2.An analysis of efficacy and safety of recombinant tissue plasminogen activator for treatment of patients with acute cerebral infarction
Ruiming WANG ; Weimin FENG ; Kan OUYANG
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care 2015;26(2):160-163
Objective To observe the therapeutic efficacy and safety of recombinant tissue plasminogen activator (rt-PA) for treatment of patients with acute cerebral infarction and investigate the prognostic factors of thrombolysis. Methods The clinical data of 60 patients with acute cerebral infarction from January 2009 to November 2013 in Department of Emergency, Hangzhou Traditional Chinese Medicine Hospital were retrospectively analyzed;of them, 30 cases received intravenous rt-PA thrombolytic treatment, being in the thrombolytic group, 0.9 mg/kg rt-PA was given to the patient within 4.5 hours after the disease onset, the total dosage could not exceed 90 mg, in which 10%was intravenously injected and the rest 90%was intravenously dripped slowly within 60 minutes. That another 30 cases did not undergo thrombolytic therapy was assigned as the control group, and they took aspirin, etc anti-platelet aggregation routine treatment. Before and after thrombolytic treatment for 1 hour, 24 hours and 14 days, the National Institutes of Health Stroke Scale (NIHSS) score was evaluated in the two groups;before and after thrombolytic therapy for 0.5, 1.0, and 1.5 hours, the patient's scores of Barthel index (BI) were observed in the two groups. In thrombolytic group, the situations of hemorrhage transformation, symptomatic hemorrhage and modified Rankin scale (mRS) score in 3 months of the patients with different ages, complications and NIHSS scores were observed. Results Before treatment, no statistically significant differences were found in the NIHSS score (15.2±3.6 vs. 15.5±3.3) and BI score (45.0±8.8 vs. 44.1±7.6) between the control group and thrombolytic group (both P>0.05);after treatment with the extension of time, the NIHSS score was gradually reduced, reaching the lowest level on the 14th day after thrombolytic treatment, while the BI score was gradually increased, reaching its peak at 1.5 hours after thrombolytic treatment, the changes being more prominent in thrombolytic group (NIHSS score:9.7±2.6 vs. 12.8±4.2, BI score:82.6±7.8 vs. 69.6±9.8, both P<0.05). In thrombolytic group, there were cerebral hemorrhage transformation 2 cases, gum bleeding 3 cases, skin bleeding 1 case, urethral bleeding 1 case, gastrointestinal bleeding and black stool 1 case. In control group, cerebral hemorrhage transformation was seen in 1 case. There was no obvious systemic hemorrhage in the two groups. In the 30 cases in thrombolytic group, the baseline NIHSS score of patients>80 years old was higher than that in cases≤80 years old (15 vs. 12); the age (years: 71.0±4.1 vs. 61.5±2.6), baseline NIHSS score (14 vs. 11) and bleeding conversion rate [37.50% (3/8) vs. 18.18% (4/22)] of cases with atrial fibrillation were higher than those not complicated with atrial fibrillation; the NIHSS score of cases with elevated international normalized ratio (INR) was lower than those without elevated INR (11 vs. 14);The bleeding conversion rate [16.67%(1/6) vs. 29.17%(7/24)] with NIHSS score≤4 were lower than those with NIHSS score>4;the mRS score in 3 months (4 vs. 2), and percentage of 3-month mRS score≤2 [11.1%(1/9) vs. 52.38%(11/21)] in cases with NIHSS score≥20 was higher than that in cases with NIHSS score<20 (all P<0.05). The fatality rate of two groups was 3.33%. Conclusions The intravenous rt-PA thrombolytic treatment can significantly promote the early recovery of neurologic impairment for patients with acute cerebral infarction. The therapy can improve the prognosis and its safety is relatively good. Meanwhile it is similarly effective for cases over 80, with complications such as atrial fibrillation, raised INR, and with different degrees of severity.
3.COMPARATIVE ANALYSIS OF NUMERICAL TAXONOMY AND 16S rDNA PCR-RFLP OF FAST-GROWING RHIZOBIA ISOLATED FROM WESTERN CHINA
Feng-Ling KAN ; Wen-Xin CHEN ;
Microbiology 1992;0(03):-
strains of fast-growing rhizobia isolated from Chinas western (mainly from Qinghai province),and 4 representative strains were compared by performing numerical taxonomy. 132 phenotypic characteristics were analyzed. The results of numerical taxonomy constructed a dendrogram. It shows that all the strains examined clustered into five phena at a similarity level of 79%. 16S rDNA PCR-RFLP were applied to 57 rhizobial strains (among the 61 strains) and 10 reference strains. The 16S rDNA-RFLP analysis described 20 different genotypic characteristics and form one dendrogram. For some large groups, the results of 16S rDNA-RFLP were agreement with that of numerical analysis of phenotypic characteristics.
