1.Perioperative treatment of patients with human munodeficiency virus undergoing spinal surgery
Changsong ZHAO ; Qiang ZHANG ; Sheng SUN ; Yao ZHANG ; Xin LI ; Rugang ZHAO
Chinese Journal of Postgraduates of Medicine 2017;40(8):673-677
Objective To observe the effect of perioperative treatment on complications in human immunodeficiency virus positive patients undergoing spinal surgery, and summarize effective perioperative management to make these patients to get better treatment. Methods Forty-eight HIV positive patients (experimental group) and 79 HIV negative patients (control group) undergoing spinal surgery from November 2010 to March 2016 were retrospectively reviewed. The two groups were comparable in age, gender, type of spinal surgery and basic diseases. Nutritional support and the uses of antibiotics and blood transfusion were strengthened in patients of experimental group. Immunomodulatory drugs, the treatment with HAART and occupational protection were also used in patients of experimental group. The patients in control group only received conventional perioperative treatment. Wound healing, opportunistic infection, the failure of internal fixation and death after the operation was observed. The perioperative treatment methods were summarized. Chi square test was used in comparison of the rate and P < 0.05 was considered statistically significant. Results Surgery was successfully completed in all patients in experimental group and control group. Two cases (4.2%) in experimental group and 4 cases(5.1%) in control group showed delayed healing of incisions. All incisions were healed after debridement and no incision infection happened. CD4+T lymphocyte count of 2 cases in the experimental group was in stage 3. Among them, 1 patient underwent emergency surgery and opportunistic infection appeared after the operation. The other patients for elective surgery took operation when CD4+T lymphocyte counts were adjusted to 2 and no complications appeared. The two groups had no internal fixation failure cases and deaths. Conclusions HIV positive patients with spinal diseases are special patients. HIV positive patients with spinal surgery can reduce complications, and achieve good clinical curative effect by reasonable preoperative assessment, optimization of perioperative treatment, proper type of operation and active prevention of opportunistic infections after surgery.
2.Perioperative treatment and protection in human immunodeficiency virus infected patients with osteoporotic vertebral compression fracture
Xin LI ; Qiang ZHANG ; Changsong ZHAO ; Sheng SUN ; Rugang ZHAO ; Juan CAI
Chinese Journal of Postgraduates of Medicine 2017;40(4):296-300
Objective To investigate the effect of perioperative treatment and protection in human immunodeficiency virus (HIV) infected patients with osteoporotic vertebral compression fracture by percutaneous kyphoplasty (PKP).Methods From February 2010 to December 2015,206 cases with osteoporotic vertebral compression fracture treated by PKP were admitted,including 13 HIV infected patients.Blood routine,biochemical indexes,liver and kidney function,blood coagulation function,immune index and preoperative nutritional status were detected before operation.Highly active antiretroviral therapy (HAART),reasonable antibiotics,nutritional and immune support were given to the HIV infected patients.Standardized operation process and meticulous operative manipulation were applied during operation.The prevention of occupational exposure protection standardization process was strictly enforced.The postoperative complications,improvement of immune function and nutritional status,vertebral height,VAS,ODI and exposure occupation of medical personnel were observed.Results All 13 HIV infected patients had successful operations,without bone cement leakage and toxic reaction.One patient had perficial infection and the others had operative incisionprimary healing.There was no death.The levels of vertebral height,VAS scores and ODI scores were significantly improved after intervention and at the end of follow-up (P < 0.05),but there were no significant differences between after the intervention and at the end of follow-up (P > 0.05).Eleven malnutrition patients with HIV infected were received nutritional and immune support,and the levels of CD4 +,ALB and Hb were significantly improved:(289.00 ± 54.29) × 106./L vs.(237.25 ± 72.70) × 106/L,(38.04 ± 5.17) g/L vs.(33.73 ± 7.16) g/L,(112.87 ± 15.54) g/L vs.(100.68 ± 18.95) g/L,P < 0.05.The levels of PLT and WBC had no significantly change (P > 0.05).Two medical personnel had occupational exposure,and none had HIV infection.Conclusions Perioperative adjuvant treatment in HIV infected patients with osteoporotic vertebral compression fracture can achieve satisfactory outcomes.Strict implementation of protective standardization process should be focused.
