1.Efficacy and Safety of Coronary Artery Bypass Grafting Without Stopping Pre-operative Aspirin Administration:A Meta Analysis
Chinese Circulation Journal 2015;(6):547-551
Objective: To systemically evaluate the efifcacy and safety of coronary artery bypass grafting (CABG) without stopping pre-operative aspirin administration for anti-platelet therapy in relevant patients. Methods: The computer searching including Cochrane Library (Issue 2, 2014), PubMed, EMbase, CBM, CNKI, WanFang Data and VIP was conducted to collect the randomized controlled trial (RCT) for CABG without stopping pre-operative aspirin administration from the data base establishment until 2014-07. There were 2 reviewers identiifed the literatures independently according to inclusion, exclusion criteria, and extracted the information, evaluated the quality of assessment methods, then meta-analysis was performed by RevMan 5.2 software. Results: A total of 8 RCT studies including 1945 patients were enrolled. The meta analysis showed that compared with stopping pre-operative aspirin administration, the patients without stopping pre-operative aspirin had obviously increased post-operative bleeding drainage as MD=235.97,P=0.01, re-operation for bleeding as OR=2.4,P=0.0005 and fresh frozen plasma transfusion requirement as MD=0.79,P<0.0001. While the packed red blood cell (PRBC) transfusion requirement as MD=0.66, P=0.05, platelet transfusion requirement as MD=0.99,P=0.25, the incidence rate of post-operative myocardial infarction as OR=1.03,P=0.90 and post-operative mortality (OR=1.24,P=0.56) were similar between two conditions. Conclusion: CABG without stopping pre-operative aspirin administration may increase the post-operative bleeding,transfusion and re-operation for bleeding; low dose aspirin administration before CABG needs further investigation to solve the above problems in clinical practice.
2.A Meta-analysis for Endoscopic Vessel Harvesting in Great Saphenous Vein in Coronary Artery Bypass Grafting
Chinese Journal of Minimally Invasive Surgery 2014;(12):1135-1139,1143
Objective To review systemically the safety of endoscopic vessel harvesting ( EVH ) in coronary artery bypass grafting (CABG). Methods By searching documentations in the Cochrane Library , Pubmed, Medline,EMbase, CBM, CNKI, Wanfang database , and Weipu database , with no limits for language , a random-controlled meta-analysis was assembled for evaluating the safety of EVH of great saphenous veins in CABG .The retrieval deadline of these databases was September 2013.Two evaluators were in charge of selecting , extracting , and assessing the quality of methodology in all these articles according to extract criterion independently.The RevMan 5.2 was used for meta-analyse. Results The whole test included 12 RCTs and 1510 patients, comprising of 857 patients with EVH and 653 patients with traditional harvesting .As compared with traditional group , the EVH group showed lower rate of postoperative incision infection [OR=0.24, 95%CI:0.16-0.36, P<0.0001], less postoperative pain [OR=-1.06, 95%CI:-1.26--0.86, P<0.0001], and less postoperative complications [OR=0.28, 95% CI:0.19-0.42, P<0.0001].There were no significant differences between the two groups in hospital stay [WMD=0.17, 95%CI:-0.22-0.56, P=0.40] and mortality [OR=0.88, 95% CI:0.30 -2.64, P=0.82]. Conclusion EVH factually reduces trauma in CABG, postoperative infection rate , postoperative pain , postoperative complications , and hospital stay ,being applicable for high risk patients .
3.Current status of prosthesis-patient mismatch after valve replacement
International Journal of Surgery 2011;38(3):179-182
Valve replacement is the primary means of treatment of valvular disease. With the further research of artificial valve, Prosthesis-patient mismatch is becoming a hot research hotspot. This paper reviews research status of Prosthesis-patient mismatch.
4.Correlation of RECK with matrix metalloproteinase-2 in regulation of trophoblast invasion of early pregnancy.
