1.Analysis of risk factors in different gender patients with atherosclerotic renal artery stenosis
Hui CHEN ; Shunhui LI ; Yuqing DENG ; Guiming WANG
Clinical Medicine of China 2015;31(12):1092-1096
Objective To analyze the relationship between traditional & emerging risk factors and the pathogenesis of atherosclerotic renal artery stenosis (ARAS) in different gender patients.Methods Selective renal artery angiography was performed immediately after routine coronary angiography in 2060 patients with suspected coronary artery disease.Traditional & emerging risk factors were recorded and compared in different gender patients with ARAS.Results Among the patients with ARAS, smoking (59.18% vs.12.50%, x2 =17.47,P<0.01) and diabetes(28.57% vs 46.87%, x2 =5.64, P<0.05) compared with both genders were significantly differences.There were significant differences in high density lipoprotein cholesterol, ApoA1, ApoB/ApoA 1, HbA1C and Hcy (t =2.62,2.07,-2.83,-2.37,3.74;P< 0.05) in the ARAS patients compared with both genders.Conclusion The main risk factors in different gender patients with ARAS were different.It is important to adopt appropriate control strategies.
2.Compared the clinical effect with X-ray or B ultrasound guided puncture target calyces of treatment upper urinary calculi in MPCNL
Hongfeng DAI ; Shunhui YUAN ; Zehui LI ; Zhipeng LI ; Lijie FU ; Jinkun LI
International Journal of Surgery 2015;42(1):16-19
Objective To compare with the efficiency between X-ray or B ultrasound guided puncture target calyces of treatment of upper urinary calculi in MPCNL.Methods From October 2010 to October 2012,we have a retrospective analysis of the 116 cases in urological department in the second affiliated hospital of Kunming Medical University,it had the sugery that was MPCNL.Selected 116 cases as the research object,(8 patients were lost to follow-up).With X-ray locating (48 cases),B ultrasound locating (53 cases),and compared with preoperative,intraoperative and postoperative clinical objective indicators of two different methods.Results X-ray locating (48 cases),the mean age was (44.86 ± 12.84) years; the mean Stone diameter(1.43 ±0.70) cm; Stone is located in the upper calyx in 1 case,the middle of calyx in 23 cases,under the calyx in 8 cases,the upper ureter in 16 cases.B ultrasonic locating (53 cases),the mean age was(46.36 ± 14.29) years; the mean Stone diameter (1.34 ±0.62) cm; Stone is located in the upper calyx in 2 cases,the middle of calyx in 24 cases,under the calyx in 8 cases,the upper ureter in 16 cases.Compared with preoperative general data of two groups,there was no statistically significant difference (P > 0.05).X-ray group,the mean operation time (130.43 ± 31.63) min ; Intraoperative blood loss(80.42 ± 43.75) mL; Postoperative hospital stay (6.20 ± 2.08) d; Infected with 8 cases (17%) of postoperative,hemorrhage in 2 cases (4%) ; and calculi exhausted rate was 90% (43/47).B Ultrasound group,the mean operation time(102.45 ± 36.32) min.Intraoperative blood loss(160.07 ± 52.33) mL;Postoperative hospital stay(5.62 ±2.37) d; Infected with 16 cases (30%) of postoperative,bleeding in 9 cases (17%) ; and calculi exhausted rate was 83% (46/53).By comparison,X-ray and B ultrasound group in operation time,intraoperative blood loss,postoperative infection,a stone exhausted rate was statistically significant (P <0.05),and postoperative hospital stay,no statistical significance (P > 0.05).Conclusion X-ray positioning compared with B ultrasound,X-ray is longer than B ultrasonic of operation time,but,blood much less,calculi exhausted rate is higher,and infected rate is lower.
3.Risk factors of septic shock after mini-percutaneous nephrolithotripsy
Guihua CAO ; Xuede QIU ; Zhipeng LI ; Delin YANG ; Shunhui YUAN ; Lu YU ; Chunwei YE ; Zhuoheng LI
China Journal of Endoscopy 2016;22(7):10-13
Objective To evaluate the risk factors of septic shock after mini-percutaneous nephrolithotripsy (mPCNL). Methods Clinical data of 1 590 cases who underwent mPCNL from January 2013 to December 2014 were retrospectively analyzed. The x2 test and logistic regression were used to identify the key risk factors for septic shock after mPCNL. Results Of the 1 590 patients, 18 patients suffered septic shock, including 6 male patients and 12 fe﹣male patients. Their mean age was (45.6 ± 13.5) years (28 ~ 69 years). White cell in urine was 100 percent, the stone diameter ranged from 1.5 to 5.0 cm, unichannel for 15 cases while multichannel for 3 cases, the operation du﹣ration ranged from 45 to 200 min, mean (87.0 ± 56.0) min. 2 in 18 cases died in multiple organ failure, the others recovered till discharged. In x2 test, female gender (P = 0.001), (+++ ~ ++++) white cells in urine (P= 0.042), un-preoperative nephrostomy drainage (P=0.041) had significant association with septic shock after mPCNL. While in multivariate analysis, female gender ( O? = 5.471, 95 % CI: 0.756~21.452, P< 0.05) and un-preoperative nephrostomy drainage (O? =3.106, 95%CI:1.283~7.907, P<0.05) were identified as independent risk factors for septic shock after mPCNL. Conclusions Female gender and un-preoperative nephrostomy drainage are the key risk factors for septic shock after mPCNL.
