1.Perioperative oxygen transport and oxygen consumption during coronary artery bypass grafting procedure
Xinmin WU ; Dongxin WANG ; Xing XU
Chinese Journal of Anesthesiology 1994;0(06):-
To investigate the perioperative oxygenation of the patient undergoing coronary artery bypass grafting procedure (CABG). Method: The relationship between oxygen transport (TO_2) and oxygen consumption (VO_2), and serum lactate level were examined in 55 patients undergoing CABF, anesthetized with midazolam, vecuronium and a moderate dose of fentanyl. Result: Good correlations between TO_2 and VO_2 at the weaning from CPB (r=0.7817, P
2.The clinical monitoring of invasive aspergillosis in surgical intensive care unit during 10 years
Ning XU ; Shuangling LI ; Ruli FENG ; Dongxin WANG
Chinese Critical Care Medicine 2014;26(9):634-638
Objective To investigate the invasive aspergillosis (IA) status in a surgical intensive care unit (SICU).Methods The clinical data including general state,operation,pathogenic microorganisms,infection position,clinical situation,treatment and prognosis of patients with IA admitted to the SICU of Peking University First Hospital from January 2004 to December 2013 were retrospectively analyzed.Results 8 220 patients admitted to the SICU of Peking University First Hospital from January 2004 to December 2013 were enrolled.Of 8 220 patients,there were 29 cases experienced IA,with an incidence of 0.35%,and the incidence of hospital onset of IA infection was 0.27% (22/8 220).The incidence of hospital onset of IA infection was accounted for 6.98% (22/315) of the incidence of hospital onset of infection in SICU in the same period.Compared with 2004-2008,in 2009-2013,the incidence of hospital onset of infection was significantly decreased [3.19% (137/4 293) vs.4.53% (178/3 927),x2=10.020,P=0.002],while the incidence of IA [0.56% (24/4 293) vs.0.13% (5/3 927),x2=10.874,P=0.001],the incidence of hospital onset of IA infection [0.40% (17/4 293) vs.0.13% (5/3 927),x2=5.556,P=0.019],and the percentage of incidence of hospital onset of IA infection according to the incidence of hospital onset of infection were increased by 5 years [12.40% (17/137) vs.2.81% (5/178),x2=10.982,P=0.001].Of 29 patients with IA,25 cases had occurred after operation,and the majority of them were from the Department of General Surgery (13 cases),and followed by post-renal transplantation (6 cases) and post-thoracic surgery (3 cases).In the total submission of 155 specimens from 29 patients with IA,there were 17 strains isolated aspergillosis,among which included 2 strains of Aspergillus fumigatus,and 15 other un-subgrouped strains.The most common infection site was lower respiratory tract (23 cases,79.31%).Sixteen patients were found with positive galactomannan (GM) test.In all the risk factors contributing to IA,the ratio of the long-term usage of broad-spectrum antibiotics over 4 days was the highest [36.25% (29/80)],which followed by the long-term use of hormone [18.75% (15/80)],complicated with acute kidney injury [18.75% (15/80)],liver injury [13.75% (11/80)],the long-term use of immunosuppressive orally [7.50% (6/18)],and complicated with neutropenia [5.00% (4/80)].In 29 patients with IA,there were 28 patients received anti-fungal treatment except for 1 patient without treatment,and those were single use of itraconazole in 1 case,single use of echinocandins in 3 cases,single use of liposomal amphotericin B in 5 cases,8 cases with voriconazole,single use of liposomal amphotericin B or echinocandins then replaced by voriconazole in 8 cases,and 3 cases of echinocandins therapy combined with voriconazole.Seventeen of 29 patients died,with a mortality rate of 58.62%.Conclusions IA is an uncommon but increasing postoperative complication of patients in SICU in recent 5 years.The most common sites of IA were lower respiratory tract.The mortality of IA is very high.So clinicians should pay more attention to the careful monitor for IA.
