1.The approach of the super wound repaired with a set of combined vascular anastomosed
Qishen FAN ; Xiangji ZHOU ; Xiaodong ZHAO ; Xuejian GAO ; Ning ZHU
Chinese Journal of Microsurgery 2013;(3):215-219
Objective To explore the value of a set of combined vascular anastomosed flap.Methods The 36 cases were injured,the site of injury in knee and leg or ankle and foot,upper limb.Skin defect with bone and joint,tendon exposure.Selection of anastomosis of blood vessel with large flap,wherein the subscapular vascular anastomosis scapular-lateral thoracic flap in 7 cases,the maximum was 70 cm × 10 cm; anastomosis of subscapular artery lateral thoracic-latissimus dorsi muscle flap in 9 cases,the maximum was 42 cm× 24 cm.Anastomosis of subscapular artery of the scapular-back the latissimus dorsi muscle flap in 2 cases; anastomotic lateral circumflex femoral vessels with lateral femoral cutaneous nerve thigh anterior medial-tensor fascia latae flap in 8 cases; anastomosis of anterior tibial artery and the superficial peroneal nerve in the anterior ankle-dorsal foot flap in 5 cases; anastomosis of dorsal vessels and superficial peroneal nerve of the extensor digitorum brevis muscle-dorsal foot joint flap in 5 cases.Results Following up 8 months to 25 years,twenty-three cases were 19 years.All flaps survived and all the wounds were covered,infection were cured,the skin have aesthesia,fracture healing.Five cases were performed muscle tendon and arthrosis solution for creating conditions for the functional recovery of limb.Conclusion Anastomosis of blood vessel anastomosis combined flap can replace multiple vascular flaps combination,saving,convenient,high success rate,widen the indications.
2.Analysis and corresponding strategy of emergency patients forgoing the invasive rescue therapy
Fan LI ; Donglei SHI ; Jian GAO ; Huadong ZHU ; Xuezhong YU
Chinese Journal of Emergency Medicine 2016;25(5):663-667
Objective To analyze the reasons of the emergency patients forgoing the invasive rescue therapy and to put forward the corresponding strategy.Methods According to whether the patients accepted the invasive rescue therapy or not,2 673 patients in resuscitation room of Peking Union Medical College Hospital were divided into rescue group (group R) and do not rescue group (group DNR).There were 2 147 cases in group R and 526 case in group DNR.The rescue consent form or do not rescue consent form was required to sign by patient self,patient' s family member or relatives.The patient' s basic information,underlying disease,payment of medical expenses,personnel who signed the consent form,treatment and prognosis in both groups were investigated.Results There was no significant gender deference in both groups (x2 =1.86,P =0.173).The mean age of patients in group DNR was much higher than that in group R (69.5 ±-12.5 vs.58.6 ± 19.2 years,F =28.92,P =0.000).The proportion of patients outside Beijing in group DNR was higher than that of group R (51.90% vs.44.01%,x2 =10.59,P =0.001).The ratios of chronic heart failure,chronic respiratory failure,chronic hepatic encephalopathy,chronic renal failure,malignant tumor in group DNR were significantly higher than that of group R (8.17% vs.3.03%,8.17% vs.2.61%,3.80% vs.1.16%,5.32% vs.1.44%,11.98% vs.2.28%,all P=0.000).The proportion of patients without insurance in group DNR was higher than that of group R (52.09% vs.41.08%,x2 =20.87,P =0.000).Except the ratio of patients self signing the consent form in group DNR was higher than that of group R (3.04% vs.0.42%,x2 =64.40,P =0.000),there were no significant deference in other people who signed the consent form such as patient's offspring,spouse,parents,siblings and others.Univariate and multivariate logistic regression analyses showed older age,non Beijing patients,chronic underlying diseases,without insurance and patients self signing the consent form were the major risk factors on refusing the invasive rescue therapy.The mortality rate of group DNR was much higher than that of group R (19.39% vs.7.68%,x2=64.40,P=0.000).Conclusions Most of patients who refused to accept invasive rescue therapy were elderly people or in condition of end stage of chronic disease.The doctors and nurses in emergency department should continue to take care of these patients and make use of noninvasive methods to treat them or relieve their pain.
