1.Stent-graft migration during endovascular repair of aortic dissection
Xuemin ZHANG ; Xiaoming ZHANG ; Qingle LI
Chinese Journal of General Surgery 2009;24(1):8-11
Objective To evaluate the cause and management of intraoperative stent-graft migration during endovascular repaire of aortic dissection (AD). Method During the period between May 2001 and Dec 2007 intraoperative stent-graft migration occurred in 17 cases ( 14 males and 3 females) including 15 acute AD cases and 2 chronic AD cases. Backward migration was noticed in 11 cases including the 2 cases found during balloon extention, in 1 case the migration found during the removal of the releasing sheath which scratched the stent-graft, in 2 cases the migration occurred when the grafts were half released. Forward migration occurred in 6 cases resulting in left subclavian artery (LSA) occlusion in 3 cases and left common carotid artery (LCCA) occlusion in the other 3 cases. For the 3 cases of LCCA occlusion, the backward migrated stent-graft was pushed forward by the cuff releasing system and consequently occluded the LCCA in 1 case, and the cuff jumped forward during release and occluded the LCCA in 1 case. Result Backward migration of stent-grafts can be treated by pushing forward the graft with the sheath or additional placement of a cuff. Intraoperative complication may be less life threatening and no perioperative death occurred in this group. Occlusion of LSA in 3 cases by forward migration of stent-grafts were left untreated and 1 case died of leter cerebellar infarction. For the LCCA occlusion in 3 cases, 2 were treated by drawing back the graft with a balloon, and in the remaining 1 case the migrated graft was pushed back with the catheter in the LSA captured by a snare. Conclusion Stent-graft migration during endovascular repair may be related with poor experience of the operator, specific anatomical condition of the patient and the design drawback of the stent-graft. Forward migration of stent-graft is less common but may be more harmful for the patient. Beside back drawing with a balloon, the captured catheter with a snare may be helpful in the management of forward migration of the released stent graft.
2.Comparison of the different methods to screen metabolic syndrome in the type 2 diabetes population
Li JIN ; Di WU ; Xuemin ZHAO
Journal of Chinese Physician 2010;(z1):38-43
Objective To evaluate the uniformity of different diagnosis criteria of metabolic syn-drome in patients with type 2 diabetes, especially the criteria that suit for metabolic syndrome in type 2 dia-betes patients.Methods The patients with type 2 diabetes, aged from 20~74 years, who were treated at Department of Endocrinology , the Third Affiliated Hospital , Qiqihar Medical University from January 2008 to November 2009 were enrolled.Four hundred and twenty one patients with integral data were analyzed . Waistline, hip line, height, body mass, blood pressure and so on were surveyed , and according to waistline and hip line the waist-to-hip ratio was calculated .On the basis of body mase/height body mass index ( kg/m2 ) was calculated .The blood sugar was detected with the hexokinase method .The blood cholesterol , tria-cylglycerol , the high density lipoprotein cholesterol were determined with the biochemistry method .Urinates the micro albumin level was determined with chemistry to try the belt technology .Diagnosis standards of WHO (1999), NCEP-ATPⅢ(2001),ACCE(2003),EGIR(1999),the Chinese CDS(2007) suggestion metabolism synthesis drafts , the triacylglycerol-waistline standard of Blackburn P forecast cardiovascular e-vent(2003) were applied to calculate prevalence rate of metabolism synthesis .Results The 421 enrolled testees were involved in the result analysis .⑴Prevalence rates of type 2diabetes and metabolism synthesis in various single component: In the investigation population the differences in body of obesity , hypertension and hypertriacylglycerolemia , the low and high density lipoprotein cholesterol blood sickness between the men and women were insignificant , but the overload (66.1%) in males was remarkably higher than that in females (49.7%).The prevalence rate in abdomen obese in males (74.0%) was remarkably higher than that in females(59.9%).⑵Abnormal distribution of metabolism in patients with type 2 diabetes: Preva-lence rate of one kind of abnormal metabolism was 27.2%.Prevalence rate of two kinds of or above two kinds of above abnormal metabolism was 61.0%.Prevalence rate of three kinds of above abnormal metabo-lism was 26.1%,and the prevalence rate in females was not higher than that of males ( P >0.05 ) .⑶After age and sex lamination ,prevalence rates of metabolism synthesis and it's the correlated disease:The preva-lence rates of the high hypertriacylglycerolemia , hypertension , metabolism synthesis had the tendency of in-creasing along with the age .Prevalence rates of abdominal obesity and the low and high density lipoprotein cholesterol blood sickness had the increased tendency in females , but it was not obvious in males .Except that 35~44 years old of age group prevalence rate of the high hypertriacylglycerolemia in males ( 62.1%) was remarkably higher than that in females ( 29.2%) ( P <0.005 ) , and the 20~35 years old age group prevalence rates of metabolism synthesis in males (41.2%)were remarkably higher than outside the females (20.0%)( P <0.05).In other various age groups ,there was insignificant difference in prevalence rate between males and females .⑷The prevalence rate of WHO diagnosis standard for metabolism synthesis (62.9%) had good concordance with the prevalence rate of the Chinese CDS diagnosis standard for metabo -lism-synthesis ( 66.7%) .The prevalence rate of ACCE diagnosis standard for metabolism synthesis (88.8%) had good concordance with the prevalence rate of the EGIR diagnosis standard for metabolism synthesis (86.6%).The prevalence rate of Blackburn P forecast cardiovascular event (20.9%),which was distanced from the result of the diagnosis standards ( P <0.005 ) .Conclusion ⑴Patients with type 2 di-abetes have high metabolism syndrome proportion rate , and the abnormal metabolism proportion rate in sin-gle group is also higher.⑵WHO (1999) metabolism syndrome diagnosis standard and CDS (2007)sugges-tion standard are suitable for Chinese metabolism -synthesis in type 2 diabetic patients .⑶The metabolism syndrome diagnostic standards of EGIR and ACCE are similar in proportion rate in Chinese patients with type 2 diabetes , which is accorded with the findings of former literatures .Whether that can be used widely deserves further study .⑷The diagnostic criteria of triacylglycerol waistline is not suitable for Chinese type 2diabetic patients.