4.Sequence pattern mining of doctor's advice for Chinese traditional medicine in HIS
Jun ZHUANG ; Feng LI ; Shiqing YE ; Kan LIU ; Jiao HE
Chinese Medical Equipment Journal 2004;0(07):-
Extensive functions can be provided to hospital management,medical treatment and teaching when massive data are reasonably processed and analyzed. Knowledge mined from sequence of doctor's advice for medicine can not only evaluate treatment quality but also provide necessary basis for establishing a safety and effective medicine treatment plan. This paper analyzes some common information of doctor's advice for medicine,mines the doctor's advice for medicine by using sequence pattern mining method,and explains the mining results.
5.Right hepatectomy with total hemihepatic vascular exclusion in hepatocellular carcinoma
Chengjun SUI ; Feng XU ; Weifeng SHEN ; Tong KAN ; Feng XIE ; Li GENG ; Yangqing HUANG ; Jiamei YANG
Chinese Journal of Hepatobiliary Surgery 2012;18(10):769-772
Objective To explore the clinical value of total hemihepatic vascular exclusion (THHVE) in right hepatectomy for hepatocellular carcinoma (HCC). Methods One hundred and twenty-three consecutive patients who underwent right hepatectomy for HCC between February 2006 and December 2008 were studied retrospectively. THHVE was used in 58 patients (group A) and Pringle maneuver in 65 patients (group B). The patient's demographics,surgical procedure and outcome were collected and compared between the two groups.ResultsThe tumor size was significantly bigger in group A than group B (7.69±3.70 cm vs.6.08±4.07 cm,P<0.05).The vascular occlusion time in group A was significantly longer than groupB (28.55±8.67 min vs.19.85±6.71 min,P<0.05). However, intraoperative blood loss in group A was significantly less than group B (304.31±270.36 ml vs.542.62±876.84 ml,P<0.05),and the elevation of serum alanine aminotransferase (ALT) on day- 1,-3 and- 7 after operation in group A were significantly lower than group B (P<0.05).The postoperative complication rate in group A was lower than group B (18.97% vs.38.46%,P<0.05).ConclusionTHHVE was a safe and efficacious technique in right hepatectomy for HCC.It significantly decreased blood loss,alleviated liver injury and reduced postoperative morbidity and mortality.
6.Extrahepatic recurrence after curative resection of hepatocellular cancer
Yanming ZHOU ; Jiamei YANG ; Bin LI ; Zhengfeng YIN ; Feng XU ; Tong KAN ; Feng XIE
Chinese Journal of General Surgery 2010;25(5):370-372
Objective To investigate the risk factors of extrahepatie recurrences after curative resection of primary hepatocellular carcinoma (HCC). Methods Clinicopathologic data of 238 curative resected cases of primary HCC were retrospectively reviewed for parameters affecting postoperative extrahepatic recurrences. Results During a median follow-up of 34 months (7 - 78 months), extrahepatic recurrences were observed in 32 out of 238 patients (13.4%). According to univariate analysis, the risk factors for extrahepatic recurrences were preoperative serum a-fetoprotein (AFP) level of > 1000 ng/ml,aspartate aminotransferase level of > 50 IU/L, presence of hepatic vein invasion, neighboring organ invasion, tumor satellites, and lack of tumor capsule formation. Preoperative serum AFP levels of > 1000 ng/ml, hepatic vein invasion, neighboring organ invasion proved to be independent risk factors by multivariate analysis. Conclusions Extrahepatic recurrences after curative resection of HCC was found to be related to preoperative serum AFP level of > 1000 ng/ml, hepatic vein invasion, and neighboring organ invasion.
