1.Risk factors and outcomes of patients with acute renal injury after intra-coronarystent implantation
Fei HE ; Jun ZHANG ; Zhongqiu LU ; Qingling GAO ; Dujuan SHA ; Guofeng FAN ; Ligang PEI
Chinese Journal of Emergency Medicine 2012;21(5):514-518
Objective To investigate the risk factors and outcomes of acute kidney injury (AKI) in patients after intra--coronary stent implantation.Methods A retrospective and case control study was done with data analysis in 325 patients who underwent intra-coronary stent implantation from January 2010 to March 2011.The patients were divided into two groups as per the criteria of AKI identified on the 7th day after implantation of stent.The variables to be studied included:(1) age,gender,hypertension,diabetes,cerebrovascular disease,left ventricular insufficiency,peripheral angiopathy,creatinine,urea nitrogen,estimated glomerular filtration rate,hyperuricemia,proteinuria,emergency operation,hydration,and medication (ACEI/ARB,statins) before operation; (2) dose of contrast media,operation time,hypotension during intra-operative period; and (3) postoperative:hypotension.The variables were analyzed with the process of One-way ANOVA and multivariate Logistical regression analysis.Consequently,the independent risk factors of AKI in patients after intra-coronary stent implantation could be found.Further,the prognosis of AKI patients was analyzed.Results Of the 325 patients,51 (15.7%) developed AKI.Compared the normal group,hospital stay (P < 0.01 ) and in-hospital mortality (P < 0.05) increased significantly in the AKI group.Monofactorial analysis showed that age,pre-operative laboratory and clinical data including left ventricular insufficiency,peripheral angiopathy,creatinine,urea nitrogen,estimated glomerular filtration rate, hyperuricemia, proteinuria, hydration and emergency operation, and intraoperative information such as operation time and hypotension,and postoperative hypotension in AKI patients group were significantly different in comparison with control group ( P < 0.05 ). Multivariate logistic regression analysis revealed that elderly age (OR =0.253),pre-operative proteinuria (OR =5.351 ),preoperative left ventricular insufficiency ( OR =8.704),eGFR ≤ 60 ml/ ( min · 1.73 m2 ) ( OR =6.677 ),prolonged operation time ( OR =1.017),intra-operative hypotension ( OR =25.245 ) were independent risk factors of AKI ( P < 0.05 ).Conclusions AKI is a common complication and associated with increase in mortality after intra-coronary stent implantation.Increase in age,pre-operative proteinuria,pre-operative left ventricular insufficiency,pre-operative low estimated glomerular filtration rate,prolonged operation time,intra-operative hypotension are the independently risk factors associated with AKI.
2.A comparative study of 99Tcm N-mercaptopyridine-N-oxide and 99Tcm-sestamibi myocardial perfusion imaging on acute myocardial infarction canine model
Fei SHA ; Xiaofei WEN ; Lihong BU ; Renfei LI ; Tong ZHANG ; Zhongnan JIN ; Baozhong SHEN
Chinese Journal of Radiology 2011;45(4):392-398
Objective The purpose of the present study is to compare the pharmacokinetic and biodistribution properties of 99Tcm N-mercaptopyridine-N-oxide (99 Tcm N-MPO) with 99 Tcm-sestamibi (99 Tcm-MIBI) in normal dogs, and to investigate the potential of 99TcmN-MPO as a myocardial perfusion agent in canines with acute myocardial infarction. Methods Twelve healthy mongrel dogs were injected intravenously with 99TcmN-MPO (n = 6) or 99Tcm-MIBI (n = 6). Tracer kinetics in body fluids were determined by collecting blood of 1 ml via a femoral vein catheter at 30 s, 1,2,3,4,5, 10, 20, 30, 40, 60and 90 min post-injection (p. i.). The collected blood samples were weighed and counted for radioactivity in a γ-counter. Anterior and posterior planar γ-camera images were collected at 10, 20, 30, 60, 90, and 120 min after injection, with organ uptake quantified by region-of-interest (ROIs) analysis. For comparison, 99Tcm-MIBI was also evaluated in the same twelve dogs. Canine infarct models were set up by micro-invasive interventional embolization. SPECT images in the canine infarct model were collected 24 hours after myocardial infarction at 30 min and 60 min after the administration of 99Tcm N-MPO (n = 5) or 99Tcm-MIBI (n = 5). Results Both of 99Tcm N-MPO and 99Tcm-M1BI had a rapid blood clearance with less than 50% of initial radioactivity remaining at 1 min [99TcmN-MPO: (35. 