1.Effects of Bio-feedback and Pelvic Electric Stimulation on Stress Urinary Incontinence
Xinkan PENG ; Yanping ZHANG ; Rongfang HUANG ; Ran GAO ; Wenjuan YANG
Journal of Kunming Medical University 2016;37(11):97-100
Objective To investigate clinical effects of bio-feedback and pelvic electric stimulation on stress urinary incontinence (SUI).Methods Fifty-six patients with SUI were selected randomly.All the patients received one or two courses of treatment and the effects were observed.Results Forty-three patients finished the treatment and the symptoms were improved.Scores of ICI-Q-SF and rotational angle of bladder were found to be significantly different from those before the treatment.Conclusions Stress urinary incontinence could be treated by bio-feedback and pelvic electric stimulation.Both the combination of treatment and individualized treatment should be taken into account.
2.Population pharmacokinetic/pharmacodynamic modeling of warfarin by nonlinear mixed effects model.
Rongfang LIN ; Weiwei LIN ; Changlian WANG ; Pinfang HUANG ; Sujun FANG
Acta Pharmaceutica Sinica 2015;50(10):1280-4
The study aimed to establish a population pharmacokinetic/pharmacodynamic (PPK/PD) model of warfarin. PCR-RFLP technique was used to genotype the CYP2C9 and VKORC1 polymorphisms of 73 patients. RP-HPLC-UV method was used to determine the 190 plasma concentrations of warfarin. Application of NONMEM, the clinical information and 263 international normalized ratio (INR) monitoring data were used to investigate the effect of genetic, physiological, pathological factors, other medication on clearance and anticoagulant response. The final model of warfarin PPK/PD was described as follows: CL = θCL · (WT/60)θWT · θCYP · eηCL (if CYP2C9*1/*1, θCYP = 1; if *1/*3, θCYP = 0.708); EC50 = θEC50 · θVKOR · eηEC50 (if VKORC1- 1639AA, θVKOR = 1; if GA, θVKOR = 2.01; V = θV; K(E0) = θK(E0); Emax = θEmax; E0 = θE0 · eηE0. Among them, the body weight (WT), CYP2C9 and VKORC1 genotype had conspicuous effect on warfarin PK/PD parameters. The goodness diagnosis, Bootstrap, NPDE verification showed that the final model was stable, effective and predictable. It may provide a reference for opitimizing the dose regimen of warfarin.
3.The Relationship between the Blood Pressure in Subjects with Impaired Glucose Relation and the Tirst-phase Insulin Secretion
Qiuling ZHANG ; Lan SHOU ; Xuefeng HUANG ; Rongfang TANG
Journal of Medical Research 2006;0(10):-
Objective To investigate the relationship between the blood pressure in subjects with impaired glucose relation and the first-phase insulin secretion.Methods The oral glucose tolerance test was performed in 126 subjects who were divided into normal blood pressure group higher blood pressure group and hypertension group.The beta-cell function was calculated by HOMA-IR and △I30/△G30.Results ①The BMI and WHR were significantly higher in hypertension group.The serum level of lipids was changed in higher blood pressure and hypertension groups.② The fasting plasma insulin level,60、120 minutes insulin level after oral 75 game glucose were significantly higher in hypertension group.③ The HOMA-IR was significantly higher in higher blood pressure and hypertension groups,with more higher in hypertension group.④ The △I30/△G30 was significantly decrease in hypertension group.There are no different in other groups.Conclusion The higher blood pressure,the more severe insulin resistance,the more decrease first-phase insulin secretion.
4.Evaluation of white matter lesions in patients with mild and moderate Alzheimer's disease using proton magnetic resonance spectroscopy and diffusion tensor imaging
Jianhua WANG ; Peiyuan LV ; Rongfang FENG ; Tianjun WANG ; Hebo WANG ; Jie WU ; Huadong ZHAO ; Yue HUANG
Chinese Journal of Behavioral Medicine and Brain Science 2010;19(4):328-330
Objective To investigate the pattern of the cerebral white matter lesions in patients with mild and moderate Alzheimer's disease(AD)and healthy controls using proton magnetic resonance spectroscopy(~1H-MRS)and diffusion tensor imaging(DTI).Methods Twenty AD patients and Twenty healthy controls were recrnited.All subjects underwent clinical examination,neuropsychological assessment.The quantitative analysis of N-acetylaspartate(NAA),myoinositol(mI),Chotine(Cho)and Creatine(Cr)resonance signals in region of interests(ROIs)located in the paraventricular white matter region bilaterally were measured.Ratios of NAA/Cr,mI/Cr and Cho/Cr were calculated in two groups.In addition,conventional MRI and DTI scanning were received,fractional anisotropy(FA)and mean diffusivity(MD)values of white matter in the same regions were measured respectively.Results No significant difference between two groups were observed in NAA/Cr ratio(P>0.05).A significantly increased mI/Cr and Cho/Cr were found in AD patients than in controls(P<0.05).FA and MD values in AD patients were 0.470±0.082 and 0.771±0.099,and in controls were 0.539±0.068 and 0.691±0.064,respectively.FA value decreased significantly in AD patients(P<0.05),M D value increased significantly in AD patients(P<0.05).After controlling for age-related,partial correlation analysis revealed a negtive correlation between mI/Cr and FA value in the patients with AD(P<0.05).No correlation between mI/Cr and MD was found(P>0.05).Conclusion The results suggest that not only the gray matter is injured,but also the white matter is abnormal in AD patients.Combining ~1H-MRS with DTI alterations could provide the valuable informations about white matter lesions in AD patients.
