1.The study on Ezscan screening for dysglycaemia in Chongqing area
Yalan ZHANG ; Xiaolan ZHAO ; Yidan WANG ; Bing ZOU ; Jiayang SHI
Chongqing Medicine 2016;45(36):5132-5135
Objective To assess the screening capacity of Ezscan for abnormal glucose metabolism .Methods A total of 1 732 permanent residents of Chongqing city underwent physical examination from August 2013 to August 2014 were selected as subjects ,questionnair survey ,physical examination and Ezscan measurement were performed .Additionally ,the levels of fasting blood‐glucose(FPG) ,OGTT 2h blood glucose ,HbA1c and serum lipid were detected .Results The prevalence rate of abnormal glucose metabolism for residents with high Ezscan score was higher than that in those with low Ezscan score .The AUC of Ezscan screening for abnormal glucose metabolism was 0 .616 ,the optimum diagnosis tangent point was 24 .0% ,the sensitivity was 67 .0% .The optimum diagnosis tangent point of FPG was 5 .5 mmol/L for abnormal glucose metabolism ,the sensitivity and speci‐ficity was 70 .5% and 61 .7% respectively ,and the AUC was 0 .824 .The sensitivity of FPG for screening abnormal glucose metabo‐lism was 47 .2% ,when the cut‐off value of FPG was 6 .1 mmol/L .Conclusion The sensitivity of Ezscan for screening abnormal glucose metabolism is higher than that of FPG (when the cut‐off value was 6 .1 mmol/L) ,Ezscan can be used as an efficiency meth‐od for early detection of abnormal glucose metabolism in the asymptomatic population .
2.Analysis of the relationship between the composition of stones and the age and sex in patients with kidney stones
Fengning MA ; Guowei SHI ; Yuehui ZHANG ; Jiayang HE
Chinese Journal of Urology 2013;(7):530-532
Objective According to the infrared spectrum of renal stone composition analysis,discuss the relationship between gender,age and kidney stone.Methods Kidney stone composition analysis of 408 cases had been done in our hospital from the 2002 to 2011 by using Fourier transform infrared spectroscopy.There were 271 males (66.4%) and 137 females (33.6%).Results There were 359 cases with calcium stones,accounting for 88.0% (359/408); 197 cases with calcium oxalate stones alone,accounting for 48.3%; 180 cases with phosphate stones,accounting for 44.1%; 211 cases with mixed composition stones,accounting for 51.7%.Main chemical composition of the stones were:calcium oxalate 48.3%,carbonate apatite 34.8%,urates 5.4%,ammonium magnesium phosphate 4.4%,ammonium carbonate eutectic 3.4%,brushite 1.5%,cystine 2.0% and protein 0.3%.Male patients accounted for 66.4% of all cases and the peak onset age was 30-59 years; Female patient accounted for 33.6% of all cases and the peak onset age was 50-59 years.Conclusions Calcium oxalate and phosphate are the most common components of kidney stones.Males age between 30-59 years and females age between 50-59 years may suffer from of kidney stone formation.
3.Study on the effect of midazolam intravenous therapy for children with convulsive status epilepticus
Maolei MA ; Lina ZHANG ; Jiayang ZHONG ; Jing SHI
Chinese Journal of Primary Medicine and Pharmacy 2013;20(22):3383-3385
Objective To observe the clinical efficacy of midazolam intravenous therapy for children with convulsive status epilepticus (CSE).Methods 133 admitted CSE children were randomly divided into treatment group (n =6 8) and control group (n =6 5).Based on symptomatic treatment,the control group was given diazepam plus phenobarbital intravenous injection,the treatment group was given midazolam injection plus intravenous infusion scheme.The clinical efficacy and adverse drug reactions were observed and compared between the two groups.Results After treatment for 3h,the total effective rate of the treatment group was 91.2%,which was significantly higher than 76.9% of control group(x2 =5.078,P =0.024).Among children with markedly effective and effective effect,the mean onset time (49.3 ± 10.4)min and seizure control time (112.1 + 24.7)min of the treatment group were significantly lower than those of control group (73.8 + 15.4) min,(157.2 ± 38.4) min,the differences were statistically significant(u =9.619,7.191,P =0.000).15 ineffective cases of control group were transferred into midazolam intravenous therapy,the total effective rate after 3h was 73.3% (11/15).1 case died in both two groups.In control group,the proportion of complications such as muscle tension descending,heart rate and blood pressure variation,respiratory depression,et al.was 49.2%,which was significantly higher than 30.9% of the treatment group (x2 =4.668,P =0.31).Conclusion Compared with diazepam plus phenobarbital scheme,midazolam intravenous administration in treatment of children with CSE takes effect faster,and with higher safety.With the increasing of midazolam dosage,alert should be taken to drug influence on respiration and heart rate.
4.Temporal alteration of stone composition and onset age in the upper urinary tract: a cross-sectional study of 1 878 cases
Wei WANG ; Fengning MA ; Ruixian PENG ; Zhiyuan LIN ; Guowei SHI ; Qiang DING ; Jiayang HE
Chinese Journal of Urology 2015;36(8):620-623
Objective To investigate if distribution of stone composition and onset age in the upper urinary tract changed during the past 12 years in China.Methods There were 1 878 urolithiasis patients of the upper urinary tract in our hospital from 2003 to 2014 enrolled in present cross-sectional study.There were 1 300 male and 578 female patients with a median onset age of 46 (6-95) years.Stone composition was measured by infrared spectrophotometry.All the patients were divided into 3 groups according to the onset year:Year 2003-2006,Year 2007-2010 and Year 2011-2014.The distributions of stone types were compared among the 3 groups.Age and gender were included as potential confounders.Chi square test,P trend test,Kruskal-Wallis test and logistic regression were employed in the statistical analysis.Results Calcium oxalate was the most common type with a dominant proportion of 78.1% (1 466/1 878),while uric acid had a small proportion of 4.8% (91/1 878).The proportions of uric acid in the 3 groups were 2.7% (12/441),5.1% (39/758) and 5.9% (40/679),showing an increasing trend (P <0.05).Multivariate analysis showed that year group was independently correlated with the proportion of uric acid,with an OR of 1.385 (95% CI,1.027-1.867).From 2003 to 2014,the proportion of uric acid calculus increased by 0.42% (95% CI,0.25%-0.59%) annually.The median ages of disease onset were 43,46 and 49 years respectively in those three groups,also showing an increasing trend with time (P <0.01).Conclusion From 2003 to 2014,the proportion of uric acid and onset age in patients of upper urinary tract calculi were increased in the present cohort.
