1.The effects of strict dietary salt restriction on blood pressure and proteinuria in chronic glomerulonephritis patients
Luying SUN ; Yu WANG ; Shufang CHEN ; Mengli SUN ; Xiaomei LI
Chinese Journal of Internal Medicine 2009;48(12):995-998
Objective To evaluate the effects of strict dietary salt restriction on blood pressure and proteinuria in chronic glomerulonephritis (CGN) patients. Methods From October 2007 to April 2009, 32 CGN inpatients were enrolled. Among them, 15 patients followed a strict dietary salt restriction menu (sodium 100 mmol/d, potassium 50 mmol/d, protein (0. 8-1. 0) g · kg~(-1) · d~(-1) , calorie (105-125) KJ · kg~(-1) · d~(-1) ) for 7 days, while the other 17 patients were fed freely offered by hospital as controls. 24 h urinary sodium excretion (24h-UNa) was used to monitor the salt intake. No changes of drug therapy were made during the study. Blood pressure was monitored every day. 24-hour urinary protein and serum biochemical parameter were measured before and after the study. Results There was no significant difference of baseline 24h-UNa between the two groups [(135.1 ±50.4) mmol/d vs (137.4 ±28.6) mmol/d) ]. During the study, the average 24h-UNa of patients with strict dietary intervention was (97. 2 ± 8.6) mmol/d. Both SBP [ (117. 7 ± 10. 0) mm Hg( 1 mm Hg=0. 133 kPa) vs (106.2 ±9.9) mm Hg] and DBP [ (76. 3 ± 6. 1 ) mm Hg vs (67. 5 ± 5. 5 ) mm Hg] decreased significantly ( P < 0. 001 ) . Proteinuria decreased significantly too [ 1. 57 (0. 3-3. 0) g/d vs 0. 57 (0. 16-2. 72) g/d,P = 0. 006]. The reduction of SBP was positively correlated with the reduction of 24h-UNa (r =0. 572, P =0. 026) , while the reduction of proteinuria correlated with both the reduction of SBP (r = 0. 568, P = 0. 027) and 24h-UNa (r =0. 525, P =0. 044). In the control group, only SBP decreased significantly [ ( 122. 6 ± 15. 5) mm Hg vs (115.8 ±10.4) mm Hg, P = 0.02] without significant changes of DBP and proteinuria When comparing the subgroups who took ACEI/ARB from both groups, the reduction of proteinuria wasmore prominent of those from the study group than the control group [ - 0. 4 ( -0. 95-0. 07) vs 0. 07 ( - 0. 39-0. 42), P = 0. 014 ]. Conclusion Strict dietary salt restriction is effective in reducing blood pressure and proteinuria in CGN patients.
2.Relationship between renal hypertension and cardiac ?_1-adrenoceptor autoantibodies in rats
Jianming ZHI ; Rongfang CHEN ; Luying ZHAO ; Rongru ZHAO
Chinese Journal of Pathophysiology 1986;0(02):-
AIM: To examine the autoantibody against ? 1-adrenoceptor and its biologic activities during the development of renal hypertension. METHODS: Renal hypertension of rat was achieved by clipped renal artery, the titre of autoantibody to ? 1-adrenoceptor was detected using ELISA immunoassay. Furthermore, the biological offects of these autoantibodies on cultured cardiomyocytes were also examined. RESULTS: After two weeks of clipping renal arteries, both the frequency of occurrence and the titre of autoantibodies to cardiac ? 1-adrenergic receptor were significantly increased as compared with the control of pre-treatment. The increased autoantibodies lasted for several weeks and then automatically decreased gradually to the pre-clipping level at 12 weeks. The biological effects of these autoantibodies displayed an "agonistic-like" activities on the beating frequency of cultured neonatal cardiomyocytes. CONCLUSION: Autoantibodies against ? 1-adrenoceptor may play a role in the elevation of peripheral vascular resistance and in the development of cardiac hypertrophy in rats with renal hypertension.
