1.Influence of tanshinone Ⅱ A on the expression of HMGB1 in rats with cerebral ischemia reperfusion injury
Meiqi ZHANG ; Changlin ZHAI ; Jianfeng TU ; Xianghong YANC
Chinese Journal of Emergency Medicine 2012;21(6):626-630
ObjectiveTo investigate the influence of Tanshinone Ⅱ A on the expression of HMGB1 in rats with cerebral ischemia-reperfusion (I/R) injury and its neural function protection.MethodsThe 32 male SD rats were randomly (random number) divided into 4 groups (8 rats per group):Sham group,I/R group,group with low dose of Tanshinone Ⅱ A ( TaLD group) and group with high dose of Tanshinone Ⅱ A (TaHD group).The cerebral I/R models were established by the method of right middle cerebral artery occlusion (MCAO).Cerebral infarct volume was detected by TTC staining.Apoptotic cell and apoptotic index were calculated by Tunnel assay.The HMGB1 levels in brain and serum was detected by Western blot and ELISA.Calmodulin (CaM) activity and malondialdehyde (malondiadehyde,MDA) content in the brain were also detected.ResultsCompared with the Sham group,the volume of cerebral infarction,the number of apoptotic cells,CaM activity,MDA content,HMGB1 levels in the brain tissue and serum in group I/R,TaLD group and TaHD group increased significantly (P < 0.01 ).Compared with the group I/R,the volume of cerebral infarction,the number of apoptotic cells,CaM activity,MDA content and the HMGB1 levels in brain tissue and serum in TaLD groupand TaHDgroup decreased significantly (P < 0.01 ).The difference of the above index between TaLD groupand TaHDgroup was significant ( P < 0.01 ).ConclusionsTan Ⅱ A could reduce the cerebral ischemic reperfusion injury in rats which was likely related with decreasing the inflammatory response in the late stage via HMGB1.
2.Treatment of hair apposition technique with tissue glue on scalp lacerations
Wenwei CAI ; Yueliang ZHENG ; Xin CHEN ; Haifei HE ; Jianfeng TU
Chinese Journal of Emergency Medicine 2008;17(6):638-641
Objective To treat scalp lacerations by using the hair apposition technique (HAT) and to compare the HAT with standard suturing in a controlled prospective trial. Method Fifty patients with scalp lacerations were treated either by HAT or by standard suturing. Two groups were evaluated in consumed times for operation, pain sores, and complications. Results There were 30 HAT patients and 20 patients treated with suturing. The took shorter operation time consumed[(3.33 vs. (6.05 t = 4.85.P < 0.01], and HAT produced significantly lower pain score [(1.73vs. (3.20t = 4.01,P < 0.01]. There was a trend that more and more patients were willing to have HAT performed. Conclusions The advantages of HAT include a shorter time consumed for operation, less pain, satisfactory wound healing, and high acceptance by patients. HAT is acceptable for treating scalp lacerations in emergency room.
3.Clinical study of methods used for evaluating the severity of patients with acute pancreatitis causedby hyperlipidemia
Jianfeng TU ; Yue YANG ; Shengang ZHOU ; Yueliang ZHENG ; Hanqing HE ; Wenwei CAI
Chinese Journal of Emergency Medicine 2012;21(2):198-201
Objective To investigate the methods used for evaluating the severity of the patients with acute pancreatitis induced by hyperlipidemia in order to find out some simple and practical biomarkers for predicting the severity of the illness.Methods Sixty-two patients with acute pancreatitis resulted from hyperlipidemia were selected from the in-patients of our hospital from January 2007 to July 2011 and were divided into two groups,namely the mild acute pancreatitis group(MAP,n =32)and the severe acute pancreatitis group(SAP,n =30)as per the Chinese Acute Pancreatitis Guideline.Two groups were comparable verified by the test of homogeneity of variance after grouping.Arterial blood gas analyses were done immediately after admission:Venous blood was taken from forearm for determining renal function and blood coagulation at 6 o'lock of next day after admission.The data of base excess(BE),creatinine(CR),C-reactive protein(CRP),fibrin(FIB)and D-Dmmer(D-D)were documented.The contrast CT imaging of pancreas was done within 48 hours after admission in all patients.APACHE Ⅱ scores and computed tomography severity index(CTSI)were calculated.The differences in BE,CR,CRP,FIB and D-D between 2 groups were analyzed by using t-test,and the correlation among them and APACHE Ⅱ score and CTSI were analyzed by Spearman test done with SPSS 18.0 software.As BE <-4.5 mnol/L,CR > 120μmol/L,CRP > 100 mg/L,FIB >5.5 g/L and D-D 800 ng/L were set respectively as a positive screening criterion,positive prediction value(PPV),negative prediction value(NPV),sensitivity and specificity of each marker and combined markers were calculated after they were set at different positive scales in order to get the optimal predictors for evaluating the severity of acute pancreatitis induced by hyperlipidemia.Results The absolute values of BE,CR,CRP,FIB and D-D in group SAP were much higher than those in group MAP(P < 0.01).Each of them had good correlation with APACHE Ⅱ score and CTSI,especially BE and D-D more significant.Each of them used separately for predicting the severity of acute pancreatitis showed PPV and NPV with high specificity but the sensitivity was hot high.The joint use of BE,CR and CRP,and joint use of FIB and D-D could be more valid as PPV and NPV with high specificity for predicting the severity of acute pancreatitis,but the sensitivity decreased.Conclusions BE,CR,CRP,FIB and D-D were good biomarkers for quickly and accurately evaluating and predicting the severity of the acute pancreatitis caused by hyperlipidemia.
