1.Effect of Mirror Therapy on Upper Extremity Motor Function and Activities of Daily Living after Stroke:A Meta-analysis
Zhongfei BAI ; Ziwei ZHANG ; Huifang WANG ; Jiani LU
Chinese Journal of Rehabilitation Theory and Practice 2016;22(12):1384-1394
Objective To systematically summarize the effects of mirror therapy on upper extremity motor function and activities of dai-ly living after stroke. Methods The literatures about mirror therapy published between January, 2006 and May, 2016 were recalled from Medline, PubMed, CINAHL, OT seeker, PEDro, Wanfang and CNKI databases. The randomized control trials were included, and those didn't concern upper extremity motor function and activities of daily living were excluded. The data were extracted and analysed with Rev-Man 5.3. Results Fourteen trials were included. Mirror therapy could significantly improve Fugl-Meyer Assessment score (SMD=0.81, 95%CI=0.43-1.20, P<0.001, I2=64%). Subgroups analysis indicated movement based mirror therapy was more effective on mild to moderate hemiplegia (SMD=0.96, 95%CI=0.59~1.34, P<0.001, I2=51%) and the subgroup differences were also significant (P=0.004). Mirror therapy could improve score of Action Research Arm Test (SMD=0.33, 95%CI=0.01-0.64, P=0.040, I2=0), Box and Block Test (SMD=0.70, 95%CI=0.03-1.37, P=0.040, I2=62%) and Brunstrom stages (SMD=1.56, 95%CI=1.07-2.06, P<0.001, I2=41%) of affected upper extremities. It could also improve activities of daily living (SMD=0.93, 95%CI=0.62-1.24, P<0.001, I2=0). No evidence revealed mirror therapy could change muscle tone of flexors of affected upper limbs (SMD=-0.22, 95%CI=-0.73-0.28, P=0.890, I2=0). Conclusion Mirror therapy can signifi-cantly improve upper extremity motor function and activity of daily living.
2.The application study on DWI monoexponential and biexponential signal decay analysis in the diagnosis of hepatocellular carcinoma
Xia TIAN ; Daohai XIE ; Ziwei LU ; Qian MENG ; Xiaoxia PING
Journal of Practical Radiology 2015;(6):950-954
Objective To evaluate mono-and bi-exponential decay models in the diagnosis of hepatocellular carcinoma (HCC). Methods 28 patients with HCC who underwent conventional MRI imaging and diffusion-weighted imaging were collected,and all the HCC lesions were proved by operation pathology.The ADC values in mono-exponential decay model and ADCst ,ADCslow , ADCfast and ffast of the lesions in bi-exponential decay model were measured through the reconstruction of ADCmap ,ADCslow map, ADCfast map and fraction of fast ADC at a workstation.The relationships between the ADC values with low,medium and high b-val-ues and different differentiation degrees of HCC were analyzed.Moreover,the relationships between the ADCst ,ADCslow ,ADCfast , ffast values and HCC defferentiation grades were also explored.Results Significant differences in ADC value were found among differ-ent degrees of HCC differentiation in middle and high b-value groups (P <0.05).A positive correlation was found between the ADC value and the degree of HCC differentiation in middle (r=0.377,P <0.01)and high b-value group (r =0.81 5,P <0.01).There were no significant differences in ADC value among the different degrees of HCC differentiation in low b-value group.There were significant differences in the values of ADCst ,ADCslow and ADCfast among different degrees of HCC differentiation.Significant posi-tive correlations were found between the values of ADCst ,ADCslow and ADCfast and the degree of differentiation (P <0.01).There were no significant differences in the values of ffast among different degrees of HCC differentiation.Conclusion ADC value in mono-exponential decay model plays a potential role in the diagnosis of different differentiation degree of HCC with a b value ≥400 s/mm2 .Furthermore,the parameters in bi-exponential decay model,especially the values of ADCst ,ADCslow and ADCfast ,can provide new and unique information in the distinction of different degrees of HCC differentiation.
