2.CT guided the preventation and treatment of hemorrhage after renal cancer cryoablation
Xiaofeng HE ; Yueyong XIAO ; Xiao ZHANG ; Peng DU ; Xin ZHANG
Chinese Journal of Radiology 2014;48(4):316-319
Objective To explore the methods of the hemorrhage prevention and the measures of hemostasis by CT guided after renal cancer cryoablation.Methods Retrospective analysis of 8 patients of renal cell carcinoma patienthave been done,all the patients were underwent cryoablation.The basic model included 10 min frozen,3 min thawed and 1 cycle were repeated.Before the cryoprobe puncture,a CT scan was taken to observe the blood supply of the tumor and the relationship between the border of the tumor and renal cortex,renal pelvis.Besides,the path of reducing the injury of normal renal cortex and renal pelvis was chosen,and the decreased number of probes was adopted by taking conformal cryoablation to reduce the damage to the renal capsule,in theensurance of the treatment efficacy.Intraoperative CT scan was performed discontinuously,to observe the covering status of the range of ice ball on the lesion and to monitor the perirenal bleeding.Postoperative ECG and blood pressure changes was observed 24 h after operation.Besides,CT scan or blood routine examination is necessary to monitor whether active bleeding happened.Results According enhanced CT image positioning puncture path,the path of probes were selected in the shortest path between the tumor margins and the renal cortical which avoid the renal pelvis.Probes were CT-guided conformal puncture into the lesion successfully for 8 patients,according to freezing basic mode to complete cryoablation.Timely intraoperative CT scan can clearly observe that a low-density ice ball wrapped lesion completely without involving the renal pelvis and normal tissue surrounding the kidney.There was no bleeding in the procedure of cryoablation.After the probe was pulled,CT scan showed:3 of the 8 patients didn't show any sign of henorrhage,in which 1 patient had heavily bleeding,about 150 ml due to the biopsy after cryoablation.The bleeding was stopped by interventional embolization.A little hemorrhage was found in two patients,about 10 ml outside renal capsule.Medium hemorrhage took place in two patients,30 nl in one patient which underwent several cycles of thawing and 60 ml in another.The patients of mild and medium hemorrhage was treated with intravenous injection of Reptilase and strict bed rest.There was a great hemorrhage in one patient,about 200 ml.The bleeding was stopped by interventional embolization.A small and moderate bleeding,it necessary to execute intravenous infusion 2 IU reptilase and strict bed rest.There was no significant active bleeding from the CT scan after 24 h operation and no change in the blood routine examination of blood hemoglobin and red blood cell count.Conclusions Before the puncture,it is necessary to perform an enhanced CT scan to understand the position,which can determine the path of the puncture.It can reduce the damage of renal cortex,renal capsule and surrounding tissue and prevent and reduce the risk of bleeding.For larger amounts of intraoperative and postoperative bleeding subjects,the embolization should be given immediately,as for the small or moderate amount of bleeding,the conservative treatment may be given firstly.
3.The detection and relevance of DTT-FRA in highly sensitized renal recipients
Lulu XIAO ; Sheng ZHANG ; Xin YE
Chinese Journal of Nephrology 1997;0(05):-
To further analyze immunoglobulin (Ig) properties of panel reactive antibodies (PRA) and their potential harmful effects on allogeneic renal transplants. Methods Since dithiothreitol (DTT) is able to crack disulphuric bond of Ig and to depoly-merize IgM with heavy molecular weight, PRA study was performed with treatment of DTT. Thus, a DTT-ERA method was established, which can identify immunoglobulin class in sera of high PRA patients. Results Among 701 recipients, whose sera were positive by the standard PRA, the positive rate of DTT-PRA was 33.2% . Besides, positive PRA patients could be divided into three groups according to their sera's sensitivity to DTT: Group 1 consisted of patients whose sera contained exclusively IgM antibodies; Group 2 consisted of patients whose sera contained of IgG antibodies only; Group 3 consisted of patients whose sera were found to contain both IgM class antibodies and IgG antibodies. Conclusion IgM class antibodies are not associated with posttrans-plant rejection, while IgG antibodies alone and mixture of IgG and IgM antibodies may mediate acute, or even hyperacute rejection.
