1.Establishment and Evaluation of Improved Hemisection Model of Spinal Cord Injury in Rats
Deri SUN ; Huiyuan HU ; Yue ZHU
Journal of China Medical University 2017;46(3):223-226,237
Objective To establish an improved hemisection model of spinal cord injury(SCI)in rats with less severe injury and increased sur-vival rate. Methods Female Sprague-Dawley rats(n=20)were randomly divided into 2 groups:standard and improved hemisection model of SCI. Basso-Beattie-Bresnahan(BBB)scores were carried out to determine the hindlimb locomotor function at 1 d,3 d,1 week and 2 weeks post SCI,respectively. In addition,duration of operation,blood loss,location of posterior midline,and success rate of spinal cord exposure during the second surgery were used as the main parameters to evaluate the significance of the new model. Results Compared with the standard hemisection model,the improved hemisection model of SCI exhibited shorter duration of operation,less blood loss,higher BBB score,more accurate location of posterior midline,and higher success rate of spinal cord exposure during the second surgery. Based on the improved hemisection model of SCI, transplantation model of scar tissue in spine cord was then successfully constructed with a success rate above 70%. Conclusion The improved hemisection model of SCI shows significant advantages in many aspects related to the operation,which is applicable to the study of SCI,especially the non-acute SCI.
2.Early oral feeding after colorectal surgery
Huiyuan WANG ; Yu FANG ; Yan ZHU ; Hong CHEN ; Lei YANG ; Dachuan LIU ; Fei LI
Chinese Journal of General Surgery 2009;24(7):550-553
Objective To investigate the safety,feasibility and effectiveness of early oral feeding after colorectal surgery. Methods A randomized controlled trial enrolled 47 patients undergoing elective open colorectal surgery from May 2007 to November 2007. The patients were randomized into group of early oral feeding (experimental group) or group of traditional oral feeding(control group). Postoperative course, gastrointestinal function, and complications were evaluated. Results No statistically significant differences were found in clinical characteristics including age, types of procedures, times of surgery or comorbidity between the two groups. There was no perioperative mortality in the two groups. Stoma1 leak occurred and progressed to abdominal abscess in one case in the control group. Passage of flatus and defecation after operation was earlier in experimental group than in control group(1.9 ± 0. 6 d vs. 2. 8 ± 0. 9 d,P <0. 01). Length of postoperative intravenous infusion was shorter in the experimental group (3. 8 ± 0. 9 d vs. 4. 8 ± 1.2 d,P < 0. 01). Length of postoperative stay was also shorter (9.0 ± 3.2 d vs. 10. 0 ± 3. 3 d, P = 0. 27) and the rate of abdominal distension was lower in experimental group(27% vs. 44%, P = 0. 23). The rate of nausea and vomiting was higher in the experimental group(31% vs. 20% ,P =0. 35), the differences were of no significance. Reinsertion of nasogastric tube due to nausea and vomiting and reoperation was necessary in 2 patients in the experimental group and control group respectively. There were 3 patients complaining fever postoperatively in the control group. Conclusions Early oral feeding after colorectal surgery is safe and feasible, and it can promote postoperative recovery effectively.
