was performed on 273patients with NK/T lymphoma who were initially treated in our hospital from January 1991 to December 2011.Of these patients,184 had Ann Arbor stage Ⅰ E disease,and 89 had stage Ⅱ E disease;209 had NCNKTL,and 64 had WR-NKTL.A total of 258 patients (94.5%) were first treated with chemotherapy.The majority of patients received CHOP or CHOP-like chemotherapy.The median dose of radiotherapy was 54Gy.Results Compared with NC-NKTL patients,WR-NKTL patients had significantly higher percentages of individuals in stage Ⅱ E and individuals with B symptoms (P <0.05 for both).The overall response rates of the two groups after treatment were similar (88.7% vs 87.9%,P =0.869).The follow-up rate was 96.3%.196 patients were followed up for at least 5 years.The 5-year overall survival (OS) and progression-free survival (PFS) were 52.6% and 41.4%,respectively.The 5-year OS of NC-NKTL patients was nonsignificantly higher than that of WR-NKTL patients (57.0% vs 39.0%,P =0.062),while the 5-year PFS of NC-NKTL patients was significantly higher than that of WR-NKTL patients (46.7% vs 25.8%,P =0.019).Conclusions Patients with early-stage WR-NKTL are more prone to systemic symptoms and cervical lymph node metastasis and have poorer prognosis,as compared with patients with early-stage NC-NKTL,so radiotherapy and prophylactic irradiation should be considered in early stage.
5.Outcomes and prognostic factors in patients with primary bone lymphoma
Ge WEN ; Hanyu WANG ; Yujing ZHANG ; Ling CAI ; Yong YANG ; Yunfei XIA ; Xunxing GUAN ; Mengzhong LIU
Chinese Journal of Radiation Oncology 2011;20(4):313-316
Objective To retrospectively analyze the treatment results and prognostic factors in patients with primary bone lymphomas (PBL).Methods Thirty-one patients with PBL treated between April 1994 and May 2009 at Sun Yat-sen University Cancer Center were analyzed.All patients were diagnosed by pathology.Twenty-two patients had stage Ⅰ E, 4 patients had stage Ⅱ E and 5 patients had stage ⅣE diseases.One patient was treated with surgical resection alone, 1 patient with radiotherapy (RT) alone, 2 patients with chemotherapy (CT) alone and 4 patients with resection followed by chemotherapy.The remaining 23 patients received CT combined with RT.The median radiation dose was 50 Gy.Results The median follow-up time was 45.2 months.The follow-up rate was 83.9%.Nine patients had a follow-up time of 10 years.The 5-year and 10-year overall survival rates were 92% and 92%, respectively.The 5-year and 10-year disease-free survival rates were 79% and 70%, respectively.In the group who received non-combined chemoradiotherapy, the complete response rate was 50%, the incidence of progression or recurrence was 2/8 and the median recurrence time was 6.8 months.In the group who received combined chemoradiotherapy, the complete response rate was 65%, the incidence of progression or recurrence was 13% and the median recurrence time was 39.1 months.In univariate analyses, favorable prognostic factors for survival included age≤50 years (χ2=5.32,P=0.021) and ECOG PS score 0-1(χ2=5.48,P=0.019).Favorable prognostic factors for DFS included IPI score≤1(χ2=7.81,P=0.005) and ECOG PS score 0-1(χ2=18.70,P=0.000).Conclusions Treatment results of patients with PBL can be generally well.CT combined with RT appears to be the treatment of choice.RT dose ≥40 Gy is safe and feasible.Younger age and better performance status are associated with a better outcome.
6.The Karamay community alcohol abuse and self-rated health status survey
Heyuan CHEN ; Hanyu ZHANG ; Chongsi ZHAO ; Xinyi GAO ; Rongping WANG ; Peiwen CHEN ; Fengchi YANG
Chinese Journal of Behavioral Medicine and Brain Science 2012;21(4):340-342
ObjectiveTo investigate the health status and incidence of alcohol abuse of Xinjiang community residents.MethodsThrough multi-stage random sampling,1992 community residents ( 15-65years old) were assessed using socio-demographic information questionnaire,alcohol use disorders identification test (AUDIT) and self-rated health measurement scale-prior test(SHRMS).Single factor analysis and rank sum test were used to identify the incidence of alcohol abuse,the distribution of different populations,and the self-rated health status of abusers.ResultsTotally 298 cases of alcohol abuse were identified,and accordingly,the prevalence rate of alcohol abuse for general population was 15.1% ( male 26.4%,female 4.8% ).Key factors for alcohol abuse included male,middle-aged,well-educated,at work,administrative work,high income levels and large number of household.The differences among groups were statistical significant.Presumably the workplace population was at high risk of alcohol abuse.Alcohol abusers were significantly worse than general population in self-rated health status(P < 0.01 ),especially in mental health and social health.ConclusionThe incidence of alcohol abuse is relatively high in Xinjiang rcgion,and the problem need more attention.Further survey and early intervention work for highrisk group are advised to achieve the purpose of prevention and control.