Journal of Huazhong University of Science and Technology (Medical Sciences) 2006;26(6):738-40
To study the role of the reversion-inducing-cysteine-rich protein with Kazal motifs (RECK) gene and matrix metalloproteinase-2 (MMP-2) in the regulation of trophoblast invasion of early pregnancy. Immunohistochemistry, Western blot and gelatin zymography were used to detect the RECK protein expression localization, expression level and MMP-2 activation level in the placental tissues harvested from 52 normal pregnant women (27 in the early pregnancy, 25 in the term pregnancy). Immunohistochemistry showed that RECK expression was found both in villous tissues of early pregnancy group and term pregnancy group and was mainly observed in cell membrane and cytoplasm of cytotrophoblasts and syneytiotrophoblasts. RECK expression increased with gestational time. RECK expression of early pregnancy group was significantly lower than that of term pregnancy group (P<0.05). RECK expression was significantly lower in cellular column (CC) with invasion ability. Western blot showed that the RECK protein expression in early pregnancy group was significantly lower than that in term pregnancy (P<0.05). The optical density values of RECK protein expression in early pregnancy group and term pregnancy group were 1.35-0.14 and 2.68+/-0.26, respectively, while MMP-2 activation ratio was contrary to RECK protein expression and decreased with the gestation time (P<0.01). The MMP-2 activation ratios of early pregnancy group and term pregnancy group were 0.46 +/- 0.05 and 0.10+/-0.02, respectively. The expression of the tumor inhibitory gene RECK was positively related with the invasion ability of trophoblasts, while the invasion gene MMP-2 was negatively related with the ability. The interaction between RECK and MMP-2 may play an important role in the regulation of the trophoblast invasion in early pregnancy.
5.Suppressing effects of MMPs inhibitor GM6001, MMP-2/9 inhibitor Ⅰ ,MMP-2/9 inhibitor Ⅱ on migration of human lens epithelial cells
Chinese Journal of Experimental Ophthalmology 2015;33(9):811-815
Background The primary pathologic mechanism of posterior capsular opacification (PCO) is proliferation,migration and epithelial-mesenchymal transformation of residuary lens epithelial cells (LECs) following cataract surgery.Matrix metalloproteinases (MMPs) play a role during the migration of LECs.Researches showed that GM6001,a broad inhibitor of MMPs,can arrest the migration of LECs,but as specific inhibitors of MMPs,the efficacy and safety of MMP-2/9 inhibitor Ⅰ and Ⅱ on LECs migration remain unclear.Objective This study was to determine and compare the inhibitory efficacy among GM6001,MMP-2/9 inhibitor Ⅰ and Ⅱ on human LECs and search the clinical medication to prevent PCO.Methods Human LECs were cultured and passaged in vitro,and the cells of 3-4 generation were incubated in 6-well plates.Then the cells of 70% confluent monolayer were cultured in DMEM without fetal bovine serum for 12 hours.GM6001,MMP-2/9 inhibitor Ⅰ and Ⅱ at different concentrations (0.25,0.50,1.00,2.00,4.00,8.00,16.00,32.00,64.00,128.00 μmol/L) were added into the culture medium for 24 hours separately,and regularly cultured cells served as the control group.A bare area was made by a 200 μl sterile spear on the cell layer,and the migrated distance and inhibitory rate were calculated.The second or third generation of cells were incubated in 96-well plates at a density of 5×105/ml (200 μl/well).GM6001 (128.00 μmol/L),MMP-2/9 inhibitor Ⅰ (64.00 μmol/L) and Ⅱ (32.00 μmol/L) were added into the culture medium for 24 hours,and the cell viability was assayed by using MTT assay.Results Cultured cells grew well with irregular arrangement and presented the polygon in shape.The migrated distance was