3.Window Settings in the Diagnosis of Invasiveness of Lung Adenocarcinoma with Ground Glass Opacities
Haixia MAO ; Huiyuan ZHU ; Yali WANG ; Sen JIANG ; Xiaofang YOU ; Xiwen SUN
Chinese Journal of Medical Imaging 2015;(6):466-469
Purpose To explore the value of window width adjustment in diagnosing the invasiveness of lung adenocarcinoma manifested as ground glass opacities on high-resolution CT, and to provide guidance for the diagnosis of lung adenocarcinoma in different types. Materials and Methods The preoperative CT data of 102 preinvasive lesions and 107 invasive lesions of lung adenocarcinoma were analyzed retrospectively. Among 102 cases of preinvasive lesions, 25 were atypical adenomatous hyperplasia (AAH), 77 were adenocarcinoma in situ (AIS). Among 107 cases of invasive lesions, 78 were minimally invasive adenocarcinoma (MIA), and 29 were invasive adenocarcinoma. The lesions were ground glass opacity (GGO) on lung window while were invisible on mediastinal window. The window width was adjusted constantly until the lesions were invisible with the fixed mediastinal window level (40 HU). When the lesions became invisible, the window width was compared and the best cut-off was found on ROC curve in the two groups. Results The window width of lesions between preinvasive lesions and invasive lesions was different (Z= - 6.203, P<0.05). Window width was a good indicator for the invasiveness of pulmonary adenocarcinoma (area under the ROC was 0.748, P<0.05), and the window width of 1303 HU was the best cut-off for preinvasive lesions and invasive lesions (sensitivity was 56.9%, specificity was 86.0%. Conclusion Window width may be useful for the diagnosis of the invasiveness of the GGO of lung adenocarcinoma on HRCT. The lesion disappearing when the window width is larger than 1303 HU is more likely to be preinvasive; while the lesion disappearing when the window width is smaller than 1303 HU is more likely to be an invasive one.
4.The relationships of IGF-1 and IGFBP-3 with growth of very low birth weight infants in the early postnatal stage
Xi FAN ; Qiliang CUI ; Hui ZHANG ; Fan WU ; Shaozhen LIANG ; Daifeng TAN ; Yuanqing LIN ; Huiyuan TAN ; Lifeng ZHU
Journal of Clinical Pediatrics 2014;(9):833-838
Objective To explore the relationships of insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding protein 3 (IGFBP-3) with growth of very low birth weight (VLBW) infants in the early postnatal stage. Methods According to the individual gestational age and birth weight, 32 cases of VLBW infants were divided into small for gestational age (SGA) group and appropriate for gestational age (AGA) group. After birth, all the infants were given the same nutritional intake. The body weight, body length, head circumference and body mass index (BMI) were monitored at different time points (d0, d7, d14 and d28 after birth). Serum IGF-1 and IGFBP-3 levels were measured by radiommunoassay, and IGF-1/IGFBP-3 molar ratio was calculated. Results There was no signiifcant difference of body weight, body length, head circumference and BMI between two groups at d0, d7, d14 after birth. Body weight and BMI in SGA group were less than those in AGA group at d28 after birth (P<0.05). The levels of IGF-1, IGFBP-3 and IGF-1/IGFBP-3 in SGA group and IGF-1/IGFBP-3 in AGA group did not change with age after birth. The levels of IGF-1 and IGFBP-3 were increased in AGA group after birth. The level of IGF-1 in AGA group at d14 and d28 after birth was higher than that in AGA group at d0 after birth (P<0.05). The level of IGFBP-3 in AGA group at d28 after birth was higher than that in AGA group at d0 after birth (P<0.05). The levels of IGF-1 and IGFBP-3 in SGA group at d28 after birth were lower than those in AGA group at d28 after birth (P<0.05). Conclusions Serum IGF-1 and IGFBP-3 levels in SGA group are lower than those in AGA group. Low levels of IGF-1 and IGFBP-3 may result in growth retardation.
