1.Effect of the deferoxamine mesylate on the prognosis of patients with intracerebral hemorrhage
Wei ZHAO ; Chunpeng ZHU ; Yao YU ; Yajing HAN ; Xuguang GAO
Clinical Medicine of China 2016;32(10):865-867,868
Objective To study the effect of the deferoxamine mesylate on the prognosis of patients with intracerebral hemorrhage(ICH) after one year. Methods From February 2013 to May 2014,spontaneous ICH patients diagnosed by computed tomography ( CT ) within 18 hours of onset in Mancheng District Hospital of Baoding were evaluated. Patients were randomly divided into experimental group and control group. The treatment of the two groups was similar except that the experimental group received deferoxamine mesylate. Patients were e?valuated by CT and neurology scale( NIHSS scale,GCS scale) at the time of admission and followed up for the first year by the RANKIN( mRS) scale. All clinical data of the two groups were compared. Results Forty?two patients were included in the study, including 21 cases in the experimental group and 21 cases in the control group,there was no significant difference in baseline data between the two groups at admission. There were 6 pa?tients with mRS ≥3 in the experimental group, and 6 patients with mRS ≥3 in the control group after one year. There was no statistically significant difference in the distribution of mRS score between the two groups after one year admission( P=1. 000) . Conclusion There may be no helpful on the prognosis of patients with intrace?rebral hemorrhage by intravenous infusion of deferoxamine mesylate,the further study is needed.
2.Relationship between the C-reactive protein and nonalcoholic fatty liver disease prevalence
Feng ZHU ; Laiming WANG ; Chunpeng JI ; Zhiliang LIU ; Chunxiang YANG ; Zhimei WANG ; Shouling WU
Clinical Medicine of China 2015;31(9):812-816
Objective To investigate the relationship between the C-reactive protein (CRP) and nonalcoholic fatty liver disease (NAFLD) prevalence.Methods In this study,63,486 workers who had participated in the Kailuan health examination from July 2012 to October 2013 and without history of drinking,myocardial infarction,stroke and cancer and without data incomplete were recruited.The observation population was divided into three groups according to the levels of CRP at baseline:group 1 (< 1 mg/L),group 2 (1-3 mg/ L) and group 3 (>3 mg/L).The prevalence of NAFLD among three groups was observed.Multiple logistic regression was used to calculated relationship between the CRP and NAFLD prevalence.Results The prevalence of NAFLD in group 1,group 2 and group 3 were 26.9%,42.1% and 49.3%,respectively,and the differences were significant (x2=2 192.31,P < 0.01).Logistic model showed that after adjustment for age,gender,waist circumference and other confounders,the association between CRP and NAFLD was strong and the OR value (95% CI) among the group 1,group 2 and group 3 were 1.00,1.49 (1.42-1.56),1.54 (1.45 -1.64),respectively.Conclusion CRP is independently associated with the nonalcoholic fatty liver disease.
3.Great trochanteric digastric osteotomy and surgical dislocation for treatment of Pipkin Ⅳ fractures
Qiyong CAO ; Bosong ZHANG ; Chunpeng ZHAO ; Shiwen ZHU ; Manyi WANG ; Xinbao WU
Chinese Journal of Orthopaedic Trauma 2017;19(8):662-668
Objective To discuss the clinical outcomes of trochanteric digastric osteotomy and surgical hip dislocation for treatment of Pipkin Ⅳ fractures. Methods We retrospectively reviewed the 12 patients with Pipkin Ⅳ fracture who had been treated by trochanteric digastric osteotomy and surgical hip dislocation from February 2012 to June 2016. They were 10 males and 2 females, with an average age of 44. 1 years ( from 24 to 63 years ) . According to the Pipkin classification for femoral head fractures, 9 fractures were type Ⅰand 3 type Ⅱ; according to Letournel-Judet classification for acetabular fractures, 10 were posterior wall fractures ( 9 belonging to the posterior superior subgroup ) and 2 transverse plus posterior wall fractures ( one involving the posterior wall belonging to the posterior superior subgroup ) . The operation time, blood loss, complications and functional results were recorded. Results The operation time averaged 165 min ( from 150 to 195 min ); the blood loss averaged 850 mL ( from 500 to 1, 200 mL ) . A spring plate was used additionally for posterior wall fracture in 7 cases. All the 12 cases obtained an average follow-up of 19 months ( from 6 to 52 months ) . Motion function was fully recovered from 6 weeks to 4 months after operation in 2 cases of preoperative incomplete sciatic nerve injury and in one case of iatrogenic incomplete sciatic nerve injury. Anatomical reduction was achieved in all femoral head fractures. According to the Matta criteria for acetabular fractures, anatomical reduction was achieved in 9 cases, good reduction in 2 and poor reduction in one. Heterotopic ossification occurred in 4 cases ( gradeⅠin one, gradeⅡin 2 and gradeⅢin one by the Brooker grading system ) . The trochanteric osteotomy was repeated in one case. No femoral head avascular necrosis was found. According to the modified Merle d'Aubigné and Postel scoring at the final follow-ups, the functional results of the affected hip were excellent in 4 cases, good in 7 and poor in one. Conclusion Trochanteric digastric osteotomy and surgical hip dislocation is a safe and effective treatment for Pipkin Ⅳ fractures.