7.Pharmacodynamics, pharmacokinetics and tissue distribution of liposomal mitoxantrone hydrochloride.
Caixia WANG ; Chunlei LI ; Xi ZHAO ; Hanyu YANG ; Na WEI ; Yanhui LI ; Li ZHANG ; Lan ZHANG
Acta Pharmaceutica Sinica 2010;45(12):1565-9
This study is to compare the pharmacodynamics, pharmacokinetics and tissue distribution of liposomal mitoxantrone (Mit-lipo) and free mitoxantrone (Mit-free). The antineoplastic effect of Mit-lipo was evaluated on PC-3 human xenograft tumor model after repeated intravenous injection at dose levels of 1, 2 and 4 mg x kg(-1). The pharmacokinetic study of Mit-lipo and Mit-free was performed on dogs following a single intravenous injection. The tissue distribution of Mit-lipo and Mit-free was observed on S-180 bearing mice after a single intravenous injection. (1) Pharmacodynamics: Mit-lipo dose-dependently inhibited PC-3 tumor growth at a dose ranging from 1 to 4 mg x kg(-1). The antitumor effect studies showed that Mit-lipo significantly improved the therapeutic effect in comparison with free drug. (2) Pharmacokinetics: in comparison with Mit-free, the AUC and t(1/2) values of Mit-lipo at the same dose level were higher than those of Mit-free in Beagle dogs. The results showed that Mit-lipo had long circulation characteristics. (3) Tissue distribution in S-180 bearing mice: compared to Mit-free, Mit-lipo preferentially accumulated into tumor zones instead of normal tissues. Tumor AUC in Mit-lipo treated animals was 8.7 fold higher than that in mice treated with the same dose of Mit-free. The Cmax values of Mit-lipo in heart, kidney, lung, spleen and intestinal tissue in Mit-lipo were 30.2%, 161.6%, 20.2%, 27.9% and 78.3% lower than those of Mit-free, respectively. The pharmacokinetics and tissue distribution of Mit-lipo changed obviously, thus increasing therapeutic effect and improving drug therapeutic index.
8.Characteristics of Thromboelastography in Patients with Advanced Pregnancy Complicated with Severe Preeclampsia
Jia JIA ; Qiaoni YANG ; Zifang ZHAO ; Hanyu QIN ; Qiushi WANG ; Bin ZANG
Journal of China Medical University 2016;45(12):1105-1109
Objective To analysis the characteristics of thromboelastography and coagulation test in patients with advanced pregnancy combined with severe preeclampsia. Methods A retrospective single?center study was conducted. 35 patients with advanced pregnancy combined with se?vere preeclampsia who were admitted to hospital from January 2012 to December 2014 were analyzed compared to 43 third trimester patients with?out any complication. All the patients were treated based on the routine strategy. Blood sample were taken from the middle elbow vein to test blood cell count,serum biochemistry test,routine coagulation test and thromboelastography. All the results,including R,K,CI,α?angle and MA value, were compared between two groups. Analysis was performed to evaluate the correlation between all parameters of TEG and coagulation test. Re?sults There was no statistical significance between two groups in age ,prothrombin time and activated partial prothrombin time. In the severe pre?eclampsia group,the R value of TEG was increased(5.21±1.20 min vs 6.19±1.55 min,t=-3.144,P=0.002),α?angel was decreased(64.43°± 7.90° vs 60.37°±7.09°,t=2.367,P=0.02),and CI was decreased(0.81±2.27 vs-0.37±1.82,t=2.495,P=0.015). In blood cell count test,the platelets count was decreased in severe preeclampsia group[(217.48±65.68)×109/L vs(166.65±61.39)×109/L,t=3.500,P=0.001]. In routine coagulation test,only thrombin clotting time was increased in severe preeclampsia group(14.59±0.51 s vs 15.28±0.97 s,F=-3.800,P<0.001). In serum biochemistry test,the albumin was decreased in severe preeclampsia group(34.75±3.90 g/L vs 28.77±4.05 g/L,t=6.632,P<0.001),while serum urea nitrogen was increased(2.78±0.87 mmol/L vs 5.98±8.07 mmol/L,F=-2.333,P=0.026). In correlation analysis,thrombin clot?ting time had relationship between R(r=0.290,P=0.010),CI(r=-0.257,P=0.023)andα?angle(r=-0.243,P=0.032). Platelets count cor?related with CI(r=0.383,P=0.001),K(r=-0.409,P<0.001),α?angle(r=0.375,P=0.001)and MA(r=0.512,P<0.001). Conclusion For those who suffered from severe preeclampsia patients with advanced pregnancy,low coagulation function occurs in most of the patients com?pared to those patients without any complications. Thromboelastography may be helpful for those who have high risk factors ,especially with low platelets count and increased thrombin clotting time ,so as to reduce the incidence of bleeding or thromboembolic diseases.
