1.The Textual Research on Ma Zhaosheng of the Last Disciple of Miao Xiyong
Journal of Zhejiang Chinese Medical University 2014;(4):398-400
[Objective]This study explores the acknowledgement of Ma Zhaosheng ’s life. [Method]This study, having been conducted by searching and combing historical documents, might come to a conclusion. [Result]Ma Zhaosheng, whose style name was ruibo and whose pseudonyms were wujingandyudan Taoist, lived in Changshu of Jiangsu provine during the Ming dynasty. His birth and death years were roughly 1570-1650 years. Ma yuanjun was his father, brother Ma Zhaozhen. Ma Zhaosheng had four sons: Ma Jue with style name of boxian, Ma Cha with style name of zhongzhao, Ma Menggui with style name of qiuqing and Ma Tinggui with style name of dangu. The medicine works of Ma Zhaosheng, the last disciple of Miao Xiyong, were more than ten kinds, but most scattered, the only remaining were the book of The Revised Print Of Traditional Chinese Medicine and the article of The Foreword Of Opinions About Talking Medicine. Ma Zhaosheng paid more attention to herbalism, and had rich clinical experience and abundant writings. [Conclution]The textual research on Ma Zhaosheng provides an important historical for analysis of his medical achievements. This research facilitates the study of Miao Xiyong’s mentoring relationship, his medical ideas and clinical experience in depth.
2.The clinic features of upper gastrointestinal bleeding among Hui-Nation patients admitted hospital on Ramadan
Liya HUANG ; Junwen MA ; Yang WU ; Zuozheng WANG
Chinese Journal of Emergency Medicine 2016;25(8):1041-1043
Objective The aim of this study was to analyze the characteristics of upper gastrointestinal bleeding (UGIB) admitted on Ramadan or no-Ramadan.Methods We analyzed HuiNation patients' admissions of UGIB in Ningxia Medical University General Hospital from 2000 to 2013 (a total of 1192 admissions).Differences in etiological,transfusion undergo early esophagogastroduodenoscopy (EGD) and hospital stays between Hui-Nation patients on Ramadan.Results Ramadan admissions were associated with significantly higher hemorrhage rates than no-Ramadan admissions among Hui-Nation patients.Peptic ulcer (56%),esophageal varices (17%) and gastric erosive (12%) were the main reason of UGIB in Ramadan.Ramadan admissions were associated with significantly blood transfusion,less likely to undergo early EGD,mortality and long length of stay (p < 0.05).Conclusions Ramadan admission of UGIH was higher than no-Ramadan.Doctor should pay more attention to this phenomenon.
3.Analysis of risk factors for acute pancreatitis with thrombotic diseases
Ying YANG ; Yuanzhen WANG ; Yajun LI ; Weijie YAO ; Zuozheng WANG ; Xiaojun YANG ; Liya HUANG
Chinese Journal of Pancreatology 2021;21(4):258-263
Objective:To investigate the risk factors of acute pancreatitis (AP) complicated with thrombotic diseases.Methods:Clinical data of 5 223 patients with AP admitted to the General Hospital of Ningxia Medical University from January 2015 to September 2020 were retrospectively analyzed. They were divided into thrombosis group and non-thrombosis group according to whether they were complicated with thrombotic diseases. The following data were recorded: gender, age, past history, time of onset, etiology, severity grade of AP, BISAP score, prothrombin time (PT), activated partial thromboplastin time (APTT), D-dimer(D-D), fibrinogen(FIB), white blood cell count(WBC), platelet count (PLT), lactate dehydrogenase (LDH), blood glucose level, with or without hypoalbuminemia, hypertriglyceridemia and hypercholesterolemia, date of diagnosis, location of thrombus, clinical manifestations and anticoagulant therapy. Univariate and Logistic multivariate regression analysis were used to analyze the risk factors of AP complicated with thrombotic diseases. The receiver operating characteristic (ROC) curve was drawn, the area under the curve (AUC) was calculated, and the efficacy of independent risk factors in predicting AP complicated with thrombotic diseases was evaluated.Results:46(0.88%) of 5 223 patients with AP were complicated with thrombosis, which occurred 8.50(2.00-15.00) days after the onset of AP; the age of onset was 66 (52-74) years; the patients with thrombotic diseases were mostly SAP patients (23/46, 50%); the most common type was deep venous thrombosis in lower extremity (19/46, 41.3%); 37 patients (80.4%) received regular anticoagulant treatment after finding thrombus, and no bleeding was found during hospitalization. Univariate analysis showed that the age of patients with thrombosis was higher than that of patients without thrombosis, APTT value was prolonged, D-D value was increased, WBC was decreased and SAP was more in AP severity, the number of patients with BISAP score ≥3 was increased significantly, and the differences were statistically significant ( P<0.05). Multivariate logistic regression analysis showed that AP severity ( OR=3.017, 95% CI 1.799-5.061, P<0.001) and age ( OR=1.029, 95% CI 1.000-1.059, P=0.049) were independent risk factors for AP patients complicated with thrombosis. The AUC of AP severity and age in predicting AP complicated with thrombotic diseases were 0.714 and 0.625, respectively. The sensitivity was 67.4% and 47.8%, and the specificity was 70.6% and 77.9%, respectively. Conclusions:The severity grade and age of AP were independent risk factors for AP complicated with thrombotic diseases. Early vigilance and clinical intervention should be given.
