1.Efficacy of integrated traditional Chinese medicine with Western medicine in patients with diarrhea-predominant irritable bowel syndrome and its relation to serum inflammatory cytokines
Shiwei TANG ; Ming CHENG ; Zhongping WU ; Yanyan HU ; Yurui PAN
Chinese Journal of General Practitioners 2017;16(7):522-526
Objective To investigate the efficacy of integrated traditional Chinese medicine (TCM) with Western medicine in treatment of diarrhea type irritable bowel syndrome (IBS-D) and its effect on serum inflammatory cytokine levels.Methods One hundred and sixty four IBS-D patients treated in Guangfu Hospital from July 2013 to August 2015 were randomly divided into study group and control group with 82 cases in each group.All patients received oral Saccharomyces boulardii 1.0 b.i.d, while patients in study group received additional Shuganjianpi decoction b.i.d for 4 weeks.The clinical efficacy was observed, serum IL-10, IFN-γ and TNF-α levels were measured in 2 groups.Results After treatment, the total score of clinical symptoms in study group was lower than that of control group [(5.71±1.41) vs.(11.70±2.88) points,t=16.707, P<0.01].Serum levels of IFN-γ, TNF-α in study group decreased significantly after treatment [IFN-γ (2.88±1.38) ng/L vs.(1.00±0.44) ng/L, t=11.609, P<0.01;TNF-α (41.26±5.29) ng/L vs.(24.13±3.27) ng/L,t=24.636, P<0.01], IL-10 significantly increased [(142.23±21.58) ng/L vs.(170.23±33.45) ng/L,t=6.291,P<0.01].The overall effective rate of study group was higher than that of control group, [87.50% (70/80) vs.68.75% (55/80), x2=8.228, P<0.01].After treatment, the quality of life scores in both groups were improved;but the improvement of diet, spirit, mood and sleep scores in study group were better than those in control group [(240±69) vs.(193±60), t=4.579, (316±74) vs.(230 ± 69), t=7.603, (297±62) vs.(228±59), t=7.211;(284±62) vs.(230±54), t=5.874, all P<0.01].Conclusion The efficacy of integrated traditional Chinese medicine with Western medicine in treatment of IBS-D is significantly better than that of Western medicine alone, which may be associated with its regulatory effect on the serum inflammatory cytokine levels.
2.The mechanism of functional tricuspid regurgitation:insight from two and three-dimensional echocardiography
Hong MENG ; Shiwei PAN ; Xiaopeng HU ; Kunjing PANG ; Jianrong LI ; Xiuzhang Lü ; Hao WANG ; Yan WANG ; Peng LI
Chinese Journal of Ultrasonography 2012;21(3):185-188
Objective To explore determinants of functional tricuspid regurgitation with twodimensional (2D) and three-dimensional (3D) echocardiography,and to provide theoretical basis for surgery treatments.Methods Fifty-six subjects with left-sided valular diseases and tricuspid regurgitation underwent 2D and 3D echocardiography examinations.The tricuspid annulus diameter,the valvular tethering height and right ventricular volume and ejection fraction were measured.Results Based on the degree of tricuspid regurgitation,the patients were grouped into mild regurgitation (group 1) and moderate or more regurgitation (group 2).Comparing the two groups by t test,the tricuspid annulus diameter,the largest distance of tricuspid valvular tethering and the end-diastolic right ventricle volume had significantly enlarged in group 2 ( P <0.01 ).And the degrees of tricuspid regurgitation had good correlations with the annulus diameter,the valvular tethering,the right ventricular volume and pulmonary artery systolic pressure.Also,the 3D echocardiography revealed there were some valvular pathologies aggravating regurgitation.Conclusions The degree of functional tricuspid regurgitation is mainly determined by the annulus dilation and pulmonary hypertension.Further more,the 3D echocardiography can give us more details of the valves.
