1.Arthroscopic treatment for avulsion fracture of tibial intercondylar anterior eminence:report of 30 cases
Jiarong CHEN ; Liu YANG ; Gang DAI ; Lin GUO
Journal of Third Military Medical University 2003;0(07):-
Objective To investigate the outcomes of arthroscopic reduction and internal fixation with cannulate lag screw for avulsion fracture of tibial intercondylar anterior eminence.Methods From May 2004 to December 2007,30 cases of tibial intercondylar anterior eminence avulsion fracture were treated by arthroscopic reduction and fixation with cannulated lag screw.Among the patients,there were 10 females and 20 males,ranging from 15 to 79 years old with an average age of 32.0.There were 12 fresh fractures and 18 old fractures.According to Meyers-McKeever-Zaricnyl's classification systems,there were 8 cases of type Ⅱ,15 cases of type Ⅲ,and 7 cases of type Ⅳ.Patients were encouraged to do postoperative rehabilitation,such as active joint extension and flexion,exercise of isometric contraction of quadriceps femoris.The treatment outcomes were evaluated by Lysholm and Irrgang knee score system.Results All patients were followed up for 3 months to 60 months(averaging 31.2 months).X rays revealed bony healing 2 months after operation.The joints were stable.Negative Lachaman and drawer and jerk tests were found in all cases,and there was no dysfunction in the knee joints.Lysholm scores were increased from(60.8?1.5)to(95.5?3.5)while Irrgang scores increased from(55.5?3.3)to(90.5?2.5).Conclusion Arthroscopic treatment of avulsion fracture of tibial intercondylar anterior eminence is an easy approach with minimal invasion,and has reliable reduction and fixation with satisfied results.
2.Clinical study on the plasma melatonin level in hypoxie-ischemic encephalopathy neonates
Meifang LIN ; Jiarong TAN ; Jing CHEN ; Chunjian GU ; Qinqin FU ; Qi JIANG
Chinese Pediatric Emergency Medicine 2010;17(1):23-25
Objective To explore the changes of plasma melatonin(MT)level in hypoxic-ischemic encephalopathy(HIE)neonates,and elucidate the function of rnelatonin in the pathogenesis and the prognosis of HIE.Methods Fourty HIE neonates were divided into 2 groups,20 mild HIE neonates and 20 moderate or severe HIE ones.The femoral vein blood were collected in 48 h and on 7 d after birth in mild HIE group,and in 48 h,on 7 d and(14±4)d after birth in moderate on severe HIE group.Twenty normal term infants served as control group.The level of plasma MT was determined with enzyme-labeled immunosorbent assay.Results Compared with control group[(8.003±1.840)ng/L],The MT level in mild HIE group in 48 h after birth[(13.311±4.025)ng/L]was higher(P<0.01),but there was no difference on 7 d[(6.605±1.269)ng/L](P>0.05);The MT level in moderate or severe HIE group in 48 h after birth[(5.487±1.997)ng/L]was lower(P<0.01),but it was higher on 7 d[(16.201±5.594)ng/L](P<0.01),there was no difference on(14±4)d[(6.799±1.765)ng/L](P>0.05).Conclusion MT may have protective action on HIE.The prognosis of HIE with rising MT level in 48 h after birth is better than that with lower MT level.
3.Effect of vitamin D supplementation on insulin resistance and blood glucose in people who are obese or people with abnormal glucose metabolism:A meta-analysis
Xiumei YIN ; Na YOU ; Heng MIAO ; Zhao LIN ; Weixing GE ; Jiarong XU
Chinese Journal of Endocrinology and Metabolism 2016;32(8):663-667
Objective To systematically review the evidence for the effect of vitamin D supplementation on insulin resistance and blood glucose in people who are obese or people with abnormal glucose metabolism. Methods We searched databases including Pubmed, Elsevier, Web of Science, and WANFANG Database etc. for randomized controlled trials comparing vitamin D or analogues with placebo. We extracted data on insulin resistance and blood glucose, including homeostasis model assessment of insulin resistance( HOMA-IR), fasting blood glucose, HbA1C (% ). A1l data were analyzed using Review Manager 5. 0. Results Nine studies involving 867 participants were included. The results of meta-analysis showed that: ( 1 ) For people who are obese and with abnormal glucose metabolism, meta-analysis showed a small improvement in HOMA-IR(SMD -0. 34,95% CI -0. 61 to -0. 06, P<0. 05) and a small effect on fasting glucose (SMD -0. 41 mmol/ L, 95% CI -0. 68 to -0. 15, P<0. 05),while such effects were not seen in people who are obese but with normal blood glucose. (2) No serious adverse events were associated with the administration of vitamin D. Conclusion vitamin D supplementation may be benefit for improving insulin resistance and fasting blood glucose in people who are obese and with abnormal glucose metabolism, but has no effect on obese people with normal blood glucose.
