1.Multicenter survey on nurses' knowledge and attitude on common complications among bedridden patients in Chinese hospitals
Jiaqian LI ; Jing CAO ; Jing JIAO ; Zhen LI ; Ge LIU ; Ying LIU ; Fangfang LI ; Xinjuan WU
Chinese Journal of Nursing 2017;52(3):327-331
Objective To investigate the knowledge and attitude of nurses on prevention and intervention of common complications among bedridden patients in Chinese hospitals and to explore the influential factors.Methods It was a cross-sectional study.A total of 3 903 nurses from 6 tertiary hospitals,11 secondary hospitals and 8 primary hospitals from 6 provinces and cities were recruited by convenience sampling and surveyed using selfdesigned questionnaires.Results Nurses' average scoring rate of knowledge and attitude were 73.46% and 85.02%.Level of hospitals,whether in ICU or not,age,working time,educational background,job title,position,employment form were influential factors for nurses' knowledge (P<0.05).Meanwhile,level of hospitals,educational background,position,employment form were influential factors for nurses' attitude (P<0.05).Conclusion Nurses took a positive attitude for prevention and intervention of common complications among bedridden patients,while the level of nurses' knowledge should be improved.
2.Studies on immune-enhancing activity of polysaccharides from Borojoa sorbilis cuter
Ben LI ; Kangsheng LIAO ; Fangfang XU ; Weiying CHEN ; Hong JIAO ; Bo LIU
Chinese Journal of Immunology 2015;(10):1342-1346
Objective:Studies on the immune-enhancing activity of Polysaccharides from the fruits of Borojoa sorbilis cuter ( polysaccharides BSCP) in vivo.Methods:54 male BALB/c mice were randomly divided into six groups.The immune suppression mice in the three experimental groups,which were induced by cyclophosphamide ( CY) at 80 mg/kg/d via intraperitoneal injection, were perfused with 100,200,400 mg/kg/d BSCP for 30 d.The effect of BSCP on cellular immune function,humoral immune function and mononuclear macrophage function were measured.Results:CY-treated mice showed a significant decrease in immune function( P<0.05),humoral immune function(P<0.01) and mononuclear macrophage function(P<0.01).The administration of BSCP was able to overcome the CY-induced immunosuppression,treatment with BSCP-L,BSCP-M and BSCP-H groups significantly enhanced the cellular immune function( each was P<0.05 ) and mononuclear macrophage function ( each was P<0.05 ) , and treatment with BSCP-M and BSCP-H significantly enhanced humoral immune function(each was P<0.01).Conclusion:BSCP could significantly increase immune responses and reduce the side effects of CY in immune system.Therefore,the BSCP could be an immunomodulatory agent.
3.Analysis of the clinical characteristics and treatment of primary gastric choriocarcinoma
Lijie WANG ; Li BAI ; Fangfang JING ; Dan SU ; Ting ZHANG ; Zhiyuan MAO ; Shunchang JIAO
Chinese Journal of Clinical Oncology 2014;(3):189-193
Objective:Primary gastric choriocarcinoma (PGC) is a rare tumor. This study aimed to analyze cases reported in Chi-nese and two cases in our hospital. This study was also conducted to investigate the clinical characteristics and treatment of PGC. Meth-ods:The Chinese Medical Current Contents and China Biology Medicine database was retrieved with the following terms:primary gas-tric choriocarcinoma, stomach choriocarcinoma, and ectopic choriocarcinoma. The clinical data in published literature were retrospec-tively analyzed. Two cases from our hospital were also retrospectively analyzed. Results:A total of 16 patients with PGC (14 case stud-ies and 2 cases from our hospital) were included in this study. The average age of the patients was 57.69 years (ranging from 42 years to 79 years). Among the 16 patients, 4 were females and 12 were males. The main clinical manifestation was abdominal discomfort (12/16). Laboratory and imaging tests were non-specific, but HCG-βin all of the patients increased (11/11). Organ or lymph node metasta-sis was found in 13 patients, including 6 cases in which two or more organs showed metastasis. These organs were primarily the liver, the stomach lymph nodes, the lungs, the brain, and the abdominal cavity. Pathological examination results showed that 12 of the 16 cas-es displayed ulcers with necrosis and hemorrhage. The four remaining cases manifested lesions. Lesions may occur in the stomach less-er curvature (5 cases), stomach sinus (6 cases), cardiac (2 cases), and gastric body (3 cases). The histological components of PGC co-ex-isted with other factors, such as adenocarcinoma (7 cases), adenocarcinoma and squamous (2 cases), adenocarcinoma and a signet ring cell (1 case), or pure choriocarcinoma (6 cases). Surgery combined with chemotherapy was the main treatment. A total of 14 patients un-derwent surgical operations. Among these patients seven underwent chemotherapy after surgery and one underwent chemotherapy. Among the 10 patients who were followed up, 8 died within six months after diagnosis. Conclusion:PGC is a rare stomach cancer with poor prognosis and primarily affects older men. No characteristic clinical manifestations were observed, but HCG-βas a specific serum tumor biomarker increased in all of the affected patients. Histological components co-existed with other stomach cancers. Surgical exci-sion combined with chemotherapy was the preferred treatment in early stages, and systemic chemotherapy was the recommended treat-ment in advanced stages.