77 ± 6. 31)% ID/mg ,99Tcm-MIBI (34. 46 ± 6. 83) % ID/mg] and less than 5% at 30 min p. i. [99Tcm N-MPO(3. 11 ± 1.44) % ID/mg,99Tcm-MIBI (2.93 ±0. 39)% ID/mg] . After injection, 99TcmN-MPO showed significant accumulation in the myocardium and prolonged retention. This rapid liver clearance of 99TcmN-MPO led to favorable heart-to-liver ratios, reaching values of 0. 54 ±0. 06 at 10 min, 1.02 ±0. 06 at 30 min, and 1.38 ±0. 06 at 60 min p. i.In contrast, the heart/liver ratio of 99Tcm-MIBI remained low at all time points (0. 46 ± 0. 03 at 10 min,0. 63 ±0. 03 at 30 min, and 0. 62 ± 0. 12 at 60 min p. i.). SPECT imaging studies in canines with acute myocardial infarction indicated that good visualization of the left ventricular wall and perfusion defects could be achieved at 30 min after administration of 99TcmN-MPO, but not 99Tcm-MIBI. Conclusion The combination of high heart uptake and rapid liver clearance makes 99TcmN-MPO a promising new radiotracer for myocardial perfusion imaging.
4.Clinical analysis of neovascular glaucoma after vitrectomy in patients with diabetic retinopathy
International Eye Science 2018;18(10):1909-1911
AIM: To explore the factors and analyze the occurrence of neovascular glaucoma(NVG)after vitrectomy for proliferative diabetic retinopathy(PDR).
METHODS:Retrospective analysis on the clinical materials from January 2013 to December 2017, including 233 PDR patients(237 eyes)treated with vitrectomy in which 20 patients(20 eyes)occurred NVG after vitrectomy surgeries. The factors might lead to NVG were investigated.
RESULTS: Totally 20 patients(20 eyes)developed NVG, in which there were 12 eyes combined with cataract surgeries, of the 12 eyes, 6 eyes had posterior lens capsule deficiency; 14 eyes complicated with hypertensions; 16 eyes complicated with hyperlipoidemia; 6 eyes had reoperations of vitrectomy surgeries; 2 eyes were silicone oil-filled eyes or silicone oil-removed eyes. There were correlations between the combinations of the cataract surgeries, posterior lens capsule deficiency, and vitrectomy with the occurrences of NVG after PDR surgeries; vitreous silicone oil filling might inhibit the occurrence of NVG to a certain extent. There was no statistical significance in hypertensions, high plasma lipids and reoperations of vitrectomy surgery for occurrence of NVG after PDR surgery.
CONCLUSION: There is positive significance in correctly grasping the timing of lens surgery, and properly selecting the vitreous cavity filler.
5.Combined anti-tumor therapeutic effect of targeted gene, hyperthermia, radionuclide brachytherapy in breast carcinoma
Dao-zhen, CHEN ; Qiu-sha, TANG ; Jing-ying, XIANG ; Fei, XU ; Li, ZHANG ; Jun-feng, WANG
Chinese Journal of Nuclear Medicine 2011;31(2):82-86
Objective To investigate the antitumor therapeutic effect of combined therapy of magnetic induction heating by nano-magnetic particles, herpes simplex virus thymidine kinase gene(HSV-tk suicide gene) and internal radiation in mice bearing MCF-7 breast carcinoma. Methods The transfection reagents, plasmids heat shock protein-HSV-tk (pHSP-HSV-tk), ferroso-ferric oxide nano-magnetic fluid flow and 188Re-ganciclovir-bovine serum albumin-nanopaticles (GCV-BSA-NP) were prepared. The heating experiments in vivo were carried out using ferroso-ferric oxide nano-magnetic fluid flow. Sixty mice tumor models bearing MCF-7 breast carcinoma were established and randomly divided into six groups. Group A was the control group, B was gene transfection therapy group, C was hyperthermia group, D was gene transfection therapy combined with radionuclide brachytherapy group, E was gene therapy combined with hyperthermia group, and F was gene therapy, hyperthermia combined with radionuclide brachytherapy group. The tumor growth, tumor mass and histopathological changes were evaluated. The expression of HSV-tk in the groups of B, D, E and F was detected by RT-PCR. Poisson distribution