3.The outcomes and prognoses of in-hospital sudden cardiac death
Shen ZHAO ; Feng CHEN ; Xiaoping WANG ; Qingming LIN ; Jun KE
Chinese Journal of Emergency Medicine 2012;21(9):1022-1025
Objective To explore the incidence,features and outcomes of in-hospital sudden cardiac death (SCD) in order to determine the predictors of survival. Methods The clinical data of 69 patients with cardiac arrest hospitalized from January 2008 through December 2010 were retrospectively analyzed.Information on genders,age,types of arrhythmia was collected and further analyzed to determine these factors associated with the occurrence and outcomes of in-hospital cardiac arrest. Results The overall incidence of SCD was 47.3 / 100 000 per year and 17.4% of them.survived at discharge.The occurrence rate was higher in male than that in female (66.7% vs.33.3%,P <0.01 ),whereas difference in gender did not affect the discharge rate ( P > 0.05 ). Survivors from in-hospital cardiac arrest were significantly younger than non-survivors (man:62.57 ± 12.83 years vs.75.56 ± 10.55 years; women:60.36 ± 13.24years vs.69.53 ± 11.72 years,P < O.01 ).From 62 ECG records of SCD patients,the incidence of nonshockable rhythms was higher than that of shockable rhythms.Compare to the non-shockable rhythms,the shockable rhythms brought a higher rate of restoration of spontaneous circulation (ROSC) (54.5% vs.24.5%,P <0.05),whereas survival rates at discharge between two groups were not statistically different ( 18.2% vs.18.4%,P > 0.05 ).Conclusions Non-shockable rhythms were more common in patients suffering from in-hospital cardiac arrest.Although defibrillation treatment contributed benefit to ROSC among patients with ventricular fibrillation or pulseless ventricular tachycardia,high-quality CPR and post-cardiac arrest care may play a more critical role in the outcomes of in-hospital sudden cardiac death.
4.Effects of Ginkgo Bilobate Extract Injection on the hemorheology, blood lipid and C-reactive protein in serum of patients with cerebral infarction
Feng LIN ; Jun ZHAO ; Wansheng CHANG ; Jieyun LI
International Journal of Traditional Chinese Medicine 2011;33(9):783-785
ObjectiveTo observe effects of ginkgo bilobate extract injection on the hemorheology,blood lipid and c-reactive protein in serum of patients with cerebral infarction. Methods62 cases patients with cerebral infarction were randomly divided into two groups by means of random number table. Two groups were both given routine treatment. The control group was treated with 20ml compound salvia injection, which was added to 250 ml normal saline, once a day, continuous therapy for 14 days, and the treatment group was treated with 20ml ginkgo bilobate extract injection, which was added to 250 ml normal saline, once a day, continuous therapy for 14 days. The clinical symptoms were observed, hemorheology related index, level of blood lipid and c-reactive protein were detected before and after the treatment. ResultsCompared with the control group,hemorheology related index decreased significantly in the treatment group, especially whole blood viscosity ( 1.57±0.28) mpa ·s (P<0.01). Blood reduced viscosity (13.95 ± 2.07) mpa ·s, erythrocyte aggregation index (1.37±0.12) , hematocrit (42.36±8.16) were also decreased significantly (P<0.05) .Triglyceride (TG)(1.23±0.12) mmol/L、 cholesterol (TC) (4.29±1.17) mmtmol/L、 low density lipoprotein cholesterol (LDIL-C)(2.31± 0.39) mmol/L and c-reactive protein ( 10.48 ±- 3.82) mg/L in serum in the treatment group were lower than those of the control group (P<0.01 orP<0.05) , high density lipoprotein cholesterol (HDL-C) ( 1.78±0.76) mmol/L in serum was higher than that of the control group (P<0.01) .The total effective rate of the treatment group and the control group was 87.1% and 67.7% respectively, there was a significant difference (x2=3.553, P<0.05). Conclusion The ginkgo bilobate extract injection can protect cerebral infarction from injury,which may be related with its action on regulating the blood viscosity and level of blood lipid.