5.Correlation between CT?feature of lobulation and epidermal growth factor receptor gene mutations in advanced pulmonary adenocarcinoma
Yanqing CHEN ; Huiyuan ZHU ; Yang YANG ; Xiwen SUN ; Tingting WANG ; Sen JIANG ; Bin WANG ; Longbai MA
Chinese Journal of Radiology 2019;53(12):1096-1100
Objective To investigate the correlation between the feature of lobulation, degree of lobulation on CT images and epidermal growth factor receptor gene (EGFR) mutations in advanced pulmonary adenocarcinoma. Methods Two hundred and one patients who were diagnosed with advanced pulmonary adenocarcinoma between January and December 2017 and had undergone a chest CT and EGFR mutation testing at Shanghai Pulmonary Hospital were enrolled in this retrospective study. The clinical and imaging data of the patients were analyzed. The patients were classified into EGFR mutations group (107 cases) and wild type group (94 cases) according to whether EGFR gene mutation occurred. The feature of lobulation (described as presence of lobulation, absence of lobulation, or obscured margin), degree of lobulation (including deep lobulation, shallow lobulation, no lobulation, and obscured) on CT images were statistically compared between the two groups. Results Based on the presence or absence of lobulation sign, there were 99, 0, 8 cases with lobulation, no lobulation, obscured margin in the EGFR mutations group and 80, 1, 13 cases in the wild type group, respectively. There was no significant difference in lobulation sign between the EGFR mutations group and wild type group (P=0.152). According to the degree of lobulation, there were 32, 67, 0, 8 cases of deep lobulation, shallow lobulation, no lobulation, obscured margin in EGFR mutations group and 60, 20, 1, 13 cases in wild type group. Significant differences of frequency were found regarding deep lobulation and shallow lobulation between the two groups (P<0.001). However, there was no significant difference between the two groups in the presence of no lobulation, and obscured margin (P>0.05). Conclusions EGFR mutations are significantly associated with shallow lobulation in advanced pulmonary adenocarcinoma. Conversely, deep lobulation is more likely to appear in advanced pulmonary adenocarcinoma with wild?type EGFR. However, there is no association between EGFR mutation status and the presence of lobulation.
6.Changes of coagulation function in patients with adenomyosis
Huiyuan ZHANG ; Anqi WANG ; Shu ZHU ; Liang YU ; Jiafan SUN ; Wei XU ; Xiuli WANG
Chinese Journal of Obstetrics and Gynecology 2022;57(3):179-189
Objective:To explore the different coagulation state in patients with adenomyosis and its clinical significance.Methods:Clinical data of the patients admitted to the First Affiliated Hospital of Nanjing Medical University from January 2017 to December 2021 were retrospectively analyzed. (1) Differential coagulation state between 25 healthy women and 25 patients with adenomyosis were compared during menstrual and non-menstrual periods. (2) The coagulation indexes of 145 patients with adenomyosis (observation group 1) and 129 patients with cervical intraepithelial neoplasia grade Ⅲ (control group 1) who underwent hysterectomy in non-menstrual period were compared. (3) The coagulation indexes of 154 patients with adenomyosis (observation group 2) and 147 women without myometrial lesions (control group 2) who underwent endometrial curettage during uterine bleeding period were compared. (4) Correlations of coagulation index with cancer antigen 125 (CA 125), cancer antigen 19-9 (CA 19-9) and uterine volume in patients with adenomyosis were analyzed. Results:(1) The coagulation state of each health women during the menstrual and non-menstrual period showed no significant differences (all P>0.05). For the 25 patients with adenomyosis, fibrinogen [FIB; 2.61 g/L(2.50-3.10 g/L)] and D-dimer [0.60 mg/L (0.40-1.00 mg/L)] in the menstrual period were significantly higher than those in the non-menstrual period [2.25 g/L (1.90-2.70 g/L) and 0.27 mg/L (0.20-0.40 mg/L), respectively; both P<0.01], while thrombin time [TT; 16.70 s (16.10-17.40 s)] in the menstrual period was significantly lower than that in the non-menstrual period [17.95 s (17.20-18.40 s); P<0.01]. (2) In the non-bleeding period, D-dimer [0.26 mg/L (0.20-0.40 mg/L)] and platelet count [257.0×10 9/L (212.0×10 9/L-308.5×10 9/L)] of observation group 1 were significantly higher than those of control group 1 (all P<0.01). Besides, FIB ( r=0.237, P=0.004) and D-dimer ( r=0.373, P<0.001) were positively correlated with CA 125, while prothrombin time (PT; r=-0.208, P=0.012) and internationalized normalized ratio of plasma prothrombin time (PT-INR; r=-0.201, P=0.015) were negatively correlated with CA 19-9. (3) In the bleeding period, PT [10.70 s (10.10-11.20 s)] and PT-INR [0.93 (0.90-1.00)] of observation group 2 were significantly lower than those of control group 2 (all P<0.01), while D-dimer [0.41 mg/L (0.20-0.80 mg/L)] was significantly higher than that in the control group 2 ( P<0.001). Furthermore, FIB ( r=0.252, P=0.038) and D-dimer ( r=0.321, P=0.008) were positively correlated with uterine volume, while activated partial thromboplastin time (APTT; r=-0.190, P=0.018) and TT ( r=-0.304, P=0.012) were negatively correlated with uterine volume. (4) During non-menstrual period and uterine bleeding period, APTT and TT in patients of observation group 1 and 2 combined with anemia were significantly lower than those of non-anemia patients (all P<0.05). Conclusion:Patients with adenomyosis have a tendency to hypercoagulability in both the uterine bleeding and non-bleeding periods, which may be related to enlarged uterine volume, increased serum CA 125 and anemia.