4.Design and application of the electronic data capture system in multi-center nursing study
Zhen LI ; Jing JIAO ; Jing CAO ; Ge LIU ; Ying LIU ; Fangfang LI ; Xiaojing ZHANG ; Xinjuan WU
Chinese Journal of Nursing 2017;52(6):730-733
We designed and applied the electronic data capture system (EDC) in order to strengthen the re-search quality and improve the efficiency of data collection of multi-center nursing research. According to the needs of research,we reasonably designed the EDC structure and functions,including data collection,verification, summary and export. Further improvement was performed after EDC was inputted into using. By using EDC,resear-chers from sub-centers completed the data collection smoothly,and the data quality met with research requirements. The design and application of EDC could effectively guarantee the data quality and improve the research efficiency.
5.Imaging manifestations and clinical diagnosis of phosphaturic mesenchymal tumor
Fangfang YAN ; Mengyu CHEN ; Zheyi CHEN ; Mei LI ; Weiwu YAO ; Fengling SHAN ; Qiong JIAO ; Qiang ZHENG
Chinese Journal of Radiology 2018;52(11):858-863
Objective To investigate the clinical and imaging characteristics of phosphaturic mesenchymal tumor and improve the clinical diagnosis. Methods From November 2014 to September 2017, 22 patients with pathologically confirmed diagnosis as phosphaturic mesenchymal tumor (PMT) were retrospectively analyzed, including 12 males and 10 females, age ranged from 30-72 years, mean (47 ± 11) years old. The clinical data, laboratory tests [serum calcium, phosphorus, alkaline phosphatase, parathyroid hormone and 1, 25- (OH) 2 D] and imaging examinations (X-ray, CT, MRI, nuclide) were collected and explored. Sixteen patients underwent SPECT scan and seven underwent PET/CT scan. Twenty patients had X-ray, eighteen patients had CT and 12 patients had MRI with enhancement. Results All patients suffered from diffuse pain for one to fifteen years, especially in lower back and lower extremities. All patients were found with low serum phosphorus, normal serum calcium. Twenty-one patients were found with elevated alkaline phosphatase, 16 with increased parathyroid hormone and 15 with decreased 1, 25 - (OH) 2 D. Thirteen lesions were located in the medullary cavity, seven in the soft tissue and two in the sinuses. Nineteen cases showed varying degrees of trabecular bone sparse, osteoporosis and osteomalacia on X-ray;There were 15 cases of multiple pseudo-fractures, including four cases of pelvic fracture complicated with femoral fracture, six cases of single fracture of pelvis, four cases of femur and one case of fibula. And seven cases showed multiple vertebral compression fractures. Thirteen lesions showed soft-tissue density and four in the medullary cavity showed high density on CT scan. The lesions presented low signal intensity on T1WI,high or low signal intensity on T2WI FLAIR and obviously enhanced in 12 patients who underwent MRI enhancement. Conclusion For patients with decreased serum phosphorus, elevated alkaline phosphatase, bone softening and fracture, octreotide or other nuclides should be primary imaging modality for confirming the location of the lesion. CT and MRI can further evaluate the nature of the lesion and improve diagnostic accuracy.
