2.Characteristics and risk factors of nosocomial infections in VLBWI
Shan SU ; Jian YANG ; Qun ZHENG ; Yingjun LAI ; Weiyuan WU
Modern Clinical Nursing 2013;(9):31-33,34
Objective To explore the characteristics of nosocomial infection and its related factors among those very low birth weight infant(VLBWI)for coming up with appropriate preventive measures.Methods Fifty-eight infants with birth weight of 1500 g or below in the hospital from January to June in 2012 were studied actively and retrospectively about their nosocomial infection and related risk factors.Results Thirty-five cases of nosocomial infection occurred among the 58 infants with a prevalence of 60.34%. The mainly pathogenic bacteria was Gram-positive bacteria(88.47%)and mostly,infections presented with lung infections(82.90%) within 21 days after birth.The risk factors included mechanical ventilation,PICC,Apga score<7,fluconazole administration and premature rupture of membranes of VLBWI.Conclusion VLBWI are prone to nosocomial infections,mostly lung infection on day 21 after birth.Management should be strengthened within 3 weeks after birth of VLBWI to minimize infections.Reduction of invasive procedures on children and antibiotic use is particularly important.On the other hand,strengthening the health care in the perinatal period and reducing the incidence of preterm birth cannot be ignored.
3.Clinical analysis of subcutaneous panniculitis-like T cell lymphoma misdiagnosed as rheumatic diseases:8 cases report
Qun SHI ; Wenjie ZHENG ; Jian LI ; Yi LIN ; Daobin ZHOU ; Yan ZHAO
Chinese Journal of Internal Medicine 2009;48(12):1019-1022
Objective To investigate the characteristics of subcutaneous panniculitis-like T cell lymphoma ( SPTCL) in order to facilitate prompt identification and proper treatment of this rare and heterogeneous disease entity. Methods For 8 patients who had been misdiagnosed as rheumatic diseases but eventually confirmed as SPTCL though pathology and immunohistochemistry, a retrospective chart review was made with regard to their clinical symptoms, laboratory test results, pathological features, responses to therapy as well as outcomes. Results These 8 patients with a male to female ratio of 1: 1 were initially misdiagnosed as a variety of rheumatic diseases such as erythema nodosa, nodular panniculitis, systemic vasculitis,etc. The period from the onset of symptoms to the confirmation of diagnosis as SPTCL was 28. 6 months on average (range, 4-84 months). All the cases presented with multiple subcutaneous nodules, plaques or tumors which involved various anatomic sites including the head and neck, the trunk, and the extremities. Fever was the most frequently accompanying symptom (7/8) , followed by lymphadenopathy (4/8) , hepatomegaly (3/8), splenomegaly (3/8). Hemophagocytic phenomenon was seen in 3 cases.A total of 22 times of biopsy involving multiple anatomic sites were performed on these 8 cases with 2. 75 times on average (range, 1-5 times). All cases demonstrated a dense lymphoid infiltrate with significant cellular heteromorphism located in the subcutaneous tissue. CD_3 was positive in the majority of the cases.Immunostaining for γδTCR was positive in one case. The anti-rheumatic therapy including steroids and immunosuppressants administered before the identification of SPTCL attained minimal therapeutic effect. In contrast, 6 cases gained partial response after chemotherapy except that the other 2 cases died of fatal pulmonary infiltration and subsequent infection. Conclusions SPTCL is a rare and heterogeneous entity which is unseldomly misdiagnosed as rheumatic disease. The anti-rheumatic therapy including steroids and immunosuppressants can attain minimal therapeutic effect. Early identification by means of histology and immunohistochemistry as well as immunostaining for PCR is critical for proper treatment.
4.Investigation on colorectal polyp recurrence and colonoscopic surveillance after polypectomy
Qinglian ZHONG ; Changjing ZHENG ; Jian HUANG ; Hongmin CHEN ; Jiayu LIN ; Qun HUANG
Journal of Chinese Physician 2016;18(7):1005-1007,1012
Objective To investigate the clinical characteristics and analyze the influencing factors of colorectal polyp recurrence after polypectomy.Methods The clinical data of colorectal polyps patients,who underwent colonoscopic polypectomy in our hospital and received a follow-up colonoscopy within 2 years [mean interval (18.8 ± 8.42) months] were collected between January 2012 and August 2015 (n =194).The polyps size,number,location,and pathology were detected.The polyps recurrence rate and influencing factors were analyzed.Results The polyps recurrence rate was 71.6% (139/194) in 2 years.The patients,who aged ≥60 years,with adenoma number≥3,located in the left hemicolon and rectum,were easier to recurrence (P < 0.05).Logistic regression analysis revealed that age and number of adenomas were independent factors of polyps recurrence whereas the sex,size,location,and pathology were not (P < 0.05)during the surveillance interval.However,19.4% nonneoplastic-polyp group and 15.5% low-risk group turn into bad side.Conclusions The outcomes indicate that age and number of adenomas ≥3 were independent factors of polyps recurrence,whereas the size and pathological type were limited in risk stratification for patients after polypectomy.Two year may be the appropriate interval for endoscopic rescreening.