3.LCZ696 is effective in treating patients with heart failure:based on PARADIGM-HF data
Yanmin XU ; Dongxin WANG ; Zhanqian CUI ; Xingmei GUO
Tianjin Medical Journal 2015;(8):837-839,840
Heart failure (HF) is a complex clinical syndrome, which is caused by cardiac structural abnormalities and dysfunction. It can lead to ventricular filling and impaired ejection capacity with high incidence and mortality . The constant activation of the rennin-angiotensin-aldosterone system (RAAS) plays an important role in the development of heart failure. Angiotensin angiotensin converting enzyme inhibitor (ACEI), angiotensin angiotensin receptor antagonist (ARB) and aldoste?rone receptor antagonist (MRA) had been confirmed to be with good therapeutic effects therefore played important roles in heart failure treatment strategy shown by large scale clinical trials. The first PARADIM-HF data published by European So?ciety of Cardiology in annual meeting on August 30, 2014 showed that LCZ696 can reduce cardiovascular mortality risk of HF patient by 20%when combining with beta blockers and MRA . It also reduced the number of hospitalizations of patients with chronic heart failure (CHF) by 21%. LCZ696, using its unique dual phase mode verified that the regulation of neuroen?docrine is the modern concept for the treatment of heart failure. LCZ696 lead to innovation and shed new light in traditional drug treatment for heart failure.
4.DAILY DIETARY INTAKES OF NITRATE, NITRITE AND VITAMIN C IN POPULATIONS AT DIFFERENT RISK OF GASTRIC CANCER
Dongxin LIN ; Yuejiao WU ; Yunqin XU ; Xiuru CHEN
Acta Nutrimenta Sinica 1956;0(03):-
Daily dietary intakes of nitrate, nitrite and vitamin C were investigated in Chanle county, Fujian province, where gastric cancer was very common, with a marked geographic variation in mortality. The average daily intake of nitrate of residents in Zhanggang village (high risk area) was 132.75 mg, which was significantly higher than that (84.65 mg) in Shouzhan village (moderate risk area), but similar to that (113.12 mg) in Meihua village (low risk area). However, nitrite intake in Zhanggang village was greatly higher than that in Shouzhan and Meihua villages (3.36 mg vs 0.21 and 0.37 mg, respectively). The average daily intake of vitamin C in Shouzhan village was 56.37 mg, significantly lower than that in Zhanggang village (123.09 mg) and in Meihua village (105.90 mg). The molar ratio of vitamin C intake to nitrite in the three villages was 3.22, 3.30 and 4.33, respectively. It was invesely associated with the mortality of gastric cancer. The results suggested that nitrate and nitrite might be etiological factors of gastric cancer in the county.
5.Prognostic value of Neutrophil-to-Lymphocyte ratio in patients with ST-segment elevation myocardial infarction
Xingmei GUO ; Dongxin WANG ; Congcong HAN ; Heng LI ; Li CUI ; Yanmin XU
Tianjin Medical Journal 2015;(8):840-844
Objective To investigate the clinical prognostic value of neutrophils to lymphocyte ratio(NLR)in patients with ST-segment elevation myocardial infarction(STIMI)who underwent percutaneous coronary intervention(PCI). Meth?ods A total of 326 patients with acute ST segment elevation myocardial infarction were enrolled. According to the neutro?phils to lymphocyte ratio, patients were divided into group T1(≤3.46), group T2(3.47-6.75)and group T3(>6.75). Basic clinical data,laboratory indexes,coronary angiography results, TIMI grading and left ventricular ejection fraction(LVEF) were collected in all groups. Incidence of adverse events in hospital such as acute heart failure, thrombosis, ventricular tachy?cardia and ventricular fibrillation, atrial fibrillation, atrioventricular block and cardiogenic shock, were recorded. Major ad?verse cardiac events(MACE), death of all causes, non-fatal MI, ischemic stroke and readmission due to heart failure at the 6-month follow-up were also noted. Results The incidence of heart failure, atrial fibrillation, ventricular tachycardia/ven?tricular fibrillation and cardiogenic shock was higher in group T3 than those in the other two groups(P < 0.05).The inci?dence of multivessel coronary artery disease was significantly higher in group T3 than that in group T1 (54.1% vs 37.0%, P<0.05). The percentage of TIMI grade 3 in post-operative infracted artery was significantly lower than that in group T1 (83.5%vs 94.4%). Left ventricular ejection fraction was significantly lower in group T3 than that of group T1 during hospital?ization (0.48 ± 0.10 vs 0.52 ± 0.10). There was no significant difference in the incidences of death, non-fatal MI, ischemic stroke at 6 month follow up. But the rate of readmission due to heart failure was significantly higher in group T3 than that in the group T1(P<0.05). Conclusion Neutrophils to lymphocyte ratio may be a useful marker to predict the prognosis of pa?tients with heart failure due to acute myocardial infarction.