4.Treatment of upper ureteral calculi by an ureteroscopy approach in a low-head lithotomy with right or left lateral tilt
Shunhui YUAN ; Delin YANG ; Zhipeng LI ; Guihua CAO ; Lu YU ; Chunwei YE ; Weiming WAN
China Journal of Endoscopy 2016;22(8):87-89
ObjectiveTo evaluate the methods in treatment of upper urinary calculi in a low-head lithotomy with right or left lateral tilt by an ureteroscopy approach. Methods From September 2009 to May 2015, 110 patients with upper ureteral calculi (after failed ESWL) were underwent holmium laser lithotripsy by a ureteroscopy approach in a low-head lithotomy with right or left lateral tilt. Their clinical data and complications were analyzed retrospectively. Results Surgical effect of patients was satisfied with the success of gravel 91 patients, with a total rate of 82.7 %gravel. Conclusion Low-head lithotomy with right or left lateral tilt is a good body position to perform ureteroscopic lithotripsy for upper ureteral calculi. It is safe and effective.
5.On predicting the T cell and B cell epitopes of platelet membrane glycoprotein II b/ III a antibody from human and mice.
Zhangqiu LI ; Meixia ZHANG ; Haiyan HU ; Shunhui LIU ; Zhigang LU
Journal of Biomedical Engineering 2010;27(5):1146-1151
HLA-A * 0201, HLA-A * 1101, and HLA-A * 2401 CTL restricted epitopes of platelet membrane glycoprotein II b/III a antibody of human and mice were predicted by use of SYFPEITHI, RANKPEP, BIMAS, SVMHC, PREDEP, MHCPRED, and PROPRED predictive programs. In the results, the peptides (found in HLAPRED) that can lead to autoimmune disease and have been published were removed; and the epitopes of HLA-A * 0201 must cover the epitopes of HLA-A * 1101 and HLA-A * 2401 being combined to predTAP and TAPPred for predicting the binding affinity of peptides toward the TAP transporter and NetChop, MAPPP, PAProc for predicting cleavages; HLA-DR Th restricted epitopes of GPII b/III a antibody were predicted by SYFPEITHI, RANKPEP, MHCPRED, and HLAPRED, after removal of the peptides (found in HLAPRED) that can lead to autoimmune disease and have been published, the Th epitopes must cover the CTL mixed epitopes as being stated above. The secondary structure, hydrophobic regions, flexibility, surface probability and the B cell epitope were predicted by using various methods. Ten mixed peptides of T cell epitopes were selected from more than 1 740 peptides. They were located at the aa9-115, aa24-38, aa50-64, aa65-81, aa109-121 of anti-GP II b/III a-Human and the aal-15, aa26-40, aa46-60, aa68-82, aa93-107 of anti-GP II b/III a-Mice. B cell epitopes of anti-GP II b/III a-Human might locate at aa5-9, aa22-30, aa40-46, aa55-71, aa80-90, aa100-105, aa110-115; and the epitopes of anti-GP II b/III a-Human might locate at aa5-10, aa38-43, aa58-70, aa77-84, and aa99-105.
Animals
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Antibodies
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immunology
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Epitopes, B-Lymphocyte
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immunology
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Epitopes, T-Lymphocyte
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immunology
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Humans
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Mice
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Platelet Glycoprotein GPIIb-IIIa Complex
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immunology
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Purpura, Thrombocytopenic, Idiopathic
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immunology
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Vaccines
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immunology
6.Combination of subradical external radiation and brachytherapy plus radical operation in the treatment of carcinoma of uterine cervix.
Xiaopeng ZHONG ; Shunhui ZHONG ; Lingfang YANG ; Li BAI ; Yuhong LAN ; Donglin YUAN ; Yunliang HUANG
Chinese Journal of Oncology 2002;24(3):291-293
OBJECTIVETo summarize retrospectively the 5-year survival rates and long-term complication of stage Ib-IIIa cervical carcinoma treated by combination of subradical external radiation and brachytherapy plus radical operation.
METHODS106 patients with cervical carcinoma were all treated by radical hysterectomy and pelvic lymphadenectomy, of whom 78 had had preoperative radiotherapy (external radiation and brachytherapy), 16 combination of brachytherapy and radical operation, 12 adjuvant postoperative radiotherapy (external radiation and brachytherapy). (60)Co was used for external radiation, in which the point B dose was 25 - 30 Gy in preoperative radiation and 40 - 50 Gy in postoperative radiation. (192)Ir high-dose-rate afterloading unit was used in brachytherapy, with a dose of 6 - 18 Gy at point A.
RESULTSThe follow up rate was 95.3%. The overall 5-year survival rates were 78.2% (61/78) in the preoperative radiotherapy group, 68.8% (11/16) in brachytherapy plus radical operation, 33.3% (4/12) in the postoperative radiotherapy group, showing a higher 5-year survival rate in the preoperative radiotherapy group than the postoperative radiotherapy group (P < 0.05). In stage II patients, the preoperative radiotherapy group -77.6% (45/58) also gave a higher survival than the postoperative radiotherapy group -25.0% (1/4) (P < 0.05). But all the other groups gave differences of insignificance. The chief long-term complications were radio-proctitis and cystitis, with incidences of 34.6% (27/78), 31.3% (5/16), 33.3% (4/12) in the preoperative radiotherapy group, brachytherapy plus radical operation group and the postoperative radiotherapy group (P > 0.05).
CONCLUSIONThe overall 5-year survival rate of combined subradical external radiation and brachytherapy plus radical operation was obviously higher than that of postoperative radiotherapy for stage Ib-IIIa and II patients, with statistically significant differences. However, the incidence of long-term complications give no statistical significance in the preoperative radiotherapy group or brachytherapy plus the operation group as compared with the postoperative radiotherapy group.
Adult ; Aged ; Aged, 80 and over ; Brachytherapy ; Combined Modality Therapy ; Female ; Humans ; Middle Aged ; Prognosis ; Retrospective Studies ; Survival Rate ; Uterine Cervical Neoplasms ; mortality ; radiotherapy ; surgery