1.Treatment Strategy of Extracranial Carotid Artery Stenosis
Jian ZHU ; Jixiang CHEN ; Daqiao GUO
Chinese Journal of Minimally Invasive Surgery 2014;(11):1005-1007
Objective To discuss the therapeutic method of extracranial athemsclerotic carotid artery stenosis . Methods A retrospective analysis was conducted in 51 patients with angiography confirmed carotid artery stenosis from January 2012 to June 2012 in our hospital.The carotid endarterectomy (CEA) was performed in 16 cases, while the carotid artery stenting (CAS) was performed in 35 cases. Results All the 51 operations were successfully completed .There were 1 case of transient ischemic attack ( TIA) 3 days after CEA operation , 1 case of postoperative stroke after CAS operation , and 1 case of carotid sinus pressure after CAS operation . The follow-up period of all the cases was 9-15 months, with an average of 13.6 months.Ultrasound review of the carotid artery found no restenosis. Conclusion According to medical information of the patients with extracranial carotid atherosclerotic stenosis , we tend to adopt the CAS treatment in patients with following situations: ①transient ischemic attack at least once within 6 months, with symptoms or signs lasting for more than 24 hours and the degree of carotid stenosis ≥70%;②mild than disabling stroke onset at least once within 6 months, with symptoms or signs lasting for more than 24 hours and the degree of carotid stenosis ≥70%; ③carotid artery stenosis ≥2 cm under neck vascular CTA and cerebral angiography .We tend to adopt CEA treatment in patients with following situations:①asymptomatic carotid stenosis with degree ≥70%;②symptomatic carotid stenosis with degree range from 50%to 69%;③asymptomatic carotid artery stenosis with degree <70%, but with instable situation of lesions under angiography or other examinations .
2.The Antagonistic Effect of PGE_1 on TGF?_1 mRNA Expression and Rat Renal Interstitial Fibrosis Induced by Unilateral Ureleral Obstruction
Hong GUO ; Miaozheng ZHU ; Jian DUAN
Journal of Chinese Physician 2001;0(03):-
Objective To explore the possible role of PGE 1 in tubulointerstitial fibrosis formation. Methods Rat model of unilateral ureteral obstruction(UUO) was established.In situ hybridation(ISH) technique, morphological observation and biochemical analysis were applied to determine TGF? 1 mRNA expression, changes of tubulointerstitium and rencortical hydroxyproline content after used PGE 1. Results 3 days after UUO,the rats renal interstitial edema, a number of mononuclear cells recruitment. On day 14,tubule atrophy, interstitial proliferative fibrosis and area enlarged,hydroxyproline content,TGF? 1 mRNA expression increased, the peak value of the latter occurred early than that of hydroxyproline peak value and interstitial area enlargement.PGE 1 could down -regulate these changes.Conclusions The antagenistic effect of PGE 1 on renal interstitial fibrosis may be partly associated with down-regulating overexpression of TGF? 1 mRNA and inhibiting mononuclear cells recruitment.
3.Study on radiation dose caused by 18F-FDG in PET/CT examination
Hai-min, ZHAO ; Jian-guo, ZHU ; Guo-ren, YANG
Chinese Journal of Nuclear Medicine 2008;28(5):347-349
Objective The aim of this study was to investigate the radiation dose caused by 18 F-fluorodeoxyglucose (FDG) in PET/CT examination and to optimize the concerned radiation protection. Methods Thirty patients from our conventional PET/CT examination were simple randomly selected, and they all underwent whole body PET/CT imaging. The radioactive dose of injected 18F-FDG was recorded. The internal radiation dose was calculated and the external radiation dose from patients was measured with the 451P-DE-SI ion chamber survey meter. The staff's dose was recorded with thermoluminescent detector (TLD). All dosimetry data were processed and analyzed statistically with Excel 2003. Results The injected radioactive dose of 18F-FDG was (432.9±51.8) MBq, and effective dose equivalent received per patient was (8.23±0.99) roSy. The correlation coefficient (r) of the dose equivalent rate and distance was-0.994 by power function curve fitting, and that of dose equivalent rate and time was - 0.988 by exponential curve fitting. The staff's dose was lower than the annual dose limit. Conclusions The patient's internal radiation dose caused by 18F-FDG in PET/CT examination is low, nonetheless, the clinician should always consider optimizing and minimizing the necessary radiation received by the patients. The patients having been injected with 18F-FDG should stay in one place to decrease their radiation to the public. From the medical point of view in optimizing radiation exposure, there may still be a potential to lower the injected 18F-FDG activity.
4. Evaluation of Therapeutic Regimens of Biapenem Against Acinetobacter Baumannii Infection in ICU Subjects by Monte Carlo Simulation
Chinese Pharmaceutical Journal 2017;52(24):2218-2222
OBJECTIVE: To provide the basis for biapenem against Acinetobacter baumannii infection in ICU patients in our hospital. METHODS: One hundred-five strains of ABA were collected. The MICs of biapenem against bacteria were measured by double broth dilution method. Four therapeutics regimens (0.3 g, q12 h; 0.3 g, q8 h; 0.3 g, q6 h; 0.6 g, q12 h) in traditional short-time infusion, extended infusion(3, 4h) and two-step infusion(1.5-5.5 h) were simulated by using the Monte Carlo simulation, then the PTAs and CRFs were calculated. RESULTS: CFRs of all treatments of biapenem against ABA infection in ICU subjects were <90%; but for non MDR-ABA, all biapenem regimens' CFR were >90% except biapenem 0.3g, q12 h(0.5 h) and 0.3 g, q12 h (two-step infusion for 1.5h). PTAs of the whole regimens were >90% when MIC≥2 mg·L-1. Extended infusion and two-step infusion got the similar PTAs and CFRs with a similar time when the regimens obtained target, more than short infusion obviously. CONCLUSION: Biapenem alone should avoid for ABA infection as expiry therapy in ICU population in our hospital. Extended infusion and two-step infusion should be priority selection as target therapy according to sensitivity test.