5.Clinical value of evaluating left ventricular mechanical synchrony by gated blood pool imaging and tissue Doppler imaging
Xiaomei WANG ; Xiaobin ZHAO ; Ping LI ; Cuihua WANG ; Jin LONG ; Yunzhou HUANG ; Rongfang SHI ; Ziwen REN
Clinical Medicine of China 2010;26(8):804-806
Objective To investigate the clinical value of the gated blood pool imaging phase analysis method in the evaluation of left ventricular mechanical synchronization in patients with chronic heart failure. Methods A total of 169 patients with chronic heart failure were enrolled in our study , using gated blood pool imaging phase analysis method to obtain left ventricular phase angle width ( PHB) and left ventricular phase angle standard deviation ( PSD) as evaluating left ventricular mechanical synchrony index; using tissue Doppler imaging (TDI) measurement of the standard deviation of systolic peak time(Ts-SD) of each segment by using the current prevailing 12 non-apical segments analysis method as evaluating left ventricular mechanical synchrony index, and parameters derived from both methods were compared. Results LVPHB was highly correlated with Ts-SD (r = 0. 83 ,P = 0. 000 ) . LVPSD was modestly correlated with Ts-SD ( r - 0. 69, P = 0. 000) . The ejection fraction measured by echocardiography was (42.93 ± 14. 89) % ,which was significantly higher than that measured by ERNA (39. 76 ± 17. 89)% (P <0. 01). Conclusions The evaluation of left ventricular mechanical synchrony in patients with chronic heart failure by the gated blood pool imaging can provide similar information with TDI, which can simultaneously measure two ventricular functions and get more accurate measurement of ejection fraction. Cardiac resynchronization therapy patients can be identified by combining two kinds of approaches, and cardiac resynchronization therapy responders could be improved as well. More patients with heart failure can benefit from cardiac resynchronization therapy therapy.
6.AmpC Enzyme Mediated by Chromosome Prevailed in Acinetobacter baumannii Strains Isolated from Burned Patients
Huali CHENG ; Yuhong PAN ; Qinghe SU ; Xuan HUANG ; Rongfang CHEN ; Feng ZHANG
Chinese Journal of Nosocomiology 2006;0(08):-
OBJECTIVE To investigate the distribation of the AmpC enzyme in Acinetobacter baumannii isolated from burned patients. METHODS Susceptibility tests were used to detect antibiotic resistance to 20 kinds of antimicrobial drugs in 20 strains of A. baumannii isolated from burned patients, AmpC enzyme genes were detected by PCR and partial positive products were chosen to sequence. RESULTS Drug resistances to ?-lactam antibiotics in 20 strains of A. baumannii isolated from burned patients had exceeded 85% except levofloxacin or cefoperazone/sulbactam. Of ADC genes 95% were positive, but all DHA genes were negative. Through sequence and Blast analysis, partial ADC positive products were identical with that of EF546445. CONCLUSIONS The multidrug resistance of A. baumannii isolated from burned patients to ?-lactam antibiotics is serious. AmpC enzyme mediated by chromosome, ADC, prevails in A. baumannii isolated from burned patients.
7.Carbapenemase of OXA-23 Prevailed in Acinetobacter baumannii Isolated from Burned Patients
Yuhong PAN ; Qinghe SU ; Xuan HUANG ; Huali CHENG ; Rongfang CHEN ; Feng ZHANG
Chinese Journal of Nosocomiology 2004;0(10):-
OBJECTIVE To investigate the disseminateion of the carbapenemase in Acinetobacter baumannii isolated from burned patients.METHODS Susceptibility tests of 20 strains of A.baumannii isolated from burned patients to 20 kinds of antimicrobial drugs were detected.Subsequently,seven genes encoding carbapenemase,including OXA-23,OXA-24,OXA-51,OXA-58,IMP,VIM and SIM,were detected by PCR and genes of partial positive products were sequenced.RESULTS Drug resistances to ?-lactam antibiotics of 20 strains of A.baumannii isolated from burned patients all exceeded 85% except to levofloxacin or cefoperazone/sulbactam.Nineteen strains(95%) were OXA-23 genes positive and all other genes were negative.Through sequence and Blast analysis,OXA-23 gene products were identical with that of CAB69042.1.CONCLUSIONS The multidrug resistance of A.baumannii isolated from burned patients to ?-lactam antibiotics is critical.Carbapenemase of OXA-23 prevails in A.baumannii isolated from burned patients.