4.Protective effect of polymyxin B in liver transplantation in rats
Yiqiao WANG ; Baiyong SHEN ; Guoqing BAO ; Xiaohui WANG ; Daohai QIAN ; Qian ZHAN ; Chunpeng PAN ; Xiaxing DENG ; Zhecheng ZHU ; Chenghong PENG ; Hongwei LI
Chinese Journal of Organ Transplantation 2012;33(4):232-235
Objective To investigate the protective effect of polymyxin B (PMB) to the liver graft after liver transplantation and the underlying mechanism in rats.Methods Male SD rats were selected as the donors and recipients.Non-artery whole liver transplantation model was established in rats according to Kamada's two-cuff method.The rats were divided into two groups by the way of random number table method:control group (normal saline,0.5 ml) and PMB group (PMB,1 mg/ml,0.4 mg/kg+ normal saline 0.5 ml).The levels of portal vein plasma endtotoxin (EU/ml)were determined by endotoxin-analyzing machine of BET-24A. ALT,BUN,and TNF-α,IL-6 in serum were measured by using machine of Automatic Analyzer and ELISA,respectively.The CD14,TLR4,NFκB and AP-1 in the grafts were measured by RT-PCR and Western blotting,and pathological changes were observed. Results PMB decreased the levels of portal vein plasma endotoxin 1 h after reperfusion in PMB group as compared with control group (P<0.05),and the levels of portal vein plasma endotoxin returned to the normal levels 6 h after reperfusion in both two groups (P>0.05).After operation,the levels of ALT,TNFα and IL-6 in serum were significantly reduced (P<0.05),the expression of CD14 and TLR4 mRNA in the grafts was significantly decreased (P<0.05),the expression of Hsp60 protein and mRNA,and NF-κB and AP1 proteins in the grafts were reduced (P<0.05),and the pathological damage to the grafts was significantly alleviated in PMB group as compared with control group.Conclusion PMB reduced the levels of portal vein plasma endotoxin after reperfusion in liver transplantation in rats.PMB improved liver function,reduced the injury of inflammatory response,decreased the levels of endotoxin signal pathway markers and alleviated the pathological damage to the grafts.
