1.Risk factors of contrast-induced nephropathy in the elderly patients with diabetes
Chinese Journal of Geriatrics 2012;31(8):662-665
Objective To understand the clinical feature of the elderly patients with diabetes during coronary angiography,and analyze the risk factors of contrast-induced nephropathy (CIN).Methods The clinical data of 269 elderly patients who had undergone coronary angiography and percutaneous coronary intervention(PCI) from January 2007 to December 2009 in our hospital were analyzed retrospectively.The patients were divided into two groups:CIN group and non-CIN group.The possible risk factors for CIN,such as glycemic control,diabetic complication,renal function,volume of contrast medium,inflammatory state,therapy of perioperative period,past medical history were analyzed and compared between the two groups. Results In 269 elderly patients with diabetes,the incidence of CIN was 9.3 % (25/269).According to estimated glomerular filtration rate (e-GFR),the patients were divided into four subgroup:≥90 ml/min,89-60 ml/min,59-30 ml/min,<29 ml/min.The incidences of CIN for the subgroups were 2.2%(1/45),4.4%(6/135),17.3%(14/81) and 50 % (4/8),respectively.Multivariate logistic gradual regressive analysis showed that loop diuretic use (OR> 6.07),preoperative e-GFR(<60 ml/min) (OR>3.27),volume of contrast medium (≥200ml) (OR>3.26),chronic kidney disease(CKD) (OR>2.80) (P=0.001,0.024,0.015,0.048) were indepen-dent risk factors for CIN (P<0.05). Conclusions Loop diuretic use,preoperative GFR (<60 ml/min),volume of contrast medium (≥200 ml) and CKD are independent risk factors of CIN.
2.Differences in clinical features and risk factors of pulmonary thromboembolism between older and younger patients
Linling CHENG ; Hua WU ; Mengzhang HE
Chinese Journal of Practical Internal Medicine 2006;0(15):-
Objective In order to improve diagnosis of pulmonary thromboembolism(PTE),the clinical features of pulmonary embolism between older and younger patients were compared.Methods Totally 105 patients(57 older and 48 younger)with diagnosed PTE were assessed retrospectively.Results There were more risk factors in the elderly as compared with younger group.Phlebitis was the major risk factor in both groups.Other risk factors,such as COPD,immobilization,malignancy and cardiac disease,were more frequent in the elderly;whereas in younger patients,intravenous drug injection and genetic factors were more frequent.Chest pain and hemoptysis were less frequent in older patients whereas syncope occurred more often in the older group."Triplicate symptoms" (including dyspnea,chest pain and hemoptysis)occurred more often in the younger group.Massive PTE occurred more often in the older patients.Severe complications were more frequent in cTnT-positive patients.Conclusion There are more risk factors in the elderly.The clinical presentation of PTE is often atypical in elderly patients,and prone to develop massive PTE.cTnT(Cardiac troponin T)is an independent predictor of prognostic implications in patients with confirmed PTE.
3.Inspiration for Chinese hospital management as drawn from Japanese ways of hospital management
Guanghua WU ; Hua HE ; Hong ZHU
Chinese Journal of Hospital Administration 1996;0(03):-
Japan has accumulated much mature experience in hospital management, which is worthy of being drawn upon by hospital managers in China. By means of an account of the model of ward rounds by doctors at three levels, the system of academic previews and the system of regular meetings for copying down and reading medical papers in foreign languages in Japanese hospitals and in light of the situation of domestic hospital management, the paper discusses measures for improving the system of ward rounds and scientific research management. The goal is to enhance the medical expertise levels, scientific research capabilities and foreign languages proficiency of medical workers in China so as to deliver better medical and healthcare services to the broad masses of the people.