3.The papeuticcurative effect analysis on malignant tumor of lung transference
Xiao ZHENG ; Luying LIU ; Xiuyong CHEN ; Al ET
China Oncology 2001;0(03):-
Purpose:To investigate the comprehensive treatment value on the malignant Tumor of lung transference.Methods:From January, 1993 to January, 1999, our hospital accepted 75 cases malignant tumor of lung transference in all. It was proved that the primary foci were lungs transference. There are 34 male cases and 41 female cases in the group. The average age is 47 years old the ages(between 27 to 71).Single primary foci reach 12 cases, and multiprimary foci reach 63 cases. Pure operation removals are 4 cases; operation with chemotherapy are 2 cases, and 6 cases are treated with plan radiotherapy before operation with chemotherapy after operation; 17 cases, radio and chemotherapy; 10 cases, only radiotherapy; 36 cases, only chemotherapy. 59 cases in 75 take additional traditional Chinese drugs.Results:The effective rate of nasopharyngeal carcinoma in lung transferring tumor (CR+PR) is 71.4% (20/28) MST is 9.5 month; the effective rate of lung cancer (CR+PR) is 53.3% (8/15) MST 8.5 month; breast cancer, 68.7% (22/32) MST 21 month. The total effective rate of this group (CR+PR) is 66.7% (50/75), CR rate is 36.04%, PR rate is 30.7%, NC rate is 25.3%, PD rate is 8%.Total MST is 13.5 month. Traditional Chinese medicine (TCM) can help the radiotherapy and chemotherapy in the function.Conclusions:The group of cases are for retrospect investigation, there are many disease type, but not many in each type, the analysis of the result shows that they are sensitive to radiotherapy and chemotherapy, the radiotherapy and chemotherapy is a kind of supplementary treatment to low degree malignant tumor of lung transference, it has definite clinical meaning if assisting with traditional Chinese medicine. [
4.Dysphagia after radiotherapy:esophageal barium fluoroscopy examination of swallowing in nasopharyngeal carcinoma patients
Fengjie LIN ; Luying XU ; Huiqin CHEN ; Huasheng LI ; Sufang QIU ; Shaojun LIN ; Cairong HU ; Jun LU
China Oncology 2015;(5):371-376
Background and purpose:Currently, subjective questionaire is the most frequently used methods to evaluate swallowing dysfunctions after radiotherapy in nasopharyngeal carcinoma patients, while lacking of effective objective examinations. This study aimed to explore effective methods to evaluate swallowing dysfunctions after radiotherapy in nasopharyngeal carcinoma patients, and gain knowledge of the incidence and severity of swallowing dysfunctions. Methods: From Oct. 2013 to Dec. 2013, 128 consecutive outpatients with previously treated nasopharyngeal carcinoma received esophageal barium lfuoroscopy examination at there regularly follow-ups to evaluate swallowing function. Among these patients, 89 were primary treated with intensity modulated radiation therapy (IMRT) and 39 with conventional radiotherapy (CRT). In this study, each patient received esophageal barium lfuoroscopy examination for 3 times with thin, thick and pasty barium and were dynamically observed using X-ray fluoroscopy from front and lateral direction. Swallowing dysfunctions were defined as follows:①The bolus could not be swallowed and blocked in the mouth;②The dilute barium diverted to the glottis or trachea;③Residual barium delayed in the pyriform sinus and vallecula;④The movement of the hyoid bone or epiglottis were restricted;⑤Bolus prolong through the pharynx;⑥Barium slowed down when went though the esophageal entrance. Results:Of the 128 patients, incidence of dysphagia was 60.2%for the entire cohort, 52.8%for IMRT group and 76.9%for CRT group. Incidence of dysphagia for IMRT group was signiifcantly lower than CRT group (P=0.018). Dysphagia incidence within 1 year, 1 to 2 years and more than 2 years after RT were 63.1%, 33.3%and 69.0%, respectively (P=0.019). Conclusion:There was a high incidence of swallowing dysfunction for the nasopharyngeal carcinoma patients treated with radiotherapy and dysphagia incidence decreased when treated with IMRT. Esophageal barium lfuoroscopy examination is objective method to evaluate the incidence and severity of the swallowing dysfunction.