5.Comparison of perioperative data between the pararectus and ilioinguinal approaches in the internal fixation of acetabular fractures: a prospective randomized control trial
Qiyong CAO ; Honghua WU ; Xu SUN ; Chunpeng ZHAO ; Shiwen ZHU ; Xinbao WU
Chinese Journal of Orthopaedic Trauma 2021;23(6):513-518
Objective:To compare the perioperative data between the pararectus and ilioinguinal approaches in the internal fixation of acetabular fractures.Methods:A randomized controlled trial was conducted to enroll 74 patients with acetabular fracture who were admitted to Department of Orthopaedic Trauma, Beijing Jishuitan Hospital from June 2018 to January 2021. They were randomly divided into 2 groups. In group A of 37 cases, there were 28 males and 9 females with an age of (55.8±15.2) years, and 10 anterior column fractures, 7 anterior+posterior hemi-transverse fractures, one transverse fracture, 3 T-shaped fractures and 16 both column fractures according to Letournel-Judet classification. In group B of 37 cases, there were 28 males and 9 females with an age of (49.4±14.6) years, and 8 anterior column fractures, 6 anterior+ posterior hemi-transverse fractures, 2 transverse fractures, 2 T-shaped fractures and 19 both column fractures according to Letournel-Judet classification. Group A was subjected to open reduction and plate fixation via the pararectus approach while group B to open reduction and plate fixation via the ilioinguinal approach. The 2 groups were compared in terms of operation time, intraoperative blood loss, postoperative reduction and perioperative complications.Results:There were no significant differences in baseline data between the 2 groups, showing comparability between them ( P>0.05). The operation time in group A [150 (120, 180) min] was significantly shorter than that in group B [180 (150, 225) min] ( P<0.05). There were no significance differences between the 2 groups in intraoperative blood loss [800 (600, 1, 000) mL versus 1, 000(600, 1, 300) mL], rate of good to excellent reduction [91.9%(34/37) versus 78.4%(29/37)], or incidence of complications [24.3%(9/37) versus 45.9%(17/37)] ( P>0.05). Conclusion:Compared with the ilioinguinal approach, the pararectus approach can reduce operation time significantly in the internal fixation of acetabular fractures.
6.Relationship Between the Changes of Cardiovascular Health Indicator and Arteriosclerosis in Middle and Elder Population
Xin DU ; Yan LIU ; Ying ZHANG ; Jihong SHI ; Zhe HUANG ; Chenrui ZHU ; Huiying LI ; Xiaoming WEI ; Liming LIN ; Hailiang XIONG ; Chunpeng JI ; Shouling WU
Chinese Circulation Journal 2016;31(2):137-141
Objective: To investigate the changes of cardiovascular health indicator and arteriosclerosis in middle and elder population.
Methods: A total of 4190 subjects with the average age of (49.78 ± 9.74) years by 3 physical examinations in Kailuan group from 2006 to 2011 were randomly stratiifed for arm ankle arterial pulse wave velocity (baPWV) examination. According to 7 AHA cardiovascular health indicators of non-smoking, normal BMI, active excise, healthy diet, normal cholesterol, blood pressure and fasting blood glucose, each indicator had 3 conditions as ideal, general and poor by scores of 2, 1 and 0 respectively. Based on the 1st and 3rd physical examinations, the changes of cardiovascular health scores (△CHS), the subjects were divided into 8 groups as△CHS≤-4,-3,-2,-1, 0, 1, 2 and△CHS≥3, n=241, 368, 611, 855, 911, 647, 354 and 203 respectively. The impacts of△CHS on baPWV values were studied by liner and Logistic regression analyses.
Results: As△CHS increased by △CHS ≤ -4, -3,-2,-1,0,1, 2 and△CHS ≥ 3, the baPWV values were decreased accordingly by cm/s as (1590.78 ± 17.93), (1566.4 ± 14.5), (1552.83 ± 11.25), (1536.59 ± 9.51), (1508.85 ± 9.21), (1499.81 ± 10.93), (1485.92 ± 14.82) and (1475.85 ± 19.57) respectively. Multiple linear regression analysis showed that with adjusted confounding factors, as△CHS increasing 1 score, baPWV increasing 15.58 cm/s (B=15.58, P<0.001). Logistic regression analysis indicated that with adjusted confounding factors, as△CHS increasing 1 score, the risk for arteriosclerosis occurrence was decreased by 14%(OR=0.86, 95%CI 0.83-0.90).
Conclusion: △CHS was negatively related to baPWV in middle and elder subjects, improving cardiovascular health indicator may decrease arteriosclerosis occurrence.