4.Analysis on Measurement Audit in Drug Testing Laboratories during 2011-2014
Xin MAO ; Xin YU ; Jing XIAO ; Xinhua XIANG ; Hezhan ZHANG
China Pharmacist 2015;(8):1423-1425
To understand the status of testing skills and quality management in drug testing laboratories. Methods:The items, pass rate and type of participating laboratories of measurement audit were analyzed during 2011-2014. Results:The number of application items was increased year by year, more than half of which focused on the content determination, and the overall pass rate was over 80%. Conclusion:The measurement audit is important for laboratories, which should be further strengthened and standard-ized.
5.Transcription and expression of excision repair cross complementing 1 in endemic arsenism caused by coal-burning
Yun, XIAO ; Ai-hua, ZHANG ; Xiao-xin, HUANG
Chinese Journal of Endemiology 2011;30(1):4-8
Objective To study the transcription and expression of excision repair cross complementing 1(ERCC1) in the peripheral blood and the skin tissue in coal-burning borne endemic arsenism, and to explore the role of arsenism in its pathogenic or carcinogenesis mechanism. Methods According to "Endemic arsenism diagnostic criteria" (WS/T 211-2001), 110 arsenism patients were chosen as case group in Xingren county,Guizhou province and they were divided into 3 groups according to their hnir arsenic: < 2(31 cases),2 ~< 4(31 cases),≥4 mg/kg(48 cases), respectively. Another 36 healthy residents about 13 km away from the endemic area were chosen as healthy control group. Under the principle of informed consent, hair samples were collected for arsenic analysis by Ag-DDC and blood samples were collected to determine mRNA expression levels of ERCCI by real-time fluorescence quantitative PCR. At the same time, skin tissue samples were collected from the voluntary surgical treatment of 62 patients with endemic arsenism as case group which were divided into 3 groups according to their hair arsenic: < 2(16 cases), 2 ~< 4(20 cases) and ≥4 mg/kg(26 cases), respectively, and these patients were also divided into general pathological changes (32 cases), precancerous (19 cases) and cancerous groups( 11cases), respectively, according to their skin pathologic diagnosis of skin lesions. Another 13 cases pathologically normal without skin cancer surgery from a certain hospital were chosen as control group. Skin samples were collected to detect the ERCC1 protein by immunohistochemical method. Results The mRNA levels of ERCC1 were 0.7156(0.2158 ~ 1.2405),0.5772(0.0843 ~ 1.1234) and 0.5490(0.1895 ~ 0.8431 ), respectively, among < 2, 2 ~< 4and ≥4 mg/kg groups, which were lower than the mRNA levels of ERCC1 in the control group[1.5128(1.0000 ~2.1295)], and the difference was statistically significant(all P < 0.05). The expression rate of ERCC1 protein were 87.5%, 80.0% and 77.0%, respectively, among < 2, 2 ~< 4 and ≥4 mg/kg groups. The expression rate of ERCC1 protein in 2 ~< 4 and ≥4 mg/kg groups were lower than the rate in the control group(100.0%), and the difference was statistically significant (all P < 0.05). The expression rate of ERCC1 protein were 84.4%, 79.0%and 72.8%, respectively, among general pathological changes, precancerous and cancerous groups compared with the control group( 100.0% ), and the difference was statistically significant(all P < 0.05). Conclusions Arsenic from coal-burning can lead to abnormal ERCC1 gene transcription and protein expression, which may inhibit DNA repair through influencing the removal of damaged DNA and promoting the incidence of arsenism development and even skin carcinogenesis.
6.Expression of coxsackie-adenovirus receptor in hearts of mice with experimental viral myocarditis and its regulatory mechanism.