3.Evaluation on the Reproductive Health Status of College Students
Yushan LI ; Quanxian WANG ; Xuemin GAO
Chinese Journal of Prevention and Control of Chronic Diseases 2006;0(02):-
Objective To evaluate the semen quality of potential semen donors of college students and investigate their reproductive health status. Methods According to the screening procedure in the Basic Standard and the Technical Norms of Human Sperm Bank revised by Chinese Ministry of Health in 2003,all sperm samples of 355 potential donors were examined. Results 37 of 355 donors sperm(10.4%) were qualified to the normal standard revised by Chinese Ministry of Health;and the rest(89.6%) were abandoned,because the sperm numbers of 267 donors were not reached the identified semen standard of the human sperm bank in the first screen,26 donors(7.4%)were with abnormal health status,4 donors did not ejaculate and got samples,9 donors with normal semen quality did not take physical health examination,the normal shape percentage of 6 donors sperm was lower than 30% and the thawed revival percentage with(a+b) grade of 6 donors was lower than 60%.135 of 355 donors(38.0%) sperm quality were qualified to the male productive standard of WHO. Conclusion The results indicated that the sperm quality of undergraduate declines and the society should pay more attention to the reproductive health of college students.
4.Alloantigen specific TCR transgenic CD8~+T cells require IL-2 to mediate allograft rejection
Xuemin XU ; Xiang XIAO ; Xianchang LI
Chinese Journal of Organ Transplantation 1996;0(04):-
Objective To study the role of IL-2 in regulating allograft rejection mediated by alloantigen-specific CD8~+ T cell.Methods T cell proliferation in vivo at a single cell level was examined using the CFSE dilution assay. IL-2 expression by activated CD4~+ versus CD8~+ T cells was determined by intracellular cytokine staining. The ability of alloantigen-specific CD8~+T cells in mediating allograft rejection was studied using the islet transplantation model.Results CD8~+ T cells divided vigorously in vivo in the allogeneic hosts regardless the presence or absence of CD4~+ T cells. CD4~+ T cells, but not CD8~+ T cells, were the primary source of IL-2 when both subsets were present. However, CD8~+ T cells could express high levels of IL-2 in the complete absence of CD4~+ T cells. In 2C TCR transgenic (Tg) mice in which the 2C TCR transgene was selectively expressed on the CD8~+ T cells that specifically recognized alloantigen (Ld) of Balb/c origin, islet allografts from Balb/c mice was promptly rejected by the 2CTg recipients with mean survival time of only 8 days. In contrast, in 2CTg mice with a genetic deletion of the IL-2 gene (2CTg-IL-2KO mice), the alloantigen specific CD8~+ T cells failed to mediate the islet allograft rejection and all the Balb/c islets survived for more than 50 days.Conclusions CD8~+ T cells appear to be very plastic in producing and utilizing IL-2. In the presence or absence of CD4~+ T cells, CD8~+ T cells can use CD4~+ derived or self derived IL-2 for proliferation and effector function respectively. In an alloantigen specific TCR transgenic model, the effector function of CD8~+ T cells is strictly IL-2 dependent. Thus, in situations where graft rejection is mediated solely by the CD8~+T cells, blocking IL-2/IL-2R pathway may be critically important in preventing transplant rejection.