7.Efficacy of dienogest versus gonadotropin-releasing hormone agonist combined with dienogest sequential therapy in the treatment of adenomyosis
Huiyuan ZHANG ; Shu ZHU ; Wei XU ; Anqi WANG ; Xiuli WANG
Chinese Journal of Obstetrics and Gynecology 2022;57(11):856-863
Objective:To investigate the efficacy and safety of dienogest (DNG) alone and gonadotropin-releasing hormone agonist (GnRH-a) combined with DNG sequential treatment to adenomyosis.Methods:The clinical data of 110 patients with adenomyosis attending the First Affiliated Hospital of Nanjing Medical University from December 2019 to March 2022 were retrospectively analyzed, including 40 patients treated with DNG (2 mg/day) alone (DNG group) and 70 patients treated with sequential DNG (2 mg/day) after 3-6 injections of GnRH-a (GnRH-a+DNG group). The clinical data before and after treatment were compared between the two groups.Results:(1) The dysmenorrhea visual analogue scale (VAS) scores, cancer antigen 125 (CA 125) and cancer antigen 19-9 (CA 19-9) levels at different time periods after treatment were significantly lower than before treatment in both groups (median before treatment: DNG group 70.0 mm, 68.55 kU/L, 22.45 kU/L respectively, GnRH-a+DNG group 80.0 mm, 151.50 kU/L, 20.44 kU/L respectively; all P<0.001). (2) The hemoglobin (Hb) levels of patients in both groups at different time periods after treatment were significantly higher than those before treatment (median: DNG group 102.00 g/L, GnRH-a+DNG group 94.00 g/L; all P<0.001). (3) Treatment with DNG alone did not have a significant effect on uterine volume in patients of DNG group ( P>0.05), and uterine volume decreased significantly in the 15th-24th months of GnRH-a+DNG group compared with that before treatment (median: 167.76 vs 227.77 cm 3; P<0.05). (4) There were no significant differences in hepatic and renal function and coagulation indexes between the two groups before and after treatment (all P>0.05), and no significant abnormal lesions were observed in breast tissue during the follow-up period. (5) The incidence of amenorrhea of GnRH-a+DNG group was higher than that of DNG group, and the incidences of irregular spotting bleeding and breakthrough hemorrhage were lower than those in DNG group. Conclusions:Whether DNG is used alone or in combination with GnRH-a in sequence, it could significantly relieve dysmenorrhea symptoms, improve the level of Hb, reduce the levels of CA 125 and CA 19-9 in patients with adenomyosis, with no adverse effects on coagulation and hepatic or renal function. GnRH-a sequential DNG therapy is superior to DNG alone in improving uterine bleeding patterns and controlling the growth of uterine volume in patients with adenomyosis.
