1.Clinical Manifestations and Pathogenic Characteristics of Different Types of Deep Sternal Wound Infection in after Cardiac Surgery
Jiagui MA ; Jianxiong AN ; Wenzhang WANG ; Xiyuan LI
Journal of China Medical University 2016;45(7):635-640
Objective To investigate the clinical features and pathogenic characteristics of different types of deep sternal wound infection in dif?ferent types after cardiac surgery. Methods A retrospective study was performed. From January 2012 to December 2014,84 patients with sec?ondary DSWI after cardiac surgery underwent the pectoralis major muscle flap transposition in our department were recruited for the study. Re?sults The average age of 84 patients with DSWI was 54.6 ± 14.8 years old,of which typeⅡDSWI patients were the most common(49/84, 58.3%). Both typeⅠand typeⅡDSWI patients showed typical clinical manifestations and early chest X?ray or Computerized tomography(CT) showed mediastinal widening(P<0.01). Some patients with typeⅢDSWI showed only local symptoms of surgery. The organisms most common?ly isolated in patients with DSWI were gram gram?negative bacilli(GNB,54.8%). Although there was no significant difference between the 3 types of DSWI patients(P>0.05),but the pathogenic results of the 3 types of those DSWI patients showed such a trend:typeⅠDSWI patients with GNB is was more common,and typeⅡDSWI patients was more prone to complicated infection. Conclusion Different types of DSWI may dis?play different features,the prevention and treatment of DSWI should be closely combined with the clinical manifestations and local pathogenic char?acteristics.
2.Effect of tribu saponin from Tribulus terrestris on the lipoprotein lipase and(hepatic) lipase activity in lipid metabolic disorder mice
Jiagui LI ; Weijing QU ; Shanqiao WEI
Chinese Traditional Patent Medicine 1992;0(06):-
AIM:To investigate the effect of tribu saponin from Tribulus terrestris(STT) on the lipoprotein lipase(LPL) and hepatic lipase(HL) activity in lipid metabolic disorder mice.METHODS:Mice being fed lipodiet were taken in STT through the experiment with Fenofibrate as positive control drug.Four weeks later,the levels of LPL in the plasma,the adipose tissue,liver tissue,muscular tissue and the levels HL activity in the plasma,liver tissue were estimated with LPL and HL Kit.RESULTS:HL activity in liver tissue in lipid metabolic disorder group was significantly lower than that in STT,Fenonbrate and normal group(P0.05).In STT group,the LPL activity in adipose was lower(P
3.Analysis of the risk factors on survival rate in 185 patients who received cardiopulmonary resuscitation with return of spontaneous circulation after discharge
Xiyuan LI ; Jianxiong AN ; Dengkai LI ; Jiagui MA ; Li CHEN
Journal of Chinese Physician 2017;19(6):868-871
Objective To investigate the survival rate and status of cerebral performance category in patients who received cardiopulmonary resuscitation (CPR) with return of spontaneous circulation (ROSC) (abbreviated by ROSC-CPR) after discharge,and to analyze the risk factors which influencing the prognosis of these patients.Methods A retrospective analysis of the clinic data coming from the patients who received cardiopulmonary resuscitation with return of spontaneous circulation and admitted to the Department of Intensive Care Unit from January 2009 to December 2016 was carried out to find corresponding risk factors influencing the prognosis.Results A total of 185 patients who received ROSC-CPR with 59.5% male,the average age of (67.15 ± 17.64) years old and the average Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score (28.80 ± 7.16) were divided into two groups,the survival group (n =56) and the death group (n =129).The total survival rate was 56/185 (30.3%).Compared to the death group,the usage rate of ventilation,blood purification and target temperature management in survival group was no significant (P > 0.05).The most common aetiology of the survival patients was cardiogenic disease,but the number of those patients with the good cerebral performance category (CPC 1/2) discharged from hospital were 16 cases (8.6%).According to logistic analysis,high value of APACHE Ⅱ score,the duration from CPR to ROSC over 10 minutes,admission took place out-of-hospital were unfavorable predictors for the prognosis (P < 0.05),while admission took place in the second four years and cases with cardiogenic aetiology were favorable predictors for the prognosis of these patients who suffered from ROSC-CPR.Conclusions The survival rate of the patients who received CPR with ROSC after discharge was still low,especially the rate of good status of CPC was very low.To shorten the duration from CPR to ROSC as possible as we can,and to strengthen target temperature management would improve the prognosis of the patients who received CPR with ROSC in our hospital in future days.
4.Pharmacological investigation of voltage-dependent Ca2+ channels in human ejaculatory sperm in vitro.