8.Risk factors for intensive care unit delirium after cardiac operation
Lijing SU ; Yilu YAN ; Wenjuan HUANG ; Qin XU ; Jinhua LIAO ; Huimin LIN ; Dandan WU ; Sailan LI ; Rongfang HU
Chinese Critical Care Medicine 2019;31(2):165-171
Objective? ?To?analyze?the?risk?factors?of?delirium?in?patients?in?cardiac?surgery?intensive?care?unit?(CSICU).? Methods? A?prospective?observational?study?was?performed.?Patients?admitted?to?CSICU?of?Fujian?Medical?University?Union?Hospital?from?March?to?August?in?2017?were?enrolled.?The?combination?of?the?Richmond?agitation?sedation?scale?(RASS)?and?the?ICU-confusion?assessment?method?(CAM-ICU)?were?used?to?evaluate?delirium.?The?patient?was?assessed?on?the?second?day?after?CSICU?admission,?twice?a?day,?the?evaluation?was?stopped,?and?the?follow-up??observation?was?terminated?after?the?patient?was?discharged?from?CSICU.?The?patients?were?divided?into?two?groups?according?to?whether?delirium?occurred?in?CSICU.?The?general?and?clinical?treatment?data?(including?condition,?operation,?anesthesia?and?CSICU?treatment)?of?the?two?groups?were?compared.?The?related?factors?of?delirium?were?identified?by?univariate?analysis?and?multifactor?Logistic?regression?analysis.? Results? A?total?of?318?cases?were?included?in?this?study.?Among?them,?93?cases?had?delirium?and?the?incidence?of?delirium?was?29.2%.?It?was?shown?by?univariate?analysis?that?age,?history?of?hypertension,?type?of?surgery,?surgical?procedure,?American?Society?of?Anesthesiologists?(ASA)?anesthesia?classification,?usage?of?propofol,?plasma?transfusion,?red?blood?cells,?platelet?transfusion,?blood?loss,?operative?time,?cardiopulmonary?bypass?(CPB)?time,?myocardial?block?time,?acute?physiology?and?chronic?health?evaluation?Ⅱ?(APACHEⅡ),?duration?of?mechanical?ventilation,?the?length?of?intensive?care?unit?(ICU)?stay,?postoperative?usage?of?diazepam,?midazolam,?fentanyl,?morphine,?chlorpromazine,?etc.?which?were?related?to?delirium,?and?occupation?? (on-the-job?or?self-employed),?medical?insurance?(city?or?provincial?medical?insurance),?education?(primary?to?junior?high?school,?high?school?or?above)?could?reduce?the?risk?of?delirium.?Colinearity?diagnosis?was?performed?on?variables?with?statistically?significant?differences,?and?variables?with?variance?expansion?factor?(VIF)?3?were?included?in?multivariate?Logistic?regression?analysis.?The?results?showed?that?age,?education?level,?type?of?surgery,?ASA?classification,?CPB?time,?APACHEⅡ,?ICU?mechanical?ventilation?time,?and?post?operation?usage?of?midazolam?were?independently?related?to?delirium?[age:?odds?ratio?(OR)?=?1.625,?95%?confidence?interval?(95%CI)?=?1.303-2.026;?education?level:?OR?=?0.293,?95%CI =?0.171-0.504;?type?of?surgery:?OR?=?2.194,?95%CI =?1.052-4.576;?ASA?classification:?OR?=?1.916,?95%CI =?1.032-3.559;?CPB?time:?OR =?2.125,?95%CI =?1.105-4.088;?APACHEⅡ:?OR =?2.091,?95%CI =?1.005-4.349;?ICU?mechanical?ventilation?time:?OR =?1.943,?95%CI?=?1.269-2.975;?midazolam:?OR =?2.653,?95%CI =?1.328-5.299;?all?P?0.05],?among?which,?high?education?level?has?a?good?protective?effect?on?delirium.? Conclusions? Age,?type?of?surgery,?ASA?classification,?CPB?time,?APACHEⅡ,?ICU?mechanical?ventilation?time,?post?operation?usage?of?midazolam?were?independent?risk?factors?for?delirium,?and?high?education?level?had?a?good?protective?effect.?Among?them,?the?educational?level,?CPB?time,?duration?of?mechanical?ventilation,?and?midazolam?are?intervention?factors.?In?clinical?treatment,?not?only?the?risk?factors?should?be?identified,?but?also?intervention?should?be?taken?to?prevent?the?occurrence?of?delirium.