3.Imaging diagnosis of granulocytic sarcoma
Zhou HUANG ; Daohai XIE ; Qian MENG ; Xiaoxia PING ; Ziwei LU ; Xiang FANG
Journal of Practical Radiology 2015;(4):625-629
Objective To summarize radiographic manifestations of granulocytic sarcoma (GS),in order to investigate its radio-graphic feature.Methods Nine patients of GS confirmed by surgery pathology and immunohistochemistry were collected.There were four cases underwent CT scan,2 underwent MRI,3 underwent CT and MRI meanwhile.Results There were 4 cases in the lymph nodes,4 cases in the bone,1 case in the enterocoelia.The density of enlarged lymph node was inhomogeneous,and smaller lymph node was homogeneous density,both enhanced obviously.The density or intensity of the lesions occurred in the canalis verteb-ralis and paravertebra was also homogeneous,slightly enhanced,with bone and medulla ossea invasion.Lesions in the enterocoelia was inhomogeneous desity with clear boundary,enhanced inhomogeneously.Conclusion GS is a rare extramedullary malignant tumor composed of immature myeloid cells.CT and MRI can provide a certain diagnostic value.The perplexity in diagnosing such lesions highlighted the need of careful interpretation of all clinacal,radiographic,histopathological and immunochistochemical details as it is one of the most frequently misdiagnosed disorder.
4.Effect of unfractionated heparin on the expression of heme oxygenase-1 in intestinal mucosa of mice with sepsis
Xiaohan YIN ; Song CHEN ; Ziwei HU ; Feng XIAO ; Siyu LU ; Xiaochun MA ; Zhenggang LUAN
Chinese Critical Care Medicine 2016;28(5):423-426
Objective To investigate the effect of unfractionated heparin (UFH) on the expression of heme oxygenase-1 (HO-1) in intestinal mucosa of mice with sepsis.Methods Thirty-six male C57BL/6J mice were randomly divided into sham group,cecal ligation and puncture (CLP) group and UHF group,n =12 in each group.Model of intestinal injury in sepsis was induced by CLP.In sham group,the mice were exposed without ligation of cecum.In UFH group,the mice were treated intravenously with 8 U of UFH via the tail vein half an hour before the operation and 12 hours after the surgery respectively.Six mice in each group were randomly chosen at 4 hours and 24 hours after operation to collect inferior vena venous blood samples and terminalileum tissues.The serum levels of interleukins (IL-1 β,IL-6),and tumor necrosis factor-α (TNF-α) were determined by enzyme linked immunosorbent assay (ELISA).The serum level of D-lactate was determined by colorimetry.Pathological changes of ileum tissue and Chiu score were observed after hematoxylin eosin (HE) staining.The HO-1 expression was detected immunohistochemically.Results In sham group,no significant changes in the serum levels of IL-1 β,IL-6,TNF-α and D-lactate were observed.Twenty-four hours after the operation,the structure of intestinal mucosa was basically normal without obvious pathology change and no HO-1 positive cells were found.The serum levels of IL-1 β,IL-6,TNF-α,and D-lactate in CLP group were gradually increased,and they were significantly increased as compared with sham group [IL-1 β (ng/L):40.87±2.88 vs.22.60±2.05 at 4 hours,113.73±3.96 vs.22.07±2.74 at 24 hours;IL-6 (ng/L):63.89±3.26 vs.44.89±3.38 at 4 hours,176.56±5.45 vs.45.76±4.02 at 24 hours;TNF-α (ng/L):194.62± 14.13 vs.152.05±6.22 at 4 hours,599.62± 10.20 vs.155.90± 14.18 at 24 hours;D-lactate (mmol/L):0.24± 0.02 vs.0.19 ± 0.01 at 4 hours,0.33 ± 0.04 vs.0.20 ± 0.02 at 24 hours,all P < 0.05].Twenty-four hours after the operation,edema and inflammation in ileal mucosa,intestinal villi structural damage were observed,the Chiu score was significantly higher than those in the sham group [4.5 (3.0-5.0) vs.0 (0-1.0),P < 0.05],and a small amount of HO-1 positive cells were localized in the intestinal mucosa.Compared with CLP group,the serum levels of IL-1 β,IL-6,TNF-α,and D-lactate of UFH group were significantly decreased [IL-1 β (ng/L):31.53 ± 2.90 vs.40.87 ± 2.88 at 4 hours,61.13 ± 2.80 vs.113.73 ± 3.96 at 24 hours;IL-6 (ng/L):51.16 ± 5.68 vs.63.89 ± 3.26 at 4 hours,81.16 ± 4.54 vs.176.56 ± 5.45 at 24 hours;TNF-α (ng/L):171.76± 5.60 vs.194.62± 14.13 at 4 hours,328.48 ± 10.79 vs.599.62± 10.20 at 24 hours;D-lactate (mmol/L):0.21 ±0.01 vs.0.24±0.02 at 4 hours,0.24±0.02 vs.0.33±0.04 at 24 hours,all P < 0.05].Twenty-four hours after the operation,intestinal injury was ameliorated,the Chiu score was significantly lower [1.5 (1.0-5.0) vs.4.5 (3.0-5.0),P < 0.05],and HO-1 positive cells in the intestinal mucosa was remarkably increased.Conclusion UFH can enhance the expression of HO-1 in intestinal mucosa,reduce the release of inflammatory factors,ameliorate the intestinal inflammatory response,and thus play a protective role in intestinal tissue in mice with sepsis.
