1.Evaluation of perioperative individualized fluid therapy in the elderly patients with coronary heart disease undergoing gastrointestinal surgery
Chinese Journal of Postgraduates of Medicine 2015;38(2):126-130
Objective To explore the best plan of perioperative individualized fluid therapy in the elderly patients with coronary heart disease undergoing gastrointestinal surgery.Methods Eighty elderly patients with coronary heart disease undergoing gastrointestinal surgery were divided into experimental group and control group by random digits table method with 40 cases each.Conventional capcity treatment was given during surgery and postoperative period in control group.Individualized fluid therapy was used during surgery and postoperative period in intensive care unit of 24 h in experimental group,which was determined based on target controlled fluid therapy according to the cardiac index,stroke volume,and stroke volume variation.Traditional fluid therapy was used in control group in the intraoperative and postoperative period.The two groups were compared in terms of postoperative hemodynamic parameters,total fluid volume,incidence of adverse cardiac events,and recovery of gastrointestinal function.Results The mean arterial pressure at the beginning of the operation,the cardiac index at operation begining 1 h and at the end of operation were (80.4 ± 6.4) mmHg (1 mmHg =0.133 kPa),(4.0 ± 0.6) L/(min ·m2),(4.1 ± 0.8) L/(min ·m2) in experimental group and (76.9 ± 8.0) mmHg,(3.5 ± 0.4) L/(min· m2),(3.6 ± 0.3) L/(min · mè) in control group,and there were significant differences between two groups (P < 0.05).During surgery and 24±hour stay in intensive care unit,the total fluid volume,crystal usage,urine and colloid usage were (2 915 ± 650),(2 715 ± 415),(1 515 ± 315),(1 225 ± 385),(419 ± 233),(619 ± 285),(1 015 ± 220),(1 535 ± 455) ml in experimental group and (3 645 ±770),(3 355 ±750),(2 315 ±320),(1 855 ±325),(602 ±31),(875 ±423),(805 ±250),(1 135 ± 205) ml in control group,and there were significant differences between two groups (P < 0.05).The perioperative adverse cardiac events rate was 30% (12/40) in experimental group,lower than 45% (18/40) in control group,but the difference was no statistically significance (P > 0.05).Conclusion In the elderly patients with coronary artery disease undergoing gastrointestinal surgery,individualized fluid therapy can effectively decrease adverse cardiac events,improve postoperative gastrointestinal function,and reduce length of hospital stay.
2.Effect of artesunate on acute rejection after small intestine transplantation in rats
Xiaodi YU ; Weizhong WANG ; Jieying JIAO ; Jianyong ZHENG ; Zhengwei ZHAO
Chinese Journal of Tissue Engineering Research 2014;(5):761-766
BACKGROUND:As the potent, specific immunosuppressants emerge, the survival rate after intestinal transplantation is improved to some extent. However, the adverse effects of immunosuppressants and expensive treatment costs are not tolerable for many patients. Therefore, it is clinical y meaningful to choose traditional Chinese medicine which presents immunosuppressive effects. Artesunate has immune suppression effect, reduces acute rejection fol owing smal intestine transplantation, and improves the success rate of smal intestine transplantation.
OBJECTIVE:To observe the effect and action mechanism of artesunate in acute rejection after smal intestine transplantation in rats.
METHODS:Al ogeneic smal intestine transplantation models were established in the closed group of
Sprague-Dawley rats and Wistar rats, and then were randomly divided into three groups, syngenic transplantation group (SD→SD), al ogeneic transplantation group (Wistar→SD), and artesunate treatment group (Wistar→SD+artesunate 60 mg/kg per day, intraperitoneal injection).
