1.Construction and function of forensic interest group for medical students of eight-year-program
Yadong GUO ; Rina SU ; Lin ZHANG ; Jifeng CAI ; Yaoqing CHEN
Chinese Journal of Medical Education Research 2012;11(9):902-904
The aim of the eight year medical education program is to cultivate high-leveled and high qualified clinical and research personnel.Constructing forensic interest group for medical students of eight year program can not only cultivate the students' English learning,innovative thinking and practice ability,which is their Achilles heel but also combine eight year medical education with forensic science teaching reform.
2.PIKA Provides an Adjuvant Effect to Induce Strong Mucosal and Systemic Humoral Immunity Against SARS-CoV
Weiwei GAI ; Yan ZHANG ; Dihan ZHOU ; Yaoqing CHEN ; Jingyi YANG ; Huimin YAN
Virologica Sinica 2011;26(2):81-94
Severe Acute Respiratory Syndrome(SARS)is a deadly infectious disease caused by SARS Coronavirus(SARS-CoV).Inactivated SARS-CoV has been explored as a vaccine against SARS-CoV.However,safe and potent adjuvants,especially with more efficient and economical needle-free vaccination are always needed more urgently in a pandemic.The development of a safe and effective mucosal adjuvant and vaccine for prevention of emergent infectious diseases such as SARS will be an important advancement.PIKA,a stabilized derivative of Poly(I:C),was previously reported to be safe and potent as adjuvant in mouse models.In the present study,we demonstrated that the intraperitoneal and intranasal co-administration of inactivated SARS-CoV vaccine together with this improved Poly(I:C)derivative induced strong anti-SARS-CoV mucosal and systemic humoral immune responses with neutralizing activity against pseudotyped virus.Although intraperitoneal immunization of inactivated SARS-CoV vaccine alone could induce a certain level of neutralizing activity in serum as well as in mucosal sites,co-administration of inactivated SARS-CoV vaccine with PIKA as adjuvant could induce a much higher neutralizing activity.When intranasal immunization was used,PIKA was obligatorily for inducing neutralizing activity in serum as well as in mucosal sites and was correlated with both mucosal IgA and mucosal IgG response.Overall,PIKA could be a good mucosal adjuvant candidate for inactivated SARS-CoV vaccine for use in possible future pandemic.
3.Changes of bonemarrow and circulating endothelial progenitor cells in mice with acute pancreatitis
Jun WU ; Enqiang MAO ; Jianfang LI ; Ying QU ; Xuehua CHEN ; Mingjun ZHANG ; Yaoqing TANG ; Shendiao ZHANG
International Journal of Surgery 2010;37(11):732-735,封3
Objective To investigate changes in number of endothelial progenitor cells(EPCs)from bone marrow and circulation in mice with acute pancreatitis.Methods BALB/c mice were assigned randomly to saline group and cerulein group.Animals were sacrificed at 12, 24 and 48 hours after injection.Bone marrow and circulating EPCs were detected by flow cyzometric analysis.Plasma VEGF, TNF-α and ET-1 were determined by enzyme-linked immunosorbent assay.The expression of VEGF in the pancreas was assessed by Western blotting.Apoptosis in situ was detected by TUNEL.Results The amounts of EPCs in bone marrow and circulation increased remarkably after cerulein injection(P < 0.05), also the levels of plasma VEGF TNF-α and ET-1(P < 0.05), the EPCs levels in bone marrow and circulation seen in the study closely mirrors the levels of VEGF detected in the circulation(r = 0.77, 0.67 individually).VEGF expression in pancreas was up-regulated after 12 h of cerulein injection compared with that of control group.Apoptosis of endothelial cells also increased in the cerulein group.Conclusion EPCs were mobilized by acute pancreatitis, which may be due to the mobilizing effect of increased levels of VEGF, EPCs may participate in the repair process of injured endothelium induced by acute pancreatitis.