5.Study on relationship between posttraumatic stress disorder and nurses′psychological capital
Qiuxia JIN ; Ziwei KE ; Yanfei LU ; Yuxin GE ; Yanyan LI ; Yiqin SUN
Chinese Journal of Practical Nursing 2017;33(9):704-707
Objective To explore the relationship between posttraumatic stress disorder and nurses′ psychological capital. Methods By convenient sampling, totally 550 nurses in 5 first-class upper level general hospitals in Zhejiang province were investigated by the posttraumatic stress disorder (PTSD)Cheeklist-Civilan Version (PCL-C) and Nurses Psychological Capital Questionnaire Revision (NPCQR), and the results were analyzed. Results 18.35%investigated nurses showed a certain degree of PTSD symptoms and 13.71% showed obvious PTSD symptoms. The positive rate was 32.06%.The overall score of nurses′psychological capital was 78.81 ± 16.54, which was in the middle level, and the dimension scores from high to low were self-efficacy (23.80±5.35), hope (23.36±5.24), resilience (19.66 ±4.29), and optimism (11.99 ± 3.21). The nurses′psychological capital had a negative effect on posttraumatic stress disorder (P<0.01). Conclusions Psychological capital of nurses is a negative predictor of PTSD symptoms, which suggested that managers should pay more attention to the development of nurses′psychological capital to reduce and prevent the occurrence of posttraumatic stress disorder,then to improve nursing service quality.
6.Efficacy of mIL-18BP and mIL-4 adenoviral coexpression gene therapy for cyclooxygenase-2 and inducible nitric oxide synthetase in murine collagen-induced arthritis
Zhong LU ; Jianhang LENG ; Hangping YAO ; Junya SHEN ; Keyi WANG ; Ziwei WANG ; Guangchao ZHUO
Chinese Journal of Rheumatology 2008;12(9):606-609
Objective A recombinant adenoviral vector containing mIL-18BP and mIL-4 fusion gene(AdmIL-18BP/mIL-4) was constructed and used to investigate the role of mIL-18BP and mIL-4 in medula-ring the expressions of cyclooxygenase-2 (COX-2) and inducible nitric oxide synthetase (iNOS) and their inducing products PGE2, NO in murine collagen-induced arthritis. Methods Male DBA-1/BOM mice were used in this study. Mice with CIA were intra-articularly injected with 107 pfu/6μl of AdmIL-18BP/mIL-4.Intra-articular injections of AdLacZ or PBS were used as controls. The mRNA expression of COX-2, iNOS in synovial tissue was analyzed by semi-quantitative RT-PCR. Expression of COX-2 and iNOS protein was estimated by Western blot method. The production of PGE2 and NO in synovia was detected by competitive ELISA and enzyme reduction of nitrate. Results The expression of COX-2, iNOS mRNA in routine synovial tissue of AdmIL-18BP/mIL-4 treatment group was significantly lower than that of AdLacZ group (0.15 vs 0.42,P<0.01 ; 0.05 vs 0.77, P<0.01) and PBS group (0.15 vs 0.65, P<0.01; 0.05 vs 0.64, P<0.01 ). And the protein expression of COX-2, iNOS from AdmIL-18BP/mIL-4 treatment group was also obviously lower than that of AdLacZ group (0.08 vs 0.92, P<0.01; 0.11 vs 1.00, P<0.01) and PBS group (0.08 vs 0.77, P<0.01; 0.11 vs 0.84, P<0.01 ). The PGE2 and NO production in synovia of AdmIL-18BP/mIL-4 treatment group was significantly lower than that of AdLacZ group [(0.68x0.06) vs (2.58±0.21)ng/mL, P<0.01; (23.4+2.5) vs (60.0±11.3)μmol/L, P<0.01 ] and PBS group [(0.68±0.06) vs (2.57±0.20)ng/mL, P<0.01; (23.4+2.5) vs (60.3±13.4)μmol/L, P<0.01]. Conclusion These data indicat that local over-expre-ssion of mIL-18BP and mIL-4 can down-regulate COX-2, iNOS and their induced product PGE2, NO in CIA mice. The combination treatment with mIL-18BP and mIL-4 is a promising therapeutic target for RA.