5.In vivo injection of CD4+CD25+ regulatory T cells affects renal impairment in MRL/lps mice
Lin FENG ; Qingchun DIAO ; Junsong ZHENG ; Juan HE ; Jun WU
Chinese Journal of Dermatology 2011;44(6):434-436
Objective To investigate the influence of CD4+CD25+ regulatory T cells (Tregs) on the disease progression in MRL/lps mice. Methods Tregs were separated by using magnetic beads from splenic cells of MRL/lps mice and BALB/c mice, and concentrated. Twenty-four MRLAps mice were equally divided into 3 groups, test group 1 injected with Tregs from MRL/lps mice, test group 2 injected with Tregs from BALB/c mice, and control group injected with physiological sodium chloride solution. Three weeks later, the levels of urine protein as well as serum anti-dsDNA antibody were determined; subsequently, the mice were sacrificed followed by histopathological and immunopathological examination of renal tissue. Results A significant decline was observed in the test group 1 compared with the test group 2 and control group in the urine protein score (10.63 ± 4.17 vs. 20.00 ± 5.35 and 18.75 ± 8.34, both P < 0.05), serum anti-dsDNA antibody level (5.36 ± 2.40 pg/ml vs. 9.57 ± 1.97 pg/ml and 10.75 ± 3.98 pg/ml, both P < 0.05), glomerular sclerosis index [(32.00 ± 12.09)% vs. (45.50 ± 13.68)% and (47.50 ± 10.78)%, both P< 0.05], and immunofluorescence intensity of IgG immune complex in renal tissue (1.88 ± 0.99 vs. 2.88 ± 0.64 and 2.75 ± 0.71, both P< 0.05). No significant difference was noted in renal tubule interstitial impairment index between the 3 groups (4.63 ± 1.92, 6.00 ± 1.07 and 5.75 ± 1.28, all P> 0.05). There was no statistical difference between the test group 2 and control group in terms of any of the above parameters (all P > 0.05). Conclusions Injection of Tregs from homologous mice could significantly down-regulate proteinuria degree, serum anti-dsDNA antibody level, glomerular sclerosis index and IgG immune complex level in renal tissue, and thereby decelerate the progression of renal impairment in MRL/lps mice.
6.The efifcacy of ultrasound guided percutaneous thermoablation for secondary hyperparathyroidism
Jun-feng, ZHAO ; Lin-xue, QIAN ; Yuan, ZU
Chinese Journal of Medical Ultrasound (Electronic Edition) 2013;(11):898-902
Objective To explore the clinic value and efficacy of color Doppler ultrasound guided percutaneous microwave/radiorequency thermoablation for secondary hyperparathyroidism. Methods Fifty-six cases of secondary hyperparathyroidism who came from nephrology department of Beijing Friendship Hospital in the period of September 2012 to September 2013 were treated by color Doppler ultrasound guided percutaneous microwave/radiorequency thermoablation. One hundred and thirty-eight glands underwent this treatment and were evaluated by contrast enhanced ultrasound before, during and after operation. The levels of serum parathyroid hormone (PTH) were measured before and at 1 week, 1 month, 6 months and 1 year after treatment. Results The whole 56 cases achieved 1 month follow-up and 34 cases and 12 cases achieved 6 months and 1 year follow-up, respectively. Two special cases had been excluded. The PTH levels of 54 cases were signiifcantly different between after and before treatment [(369.5±183.4) ng/L vs (1321.6±471.4) ng/L, t=10.727, P=0.000]. The PTH levels continued to fall at the ifrst week after treatment, but there was no statistical signiifcance between the ifrst week and the ifrst day after treatment [(324.6±172.8) ng/L vs (369.5±183.4) ng/L], while there was signiifcantly different between the ifrst week after treatment and before treatment [(324.6±172.8) ng/L vs (1321.6±471.4) ng/L, t=9.364, P=0.000]. The PTH levels increased from (324.6±172.8) ng/L to (332.5±164.9) ng/L at 1 week and 1 month after ablation, while there was no signiifcant difference.But there is signiifcantly different between 1 month after treatment and before treatment (t=11.348, P=0.000). The PTH level at 6 months after treatment [(205.2±136.3) ng/L] and 1 year after treatment [(177.1±171.5) ng/L] had signiifcant difference compared with the value before treatment (t=8.737, P=0.000; t=7.655, P=0.017). Conclusion Color Doppler ultrasound guided percutaneous microwave/radiorequency thermoablation can be considered as a feasible and effective nonsurgical alternative treatment for secondary hyperparathyroidism patients.
8.Application of the customer satisfaction theory in quality management system of medical laboratories
Lixin WANG ; Feng LI ; Liru WANG ; Lin PAN ; Jun WEI
Chinese Journal of Hospital Administration 2014;30(1):34-36
Medical laboratories provide test data and consultation services and are engaged in ensuring test results being timely,accurate and reliable,which are satisfactory for their service recipients.A summary of the customer satisfaction theory and quality management system,and an analysis of problems found in the quality management of such laboratories,attempt to pinpoint underlying causes of service quality setbacks.Based on such studies,the quality management system is built in accordance with customer satisfaction theory and CNAS-CL02 Accreditation Criteria for the Quality and Competence of Medical Laboratories (ISO 15189:2007).Such efforts aim to continuously improve service quality and ensure customer satisfaction.