4.Effect of pancreatic duct stenting in the treatment of severe acute pancreatitis: a retrospective study in a single center
Di LIU ; Chengsi ZHAO ; Weijie YAO ; Anning CHEN ; Xiaojuan YANG ; Xiaojun YANG ; Hui BAI ; Liya HUANG ; Zuozheng WANG
Chinese Journal of Hepatobiliary Surgery 2023;29(8):594-598
Objective:To evaluate the effect of pancreatic duct stenting in the treatment of severe acute pancreatitis (SAP).Methods:The clinical data of 68 patients with SAP admitted to the Department of Hepatobiliary Surgery, General Hospital of Ningxia Medical University from January, 2019 to July, 2020 were retrospectively analyzed, including 38 males and 30 females, aged (44.85±8.51) years old. The patients were divided into two groups according to the treatment modality: the conservative group ( n=41) which received the conservative management, and the stent group ( n=27) which underwent pancreatic duct stent implantation and conservative management. The basic information, parenteral nutrition support time, fasting days, and other clinical data of patients were collected. Serum amylase, white blood cell count, acute physiology and chronic health (APACHE) II score and CT score were compared between the two groups at admission and 48 hours after treatment. Results:The serum amylase, white blood cell count, APACHE II score and CT score of the two groups were significantly lower after treatment (all P<0.05). Compared with the conservative group, the APACHE II score [(5.52±2.15) vs. (8.76±2.50)] and CT score [(4.85±1.96) vs. (6.18±1.07)] of patients were lower in the stent group after treatment (both P<0.05). Pancreatic duct stents were successfully implanted in all 27 patients of the stent group. Intubation to the main pancreatic duct failed in one patient, while the accessory pancreatic duct was alternatively intubated through the accessory nipple. No severe complications such as iatrogenic pancreatitis, bleeding, and perforation occurred after endoscopic retrograde cholangiopancreatography. The incidence of postoperative local complications was lower [18.52%(5/27) vs. 41.46%(17/41)], the proportion of antibiotic use>3 types [29.63%(8/27) vs. 56.10%(23/41)] decreased, and the analgesic episodes decreased [2(1, 3) vs. 4(3, 6)] in the stent group. The antibiotic usage duration [8(3, 11) d vs. 13(10, 19) d], the parenteral nutrition time [7(4, 15)d vs. 15(8, 18)d], the fasting time [5(3, 11) d vs. 11(6, 13)d] and the hospital stay [10(5, 16) d vs. 15(13, 23)d] were all shortened (all P<0.05). Conclusion:Both conservative management and pancreatic duct stenting can alleviate the clinical symptoms of SAP, and pancreatic duct stenting could help reduce local complications, relieve symptoms, and shorten hospital stay.
5.Clinical study on simultaneous bacterial and fungal culture of bile and pancreatic juice in acute biliary pancreatitis
Chengsi ZHAO ; Weijie YAO ; Zuozheng WANG ; Xiaojuan YANG ; Xiaojun YANG ; Hui BAI ; Liya HUANG ; Anning CHEN
Chinese Journal of Hepatobiliary Surgery 2022;28(10):740-746
Objective:To investigate the characteristics and clinical significance of distribution of bacteria and fungi in pancreatic fluid and bile in patients with acute biliary pancreatitis (ABP).Methods:The clinical data of patients with ABP who underwent endoscopic retrograde cholangiopancreatography (ERCP) and pancreatic duct stenting with simultaneous bacterial and fungal culture of bile and pancreatic fluid at the Department of Hepatobiliary Surgery, General Hospital of Ningxia Medical University from January 1, 2019, to June 30, 2021 were retrospectively analyzed. Of 202 patients, there were 102 males, and 100 females, aged (54±16) years old. Patients were divided into two groups by presence or absence of pancreatic infection: the pancreatic infection group ( n=20) and the non-pancreatic infection group ( n=182). Of the 76 patients with positive bile bacterial cultures, 60 patients with positive pancreatic fluid bacterial cultures were included in the positive pancreatic fluid culture group and 16 patients with negative pancreatic fluid cultures were included in the negative pancreatic fluid culture group. The clinical data including the type and distribution of bacteria cultured, complications, and co-infections of patients were compared. Factors associated with pancreatic infection were analyzed using logistic regression and the value of assessment of the associated factors was analyzed by plotting the receiver operating characteristic (ROC) curve. Results:Of 404 specimens (202 each of pancreatic fluid and bile) were sent for examination, 152 (37.6%) were positive. 174 strains were isolated from the 152 positive specimens, 96 (55.2%) gram-negative, 70 (40.2%) gram-positive and 8 (4.6%) fungal strains. Compared to the pancreatic fluid culture-negative group, patients in the pancreatic fluid culture positive group had a statistically significant ( P<0.05) increased risk of neutrophil to lymphocyte ratio, duration of fever, Balthazar CT score, complication rate, and development of pancreatic necrosis, pancreatic infection and systemic inflammatory response syndrome (SIRS). Compared to patients in the non-pancreatic infection group, patients in the pancreatic infection group had a statistically significant ( P<0.05) increase in duration of fever on admission, duration of fasting, and proportion of patients with combined SIRS, positive bile cultures, positive pancreatic fluid cultures, and diabetes mellitus. Logistic regression analysis showed that positive pancreatic fluid cultures ( OR=6.699, 95% CI: 1.159-38.725) and diabetes mellitus on admission ( OR=4.625, 95% CI: 1.304-16.394) were risk factors for late pancreatic infection ( P<0.05). The area under the ROC curve for the combination of both positive pancreatic fluid culture and diabetes mellitus in predicting late pancreatic infection in patients was 0.788, with a specificity of 59.30% and a sensitivity of 90.00%. Conclusions:Bacterial culture in pancreatic juice and bile of ABP patients showed mainly Gram-negative bacteria. Early culture of pancreatic juice and bile had positive significance in ABP evaluation, infection prediction and anti-infection treatment.