3.Evaluation of pulmonary hypertension and surgical therapeutic effects using radionuclide pulmonary perfusion imaging in patients with pulmonary hypertension of valvular heart disease
Shiwei PAN ; Shengshou HU ; Jianping XU ; Wei WANG ; Xuemei WANG ; Feng LIU ; Jun FENG ; Zhuoxiang HE ; Wenjun SU
Chinese Journal of Thoracic and Cardiovascular Surgery 2010;26(4):240-243
Objective To evaluate pulmonary hypertension(PH) and surgical therapeutic effects using radionuclide pulmonary perfusion imaging in patients of valvular heart disease. Methods And material 115 patients accumulated with valvular disease were included from May 2001 to August 2007. Echocardiography and first-pass radionuclide pulmonary perfusion imaging(FPPPI) were performed in all patients before surgery,7days after surgery and 3 months after surgery(33cases). Patients were divided into four groups. Pulmonary artery pressure (PAP) is normal group[mean pulmonary arterial pressure (MPAP)≤20mm Hg(1 mm Hg =0. 133 kPa)]; PAP slightly rise group[20 mm Hg < MPAP≤30 mm Hg]; PAP moderate rise group[30 mm Hg < MPAP≤50 mm Hg]; PAP weighty rise group[MPAP >50 mm Hg]. Results Lung Equilibrium Time (LET)by FPPPI were(18.87 ± 4.80) s, (26. 17 ± 7.09) s, (38.48 ± 7.09) s and (54.59 ± 7.96) s in this four groups before surgery. LET were 17.58 ±4.52, 21.51 ±6.44, 23.94 ±5.85, 27.29 ±6.70 in this four groups 7 days after surgery (P<0.001). There were no siguificantly differences of LET in 33 cases 3 months after surgery compared with those of 7 days after surgery. Conclusion Pulmonary arterial pressure siguificantly decreased 7 days after surgery in patients with PH of valvular heart disease, especially in those of slightly and moderate rise groups. FPPPI is an accuracy method in evaluating surgical therapeutic effects in valvular heart disease.
4. Determination of phenylglyoxylic acid and mandelic acid in urine by high performance liquid chromatography method
Shiwei CUI ; Xingfu PAN ; Huifang YAN
Chinese Journal of Industrial Hygiene and Occupational Diseases 2017;35(10):774-776
Objective:
To revise the standard method for the determination of phenylglyoxylic acid(PGA)and mandelic acid(MA) in urine by ultra-performance liquid chromatography.
Methods:
The original standard method was evaluated by experiment, and the chromatographic column, the detection limit,quantitation limit and stabilityof the method were studied.
Results:
The samples were separated by BEH Phenyl(50mm×2.1mm×1.7μm)column and the internal standard working curve method was used. The regression equations were
5.Surgical treatment of coronary artery aneurysm.
Qingyu WU ; Dianyuan LI ; Shengshou HU ; Shiwei PAN ; Feng LU
Chinese Journal of Surgery 2002;40(5):351-353
OBJECTIVETo describe the diagnosis and surgical management of coronary artery aneurysm.
METHODSBetween October 1996 and May 2000, 6 patients with coronary artery aneurysm underwent surgical treatment. Of these patients, 3 had Kawasaki disease and 3 coronary artery fistula. All patients underwent coronary artery bypass grafting. Three patients had aneurysms resected and fistulous ostium closed. One patient received aortic valve replacement.
RESULTSThere were no deaths and later death, nor major complications during the hospital stay. The results of follow-up were satisfactory.
CONCLUSIONSCoronary artery aneurysm is rare and its prognosis is poor. Early diagnosis and operation are necessary. The aneurysm should be resected, the coronary artery should be bypassed, and other associated diseases should be treated properly.
Adult ; Coronary Aneurysm ; diagnosis ; mortality ; surgery ; Coronary Artery Bypass ; adverse effects ; Female ; Follow-Up Studies ; Humans ; Male ; Vascular Fistula
6.Echocardiography diagnosis and surgical outcome of rheumatic tricuspid valve disease
Hong MENG ; Shiwei PAN ; Bin LI ; Ye ZHENG ; Qinglong MENG ; Kunjing PANG ; Hao WANG
Chinese Journal of Ultrasonography 2019;28(1):17-20
Objective To review the patients with rheumatic tricuspid valve disease ( RTVD) who were confirmed in cardiac operation and underwent tricuspid valve repair ,and summarize two and three-dimensional echocardiography ( 2D-STE ,3D-STE) characteristics of RTVD ,and evaluate the surgical procedures and outcomes of RTVD . Methods Between December 2009 and December 2017 ,359 patients with rheumatic heart disease ( RHD) underwent left-sided valvular replacement were enrolled . During the operation , 56 patients with RTVD were confirmed . All patients underwent 2D-STE and 3D-STE preoperatively . The preoperative echo characteristics of RTVD and the procedure of tricuspid valvular repair were reviewed . The morphology and function of tricuspid valve were followed after operation . Results Fifteen patients with RTVD were diagnosed by transthoracic echocardiography( TTE) preoperatively .Eight patients were presented tricuspid stenosis . Tricuspid annulus diameter [ ( 40 .3 ± 5 .6 ) mm ] , tethering distance[(5.9±2.2)mm] ,andpulmonaryarterysystolicpressure[(46.3±15.9)mmHg(1mmHg=0.133 kPa) ] were measured by echocardiography ,preoperatively . Moderate and severe tricuspid regurgitation were presented in 32 patients( 57 .1% ) . All patients underwent tricuspid valvular repair . During the mean follow-up (78 .9 months) ,tricuspid annulus diameter was reduced and tricuspid regurgitation was relieved . Recurrent tricuspid regurgitation occurred in 8 patients(14 .3% ) . Conclusions Preoperatively 2D-STE and 3D-STE need to evaluate tricuspid valve very carefully . Compared with functional tricuspid regurgitation , RTVD has some characteristics ,including more serious tricuspid reflux grade ,higher tethering distance ,the mismatch between tricuspid reflux degree and tricuspid anmular diameter or pulmonary artery pressure . Tricuspid valve repair shows better early and mid-term outcomes .