4.Application of SimMan patient simulator in teaching of internal medicine clinical skill for undergraduates majored in clinical medicine
Jiarong TANG ; Qiang ZHOU ; Li LIN ; Peng ZUO ; Chang XU ; Yan WANG ; Tao WANG ; Jianmiao WANG ; Xiang JIAN
Chinese Journal of Medical Education Research 2012;11(8):844-847
In this study,the common critical medical cases were organically combined with SimMan simulation system,which enabled students to deeply understand the diagnosis,treatment of disease and clinical operation as consulting real patients.Also,it could improve their clinical thinking ability,clinical skills and operational level.
5. Evaluation of a low dose imaging protocol on radiation exposure reduction in pediatric supraventricular tachycardia ablation procedure
Feng WANG ; Ying LU ; Chao YUAN ; Jiarong BAI ; Haosheng YANG ; Lin WU
Chinese Journal of Pediatrics 2017;55(4):272-276
Objective:
To evaluate the feasibility and efficiency of a low dose imaging protocol on reducing X-ray dose level in pediatric supraventricular tachycardia (SVT) ablation procedure.
Method:
Data were collected from 103 patients who underwent catheter ablation for SVT in Children′s Hospital of Fudan University from January 2014 to October 2016 in terms of body weight, body surface area (BSA), SVT types, accessory pathway location, fluoroscopy time and the radiation dose (including AIR KERMA and dose area product) in a case observational study.The fluoroscopy protocols were operated at 36 nGy/frame and 10 frames/s (Standard group,
6.Exploration of the immune mechanism in systemic lupus erythematosus MRL/lpr mice
Shaosong KUANG ; Lin YANG ; Jiarong YAN ; Qiaoyan TAN ; Lulu DAI ; Xiaojiang TANG
Chinese Journal of Comparative Medicine 2018;28(4):38-42
Objective To explore the immune mechanism in the systemic lupus erythematosus MRL/lpr mice at different months of age, and to provide the basis for research of its pathogenesis. Methods 3-,4-,5- and 6-month old female MRL/lpr mice, and wild type C57 female mice were used in this study, 10 mice per each group. Their organ coefficients were determined. ELISA was performed to detect the serum levels of double stranded DNA(ds-DNA) antibody. The interleukins IL-2,IL-4,IL-17 and tumor necrosis factor-α(TNF-α)in spleen tissue were detected. Flow cytometry was used to assess the content of spleen lymphocyte CD3 cells and CD4/CD8 cell ratio. Results Compared with the 3-month old wild-type C57 mice,the spleen coefficient,the blood concentration of ds-DNA antibody,IL-2 and TNF-α in the 3- to 6-month old MRL/lpr mice were significantly increased(P < 0.05). There was no significant difference between the concentrations of interleukin IL-4(P> 0.05). The blood concentration of IL-17 in the 5- and 6-month old MRL/lpr mice was significantly lower(P < 0.05 or P < 0.01)than that in the 3-month old MRL/lpr mice. The rest indexes of MRL/lpr mice showed no obvious changes or significant difference in the mice at different ages. Compared with the 3-month old C57 mice,the spleen CD3 lymphocyte concentration in the MRL/lpr mice was significantly decreased(P< 0.01). With the increasing age, the CD3 lymphocyte concentration and D4 +/CD8 +cell ratio in the MRL/lpr mice were decreased, however, showing a non-significant difference(P ﹥0.05). Conclusions The data obtained in this study indicate that 3-month old lupus MRL/lpr mice have already immune injury,increasing with the increase of age of the mice.