9.Comparison of three different molecular assays for the detection and molecular characterization of circulating tumor cells in breast cancer
Changrui SUN ; Jun DENG ; Lin FENG ; Hua HONG ; Yongmei JIANG
Chinese Journal of Laboratory Medicine 2015;(10):666-671
Objective Comparison of three different molecular assays for the detection and molecular characterization of circulating tumor cells in breast cancer .Methods The retrospective study compared three different molecular assays to detect CTC in the peripheral blood of 30 healthy individuals and 71 benign breast disease patients and 83 early and 84 metastatic breast cancer patients .All samples were collected at the outpatient , inpatient and physical examination department of Sichuan Provincial People ′s Hospital from January 2011 to June 2014.The same cDNAs were analyzed by:singleplex RT-qPCR assay for BCL-2, multiplex RT-qPCR for BCL-2, HER-2, HMAM, and a commercially available molecular assay (AdnaTest BreastCancer ) for GA733-2, MUC-1, HER-2.The positive of CTC were compared among healthy individuals and benign breast disease patients and breast cancer patients .Chi square test was used to compare the expression of gene markers among the three groups , and the agreement of Kappa test was used to evaluate the method.Results (1) Detection rates of early breast cancer by single RT-qPCR, Adna kits and multiple RT-qPCR were 13.3%, 16.9% and 18.1%, respectively , and the detection of metastatic breast cancer were 31.0%, 42.9%and 35.7%, respectively.There were significant differences in the positive of CTC by three molecular assays between healthy individuals and benign breast disease patients and early breast cancer patients ( The test values were 4.235 and 4.301, 5.367 and 5.474, 5.894 and 6.023 respectively, P<0.05).There were no differences between benign breast disease patients and early breast cancer patients (The test values were 0.891,0.748 and 0.701 respectively,P >0.05) .There were significant differences between metastasis breast cancer patients and healthy individuals and benign breast disease patients and early breast cancer patients ( The test values were 8.429,7.553 and 7.061;10.24, 9.025 and 8.745; 9.658, 8.417 and 8.201 respectively,P<0.05).(2) In early breast cancer: The concordance between AdnaTest and single RT-qPCR was 79.5%while between AdnaTest and multiplex RT-qPCR was 77.1%.No agreement was found among them ( The test values were 1.065 and 1.871, P were 0.371 and 0.258 ) .The concordance between single RT-qPCR and multiplex RT-qPCR was 80.7%.No agreement was found between them (The test values was 2.814, P was 0.156).(3) In patients with overt metastasis:The concordance between AdnaTest and single RT-qPCR was 78.6%( The test values was 10.986).While between AdnaTest and multiplex RT-qPCR was 80.9%( The test values was 9.251 ) . Agreements were found among them ( P was 0.002 and 0.005 respectively ) .The concordance between single and multiplex RT-qPCR was 88.1%( The test values was 12.364 ) .Agreement was found between them (P was 0.001).Conclusions No correlations were found among different molecular methods to detect CTC in the early primary breast cancer , but correlations were found in the metastatic breast cancer , suggesting that different rate of CTC caused by the number of CTC and its heterogeneity should be considered to the clinical diagnosis and treatment of breast cancer while molecular method is used .
10.Case-control Study on Risk Factors for Asthma in Children in Qingdao
Rong-Jun LIN ; Yong-Feng YU ; Xiao-Bin ZHOU ;
Chinese Journal of Prevention and Control of Chronic Diseases 2006;0(05):-
Objective To explore the risk factors for asthma in children.Methods A 1:1 matched and hospital-based case-control study was conducted to analyses risk factors for asthma in 300 pairs of children by logistic regression analysis. Results The result of univariate Logistic regression analysis showed that there were 17 related factors for children asthma, including disease history of parents in respiratory system,family income,atopie character,history of acute respiratory infections, eating habit,the amount of sea foods intakes,foam plastics,family decoration,the way of exhaust fume in kitchen,the exhaust effectiveness,raising pet in house,family history of asthma,family history of allergic rhinitis,family history of food allergy,dust allergy of parents,systemic therapy after the first attack.With multivariate Logistic regression analysis,7 factors were entered the model,6 risk factors including father's history of respiratory diseases(OR 3.771,95%CI 1.533~9.278),low family income(OR 1.503, 95%CI 1.258~1.795),atopy(OR 3.788,95%CI 2.368~6.058),meat-eating habit(OR 2.042,95%CI 1.481~2.815),asthma history of family members(OR 1.710,95%CI 0.988~2.958),the family history of allergic rhinitis(OR 1.991,95%CI 1.234~3.211), and 1 protective factor of raising pet in house(OR 0.443,95%CI 0.265~0.739).The coefficients of these factors in multivariate logistic regression model were 1.327、0.407、1.322、0.714、0.536、0.689、and-0.814 respectively.Conclusion Children asthma was a multi-factorial complex disease,and the interaction of environmental and genetic risk factors played an important role in the onset of this disease.