4.Analysis of ZHOU Zhong-ying’effective combination drugs in preventing and teeating systemic lupus erythematosus by association rules based on Chi-squared analysis and influence degree
Wenlin LI ; Qiang TU ; Lizhong GUO ; Diping CHEN ; Jianfeng LU ; Qin LIU
China Journal of Traditional Chinese Medicine and Pharmacy 2006;0(09):-
Objective:To analyse ZHOU Zhong-ying’effective combination drugs in preventing and treating the systemic lupus erythematosus(SLE).Methods:Association rules based on Chi-squared analysis and influence degree was used.Results:73 Rules of TCM couples were selected in the high frequency drugs distribution,and the drugs were mainly those for heat clearing,antidote medicines and blood act stasis remove medicines,which was in accordance with the main pathological mechanism factor for SLE given by Professor Zhou.Conclusion:The new method could find out many significant TCM couples in the study of the compatibility of TCM.
5.Practice and strategy considerations for hospital talents introduction
Jianfeng TU ; Yaping ZHANG ; Yue YANG ; Zhiming HU ; Dongsheng HUANG
Chinese Journal of Hospital Administration 2018;34(1):44-47
The paper probed into key challenges in talents introduction of hospitals ,especially introduction strategy and practical considerations.In its"MVPPS"(Money ,Value ,Platform ,Promise , Service)theory framework ,V(value)is the core ,and P(platform)is the key ,while P(promise)and M (money ,remuneration)are the cornerstone.The hospital can attract excellent talents by means of common value ,reasonable material conditions ,ideal development platform and service ,and promises fulfilled ,thus achieving fast disciplines development .
6.Safety and efficacy of tirofiban in elderly patients with acute coronary syndrome
Shenghu HE ; Bin YUAN ; Shu CHEN ; Yi ZHANG ; Jing ZHANG ; Jianfeng YAN ; Yong XIE ; Xiaodong LIU ; Lei SUN ; Rixin XU ; Xiang GU ; Lili TU ; Genshan MA
Chinese Journal of Emergency Medicine 2009;18(8):826-830
ObjectiveTo evaluate the safety and efficacy of firofiban in gerontal patients with acute coronary syndrome(ACS). MethodA total of 106 elderly patients with ACS admitted form December 2006 to June 2008 were enrolled in a prospective case-control study. Patients were divided into percutaneous coronary intervention (PCI) group and medicine group. Both groups were randomly divided into two sub-groups, tirofiban sub-group and placebo sub-group. Patients in the PCI group received tirofiban infused in dose of 10 μg·kg- within 3 minutes as loading dose before operation and then an infusion of 0.15μg'kg-1·min-1 as maintenance dose for 24~36 hours. In medicine group,the loading dose was 0.4 μg·kg-1·min-1×30 min and the maintaining dose was 0.1 μg·kg-1·min-1×48 hours, The rates of major adverse cardiac events (MACE) consisting of death, myocardial infarction or refractory ischemia during hospital stay stay and 30 days' follow-up, bleeding rates TIMI grade, corrected TIMI frame count (CTFC) and myocardial blush grade(MBG) after PCI were compared between sub-groups of PCI group. ResultsThe basic clinical data were similar among the sub-groups. In medicine group,the MACE rate during 30 days' follow-up was much lower in the tirofiban sub-group than in the placebo sub-group (12.0% vs. 36.4 %, P < 0.05). In comparison with medicine group, in PCI group, there were fewer TIMI frames [(23.5 ±5.1) frames vs. (31.4±5.2) frames, P < 0.01] and higher percentage of myocardial blush grade 3(64.3% vs. 29.0%, P < 0.01) in firotiban sub-group of PCI group. No significant differences in bleeding rates were found between all sub-groups. ConclusionsTirofiban is safe and effective in gerontal ACS patients with blood flow and reperfusion improved.