8.The effects of combining repeated transcranial magnetic stimulation with modified constraint-induced movement therapy on walking ability after a stroke
Dongyan ZHU ; Hongjian LU ; Zhidong HUANG ; Liang WANG ; Jiajia ZHAI ; Qian XU ; Zhenzhen HAN ; Yuejiao CAO ; Huiyuan JI
Chinese Journal of Physical Medicine and Rehabilitation 2023;45(9):781-785
Objective:To seek any differential effect of combining repeated transcranial magnetic stimulation (rTMS) with a modified version of constraint-induced movement therapy (mCIMT) on the walking ability of stroke survivors.Methods:Seventy-five stroke survivors were randomly divided into a sham rTMS group, an rTMS group and a combined group, each of 25. In addition to 40 minutes of routine rehabilitation daily, including balance training, transfer training, muscle strength training, and proprioceptive training five times a week for 4 weeks, the sham rTMS group and rTMS group received sham or genuine rTMS. The combined group received 20 minutes of rTMS followed by mCIMT training 30 minutes later. The treatment was performed once a day, 5 days a week for 4 weeks. Before and after the treatment, all groups were evaluated using the Fugl-Meyer lower extremity assessment, the Berg balance scale, a 10-metre walk test and the modified Barthel index.Results:Significant improvement was observed in the average scores of all three groups in all of the assessments. The combined group′s averages were, however, significantly better than those of the other two groups.Conclusion:Supplementing mCIMT with rTMS can better improve the walking and other abilities in the activities of daily living of stroke survivors.
9. Correlation between CT-feature of lobulation and epidermal growth factor receptor gene mutations in advanced pulmonary adenocarcinoma
Yanqing CHEN ; Huiyuan ZHU ; Yang YANG ; Xiwen SUN ; Tingting WANG ; Sen JIANG ; Bin WANG ; Longbai MA
Chinese Journal of Radiology 2019;53(12):1096-1100
Objective:
To investigate the correlation between the feature of lobulation, degree of lobulation on CT images and epidermal growth factor receptor gene (EGFR) mutations in advanced pulmonary adenocarcinoma.
Methods:
Two hundred and one patients who were diagnosed with advanced pulmonary adenocarcinoma between January and December 2017 and had undergone a chest CT and EGFR mutation testing at Shanghai Pulmonary Hospital were enrolled in this retrospective study. The clinical and imaging data of the patients were analyzed. The patients were classified into EGFR mutations group (107 cases) and wild type group (94 cases) according to whether EGFR gene mutation occurred. The feature of lobulation (described as presence of lobulation, absence of lobulation, or obscured margin), degree of lobulation (including deep lobulation, shallow lobulation, no lobulation, and obscured) on CT images were statistically compared between the two groups.
Results:
Based on the presence or absence of lobulation sign, there were 99, 0, 8 cases with lobulation, no lobulation, obscured margin in the EGFR mutations group and 80, 1, 13 cases in the wild type group, respectively. There was no significant difference in lobulation sign between the EGFR mutations group and wild type group (
10.Review and Prospect of Development Status of Traditional Chinese Medicine Processing Technology from 1.0 to 4.0
Ying ZHU ; Peilin SONG ; Hailun ZHOU ; Huiyuan XU ; Yu YANG ; Qinwan HUANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(1):276-285
The development and application of processing technology is closely related to the quality of Chinese medicine. Currently, Chinese medicine processing is still in the mechanization stage with limited processing equipment, low levels of automation and intelligence. As a result, the imprecise control of parameters during processing leads to unstable quality of Chinese herbal pieces. However, with the arrival of the big data era and the continuous development of "Internet+", Chinese medicine processing technology and equipment have been continuously improved and updated, and gradually shifted to the development direction of automation and intelligence. The linkage production technology of Chinese herbal pieces optimizes the separate processing equipment coupling into the production line for continuous manufacture of Chinese herbal pieces, intending to improve production efficiency. The large-scale industrialized production of Chinese herbal pieces tends towards digital technology of processing experience and online inspection technology based on machine vision, electronic nose, and electronic tongue. These technologies are crucial prerequisites for standardizing the parameters of Chinese medicine processing. And further by docking the processing process and equipment with the internet, realizing the intelligent control of the production process is an important process for the transformation and upgrading of Chinese herbal piece industry in the future. In this paper, we summarized the development characteristics of different stages of Chinese medicine processing technology, combed application and development of processing theory, the evolution of processing equipment, and problems in the current industrial development stage of Chinese medicine processing, in order to provide ideas and methods for achieving digital and intelligent innovation of processing technology as well as high-efficient and high-quality production of Chinese herbal pieces.