Xiao-hua YU ; Ping ZHANG ; Xin-gang ZHANG
Chinese Journal of Pediatrics 2006;44(2):137-138
Animals
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Coxsackie and Adenovirus Receptor-Like Membrane Protein
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Coxsackievirus Infections
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genetics
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metabolism
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Disease Models, Animal
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Enterovirus B, Human
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pathogenicity
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Heart
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drug effects
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Immunohistochemistry
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Interleukin-1beta
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administration & dosage
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pharmacology
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Male
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Mice
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Mice, Inbred BALB C
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Myocarditis
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drug therapy
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genetics
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metabolism
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pathology
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virology
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Myocardium
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metabolism
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pathology
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RNA, Messenger
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Receptors, Virus
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genetics
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metabolism
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Reverse Transcriptase Polymerase Chain Reaction
7.The risk factors of prehypertension and the relationship between blood pressure and atherosclerosis
Yan ZHANG ; Xin XIAO ; Yalan MIN ; Ling TU ; Cuntai ZHANG
Journal of Chinese Physician 2013;(4):437-440
Objective To explore the risk factors of prehypertension and the relationship between blood pressure and atherosclerosis.Methods The data of 456 cases in the Department of General Medicine were cross-sectional analyzed,including 174 subjects with normotension and 282 with prehypertension.The information was consisted of demographic characteristics,blood pressure,blood biochemical metabolism index,brachia-ankle pulse wave velocity (baPWV),ankle-brachial index (ABI) and carotid intima media thickness (CIMT).Results Compared to normotension group,the levels of systolic pressure,diastolic pressure,pulse pressure,body mass index,fasting blood glucose,glycosylated hemoglobin,triglyceride,uric acid,and C-reactive protein in prehypertension group were significantly increased (P < 0.05) ; and high-density lipoprotein cholesterol was significantly decreased (P <0.05) ; the body mass index(OR =1.185),triglyceride(OR =1.302),and fasting blood sugar (OR =1.690) were the independent risk factors of prehypertension ; baPWV and CIMT in prehypertension group were higher,but ABI and artery atheromatous plaque rate were not obvious changed.When baPWV or CIMT were set as the dependent variables,multiple linear regression analysis showed that systolic blood pressure(β =0.226,P =0.007),fasting blood glucose(β =0.209,P =0.018),and age(β =0.279,P =0.002) were risk factors of baPWV;systolic blood pressure(β =0.118,P =0.015),body mass index(β =0.109,P =0.001),and age(β =0.396,P =0.001) were risk factors of CIMT.Conclusions Body mass index,triglycerides,and fasting blood sugar were the independent risk factors of prehypertension.The early subclinical damage of hardening of the arteries was occurred in the prehypertension cases,and systolic blood pressure was closely related with baPWV or CIMT.
8.The diagnostic value of MRI in patients with placenta previa and implantation presented negative in ultrasound
Xin ZHAO ; Kai ZHANG ; Yichang XIAO ; Xiao'an ZHANG ;
Journal of Practical Radiology 2017;33(6):591-594
Objective To discuss the role of MRI in diagnosis and for the placenta previa and implantation presented negative in ultrasound.Methods Patients of placenta previa without placenta implantation confirmed by ultrasound were analyzed retrospectively.The patients were divided into A and B groups according to different treatment stages.A group underwent uterine segment cesarean section directly without MRI.B group underwent MRI scan first.And the MRI positive patients (B1 group) got abdominal aortic balloon temporarily block technique combined with the lower uterine segment cesarean section,if necessary,uterine artery embolization.The negative ones (B2 group) got uterine segment cesarean section directly.The placenta implantation was diagnosed by operation and (or) pathology.The maternal blood loss and hysterectomy rate between A and B group were compared.Results The sensitivity and specificity of MRI scan in placenta implantation was 0.75 and 0.916.The blood loss showed significant difference (P<0.001).Hysterectomy rates presented no significant difference (P>0.05).Conclusion When the ultrasound only showed placenta previa without implantation,the further test of MRI scan could detect the placenta implantation patients.After diagnosed by MRI,obstetrics and gynecology jointly intervene could effectively reduce the blood loss,or reduce the rate of hysterectomy.
