1.Problems in the construction of HIS and countermeasures
Chinese Journal of Hospital Administration 1996;0(12):-
In view of the problems of information systems in the development and application of software, system configurations, and the maintenance and management of computers, the author puts forward the countermeasure of establishing a hospital directors inquiries centered information network management system so as to enhance the scientific management level of a hospital.
2.Double filtration plasmapheresis combined with daclizumab in the treatment for sensitized recipients of cadaver kidney transplantation
Hongfeng HUANG ; Jianghua CHEN ; Jianyong WU
Chinese Journal of Urology 1994;0(02):-
20% ) were assigned to 2 groups according to study intervention: group A ( n =72) receiving DFPP and group B ( n =41) as controls.Group A was subdivided into 2 groups:group A1 ( n =44) was treated by DFPP alone and group A2 ( n =28) was treated by DFPP plus Dac.The incidence rates of HAR,AR,adverse reaction,patie nt/kidney survival,kidney function were observed. All the patients obtained a fo llow-up ≥12 months. Results In 72 patients of group A ,the level of PRA decreased from (60.5?17.7)% to (19.3?11.2)%,with a mean of (41.2?16.9)% ( P 0.05),with 1 kidney-year survival of 94.4% in group A and 78.0 % in group B ( P 0.05);those of AR were 36.4% and 14.3%,respectively ( P 0.05).No difference in infection episodes an d adverse events between group A and PRA-negative recipients, the same as those between group A1 and A2. Conclusions DFPP can decrease the level of PRA significantly before transplantation by selectively eliminating the sensitive antibody,especially when combined with Dac,which can make sensiti zed recipients get the chance of transplanting and further reduce the incidence of AR.The patient/kidney survival rates of 1 year are satisfactory.Being well to lerated by the sensitized patients,treatment of DFPP combined with Dac is safe a nd effective.
3.Discussion about Management of In Vitro Diagnostic Reagent.
Liang HUANG ; Jianghua ZHU ; Haiyi GU ; Yimin GENG
Chinese Journal of Medical Instrumentation 2015;39(3):232-234
OBJECTIVEIn order to adapt the rapid development of modern medicine, this paper is aimed to analyze the application of in vitro diagnostic reagents (IVD Reagents) in hospital management and improve the overall level of hospital management.
METHODSBy groping the management experience of IVD reagents, we discuss the internal hospital management mode of IVD reagents in reality.
RESULTSWith the continuous improvements on the information platform of IVD reagents,we can realize benefit analysis of IVD reagents within the process of management.
CONCLUSIONReasonable management on IVD reagentscan improve the working efficiency in hospitals and provide swifter and better medical service for patients.
Central Supply, Hospital ; organization & administration ; Equipment and Supplies, Hospital ; standards ; Indicators and Reagents ; standards
4.Experimental study of (RGD)_3-tTF fusion proteins binding specifically to tumor vasculature in the colonic carcinoma nude mice model
Zhengjie HUANG ; Qi LUO ; Jianghua YAN ; Shengyu WANG
China Oncology 2009;19(10):735-741
Background and purpose: Tumor vasculature is increasingly recognized as a target for cancer therapy. In recent years, a fusion protein consisting of the extra cellular domain of tissue factor (truncated tissue factor, tTF) was fused to the antibody selectively binding to tumor vasculature. Antibody-truncated tissue factor(Ab-tTF) fusion protein specifically induced thrombotic occlusion of tumor vessels resulting in tumor growth retardation or regression in some types of solid tumors. However, there were still some disadvantages in the above approach. We constructed and expressed that the (RGD)_3-tTF fusion protein with peptides arginine-glycine-aspartic acid (GRGDSP, abbr. RGD)as the carrier of tTF to explore whether it bad the capability of targeting to tumor vasculature in the colonic carcinoma model. Methods: The (RGD)_3-tTF fusion gene consisting of the tTF was fused to three series-wound peptides RGD. The (RGD)_3-tTF construct was expressed in Escherichia coil BL21(DE_3). The fusion protein was purified through Nickel affinity chromatography