3.The expression and significance of p53 and CDK4 in human endometrial adenocarcinoma
Lanying XING ; Qing GAO ; Gaixia ZHU ; Jiangbo FAN
Journal of Xi'an Jiaotong University(Medical Sciences) 1981;0(02):-
Objective To investigate the expression and significance of p53 and CDK4 proteins in human endometrial adenocarcinoma. Methods Expressions of p53 and CDK4 proteins were detected by immunohistochemical technique in 32 cases of endometrial adenocarcinoma. Results The positive expression rate of p53 protein in the 32 cases of endometrial adenocarcinoma was 43.8% (14/32), and the positive rate of p53 in endometrial adenocarcinoma was negatively related to pathological grade, myometrial invasion and lymph node metastasis (P 0.05). The positive expression rate of CDK4 was 68.8% (22/32), and CDK4 expression was significantly associated with myometrial invasion and lymph node metastasis (P 0.05) . There was negative correlation between p53 and CDK4 (P
4.Effect of Xiaoyao Powder Combined with Prozac on Post-stroke Depression
Ying LI ; Hai-yong ZHU ; Hui-juan GAO ; Liubo FAN
Chinese Journal of Rehabilitation Theory and Practice 2006;12(6):501-502
ObjectiveTo observe the effect of Xiaoyao powder combined with prozac and psychological therapy on post-stroke depression (PSD).Methods85 PSD patients were randomly divided into the treatment group (n=43) and control group (n=42). All patients were treated with routine therapy, including prozac and psychological therapy. Patients in the treatment group were also given Xiaoyao powder. Scores of Hamilton Depression Scale (HAMD), modified Barthel index (MBI) and Scandinavian Stroke Scale (SSS) of all patients were evaluated before and after therapy.ResultsAfter treatment, the effective rate and MBI scores were significantly higher and scores of HAMD and SSS were significantly lower for patients of the treatment group compared with those of the control group (P<0.01).ConclusionXiaoyao powder combined with prozac and psychological therapy can improve depression and neural function of PSD patients significantly.
5.Evaluate the carotid artery stiffness of acquired immune deficiency syndrome patients by ultrasound quantitive artery stiffness technique
Haohui, ZHU ; Jianjun, YUAN ; Yisa, WANG ; Fan, GAO ; Xiao, WANG ; Changhuan, WEI ; Jiyun, CHEN ; Xiaohui, FAN
Chinese Journal of Medical Ultrasound (Electronic Edition) 2015;(7):541-544
Objetive To evaluate the carotid artery stiffness of acquired immune deficiency syndrome (AIDS) and analyze the mechanism and influence factors. Methods Fifty cases of AIDS patients and Fifty healthy people were enrolled in this study according to the principles of randomize and control. Quantitive inter-media thickness (QIMT) and quantitive artery stiffness (QAS) technique were employed to evaluate the inter-media thickness (IMT) and stiffness of right carotid artery. The parameters included IMT, compliance coefficent (CC), stiffness β (β), and pulse wave velocity (PWV). Unpaired t test was used to compare the parameters between two groups, and Pearson correlation analysis was used for linear correlation analysis. Results There were no statistically difference of carotid artery IMT between two groups [(0.569±0.095) mm vs (0.512±0.114) mm, P>0.05]. There was statistically difference of stiffness parameters (CC,β, PWV) between two groups [(0.59±0.21) mm2/kPa vs (1.04±0.41) mm2/kPa, 13.01±6.10 vs 8.14±1.37, (8.70±1.65) m/s vs (6.81±1.37) m/s, all P<0.05]. There was statistically signification association between HIV-infection time and CC,β, PWV ( r value was-0.575, 0.380, 0.417, all P<0.05 ), but there was no association between HIV-infection time and IMT( r value was 0.191, P>0.05 ). There was no statistically signification association between IMT, CC,β, PWV and CD4+, CD8+T cell count (r was 0.000, 0.012,-0.093,-0.097, 0.096, 0.012, 0.056, 0.024, all P>0.05). Conclusion The carotid artery stiffness of AIDS patients is reduced. HIV may play a role in the development of artery stiffness in AIDS patients.