7.Emergency multimodal computed tomography for the diagnosis of stroke mimic--epileptic seizure
Xiaowei Hu ; Shicun Huang ; Ziwei Lu ; Feirong Yao ; Yiqing Wang ; Yeting Lu ; Xiangyi Zhu ; Min Xu ; Qi Fang
Neurology Asia 2020;25(3):269-277
Background and Objectives: Stroke mimics are medical conditions producing stroke-like symptoms
but eventually get diagnosed as non-stroke diseases. Epileptic seizure is a common type of stroke
mimic. The purpose of this study is to investigate the application of emergency multimodal computed
tomography (CT) in the diagnosis of epileptic seizure. Methods: We retrospectively reviewed the case
group of patients with suspected stroke in the emergency stroke care service of the First Affiliated
Hospital of Suzhou University from September 2017 to October 2019. We included those who underwent
multimodal CT, including non-contrasted cranial CT, CT perfusion with CT angiography, and were
ultimately diagnosed as epileptic seizures. Ten patients with acute anterior circulation ischemic stroke
were assigned as controls. Results: A total of five cases met the inclusion criteria. Multimodal CT was
completed within 2.25 to 3.50h from symptom onset. On CT perfusion, hyperperfusion was shown in
four cases and slightly increased perfusion in one case with epileptic seizures. Cerebral blood flow
and cerebral blood volume were significantly increased, while time to peak and mean transit time
decreased in the regions of interest of the epileptic hemisphere when compared to either the non-affected hemisphere or the ischemic area in the control group (P<0.05). The abnormal perfusion areas did not follow vascular territory supply and CT angiography did not show vessel occlusion in the case group.
Conclusion: Emergency multimodal CT could be used effectively to differentiate epileptic seizure
from stroke.
8.Diagnostic value of dynamic monitoring of C-reactive protein in drain drainage to predict early anastomotic leakage after colorectal cancer surgery.
Jia LU ; Lei ZHENG ; Runtian LI ; Chunmin HAO ; Wenbin GAO ; Ziwei FENG ; Guangya YIN ; Yue WANG ;
Chinese Journal of Gastrointestinal Surgery 2017;20(9):1055-1059
OBJECTIVETo evaluate the diagnostic value of dynamic monitoring of C-reactive protein (CRP) in drainage fluid in predicting early anastomotic leakage after colorectal surgery.
METHODSThis study enrolled 172 patients, who were diagnosed as colorectal cancer before operation and underwent radical surgery, without residual tumor tissues by postoperative pathology and perioperative infection, at the Tianjin Medical University Cancer Hospital between July 2015 and January 2016. The C-reactive(CRP) protein level in drainage fluid was continuously monitored from postoperative days (POD) 1 to 5. CRP level was compared between anastomotic leakage (AL) group and non-anastomotic leakage (NAL) group. Receiver operating characteristics (ROC) curve was used to estimate the value of monitoring CRP in drainage fluid to predict anastomotic leakage after colorectal surgery.