4.Th17/Treg imbalance in the peripheral blood of patients with psoriasis vulgaris
Rongguo HE ; Shaoguo WU ; Hua TIAN ; Qinxue WU ; Yunxue WU
Chinese Journal of Dermatology 2011;44(6):411-414
Objective To investigate the imbalance between T helper 17 (Th17) cells and CD4+CD25+ regulatory T (Treg) cells in the peripheral blood of patients with psoriasis vulgaris and its significance. Methods Peripheral blood were collected from 48 patients with psoriasis vulgaris and 32 normal human controls. Pasoriasis area and severity index (PASI) was used to assess the disease severity in these patients. Flow cytometry was performed to determine the percentage of Th17 and Treg cells in peripheral blood, enzyme linked immunosorbent assay (ELISA) to measure the levels of serum interleukin (IL) -17 and IL-10. Results There was a significant increase in the percentage of Th17 cells [(2.70 ± 1.43)% vs. (0.86 ± 0.25)%, P< 0.01] and serum IL-17 level (90.65 ± 29.61 ng/L vs. 48.82 ± 5.49 ng/L, P < 0.01), but a decrease in the percentage of Treg cells [(3.63 ± 1.14)% vs. (7.87 ± 1.26)%, P< 0.01] and serum IL-10 level (17.78 ± 4.09 ng/L vs. 23.76 ± 3.82 ng/L, P <0.01) in patients with psoriasis vulgaris compared with the normal controls. The ratios of Thl7 to Treg cells and serum IL-17 to IL-10 level were significantly higher (0.95 ± 0.76 vs. 0.12 ± 0.06, 5.78 ± 3.19 vs. 2.16 ±0.68, both P < 0.01) in the patients than in the normal controls. The PASI score in patients was positively correlated with the percentage of Th17, serum level of IL-17, Th17/Treg ratio and IL-17/IL-10 ratio (r = 0.97,0.93, 0.99 and 0.97, all P < 0.01), but negatively correlated with the percentage of Treg cells and serum IL-10 level (r = -0.87, -0.90, both P < 0.01). Conclusion The imbalance between Th17 and Treg cells may play an important role in the pathogenesis of psoriasis vulgaris.
6.The expression of heparanase in non-melanoma skin cancer and its clinical significance
Rongguo HE ; Dongqi ZOU ; Hua TIAN ; Qingxue WU ; Yunxue WU
Journal of Chinese Physician 2010;12(8):1041-1044
Objective To investigate the expression of heparanase in non-melanoma skin cancer including cutaneous squamous cell carcinoma (CSCC) and basal cell carcinoma (BCC) and the relationship among heparanase expression and pathologic grading and lymph nodes metastasis of CSCC. Methods The expressions of heparanase were detected by RT-PCR assay and immunohistochemical staining in 38 cases of CSCC, 33 BCC and 19 normal human skin tissues. Then the relationship between heparanase expression and CSCC clinical pathological features was explored. Results The positive rate ( 68.4%, 60. 5% ) of heparanase mRNA and heparanase in CSCC (24. 2%, 18. 2% ) was significantly higher than those of BCC and normal skin tissue ( 10. 5% ,5.3% ) ( P <0. 01 ) . Heparanase expression rate in CSCC with lymph nodes metastasis (92. 3% ,84.6% ) and Ⅲ~Ⅳ(Broders) (92. 3% ,84. 6% ) was higher than those in tumor without lymph nodes metastasis (56. 0% ,48.0% ) and Ⅰ~Ⅱ (Broders) (56. 0% ,48. 0% ) ( P <0. 05). Conclusions Heparanase was over-expressed in CSCC compared with BCC and normal skin tissues. Expression of heparanase was correlated to pathologic grade and lymph nodes metastasis of CSCC.
7.The associaion of serum uric acid level with prevalence of non-alcoholic fatty liver in Uyghur and Han ethnicities
Wen CAI ; Fangping HE ; Xuan WU ; Hua YAO
Chinese Journal of Endocrinology and Metabolism 2012;(11):890-894
Objective To explore the association of serum uric acid level with non-alcoholic fatty liver disease(NAFLD) in Han and Uyghur ethnic groups.Methods A cross-sectional study was performed in the population in 2011 in the First Affiliated Hospital of Xinjiang Medical University.The study included 2439 Uyghurs and 2285 Hans with a questionnaire survey,and body mass index (BMI),waist circumference,blood pressure,blood glucose,blood lipid,and serum uric acid (SUA) level were measured.The participants were divided into 4 groups according to the quartiles of the SUA levels within the normal range,and those with SUA levels above the normal range served as hyperuricemia group.The associations between serum uric acid level and prevalence of non-alcoholic fatty liver,hyperuricemia,and metabolic syndrome (MS,including each component of MS) were analyzed.Results Among Uyghurs and Hans,the detection rates of NAFLD were 26.7% and 23.6% respectively,the detection rates of hyperuricemia were 7.8% and 18.2%,and the level of serum uric acid in Uyghur group was lower than that in Han group (P<0.01).The detection rate of NAFLD in the hyperuricemia patients was significantly higher than that in nonhyperuricemia group.Among the Uyghurs and Hans,the detection rates of NAFLD in the hyperuricenia patients were 24.0% and 19.9%.The detection rate of NAFLD was positively associated with concentration of serum acid even that within the normal range.Conclusion The relationship between the level of serum uric acid and the prevalence of NAFLD is more evident in Uyghur than that in Han.
