1.Simvastatin in combination with aspirinon for diabetic renal microangipathy in patients with inflammation factor
Jing LIU ; Jiansheng JIN ; Hongying WU
Clinical Medicine of China 2008;24(12):1203-1206
Objective To investigate the clinical significance of serum P-selection,TNF-α,hs-CRP,IL-1β, ICAM in patients with diabetic renal microangipathy, and the therapeutic mechanism of Simvastatin combined with aspirinon in treating renal microangipathy. Methods The serum levels of P-selection,TNF-α, hs-CRP, IL-1β, ICAM were determined by ELISA in all groups. Patients with diabetic renal microangipathy treated with simvastatin and as-pirinon. Results ① The serum levels of P-selection,TNF-α,hs-CRP,IL-1β,ICAM in DM groups were higher than those of normal controls(P<0.01). ②After treatment with simvastatin and aspirinon for 8 weeks in patients with di-abetic nephropathy,the serum levels of P-selection, TNF-α, hs-CRP, IL-1β, ICAM were all decreased significantly compared with those before treatment respectively (P<0.01). After treatment for 16 weeks the above indices re-mained decreased until treatment for 21 weeks (P<0.01). Conclusion ①The plasma levels of Poselection,TNF-α and hs-CRP, IL-1β, ICAM are correlated to the occurance and development of diabetic renal microangiopathy, becom-ing predicted factors in early stage of diabetic renal microangiopathy. ②The therapeutic mechanism of simvastatin and aspirinon in patients with diabetic nephropathy lies probably in the inhibition of these factors expression, thus di-rectly or indirectly affecting the prolffer-ation of mesangial cells and mesangial matrix.
2.Study of the relationship between lung function,nitric oxide and endothelin -1 in hypoxemia of liver cirrhosis
Jin LIU ; Yi TIAN ; Jiansheng LIU
Chinese Journal of Postgraduates of Medicine 2009;32(25):18-20
r cirrhosis. NO and ET-1 are involved corporately in the development of liver cirrhosis, but not the main factors facilitating hypoxemia of liver cirrhosis.
3.The relationship between IL-1β,intercellular adhesion molecule in serum and diabetic renal microangiopathy
Hongying WU ; Jiansheng JIN ; Jing LIU ; Yinan LI
Chinese Journal of Postgraduates of Medicine 2008;31(34):7-10
Objective To study the influence of interleukin(IL)-1β,intercellular adhesion molecule(ICAM)on diahetic renal microangiopathy.Methods Sixty-two patients with type 2 diabetic mellitus were divided into three groups:normal albumin urine group(20 patients),microamount albumin urine group(22 patients),and dominancy albumin urine group(20 patients)according to their urinary albumin excretion rate(UAER).IL-1β,ICAM was measured by enzyme-linkedimmuno sorbent assay(ELISA)method in the type 2 diabetic mellitus and the healthy persons.Results The concentration of IL-1β,ICAM in the three groups with type 2 diabetic mellitus was higher than that of the twenty healthy persons(P<0.05),higher in the dominancy albumin urine group than that in the microamount albumin urine and normal albumin urine groups(P<0.01).The concentration of IL-1β in the microamount albumin urine group was higher than that in the normal albumin urine group(P<0.05),the concentration of ICAM in the microamount albumin urine and normal albumin urine groups was equal(P>0.05).Higher serum IL-1β and ICAM was associated with higher UAER(P<0.05).The concentrations of IL-1βwas positively correlated with ICAM.Conclusion ICAM,IL-1β is probably correlated to UAER of diabetic renal microangiopathy,80 it has very important meaning and clinic value to measure the concentration of IL-1β,ICAM in serum earlier.
4.Plasma N-terminal pro-brain natriuretic peptide level and its clinical significance in liver cirrhosis
Yi TIAN ; Jin LIU ; Jiansheng LIU ; Xiaohong ZHANG ; Ming MA
Chinese Journal of Postgraduates of Medicine 2008;31(31):19-21
Objective To detect the levels of plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) and investigate its relationship with liver function, ascites and heart structure in patients with liver cirrhosis. Methods The levels of plasma NT-proBNP and various clinical and biochemical parameters were determined in 60 patients with liver cirrhosis and 30 healthy controls. Meanwhile Child-Pugh liver function was classified. All people underwent color Doppler echocardiography. Results The level of plasma NT-proBNP was significantly elevated in patients with liver cirrhosis [(38.63±36.05)pmol/L], compared with that of the controls [(7.50±8.25)pmol/L],P<0.01. There was no significant difference in different Child-Pugh class and aseites amount of liver cirrhosis. E/A < 1 and E wave decelerate time (EDT) was in-creased in liver cirrhosis. Conclusion The levels of plasma NT-proBNP in liver cirrhosis are significantly elevated, and related to early impairment of diastolic function. But it does not correlate with liver function and aseites.