column. The activity of inducing blood coagulation was detected by clotting assay and coagulation factor X (FX) activation assay. The specific binding to integrins α_vβ_3 was analyzed by indirect enzyme linked immunosorbent assay (ELISA). All these were compared with the fusion protein RGD-tTE Colonic nude mice models were randomly divided into 3 groups (1 nude mice per group).Tumors were stained by the (RGD)_3-tTE RGD-tTF fusion protein and tTF which were labeled with Fluorescein Isothiocyanate(FITC). The location of the (RGD)_3-tTF fusion protein in the colonic carcinoma bearing nude mice tissue was analyzed by immunofluorescence assay. Results: The (RGD)_3-tTF fusion protein retained tissue factor thrombogenic activities. With increasing concentration, the clotting time was shortened correspondingly. Under the conditions of Ca~(2+), the clotting time was 9.96±0.56 min when the concentration was 6 μmol/L(P<0.01). The (RGD)_3-tTF fusion protein could activise F X above 6 μmol/L concentration, which was similar to RGD-tTF fusion (F=0.147, P>0.05). The ability of the (RGD)_3-tTF fusion protein binding specifically to integrins α_vβ_3 was stronger than that of the RGD-tTF fusion protein in the same concentration (F=164.81, P<0.01), which was apparently indicated by the A_(405nm) 1.25 and 0.95 when the concentration was 0.24 μmol/L. Immunofluorescence assay showed that the (RGD)_3-tTF fusion protein was assembling in the tumor vasculature of the colonic carcinoma bearing nude mice. Conclusion: The (RGD)_3-tTF fusion protein which retained tissue factor thrombogenic activities could bind specifically and efficiently to tumor vasculature in the colonic carcinoma bearing mice through binding to the tumor marker integrins α_vβ_3. It might be a promising foundation for further studies on the colon cancer molecular targeted therapy with tTF as an effective factor.
5.Intervention of Ginkgo biloba extract on renal hemodynamics and its clinical protective mechanism
Hongfeng HUANG ; Qian LIANG ; Lan LAN ; Jianyong WU ; Jianghua CHEN
Chinese Journal of Organ Transplantation 2015;36(11):652-656
Objective To observe the effect and safety of Ginkgo biloba extract (EGb) in patients with chronic allograft nephropathy (CAN),and to study the clinical protective mechanism of EGb.Method A prospective,non-randomized,controlled study was conducted on 103 cases of CAN from March 2013 to March 2015.All patients were divided into experimental group (group A,53 cases) and control group (group B,50 cases).The group A was treated with EGb.Patients were followed up for at least 6 months.Before and after treatment,the changes in renal hemodynamic parameters were observed.The biochemical parameters were also observed,including 24-h urinary protein,urinary albumin,serum creatinine (Scr),triglyceride (TG),total cholesterol (TC),estimated glomerular filtration rate (eGFR),platelet count (PLT),fibrinogen (FIB),D-dimer (DD),activated partial thromboplastin time (APTT).The clinical efficacy and safety were analyzed.Result (1) Therewere no significant differences in clinical and biochemical parameters between the two groups before treatment (P>0.05).(2) After treatment,the systolic peak flow velocity (Vmax) of segmental artery and arcuate artery in the experimental group was significantly higher than in the control group,and the resistance index (RI) in the experimental group was significantly lower than that in the control group,P<0.05.(3) In both two groups,the 24-h urinary protein,urinaryalbumin,TG,TC and Scr were decreased after treatment (P<0.05),and eGFR was elevated (P<0.05).Moreover,the changes in 24-h urinary protein and urinary albumin in the experimental group were more significant than the control group after treatment (P<0.05).(3) PLT,FIB and DD in experimental group were significantly decreased after treatment,and APTT was increased significantly (P<0.05).PLT,FIB,DD and APTT had significant change after treatment in the experimental group as compared with control group.(4) There were no significant differences in adverse reactions between two groups (x2 =0.047,P =0.828).Conclusion The therapy of EGb in patients with CAN could reduce urinary protein and improve hypercoagulable state,and had few adverse reaction with good security.