6.Analysis on related factors of axillary lymph node metastasis in patients with cT1-2 N0 breast cancer
Zhushan CUI ; Ye DU ; Zhu ZHU ; Pin GAO ; Jiawei LI ; Zhimin FAN
Journal of Jilin University(Medicine Edition) 2015;(6):1239-1244
Objective To investigate the relationships between axillary lymph node metastasis and clinicopathologic features in the patients with cT1-2 N0 breast cancer and clarify the law of axillary lymph node metastasis,and to find the risk factor,and provide the theoretical basis for individuation therapy.Methods 687 patients with cT1-2 N0 breast cancer were divided into negative group and positive group according to the pathological results of axillary lymph node,and the clinicopathologic features were layered.The risk factors of axillary lymph node metastasis were screened out by Chi-square test and Logistic regression analysis.Results In 687 cases of cT1-2 N0 breast cancer,156 (22.7%)cases were observed with axillary lymph node metastasis. The age,cT stage,pT stage, pathological type,vascular invasion,perineural invasion estrogen receptor (ER),progesterone receptor (PR), and molecular subtyping were the factors that influenced axillary lymph node metastasis in univariate analyses.The age < 35 years, cT2 , invasive ductal carcinoma, vascular invasion positive and Luminal subtyping were the independent risk factors of axillary lymph nodes metastasis in multivariate analyses (r = 3.440,P = 0.010;r =1.770,P =0.007;r = 3.397,P = 0.001;r = 7.434,P = 0.000;r = 2.212,P = 0.015).Conclusion In the patients with cT1-2 N0 breast cancer,the age,cT,pathological type,vascular invasion and molecular subtyping are important predictors of axillary lymph node metastasis and vascular invasion was the most important predictor.The preoperative comprehensive analysis and evaluation of clinical data and preoperative pathological results obtained will help to select the right surgical operation.
7.Comparative study on clinical efficacy of different surgical methods for axillary osmidrosis
Likang ZHANG ; Bin MENG ; Liyu WANG ; Disheng MENG ; Jun LU ; Huagui FAN ; Jiahui FAN ; Lubirou GAO ; Jiangfeng ZHU
Journal of Regional Anatomy and Operative Surgery 2014;(2):172-174
Objective To investigate the most appropriate surgical methods,different surgical modes of osmidrosis and their clinical effi-cacy were observed. Methods Clinical data was collected from 200 cases of axillary osmidrosis from January 2011 to July 2013. These cases were divided into four groups of the traditional group,minimally invasive group,RF pen-frequency electric cautery group and improved curet-tage group. Results The traditional group(80 cases) has an average healing period of 18. 7 days for operative incision including 78 cured cases(97. 5%)and 2 significant improved cases(2. 5%). The minimally invasive group(60 cases)has an average healing time of 8. 6 days, among which there are 3 cured cases(5%),8 significant improved cases(13. 3%),16 improved cases(26. 7%),4 cases(6. 7%)with weak curative effect and 29 failed cases(48. 3%). In the RF pen-frequency electric cautery group(30 cases),there are 5 significant improved ca-ses(16.7%),8improvedcases(26.7%)and17failedcases(56.6%).Theimprovedcurettagegroup(30cases)withanaverageincision healingtimeof9.8dayscontains28curedcases(93.3%)and2significantimprovedcases(6.7%). Conclusion Thetraditionalgroup shows the best curative effect,nevertheless the incision needs a considerably amount of time to recover. The patients under the treatment of minimally invasive surgery or RF pen-frequency electric cautery can recover in short time but recrudescence always occur. The improved cu-rettage method,which is effective and safe,combines the advantages of traditional surgery and minimally invasive surgery. However,large scar left from this method still remains as its major disadvantage but the overall curative effect is satisfactory. The improved curettage is proved to be the most appropriate method for axillary osmidrosis.
8.Screening of the effective cellulose-degradable strain and its application in the production of cellulose bioethanol
Pengfei GAO ; Daidi FAN ; Pei MA ; Yane LUO ; Xiaoxuan MA ; Chenhui ZHU ; Junfeng HUI
Journal of Pharmaceutical Analysis 2009;21(3):184-188
Strains from the cellulose-containing environment were collected. Primary screening(by filter-paper Hutchison solid culture medium and sodium carboxymethylcellulose solid culture medium) and reelection(by filter-paper inorganic salt culture medium and sodium carboxymethylcellulosc Congo red coltnre medium) indicated that five strains obtained were best suited for high performance cellulose degradation. Determination of sodium carboxymethylcellulose activity(CMCA) and filter paper activity(FPA) was accomplished for each of the five. The strongest of the five in CMCA and FPA was applied to the production of cellulose bioethanol by separate hydrolysis and fermentation(SHF) and simultaneous saccharification and fermentation(SSF) respectively.