5.Long-term results of nasopharyngeal carcinoma treated with radiotherapy:1706 cases report
Jianji PAN ; Yu ZHANG ; Shaojun LIN ; Ling YANG ; Luying XU ; Chuanben CHEN ; Caizhu PAN
Chinese Journal of Radiation Oncology 2008;17(4):247-251
Objective To analyze the long-term efficacy,prognostic factors and radiation sequela of nasopharyngeal carcinoma(NPC)treated with radiotherapy at the end of last century.Methods From January 1995 to December 1998,1706 newly diagnosed NPC patients treated with radiotherapy were included in the retrospective clinical analysis.There were 1081 patients treated with radiotherapy alone,625 with two to three circles of chemotherapy(5-Fu and DDP)before radiotherapy,23 with thermotherapy during radiotherapy and 162 with braehytherapy by 192Ir after external beam radiation.Results The 5-year overall survival. local control survival and disease-free survival rates were 67.60%.84.20%and 64.22%.respectively.The 5-year survival of patients with stage Ⅰ,Ⅱ,Ⅲand Ⅳ(the Fuzhou Staging,1992)were 100%,75.93%,66.47%and 49.34%.respectively.Cox regression analysis showed that the TNM classification,radiotherapy discontinuance,chemotherapy,sex,age and anemia before radiotherapy were the significant factors of survival.Conclusions Our experience shows that the main factors for the long term survival of NPC patients after radiotherapy are early TNM stage,young age,female,non-anemia before radiotherapy, radiotherapy continuance and chemotherapy.
6.Study on clinical typing of nasopharyngeal carcinoma in patients treated by intensity-modulated radiotherapy
Ran ZHANG ; Junxin WU ; Luying XU ; Shaojun LIN ; Ling YANG ; Chuanben CHEN ; Jianji PAN
Chinese Journal of Radiation Oncology 2013;(3):217-219
Objective To investigate the clinical typing of nasopharyngeal carcinoma in patients treated by intensity-modulated radiation therapy (IMRT).Methods A retrospective analysis was performed on 333 patients with nasopharyngeal carcinoma who were initially treated in our hospital from 2003 to 2006 ;they had no distant metastasis and received IMRT.These patients were divided into 4 clinical types according to their prognosis:type Ⅰ (without local-regional recurrence and without distant metastasis),type Ⅱ (with local-regional recurrence and without distant metastasis),type Ⅲ (without local-regional recurrence and with distant metastasis),and type Ⅳ (with local-regional recurrence and with distant metastasis).Results Of all the patients,70.0% (233) were of type Ⅰ,12.9% (43) of type Ⅱ,16.5% (55) of type Ⅲ,and 0.6% (2) of type Ⅳ.Of 57 patients with stage Ⅰ-Ⅱ nasophayngeal carcinoma,86% (49) were of type Ⅰ,11% (6) of type Ⅱ,4% (2) of type Ⅲ,and 0% (0) of type Ⅳ,and of 276 patients with stage Ⅲ-Ⅳ nasopharyngeal carcinoma,66.7% (184) were of type Ⅰ,13.4% (37) of type Ⅱ,19.2% (53) of type Ⅲ,and 0.7% (2) of type Ⅳ,with significant differences between the two patient groups (P =0.007).Of the 69 patients who received IMRT alone,80% (55) were of type Ⅰ,12% (8) of type Ⅱ,9%(6) of type Ⅲ,and 0% (0) of type Ⅳ; of the 218 patients who received IMRT combined with neoadjuvant plus concurrent chemotherapy,68.8% (150) were of type Ⅰ,13.8% (30) of type Ⅱ,16.5%(36) of type Ⅲ,and 0.9% (2) of type Ⅳ; of the 46 patients who received IMRT combined with neoadjuvant plus adjuvant chemotherapy,61% (28) were of type Ⅰ,11% (5) of type Ⅱ,28% (13) of type Ⅲ,and 0% (0) of type Ⅳ.Conclusions In patients with early and advanced nasopharyngeal carcinoma,type Ⅰ is the most common,and type Ⅳ is the least common;type Ⅱ is more frequent than type Ⅲ in early patients,while type Ⅲ is more frequent than type Ⅱ in advanced patients.The percentage of type Ⅰ patients increases,while that of type Ⅱ-Ⅳ patients decreases,as compared with the data of those treated by conventional radiotherapy.