6.Relationship between the detection of carotid plaque's micro flow signals by B-flow imaging and acute cerebral infarction
Gongxian YUAN ; Yinghui WANG ; Jianghua REN ; Congxin HUANG
Chinese Journal of General Practitioners 2012;11(9):658-660
Objective To detect the micro flow signals of carotid plaque by ultrasound B-flow imaging (BFI) and elucidate its relationship with acute cerebral infarction.Methods A total of 63 patients with carotid plaques were divided into 2 groups.acute cerebral infarction (ACI,n =48) and control (n =15).BFI was used to detect the micro flow signals of plaques and comparisons were made with the categorizing results of contrast enhanced ultrasound (CEU).The data were analyzed between two methods.Results The micro flow signals were detected in 15.7% (22/140)patients in the ACI group vs.2.3%(1/44) in the control group.There were more signals in hypoechoic plaques.The detection percentage of micro flow in grade Ⅲ was significantly higher than that in grades Ⅰ and Ⅱ with CEU (P =0.005,P =0.027).No significant differences existed between grades Ⅲ and Ⅳ (P =1.000).Conclusion BFI can detect effectively the micro flow signals of carotid plaques and this characteristic is correlated with the symptoms of ACI.
7.Clinical effects of double filtration plasmapheresis for sensitized recipients of cadaver kidney transplantation
Yu CUI ; Hongfeng HUANG ; Wenhua LEI ; Jianghua CHEN
Chinese Journal of Organ Transplantation 2013;(4):206-208
Objective To investigate the clinical efficacy and safety of double filtration plasmapheresis (DFPP) pretreatment combined with CD25 monoclonal antibody inducible therapy for sensitized recipients of cadaver kidney transplantation.Method The clinical data of 45 sensitized recipients who received the pretreatment with DFPP and CD25 monoclonal antibody from November 2011 to January 2012 were retrospectively analyzed.Panel reactive antibody (PRA) was examined by using ELISA.Before the DFPP combined with CD25 monoclonal antibody,the PRA was (56.5 ± 19.9) % (> 20%),and after the pretreatment,the PRA level was decreased to (18.9 ± 19.1)%.HLA mismatch of recipients and donators was (2.1 ± 0.7),and the lymphocytotoxic crossmatch tests before operation were negative.The incidence of patient/kidney survival,transplantation rejection and pulmonary infection were observed.All the patients were followed up for 12 months.Result During the follow-up period,no patient died,and transplanted kidney dysfunction occurred in 2/45 recipients.Twelve months after months,the survival rate was 100% and transplanted kidney survival rate was 95.6% (43/45).One (2.2%) of 45 recipients had hyperacute rejection during the operation,and was given plasmapheresis after the resection of the transplanted kidney.Twelve (26.7%) of 45 recipients had acute rejection:11 recipients completely recovered after methylprednisolone and ATG therapy,and 1 recipient given plasmapheresis for kidney dysfunction.Four (8.9%) had the pulmonary infection after operation,and all of them recovered after antiinflammation treatment.Conclusion DFPP pretreatment before kidney transplantation combined with CD25 monoclonal antibody inducible therapy is safe and effective,specially for sensitized recipients.
8.Pulse wave velocity, ankle-brachial index and carotid intima-media thickness measurement in the assessment of vascular status in elderly patients with isolated systolic hypertension
Gongxian YUAN ; Hua WANG ; Jianghua REN ; Congxin HUANG ; Yinghui WANG
Chinese Journal of Health Management 2012;06(4):228-231
Objective To evaluate the relation of circadian blood pressure rhythm with vascular status in elderly patients with isolated systolic hypertension.MethodsAnkle-brachial index (ABI),brachial-ankle pulse wave velocity (baPWV) and carotid intima-media thickness (IMT) were measured in 74 elderly patients with non-dipper hypertension (non-dipper group)、78 elderly patients with dipper hypertension ( dipper group),and 72 healthy controls ( control group).Results In comparison with the dipper group,baPWV and IMT of the non-dipper group were significantly increased [ baPWV (1801.61± 314.27) vs (1658.67±274.80) (cm/s)],P<0.01; IMT:(0.96 ±0.22) vs (0.87 +0.19) (mm),(P<0.05),while ABI of the non-dipper group was decreased (1.03 ±0.17 vs1.12 ±0.18,P<0.01).Identification rate was significantly different among 3 groups when baPWV >1400 cm/s (x2 =12.57,P <0.01) or ABI <0.9 ( x2 =9.74,P <0.01).The detection of carotid plaques was also significantly different ( x2 =16.49,P < 0.01).Conclusions These findings suggest that vascular damage could be found in elderly patients with isolated systolic hypertension,especially in those with non-dipper hypertension.ABI,baPWV and IMT measurement may be helpful for the assessment of vascular status.