7.Management practice and thinking of different DRGs grouped patients in clinical pathway
Jiarong LIN ; Zhijun SU ; Huiming ZHENG ; Yunzong SUN ; Xueyu CAI ; Mengling GUO ; Juanjuan ZHENG ; Qinglun LIN
Chinese Journal of Hospital Administration 2019;35(7):548-553
Objective To analysis the clinical pathway management efficiency under different DRG groups, for a basis for further optimizing clinical pathway management. Methods The retrospective analysis method was used to compare the average length of stay, sub-average costs, and drug proportions of patients with different DRGs in the same clinical pathway. Shapiro-Wilk was used to detect the normality of the samples, t test was used to analyze measurement data conformed to the normal distribution, non-parametric test was used to analyze the abnormal distribution data, and enumeration data was detected by using chi-square test. Results For patients with a clinical pathway of bronchial pneumonia, patients with severe complications and concomitant symptoms had no significant difference in mean hospitalization and sub-costs, regardless of whether they completed or entered the clinical pathway ( P >0.05). For the other two DRG patients, the difference between the average length of stay, sub-average costs, and the proportion of medications for patients who completed the clinical pathway and withdrew from or did not complete the clinical pathway was significant(P<0.05). In the severe surgical group, the length of stay and average cost for patients who completed the clinical pathway were lower than those who exited or did not enter the clinical pathway(P<0.05). Conclusions Patients with different severity of DRGs should be cautious when they are enrolled in the clinical pathway.
8.The correlation analysis between the neutrophil-lymphocyte ratio and systemic lupus erythematosus viscera involvement and disease activity
Wei LIN ; Weiru ZHANG ; Tong LI ; Xuan WANG ; Jiarong LI ; Meng WANG ; Ting HUANG ; Yueyuan ZHOU ; Yi PENG ; Wangbin NING
Chinese Journal of Nephrology 2019;35(3):191-197
Objective To investigate the correlation between neutrophil-lymphocyte ratio (NLR) and disease activity of systemic lupus erythematosus (SLE),and the changes of NLR in different organ involvement of SLE patients.Methods A total of 155 SLE patients and 135 healthy controls from the Rheumatology Department of Xiangya Hospital were enrolled in this study from 2010 to 2018.Patients with SLE were divided into lupus nephritis group (LN group) and non-lupus nephritis group (non-LN group),serositis group and non-serositis group,according to whether they had kidney involvement or serositis.According to the SLE disease activity index 2000(SLEDAI-2000),the patients were divided into mild to moderate disease activity group (SLEDAI score < 15) and severe disease activity group (SLEDAI score≥ 15).The NLR values of the above groups were compared.Spearman's correlation analysis was used to analyze the correlation between NLR and SLE patients' laboratory indexes.Multiple linear regression model was used to analyze the relationship between NLR and SLE disease activity.Receiver operating characteristic curve (ROC) was used to evaluate the value of NLR in SLE diagnosis and activity assessment.Results (1)The NLR value of SLE patients was significantly higher than that of healthy control group,and the difference was statistically significant (P < 0.01).(2)The NLR value of SLE patients in the LN group was higher than that in the non-LN group,and the NLR value of SLE patients with serositis was higher than that in the group without serositis,with statistically significant differences (both P < 0.05).(3)The NLR value of SLE patients in the severe disease activity group was higher than that in the mild and moderate disease activity group,and the difference was statistically significant (P < 0.01).(4)NLR of SLE patients was positively correlated with CRP (rs=0.188,P=0.019),SLEDAI score (rs=0.264,P=0.001),and negatively correlated with total serum protein (rs=-0.250,P=0.002) and serum albumin (rs=-0.329,P < 0.001),respectively.(5) Multiple linear regression showed that NLR was independently associated with SLE disease activity (B=0.351,95%CI 0.012-0.690,t=2.047,P=0.042).(6) According to ROC curve,the optimal cut-off value of NLR for SLE diagnosis was 2.17 (sensitivity 60.0%,specificity 83.1%,AUC=0.744),and the best cut-off value for predicting the activity of severe disease activity in SLE patients was 3.28 (sensitivity 58.5%,specificity 78.1%,AUC=0.700).Conclusion NLR is closely related to renal involvement,serositis and disease activity in SLE patients,which indicates that NLR,as a new inflammatory indicator,is of great significance for the assessment of SLE disease activity and organ involvement.