5.Edge-to-edge chordal transfer repair for anterior leaflet prolapse of mitral valve in 21 patients.
Jian-qun ZHANG ; Li-qun CHI ; Qing-yu KONG ; Si-hong ZHENG ; Wei XIAO
Chinese Medical Journal 2010;123(17):2320-2323
BACKGROUNDRepair of anterior mitral leaflet (AML) prolapse is still a technical challenge for cardiac surgeons. It is an important issue to find a way to repair the AML prolapse with a reliable and reproducible technique.
METHODSBetween January 2002 and June 2009, the operation of chordal transfer based on the "edge-to-edge" technique was performed in 21 patients with serious mitral valve regurgitation because of prolapse of the anterior leaflet. After the operation, echocardiography was performed in each patient before discharge and at the time of follow-up.
RESULTSAll patients survived the operation. One patient required mitral valve replacement because of anterior leaflet perforation 3 days after the operation. The other patients were free from reoperation. At the time of follow-up, all these patients were in New York Heart Association (NYHA) functional class I. In all these patients, pre-discharge and follow-up echocardiography showed neither stenosis nor significant regurgitation of the mitral valve: the cross-sectional area of the mitral valve was 3.3 - 4.8 cm(2) (mean (3.78 ± 0.52) cm(2)), the mean regurgitation area was (0.45 ± 0.22) cm(2). At the same time, both dimension of left atrium and left ventricle reduced significantly (left atrium diameter: pre-operation (48.26 ± 11.12) mm, post-operation (37.57 ± 9.56) mm, P < 0.05; the end-diastolic diameter of the left ventricle: pre-operation (61.43 ± 8.24) mm, post-operation (42.35 ± 10.79) mm, P < 0.01).
CONCLUSION"Edge-to-edge" chordal transfer technique is a simple, reliable, and reproducible technique that can provide good results for repair of anterior leaflet prolapse of mitral valve.
Adolescent ; Adult ; Aged ; Chordae Tendineae ; surgery ; Echocardiography ; Female ; Humans ; Male ; Middle Aged ; Mitral Valve ; surgery ; Mitral Valve Prolapse ; diagnostic imaging ; surgery ; Suture Techniques
6.Serum levels of soluble intercellular adhesion molecule-1 in patients with cerebral infarct.
Shui-Jiang SONG ; Shu-Qun WEN ; Jian-Zheng HUANG
Journal of Zhejiang University. Medical sciences 2003;32(1):56-58
OBJECTIVETo observe the changes of the levels of soluble intercellular adhesion molecule-1(sICAM-1) in serum of patients with cerebral infarct and to explore the effect of sICAM-1 on cerebral infarct.
METHODSThe serum levels of sICAM-1 in 55 patients with cerebral infarct both in acute stage(within 2 days) and convalescence(2 weeks after attack) were detected by using ELISA. At the same time, we compare the results with those of 32 patients having other neurologic diseases(20 patients with sciatica, 12 with trigeminal neuralgia) and 30 healthy subjects.
RESULTS(1) The serum levels of sICAM-1 of patients with cerebral infarct (acute stage: 766+/-179 microgram/L, convalescence: 602+/-155 microgram/L, respectively) were significantly higher than those of the control groups(530+/-77 microgram/L and 521+/-116 microgram/L, respectively, P<0.01). (2)There was a positive correlation of SICAM levels with the amount of leukocytes in acute stage(r=0.285,P<0.05), but negative correlation to clinical severity of cerebral infarct(r= 0.333,P<0.05). And there was no significant correlation between the level of sICAM-1 and the levels of cholesterol and triglyceride in serum(r= 0.042 and r=0.061, respectively, P>0.05). (3)There was no significant difference between sICAM levels of patients of cerebral cortex infarct and those of patients with basal ganglia infarct(773+/-178 microgram/L and 758+/-183 microgram/L, respectively, P>0.05). (4)The levels of sICAM-1 between patients of cerebral infarct with or without hypertension were no significant difference(774+/-189 microgram/L and 754+/-165 microgram/L, respectively, P>0.05).
CONCLUSIONThe levels of sICAM-1 increase significantly in patients with cerebral infarct. sICAM-1 may participate in the pathophysiologic process through inflammatory mechanism.
Aged ; Cerebral Infarction ; blood ; Female ; Humans ; Intercellular Adhesion Molecule-1 ; blood ; physiology ; Leukocyte Count ; Lipids ; blood ; Male ; Middle Aged
7.Progress of studies on medicinal fungus Phellinus.
Wei-Bo ZHANG ; Jia-Guo WANG ; Zheng-Kuo LI ; Li-Qun YANG ; Jian QIN ; Zhong-Huai XIANG ; Hong-Juan CUI
China Journal of Chinese Materia Medica 2014;39(15):2838-2845
The real sanghuang is a new species belonging to the Inonotus, which is commonly used for cancer treatment and human immune system improvement. This review summarized the progress on the studies of Phellinus Quel in recent years, including its taxonomy status, bioactive components, pharmacodynamics, separation and purification technologies. In addition, some related problems and perspectives were also discussed.
