1.The impact of Japanese Fukushima nuclear accident on environmental radiation levels in some areas of Liaoning province
Erwei SHI ; Yong CUI ; Qian ZHANG ; Di LI ; Xin LI ; Shuang YAO ; Minghui LIU ; Junqiao GUO
Chinese Journal of Radiological Medicine and Protection 2012;32(2):137-140
Objective To investigate the environmental impact of the Japanese Fukushima No.1 nuclear power plant accident on radiation levels in some areas of Liaoning province.Methods The emergent monitoring was performed by detecting atmosphere aerosols,precipitations,drinking water,vegetables,milk and seafood by gamma spectrometry analysis and gross activity measurements.Results The fission radionuclides of 131I,134Cs and 137Cs were detected in atmosphere aerosols 20 d after nuclear accident.The rad ionuclides of 131I,134Cs and 137Cs were found existing in atmosphere for 25,4 and 6 d,respectively,with the highest concentrations of 4.6 × 10 3,2.9 × 10-4 and 4.2 × 10-4 Bq/m3,respectively.The man-made fission radionuclides could not be detected in vegetablcs,drinking water and milk from Shenyang city and seafood from Dandong city.Conclusions The atmosphere might be slightly contaminated in Liaoning province due to the nuclear accident,whereas the vegetables,milk and drinking water not contaminated.
2.Correlation of human leucocyte antigen matching to acute rejection and allograft survival after renal allograft
Liuyang LI ; Jianrong CHEN ; Jun QIAN ; Min LI ; Erwei SUN ; Ying GUO ; Liangsheng YUE ; Lipei FAN ; Hua CHEN ; Ming ZHAO
Chinese Journal of Tissue Engineering Research 2008;12(31):6165-6168
BACKGROUND: Panel reactive antibody (PRA) can mediate hyperacute rejection, and lead to decrease in success rate of transplantation and survival rate of renal graft in highly sensitized recipients compared to non-sensitized recipients.OBJECTIVE: According to human leucocyte antigen (HLA) cross-matching standards to select suitable donors for sensitized recipients and to evaluate the incidence of acute rejection and survival rate of renal allografts.DESIGN: Case observation.SETTING: Zhujiang Hospital of Southern Medical University.PARTICIPANTS: 136 sensitized recipients with positive PRA underwent renal transplantation in Department of Organ Transplantation, Zhujiang Hospital of Southern Medical University between January 1997 and December 2003 were selected, including 41 males and 95 females, aged (45±9) years. Recipients of first, second, third, and fourth transplant were 115, 18, 2 and 1 case, respectively. The informed consent was obtained from all patients. The protocol was approved by Hospital Ethics Committee. Lambda antigen tray (LAT) and LAT-Mix were purchased from One Lambda, Inc, USA. Special monoclonal tray -Asian HLA class Ⅰ (SMT72R) and Micro SSP Generic HLA Class Ⅱ (DRB/DQB) were also purchased from One Lambda, Inc, USA.METHODS: Pre-operative PRA levels and specificity of recipients were detected by ELISA test with Lambda antigen tray (LAT). Donor and recipient HLA class Ⅰ typing was performed with special tray - Asian HLA class Ⅰ (SMT72R), and HLA class Ⅱ gene typing with Micro SSP Generic HLA Class Ⅱ (DRB/DQB) (Micro-SSP). HLA-matching between donor and recipient was performed according to HLA cross-reactive group (CREG) standards by UNOS and class Ⅱ antigen permissible mismatch. The incidence of acute rejection and survival rate of renal allografts were evaluated within 1, 3 and 5 years.MAIN OUTCOME MEASURES: ①PRA levels and specificity of sensitized recipients before and after transplantation; ②HLA-matching between donor and recipient; ③Incidence of acute rejection and survival rate of renal allografts after transplantation.RESULTS: 136 PRA positive sensitized recipients were all included in final analysis. ① There were 104 recipients with anti-HLA class Ⅰ IgG antibody, 76 with anti-HLA class Ⅱ IgG antibody, and 44 with both anti-HLA class Ⅰ and Ⅱ IgG antibodies in 136 recipients. ②The number of cases of 0, 1, 2, 3, and 4 mismatch (MM) was 7, 26, 47, 39 and 17, respectively by the standard of conventional HLA antigen matching; However, the number of the recipients with 0, 1, 2, 3, and 4MM was 31, 53, 36, 16, and 0, respectively according to the principle of HLA CREG matching. ③By the principle of HLA CREG matching, rates of acute rejection in sensitized recipients with 2MM and 3MM HLA-CREG were significantly higher than those with 0MM (P < 0.05). Renal allograft survival rate in sensitized recipients with 0MM was significantly higher than those with 2MM and 3MM (P < 0.05).CONCLUSION: ①HLA CREG matching can significantly improve the ratio of well-matched. ② Good HLA matching can reduce the incidence of acute rejection in sensitized recipients and increase the survival rate of renal grafts.