3.Step sequential therapy in rescuing infantile postrenal acute renal renal failure induced by melamine
Geng MA ; Wenliang YU ; Yongji DENG ; Xuhua GE ; Zheng GE ; Yong LIU ; Rugang LU ; Shaodong ZHAO ; Dongmei CHEN
Chinese Journal of Emergency Medicine 2008;17(12):1241-1244
Objective To investigate clinical characteristics and emergency managements of postrenal acute renal failure(ARV)induced by melamine in infant.Method Fluid therapy for urine alkalization and hydration,cistoscope drainage and peritoneal dialysis step by step were exerted in those who had both a history of certain milk intake and ARF according to the definition of pediatric ARF which developed by Pediatric Nephrology Assembly of Chinese Pediatric Association in 1994.Results Thirty-four postrenal ARF cases with anuria due to melamine in Nanjing Children's Hospital of Nanjing Medical University were involved in the study.Seventy cases(50%)re-ceived fluid therapy only.Nine cases(26.5%)received fluid thempy and eistoscope drainagemand 4 cases (11.8%)received fluid therapy and cistoscope drainage and peritoneal dialysis.Four cases(11.8%)received ur-gent peritoneal dialysis due to severe hyperkalemia.All cases(100%)survived.The urine pH at the first day.the second day,and after the second day in those who just pass away urine were 6.1±1.0、6.5±0.7.5.3±0.4,respectively(F=4.563,P=0.026).Conclusions Fluid therapy for urine alkalization and hydration and stop sequential thempy are effective in infant with postrenal ARF induced by melamine.
4.Evaluation of pathogenicity of Acinetobacter venetum by using Caenorhabditis elegans
Yu LI ; Xueyan WANG ; Xiaoke HU ; Mengdi YANG ; Huan LUO ; Jing LIANG ; Longfei LI ; Jinping ZHAO ; Jie BI ; Bin CHEN ; Rugang WANG
Journal of Preventive Medicine 2019;31(11):1086-1090
Objective:
To evaluate the pathogenicity of Acinetobacter venetum(Av),which is expected to be used as an environmental remediation agent,using Caenorhabditis elegans(C.elegans).
Methods:
The C.elegans were cultured on the media loaded with E.coli OP50 and Av,respectively. The pathogenicity of Av was evaluated by observing the effects of Av on the growth,movement,digestive function,lifespan and reproduction of C.elegans,compared with that of another evaluation system according to NY 1109-2017 General Biosafety Standard for Microbial Fertilizers.
Results:
By C. elegans system,it was found that the body length,width,head thrash frequency,body bending frequency and average lifespan [(13.5±0.4)d vs.(13.7±0.4)d] of adult nematodes in the Av group were not significantly different from those in the OP50 group(all P>0.05);while the average time of defecation cycle in the Av group shortened,the total number of progenies in the Av group increased by 18.7%(all P<0.05). According to NY1109-2017 General Biosafety Standard for Microbial Fertilizers,it was found that the oral LD50 values for both male and female mice were more than 10 g/kgbw,which was practically non-toxic;the pathogenicity test of acute intraperitoneal injection showed that the animals did not have signs of poisoning,deaths or any abnormalities in gross anatomy;Av had no irritation to damaged skin and eyes of rabbits;the hemolysis test was negative;Av was sensitive to seven antibiotics and was medium to one antibiotic.
Conclusion
Av is not pathogenic. C. elegans can be used in early screening for the pathogenicity of environmental remediation agents.