and one-way analysis of variance (ANOVA) were used for statistical analysis by SPSS 10.0 software. Results In the animal heating experiments, the temperature of tumor increased up to 39.6 ℃, 43.2 ℃, and 48.1 ℃ quickly with different injected doses (2, 4 and 6 mg respectively) of nano-magnetic particles and maintained for 40 min. The temperature of tumor tissue reduced to 36.8 ℃, 37.5 ℃ and 37.8 ℃ in 10 min when alternating magnetic field (AMF) stopped. The tumor mass in Groups C ((452.50 ±30.29) mg), D ((240.98 ±35.32)mg), E((231.87 ±27.41) mg) and F ((141.55 ±23.78) mg) were much lower than that in Group A ((719.12±22.65) mg) (F=800.07, P<0. 01), with the most significant treatment effect in Group F.The tumor mass in Group B((684.05 ±24.02) mg) was higher than that in Group D (t =32. 805, P <0. 05). Semi-quantitative RT-PCR analysis showed that the expression of HSV-tk in Groups B and D (0.33 ±0. 13 and 0. 46 ±0.12) was significantly different from that in Groups E and F (0.66 ±0.13 and 0.74 ±0. 11)(F = 21. 573, P < 0.05). Conclusion Combined use of hyperthermia, gene therapy and radionuclide brachytherapy could effectively depress the growth of MCF-7 breast carcinoma, thus possessing treatment potential for this tumor.
6.Clinical evaluation of low vision and central foveal thickness in highly myopic cataract eyes after phacoemulsification
Ji-Li, CHEN ; Ting-Yi, CAO ; Fei-Ping, XU ; Sha-Sha, WANG ; Yu, ZHANG ; Xiao-Ling, XIE ; Wen-Xia, CHEN ; Ce, ZHENG
International Eye Science 2015;(7):1242-1244
measured by OCT 1 and 3mo after surgery. Chi-square test was used to compare preoperative and postoperative BCVA. Pearsion’s correlation was used to evaluate relationship between postoperative BCVA and central foveal thickness.RESULTS:The ratio of BCVA<0. 05 was 30%,14%, 11%and 7% respectively for per-operation, 1wk, 1 and 3mo post - operation. After surgery, the central foveal thickness was significantly increased in group with BCVA<0. 3 comparing to group with BCVA≥0. 3. Three month post-operation, central foveal thickness was significantly decreased in both groups comparing to that in 1mo post-operation (P<0. 01). There has significant correlation between 3mo postoperative BCVA and central foveal thickness (r=-0.716, P<0.05).CONCLUSlON: ln this study, BCVA is improved after 3mo follow up. There has significant correlation between postoperative BCVA and central foveal thickness.
7.Medical rescue action for large number of the sick and wounded in maritime disaster at sea
Peizeng XIE ; Xianbin WANG ; Xiao BAI ; Fei SONG ; Dajun CHEN ; Jian LIU ; Yu LIN ; Jianping SHA ; Hongsheng ZHU ; Hui ZHU
Chinese Journal of Emergency Medicine 2010;19(11):1140-1142
Objective To investigate the effect of medical rescue of the Maritime Medical Team (Corps) for mass sick and wounded in maritime disaster so as to improve the medical rescue capacity for maritime disasters.Method The construction of maritime medical teams (corps) constituted with various numbers of 10, 15,50 and 120 team members, and the development of algorithm in practice were reviewed. In 68 maritime disasters from January 2003 to December 2009, 937 wounded were rescued by first-aid at sea. The patients were classified and given cardiopulmonary cerebral resuscitation, emergency operation, complication prevention, comprehensive treatment for seawater immersion wound and rapidly referred to hospitals. Results Of 937 patients, 872 survived (93%) and 65 died (7%). Of the dead, 16 died in one hour (25%), 43 died in 24 hours after injury (66%),andofthem, 61died of trauma (94% ) , 2 died of drowning and 1 died of poisoning. Conclusions Besides a good command of the features of mass sick and wounded, organization and program, treatment strategies and measures, the timely and effective assignment for on-site first aid at sea and safe transfer were very important for medical rescue of mass patients in maritime disaster. After the practice of maritime medical team (corps) in medical rescue during maritime disaster, the rapid response capability, cooperation and the quality of rescue were improved, and the experience of medical service of marine medical team (corps) was enriched.