4.Clinical characteristics and surgical treatment for duodenal stromal tumor
Maosong CHEN ; Shaoliang HAN ; Caiyan PAN ; Kuan HE ; Yaoqing CAI ; Zuolin ZHOU ; Hanzhang HUANG
Chinese Journal of General Surgery 2017;32(7):561-564
Objective To investigate the clinical characteristics,surgical treatment and outcome for patients with duodenal stromal tumor.Methods Data of 40 patients with stromal tumor of duodenum were reviewed retrospectively.Results All patients received resection including local resection in 14 cases,segmental resection of the duodenum in 17 cases,and pancreaticoduodenectomy in 9 cases.38 cases were followed-up,and two were lost.The median follow-up was 59 months (range 3-240 mos).The 1,3,and 5-year overall survival rates were 92%,76% and 68%,respectively.No recurrence was found in very-low-risk tumor (n =1) and low-risk turmors (n =4).The 1,3,and 5-year overall survival rates for intermediate-risk tumors were 95%,80% and 70%,respectively;and those were 69 %,31%,and 0 for high-risk tumors,respectively.14 of 33 cases (42%) suffered from recurrence after radical resection for intermediate or high-risk tumors.33 postoperative cases received treatment with Imatinib (Glivec) for more than one year,and one case developed recurrence at 2.5 years after operation.4 patients with synchronous liver metastasis received palliative resection and Imatinib,and two survived more than 1 year.Conclusion Surgery is the first choice for duodenal stromal tumor,and Imatinib should be administered for high-risk disease after surgery.
5.Levels of procalcitonin in blood and tissue of acute pancreatitis rats
Hongchang LI ; Ruoqing LEI ; Zhiwei XU ; Qinggang WANG ; Chunyu CHAI ; Yang DENG ; Xubo WU ; Jun WU ; Sheng CHEN ; Tianquan HAN ; Yaoqing TANG ; Shengdao ZHANG
Chinese Journal of Pancreatology 2010;10(3):187-189
Objective To investigate the variation of procalcitonin(PCT) in blood and tissue level of acute pancreatitis rats and probe its significant. Methods One hundred and two male Wistar rats were randomly divided into control group ( n = 6 ), lipopolysaccharide group ( LPS, n = 24 ), acute edematous pancreatitis (AEP) group ( n = 24), acute necrotizing pancreatitis (ANP) group ( n = 24), AN P + LPS group ( n = 24). Subcutaneous injection of cerulein was used for AEP induction, while ANP model was induced by retrograde injection of sodium taurocholate into the biliary and pancreatic duct. The rats were sacrificed at 3,6, 18 and 24 hours after model induction. Pancreatic tissue was harvested and the pathological scores were assessed. Levels of PCT in serum, liver, lung, spleen, pancreas, small intestine, large intestine tissue was harvested and tissue levels of PCT were determined. Results AEP and ANP models were established successfully. At 6 h, the serum levels of PCT in control group, LPS group, AEP group, ANP group and ANP +LPS group were (0.0144 ±0.0082) ng/ml, (0. 1722 ±0.0449) ng/ml,(0.4751 ±0.0572) ng/ml, (0.7070 ±0. 1040) ng/ml and ( 1. 1960 ±0.8644) ng/ml, respectively; and the difference was statistically significant (P < 0.05 ). PCT could be detected in liver, lung, spleen, pancreas, small intestine and large intestine tissue of normal rats. PCT levels in liver and pancreas of ANP group were not statistically different, but the PCT levels in lung, spleen, and large intestine tissue significantly decreased, and the corresponding values were (5.63 ±0.62) ng/ml vs. (6.85 ±0.46) mg/ml, (4.73 ±1.27) mg/ml vs. (6.88 ±0.37) ng/ml, (1.08 ±0.52) ng/ml vs. (4.12 ± 1.02) ng/ml (P <0.01 ). However, the PCT levels in small intestine significantly increased, which were (2.51 ±0.90) ng/ml vs (0.98 ±0. 12) ng/ml (P<0. 01). Conclusions Serum PCT level was associated with the severity of AP and infection; the changes of PCT levels in different tissues may be related with the changes of organ's function.
