1.Clinical experience of using oxytocin antagonist atosiban in the rescue therapy of preterm labour
Jianping TAN ; Hui CHEN ; Bijun DU ; Yinglin LIU ; Yunhui WANG ; Jianping ZHANG
Chinese Journal of Obstetrics and Gynecology 2008;43(2):81-84
Objective To investigate the effectiveness of oxytoein antagonist atosiban in the alternative rescue therapy of preterm labor.MethodsAlternative toeolysis atosiban was given as rescue therapy to 35 women,who had received ritodrine or magnesium sulphate but failed,due to either progression of labour or intolerable adverse events.Atosiban was administered for up to 48 hours.Efficacy and tolerability were assessed based on the proportion of women who did not deliver and did not need alternative toeolytie therapy at 48 hours and 7 days after therapy initiation.The numbers of maternal adverse events and neonatal morbidity were also assessed.ResultsEfficacy and tolerability at 48 hours and 7 days after atosiban nitiation were 77%(27/35)and 60%(21/35).One woman presented drug-related side effects with mild nausea and omiting.Thirty-four women have delivered and one bigemina(28 weeks)is being followed-up.In 34 women,11 delivered before 28 gestational weeks,17 delivered after 28 gestational weeks,3 delivered after 34 weeks and 3 had term delivery.Pregnancies were rolonged by 4 hours to 14+2 weeks.There were nine neonatal deaths,with gestational ages less than 28 weeks at delivery.Conclusion xytocin antagonist atosiban could be given as alternative rescue therapy if therapy with ritodrine or magnesium sulphate fails in the treatment of preterm labor,and it is safe and effective.
2.Pharmaceutical Care of MODS Patient Treated by Continuous Renal Replacement Therapy
Bijun LYU ; Fenghua LIANG ; Lu TAN ; Wenying CHEN
Herald of Medicine 2018;37(2):249-253
Objective To discuss the contribution of clinical pharmacists in anti-infection treatment of a patient with multiple organ dysfunction syndrome ( MODS) undergoing continuous renal replacement therapy ( CRRT). Methods Pharmacists participated in the anti-infection treatment of a MODS patient undergoing CRRT.Pharmacists assisted physicians in optimizing the therapeutic regimen based on treatment guidelines and relative information. Results Physicians accepted the advice of pharmacists after comprehensive evaluation.Ten days later,the patient recovered from shock,as the infection indexes were improved significantly.He then moved back to the general ward. Conclusion Pharmacists should positively participate in clinical treatment with physicians,in order to play a critical role in ensuring the safety and efficacy of the medication.
3.A retrospective analysis of complications during hospitalization in twins with birth weight discordance
Xue LI ; Xiaohua TAN ; Bijun SHI ; Qian CHEN ; Yong ZHANG ; Zhen PAN ; Zicong CAI ; Chunhong JIA ; Qiliang CUI
Chinese Journal of Neonatology 2023;38(11):655-659
Objective:To study the incidences of complications in twins with birth weight discordance (BWD) during hospitalization.Methods:From January 2011 to December 2020, twins born in the Department of Obstetrics and hospitalized in NICU of our hospital were retrospectively studied. Twins with BWD>15% were assigned into BWDT group and BWD≤15% into twins with birth weight concordant (BWCT) group. Complications during hospitalization were compared between the two groups.Results:A total of 1 546 pairs of twins were enrolled, including 486 (31.4%) in BWDT group and 1 060 (68.6%) in BWCT group. Compared with BWCT group, BWDT group had significantly higher incidences of pulmonary surfactant (PS) utilization (47.7% vs. 42.2%), continuous positive airway pressure ≥ 24 h (40.5% vs. 35.0%), high-flow nasal cannula ≥ 24 h (22.8% vs. 16.3%), neonatal respiratory distress syndrome (52.9% vs. 47.1%), bronchopulmonary dysplasia (BPD) (15.6% vs. 11.1%), persistent pulmonary hypertension of the newborn (3.1% vs. 1.4%) and anemia (79.6% vs. 70.1%) (all P<0.05). After adjusting for confounding factors, the risks of pulmonary hemorrhage ( OR=2.036, 95% CI 1.119-3.703, P=0.020) and BPD ( OR=2.960, 95% CI 1.656-5.219, P=0.010) in BWDT group were higher than BWCT group. Conclusions:BWD twins has higher incidences of complications during hospitalization than BWC twins.
4.Clinical applicability of the four-grade tricuspid regurgitation classification in relation to the guideline-recommended three-grade classification
Xi ZHANG ; Yuxin ZHANG ; Bijun TAN ; Ying HOU ; Liwei WEN ; Lijun YUAN ; Changyang XING
Chinese Journal of Ultrasonography 2024;33(6):475-481
Objective:To investigate the clinical applicability of the four-grade grading(G4) advocated by the academy in recent years compared with the guideline-recommended three-grade grading(G3) in functional tricuspid regurgitation (FTR).Methods:A total of 137 consecutive patients were prospectively included from outpatient and inpatient clinics at Tangdu Hospital, Air Force Medical University from May to December 2023. All patients underwent echocardiography and were graded for regurgitation based on the 2017 American Society of Echocardiography Valve Evaluation Guidelines as the reference standard. The patients with regurgitation were grouped according to the G3 based on the guidelines and the G4 advocated by the academic community in recent years, respectively. The consistency of the regurgitation grading between multi-indicators and single-indicators was analyzed using the Kappa test for both G3 and G4. The quantitative regurgitation relevant parameters were analyzed using ROC curves to evaluate the diagnostic efficacies for G4, including the vena contracta width (VCW), the area of the color flow jet (A Jet), and the radius of the PISA (R PISA). Results:The results of consistency analysis showed that the consistency of regurgitation volume (RVol) was significantly higher in the G4 multi-indicators comprehensive assessment versus the single-indicators assessment compared with the G3, with a Kappa value of 0.84 vs. 0.30. The consistency of effective regurgitant orifice area (EROA) and VCW remained unchanged, with a Kappa value of 0.76 vs. 0.89, 0.51 vs. 0.66. ROC curve analysis showed that for the G4, the area under the curve (AUC) for moderate regurgitation were 0.854, 0.993, and 0.894, respectively, while for moderate-severe regurgitation, these values were 0.899, 0.979, and 0.917, respectively.Conclusions:For FTR, the G4 currently advocated by the academic community has better consistency between single-indicators and comprehensive indicators grading than the G3 based on the guideline, which is clinically applicable; A Jet, R PISA, and VCW can be supplemented to the G4, which helps to improve the quantitative assessment system.