9.Application of tissue synchronization imaging by real-time thriplane echocardiography in cardiac resynchronization therapy
Changhua WEI ; Yisa WANG ; Haohui ZHU ; Jiyun CHEN ; Fan GAO ; Xuezheng QU ; Jianjun YUAN
Chinese Journal of Ultrasonography 2015;(7):553-557
Objective To investigate the applicable value of tissue synchronization imaging (TSI)by real-time thriplane echocardiography (RT3PE)in cardiac resynchronization therapy (CRT).Methods Twenty-four patients with heart failure scheduled for CRT and 24 healthy controls were enrolled.Two dimensional echocardiography was performed to get the left ventricular internal diameter at end-diastole and end-systole(LVIDd,LVIDs ),left ventricular ejection fraction (LVEF ),velocity time integral of left ventricular outflow tract flow (VTILVOT ).The RT3PE TSI was performed to measure the time to peak systolic velocities(Tp)of left ventricle basal and middle segments(12 segments),software will automatically calculate the maximal difierence (12-Tp-DIF)and standard deviation (12-Tp-SD)of Tp in 12 segment. Identity the segment where wall motion most delay and to guide electrode placement.AV and VV interval optimization were performed under guidance of TSI after 1 month of CRT.Results In before CRT,after CRT,after optimization and control group,LVIDd,Tp,LVIDs,12-Tp-DIF and 12-Tp-SD were decreased in the order,LVEF and VTILVOT were increased in the order.There were significant difference between the groups(all P < 0.05 ).TSI showed that left ventricular systolic dyssynchrony was present in all patients before CRT.The most delay segment and electrode location was consistent.There were close correlation between 12-Tp-DIF and LVEF (r =-0.70,P =0.000),between 12-Tp-SD and LVEF(r =-0.73,P =0.000).Conclusions Left ventricular systolic synchronicity can be evaluated accurately and intuitively using TSI by RT3PE.It has important clinical significance in prospectively select patients for CRT,help to guide electrode placement and to optimize device programming.
10.Changes of retinal vessel quantitative parameters and their correlation with blood pressure in hyperten-sive population
Feng HUANG ; Pengli ZHU ; Fan LIN ; Yin YUAN ; Qiaowei LI ; Zhonghai GAO ; Falin CHEN ; Jiangang HUANG
Chinese Journal of cardiovascular Rehabilitation Medicine 2015;24(5):480-484
Objective:To explore changes of central retinal vascular caliber and fractal dimension (Df) and their cor‐relation with blood pressure in hypertensive population .Methods :A total of 2169 subjects>30 years old were en‐rolled in this cross‐sectional study .They were divided into hypertension group (n=819) and non‐hypertension group (n=1350) .Fundus photos were collected in all subjects ,and semi‐automatic software was used to quantitatively ana‐lyze central retinal vascular caliber and Df ,and they were compared between two groups .Results:Compared with non- hypertension group ,there were significant reductions in central retinal arteriolar equivalent [CRAE ,(135.2 ± 10.72) μm vs .(132.25 ± 11.56) μm] ,central retinal venular equivalent [CRVE ,(184.95 ± 16.29) μm vs . (182.52 ± 17.07)μm] and Df [ (1.38 ± 0.05) vs .(1.34 ± 0.05)] in hypertension group , P<0.01 all .After adjus‐ting for age and gender ,analysis of covariance indicated that CRAE and Df of hypertension group were still signifi‐cantly lower than those of non - hypertension group (P<0.01 both) .Linear correlation analysis indicated that sys‐tolic blood pressure (SBP) ,diastolic blood pressure (DBP) and pulse pressure (PP) were inversely correlated with CRAE and Df ( r= -0.340~ -0.174 , P<0.01 all) .After adjusting for cardiovascular risk factors ,multi‐factor linear regression analysis indicated that CRAE and Df were still inversely correlated with SBP ,DBP and PP (stand‐ardizedβ= -0.190~ -0.134 ,P<0.01 all) .Df of hypertension course >5 years group was significantly lower than that of ≤5 years group [ (1.33 ± 0.05) vs .(1.35 ± 0.05)] , P<0.01. Conclusion:CARE ,Df are significantly in‐versely correlated to SBP ,DBP and PP in hypertensive population ,while correlation of Df is most .