gradually reduced as the increase of concentrations of GM6001,MMP-2/9 inhibitor Ⅰ and Ⅱ,showing significant differences among the various concentration groups (GM6001:F=248.647,P<0.05;MMP-2/9 inhibitor Ⅰ:F=357.125,P<0.05;MP2/9 inhibitor Ⅱ:F=396.374,P< 0.05).The cell migrated distance in the control group was set to 1,the relative migrated distances were 0.478 ± 0.091,0.294±0.088 and 0.191 ±0.081 in the GM6001 group,MMP-2/9 inhibitor Ⅰ group and MMP-2/9 inhibitor Ⅱ group at the concentrations of 32.00 μmol/L,respectively,showing a significant difference among the groups (F =116.031,P<0.01),and cell migrated distance was obviously shorter in the MMP-2/9 inhibitor Ⅱ group than that in the GM6001 group or MMP-2/9 inhibitor Ⅰ group (all at P<0.01).The A values were 0.607±0.016,0.567±0.015,0.583±0.010 and 0.595 ±0.0138 in the control group,GM6001 group (128.00 μmol/L),MMP-2/9 inhibitor Ⅰ group (64.00 μmol/L) and MMP-2/9 inhibitor Ⅱ group (32.00 μmol/L),respectively,without significant difference among the groups (F=1.403,P>0.05).Conclusions GM6001,MMP-2/9 inhibitor Ⅰ and Ⅱ reduce the mobility of human LECs effectively but do not affect the viability of the cells in vitro.MMP-2/9 inhibitor Ⅱ appears to be most dominant in inhibiting migration of human LECs.
6.Analysis of hypothalamic-pituitary-adrenal axis function in type 2 diabetes mellitus patients combined with depression with different courses
Chinese Journal of Postgraduates of Medicine 2013;36(34):40-42
Objective To analyze the hypothalamic-pituitary-adrenal axis function in type 2 diabetes mellitus(T2DM) patients combined with depression with different courses.Methods Forty T2DM without depression patients (T2DM without depression group) and 42 T2DM combined with depression patients (T2DM combined with depression group) were divided into 3 groups according to the courses:< 5years,5-15 years,> 15 years.Thirty healthy person were selected as control group.The levels of serum adrenocorticotropic hormone (ACTH),cortisol (Cor),fasting blood glucose (FPG),glycosylated hemoglobin (HbA1c),24 h urinary-free cortisol (UFC) were determined at 8:00 Am.Results The levels of serum ACTH,24 h UFC in T2DM without depression group were higher than those in control group [(241.7 ±132.6) pg/L vs.(174.1 ± 108.2) pg/L and (96.67 ± 15.92) μg vs.(76.04 ±24.60) μg],and there were significant differences (P < 0.05 or < 0.01).There were no significant differences in the levels of serum ACTH,Cor,24 h UFC among < 5 years,5-15 years,> 15 years in T2DM without depression group (P>0.05).The levels of serum Cor,24 h UFC in T2DM combined with depression group were higher than those in T2DM without depression group and control group,and there were significant differences (P < 0.01),but compared with those in T2DM without depression group with the same courses,only ACTH was different in <5 years (P < 0.01),Cor,24 h UFC was different in > 15 years (P < 0.01).There was significant difference in the level of serum ACTH between < 5 years and 5-15 years,> 15 years in T2DM combined with depression group (P < 0.01),Cor had no difference among different courses (P > 0.05),24 h UFC had difference between > 15 years and < 5 years,5-15 years (P< 0.01 or < 0.05).In T2DM without depression group,the level of serum Cor was positively correlated with FPG (P < 0.01),the level of serum ACTH was positively correlated with FPG (P <0.05).In T2DM combined with depression group,the level of serum Cor was positively correlated with FPG,HbA1c (P < 0.01),the level of serum ACTH was no relationship with others,the level of serum 24 h UFC was positively correlated with FPG,HbA1c (P< 0.01).Conclusion With the prolonged courses of diabetes,the function of hypothalamic-pituitary-adrenal axis gets worse in T2DM patients combined with depression.