9.Reliability and validity of Chinese version of Intensive Care Unit Environment Stressor Questionnaire
Lijing SU ; Yilu YAN ; Wenjuan HUANG ; Jinhua LIAO ; Sailan LI ; Rongfang HU
Chinese Journal of Nursing 2018;53(4):508-512
Objective To translate the English vcrsion of Intensive Care Unit Environment Stressor Questionnaire (ESQ) into Chinese,and test the reliability and validity of the Chinese version of Intensive Care Unit Environment Stressor Questionnaire (ESQ-C).Methods The ESQ-C was translated from the ESQ and back-translated,Delphi tcchnique was used to conduct cultural adaption.The reliability and validity of ESQ-C were tested in 313 cardiac surgery ICU patients.Results The ESQ-C contained 42 items.Eight factors that explained 51.803% of the variance were extracted after exploratory factor analysis.The Cronbach's α coefficient of the questionnaire was 0.851,the odd-even split-half reliability was 0.888.Conclusion ESQ-C was proved to be valid and reliable.It's a valuablc tool to assess the environment stressors of ICU patients in China.
10.Diagnostic value of combined measurement of serum procalcitonin and β2 microglobulin in tsutsugamushi disease
Kangkang HONG ; Laodong LI ; Lianqiang JIANG ; Rongfang JIANG ; Ying HUANG ; Ziping SHU
Chinese Journal of Endemiology 2018;37(9):711-715
Objective To explore the diagnostic values of combined detection of serum procalcitonin (PCT) and β2 microglobulin (β2MG) in tsutsugamushi disease.Methods Serum PCT and β2MG were compared in cases of tsutsugamushi disease and fever patients at the same time,who were hospitalized at Fourth Affiliated Hospital of Guangxi Medical University from June 2014 to May 2017.The best diagnosis cut-off value of tsutsugamushi disease was calculated by receiver operating characteristic (ROC) curve.Results A total of 57 cases of tsutsugamushi disease,40 cases of sepsis,17 cases of acquired immunodeficiency syndrome (AIDS),17 cases of severe community-acquired pneumonia (SCAP),63 cases of common community-acquired pneumonia (CCAP),14 cases of pulmonary tuberculosis (PTB),20 cases of upper respiratory tract infection,13 cases of other infectious fever and 28 cases of non-infectious fever patients were selected.The level of serum PCT in tsutsugamushi disease [0.87 (0.68-1.34) μg/L] was higher than those in AIDS [0.47 (0.20-1.12) μg/L],CCAP [0.17 (0.09-0.51) μg/L],PTB [0.13 (0.05-0.18) μg/L],upper respiratory tract infection [0.23 (0.05-0.48) μg/L] and non-infectious fever [0.09 (0.06-0.13) μg/L],but was lower than those in sepsis [5.00 (1.04-18.78) μg/L] and SCAP [3.35 (0.76-14.41) p,g/L,P < 0.05],while the difference was not significant compared with other infectious fever [0.76 (0.13-1.99) μg/L,P > 0.05].The level of serum β2MG in tsutsugamushi disease [(5.67 (4.47-7.90) mg/L] was higher than those in sepsis [2.83 (2.10-4.54) mg/L],AIDS [3.85 (3.19-5.22) mg/L],SCAP [3.83 (2.98-5.58) mg/L],CCAP [1.99 (1.51-2.75) mg/L],PTB [1.92 (1.37-3.00) mg/L],upper respiratory tract infection [2.02 (1.25-2.74) mg/L],other infectious fever [2.45 (1.51-4.12) mg/L] and non-infectious fever [2.99 (2.06-4.30) mg/L,P < 0.05].ROC curve showed that the most suitable diagnosis cut-off value of serum PCT in tsutsugamushi disease was 0.53 μg/L,the sensitivity was 94.7%,and the specificity was 60.4%.The critical value of serum β2MG was 3.74 mg/L in diagnosis of tsutsugamushi disease,its corresponding sensitivity and specificity were 91.2% and 75.9%,respectively.The sensitivity and specificity of combined serum PCT and β2MG in diagnosis of tsutsugamushi disease was 87.7% and 86.3%,respectively.Conclusion Combined detection with serum PCT and β2MG can improve early diagnosis of tsutsugamushi disease.