RESULTS AND CONCLUSION:Rats in syngenic transplantation group survived for more than 10 days and they were al kil ed on day 10. The average survival of rats in al ogeneic transplantation group and artesunate treatment group was respectively (6.73±0.58) days and (8.50±0.74) days, with significant differences between the two groups (P<0.01). Histopathological examination showed that, there was no apparent rejection in syngenic transplantation group specimens, but mild, moderate and severe rejections in al ogeneic transplantation group on days 3, 5, 7. In treatment group, some specimens had mild rejection, but appeared relatively late to a low degree. Enzyme linked immunosorbent assay results revealed that, serum interleukin-2 and interferon-gamma expression levels in al ogeneic transplantation group were significantly higher than other two groups after surgery (P<0.01), serum interleukin-2 gene expression level in treatment group was also higher than syngenic transplantation group, but there was no significant difference (P>0.05), serum interferon-gamma expression level in treatment group was higher than syngenic transplantation group (P<0.05). Artesunate can inhibit acute rejection after rat smal intestine transplantation, and its mechanism may be related to inhibition effect on the secretion and expression of interleukin-2, interferon-gamma and other cytokines.
3.Serum levels of soluble CD23 and thrombopoietin in chronic lymphocytic leukemia
Hui YU ; Wei XU ; Qiudan SHEN ; Yujie WU ; Jianyong LI
Chinese Journal of Internal Medicine 2008;47(10):826-829
Objective To investigate the serum levels of soluble CD23 ( sCD23 ) and thrombopeietin (TPO) in chronic lymphocytic leukemia (CLL) and their correlation with other prognostic factors. Methods The serum levels of sCD23 and TPO of 25 CLL patients were detected with enzyme linked immunosorbent assay. Flow cytometry was employed to determine the expression of CD38 and ZAP-70 protein. Results TPO level in CLL patients was significantly higher than that in normal controls 67.22 - 1881.77 ng/L and 70. 29 - 147. 98 ng/L respectively, P =0. 003. sCD23 level in CLL patients was significantly higher than that in normal controls 129. 80-405. 31 U/ml and 0. 65 -32. 99 U/ml respectively, P =0. 000. TPO level was significantly correlated with Binet stage and CD38 expression. Patients in stage B and C had higher level of TPO than those in stage A 140. 57 -457.48 ng/L and 121.92 - 163.83 ng/L respectively, P =0.014,while TPO level was higher in patients with higher CD38 expression than in patients lower CD38 expression 113.23- 199. 10 ng/L and 141.34 -454. 92 ng/L respectively, P = 0. 033. No significant correlation of sCD23 and TPO levels with ZAP-70 protein, sex, age, peripheral lymphocyte count and lactate dehydrogenase were observed. Conclusion Serum TPO level might be a prognostic factor in CLL.
4.Clinical application of high-frequency electric snare in treatment of airway neoplasm
Haiwang ZHANG ; Meixia SU ; Lixia YU ; Yefeng CHEN ; Yongchun RUAN ; Jianyong MA ; Minghui LI ; Wei HE
China Journal of Endoscopy 2017;23(8):95-98
Objective To investigate the clinical efficacy and safety of high-frequency electric snare for the treatment of main airway neoplasm through bronchoscopy. Methods The clinical datas of 18 patients from July 2013 to April 2016, who had main airway neoplasm and were treated with high-frequency electric snare through bronchoscopy, were retrospectively analyzed. Meanwhile, the interventional bronchoscopic techniques partly included argon plasma coagulation and cryoablation. After operarion, the relief of symptoms and complications were observed. Results After operarion, the clinical symptoms, shortness of breath, dyspnea index score and the degree of airway stenosis were improved significantly. No serious complications such as massive hemoptysis occurred in all patients. Conclusion High-frequency electric snare is an effective and safe approach for the treatment of main airway neoplasm.