5.Dilated cardiomyopathy in a neonate.
Rong-chang SHAO ; Jian-guo ZHU ; Qiong WANG
Chinese Journal of Pediatrics 2007;45(1):19-19
6.Status, Opportunities and Challenges for the Regulation of Traditional Chinese Medicine (TCM) in Canada
Libin ZHAO ; Jian BAI ; Yonghong ZHU ; Zhixin GUO ; He SUN
International Journal of Traditional Chinese Medicine 2009;31(1):68-70
It has been 4 years since Natural Health Products Regulations(NHPRs)was enforced by Health Canada in January of 2004.In the past time,how will it affect the marketed Traditional Chinese Medicines(TCM) in Canadian market? Recently,The two TCM products Carditionic Pill (Fufang Danshen Diwan)and Chaihu Pill from Tasly have been newly certificated by Health Canada recently.Taking them as examples,this article introduces the current status.opportunities and challenges for the regulation of TCM in Canada.and suggests that the domestic TCM corporations push the product registration as soon as possible.
8.Five years experience of Fournier's gangrene emergency treatment of 12 cases in single centre
Yichen ZHU ; Yuwen GUO ; Lei ZHANG ; Jian ZHANG ; Ye TIAN
International Journal of Surgery 2013;40(11):743-745
Objecitve To conclude the clinical manifestation of Fournier's gangrene (FG) and its emergency treatment.Methods From 2006 to 201 1,12 patient were involved in the study,all had received debridement,wide spectrum antibiotics and support therapy,the clinical manifestation,treatment choice and prognosis were analyzed retrospectively.Results All patients were male with 67.7 year-old mean age.Initial lesions were all in scrotal skin,an average procedures of each patient was 3.5,mean hospitalization days was 29.7 days.Surgical wound was healed by left scrotal skin in all cases,2 cases with huge urethra defect were received perineostomy.Ten cases were survived with 57-months follow-up and mortality was 16.7%.Conclusions Fournier is one of emergency disease of Urology.Its mortality is still high.Intensive care and appropriate anti-biotic therapy combined with surgical treatment is the key of FG's management.
9.The diagnostic value of musculoskeletal ultrasound in gouty arthritis
Yan ZHANG ; Hong ZHANG ; Junhua GUO ; Jian ZHU ; Feng HUANG
Chinese Journal of Internal Medicine 2012;51(4):304-307
Objective To observe the characteristic features of musculoskeletal ultrasound (MSUS) in gouty arthritis (GA) and to assess its value in GA diagnosis.Methods Patients with GA and non-GA who underwent MSUS examination in Chinese PLA General Hospital were enrolled in this study. The synovitis,tenosynovitis,soft tissue swelling,bone erosion,bursitis and ossification were measured by greyscale ultrasound,and the synovial vascularity was measured by power Doppler ultrasound to evaluate the degree of inflammation.Results The ultrasound images of GA were intended to have specific features like tophus,hyperechoic deposition on the surface of the articular hyaline cartilage ( double contour sign ),hyperechoic deposition in the synovium appearing as bright stippled foci,and bright strap in tendons with a significant difference when compared with non-GA group (P < 0.05).The percentage of tenosynovitis and bone erosion in non-GA group was higher than that in the GA group with a significant difference (P <0.05 ). Tophus,double contour sign,bright stippled foci or bright stippled foci in tendons together suggested gout with a specificity of 92.4% and a sensitivity of 60.3%,the AUC of ROC was 0.764 ( P <0.05).Conclusion Tophus,double contour sign,bright foci and bright strap detected by MSUS are of diagnostic value on GA and MSUS may be a promising tool in diagnosing GA.
10.Modified technique of ureteral stent placement during transurethral resection of bladder cancer invading the ureteral orifice
Yuwen GUO ; Zhipeng WANG ; Jian ZHANG ; Lujia ZHANG ; Yichen ZHU
International Journal of Surgery 2017;44(6):400-404
Objective To evaluate the efficacy and safety of modified technique of ureteral stent placement during transurethral resection of bladder tumor.Methods Seventeen patients with muscle invasive bladder cancer invading the ureteral orifice from March 2014 to June 2016 in Beijing Friendship Hospital were randomly divided into two groups.In the modified technique group (group A,n =10),tumor was resected until the ureteral orifice was exposed.Then,a guide wire was placed through the tunnel of Electrode loop and the ureteral stent was placed along the guide wire.In control group (group B,7 cases),after ureteral orifice exposed,the guide wire and ureteral stent was placed with cystoscopy.The demographic,oncological baseline and operative factors were evaluated between two groups.Results There was no difference in tumor grade and maximum diameter between two groups (P > 0.05).The operation time in group A was significantly shorter than that in group B [(39.5 ± 14.8)min vs (59.3 ± 16.2) min,P =0.020],and the intraoperative vision clarity score was better in group A as well [(7.7 ± 1.3) vs (5.9± 1.2),P =0.010].There was no statistical difference between the two groups in the complication.Conclusions The modified technique can improve the efficiency of ureteral stent placement during transurethral resection of bladder tumor without any risk enhancement.