Lu, LI ; Jihong, LIU ; Jiagui, LI ; Zhangqun, YE
Journal of Huazhong University of Science and Technology (Medical Sciences) 2006;26(5):607-9
The types of the voltage-dependent calcium channels (VDCCs) in human ejaculatory sperm and the effects of calcium channel blocker (CCB) on human sperm motility parameters in vitro were investigated. The human sperm motility parameters in vitro in response to the pharmacological agents nifedipine (NIF, inhibitor of L-type VDCC) and co-conotoxin (GVIA, inhibitor of N-type VDCC) were compared and analyzed statistically. The results showed that NIF (1, 5, 10 micromol/L) could not only significantly affect human sperm's shape but also spermatozoa motility after incubated at least 10 min in vitro (P<0.001). GVIA (0.1, 0.5 and 1 micromol/L) could just only significantly affect human sperm's progressive motility (a %+b %) after incubated for 20 min in vitro (P<0.01), but they both could not significantly affect spermic abnormality rate. It is suggested that L-type VDCC, non L-type VDCCs and isoform of L-type VDCC exist in the cell membrane of human sperm solely or together, and they participate in the spermic physiological processes especially the spermic motility.
5.Isolation and purification of alpha-glycerophosphate oxidase in a polyethylene glycol/(NH4 )2SO4 aqueous two-phase system.
Yao MENG ; Jiagui JIN ; Shuangfeng LIU ; Min YANG ; Qinglian ZHANG ; Li WAN ; Kun TANG
Journal of Biomedical Engineering 2014;31(1):136-141
Alpha-glycerophosphate oxidase (alpha-GPO) from Enterococcus casseli flavus was successfully isolated and purified by using polyethylene glycol (PEG)/(NH4)2SO4 aqueous two-phase system (ATPS). The results showed that the chosen PEG/(NH4)2SO4 ATPS could be affected by PEG molecular weight, pH, concentration of PEG and (NH4)2SO4, and inorganic salt as well as additional amount of crude enzyme. After evaluating these influencing factors, the final optimum purification strategy was formed by 16.5% (m/m) PEG2000, 13.2% (m/m) (NH4)2SO4, pH 7.5 and 30% (m/m) additive crude enzyme, respectively. The NaCl was a negative influencing factor which would lead to lower purification fold and activity recovery. These conditions eventually resulted in the activity recovery of 89% (m/m), distribution coefficient of 1.2 and purification fold of 7.0.
Ammonium Sulfate
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chemistry
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Glycerolphosphate Dehydrogenase
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chemistry
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isolation & purification
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Molecular Weight
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Polyethylene Glycols
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chemistry
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Water
7.Clinical study of rociverine tablets combined with Suoquan capsules in the treatment of female patients with overactive bladder syndrome
Dongwei YAO ; Cheng LIU ; Xuejun LIU ; Duo LIU ; Jiagui MU ; Dongsheng ZHU ; Li FAN
Chinese Journal of Primary Medicine and Pharmacy 2016;23(14):2130-2133,2134
Objective To assess the efficacy and safety of combining rociverine tablets with Suoquan cap-sules in the treatment of female patients with overactive bladder(OAB).Methods 152 female patients with OAB were randomly divided into three groups.Patients in rociverine group were administered rociverine tablets 10mg three times a day for 4 weeks.Patients in Suoquan capsule group were administered Suoquan capsules 1.8g three times a day for 4 weeks.Patients in combination group were administered rociverine tablets 10mg and Suoquan capsule 1.8g three times a day for 4 weeks.Each group of patients had to complete 3d voiding diary before and after treatment to record daily frequency of micturition,urgency,urgency incontinence,nocturia and avoiding volumes,OABSS score and drug side effects were also observed.All the data were analyzed to assess the efficacy and safety of treatment.Results There were significant differences in daily frequency of micturition,urgency,urgency incontinence,nocturia,avoiding volumes and OABSS score of patients in each group before and after treatment(all P <0.01 ).Moreover,compared with combination group,rociverine and Suoquan capsule group all had significant differences(F =41.765,53.834, 25.304,37.867,214.791,73.486,all P <0.01 ).There was no significant differences between rociverine and Suoquan capsule group(all P >0.05).The incidence rates of adverse events of rociverine and combination group were 7.8% and 22.6%,respectively,there was significant difference between the two groups(χ2 =4.372,P =0.032). Conclusion Combining rociverine tablets with Suoquan capsules in the treatment of female patients with OAB was effective and safe.