9.Hospitalization days and costs of patients with acute cholecystitis in different departments by DRGs
Xueyu CAI ; Huiming ZHENG ; Jiarong LIN ; Juanjuan ZHENG ; Yunzong SUN ; Mengling GUO ; Zhijun SU
Chinese Journal of Hospital Administration 2019;35(7):554-558
Objective To analyze the differences in hospitalization days and costs of patients with acute cholecystitis in different departments or diagnosis related groups ( DRGs ), and provide scientific references for clinical medical management. Methods All the medical record homepages of the patients with acute cholecystitis were selected from a tertiary hospital from January 2017 to December 2017. The hospital analysis system of DRGs was used to calculate the classification results of DRGs. The Kruskal-Wallis H test was used to analyze the differences in hospital stays and costs between different DRGs or departments. Results The average length of stay was the shortest and the hospitalization cost in the department of hepatobiliary surgery was lower than other departments among patients with surgery and non-surgical(all P<0.05); The average length of stay at the department of hepatobiliary surgery was lower than the same other DRGs groups, namely the department of digestive medicine and gastrointestinal surgery(all P<0.05). There was no significant difference in the cost of " acute biliary tract disease with complications" between the various departments(P>0.05). The average cost in the department of hepatobiliary surgery was the lowest, and the average cost of gastrointestinal surgery was the highest in two DRGs of " acute biliary disease without complications and concomitant symptoms" and " laparoscopic cholecystectomy without common bile duct exploration" ( all P < 0.05 ). Conclusions Department of hepatobiliary surgery was better than other departments in the treatment of acute cholecystitis. Medical institutions should follow the principle of special treatment to reduce interdisciplinary patients and improve the professional competitiveness of the department.
10.Potential therapeutic effects and applications of Eucommiae Folium in secondary hypertension
Mengyuan LI ; Yanchao ZHENG ; Sha DENG ; Tian YU ; Yucong MA ; Jiaming GE ; Jiarong LI ; Xiankuan LI ; Lin MA
Journal of Pharmaceutical Analysis 2022;12(5):711-718
Eucommiae Folium(EF),a traditional Chinese medicine,has been used to treat secondary hypertension,including renal hypertension and salt-sensitive hypertension,as well as hypertension caused by thoracic aortic endothelial dysfunction,a high-fat diet,and oxidized low-density lipoprotein.The antihyperten-sive components of EF are divided into four categories:flavonoids,iridoids,lignans,and phenyl-propanoids,such as chlorogenic acid,geniposide acid and pinoresinol diglucoside.EF regulates the occurrence and development of hypertension by regulating biological processes,such as inhibiting inflammation,regulating the nitric oxide synthase pathway,reducing oxidative stress levels,regulating endothelial vasoactive factors,and lowering blood pressure.However,its molecular antihypertensive mechanisms are still unclear and require further investigation.In this review,by consulting the relevant literature on the antihypertensive effects of EF and using network pharmacology,we summarized the active ingredients and pharmacological mechanisms of EF in the treatment of hypertension to clarify how EF is associated with secondary hypertension,the related components,and underlying mechanisms.The results of the network pharmacology analysis indicated that EF treats hypertension through a multi-component,multi-target and multi-pathway mechanism.In particular,we discussed the role of EF tar-gets in the treatment of hypertension,including epithelial sodium channel,heat shock protein70,rho-associated protein kinase 1,catalase,and superoxide dismutase.The relevant signal transduction path-ways,the ras homolog family member A(RhoA)/Rho-associated protein kinase(ROCK)and nicotinamide adenine dinucleotide phosphate(NADPH)oxidase/eNOS/NO/Ca2+pathways,are also discussed.