7.Theme clusters and evolutions of research on medical protection against nerve agents
Li SHENG ; Junhong WANG ; Tianxi DIAO
Military Medical Sciences 2015;(4):261-265
Objective To find the course of theme evolution for study of medical protection against nerve agents.Meth-ods A method of information visualization based on co-cited analysis was used.The research domain of medical protection against nerve agents was mapped using software VOSviewer.Results There were five research clusters including clinical research, oxime reactivators, detoxification and detection,and bioscavengers.Conclusion Theme evolution is described and research trends are predicted.
8.Clinical study of the patients with Stanford type A aortic dissection received urgent surgery
Mingming ZHANG ; Yuanyuan WU ; Junhong LI
Chinese Journal of Emergency Medicine 2016;25(1):79-82
Objective To analyse the factors influencing the death of patients with aortic dissection (Stanford type A arota dissection) who underwent urgent surgery.Methods The clinical data of 197 patients with aortic dissection (Stanford type A arota dissection) treated with urgent surgery from the First Affiliate Hosiptal of Xinjiang Medical University were retrospectively analyzed between January 2009 and June 2015 in order to determine the factors influencing the early-mortality.Results Of them,23 patietns dead.In univariant analysis,the rate of mortality was 11.68%.The following factors at admission were independetly associated with early-mortality:hypertension,coronary atherosclerotic heart disease,LVEF ≤ 50%,time consumed for CPB ≥ 180 min,time required for cross-clamping aorta ≥ 120 min,Cr ≥ 130 μmol/L,rethoracotomy for hemostasis (P <0.05).The preoperative renal failure (Cr≥130 μmol/L) and time consumed for cross-clamping aorta ≥ 120 min were strongly associated with the early-mortality based on the logistic regression analyses.Conclusions The risk of aortic dissection surgery is very high,and it is mondatory to carefully evaluate the patient' s general condition and the indications during peroperative period,and to take active measures to shorten the time of clamping aorta and total operation time in order to reduce the risk of operation and increase the survival rate of patients.
9.Determination of Bullatine A in Gutongling Babu Plaster by HPLC
Junhong LI ; Rixian JIN ; Bin ZHAO
Chinese Journal of Information on Traditional Chinese Medicine 2006;0(04):-
Objective To establish a method for the determination of Bullatine A in Gutongling Babu plaster. Method The Bullatine A was determined by HPLC on Kromasil-C18 column, and the mobile phase consisted of phosphate buffered solution (pH 7.3) - methanol (28∶72), the detection wavelength was 210 nm. Result A good linear relationship of Bullatine A was showed in the range of 0.212 0~4.770 0 ?g (r =0.999 99), and the average recovery was 100.10%, RSD=2.53% (n =6). Conclusion The method is accurate and reliable, and can be used for quality control of Gubitong Babu plaster.
10.The study on the association between smoking and pain intensity in heroin-dependent patients receiving methadone maintenance treatment
Biao LI ; Baoliang ZHONG ; Junhong ZHU
Chinese Journal of Nervous and Mental Diseases 2017;43(7):391-395
Objective To explore the relationship between smoking and pain intensity in heroin-dependent patients (HDPs) receiving methadone maintenance treatment (MMT).Methods A total of 603 HDPs from MMT outpatients completed a socio-demographic and clinical characteristics questionnaire,a smoking questionnaire,Heaviness of Smoking Index,and Zung's Self-rating Depression Scale.Five-point Verbal Rating Scale was used to assess pain intensity.Results After adjustment for the confounding effects of socio-demographics,clinical characteristics,and depressive symptoms in the analysis of covariance,smokers had significantly higher pain intensity score compared with non-smokers (F=1 1.836,P=0.002).Multiple comparisons showed that the pain intensity level of patients with moderate-to-severe nicotine dependence was the highest,patients with mild nicotine dependence took the second place,and patients with no nicotine dependence was the lowest [(3.11±1.04) vs.(2.67±1.13) vs.(2.47± 1.15),all P<0.05].Conclusion Smoking is significantly associated with pain in HDPs receiving MMT.The more severe the nicotine dependence that a HDP has,the intense the pain he/she has.