8.Effects of genistein on expressions of jak1 kinase and inteleukin-4 in lung of guinea pigs with bronchial asthma.
Xiu-feng ZHANG ; Zhen-hua HE ; Xiao-wu TAN
Chinese Journal of Applied Physiology 2009;25(3):328-348
Animals
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Asthma
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drug therapy
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metabolism
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Genistein
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pharmacology
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therapeutic use
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Guinea Pigs
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Interleukin-4
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genetics
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metabolism
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Janus Kinase 1
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genetics
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metabolism
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Lung
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metabolism
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Male
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Protein Kinase Inhibitors
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pharmacology
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therapeutic use
9.~(99m)Tc-octreotide scintigraphy and planar X-ray mammography diagnosis of breast cancer
Xiaojiang HE ; Jinxiong HUANG ; Guibing CHEN ; Hao YU ; Hua WU
Chinese Journal of Medical Imaging Technology 2009;25(10):1892-1895
Objective To compare the value of (~99m) Tc-octreotide scintigraphy and planar X-ray mammography in the diagnosis of breast cancer. Methods A total of 32 patients with suspected breast cancer were enrolled into this study. All patients underwent (~99m) Tc-octreotide scintigraphy and planar X-ray mammography. The diagnostic efficiency of (~99m) Tc-octreotide scintigraphy and planar X-ray mammography were compared based on the post-surgery pathology. Results The sensitivity of (~99m) Tc-octreotide scintigraphy and planar X-ray mammography in the diagnosis of breast cancer was 91.67% and 66.67%, the specificity was 100% and 37.50%, the accuracy was 93.75% and 59.38%, respectively. Combining (~99m) Tc-octreotide scintigraphy with planar X-ray mammography, the sensitivity, specificity, accuracy, positive predicting values and negative predicting values for breast cancer was 95.83%, 100%, 96.88%, 82.14% and 47.06%, respectively. Conclusion The diagnostic efficiency of (~99m) Tc-octreotide scintigraphy for breast cancer is superior to planar X-ray mammography. (~99m) Tc-octreotide scintigraphy combined with planar X-ray mammography, the diagnostic efficiency for breast cancer will be further improved.
10.The early effect of treatment in developmental dysplasia of the hip (TonnisⅢ - Ⅵ):one stage open reduction combined with osteotomy for “walking age”children
Hua JIANG ; Xuanzhao WU ; Gang CHEN ; Xiaobo TONG ; Kunfeng HE
Chongqing Medicine 2014;(14):1716-1717
Objective To investigate the clinical results in the treatment of developmental dysplasia of the hip (DDH) with one stage open reduction and Salter or Dega osteotomy for “walking age”children .Methods We retrospectively reviewed 16 patients(16 hips)with unilateral hip dislocation who had undergone one‐stage open reduction and Salter or Dega innominate osteotomy in the the“walking age”children .the results were evaluated clinically by McKay′s classification and radiologically by the modified Severin′s classification .Early signs of osteonecrosis were identified by neck widening ,epiphysis fragmentation ,and presence of a metaphyseal growth disturbance line in the first year after the operation .Results After a follow‐up of one year on average ,good clinical and ra‐diographic results were noted in 87 .5% and 81 .25% of the patients ,respectively .Osteonecrosis occurred in 3 hips(18 .75% ) .Con‐clusion One‐stage open reduction and Salter or Dega osteotomy is an effective treatment for developmental dysplasia of the hip in walking age .