5.Training general practitioners in hypertension management with expert-guided network tracing system
Xiaoling XU ; Xinhua TANG ; Jing YAN ; Wei YU ; Yifeng ZHANG ; Shunyuan FANG ; Jianyong LUO ; Hongyi JIN
Chinese Journal of General Practitioners 2012;(11):824-828
Objective To evaluate the application of “expert-guided network tracking system” in training community general practitioner for hypertension management.Methods Total 855 general practitioners (GPs) from 20 community health service centers in Hangzhou,Jiaxing and Shaoxing of Zhejiang province were divided into two groups: 430 GPs from 10 community health centers received training for hypertension management using “ expert-guided networking tracking system” (intervention group) in December 2008 and 425 GPs from another 10 health centers received conventional training (control group).Questionnaire surveys about the knowledge and skill of hypertension management were conducted before and 3 y after training.Results The awareness rates of knowledge about hypertension prevention and control,non-drug therapy and drug therapy increased from 37.0% (159/430),45.6% (196/430),42.8% (184/430) to 66.8% (284/425),81.4% (346/425),77.6% (330/425),respectively and the accuracy of case analysis increased from 38.4% (490/1290) to 73.3% (946/1290) (P <0.01) after training in intervention group.Meanwhile the knowledge and case management abilities in control group were also improved after conventional training,but the degree was significantly lower than that in the intervention group.Conclusions “Expert-guided networking tracking system” can significantly improve the knowledge and skills for hypertension management in community general practitioners.
6.Role of miR-24 in the regulation of 3T3-L1 adipicyte differentiation and the expression of fatty acid binding protein
Limei YAN ; Qiuyan LIANG ; Jinhua XU ; Jianyong WU ; Rongjiao WANG ; Xiaohua YU ; Jingou XU ; Hesheng OU
Chinese Pharmacological Bulletin 2010;26(4):483-487
Aim To explore the effect of microRNAs on the differentiation of 3T3-L1 adipocytes and the expression of adipo-related gene-fatty acid binding protein during the adipocyte differentiation.Methods adipo-related microRNAs during 3T3-L1 adipocyte differentiation were screened and identified by micorRNA microarray.Constructed high-expression plasmids of the adipo-related microRNAs,were transfected into the 3T3-L1 preadipocytes by lipofectamine.While the effect of adipo-related microRNAs on the course of 3T3-L1 adipocyte differentiation was observed,the protein and mRNA expression level of fatty acid binding protein(FABP4)were analyzed by Western blot and RT-PCR during 3T3-L1 adipocyte differentiation.Results The expression profiles of microRNAs have significant changed during 3T3-L1 adipocyte differentiation,in which 35 microRNAs among them down-relation,the most lowly expression is miR-24;17 microRNAs among them up-relation,the most highly expression is miR-21.MiR-24 significantly inhibited adipocyte differentiation and maturity,while miR-21 have no significant effect.MiR-24 significantly inhibited the expression of FABP4,but had no effect on the level of its mRNA;miR-21 had no effect on the expression of protein and mRNA of FABP4.Conclusion There exist adipogenic-related microRNAs during 3T3-L1 adipocyte differentiation; miR-24 play an important role in the regulation of 3T3-L1 preadipocyte differentiation into adipocyte and the(FABP4)protein expression.
7.Application of confocal laser scanning microscopy in the differentiation between seborrheic keratosis and Bowen′s disease
Yunmin ZOU ; Shirong YU ; Xiujuan WU ; Dezhi ZHANG ; Jianyong LIU ; Caoying WU ; Xiaojing KANG
Chinese Journal of Dermatology 2016;49(10):731-733
Objective To evaluate the application value of confocal laser scanning microscopy(CLSM)in the differentiation between seborrheic keratosis and Bowen′s disease. Methods CLSM was used to observe typical skin lesions in 88 patients clinically diagnosed with seborrheic keratosis and 18 patients clinically diagnosed with Bowen′s disease. Then, tissue specimens were resected from these lesions and subjected to histopathological examination. Results CLSM imaging of seborrheic keratosis lesions showed gyrus?like structures and keratin?filled inclusion cysts in the epidermis with trabecula?like extension of rete ridges in all the 88 cases, basal cells arranged in a cordike or radial pattern in 9 cases, and bright reflective structures in the basal layer and dermis in 6 cases. CLSM imaging of Bowen′s disease lesions revealed disorderly arrangement of large, irregularly shaped atypical cells in some areas in the middle and lower epidermis, and infiltration of scattered mononuclear cells in the superficial dermis. Conclusion CLSM images of seborrheic keratosis are different from those of Bowen′s disease, and CLSM may be helpful for their differential diagnosis.