6.Clinical analysis of 33 cases of acute recurrent pancreatitis
Liangshun XIONG ; Jingyi WU ; Jian FEI ; Enqiang MAO ; Ruoqing LEI ; Jiancheng WANG ; Sheng CHEN ; Weize WU ; Tianquan HAN ; Chenghong PENG ; Yaoqing TANG ; Shengdao ZHANG
Chinese Journal of Hepatobiliary Surgery 2010;16(3):164-166
Objective To investigate the etiology of acute recurrent pancreatitis (ACP) and de-termine how to further enhance its level of treatment.Methods The clinical data of 33 patients with ACP treated in Ruijin Hospital from 2003 to 2007 were retrospectively analyzed.Results Of the 33 patients with an average age of 55 (22-86), 18 (55%) were male and 15 (45%) female.ACP occurred once in 26 patients, twice in 4 and 3 times in 3.The disease appeared whithin 1 year in 29 patients, 1-2 years in 2, 2-3 years in 1 and 3 years in 1 after being dischared from hospital.For its etiology, it was of biliary origin in 29 patients, hyperlipidemia in 1, pancreatic tumor in 1 and unknow reasons in 2.Twenty-four patients were treated with operation or endoscopy.Two patients died and the mortali-ty was 9.1%.Conclusion ACP is mainly due to biliary origin in China.Operative intervention at an appropriate opportunity can effectively reduce the recurrence of biliary-origin pancreatitis.
7.Clinical study on the early predictive value of renal resistive index in acute kidney injury associated with severe acute pancreatitis
Jun WU ; Zhiwei XU ; Hong ZHANG ; Jie HUANG ; Shuai QIN ; Lei LI ; Hongping QU ; Dechang CHEN ; Yaoqing TANG
Chinese Critical Care Medicine 2019;31(8):998-1003
To investigate the value of renal resistive index (RRI) in early predictor and discriminator of severe acute pancreatitis (SAP)-related acute kidney injury (AKI). Methods A retrospective observational study was conducted. SAP patients complicated with AKI (within 1 week of onset) and admitted to intensive care unit (ICU) of Ruijin Hospital Shanghai Jiaotong University School of Medicine from January 2016 to June 2019 were enrolled. The RRI within 24 hours admission was measured. Clinical data such as acute physiology and chronic health evaluation Ⅱ(APACHEⅡ), heart rate (HR), mean arterial pressure (MAP), central venous pressure (CVP), intra-abdominal pressure (IAP), arterial blood lactate (Lac), oxygenation index (PaO2/FiO2), base excess (BE), serum creatinine (SCr), urine output, norepinephrine (NE) and RRI were collected. Within 24 hours and 7 days after ICU admission, patients were grouped according to AKI classification criteria of Kidney Disease: Improving Global Outcomes (KDIGO), and the differences of relevant parameters were statistically analyzed. Influence factors of AKI grading were screened by Logistic regression analysis. Pearson correlation analysis was used to analyze the correlation between RRI and other parameters. The predictive value of RRI for AKI classification was analyzed by receiver operating characteristic (ROC) curve. Results A total 57 patients were included, with an average age of (54.6±13.5) years old, and APACHEⅡscore of 21.8±5.6. Within 24 hours, the number of patients suffered from stage 1-3 AKI were 19 (33.3%), 18 (31.6%) and 20 (35.1%), respectively. On day 7, the number of patients suffered from stage 0-3 AKI were 21 (36.9%), 8 (14.0%), 9 (15.8%) and 19 (33.3%), respectively. The higher APACHEⅡ score, CVP, IAP, Lac, NE dosage and RRI were found in the group with higher AKI grades, especially in the group with stage 3 AKI on day 7. RRI of patients with stage 3 AKI was significantly higher than that of patients with stage 1 and 2 AKI within 24 hours (0.74±0.04 vs. 0.65±0.05, 0.68±0.05, both P < 0.05). Similarly, RRI of patients with stage 2 and 3 AKI were significantly higher than that of patients with stage 0 and 1 AKI on day 7 (0.70±0.04, 0.74±0.04 vs. 0.65±0.05, 0.66±0.05, all P < 0.05). Multivariate Logistic regression analysis showed that RRI was an independent factor of AKI classification [odds ratio (OR) = 3.15, 95% confidence interval (95%CI) = 1.09-9.04, P < 0.05], and IAP and CVP also had significant impacts on AKI grading [OR value was 2.11 (95%CI = 1.16-4.22), 3.78 (95%CI = 1.21-12.90), both P < 0.05]. ROC curve analysis showed that the area under curve (AUC) of RRI for predicting AKI ≥2 stage was 0.87 (P < 0.05); the cut-off ﹥ 0.71, sensitivity was 71% and specificity was 83%. The correlation analysis showed that RRI was positively correlated to a certain extent with IAP and lactic acid (r1 = 0.49, r2 = 0.39, both P < 0.05). Conclusion High RRI on ICU admission was a significant predictor for development of severe AKI during the first week, and RRI can help predict the tendency of AKI in SAP.