6.Comparative analysis of the changes of thyroid-stimulating hormone and the flow velocity of superior thyroid artery in the treatment of diffuse toxic goiter and Hashimoto's thyroiditis with methimazole
Jianfen WEI ; Naijun WU ; Minghui CHENG ; Xishuang CHENG ; Jie REN ; Yuqian JIN ; Lijing JIAO ; Fangfang KAN ; Jiaxi SHENG
Clinical Medicine of China 2024;40(2):108-113
Objective:To investigate the changes of thyroid hormones and the flow velocity of superior thyroid artery in patients with Graves' disease and Hashimoto's thyrotoxicosis before and after treatment with methimazole.Methods:A case-control study was conducted to select 45 cases of Graves' disease and 45 cases of Hashimoto's thyroiditis from October 2021 to December 2022 in the Department of Endocrinology, North China University of Science and Technology Affiliated Hospital. The changes of thyroid hormone and blood flow velocity of superior thyroid artery in patients with Graves' disease and Hashimoto's thyroiditis before and after treatment with methimazole were analyzed. Measurement data satisfying normal distribution were expressed by xˉ±s, and the mean between two groups was compared by t test. Measurement data not satisfying normal distribution were expressed by M( Q1, Q3), and the median between two groups was compared by Wilcoxon rank sum test. χ 2 test was used to compare the constituent ratio of enumeration data among groups. Results:There was no significant difference in thyroid stimulating hormone (TSH) between the two groups before treatment, and there was no significant difference in TSH between the two groups after 1 month and 3 months of treatment (all P>0.05). The levels of free triiodothyronine (FT3) were (24.09±9.29) pmol/L and (17.41±9.36) pmol/L in Graves' disease group and Hashimoto's thyroiditis group respectively before treatment. FT4 were (60.23±20.82) and (43.47±21.71) pmol/L, respectively, and the peak stolie vloiy (PSV) were (69.53±5.70) and (52.65±4.64) cm/s, respectively in Graves' disease group and Hashimoto's thyroiditis group respectively before treatment. There were significant differences between the two groups ( t values wrere 3.39 and 3.74, Z=13.83, all P<0.001). The difference of FT3 between one month after treatment and before treatment was (-6.36±5.32) and (-12.64±9.08) pmol/L ( t=4.02, P<0.001) and the difference in FT3 between 3 months of treatment and before treatment was (-10.14±9.50) and (-17.80±11.17) pmol/L, respectively ( t=3.51, P<0.001) between the Graves disease group and the Hashimoto's thyroiditis group. The difference in FT4 between the Graves disease group and the Hashimoto's thyroiditis group after 1 month of treatment and before treatment was (-28.47±10.09) and (-20.57±14.48) pmol/L ( t=7.01, P<0.001), and the difference of FT4 was (-47.06±20.57) and (-30.17±20.54) pmol/L ( t=3.91, P<0.001) between the Graves disease group and the Hashimoto toxin group. The difference between one month after treatment and before treatment was (-13.10(-34.10,-2.60)) and (-10.50(-27.5,-0.20)) cm/s ( Z=2.63, P=0.009), respectively. The difference between 3 months and before treatment was (-31.40(-53.20,-12.70)) and (-19.90(-46.00,-4.70)cm/s ( Z=4.40, P<0.001)) between the Graves disease group and the Hashimoto's thyroiditis group, and the difference was statistically significant. Conclusion:Thyroid hormone levels were decreased after treatment with methimazole in patients with diffuse toxic goiter and Hashimoto toxemia, but the difference was not statistically significant. The PSV level of superior thyroid artery in patients with diffuse toxic goiter was significantly lower than that in patients with Hashimoto's thyrotoxicosis.