6.TNFα, SP-A expression and clinical significance of varying degrees of pneumonia in children
Jialei ZHOU ; Dongxin XU ; Yi LI ; Zhimin CHEN
China Modern Doctor 2014;(18):145-147
Objective To observe the expression levels change and it's clinical significance of TNF-α, SP-A in chil-dren with varying degrees of pneumonia. Methods A total 195 cases of pneumonia children patients were divided into ordinary pneumonia and severe pneumonia patients , another 65 cases of non-pneumonic children patients as the con-trol group, ELISA assay was used to detect serum TNF-α and SP-A level. Results The levels of serum SP-A and TNF-αof pneumonia children group were higher than the control group's , and severe pneumonia patients ’ were high-er than ordinary pneumonia. Conclusion The expression level of TNF-α and SP-A increased significant in the patho-genesis of children with severe pneumonia which could reflect the degree of lung injury and as a indicator in clinical testing.
7.Efficacy observation on prevention of chemotherapy-related anemia by combined therapy of traditional Chinese medicine in malignant tumors
Changwen ZHANG ; Mao MAO ; Dongxin XU ; Ning JIAO ; Yu XU ; Lifang CHEN ; Jinlan ZHANG
Cancer Research and Clinic 2023;35(2):133-136
Objective:To explore the effect of combined therapy of traditional Chinese medicine on prevention of chemotherapy-related anemia in malignant tumors.Methods:Seventy-nine patients with malignant tumors diagnosed in Zibo Hospital of Traditional Chinese Medicine from January 2019 to January 2021 were selected, and the patients were divided into experimental group (40 cases) and control group (39 cases) according to the random number table method. The control group received chemotherapy and the experimental group received chemotherapy and combined therapy of traditional Chinese medicine (Wuhong Tang combined with moxibustion). The hemoglobin (Hb) level, Karnofsky score and adverse effects were recorded before and on days 7, 14 and 21 after chemotherapy in the two groups.Results:The Hb level in the experimental group was higher than that in the control group [(117±28) g/L vs. (100±31) g/L] on day 21 after chemotherapy, and the difference was statistically significant ( t = -3.08, P = 0.030). The total effective rate of the experimental group was higher than that of the control group [85% (34/40) vs. 66.7% (26/39)], but the difference was not statistically significant ( χ2 = 4.96, P = 0.084). Karnofsky scores were (77±9) points and (77±12) points before and on day 21 after treatment in the experimental group, with no statistical difference ( t = -0.50, P = 0.623); Karnofsky scores were (78±10) points and (67±9) points in the control group, with statistical difference ( t = 8.32, P < 0.001). There was no statistical difference in Karnofsky score before treatment between the two groups ( t = 1.85, P = 0.068), but the experimental group was higher than the control group on day 21 after treatment ( t = 4.88, P < 0.001). The difference in the incidence of nausea and vomiting between the two groups was not statistically significant ( P > 0.05), and no chemotherapy-related hepatic, renal or cardiac adverse reactions were observed in either group. Conclusions:Combined therapy of traditional Chinese medicine could effectively prevent chemotherapy-related anemia and improve the quality of life of patients.