5.Why did street blood donors re-donate or lapse? A analysis in Nanjing
Han XIAO ; Yudong DAI ; Yilun ZHAO ; Li QIU ; Rugang LIU ; Zhenping LIN
Chinese Journal of Blood Transfusion 2021;34(10):1126-1129
【Objective】 To analyze the influencing factors of blood re-donation among street voluntary blood donors in Nanjing, and to provide basis for increasing the proportion of blood donation/donors. 【Methods】 29 650 street voluntary blood donors in Nanjing from May 21, 2017 to May 21, 2018 in the information management system of Nanjing Red Cross Blood Center were taken as the sampling population, and 2 965 (10%) were randomly selected to ask whether they donated again and reasons by telephone calls. They were divided into re-donation group and lapsed group.The demographic variables and donation frequency of street blood donors in the two groups were analyzed and compared by Chi-square test, and multivariate logistic regression was used to analyze the influencing factors of re-donation of blood donors. 【Results】 The response rate of this survey was 63.37% (1 879/2 965), and the re-donation rate of street blood donors in Nanjing from May 2017 to May 2018 was 40.34% (758/1 879), which was lower than the re-donation rate of global blood donors as 50%. The primary motivation for street blood donors in Nanjing to donate blood again was "help others", accounted for 62.27% (472/758), and the primary deterrent to redonate blood again was "too busy to donate blood", accounted for 49.15% (551/1 121). 【Conclusion】 There is a certain gap between the rate of blood re-donation in Nanjing and worldwide, therefore, further incentive measures are needed and flexible recruitment and blood donation methods should be adopted to facilitate blood donation for donors.
6.Effects of exercise on cardiovascular and pulmonary function in polluted air environment and countermeasures
Yanwei LI ; Yu LI ; Ning LI ; Fanghong ZHAO ; Rugang WANG
Journal of Public Health and Preventive Medicine 2020;31(4):19-22
With the improvement of living standards in China, people pay more and more attention to sports and fitness. Therefore, the contradiction between air pollution and sports becomes an urgent problem to be solved. In this paper, the acute and chronic effects of exercise on human cardiovascular and pulmonary functions under the environment of particulate matter pollution are summarized and analyzed, and countermeasures are put forward on the basis of this analysis.
7.Promote and deter factors of blood donation among street blood donors in Nanjing based on the theory of planned behavior
Zhiqian DUAN ; Shangyun YING ; Li QIU ; Zhenping LIN ; Rugang LIU ; Yilun ZHAO ; Yudong DAI
Chinese Journal of Blood Transfusion 2021;34(9):1017-1021
【Objective】 To explore the promote and deter factors of blood donation among street blood donors in Nanjing, in order to improve the accuracy of street blood donors recruitment. 【Methods】 A questionnaire with high confidence was designed based on the theory of planned behavior(TPB). The multi-stage hierarchical sampling method was adopted according to the geographical location and economic development level of 11 districts(regions) in Nanjing, and the street blood donors were divided into three groups according to the history of blood donation: one donation(n=361), donation numbers ≥ 2(n=417)and non-donation (n=241). The blood donation behavior was investigated from four aspects as external promote factors (such as seeking a free blood examination, self-interest factors, etc.), internal promote factors(such as altruistic, self-interest factors, blood donation can help others, etc.), external deter factors (too busy to donate blood, opposition from my family, etc.) and internal deter actors ( worry about dizziness after blood donation, fear of needles, ect.). The database was established using Epidata software, and chi-square test was applied for statistical analysis between groups. 【Results】 The groups mainly affected by the promote factors (altruistic and self-interest factors) of Nanjing street population in blood donation were unmarried, 18~24 years old, childless, below bachelor degree, and have barely no income. The main groups less affected by the deter factors were students, male, unmarried, 18~24 years old, childless and have barely no income.Promote factors increases with the number of blood donations, while deter factors decreases with the number of blood donation. 【Conclusion】 TBP can better analyze and explain the promote and deter factors affecting blood donation behavior among street blood donors in Nanjing, which is helpful for blood stations to formulate targeted measures to improve the availability of street blood donors.