5.The change of stone composition and its related risk factors in recurrent urolithiasis
Wei WANG ; Fengning MA ; Ruixian PENG ; Zhiyuan LIN ; Guowei SHI ; Qiang DING ; Jiayang HE
Chinese Journal of Urology 2015;(10):752-756
Objective To investigate the proportion , risk factors and tendency of change of stone composition in recurrent urolithiasis .Methods Eighty-five recurrent urolithiasis patients from 2002 to 2014 were enrolled in this retrospective cohort study .There were 61 male and 24 female patients with a median age of 51 (21-89) years at initial events.Among those patients, 70 had two events, 12 had three events, and 3 had more than 3 events.Compositions of initial and recurrent stones were measured by infrared spectrophotometry.Stone type, recurrence interval and recurrence frequency were studied as potential risk factors for composition change . Chi square test and logistic regression analysis were employed in the statistical analysis.Results Stone composition changed during recurrence in 26 patients ( 30.6%) . Univariate analysis showed the risk ratio of composition change in the patients with recurrence interval of 1-5 years was 0.518 (95%CI, 0.277-0.967, P<0.05) when compared with those of less than 1 year or more than 5 years.Logistic regression analysis showed the odds ratio of recurrence interval of 1-5 years was 0.231 (95%CI, 0.075-0.707, P=0.010).The mutual conversion between calcium oxalate and infection stones was mostly observed when stone composition changed during recurrence .Twenty percent of calcium oxalate stones changed to infection stones and 29.2% of infection stones changed to calcium oxalate .
Conclusions Stone composition changes in about one third patients of recurrent urolithiasis .The mutual conversion between calcium oxalate and infection stones is the most common change .Recurrence interval is an independent risk factor to predict composition change .Repeated stone analysis should be suggested to patients with recurrent interval of less than 1 year or more than 5 years.
6.Study of the value of PSADT in the follow-up of patients with prostate cancer after MAB therapy
Wei WANG ; Guowei SHI ; Jiayang HE ; Renyuan ZHOU ; Wenzhang WANG ; Qiang DING
Chinese Journal of Urology 2013;(4):301-304
Objective To study the value of PSADT in predicting the prognosis and the possibility of disease progression for patients with prostate cancer after MAB therapy.Methods Based on the retrospective review of the history and the follow-up of 159 prostate cancer patients,who received MAB therapy in our department from January 1994 to December 2010,PSADT values were calculated and survival analysis was performed.The ages at diagnosis ranged from 54 to 90 years with a median of 74 years.The pretreatment PSA value ranged from 2.6 to 275.0 μg/L with a median of 46.8 μg/L.The patients of Gleason score ≤6,7 and ≥8 constituted 27.7%,42.1% and 25.2%,respectively.Only 26.4% of the patients were staged as T1N0M0-T2N0M0 and the others had locally advanced disease or metastasis.A multivariate analysis with a Cox's proportional hazard model was used and the disease progression rates in different PSADT groups were also compared.Chi-square test and Log-rank test were applied in statistic analysis.Results The 159 patients received follow-up with a median period of 28 months (6-126 m).The median PSADT of these 159 patients was 5.7 months (0.5-21.0 m).The 3-year and 5-year survival for the 71 patients,whose PSADT were not less than 6 months,were 89.4% and 47.6% respectively,compared with 49.8% and 30.6% for the other 88 patients whose PSADT were less than 6 months.The survivals were significantly different between the two groups (P < 0.01).It was confirmed by a further multivariate analysis with a Cox' s proportional hazard model that PSADT was one of the predictive factors of the prognosis of these prostate cancer patients with a hazard ratio of 2.6 (P < 0.01).Moreover,disease progression were found in 19.7% of the PSADT≥6 m group during the follow-up compared with 63.6% in the PSADT <6 m group.The disease progression rates were also significantly different (P < 0.0 l).Conclusions PSADT can be used to predict the prognosis of patients with prostate cancer after the MAB therapy.The survival for the patients,whose PSADT are not less than 6 months,is higher than those whose PSADT less than 6 months.Meanwhile,PSADT can predict the possibility of disease progression after MAB treatment.
7.Incidence rate and protection strategy of sexual dysfunction after minimally invasive surgery for benign prostatic hyperplasia
Jun ZHANG ; Guowei SHI ; Jiayang HE
Journal of Modern Urology 2023;28(1):5-9
In recent years, minimally invasive surgery has been rapidly developed and has become the first choice for the treatment of moderate to severe benign prostatic hyperplasia (BPH). Although it can significantly improve the lower urinary tract symptoms, reduce complications, and enhance security, postoperative sexual dysfunction(SD) is still common, which affects the patients’ quality of life. In this paper, we discuss the incidence rate of SD after BPH surgery, the protection strategy of sexual function, and how to choose reasonable treatment from the perspective of sexual function protection.