1.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.
2.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.
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.An analysis on viral prevalence of acute lower respiratory tract infection in children
Juan WANG ; Niguang XIAO ; Qionghua ZHOU ; Rongfang ZHANG ; Lili ZHONG ; Han HUANG ; Saizhen ZENG ; Bing ZHANG ; Zhaojun DUAN ; Zhiping XIE ; Hanchun GAO
Journal of Chinese Physician 2011;13(1):29-32
Objective To investigate the viral prevalence of acute lower respiratory tract infection (ALRTI)in children. Methods Totally 1165 children with clinical diagnosis of ALRTI during the period from August 2007 to September 2008 were involved in our study. The nasopharyngeal aspirate specimen was collected from each patient. RT-PCRs were performed to detect common respiratory tract viruses including respiratory syncytial virus (RSV), rhinovirus (HRV), parainfluenza virus (PIV, type 1 -3 ), influzenza virus type A and B (IFA,IFB), and PCR was used to detect adenovirus (ADV). Results 783 patients were identified to have at least one kind of viral pathogens and the overall positive rate was 67.2%. The most common virus was RSV (27%), followed by HRV ( 17.4% ) and PIV3 ( 13. 9% ). The peak infection seasons were winter and autumn. The etiological spectrum of ALRTI varied in different age groups. Two or more viruses were identified in 284 out of 783 cases ( 36. 3% ). The mixed infection rate was high in infants under 1 year old (63.7%) while it decreased to 8. 5% in children older than 3 years of age. Conclusion RSV, HRV and PIV3 were the most predominant pathogens in children less than 1 year old. The peak infection seasons were winter and autumn. The infection rate and mixed infection rate in infants under 1 year old were highest. The most common style was RSV and HRV mixed infection.
9. Application of immunohistochemistry for p16 and GATA3 and molecular HPV typing in diagnosis of secondary bladder involvement by cervical carcinoma
Rongfang HUANG ; Cheng HE ; Weifeng ZHU ; Yan LI ; Gang CHEN
Chinese Journal of Pathology 2017;46(6):388-392
Objective:
To investigate the expression of p16 and GATA3 and the detection of human papillomavirus (HPV) in secondary bladder involvement by cervical carcinomas.
Methods:
Sixteen cases of cervical carcinoma with bladder involvement diagnosed from December 2008 to March 2016 were collected and evaluated by light microscopy, immunohistochemistry for p16 and GATA3 detection and PCR-reverse dot blot for molecular typing of HPV.
Results:
The age of the patients ranged from 25 to 76 years with median of 52 years. Morphologically, 14 cases(14/16) showed tumor nests infiltrating lamina propria or muscle bundles of the bladder. By immunohistochemistry, 15 cases (15/16) were found to be diffusely and strongly positive for p16, and 1 showed patchy staining pattern. Seven cases (7/7) of corresponding original cervical cancers were also diffusely and strongly positive for p16. GATA3 staining was negative in 13 cases (13/16), and focal weak to moderate positivity was detected in 3 cases.Three cases (3/7) of corresponding original cervical cancers showed focal weak to moderate positivity of GATA3. Fifteen cases (15/16) showed concordant high risk HPV-positivity, including HPV16 in 8 cases and HPV31 in one case. Five cases showed co-infection of HPV16 and HPV18. One case showed co-infection with HPV18 and HPV45.
Conclusion
Differential diagnosis by p16 or GATA3 alone is of limited value. Combination of immunohistochemistry for p16 and GATA3 and molecular typing for HPV detection are useful to distinguish primary bladder carcinoma from the secondary involvement by cervical carcinoma.
10.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.