1.Clinical evaluation of the efficacy and influencing factors for stent placement in treating benign and malignant esophageal stenosis
Xiaohua GUO ; Maoquan LI ; Qing ZHANG
Journal of Interventional Radiology 1994;0(04):-
Objective To evaluate clinical effectiveness and influence factors in the treatment of benign and malignant esophageal stenosis by placing esophageal stent. Methods A series of this research comprised of 29 cases with esophageal cancer, 10 cardiac carcinoma, 5 cardiac achalasia, 6 benign esophageal stricture after operation. The lengths of lesion ranged from 2 to 14 cm in length with mean of 7.3 cm. Fistuli were found among malignant esophageal stenosis in 6 cases. According to the dysphagia scores, 12 cases were designated as Ⅰ grade, 31 with Ⅱ, and 14 with Ⅲ. 46 cases of malignancy were undertaken radiation therapy combined with transcatheter arterial chemotherapy from 15 to 30 days after stent placement. Results 62 stents were placed in 57 cases (52 domestic stents, 10 Boston ultraflex), including 4 cases with 2 stents being once placed, 1 case with second time stent placement because of restenosis 4 month later. All stents were placed successfully without serious complications, such as esophageal perforation, massive hemorrhage. 5 cases of cardiac achalasia and 6 cases of benign esophageal stricture are still alive now. The survival rates of 6, 12, 24 and 36 months in 46 malignant cases, were 67.4%(31/46), 43.5%(20/46), 26.1%(12/46), and 19.6%(9/46) respectively. Dysphagia were relieved significantly form 7 to 15 days after stent placement. Conclusions Esophageal stent placement combined with radiation therapy and transcatheter arterial chemotherapy could improve patient life qualities and survival rates significantly in malignant stricture. The effects on benign esophageal stricture by stent placement are comparable with that of surgical treatment.
2.Re-understanding of the Treatment of Ectopic Pregnancy from Blood Stasis
Lixia XU ; Qing GU ; Xiaohua WU
Journal of Zhejiang Chinese Medical University 2016;40(6):475-478
Objective] To explore the theoretical origin, clinical application method, effect and practical significance of the treatment of ectopic pregnancy with blood stasis. [Method] From blood stasis on the treatment by promoting blood circulation to remove blood stasis, Yiqi Yangxue Huayu Shapei, expelling blood circulation, method to eliminate the disease, stage of treatment, a reasonable choice of promoting blood circulation and removing blood stasis drugs in the treatment of ectopic pregnancy. [Results] From blood stasis on the treatment of ectopic pregnancy, it can accelerate the beta HCG negative, and speed up the ectopic pregnancy mass absorption, clinical curative effect significantly, the greatest degree of protection of fallopian tube integrity, improve blood circulation, and tubal function recovery, increase after treatment the chances of conception. [Conclusion] Qi stagnation, blood stasis and Qi deficiency and blood stasis are ectopic pregnancy basic pathogenesis, less empirical abdominal blood stasis is the essence of its pathogenesis. The existence of blood stasis in ectopic pregnancy of each type and disease development of the whole process, in the occurrence of the disease, and occupies an important position in the development, promoting blood circulation and removing blood stasis is the basic treatment, should be in clinical dialectical treatment of the whole process of fusion.
3.Analysis and intervention of ethical problems in new technique therapy of wound care
Qixia JIANG ; Xiaohua LI ; Guobin YANG ; Xin ZHOU ; Qing PENG
Journal of Medical Postgraduates 2014;(7):722-724
Objective Medical ethical problems have become underlying risks since the introduce of Negative pressure wound therapy ( NPWT) in Wound Care Center .The article was to analyze ethical problems in applying new technology in wound care and take intervention countermeasures to investigate the effects . Methods Patients treated by NPWT from January 2009 to Decem-ber 2012 were collected as objectives of investigation from the indexes of compliance rate , cure rate and adverse event rate .The ethical problems related to efficacy ,safety and conflicts of patients′economic interests during the application of NPWT were analyzed .On the basis of the ethnical core principle which was harmless , beneficial, respectful and justifiable , the details of effectiveness and safety of NPWT technique , informed consent form and emergency response protocols of the adverse events were designed according to interna -tional guidelines .Nurses received standardized training to learn new technology . Results 78 cases with chronic wounds accepted negative pressure wound therapy and all cooperated to complete treatment , compliance rate was 100%, no adverse events , the average cure rate was 91 .03%.The treatment costs are less than international and national costs from 75%to 66%. Conclusion Following the ethical principle , informed consent , good communication , strict entry system and standardized operation process make sure the safety and effectiveness of new technology and optimize patients′benefits .