5.An epidemiology study of the relationship between pancreatic cancer and diabetes mellitus
Lingyan SHI ; Peichen ZHANG ; Rong JIN ; Jiansheng WU
Chinese Journal of Pancreatology 2008;8(5):319-321
Objective To investigate the relationship between pancreatic cancer and diabetes mellitus (DM). Methods Two hundreds and twenty patients with pancreatic cancer and 300 controls, who suffered from non-digestive tract, non-neoplastic or non-hormone-related disorders, were enrolled from 1997 to 2007. The incidence of diabetes between the two groups and the relationship between pancreatic cancer and diabetes were compared, pancreatic cancer patients with DM were compared with patients without DM for their gender, age, location and differentiate degree of the cancer. Results The incidence of DM in the two groups were 33.1% and 9.67%, respectively, and the difference was significant (P < 0.05). In the pancreatic cancer group, the proportion of patients with DM diagnosed within 2 years or for more than 10 years were 25.91% (57/73) and 3.18% (7/73), which were significant higher than those in the control group 6.0% (18/29) and 0.67% (2/29)) (χ2=46.15, P<0.01, 0R=6.07; χ2 =4.72, P<0.01, OR=4.90). In the pancreatic cancer group, the proportion of patients with DM diagnosed within 2~5 years or 5~10 years was not significant different when compared with that of the control group, and there was no significant difference in terms of gender, age and cancer location between the pancreatic cancer patients with DM and without DM. The majority of pancreatic cancer patients with DM had corpora mammillaria or well differentiated adenocarcinoma, and the majority of pancreatic cancer patients without DM had differentiated adenocarcinoma. Conclusions DM was closely related with pancreatic cancer and DM may be one of the presentations of pancreatic cancer, as well as a possible risk factor for the tumor.
6.Relationship between expression of multidrug-resistant genes in ulcerative colitis and disease behavior
Yingjian ZHANG ; Jiansheng LI ; Jianjun JIN ; Shuangqin ZHAO
Chinese Journal of Digestive Endoscopy 2010;27(7):360-362
Objective To study the relationship between expression of multidrug resistant 1 ( MDR1) gene encoded P-glycoprotein ( P-gp) and multidrug resistance relation protein ( MRP) in ulcerative colitis and the disease behavior. Methods Sections of endoscopic biopsy samples from patients with ulcerative colitis were studied by immunohistochemistry with monoclonal antibody of MDR1 gene encoded P-gp and MRP. Results Expressions of MDR1 gene encoded P-gp and MRP in the 12th month and 18th month of ulcerative colitis were 40. 5% , 45.9% , 48. 6% and 51.4% , respectively, which were all significantly higher than those of early phase ( P < 0.05). P-gp and MRP expressions in active stage and remission stage of ulcerative colitis were 36.4% , 18. 6% , 46. 1% and 25.4% , respectively, which was significantly different between the two stages (P < 0.05 ). At active stage of ulcerative colitis there was no significant difference in expressions of P-gp and MRP among mild, moderate and severe patients (P > 0. 05 ). Conclusion Examination of P-gp and MRP expressions is feasible and dependable in presenting evidence of drug insistence. However, it is not suitable to be an indicator of severity because of its poor differentiation ability in active stage.
7.Changes of serum T-PSA, F-PSA and F/T ratio in patients with prostate cancer and its clinical significance
Guoping ZHAO ; Jiansheng LAI ; Weigang HUANG ; Jin LIN ; Shengli XU
Chinese Journal of Pathophysiology 2000;0(07):-
AIM: To evaluate the changes of serum total prostate specific antigen (T-PSA), free prostate specific antigen (F-PSA) and the ratio of F-PSA to T-PSA (F/T) in patients with prostate cancer (PCa) and its clinical significance. METHODS: The concentrations of T-PSA and F-PSA in serum were measured by micropartical enzyme immunoassay (MEIA) using AxSYM System, and the F/T ratio was calculated. RESULTS: Before operation, the concentrations of T-PSA and F-PSA in patients with PCa were much higher and F/T ratio was significantly lower than that in patients with benign prostate hyperplasia (BPH). T-PSA and F-PSA levels decreased, but F/T ratio increased after operation in PCa and BPH. F/T ratio in 83.5% PCa and 6.5% BPH was less than 0.16. To diagnosis PCa, the sensitivity of F/T ratio was 83.5%, and the specificity was 86.7%. CONCLUSION: Serum T-PSA, F-PSA and F/T ratio are important parameters for the early diagnosis of prostate cancer. [
8.Thinking about the current clinical practice situation of seven-year clinic students
Jiansheng WANG ; Jin-xiang ZHU ; Ming-xin ZHANG ; Su-na ZHOU ; TANGSAKAR Ermek
Chinese Journal of Medical Education Research 2012;11(2):151-153
Clinical practice is a key step that seven-year clinic student take to become doctors.Take the First Affiliated Hospital of Xi'an Jiaotong University as an example,in the medical practice of seven-year clinic students,there still exist some problems such as students' being unable to transform from probationers to doctors,not good at treating with interpersonal relationship in the department and having no perseverant practice attitude.So training before practice should be perfected and supervision should be strengthened to make the seven-year clinic students better.