8.Efficacy of parent-child emotional regulation and resilience group training on adolescent depression
Junxiang CHENG ; Juan ZHAO ; Yaoqing FENG ; Baoli SONG ; Ying LI ; Yangjie CHEN ; Xiaomei LIU ; Shifan HAN
Chinese Journal of Behavioral Medicine and Brain Science 2023;32(12):1078-1085
Objective:To explore the application effect of parent-child emotional regulation and resilience group training in adolescent depression patients.Methods:From August 2020 to September 2021, a total of 118 adolescent depression patients were enrolled and randomly divided into the intervention group(66 cases) and the control group(66 cases) by a random number table method.The intervention group received medication therapy and parent-child group emotional regulation and psychological resilience training, while the control group received medication therapy and commonly used individual, family or group therapy in clinical practice.The Hamilton Depression rating scale(HAMD-24 version), Herth hope scale(HHS), Connor-Davidson resilience scale(CD-RISC), and family adaptability and cohesion evaluation scale, second edition Chinese version(FACES-Ⅱ-CV) were adopted to investigate participants at baseline, 12-week, 24-week, and 36-week after intervention.SPSS 26.0 statistical software was used to perform repeated measurement analysis of variance on the data.Results:(1)The interaction effect between two groups of HAMD scores( F=54.0, P<0.001), group main effect( F=401.4, P<0.001), and time main effect( F=116.6, P<0.001) were all significant.Further simple effect analysis showed that there were statistically significant differences in HAMD scores at various time points after intervention between the intervention group(26.2±6.5, 19.3±5.9, 11.3±5.6) and the control group(33.1±9.1, 30.3±7.9, 25.0±8.4)(all P<0.05). Intragroup comparison showed the HAMD scores of the intervention group and control group at each time point after intervention were lower than those before intervention (all P<0.05). (2)The interaction effect of CD-RISC scores between two groups of patients( F=72.1, P<0.001), group main effect( F=48.9, P<0.001), and time main effect( F=174.9, P<0.001) were significant.Further simple effect analysis showed that the CD-RISC score of the intervention group at each time point after intervention were higher than those of the control group(all P<0.05). Intragroup comparison showed the scores of CD-RISC at each time point after intervention in the intervention group and the control group were higher than those before intervention(all P<0.05). (3)The interaction effect of HHS scores( F=121.6, P<0.001), group main effect( F=57.4, P<0.001), and time main effect( F=208.1, P<0.001) of the two groups of patients were significant.Further simple effect analysis showed that the HHS scores of the intervention group were higher than those of the control group at all time points after intervention(all P<0.05). Intragroup comparison showed the HHS scores of the intervention group and the control group at each time point after intervention were higher than those before intervention(all P<0.05). (4)The interaction effect of FACES-Ⅱ-CV scores( F=45.0, P<0.001), group main effect( F=20.3, P<0.001), and time main effect( F=154.5, P<0.001) of the two groups of patients were significant.Further simple effect analysis showed that the FACES-Ⅱ-CV scores of the intervention group were higher than those of the control group at all time points after intervention(all P<0.05). Intragroup comparison showed the FACES-Ⅱ-CV scores of the intervention group and the control group at each time point after intervention were higher than those before intervention(all P<0.05). (5)The total effective rate of the intervention group was higher than that of the control group(95.1%, 87.7%)( P<0.001). Conclusion:In adolescents with depression, parent-child group emotional regulation and resilience training can effectively reduce depression emotion, increase the level of hope and resilience of patients and enhance family intimacy and adaptability.