4.Vacuum-assisted closure for chronic wounds: An analysis of 12 cases
Qixia JIANG ; Xiaohua LI ; Suqin HU ; Qing PENG ; Xin ZHOU
Journal of Medical Postgraduates 2003;0(12):-
Objective: Vacuum-assisted closure(VAC) is a new technique for wound treatment,whose clinical application at home is but at the initial stage.The aim of this study was to investigate the procedure,therapeutic course and the effectiveness of the technique in the treatment of chronic wounds.Methods: This study included 12 cases of chronic or infected wound,which were more than 100 cm2 in size,either undermined,or drainage-obstructed,or difficult to heal despite over a month of previous treatment.We used the Freedom Negative Pressure Wounds Therapy Machine and the Ten-Step Management Procedure for a regular course of 30-50 days.We recorded and analyzed the pre-and post-treatment PUSH(pressure ulcer scale for healing) scores,healing modes,healing time and cure rate of all the cases.Results: The 12 cases were treated by VAC for(27.7 ? 22.6) days,of which 9 were cured,1 improved and 2 healed after moisture therapy followed by further treatment in the surgical department.The average healing time was(59.36 ? 22.88) days and the total cure rate was 91.7%.Age is positively correlated with healing time,but other factors showed no significant correlation with healing time and cure rate.Conclusion: The VAC technique is applicable to chronic wounds in patients of all ages,and the best therapeutic course is 30-50 days,which helps to raise the cure rate of intractable wounds.
5.Expression of solute carrier proteins SLC35E1 and SLC35E2B in skin lesions of patients with Mycobacterium infections
Yunling YAN ; Baoqing ZHENG ; Xueyu HE ; Qing CHENG ; Xiaohua WANG
Chinese Journal of Dermatology 2021;54(4):347-351
Objective:To investigate the expression of solute carrier family 35 member E1 (SLC35E1) and SLC35E2B in skin lesions of patients with Mycobacterium infections. Methods:Paraffin-embedded skin tissues of 31 patients confirmedly diagnosed with Mycobacterium infections were collected from Dermatology Hospital of Southern Medical University from 2014 to 2018, including 10 cases of multibacillary leprosy, 9 of nontuberculous mycobacterial infection, 7 of cutaneous tuberculosis, and 5 of erythema induratum. Meanwhile, paraffin-embedded skin tissues of 10 healthy individuals were collected, and served as normal control group. Immunohistochemical staining was performed to determine the expression of SLC35E1 and SLC35E2B in the lesional and normal control skin specimens, and immunofluorescence staining to observe the co-expression of CD68 and S100 with SLC35E1 and SLC35E2B in the skin lesions. Results:Neither SLC35E1 nor SLC35E2B was expressed in the normal control group, but high expression of SLC35E1 and SLC35E2B was observed in the dermis of skin lesions from the patients with leprosy, nontuberculous mycobacterial infection, cutaneous tuberculosis or erythema induratum. Immunohistochemical staining showed that the expression of SLC35E1 and SLC35E2B (expressed as average optical density) was significantly higher in the multibacillary leprosy group (0.143 ± 0.010, 0.169 ± 0.004, respectively) , nontuberculous mycobacterial infection group (0.278 ± 0.015, 0.229 ± 0.088, respectively) , cutaneous tuberculosis group (0.171 ± 0.010, 0.103 ± 0.016, respectively) and erythema induratum group (0.200 ± 0.015, 0.118 ± 0.021, respectively) than in the normal control group (both 0, all P < 0.05) . Immunofluorescence staining showed co-expression of SLC35E1 and SLC35E2B with CD68 in skin lesions of the patients with leprosy, nontuberculous mycobacterial infection, cutaneous tuberculosis. Conclusion:Both SLC35E1 and SLCE2B were markedly highly expressed in skin lesions of patients with Mycobacterium infections.