9.Prenatal ultrasound diagnosis of otocephaly and review of the literatures
Ai-qing, ZHANG ; Xiao-xin, ZHANG ; Yi-qun, GU
Chinese Journal of Medical Ultrasound (Electronic Edition) 2013;(7):548-553
Objective To investigate the ultrasound characteristics of prenatal fetus otocephaly . Methods Three prenatal fetus with otocephaly were examined with two -and three-dimensional ultrasoundand examined results were compared with the those of induced labor or autopsy ,and ultrasound characteristicsof prenatal fetus were analyzed and summarized .Results The ultrasound performance of three prenatal fetuswith otocephaly and the examination of the appearance after induced labor showed :(1) The most intuitiveinitial sonographic performance of otocephaly was manifested by the absence of stomach bubble andoverabundance of amniotic fluid.Among three fetus,one fetus had overabundance of amniotic fluid at the midstageof pregnancy,one fetus had normal amniotic fluid at the mid-stage of pregnancy and one fetus hadextremely high amount of amniotic fluid and absence of stomach bubble at late stage of pregnancy .(2) Allthree fetus showed agnathy and synotia (shifts of both ears to the midline) and microstomia deformity.(3) All three fetus had associated complications with deformity in other systems including two cases of patients withcleft lip and palat,both were the fracture unilateral cleft lip derived from small mouth .One fetus withdysmelia and one fetus with complicated cardiovascular deformity and situs inversus and .(4) The results ofexamination after induced labor or autopsy were consistent with those of the prenatal ultrasound examination . Conclusions Prenatal ultrasound examination is an effective and feasible means for the diagnoses ofotocephaly.When the symptoms of “absence of stomach bubble and extremely high amount of amniotic fluid ”occurred,the fetal ear and submaxilla should be examined to confirm stand -alone otocephaly prenatally.
10.Analysis on macula injury caused by laser
Yan, ZHANG ; Yan, CAI ; Xiao-Ling, ZHANG ; Yong-Xin, GU ; Xiao-Wei, GAO ; Yun, XIAO
International Eye Science 2016;16(6):1176-1179
?AIM: To discuss the effect of laser exposure on visual acuity and macula.?METHODS: Retrospective and consecutive case series. A retrospective analysis of 11 patients (11 eyes) with laser retinal injury was carried out from January 2014 to June 2015 in Ophthalmology Department of No. 474 Hospital of Chinese PLA. All individuals underwent visual acuity, best corrected visual acuity ( BCVA ) , and spectral-domain optical coherence tomography ( SD-OCT) for macular at first visit, and fundus fluorescein angiography ( FFA ) , visual field, and multifocal electroretinogram ( mf ERG ) were perform if necessary. Symptomatic therapies, supportive therapies and pars plana vitrectomy ( PPV ) were performed depended on the patient’s condition. The patients were followed-up at 1, 3 and 6mo after the first visit, and patients were undertaken visual acuity, BCVA, macular SD-OCT and so on.?RESULTS: Eight patients ( 73%) were under 18 years old and all patients were young males, who were injured by laser pointers when playing. Three patients ( 27%) over 18 years old were injured accidentally at work. Ten (91%) patients’ BCVA were ≤0. 3, while one ( 9%) patient’s BCVA was higher ≥0. 3. Full-thickness macular holes ( the diameter 224-519 μm ) were detected in 10 patients (91%), while sub-foveal RPE changes and IS/OS injury in 1 patient ( 9%) . Macular hole with traction or cystoid edema in 6 eyes (55%) were received PPV, while the other 5 eyes ( 4 eyes with stable macular hole and 1 eyes with RPE injury ) received conservative treatment. Macular hole closed successfully in 1 eye ( 17%) after PPV, while macular hole in the other 5 eyes ( 83%) were stable after PPV of which the cystoid edema faded. The 4 patients with macular hole and 1 patient with RPE injury were stable during follow-up period. However, the BCVA in all patients had no significant improvement at end.?CONCLUSION: Exposure to laser devices could lead to severe macula injury that could reduce central vision, which is permanent.