5.Application of carotid shunt in extra-cranial vascular surgery: report of 23 cases
Xiaoming ZHANG ; Wei LI ; Xuemin ZHANG
Chinese Journal of General Surgery 2000;0(11):-
ObjectiveTo evaluate the use of carotid shunting for the protection of cerebral function during extra-cranial carotid surgery. MethodsTwenty-three patients with carotid artery related disease underwent surgery under carotid shunting, with age ranging from 11 to 76 years (mean of 55). Carotid endarterectomy was performed for carotid atherosclerotic stenosis in 12 cases, excision for carotid body tumor (CBT) in 4 cases, resection of carotid pseudoaneurysm in 4 cases, partial excision of internal carotid aneurysm in 2 cases, and segmental resection of carotid artery and end to end anastomosis in one case. ResultsThere was no mortality nor complications related to cerebral ischemia. Horner signs developed in one case of CBT. ConclusionThe protecting effect of carotid shunting is excellent for surgical procedures involving carotid artery.
6.Effects of ketamine on endotoxin-induced proinflammatory cytokine production and NF-?B activation in vivo
Jianguo LI ; Xuemin SONG ; Yanlin WANG
Chinese Journal of Anesthesiology 1996;0(09):-
Objective To investigate the effects of ketamine on endotexin-induced production of proinflammatory cytokines(IL-6, TNF-?) and activation of their medulating factor NF-?B in vivo. Methods Forty adult male SD rats weighing 200-250 g were randomly divided into 4 groups: (Ⅰ)control group(n=10); (Ⅱ) endotoxin group received intravenous endotoxin(Escherichia coli O111: B4, Sigma) 5 mg?kg~(-1)(n=10); (Ⅲ, Ⅳ)endotexin+ketamine group received ketamine or 5 or 10mg?kg~(-1)?h~(-1) after endotoxin(n=10). The animals were anesthetized with urethane i.p. (1g?kg~(-1)). Carotid artery was cannulated for BP and HR monitoring and jugular vein was cannulated for fluid or drug administration. Two hours after endotoxin administration the animals were sacrificed by exsanguination. Blood was collected and peripheral blood monocytes(PBMC) were isolated. NF-?B activity in PBMC was measured by EMSA and plasma TNF-? and IL-6 levels were determined by ELISA. Results Progressive hypotension and tachycardia developed after endotoxin administration. Endotexin also increased NF-?B activity in PBMCs and plasma TNF-? and IL-6. Ketamine 10 mg?kg~(-1) attenuated the endotexin-induced hemedynamie levels. Ketamine(5, 50 mg?kg~(-1)?h~(-1)) suppressed NF-?B activity in PBMC and inhihited plasma TNF-? level but plasma IL-6 level was not affected. Conclusion Ketamine can suppress endotoxin-induced NF-?appa B activation. Subanesthetic dose of ketamine has anti-inflammatory action.
7.Distribution of aldosterone synthase gene polymorphism in Hebei province in China
Qingxiang LI ; Xuemin CAO ; Xiaoling ZHU
International Journal of Laboratory Medicine 2006;0(03):-
0.05).(2)Distribution of CYP11B2 -344C/T genotype and allele frequencies in Hebei was significantly different from that of other countries(P
8.Effect of nicotine on coagulation abnormalities in endotoxemic rats
Wei LIU ; Jianguo LI ; Xuemin SONG ; Hui HANG ; Guang LI
Chinese Journal of Anesthesiology 2011;31(3):338-341
Objective To investigate the effect of nicotine on coagulation abnormalities in endotoxemic rats.Methods Ninety-six male SD rats weighing 200-250 g were randomly divided into 4 groups (n=24 each): group normal saline (group NS);group LPS;group nicotine(group NIC)and group α-bungarotoxin (α7 nicotinic acetylcholine receptor antagonist, group α-BGT) . Endotoxemia was induced by LPS 10 mg/kg injected via femoral vein in LPS, NIC and α-BGT groups. In group NIC nicotine 400 μg/kg was injected intraperitoneally at 30 min before LPS injection. In group α-BGT α-BGT 1 μg/kg was injected intraperitoneally at 15 min before intraperitoneal nicotine. Prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(Fib),antithrombin (AT),von Willebrand factor(vWF),plasminogen activator inhibitor-1(PAI-1),D-dimer,platelet count and TNF-α were measured before (baseline) and 2, 4 and 6 h after LPS injection.Results PT and APTT were significantly prolonged and plasma Fib and AT concentrations and platelet count were significantly decreased, while plasma PAI-1, D-dimer, vWF and TNF-α concentrations were significantly increased after LPS administration in group LPS as compared with group NS. Nitotine pretreatment significantly attenuated the LPS-induced changes in group NIC.The effect of nicotine was counteracted by α-BGT. Conclusion Nicotine can attenuate coagulation abnormalities induced by LPS by acting on α7 nicotinic acetylcholine receptor.