6.Discussion on antiplatelet aggregation treatment options in high sensitive C-reactive protein less than 2 mg/L in patients with angina pectoris
Wei YU ; Fengyun ZHOU ; Qing LIU ; Sujuan ZHU ; Xiaohua JIN ; Peng LIU
Tianjin Medical Journal 2016;44(8):967-969
Objective To evaluate the feasibility of application of single and dual antiplatelet aggregation therapy in high sensitive C-reactive protein (hs-CRP) level in patients with angina pectoris. Methods Ninety-six hospitalized patients with angina 6~48 h (hs-CRP< 2 mg/L) were selected and randomly divided into single aspirin group (aspirin 100 mg/d, n=48) and aspirin plus clopidogrel combination therapy group (aspirin 100 mg/d and clopidogrel 75 mg/d, n=48). The efficacy was evaluated after 30-day treatment. Data of composite end points were analyzed by follow-up in patients within 6 months. Results The total effective rates were 85.42%for combination therapy group and 81.25%for single aspirin group. There was no significant difference in total effective rate between two groups (P>0.05). There were no significant differences in events of composite end points in patients after treatment between two groups (P > 0.05). Conclusion For angina pectoris patients with hs-CRP<2 mg/L, the risk of cardiovascular events is relatively little. There is no obvious difference in curative effect between single and dual antiplatelet aggreration therapies.
7.The influence of rHuEPO on inflammatory factors in the process of renal interstitial fibrosis and its possible mechanism
Luojia JIANG ; Liping YANG ; Xianfeng WU ; Chong HUANG ; Xiaohua QING ; Xiangdong FANG ; Weiping TU
Journal of Medical Postgraduates 2015;(6):594-599
Objective Clinical treatment can delay the development of renal interstitial fibrosis , but it can not reverse renal dysfuntion.The article was to discuss the influence of recombinant human erythropoietin ( rHuEPO ) on inflammatory factors in the process of renal interstitial fibrosis and its possible mechanism . Methods The vitro cultured HK-2 cells were randomized into 7 groups:the blank control group , rHuEPO control group ( addition of 20U/mL rHuEPO), albumin stimulation group (addition of 5mg/mL albumin), 5mg/mL rHuEPO intervention group (5mg/mL albumin +5U/mL rHuEPO), 10 U/mL rHuEPO intervention group (5mg/mL albumin +10 U/mL rHuEPO), 20U/mL rHuEPO intervention group (5mg/mL albumin +20U/mL rHuEPO), and Rho inhibi-taion group (addition of 5mg/mL albumin 30min after 10μmol/L Y27632), 24 h acting time for each group.We observed the changes of cell morphology in each group .Reverse transcription polymerase chain reaction ( RT-PCR) was used to evaluate the mRNA levels of RhoA, ROCK1 and IL-6 , and ELISA was applied to measure the levels of supernatant TNF-αand IL-6 protein. Results The form of pebbles or paving stone was observed in blank control group and rHuEPO intervention groups , a long and thin spindle change with the appearance of fibre cells in albumin stimulation group , the transformation to pebbles in 5, 10, 20 mg/mL rHuEPO intervention groups , the form of oval and slightly increased intercellular space in Rho inhibitaion group .Compared with the blank control group , the expressions of RhoA mRNA, ROCK1 mRNA and IL-6 mRNA significantly increased in the albumin stimulation group (P<0.05), while significantly reduced in 5, 10, 20 mg/mL rHuEPO intervention groups (P<0.05), which was in negative relation with the rHuEPO concentrations .Compared with the albumin stimulation group , the expressions of ROCK 1 mRNA and IL-6 mRNA reduced in Rho inhibtation group (P<0.05), while there was no significant difference as to the expression of RhoA mRNA .ELISA results showed:compared with blank control group , the expressions of supernatant TNF-α([452.32 ±33.23] ng/L vs [1347.54 ±41.52] ng/L), IL-6 protein([884.62 ±0.73] pg/L vs [95.12 ±0.32]pg/LP<0.05) increased significantly.Compared with albumin stim-ulation group, the expressions of TNF-αin 5, 10, 20 mg/mL rHuEPO intervention groups and Rho inhibitation group reduced signifi-cantly([1003.32 ±3.42] ng/L, [821.32 ±21.32] ng/L, [590.15 ±7.68] ng/L, [488.13 ±65.03] ng/L vs [1 347.54 ± 41.52]ng/L,P<0.05), while the expressions of IL-6 mRNA reduced accordingly in 5, 10, 20 mg/mL rHuEPO intervention groups and Rho inhibitation group reduced significantly ([656.68 ±0.55] pg/L, [422.35 ±0.22] pg/L, [217.32 ±0.35] pg/L, [309.49 ±0.21] pg/L vs [884.62 ±0.73]pg/L,P<0.05).Moreover, there was significant statistical difference among 5, 10, 20 mg/mL rHuEPO intervention groups(P<0.05). Conclusion RHuEPO can inhibit the transdifferentiation process of HK-2 cells in-duced by albumin by suppressing inflammation factors , and the mechanism may be involved in RhoA/ROCK signaling pathway .