7.Ultrasound-guided application of cervical plexus nerve block in radiofrequency ablation of thyroid and parathyroid benign lesions
Chun YAO ; Linli CHEN ; Meilin TU ; Chengzhong PENG ; Jie YAO ; Jianfeng BAO
Chinese Journal of Ultrasonography 2018;27(4):314-317
Objective To investigate the efficacy of ultrasound-guided cervical plexus block in radiofrequency ablation of thyroid and parathyroid benign lesions . Methods One hundred and twenty-five patients with thyroid nodules or hyperparathyroidism , who were undergone ultrasound guided radiofrequency ablation ,were randomly assigned to receive either ultrasound-guided cervical plexus block or local infiltration anesthesia ,and the pain grading was evaluated by numerical rating scale ( NRS ) . The anesthetic dosage and the effect of thermal ablation surgery of ultrasound-guided cervical plexus block anesthesia and local anesthesia were compared . Results The anesthetic dosage in ultrasound-guided cervical plexus block was lower than that in local infiltration anesthesia( t = 17 .681 , P < 0 .05) . The pain grading of ultrasound-guided cervical plexus block was lower than that of local infiltration anesthesia( χ2 = 33 .738 , P < 0 .05) . Conclusions Ultrasound-guided cervical plexus nerve block has lower anesthetic dosage and pain grading in the radiofrequency ablation of thyroid and parathyroid benign lesions ,which may be widely applied in clinical .
8.Efficacy of flexible negative pressure ureteral access sheath plus disposable flexible ureteroscope versus SMP in the treatment of 2-3 cm renal calculi
Jianfeng LIN ; Zhibin YE ; Liren HU ; Fulyu LIANG ; Jianping TU ; Chaohao MIAO ; Xianming FAN
Journal of Modern Urology 2024;29(7):617-621,626
Objective To explore the efficacy of negative pressure ureteral access sheath combined with disposable flexible ureteroscope(UAS+FRUS)in the treatment of renal calculi of 2-3 cm,so as to provide reference for the treatment.Methods A retrospective analysis was conducted on 130 cases of renal calculi of 2-3 cm treated with surgery in Xiamen Third Hospital during Sep.2021 and Sep.2023,including 68 cases with UAS+FRUS and 62 cases with super-mini percutaneous nephrolithotripsy(SMP).The perioperative indexes and stone-clearance rate(SFR)were compared between the two groups.Results All operations were successful.There were no statistically significant differences in the total SFR and incidence of complications(5.88%vs.9.67%)between the two groups 3 days(88.24%vs.90.32%)and 1 month(91.18%vs.93.55%)after surgery(P>0.05).For patients with lower calyceal calculi with infundibulopelvic angle(IPA)<45°,the SFR of the UAS+FRUS group was significantly lower than that of the SMP group(57.14%vs.100%,P<0.05).The UAS+FRUS group had a longer operation time than the SMP group[(104.94±8.79)minutes vs.(77.98±6.60)minutes,P<0.001],higher hospitalization costs[(23 112.82±1152.34)yuan vs.(21 975.84±1512.24)yuan,P<0.001],less postoperative decrease in hemoglobin[(6.71±2.07)g/L vs.(9.81±4.80)g/L,P<0.001],and shorter postoperative hospitalization time[(3.28±0.51)d vs.(5.58±0.71)d,P<0.001].The UAS+FRUS group had lower postoperative VAS score at 6,24,and 48 hours than the SMP group[(6.38±0.69)vs.(7.87±0.88);(3.62±0.73)vs.(5.81±0.83)and(3.12±0.33)vs.(3.81±0.60)],with statistical significance(P<0.05).Conclusion Both surgical methods have a high SFR in the treatment of renal calculi of 2-3 cm.SMP has the advantages of short operation time,low hospitalization costs,and high SFR for lower calyx calculi,while UAS+FURS has the advantages of little bleeding,minimal trauma,and short hospital stay.Surgeons can make reasonable choices based on the patients'condition and willingness,combined with their own surgical experience.