9.Utility of fluorescence in situ hybridization for the diagnosis of bladder urothelial carcinoma
Jianwen HUANG ; Ruihua AN ; Yunwei LI ; Jiagui MU ; Xiuguo GAN ; Lei YU ; Jinyang YUAN
Chinese Journal of Urology 2012;(12):918-921
Objective To evaluate the clinical value of fluorescence in situ hybridization (FISH) method for diagnosis of bladder urothelial carcinoma.Methods Urine samples from 81 patients suspected of having bladder urothelial carcinoma were collected for immediate urine cytology and FISH analysis.All patients underwent cystoscopy for identification of bladder lesions.Urine samples from 8 patients with benign disease of urinary system werealso analyzed by means of FISH and cytology.The sensitivity and specificity of FISH were compared with cytology.Results 81 subjects of bladder urothelial carcinoma were verified with pathology,which included 34 non-muscle invasive carcinoma,14 cases with muscle invasive carcinoma,42 cases with high-grade carcinoma,and 24 cases with low-grade carcinoma.Residual cases included 12 verified benign disease of urinary system,and to serve as controls with 8 patients with benign disease of urinary system.The sensitivities of FISH,cytology and cystoscopy were 72.8%,27.2% and 97.5%.The sensitivity of FISH was superior to cytology,but inferior to cystoscopy.The specificity and diagnostic concordance rate of FISH and cytology were 85.0%,100.0% and 75.2%,41.6%,respectively.Conclusion FISH analysis as a non-invasive method has good sensitivity and specificity for diagnosing bladder urothelial carcinoma.
10.Analysis of surgical treatment with pectoralis major muscle flap for deep sternal infection after cardiac surgery: a case series of 189 patients.
Dong LIU ; Wenzhang WANG ; Aibing CAI ; Zhiyi HAN ; Xiyuan LI ; Jiagui MA
Chinese Journal of Surgery 2015;53(3):193-196
OBJECTIVETo analyze and summarize the clinical features and experience in surgical treatment of deep sternal infection (DSWI).
METHODSThis was a retrospective study. From January 2008 to December 2013, 189 patients with secondary DSWI after cardiac surgery underwent the pectoralis major muscle flap transposition in our department. There were 116 male and 73 female patients. The mean age was (54 ± 21) years, the body mass index was (26. 1 ± 1. 3) kg/m2. The incidence of postoperation DSWI were after isolated coronary artery bypass grafting (CABG) in 93 patients, after other heart surgery plus CABG in 13 patients, after valve surgery in 47 patients, after thoracic aortic surgery in 16 patients, after congenital heart disease in 18 patients, and after cardiac injury in 2 patients. Clean patients' wound and extract secretions, clear the infection thoroughly by surgery and select antibiotics based on susceptibility results, and then repair the wound with appropriate muscle flap, place drain tube with negative pressure. Of all the 189 patients, 184 used isolate pectoralis, 1 used isolate rectus, and 4 used pectoralis plus rectus.
RESULTSThe operative wounds of 179 patients were primary healing (94. 7%). Hospital discharge was postponed by 1 week for 7 patients, due to subcutaneous wound infection. Subcutaneous wound infection occurred again in 8 patients 1 week after hospital discharge, and their wounds healed after wound dressing. Nine patients (4. 7%) did not recover, due to residue of the sequestrum and costal chondritis, whom were later cured by undergoing a second treatment of debridement and pectoralis major muscle flap transposition. Eight patients died, in which 2 died of respiratory failure, 2 died of bacterial endocarditis with septicemia, 2 died of renal failure, 1 died of intraoperative bleeding leading to brain death and the 1 died of heart failure. The mortality rate was 4. 2% . The average length of postoperative hospital stay was (14 ± 5) days. The longest postoperative follow-up period was 40 months, the median time was 26 months, the follow-up rate was 83. 9% . Totally 179 patients were no-reinfected, 2 patients were reinfected because of artificial vascular rejection.
CONCLUSIONTo perform surgical debridement and then reconstruct the sternal defect with pectoralis major muscle flap actively for the patient is an effective measure to improve patient's survival rate.
Adult ; Aged ; Cardiac Surgical Procedures ; adverse effects ; Coronary Artery Bypass ; Debridement ; Female ; Heart Defects, Congenital ; Humans ; Incidence ; Length of Stay ; Male ; Middle Aged ; Pectoralis Muscles ; transplantation ; Postoperative Complications ; Postoperative Period ; Retrospective Studies ; Sternum ; surgery ; Surgical Flaps ; Surgical Wound Infection ; surgery ; Wound Healing