8.Determination of Pharmacokinetic Parameters of P-methoxybenzyl Alcohol from Gastrodiae Rhizoma in Plasma of Rats by HPLC
Xiaohua DUAN ; Weili WANG ; Shuang WU ; Hanwen YAN ; Lisong LIU ; Qing LIN
Chinese Journal of Information on Traditional Chinese Medicine 2015;(6):99-102
Objective To determine the pharmacokinetic parameters of P-methoxybenzyl alcohol from Gastrodiae Rhizoma in plasma of rats by HPLC. Methods Gavage and intravenous injection were employed for administration. HPLC was used to determine the concentrations of P-methoxybenzyl alcohol from Gastrodiae Rhizoma in plasma of rats in different time points. The pharmacokinetic parameters were computed by DAS3.0. Results The linear range of P-methoxybenzyl alcohol in plasma was 0.63-321.17 μg/mL, r 2=0.994 5. Intra-day accuracy, inter-day accuracy, absolute recovery and stability were in specified range. Conclusion The method is simple and accurate for the determination of the pharmacokinetic parameters of P-methoxybenzyl alcohol from Gastrodiae Rhizoma in plasma of rats.
9.Study on negative pressure wound therapy combined with moist wound therapy for traffic crush injury
Qixia JIANG ; Lixia ZHU ; Yuan ZHANG ; Xiaohua LI ; Qing PENG ; Xin ZHOU
Journal of Medical Postgraduates 2014;(9):955-958
Objective Negative pressure wound therapy (NPWT) and moist wound therapy (MWT) are two new methods for wound care .Whether the united is better than the single .The study was to observe and compare the effects of using negative pres-sure wound therapy ( NPWT) combined with moist wound therapy ( MWT) and simple MWT in the treatment of traffic crush injuries . Methods 32 cases were randomly divided into two groups:intervention group and control group , 16 cases for each group .In interven-tion group, wounds were first treated by NPWT for 21 days, followed by standardized MWT till healing .In control group, wounds were treated by standardized MWT till healing .Consensus methods were applied in the measurements before treatment , 7 days, 14 days and 21 days after treatment .The measurements were involved in wound size , depth, undermined edge and the ratio of granulation tissue covering wound bed .Calculation were made on the construction rates of wound size , depth, volume and undermined edge along with re-cords of the time 100%granulation tissue covering wound bed and healing .The database was set up and statistical analysis were done by SPSS 16.0 software. Results The healing rate was 100%for both groups.During 21 days of treatment, the construction rates of wound size, volume, depth and undermined edge of intervention group were better than those of control group (P<0.05).The time 100%granulation tissue covering wound bed of intervention group was shorter than that of control group ([25.00 ±5.77] d vs [41.25 ±18.32]d, P=0.000).The healing time of intervention group was about two weeks shorter than of control group , but with no significance([67.63 ±22.38]d vs [83.56 ±55.31]d, P=0.597). Conclusion NPWT is applicable to traffic crush injuries in combination with MWT , which could promote the growth of granulation tissue and help construct and heal the wounds .NPWT combined with MWT has prior effects to simple MWT .
10.The evaluation of efficacy and safety of nicorandil on coronary slow flow phenomenon
Jianming ZHANG ; Feng ZHU ; Huaming MU ; Xiaohua PANG ; Jianjun YANG ; Zhongjie WU ; Qing MI
Chongqing Medicine 2013;(24):2869-2870,2872
Objective To evaluate the effect and safety of nicorandil on Coronary Slow Flow Phenomenon (CSFP) .Methods The CSFP patients(n=60) were randomly divided into the control group treated with placebo and the treatment group treated with nicorandil .The changes of the clinical symptoms ,the frequency and duration of pectoralgia ,the six-minute walk test ,and TIMI frame counts were observed before and after treatment .Results The treatment group had a better therapeutic effect than the con-trol group(P<0 .05) .There were significant differences in the frequency and duration of pectoralgia ,the six-minute walk test ,and TIMI frame counts in treatment group before and after treatment ,which were superior to those of control group (P<0 .05 ,P<0 .01) .The blood routine examinations and hepatorenal function were within the normal range before and after treatment .Conclusion Nicorandil has better therapeutic effect and safety on CSFP .