7.Photodynamic effects of gold nanostars loading chlorin e6 on lung cancer A549 cells
LI Chenlu ; XIA Fangfang ; ZHANG Amin ; CUI Daxiang
Chinese Journal of Cancer Biotherapy 2018;25(4):394-400
[Abstract] Objective: To prepare GNS (gold nanostars) loading photosensitizer chlorin e6 (Ce6) and to investigate its photodynamic effects on lung cancerA549 cells. Methods: GNS was firstly modified by SH-PEG-NH2 and then mixed with Ce6 and shaken overnight to prepare GNS-PEG@Ce6, which had photodynamic therapy effects. The characterization, morphology and encapsulation rate were detected. The difference between the phagocytosis of Ce6 and GNS-PEG@Ce6 by A549 cells were observed with a Leical TCS SP8 confocal laser scanning microscope. MTT assay was used to examine the inhibitory effect of GNS-PEG@Ce6 on the proliferation of A549 cells while FCM was used to detect the effect of probe GNS-PEG@Ce6 on the apoptosis ofA549 cells. Results: The particle size of the GNS-PEG@Ce6 was about 100 nm. The prepared GNS-PEG@Ce6 nanoparticles exhibited good dispersion and stability and the encapsulation rate of Ce6 was about 50%. GNS-PEG@Ce6 entered the cells by endocytosis and mainly distributed in the cytoplasm; compared with Ce6, GNS-PEG@Ce6 could enter the cells more effectively. The proliferation-suppression effect of GNS-PEG@Ce6 on A549 cells was significantly stronger than that of Ce6 (P<0.05). The results of flow cytometry showed that the probe exhibited strong apoptotic effect on A549 cells. Conclusion: GNS, as the drug carrier, could effectively increase the Ce6 uptake efficacy in A549 cells, thus further enhancing the killing effects of Ce6 on lung cancerA549 cells.
8.Gender and magnetic resonance imaging classification-related differences in clinical and biochemical characteristics of Cushing's disease: a single-centre study.
Yufan CHEN ; Xiaobo MEI ; Fangfang JIAN ; Qinyun MA ; Xiao CHEN ; Liuguan BIAN ; Qingfang SUN
Chinese Medical Journal 2014;127(22):3948-3956
BACKGROUNDCushing's disease (CD) presents a remarkable preponderance in female gender, and a significant minority of patients with CD presented with negative magnetic resonance imaging (MRI) findings. The aim of this study was to evaluate gender-related and MRI classification-related differences in clinical and biochemical characteristics of CD.
METHODSWe retrospectively studied 169 patients with CD, comprising 132 females and 37 males, and 33 patients had no visible adenoma on MRI.
RESULTSWe observed that male and MRI-positive patients presented with high adrenocorticotropic hormone (ACTH) values (P < 0.05). Female patients presented with higher prevalence of hirsutism and hyperpigmentation and lower prevalence of purple striae (P < 0.05). The prevalence of buffalo-hump and hypertension was greater in MRI-negative patients (P < 0.05). In addition, male patients with CD presented at a younger age compared with females (P < 0.05). Patients with fatigue and hypokalaemia presented significantly higher urinary-free cortisol, ACTH and cortisol levels compared with patients without these symptoms (P < 0.05). The prevalence of LH reduction, hyper total cholesterol (TC) and hyper low-density lipoprotein was more frequent in MRI-positive patients (P < 0.05). Hyper-TC levels and PRL reduction were more frequent in males (P < 0.05). T3, T4 and FT3 levels negatively correlated with age at diagnosis (r = -0.310, P < 0.01; r = -0.191, P < 0.05; r = -0.216, P < 0.05). T3, T4, FT3 and FT4 levels significantly negatively correlated with 8-am plasma cortisol levels (r = -0.328, P < 0.01; r = -0.195, P < 0.05; r = -0.333, P < 0.01; r = -0.180, P < 0.05). Females presented higher total protein level (P < 0.01) and lower blood urea nitrogen and serum creatinine levels (P < 0.01), compared with male patients.
CONCLUSIONSCarefulness and caution are required in all patients with CD, because of the complexity of clinical and biochemical characteristics in CD patients of different gender and MRI classification, particularly male patients and MRI-negative patients.