9.Effects of Zizhu Ointment Combined with Tendon Clearance on Serum Levels of NLRP3, IL-1β, and IL-18, in Treatment of Non-ischemic Diabetic Foot Ulcers
Yaoqing SUN ; Weijing FAN ; Renyan HUANG ; Huimin LU ; Hong CHEN ; Guobin LIU
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(21):212-218
ObjectiveTo observe the effect of tendon clearing combined with Zizhu ointment on the serum levels of nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammasomes, interleukin (IL)-1β, and IL-18 in the treatment of non-ischemic diabetic foot ulcers. MethodA total of 106 patients with non-defective diabetic foot ulcers who attended the outpatient clinic and wards of the Vascular Surgery Department of Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine from March 2023 to March 2024 were selected. The patients with non-ischemic diabetic foot ulcers who met the inclusion criteria were assigned with the random number table method into an observation group and a control group, with 53 patients in each group. Patients in both groups received basic treatment. The local ulcers in the observation group received tendon clearing combined with Zizhu ointment, while those in the control group received conventional debridement combined with topical solution of bovine basic fibroblast growth factor. The serum NLRP3, IL-1β, and IL-18 levels, ulcer area, traditional Chinese medicine (TCM) symptom scores, visual analogue scale (VAS) score, and DMIST score were measured and recorded in the two groups before and after treatment. The ulcer healing rate and incidence of adverse reactions were compared between the two groups. ResultThe observation group had higher ulcer healing rate than the control group (P<0.01). After treatment, both groups showed lowered serum NLRP3, IL-1β, and IL-18 levels, reduced ulcer area, and declined TCM symptom score, VAS score, and DMIST score (P<0.01). Moreover, these indicators were lower in the observation group than in the control group (P<0.05, P<0.01). Neither group showed significant changes in the liver and kidney function indicators after treatment. Significant adverse reactions occurred in neither group during the treatment course. ConclusionTendon clearance combined with Zizhu ointment was effective and safe in treating non-ischemic diabetic foot ulcers. It may exert the therapeutic effect by reducing the inflammation of the local ulcers.
10.Technical specification for clinical application of critical ultrasonography
Wanhong YIN ; Xiaoting WANG ; Dawei LIU ; Yangong CHAO ; Xiangdong GUAN ; Yan KANG ; Jing YAN ; Xiaochun MA ; Yaoqing TANG ; Zhenjie HU ; Kaijiang YU ; Dechang CHEN ; Yuhang AI ; Lina ZHANG ; Hongmin ZHANG ; Jun WU ; Lixia LIU ; Ran ZHU ; Wei HE ; Qing ZHANG ; Xin DING ; Li LI ; Yi LI ; Haitao LIU ; Qinbing ZENG ; Xiang SI ; Huan CHEN ; Junwei ZHANG ; Qianghong XU ; Wenjin CHEN ; Xiukai CHEN ; Daozheng HUANG ; Shuhan CAI ; Xiuling SHANG ; Jian GUAN ; Juan DU ; Li ZHAO ; Minjia WANG ; Song CUI ; Xiaomeng WANG ; Ran ZHOU ; Xueying ZENG ; Yiping WANG ; Liwen LYU ; Weihua ZHU ; Ying ZHU ; Jun DUAN ; Jing YANG ; Hao YANG ; Chinese Critical Ultrasound Study Group ; Gritical Hemodynamic Therapy Collabration Group
Chinese Journal of Internal Medicine 2018;57(6):397-417
Critical ultrasonography(CUS) is different from the traditional diagnostic ultrasound,the examiner and interpreter of the image are critical care medicine physicians.The core content of CUS is to evaluate the pathophysiological changes of organs and systems and etiology changes.With the idea of critical care medicine as the soul,it can integrate the above information and clinical information,bedside real-time diagnosis and titration treatment,and evaluate the therapeutic effect so as to improve the outcome.CUS is a traditional technique which is applied as a new application method.The consensus of experts on critical ultrasonography in China released in 2016 put forward consensus suggestions on the concept,implementation and application of CUS.It should be further emphasized that the accurate and objective assessment and implementation of CUS requires the standardization of ultrasound image acquisition and the need to establish a CUS procedure.At the same time,the standardized training for CUS accepted by critical care medicine physicians requires the application of technical specifications,and the establishment of technical specifications is the basis for the quality control and continuous improvement of CUS.Chinese Critical Ultrasound Study Group and Critical Hemodynamic Therapy Collabration Group,based on the rich experience of clinical practice in critical care and research,combined with the essence of CUS,to learn the traditional ultrasonic essence,established the clinical application technical specifications of CUS,including in five parts:basic view and relevant indicators to obtain in CUS;basic norms for viscera organ assessment and special assessment;standardized processes and systematic inspection programs;examples of CUS applications;CUS training and the application of qualification certification.The establishment of applied technology standard is helpful for standardized training and clinical correct implementation.It is helpful for clinical evaluation and correct guidance treatment,and is also helpful for quality control and continuous improvement of CUS application.