9.Experiences in carotid-artery stenting with the use of filter in 35 cases
Wei LI ; Xiaoming ZHANG ; Xuemin ZHANG ; Qingle LI
Chinese Journal of General Surgery 2009;24(3):204-206
Objective To establish technique skills and evaluate complications of carotid artery stenting with the use of Filter. Methods In this study, 38 carotid lesions in 35 patients (with an asymptomatic stenosis exceeding 70% or a symptomatic stenosis exceeding 50% ) received stenting with the use of protective filter. The skills, complication and outcomes were evaluated. Follow-up surveillance included ultrasound examination, CTA, or MRA. Results The technique was successful in all 38 lesions. Angiography after stenting showed that the treated vessels were all patent (remained stenosis was less than 20% ). Sclerotic debris was found in 21 (55.3%) filters, 3 of which were full filled with debris. Complications included 1 (2.6%) stroke and hemiplegia, and I (2.6%) cerebral bleeding, 2 (5.3%) TIA after stenting and recovered after withdrawing the filter, 10 (26.3% ) suffered from perioperative transient decrease of heart rate and blood pressure. In a follow-up of 6 to 54 months (mean 32 months), all treated vessels were patent except 1 with stent-graft for carotid ulcer, no new TIA and stroke was found. Conclusion Meticulous technique and the use of carotid fiter permits carotid stenting in a safe and effective manner and prevents complications.
10.Distractive effect in multiple-object tracking task
Xuemin ZHANG ; Yongna LI ; Li HE ; Hua SHU ; Yuan GAO
Chinese Journal of Tissue Engineering Research 2005;9(44):155-157
BACKGROUND: Research on selective attention of mobile visual information is relatively scarce because of difficulties in technology, methodology and experimental condition control. As is well known, most visual information in the real world is mobile and changeable. To examine the mechanism of mobile visual information is helpful to designing natural and highly efficient human-computer interface as well as selecting specialized personnel in special fields OBJECTIVE: To explore the distractive effect of the number, color, and form changes of distractors on multiple-target tracking performance. DESIGN: The present study was a 3 × 2 × 2 within subject design. Participants were undergraduates from Beijing Normal University.SETTING: Institute of Cognitive Neuroscience and Learning, Beijing Normal University.PARTICIPANTS: The experiment was performed in the Experimental Psychology Lab of Beijing Normal University in April 2003. Twenty-four undergraduates from Beijing Normal University participated in the experiment. Among them there were 11 males and 13 females aged 17-25 years.They all reported normal or corrected-to-normal vision and normal color perception.METHODS: ① Stimuli were presented on a 17-inch Founder monitor with the resolution of 1028 × 800 pixels. A Founder computer controlled the stimulus presentation and randomization of trials. Response latencies were collected by keyboard response with accuracy of one millisecond. The stimuli were randomly moving "日" characters. The number of "日" characters is 4, 8 and 12. As the participants were tracking the objects, the targets would transform to "(│)" and "(│)", and the distractors would change to "(│)" , "(│)", or "H" by removing lines from "日 ". All distractors and targets were red at the beginning of moving. ② The correct responses were analyzed with 3-factor repeated measures analysis of variance, multiple comparison analysis, and pairwise T-test.MAIN OUTCOME MEASURES: Response time and accuracy of pressing the keys.RESULTS: The data of 24 participants were involved in the final statistical analysis. ① The three-factor repeated measures ANOVA results showed that the main effect of the number change of distractors was significant [F(1,22)=6.040, P < 0.05]. The further ANOVA and pairwise comparison in different experiment conditions also showed no distractive effects when target and distractor had different shape but the same color [F(1,2,3)=9.965, P < 0.01]. The further pairwise comparison indicated that when the number of distractors was 2 and 6, the participants' response latencies had no significant effects, and they had significant effect when the number of distractors was 2 and 10, or 6 and 10 (RT10-RT2=46 ms, P < 0.05, two-tail test; RT10-RT6=28ms, P < 0.05, one-tail test). These results showed that the increase in the number of distractors had distractive effects. ② There had no significant effect whether target and distractor had the same color or not, when the number of distractors was 2 and 10. And there had significant effects whether the color of target and distractor was the same or not when the number of distractors was 6; the same shape of target and distractor produced distractive effects (Tsame colons=1.926; Tdifferent colons=2.044,P < 0.05, one-tail test). The main effect of the color was not significant. The further pairwise comparison showed the same result. That is,the color change of diatractors had no obvious distractive effect.CONCLUSION: ① There was distractive effect when the number of distractors increased while the shape and color of distractor and target were different. ② There was no distractive effect when the number of distractors increased while the shape of distractor and target was the same. ③ There was distractive effect when the number of distractors increased while the shape of distractor and target was different, and there was distractive effect when the color of distractor and target was the same.