7.Mid-term outcomes in patients undergoing tricuspid valve repair with rheumatic tricuspid valve disease
Ye ZHENG ; Shiwei PAN ; Hong MENG ; Chuan TIAN ; Bin LI ; Jinxiao WANG ; Jianfeng HOU ; Zhe ZHENG ; Hansong SUN ; Shengshou HU
Chinese Journal of Thoracic and Cardiovascular Surgery 2017;33(12):716-720
Objective The aim of this study was to summarize the characteristics of rheumatic tricuspid valve disease ( RTVD) and to evaluate the mid-term outcomes in patients undergoing tricuspid valve repair with RTVD. Methods Between January 2009 and June 2016, 251 consecutive patients with rheumatic heart disease( RHD) underwent left-sided valvular re-placement by a single surgeon. We analyzed 39 patients with RTVD which was diagnosed during the operation. Among them, 32 patients, with moderate or higher tricuspid regurgitation( TR) , were compared with other 59 patients of functional tricuspid regurgitation( FTR) for a better understanding of the features of the RTVD. A total of 39 patients were categorized into 2 groups:Ring annuloplasty group(n=33) and non-Ring annuloplasty group(n=6) which consisted of modified De Vega annu-loplasty for 4 patients and edge-to-edge repair for 2. Meanwhile, 13 of them underwent concomitant tricuspid commissurotomy and 1 patient had a tricuspid leaflet augmentation procedure. We analyzed the mid-term outcomes of 22 patients( follow-up du-ration>1 year)with a mean follow-up duration of(45.5 ±25.1) months. Results Compared with FTR, patients with RTVD had higher preoperative TR grade(3.1 ±0.8 vs. 2.6 ±0.7, P=0.004) but with lower preoperative PASP[(53.8 ±19.4) mmHgvs.(63.6±21.5)mmHg,P=0.037)](1mmHg=0.133kPa) andtricuspidannulusdiameter(TAD) thatobserved bothinpreoperativeechocardiogramtests[(37.0±5.7)mmvs.(41.9±6.7)mm,P=0.018)]andintraoperativedetection [(35.6±4.1)mmvs.(39.9±6.5)mm,P=0.000)] . TherewasnoearlymortalityandresidualmoderateorhigherTR grades in either group. Compared with patients in non-ring annuloplasty group, patients in ring annuloplasty group showed low-er postoperative TR grade(0. 2 ± 0. 4 vs. 0. 7 ± 0. 5, P=0. 039) and acceptable TR grade(0. 8 ± 0. 5 vs. 1. 3 ± 1. 9, P>0. 050) during the mid-term follow-up. PASP, the peak diastolic velocity and pressure gradient across tricuspid valve were not different between groups in preoperative, postoperative and follow-up. Conclusion Compared with FTR, Patients with RTVD had lower preoperative PASP and TAD, but with a higher preoperative TR grade. In our study, ring annuloplasty showed simi-lar mid-term outcomes compared with other procedures.
8. Prognostic value of important driver gene mutations in patients with radical resection of pancreatic cancer
Jing SHEN ; Suizhi GAO ; Huan WANG ; Xiaohan SHI ; Bo LI ; Yaqi PAN ; Shuo SHEN ; Zhuo SHAO ; Shiwei GUO ; Gang JIN
Chinese Journal of Surgery 2019;57(11):840-847
Objective:
To examine the prognostic value of four important driver gene mutations in patients with radical resection of pancreatic cancer.
Methods:
The clinical data and follow-up data of pancreatic cancer patients undergoing radical pancreatectomy and targeted sequencing from January 2016 to March 2018 at Department of Hepato-Biliary-Pancreatic Surgery, Changhai Hospital were retrospectively analyzed.There were 159 males and 88 females,aged of (60.8±8.7)years(range:33-83 years) and preoperative CA19-9 of (492.4±496.6)kU/L(range: 2-1 200 kU/L). One hundred and fifty nine cases of tumors were located in the head and 88 cases in the body and tail of the pancreas. After univariate analysis of clinical pathological factors (including gender, age, preoperative CA19-9, tumor location, tumor differentiation, pathological T and N stage,