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Basidiomycota
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chemistry
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classification
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Medicine, Chinese Traditional
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methods
8.The expression and correlation of VEGF and MMP-2 in rectal carcinoma
Jian-Jun WANG ; Zheng-De ZHU ; Zhi-Su LIU ; Cong-Qing JIANG ; Qun QIAN ; Yu-Feng YUAN ;
Cancer Research and Clinic 2006;0(10):-
Objective To study the expression and the relation of vascular endothelial growth factor (VEGF)and matrix metal proteinase-2(MMP-2)in rectal cancer and evaluate their roles in rectal carcinogen- esis and development.Methods The expression of VEGF and MMP-2 in 52 cases of rectal cancer was de- tected by immunohistochemical SP technique.12 cases normal rectal tissue served as the control group.Re- suits The expression of VEGF in rectal carcinoma(67.3 %)was much higher than that in control group(P
9.Short - and long -term efficacies of microvascular decompression on elderly patients with constitutional hemifacial spasm
Zhe CHEN ; Ting-Kai LIN ; Jian-Qun ZHENG
Chinese Journal of Neuromedicine 2011;10(7):728-730
Objective To investigate the efficacy of microvascular decompression on elderly patients with constitutional hemifacial spasm (HFS) in short- and long-terms. Methods Eighty-six elderly patients with HFS and 430 non-elderly patients with HFS, admitted to our hospital from June 2000 to June 2005, were selected in our study; their clinical data were retrospectively analyzed and their shortand long-term efficacies were compared. Results The total effective rate was not significantly different between elderly patients (96.6%, 81/86) and non-elderly group (97.9%, 421/430, P>0.05). Early complications appeared in 12.8% of the elderly patients (11/86) and 9.1% of the non-elderly group (39/430); no obvious difference was noted between the 2 groups (P>0.05). The recurrence rate in elderly group was 2.3% (2/86) and non-elderly group was 1.1% (5/430); no obvious difference was noted between the 2 groups (P>0.05). Rate of long-term complications in elderly group was 12.8% (11/86), and that of non-elderly group was 9.1% (39/430); no obvious difference was noted between the 2 groups (P>0.05). Conclusion The short- and long-term efficacies of microvascular decompression on HFS were equivalent between elderly and non-elderly patients; although several negative factors might cause surgical difficulty and increased risk in the elderly patients, as long as appropriate measures and skills are taken, the efficacy and safety of the surgery can be ensured.
10.Radical cystectomy in patients with pathological non-muscle invasive bladder cancer
Han HAO ; Xiaohong SU ; Wei ZHENG ; Peng GE ; Qun HE ; Qi SHEN ; Xinyu YANG ; Zheng ZHANG ; Xuesong LI ; Jian LIN ; Liqun ZHOU
Journal of Peking University(Health Sciences) 2016;48(4):627-631
Objective:Carcinoma of bladder is the most common malignancy in the urinary system in China.Most patients with this disease had non-muscle invasive bladder cancer (NMIBC)at the time of diagnosis.Radical cystectomy was indicated for patients with high risk or refractory NMIBC.We aimed to investigate the overall survival and disease-specific survival and related influence factors in patients un-dergoing radical cystectomy for pathological non-muscle invasive bladder cancer.Methods:From Jan. 2006 to Dec.2012,a total of 164 patients with pathological non-muscle invasive bladder cancer under-went radical cystectomy in Peking University First Hospital.Clinical data were retrospectively collected. Incidence of lymph node metastasis and disease recurrence were calculated.The risk factors of disease re-currence were analyzed.Kaplan-Meier plots were used to estimate the overall survival and cancer-specific survival.Multivariate Cox regression analysis was used to evaluate the prognostic factors for survival.Re-sults:Of all the patients included,159 had T1 disease,and 5 had CIS only.The median follow-up dura-tion was 46.5 months (range:7 -99 months).Fourteen patients were lost during the follow-up.Lymph node metastasis was noted in 6 patients (3.7%),4 patients had N1 disease,one patient had N2 di-sease,and one patient had N3 disease.Disease recurrence occurred in 16 patients (9.8%).The most common recurrence sites were the liver,bones,and lungs.The 5-year overall survival and disease-spe-cific survival for all the patients were 85% and 91%,respectively.The patients who underwent pelvic lymph node dissection showed a better prognosis in terms of disease-specific survival than those without (P =0.012).Patients with recurrence harbored a significant poorer survival (P <0.001).According to univariate Cox regression analysis,whether lymph node dissection was performed was an independent risk factor of disease recurrence (P =0.050,OR =2.695,95%CI 0.999 -7.271).In COX regression mo-del,age (P =0.008,OR =1.071,95%CI 1.018 -1.126)and whether lymph node dissection was performed (P =0.011,OR =3.385,95%CI 1.329 -8.621)were related to disease-specific survival. Conclusion:Patients with pathological non-muscle invasive bladder cancer underwent early radical cys-tectomy have a favorable prognosis,and bilateral pelvic lymph node dissection is essential for this proce-dure as it gains a survival benefit for the patients.