8.Low-frequency magnetic fields promote neovascularization in a rabbit model of atherosclerosis combined with limb ischemia
Jianyong ZHANG ; Hui PENG ; Dekai MENG ; Hui CHEN ; Yunqiang ZHANG ; Hualong YU
Chinese Journal of Tissue Engineering Research 2014;(27):4375-4382
BACKGROUND:Studies on basic research of magnetic treatment of limb ischemic disease are not much, because poor compliance of animals and the stability of the magnetic field strength are difficult to control, resulting in big experimental error and decreased credibility of the results. For this kind of problem, experimental study on low-frequency electromagnetic magnetic cages for treatment of ischemic limbs was conducted, thus overcoming the two major issues of poor compliance of animals and difficult control of the stability of magnetic field strength.
OBJECTIVE:To investigate the effects of self-made low-frequency magnetic fields of rabbit cages on neovascular growth-promoting factor of rabbits with limb ischemia.
METHODS:A total of 96 rabbit models of atherosclerosis were constructed, numbered and randomly divided into ischemia group and non-ischemia group (12 treatment combination in each group). Experiments in each group were performed four times according to the requirement of factorial design. Electromagnetic field intensity factor A (0, 3, 6, 12 mT) and the time factor B (3, 5, 7 days) were set.
RESULTS AND CONCLUSION:Low-frequency magnetic field could apparently promote hypoxia inducible factor-1α, vascular endothelial growth factor and CD34 expression in ischemic limb of rabbits. Electromagnetic field intensity factor A was a key factor for contributing to the expression of hypoxia inducible factor-1α, vascular endothelial growth factor and CD34, and the time factor B was secondary factor. Low-frequency magnetic field also promoted hypoxia inducible factor-1αexpression in non-ischemia limb, but did not promote vascular endothelial growth factor and CD34 expression. Thus, the expression of vascular endothelial growth factor and CD34 was regulated by hypoxia inducible factor-1α, as wel as other factors, in the ischemic state.
9.Community-based hypertension management for elderly patients
Li YANG ; Xiaoling XU ; Jing YAN ; Wei YU ; Yifeng ZHANG ; Jianyong LUO ; Qingmin LIU
Chinese Journal of General Practitioners 2014;13(11):923-925
Using the method of stratified random cluster sampling,8 996 elderly hypertensive patients in community were selected in the study.Patients entered the community-based hypertension program receiving stratified management,individualized treatment and health education.After 3 years of intervention,the disease awareness rate,treatment compliance rate and hypertensive control rate were increased from 68.30%,55.40% and 38.60% to 98.90%,86.70% and 77.80%,respectively (P <0.05).The systolic and diastolic pressure,body mass index,triglyceride levels and other hypertensionrelated indicators were improved significantly,the number of individuals with obesity/overweight,smoking and drinking were decreased and those with regular exercise increased (all P < 0.05).The results indicate that community-based comprehensive hypertension management is effective for hypertension control for elderly patients in community.
10.The analysis of current situation of hypertension control and its influencing factors among geriatric patients in Hangzhou, Jiaxing and Shaoxing in Zhejiang province
Li YANG ; Xiaoling XU ; Jing YAN ; Wei YU ; Yifeng ZHANG ; Jianyong LUO ; Qingmin LIU
Chinese Journal of Geriatrics 2015;34(2):210-214
Objective From October 2010 to explore the current situation of hypertension control and its influencing factors among geriatric patients in Hangzhou,Jiaxing and Shaoxing in Zhejiang province.Methods To April 2011,10 644 geriatric patients aged 60 years and over were included,and related questionnaire survey,physical examination and laboratory examination were carried out.The situation of hypertension control and influencing factors were analyzed.Results The control rate of hypertension was 38.6%,and its standardized rate was 27.6%.It showed that female,inhabited city,high level of education degree and regular exercise were positively correlated with hypertension control,while age,smoking,high salt diet and abdominal obesity were negatively correlated with hypertension control,and standardized treatment had a close relationship with hypertension control.Conclusions The situations of hypertensive control among geriatric patients in Hangzhou,Jiaxing,Shaoxing in Zhejiang province are still unsatisfactory.Strengthening standardization management measures for improving the control rate of hypertension is needed and has actual value.