7.Predictive Value of Inflammatory Factors on All Cause Mortality in Normal Population:6.9 Years Follow-up Results in Kailuan Group for 83,000 Subjects
Xin DU ; Chunpeng JI ; Ying ZHANG ; Jihong SHI ; Zhe HUANG ; Chenrui ZHU ; Huiying LI ; Xiaoming WEI ; Liming LIN ; Hailiang XIONG ; Yan LIU ; Shouling WU
Chinese Circulation Journal 2016;31(3):245-249
Objective: To explore the predictive value of inlfammatory factors on all cause mortality in normal population.
Methods: In our prospective cohort study, a total of 83,228 subjects from physical examination of Kailuan group from 2006-07 to 2007-10 were enrolled, nobody had acute inlfammation. The death information was collected once per year and the last follow-up was conducted in 2013-12-31. According to baseline levels, white blood cells (WBC), ratio of neutrophil/lymphocyte ratio (N/L) and C-reactive protein (CRP) were respectively divided into 4 Quartile groups; all cause mortality was compared among different groups and their risks were studied by multi-Cox regression analysis.
Results: The average follow-up time was 6.9 years. All cause mortality in Quartile 1, Quartile 2, Quartile 3 and Quartile 4 groups for WBC were 4.2%, 4.5%, 4.5% and 5.0% respectively; for N/L were 3.3%, 3.6%, 4.5% and 6.7% respectively; for CRP were 3.0%, 3.6%, 4.8% and 6.8% respectively. Multi-Cox regression analysis indicated that with adjusted age, gender, waist and other confounders, by elevation of WBC, N/R and CRP, the risks of all cause mortality were increased accordingly, and the risks in Quartile 4 groups were higher than those in Quartile 1 groups as for WBC, it was 1.17-time (95% CI 1.06-1.29);for N/L, it was 1.44-time (95% CI 1.31-1.59); for CRP, it was 1.33-time (95% CI 1.20-1.47) respectively.
Conclusion: Elevated WBC, N/R and CRP are independent risk factors for all cause mortality in normal population.
8.Relationship between hepatic arterial buffer response and early biliary complications and small-for-size syndrome after living donor liver transplantation
Daohai QIAN ; Qin LIU ; Xiaohui WANG ; Chunpeng PAN ; Baiyong SHEN ; Guoqing BAO ; Yiqiao WANG ; Chenghong PENG ; Zhecheng ZHU ; Xiaxing DENG ; Qian ZHAN ; Hongwei LI
Chinese Journal of Hepatobiliary Surgery 2012;18(6):411-415
Objective To study the relationship between hepatic arterial buffer response (HABR),recovery of liver function,early biliary complications and small-for-size syndrome (SFSS).Methods Early hepatic hemodynamic parameters (including hepatic arterial flow (HAF),portal venous flow (PVF) were measured using duplex Doppler sonography in 34 patients who received living donor liver transplantation (preoperatively n=26,intraoperatively n=26) and on postoperative days 1,2,3,and 7.Alanine aminotransferase (ALT),aspartate aminotransferase (AST) and total bilirubin (TBIL) level were measured preoperatively and on postoperative days 1,2,3,7,14,21,and 28.If TBIL level was elevated,we used B ultrasonography or CT and even ERCP to diagnose early biliary complications.The days taken for AST,AI T and TBIL to recover and the number of patients with early (<60 days) biliary complications (bile leakage or bile stricture) and with small-for-size syndrome (SFSS) were recorded.Results Passive hepatic artery buffer response (HABR) was present in 11 patients early after living donor liver transplantation (group 1) and it disappeared in 23 patients (group 2).The recovery in days taken for normalization of AST (10.6± 8.8),AIT (11.6±9.0) and TBlL (average of 29) in group 1 were shorter than in group 2.However,the differences did not reach statistics difference (P>0.05).The overall incidences of early biliary complications and small-for-size syndrome (SFSS) in group 1 were significantly lower than in group 2 (P=0.04).The survival rate in group 1 was 82 %,compared with 74 % in group 2.Conclusions Passive hepatic arterial buffer response (HABR) disappeared in some patients early after living donor liver transplantation.There were high incidences of early biliary complications and small-for-size syndrome (SFSS) in these patients.Measurcment of hepatic buffer response in the early stage after living donor liver tranaplanta tion is valuable for predition of early biliary complications and small-for-size syndrome (SFSS),thus helping to prevent failure in transplantation.