9. The diagnostic performance of version 2018 LI-RADS for hepatocellular carcinoma on Gd-EOB-DTPA enhanced MRI
Caiwei YANG ; Hanyu JIANG ; Bin SONG ; Jie CHEN
Chinese Journal of Radiology 2019;53(12):1060-1064
Objective:
To explore the diagnostic performance of the most recent 2018 version of liver reporting and data system (LI-RADS) on gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) enhanced MRI to diagnose hepatocellular carcinoma (HCC) in high-risk patients.
Methods:
From July 2015 to September 2018, 130 consecutive high-risk patients with 134 focal liver lesions were retrospectively enrolled in our center and underwent Gd-EOB-DTPA-enhanced MRI and subsequent hepatectomy within 1 month. Two independent radiologists blindly reviewed the preoperative MR images of all patients, and determined the presence of major features, ancillary features and the LI-RADS categories according to the version 2018 LI-RADS of each liver observation. The sensitivity, specificity, positive predictive value, negative predictive value, Youden index and accuracy of the 2018 version of LI-RADS were evaluated with postoperative histopathological results as references. The inter-observer agreement between the two radiologists was tested by Kappa analysis.
Results:
The Kappa value of the LI-RADS categories between two radiologists was 0.628 (95
10.The diagnostic performance of version 2018 LI?RADS for hepatocellular carcinoma on Gd?EOB?DTPA enhanced MRI
Caiwei YANG ; Hanyu JIANG ; Bin SONG ; Jie CHEN
Chinese Journal of Radiology 2019;53(12):1060-1064
Objective To explore the diagnostic performance of the most recent 2018 version of liver reporting and data system (LI?RADS) on gadolinium?ethoxybenzyl?diethylenetriamine pentaacetic acid (Gd?EOB?DTPA) enhanced MRI to diagnose hepatocellular carcinoma (HCC) in high?risk patients. Methods From July 2015 to September 2018, 130 consecutive high?risk patients with 134 focal liver lesions were retrospectively enrolled in our center and underwent Gd?EOB?DTPA?enhanced MRI and subsequent hepatectomy within 1 month. Two independent radiologists blindly reviewed the preoperative MR images of all patients, and determined the presence of major features, ancillary features and the LI?RADS categories according to the version 2018 LI?RADS of each liver observation. The sensitivity, specificity, positive predictive value, negative predictive value, Youden index and accuracy of the 2018 version of LI?RADS were evaluated with postoperative histopathological results as references. The inter?observer agreement between the two radiologists was tested by Kappa analysis. Results The Kappa value of the LI?RADS categories between two radiologists was 0.628 (95%CI: 0.565 to 0.691). The sensitivity, specificity, Youden index values and accuracy of LR?5 by the two reviewers were 80.4% (78/97), 87.6% (85/97); 75.7% (28/37), 73.0% (27/37); 0.560 8, 0.605 9; 79.1% (106/134), 83.6% (112/136), respectively. These measures of LR?4+LR?5 were 91.8% (85/97), 96.9% (94/97); 67.6% (25/37), 67.6% (25/37); 0.605 9, 0.644 6; 82.1% (110/134), 88.8% (119/134), respectively. Conclusion Version 2018 LI?RADS demonstrated high sensitivity and accuracy to diagnosis HCC in high?risk patients on Gd?EOB?DTPA enhanced MRI.