9.Prognosis and risk factors of Coronavirus Disease-19 associated acute pancreatitis
Jianfeng TU ; Zhaowang TAN ; Yunyun MAO ; Yueliang ZHENG ; Qian LI ; Sheng’ang ZHOU ; Hengjie LI ; Wenwei CAI
Chinese Journal of Emergency Medicine 2024;33(9):1291-1296
Objective:To analyze the clinical features, prognosis and risk factors of SARS-CoV-2 associated acute pancreatitis (SAAP), and provide a basis for early prevention and treatment of SAAP.Methods:Patients with coronavirus disease 19 infection (COVID-19) admitted to Zhejiang Provincial People's Hospital from December 1, 2022 to January 31, 2023 were retrospectively analyzed. Clinical characteristics such as age, gender and other data were recorded, and the indexes of blood routine, liver and kidney function, inflammatory factor, coagulation function, blood gas analysis, immunoglobulin and complement were collected after admission. Patients were divided into pancreatic injury group and non-pancreatic injury group according to the level of serum amylase/lipase. The difference of prognosis and related hematological parameters between the two groups was compared. Multifactorial logistic regression equation was constructed to analyze the risk factors of SAAP.Results:A total of 2 101 patients with COVID-19 who met the criteria were included, including 298 patients in the pancreatic injury group and 1 803 patients in the non-pancreatic injury group. 17 cases (5.7%) in the pancreatic injury group met the diagnostic criteria for AP. The age, male percentage and mortality rate of the pancreatic injury group were all significantly higher than those of the non-pancreatic injury group (all P<0.05). In the pancreatic injury group, white blood cell count, neutrophil-to-lymphocyte ratio, C-reactive protein (CRP), calcitoninogen, erythrocyte sedimentation rate, inflammatory cytokines, tumour necrosis factor, liver and kidney functions, coagulation (D-dimer and plasma fibrinogen degradation products), and lactate level were significantly higher than those in the non-pancreatic injury group (all P<0.05). Serum complement C3, albumin, albumin globule ratio and arterial oxygenation index were lower in the pancreatic injury group (all P<0.05). Multifactorial logistic regression analysis showed that gender, age, CRP, calcitoninogen, total bilirubin, creatinine, PaO 2, PaO 2/FiO 2 and lactate were independent risk factors for the occurrence of pancreatic injury in patients with COVID-19 (all P<0.05). Conclusions:Inflammation-related markers, D-dimer and fibrinogen degradation products were significantly higher in COVID-19 patients comorbid with pancreatic injury than in the patients without pancreatic injury. The risk of SAAP was significantly higher in male patients of senior age. Sex, age, CRP, calcitoninogen, total bilirubin, creatinine, oxygenation index, and lactic acid were independent risk factors for the onset of pancreatic injury in COVID-19 patients.
10.Abdominal acupuncture for treatment of allergic rhinitis:A randomized controlled clinical trial
Zhaoxin LI ; Qian LIU ; Rongyuan ZHANG ; Xuefei REN ; Jianfeng TU ; Jiaping WU ; Dongmei WANG ; Caifeng GUO
China Modern Doctor 2024;62(22):37-40,49
Objective To observe the effect of abdominal acupuncture in treating allergic rhinitis(AR).Methods Twenty-seven AR patients who attended Fangshan Hospital,Beijing University of Chinese Medicine from August to October 2022 were selected.They were divided into treatment group(15 cases)and control group(12 cases)according to randomized numerical table method.The treatment group received abdominal acupuncture.The control group at the same point was used one-time sterile cannula acupuncture to simulate acupuncture,but no needle was inserted into the acupoint.Two groups were treated,3 times a week for 4 weeks.The visual analogue scale(VAS),rhinoconjunctivitis quality of life questionnaire(RQLQ),Pittsburgh sleep quality index(PSQI)scores,and the histamine(HIS),leukotriene D4(LTD4),immunoglobulin E(IgE)levels were compared between two groups before and after treatment.Results At each time point after treatment,the VAS,RQLQ,PSQI scores and HIS,LTD4,IgE levels of patients in treatment group were significantly lower than those before treatment(P<0.05).There were no statistically significant differences in VAS,RQLQ,and PSQI scores,the HIS,LTD4,and IgE levels after 2-week treatment in both groups(P>0.05).After 4-week treatment and follow-up 4-week,the VAS,RQLQ,and PSQI scores,the HIS,and LTD4 levels in treatment group were significantly lower than those in control group(P<0.05).Conclusion Abdominal acupuncture has good therapeutic effect on AR and significantly improves life quality of the patients,which can reduce the levels of HIS,LTD4 and IgE.The therapy is worthy of clinical application.