9.Mechanism of ultrasound-mediated microbubbles enhancing homing effect of transplanted mesenchymal stem cells
Jian QIAN ; Fei CHEN ; Guofeng FAN ; Dujuan SHA ; Luna WANG ; Qiming LI ; Hao MA ; Yibing CHEN ; Jun ZHANG
Chinese Journal of Tissue Engineering Research 2014;(45):7294-7298
BACKGROUND:Animal studies have indicated ultrasound-mediated microbubbles can significantly enhance the effect of stem cel transplantation to treat ischemic diseases. But its mechanism is stil unknown.
OBJECTIVE:To explore the mechanism of ultrasound-mediated microbubbles to significantly enhance the effect of stem cel transplantation in the treatment of ischemic diseases.
METHODS:Bone marrow mesenchymal stem cel s and vascular endothelial cel s of rats were cultured in vitro, and then randomized to three groups:control group with no intervention, ultrasound group exposed to ultrasound at 1 MHz, 1 W/cm2 for 90 seconds, and ultrasound-mediated microbubble group treated with 5μL liposomes ultrasound microbubbles containing fluorocarbon gases (about 2×1011/L) and ultrasound exposure at 1 MHz, 1 W/cm2 for 90 seconds.
RESULTS AND CONCLUSION:Compared to the control group, ultrasound-mediated microbubbles significantly increased expressions of vascular endothelial growth factor and stromal cel-derived factor 1 in the supernatant of
vascular endothelial cel s (P<0.05);ultrasound had no effect on the expression of vascular endothelial growth factor, but decreased the level of stromal cel-derived factor 1 (P<0.01). Ultrasound-mediated microbubbles and the ultrasound alone could significantly enhance the CXCR4 gene expression in bone marrow mesenchymal stem cel s as compared with the control group (P<0.01), but there was no difference between the ultrasound-mediated microbubble group and the ultrasound group (P>0.05). These findings suggest that 1 W/cm2 ultrasound-mediated microbubbles can promote vascular endothelial growth factor and stromal cel-derived factor 1 secretion by vascular endothelia cel s, and meanwhile promote CXCR4 gene expression in bone marrow mesenchymal stem cel s. This may be the mechanism of the ultrasound-mediated microbubbles enhancing homing effect of transplanted stem cel s.
10.Photosensitive resin used for 3D printing and its application in dentistry
Li-Sha ZHU ; Yu-Ming CHEN ; He-Fei LI ; Hong KANG
Chinese Journal of Tissue Engineering Research 2018;22(6):979-984
BACKGROUND:Nowadays,digitalization has become a major trend in the field of dentistry.It is highly important to apply 3D printing technology with the material of photosensitive resin to orthodontics,prosthodontics and so on.OBJECTIVE:To review the composition of photosensitive resin for 3D printing and its main commercial series,and to discuss about applications and prospects of photosensitive resin in the field of dentistry.METHODS:Using "3D printing,digitalization,photosensitive resin,dentistry" as key words in English and Chinese,the authors seareched the database PubMed and CNKI,respectively,for articles addressing the development of 3D printing technology,classification and composition of photosensitive resin as well as the progress and application of photosensitive resin in the field of dentistry over the past 15 years (1991-2016).RESULTS AND CONCLUSION:Because of achieving the visualization of data,having advantages such as personalized design printing,fast small batch production,efficient and free molding manufacturing and being easy to manufacture complex modeling products,3D printing technology has been developed rapidly in various areas.Light-curing rapid prototyping technology (Stereo Lithigraphy Apparatus,SLA),based on photosensitive resin,is one of the most widely used technological processes of 3D printing.Photosensitive resin for 3D printing can be classified by composition and the main commercial series.At present,the development of photosensitive resin for 3D printing meets the demand of personalized design in the field of dentistry.It has been developed rapidly in orthodontics,prosthodontics,oral implantology,and oral internal medicine.It can be used in fixed denture,implanted surgical guide,base for removable denture and fused model manufacture.With the continuous expansion of the types of materials and improvement of material performance,digital dentistry will become a major trend in the future.