Adolescent ; Adult ; Aged ; Dyslipidemias ; diagnosis ; Female ; Humans ; Hypertension ; diagnosis ; Hypokalemia ; diagnosis ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Pituitary ACTH Hypersecretion ; complications ; diagnosis ; Retrospective Studies ; Sex Factors ; Young Adult
9.Advances in bronchoscopic diagnosis and treatment for peripheral pulmonary lesions
Runchang LI ; Fangfang XIE ; Junxiang CHEN ; Jiayuan SUN
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2023;30(03):470-475
The detection of peripheral pulmonary lesions has increased gradually with the popularity of CT. Rapid and accurate diagnosis, and individualized treatment are two aspects we need to pay great attention to. These situations also raise higher request for the technique in diagnosis and treatment. At present, the commonly used transthoracic methods can increase the risk of complications such as pneumothorax and bleeding. The newly bronchoscopic approaches for diagnosis and treatment make less injury via natural lumen and have been applied widely in clinics. This review will introduce the worth expecting progress in bronchoscopic diagnosis and treatment for peripheral pulmonary lesions.
10. Analysis of pressure-time and flow-time curve in ventilator
Yunzhen WU ; Fangfang JIAO ; Weili LIU ; Fuquan GAO
Chinese Critical Care Medicine 2019;31(12):1491-1496
Objective:
To better understand the significance of the pressure-time curve and flow-time curve from the perspective of PB840 ventilator working principle.
Methods:
① Mechanical principle: flow supply valves (air valve and oxygen valve) and exhalation valve in PB840 ventilator were controlled to achieve the ventilation target (volume or pressure) by the central processing unit according to the monitoring data from pressure sensors (P1 at the supply side, P2 at the exhalation side) and flow sensors (Q1 at the air side, Q2 at the oxygen side, Q3 at the exhalation side). ② The essence of curve: each point means a value of pressure or flow at a certain time measured by the sensors or calculated by the system. ③ The respiratory process could be divided into inspiratory part, expiratory part, and the connection part from expiratory to inspiratory. The air running state and the respiratory mechanics relationship at the three parts could be inferred according to the form of curves.
Results:
① Inspiratory process: at volume-controlled and constant flow ventilation: there should be a relationship "Pc-Pa = XR" between alveolar pressure (Pa) and circuit pressure (Pc) according to Ohm law. So, the Pc curve (pressure-time curve) could indirectly reflect the Pa curve with the flow (X) and resistance (R) being constant. At pressure-set ventilation: it is the goal of ventilator to maintain the Pc at the target level. So, the stability of the target pressure line in pressure-time curve reflects the matching ability of the flow supply valves and the exhalation valve. ② Expiratory process: it could be divided into pre-expiratory [without basic flow (Ba) or bias flow (Bi)] and post-expiratory (with Ba or Bi), where Ba or Bi is equal to "Q1+Q2". So, the mathematical function are "X(t) = Q3t" in pre-part, and "X(t) = Q3t-(Q1t+Q2t)" in post-part. The relationship between pressure and flow at peak expiratory flow point: it could be found that there is an obvious time span and area formation under the curve from 0 to peak point (Fpeak) after stretching the abscissa axis of flow-time curve. It means that some gas have been discharged from the lung when it arrives at the peak point. So, the alveolar pressure should be lower than the platform pressure at the point (Pplat). The circuit pressure is significantly higher than positive end expiratory pressure (PEEP) at the point in the stretching axis diagram. So, it means that the formula "RE = (Pplat-PEEP)/Fpeak" to calculate the expiratory resistance (RE) is unreasonable in the angle of Ohm law. ③ The process from exhalation to inspiratory: according to the difference of the starting point of the conversion, it could be divided into two cases: one is that the inspiratory started from the ending of exhalation. Here, the inhaling starting point is lying in the abscissa axis. The other is that the inspiratory started before the ending of exhalation (with endogenous positive end expiratory pressure). Here, the starting point is lying below the abscissa axis, and the slope of the following curve is obviously larger than the slope of natural expiratory curve. According to the difference of results from the starting point to the end of the inhalation triggering effort, it could be divided into two cases: one is that it reach the trigger point. Here, the expiratory curve extends upward from or below the horizontal axis until an effective air supply is triggered. The other is that it could not reach the trigger point. Here, the expiratory curve extends upward from or below the horizontal axis, but then runs downward (meaning exhaling).
Conclusion
It is helpful to analyze the ventilation state, ventilation failure, and the causes of man-machine confrontation with understanding the ventilation principle and the air route map of the ventilator.