9.Changes of varicosis and hemodynamics in cirrhotic patients with portal vein hypertension after Hassab devascularization
Yingjian ZHANG ; Jiansheng LI ; Ping WANG ; Jianjun JIN ; Shuangqin ZHAO ; Shitong ZHANG ; Yanli BAI ; Yufeng ZHENG
Chinese Journal of Digestive Endoscopy 2010;27(10):518-521
Objective To analyze the changes of varicosis and hemodynamics in cirrhotic patients with portal vein hypertension at different stages after Hassab devascularization, and to evaluate the outcome.Methods Hassab devascularization was performed in 161 patients with portal vein hypertension, who were all evaluated by means of endoscopy, Doppler color imaging and Child-Pugh grading before and 6, 12, 18,24 months after the procedure, respectively.Results The rates of mild esophageal varicosis were 44.0%,34.8% and 28.3% at 6, 12 and 18 months after Hassab devascularization, respectively, which were all significantly higher than that before the operation(7.5%, P < 0.05), while the rates of severe esophageal varicosis were 25.2%, 29.7% and 34.9% at 6, 12 and 18 months after the procedure, which were significantly lower than that before(65.2%, P < 0.05).The incidence of varices in gastric fundus was correlated with the severity of esophageal varices.At 12 months after the operation, the inner diameters of portal vein and its right branch significantly decreased when compared with those before(P < 0.05), the maximal flow rate,volume of portal vein and average flow rate of the left branch also significantly decreased(P < 0.05).At 6 months after the operation, the average flow rate of the right branch slowed down(P < 0.05).Child-Pugh Grade A accounted for 63.5%, 60.6% and 57.9% at 6, 12 and 18 months after the operation, respectively, which were significantly higher than that before(48.4%, P <0.05).When evaluated at 24 months after the procedure, all variables were getting close to those before.Conclusion The severity of esophageal varices mitigates in 18 months after Hassab.Hemodynamics of portal vein system decreases in 12 months.The overall liver function improves in 18 months after the operation.
10.Clinical analysis of 76 patients with colorectal high grade intraepithelial neoplasia diagnosed by colonoscopic biopsy
Wei LIU ; Jin WANG ; Hong WANG ; Xiangyu CHEN ; Jiansheng LI ; Shuai LYU
Chinese Journal of Digestion 2017;37(2):84-87
Objective To analyze colonoscopic appearances,computed tomography (CT) imaging features and their correlation with postoperative pathology in patients with colorectal high grade intraepithelial neoplasia (HGIN) diagnosed by colonoscopic biopsy.Methods From October 2009 to October 2015,patients diagnosed as colorectal HGIN by colonoscopic biopsy who received endoscopic resection or operation,and had complete postoperative pathological data were enrolled.The results of CT imaging before operation,postoperative pathological type,the maximum diameter of lesions,sessile lesions or pedunculated lesions and enlarged lymph nodes were analyzed.Chi-square test were performed for statistical analysis.Sensitivity and specificity of CT imaging before operation in the detection of invasive colorectal cancer were calculated.Results Among the 76 patients,21.1% (16/76) patients were HGIN,and 78.9% (60/76) were invasive cancer confirmed by postoperative pathology.The incidence rate of invasive carcinoma in patients aged ≤50 years (3/14) was significantly lower than that of patients aged >50 years (91.9%,57/62),and the difference was statistically significant (x2 =30.05,P<0.01).The incidence rate of invasive carcinoma in protruding lesions with maximum diameter ≥ 3.0 cm was 98.3% (57/58),which was higher than that of lesions with maximum diameter <3.0 cm(2/16),and the difference was statistically significant (x2 =51.91,P<0.01).The incidence rate of invasive carcinoma in pedicle polyps group (2/13) was lower than that of sessile lesions (93.4%,57/61),and the difference was statistically significant (x2 =35.72,P<0.01).The sensitivity and specificity of CT in the diagnosis of invasive colorectal cancer was 95.0% and 84.6%,respectively.The incidence rate of invasive carcinoma in patients with enlarged lymph nodes detected by CT (93.3 %,42/45) was significantly higher than that of patients without enlarged lymph nodes (64.3%,18/28),and the difference was statistically significant (x2=9.95,P =0.002).Conclusions CT examination can compensate for the diagnostic deficiency of colonoscopic biopsy which inadequately diagnosed some invasive carcinoma as HGIN.The incidence of invasive cancer is high in patients with age over 50 years,large lesions,sessile lesions,CT indicating colorectal neoplasms and with enlarged lymph nodes.