8.Repeat hepatectomy for post-hepatectomy recurrent hepatocellular carcinoma
Shoufei JIAO ; Guanqun LI ; Dongxin ZHANG ; Yingchen XU ; Jie LIU ; Feng XIA ; Lijun ZHANG ; Jianzhu FU ; Jiajun JI ; Guangming LI
Chinese Journal of Hepatobiliary Surgery 2020;26(5):335-338
Objective:To study the impact of repeat hepatectomy for patients with post-hepatectomy recurrent hepatocellular carcinoma (HCC).Methods:The data of patients who developed post-hepatecotmy recurrent HCC and underwent repeat hepatectomy at the General Surgery Department of Beijing Tongren Hospital from May 2013 to May 2016 (the Recurrence Group), were retrospectively compared with the data from patients who underwent initial hepatectomy for HCC during the same study period (the Primary Group). The general data, perioperative data, postoperative complications and survival of the two groups were compared.Results:The primary group included 179 patients, consisting of 133 males and 46 females, aged (57.3±11.7) years, with a range from 14.0 to 84.0 years. The recurrence group included 36 patients, consisting of 30 males and 6 females, aged (55.9±11.4) years, with a range from 40.0 to 77.0 years. There were no statistically significant differences between the two groups in gender, age, hepatitis virus infection status, preoperative alpha fetoprotein, Child-Pugh score and indocyanine green retention rate at 15 min ( P>0.05). However, there were statistically significant differences ( P<0.05) between the two groups in operative time [(244.2±84.3)min vs. (283.4±66.8)min], intraoperative blood loss[(428.5±151.6)ml vs. (756.2±187.4)ml], anatomic or nonanatomic hepatectomy, single tumor or multiple tumors, and maximum tumor diameter[(5.81±2.24)cm vs. (3.69±1.55)cm]. There were no statistically significant differences between the two groups in incidences of tumor capsular invasion, tumor thrombus and degrees of tumor differentiation ( P>0.05). There were no statistically significant differences in surgical complication rates ( P>0.05), and in 1-year and 3-year overall and disease free survival rates between the two groups ( P>0.05). Conclusions:Repeat hepatectomy for recurrent HCC after hepatectomy was safe and effective. Its long-term survival outcomes were similar to first hepatectomy for HCC.
9. Correlations between genetic variations of glutathione synthetase gene and the response to platinum-based chemotherapy and prognosis of small cell lung cancer patients
Ting FENG ; Hongmin LI ; Peng YUAN ; Dianke YU ; Fei MA ; Wenle TAN ; Zhongli DU ; Jie YANG ; Ying HUANG ; Dongxin LIN ; Binghe XU ; Wen TAN
Chinese Journal of Oncology 2017;39(2):115-120
Objective:
To explore the associations between genetic variations of glutathione synthetase gene (GSS) and response to platinum-based chemotherapy of small cell lung cancer(SCLC), and to analyze the influencing factors on survival.
Methods:
Four haplotype-tagging single nucleotide polymorphisms (htSNPs) of GSS were genotyped by Sequenom MassARRAY methods in 903 SCLC patients who received platinum-based chemotherapy, and had different response and survival time. The associations between genotypes and platinum-based chemotherapy response were measured by odds ratios (
10. Genetic variation in DNA polymerase kappa gene is associated with the prognosis after platinum-based chemotherapy in small cell lung cancer patients
Jinna CHEN ; Ting FENG ; Jie YANG ; Hongmin LI ; Peng YUAN ; Fei MA ; Luxi YIN ; Dongxin LIN ; Binghe XU ; Wen TAN
Chinese Journal of Oncology 2019;41(2):112-117
Objective:
To investigate the associations between genetic variations of DNA polymerase kappa (POLK) and treatment response to platinum-based chemotherapy of small cell lung cancer (SCLC), and to analyze the influencing factors on survival.
Methods:
Five haplotype-tagging single nucleotide polymorphisms (htSNPs) of POLK were genotyped by Sequenom MassARRAY methods in 1 030 SCLC patients who received platinum-based chemotherapy, and had different response and survival time. The associations between SNPs and treatment response were analyzed by computing the odds ratios (