RESULTSAmong 172 patients, 101 cases were male and 71 cases were female, with age of (59.9±10.3) years. Anastomotic leakage occurred after colorectal surgery in 24 cases(14.0%, AL group ) and other 148 cases were defined as NAL group. Other than body mass index (BMI), differences in baseline data were not statistically significant between two groups. The CRP lever in AL group and NAL group showed rising trend from POD1 to POD4 [Day 1: (6.7±8.4) g/L vs. (8.0±10.6) g/L; Day 2: (24.8±14.6) g/L vs. (28.3±21.1) g/L, Day 3: (54.8±26.5) g/L vs. (53.8±27.6)g/L, Day 4: (62.0±32.2) g/L vs. (58.4±30.7) g/L], while the differences were not significant (all P>0.05). At POD 5, the CRP lever of AL group increased continuously, while that of NAL group decreased with significant difference [(65.3±38.9) g/L vs. (44.7±39.5) g/L, t=-2.85, P=0.005]. Further stratification analysis on AL group revealed CRP level in early AL (AL occurrence
CONCLUSIONContinuous increase of CRP level in abdominal drainage fluid from POD 1 to POD 5 indicates the occurrence of AL after colorectal cancer operation, especially the detection of CRP level at POD 5 is important.
9. Effect of workplace bullying on posttraumatic stress disorder in nursing staff
Yiqin SUN ; Yuxin GE ; Ziwei KE ; Yanyan LI ; Qiuxia JIN ; Yanfei LU
Chinese Journal of Industrial Hygiene and Occupational Diseases 2018;36(1):22-25
Objective:
To investigate the relationship between workplace bullying and posttraumatic stress disorder (PTSD) in nursing staff, and to analyze the role of psychological capital between workplace bullying and PTSD.
Methods:
From December 2014 to June 2015, convenience sampling was used to collect 496 nurses from 5 grade A tertiary hospitals in a province of China. Their workplace bullying, psychological capital, and PTSD status were assessed using the Negative Acts Questionnaire, Psychological Capital Questionnaire, and Posttraumatic Stress Disorder Self-Rating Scale, respectively. The correlation between variables was analyzed using a structural equation model.
Results:
Among these nurses, the scores of negative acts, psychological capital, and PTSD were 37.15±12.83, 78.81±16.54, and 34.56±12.52, respectively. The score on each dimension of negative acts was positively correlated with that on each dimension of PTSD (
10. Preliminary study on effect of intraoperative goal-directed fluid management on pulmonary function and oxygen dynamics in patients with severe burns
Ziwei WANG ; Yan CHEN ; Fujun CHENG ; Xingqi CHEN ; Yong YANG ; Kaizhi LU
Chinese Journal of Burns 2019;35(10):733-739
Objective:
To preliminarily investigate the effect of intraoperative goal-directed fluid management (GDFM) on pulmonary function and oxygen dynamics in patients with severe burns.
Methods:
From February 2017 to May 2018, 30 patients admitted to Burn Department of our hospital with severe burns who met the criteria for inclusion and needed escharectomy and skin grafting were enrolled in this prospective randomized controlled trial. The patients were divided into group GDFM of 15 cases [14 males and 1 female, (45±14) years old] and conventional liquid management group of 15 cases [12 males and 3 females, (42±10) years old] according to the random number table. During escharectomy and skin grafting, volume of patients in group GDFM was managed according to the GDFM scheme, based on cardiac output index, stroke volume variation, stroke volume index, hemoglobin, central venous oxygen saturation (ScvO2), and other parameters; volume of patients in conventional liquid management group was managed according to clinical experience and conventional liquid management scheme, based on mean arterial pressure, central venous pressure, urine output, hemoglobin, and other parameters. At post operation hour (POH) 1, 6, 12, and 24, arterial and venous blood was collected from patients of the two groups to determine the levels of extravascular lung water index (ELWI), global end-diastolic volume index (GEDI), oxygenation index, ScvO2, central venous-to-arterial blood carbon dioxide partial pressure difference (Pcv-aCO2), lactic acid, pH value, bicarbonate ion, and base excess routinely. Data were processed with Fisher′s exact probability test,