8.The preliminary study of setup errors' impact on dose distribution of image guide radiation therapy for head and neck cancer
Luying XU ; Jianji PAN ; Xiaoliang WANG ; Penggang BAI ; Qixin LI ; Zhaodong FEI ; Chuanben CHEN ; Liqin MA ; Tianlan TANG
Chinese Journal of Radiation Oncology 2011;20(6):506-509
Objective To measure the set-up errors of patients with head and neck (H&N) cancer during the image guided intensity-modulated radiotherapy (IMRT) treatment and analyze the impact of setup errors on dose distribution ; then to further investigate the necessity of adjustment online for H&N cancer during IMRT treatment.Methods Cone-beam CT (CBCT) scanning of thirty patients with H&N cancer were acquired by once weekly with a total of 6 times during IMRT treatment.The CBCT images and the original planning CT images were matched by the bony structure and worked out the translational errors of the x,y,z axis,as well as rotational errors.The dose distributions were recalculated based on the data of each setup error.The dose of planning target volume (PTV) and organs at risk were calculated in the replanning,and than compared with the original plan by paired t-test.Results The mean value of x,y,z axis translational set-up errors were ( 1.06 ± 0.95 ) mm,( 0.95 ± 0.77 ) mm and ( 1.31 ± 1.07 ) mm,respectively.The rotational error of x,y,z axis were ( 1.04 ±0.791 ),( 1.06 ±0.89) and (0.81 ±0.61 ),respectively.PTV 95% volume dose ( D95 ) and PTV minimal dose of replanning for 6 times set-up were lower than original plan (6526.6 cGy:6630.3 cGy,t =3.98,P =0.000 and 5632.6 cGy:5792.5 cGy,t =- 2.89,P =0.007).Brain stem received 45 Gydose volume ( V45 ) and 1% brain stem volume dose ( D01 )were higher than original plan ( 3.54%:2.75%,t =3.84,P =0.001 and 5129.7 cGy:4919.3 cGy,t =4.36,P =0.000).Conclusions The set-up errors led to the dose of PTV D95 obviously insufficient and significantly increased V45,D01 of the brainstem.So,adjustment online is necessary for H&N cancer during IMRT treatment.
9.The Experience and Implications of the Artificial Intelligence Payment in the US.
Chunlu YU ; Wen CHEN ; Luying ZHANG
Chinese Health Economics 2024;43(7):93-96
Objective:To summarize the main practices and experiences of the Centers for Medicare&Medicaid Services in the US.to pay for artificial intelligence(AI),which can provide references for the formulation of health insurance payment policies in China.Methods:Based on the literature study,it systematically analyzed the payment mechanism and typical cases of AI pay-ment in the US.Results:The US.has established four payment mechanisms for AI used in inpatient,outpatient and physician ser-vices,and set clear criteria for inclusion and payment,which has facilitated the clinical use of AI.Conclusion:It is suggested that China establish the payment mechanism for AI,focus on the clinical benefits of AI,and be alert of the overuse of AI.
10.The Experience and Implications of the Artificial Intelligence Payment in the US.
Chunlu YU ; Wen CHEN ; Luying ZHANG
Chinese Health Economics 2024;43(7):93-96
Objective:To summarize the main practices and experiences of the Centers for Medicare&Medicaid Services in the US.to pay for artificial intelligence(AI),which can provide references for the formulation of health insurance payment policies in China.Methods:Based on the literature study,it systematically analyzed the payment mechanism and typical cases of AI pay-ment in the US.Results:The US.has established four payment mechanisms for AI used in inpatient,outpatient and physician ser-vices,and set clear criteria for inclusion and payment,which has facilitated the clinical use of AI.Conclusion:It is suggested that China establish the payment mechanism for AI,focus on the clinical benefits of AI,and be alert of the overuse of AI.