3.Solitary fibrous tumor of the pelvis: report of 5 cases and review of literatures
Tong ZHANG ; Lei LIANG ; Erwei GUO
International Journal of Surgery 2017;44(9):595-598,后插1
Objective To investigate the clinic pathologic characteristics,pathologic diagnosis,differential diagnosis management of solitary fibrous tumor and improve the level of its diagnosis and treatment.Methods This was a retrospective analysis of clinical data and pathological features in 5 cases of solitary fibrous tumor of pelvis from March 2002 to December 2016,and the related literatures were also reviewed.Solitary fibrous tumor was male predominance(4 males;1 females)and the age ranged from 32 to 62 years with an average of 52 years.Four patients presented with a mass in pelvis which was found incidentally in a comprehensive medical examination.One patient was afflicted flank pain.CT imagine examinations showed that most of the solitary fibrous tumor were well-defined soft tissue masses with intense enhancement.1 case exhibited myxomatoid changes.Only 1 case showed typical manifestations of fibrous tissue on MRI scan.All of these patients were successfully treated with open surgical resection of tumor.Results The operation was successful in the 5 cases.The average operation time was 260 min.The average blood loss was 1 200 ml.Pathologic examination revealed solitary fibrous tumor.Histologically,the neophlasm were composed of round and oval cells.The most essential characteristic was monatypical spindle-shaped tumor cells on a collagenous background.Keloid-type collagen,hypocellular and hypercellular areas could be observed in all the cases,and mitoses was rare.Immunohisto-chemically,the tumor cells were positive for vimentin,CD99,Bcl-2 in five cases,but negative for CK,SMA in all cases.There was recurrence in one patient with a median follow-up of 9 (2-26) months,and no metastasis in 4 patients.Conclusions Solitary fibrous tumor of the pelvis is a rare tumor which has no special characteristics in clinical and iconography,and its diagnosis mainly depend on the histopathologic features and immunohistochemistry.Completely resection of tumor could usually cure the disease,while careful follow-up is still necessary.
4.Choice of operation time for ureteral calculi patients with COVID-19 infection
Lei LIANG ; Longjie MA ; Tong ZHANG ; Erwei GUO ; Ming LI
International Journal of Surgery 2024;51(2):103-107
Objective:To compare the difference between the operation of ureteral calculi patients with COVID-19 infection during COVID-19 infection and after recovery to find out the best timing for surgery.Methods:The clinical data of 327 ureteral calculi patients with COVID-19 infection were retrospectively analyzed, including 141 cases who underwent ureteroscopic surgery. According to the time of ureteroscopic surgery, the patients were divided into two groups: operation before recovery of COVID-19 infection group ( n=81) and operation after recovery of COVID-19 infection group ( n=60). The success rate of primary surgery, stone removal incidence, complication inciednce, mortality, operation time, postoperative hemoglobin decline, hospital stay, and total hospitalization cost and other indicators of the two groups were compared between the two groups. Measurement data were expressed as mean±standard deviation ( ± s), independent t-test was used for inter-group comparison. Chi-test or continuous correction Chi-test was used for inter-group comparison for count data. Results:The success rate of primary surgery (38.3%, 31/81), stone removal rate (86.4%, 70/81) in the operation before recovery of COVID-19 infection group were significantly lower than those in the operation after recovery of COVID-19 infection group [80.0% (48/60), 98.3% (59/60)], and the differences were statistically significant ( P< 0.05). The incidence of complication, postoperative hemoglobin decline [(2.1±0.6) g/L vs (0.6±0.3) g/L], hospital stay [(14.7±3.6) d vs (4.1±1.1) d], total hospitalization cost [(34 733.3±4 412.4) yuan vs (21 919.7±3 251.3) yuan] of the operation before recovery of COVID-19 infection group were significantly higher than those in the operation after recovery of COVID-19 infection group, and the differences were statistically significant ( P< 0.001). The operation time of the operation before recovery of COVID-19 infection group was shorter [(16.9±5.4) min vs (37.7±8.9) min], and the difference was statistically significant ( P< 0.001). There was no significant difference in mortality between the two groups (3.7% vs 0, P> 0.05). Conclusion:The risk of surgical treatment for ureteral calculi patients with COVID-19 infection is high, The treatment of them should mainly be conservative treatment, and operation should be performed after COVID-19 infection is cured.
5.Nested case-control study on paediatric early warning score and ventilator-associated complications in children with acute respiratory distress syndrome.
Yanhui LU ; Zhenkui LIU ; Shiyang LI ; Yanfei WANG ; Chunmei LI ; Erwei YUAN ; Jing XING ; Weiping GUO
Journal of Central South University(Medical Sciences) 2019;44(9):996-1002
To explore the relationship between paediatric early warning score (PEWS) and the occurrence of mechanical ventilation complications in children with acute respiratory distress syndrome (ARDS).
Methods: A total of 110 children with ARDS diagnosed in First Affiliated Hospital of Hebei North University, who underwent mechanical ventilation, were selected. The baseline data, blood gas analysis index, laboratory test index, ventilator parameters, pediatric critical illness score (PCIS) and PEWS in the children were recorded. With reference to ventilatory treatment results, the children with ventilator-associated complications were included in the trial group (n=20), while the patients with good cohort status were included in the control group (n=40) according to the nested case-control study. Independent sample t-test and multivariate logistic regression analysis were used to analyze the factors affecting the occurrence of complications after ventilatory treatment.
Results: There were statistically significant differences in multiple organ dysfunction syndrome (MODS), partial pressure of oxygen/fraction of inspired oxygen (PaO2/FiO2), partial pressure of carbon dioxide (PaCO2), serum creatinine (SCr), albumin (ALB), blood urea nitrogen (BUN), mechanical ventilation time, mean article pressure (MAP), tidal volume (VT), positive end-expiratory pressure (PEEP), PCIS, PEWS between the control group and the experimental group (all P<0.05). Multivariate logistic regression analysis showed that MODS, PaO2/FiO2, PaCO2, VT, PEEP and PEWS had influence on complications after mechanical ventilation in children with ARDS (all P<0.05).
Conclusion: The MODS, PaO2/FiO2, PaCO2, VT, PEEP, and PEWS exert effects on complications after mechanical ventilation in children with ARDS. PEWS combined with other indicators can assess the risk of complications in children with ARDS after mechanical ventilation.
Case-Control Studies
;
Child
;
Humans
;
Positive-Pressure Respiration
;
Respiration, Artificial
;
Respiratory Distress Syndrome, Adult
;
Tidal Volume