9.Effect of gender matching on the outcomes of living-donor renal transplantation
Jingyi ZHOU ; Hongfeng HUANG ; Junhao LV ; Jianghua CHEN
Chinese Journal of Nephrology 2013;(4):243-247
Objective To evaluate the effect of gender matching on the outcomes of livingdonor renal transplantation.Methods A total of 419 cases of living-donor renal transplantation in our center were divided into male-donor-male-recipient (MDMR) group,male-donor-female-recipient (MDFR) group,female-donor-male-recipient (FDMR) group,female-donor-female-recipient (FDFR)group.The outcomes including graft and patient survival,acute rejection and renal function were analyzed retrospectively.Results Compared to MDMR group,MDFR group and FDFR group had lower Scr [(80.7±17.9),(87.4±21.9) μmol/L vs (120.3±72.5) μmol/L,all P < 0.05] and uric acid (UA) [(318.1 ± 86.4),(303.5 ± 66.9) μmol/L vs (358.4 ± 77.8) μmol/L,P < 0.05] 6 months after operation.Compared to MDFR group,FDMR group had higher Scr[(117.7±27.4) μmol/L vs (80.7±17.9) μmol/L,P < 0.01],UA [(371.0±92.4) μmol/L vs (318.1±86.4) μmol/L,P < 0.05] and lower glomerular filtration rate (GFR) [(70.4± 17.8) ml/min vs (79.6± 18.9) ml/min,P < 0.05].Compared to FDMR group,FDFR group had lower Scr [(87.4±21.9) μmol/L vs (117.7±27.4) μmol/L,P < 0.01] and UA [(303.5±66.9)μmol/L vs (371.092.4) μmol/L,P< 0.01].Compared to MDFR group,FDFR group showed lower GFR [(72.4±25.3) ml/min vs (82.7± 18.7) ml/min,P < 0.05] 1 year after operation.Compared to MDMR group,FDFR group showed lower UA [(322.9±69.7) μmol/L vs (376.0±66.2) μmol/L,P < 0.05] 2 years after operation.Compared to FDMR group,FDFR group showed lower Scr [(88.7 ±27.0) μmol/L vs (112.7±27.8) μmol/L,P < 0.05] and UA [(318.3 ±61.2) μmol/L vs (396.2± 100.3) μmol/L,P < 0.05] 3 years after operation.5 years after operation,there were no significant differences in above indexes,the incidence of slow graft function,acute rejection and survival of graft and patient among groups.Conclusions Male recipients of female donors have the worst renal function while female recipients have better outcomes after operation.
10.Effect of acute humoral rejection on renal allograft survival
Rending WANG ; Huiping WANG ; Jianyong WU ; Yimin WANG ; Jianguo ZHANG ; Hongfeng HUANG ; Qiang HE ; Jianghua CHEN
Chinese Journal of Organ Transplantation 2010;31(6):336-339
Objective To explore the effect of acute humoral rejection on kidney graft survival.Methods 1098 patients received cadaveric renal transplant from January 2002 to December 2008 in our center. All patients were given triple immunosuppressants including tacrolimus or cyclosporine.According to patients who experienced biopsy-proved humoral rejection and cellular rejection within one year post-transplant, there were 53 cases in humoral rejection group, 109 in cellular rejection group (including 63 patients with borderline change), and 936 in normal group. Patients who experienced acute rejection received mythyl-prednisolone pulse, or received anti-CD3 antibody/plasma exchange/globulin. Clinical characteristics before operation including sex, age, HLA mismatch, panel reactive antibody, cold/warm ischemic time, graft loss rate and graft survival were compared among three groups. The effect of completely reversed cellular rejection and humoral rejection on graft survival was analyzed. Results There was no significant difference in sex, age and cold ischemic time among three groups, but there was significant difference in warm ischemic time, level of PRA and HLA mismatch between cellular rejection group or humor rejection group and normal group (P<0. 05). During a follow-up period, the incidence of graft loss in humoral rejection group was 27.4 %, significantly higher than 7.3 % in cellular rejection group and 2.2 % in normal group, P<0. 001. Kaplan-Meier analysis revealed the survival rate of grafts in humoral rejection group was significantly lower than in cellular rejection group and normal group (P<0.001 ). After patients with irreversible rejection were excluded,there was no significant difference in the survival rate of grafts among the three groups.Conclusion Patients with acute humoral rejection survived with inferior graft outcome,but completely reversible rejection showed no effect on the graft survival.