9.Relationship Between Longitudinal Trajectory of Systolic Blood Pressure and Atrial Fibrillation Occurrence in Kailuan Group Population
Xin DU ; Ruiying ZHANG ; Ying ZHANG ; Jihong SHI ; Zhe HUANG ; Chenrui ZHU ; Huiying LI ; Xiaoming WEI ; Liming LIN ; Hailiang XIONG ; Yan LIU ; Chunpeng JI ; Shouling WU
Chinese Circulation Journal 2017;32(6):584-588
Objective: To explore the relationship between longitudinal trajectory of systolic blood pressure (SPB) and atrial fibrillation (AF) in Kailuan group population. Methods: Our study cohort consisted of 40727 participants with the specific criteria in Kailuan group, Tangshan. SAS Proc Traj procedure was used to identify longitudinal trajectories of SPB throughout 2006-2007, 2008-2009 and 2010-2011. There were 5 longitudinal trajectories generated: Low-stable group,n=10950, Moderate-stable group, n=19158, Moderate-high stable group,n=3713, High-moderate stable group,n=4702 and High stable group,n=2181. Log-rank test was performed to compare AF incidence throughout 2012-2013 and 2014-2015 by physical examination among different groups; Multi Cox regression analysis was conducted to study the relationship among different SBP longitudinal trajectories and AF occurrence. Results:①The mean age of participants was (51.81±11.54) years including 30693 (75.4%) male.②AF occurrence rates in Low-stable, Moderate-stable, Moderate-high stable, High-moderate stable and High stable groups were 0.1%, 0.2%, 0.5%, 0.5% and 0.6% respectively, allP<0.05.③Multi Cox regression analysis presented that with adjusted confounding factors, compared with the patients in Low-stable group, Moderate-high stable, High-moderate stable and High stable SBP longitudinal trajectories were the risk factors for new AF occurrence (HR=7.58, 95% CI 2.08-27.73), (HR=5.30, 95% CI 1.88-14.95) and (HR=8.52, 95% CI 1.96-37.09) respectively, allP<0.05. With excluded history of myocardial infarction/stroke, the sensitivity study showed the similar result with the major research trend. Conclusion: Elevated long trajectory of SPB was the risk factor for new AF occurrence in Kailuan group population.
10.Intelligent robot-assisted minimally invasive reduction system for reduction of unstable pelvic fractures: a cadaveric study
Chunpeng ZHAO ; Yu WANG ; Xu SUN ; Gang ZHU ; Honghu XIAO ; Lijia ZHANG ; Xiangrui ZHAO ; Shuchang SHI ; Xinbao WU
Chinese Journal of Orthopaedic Trauma 2022;24(5):372-379
Objective:To evaluate a self-designed intelligent robot-assisted minimally invasive reduction system in the reduction of unstable pelvic fractures by a cadaveric anatomic study.Methods:Ten unembalmed cadavers (7 male and 3 female ones) were used in this study. In each cadaveric specimen an unstable pelvic fracture was created in accordance with clinical case models (3 cases of type B1, 4 cases of type B2 and 3 cases of type C1 by the Tile classification). A self-designed intelligent robot-assisted minimally invasive reduction system was used to assist the reduction in the cadaveric models. Intraoperative registration and navigation time, autonomous reduction time, total operation time and reduction error were measured.Results:Effective reduction was completed in 10 bone models with the assistance of our self-designed intelligent robot-assisted minimally invasive reduction system. The time for intraoperative registration and navigation averaged 47.4 min (from 32 to 74 min), the autonomous reduction time 73.9 min (from 48 to 96 min), and the total operation time 121.3 min (from 83 to 170 min). The reduction error averaged 2.02 mm (from 1.67 to 2.62 mm), and the reduction results met the clinical requirements.Conclusion:Our self-designed intelligent robot-assisted minimally invasive reduction system is a new clinical solution for unstable pelvic fractures, showing advantages of agreement with clinical operative procedures, high reduction accuracy and operational feasibility, and reduced radiation exposure compared to a conventional operation.