7.Inhibitory effects of sustained-release 5-fluorouracil microparticles on the growth of HepG2 cells
Feng XIE ; Jiamei YANG ; Feng XU ; Tong KAN ; Yangqing HUANG ; Fei FAN
Chinese Journal of Digestive Surgery 2008;7(6):433-435
Objective To evaluate the inhibitory effects of sustained-release 5-fluorouracil(5-FU)micmparticles on the growth of HepG2 eels.Methods The inhibitory effects of sustained-releage 5-FU micropartides,5-FU microparticles and poly L-lactic acid on HepG2 cells were detected by MTT assay.The HepG2 cell apoptosis was demonstrated by flow cytomerry after Hoehest staining.Results The survival rate of HepG2 cells in sustained-release 5-FU microparticles group decreased as time passed by.The survival rate of HepG2 cells in 5-FU microparticles group wag the lowest on the first day,and then it increased gradually.The survival rates of HepG2 ceHs in 5-FU microparticles group on day 21 and 28 were hJigher than those in sustained-release 5-FU microparticles group.The survival rate of HepG2 cells in poly L-lactic acid group WSB higher than that in the other two groups.The difference upon survival rate among the 3 groups had statistical significance(F=3163.52,128.47.P<0.01).Conclusions The sustained-release 5-FU micropartieles could keep on inhibiting tlle growth and inducing apoptosis of HepG2 cells in time-dependant manner.The inhibitory effect of sustained-release 5-FU is better than that of 5-FU microparticles.
9.The application of absorbable self-enhancing cartilage nails in the treatment of radial head fractures
Danmou XING ; Wusheng KAN ; Dong REN ; Wei FENG ; Fei WU ; Yan CHEN ; Zhengren PENG
Chinese Journal of Orthopaedics 2013;(1):50-54
Objective To evaluate the clinical effect of absorbable self-enhancing cartilage nails in the treatment of radial head fractures.Methods Data of 22 patients with radial head fractures,who had undergone open reduction and internal fixation with absorbable self-enhancing cartilage nails from January 2008 to December 2011,were retrospectively analyzed.Among them,data of 18 patients were complete,including 10 males and 8 females.According to the Mason classification,there were 14 cases of Mason Ⅱ,3 cases of Mason Ⅲ and 1 case of Mason Ⅳ.Two patients were combined with radial neck fractures,9 with osteochondral fractures of capitellum,and 1 with posterior dislocation of the elbow and olecranon avulsion fracture.The radial head fractures were temporarily fixed with Kirschner wires after open reduction,then absorbable self-enhancing cartilage nails with length from 16 to 24 mm and diameters of 1.5 mm were applied to reach final fixation.The heads of nails were right underneath of cartilages without penetrating bone cortexes on the contralateral side.The radial neck fractures were reduced and fixed with T-plates or anatomical plates after the radial head fractures were fixed with cartilage nails.Four cases of osteochondral fracture of capitellum were fixed with absorbable sutures to external epicondyle of humerus.For other 5 cases of osteochondral fracture of capitellum,the bone fragments were removed due to too small to fix.Results All 18 patients were followed up for 6 to 54 months (average,31.3 months).All fractures achieved bone union,and the healing time ranged from 5 to 12 weeks (average,8.7 weeks).There were no complications,such as internal fixation failure,nonunion,hematoma,sinus formation,osteolytic changes of radial heads and so on.According to the Broberg-Morrey elbow performance score,13 cases were excellent,4 good,and 1 fair,with the total excellent and good rate of 94.44% (17/18).At final follow-up,the elbow range of motion was 90° to 150° (average,123.8°),and the range of forearm rotation was 130° to 180° (average,152.5°).Conclusion Absorbable self-enhancing cartilage nails can be used to treat various kinds of radial head fractures,and the results are satisfactory.
10.Biomechanical property changes following rat cornea collagen crosslinking using glyceraldehyde
Ying, WANG ; Feng-mei, HAN ; Yan-hua, CHU ; Quan-hong, HAN ; Kan-xing, ZHAO
Chinese Journal of Experimental Ophthalmology 2012;30(5):414-417
BackgroundSeveral cornea collagen crosslinking methods have been used to treat keratoconus.However,the safety of these methods is dissatisfactory.Glyceraldehyde is a very potent and highly reactive crosslinking agent,with little toxicity,but its effect on corneal biomechanical property is poorly clear.ObjectiveThe aim of this study was to evaluate the biomechanical effects of glyceraldehyde collagen crosslinking on rats cornea.Methods Fifteen clean SD rats were randomly divided into 0.005 mol/L glyceraldhyde group,0.050 mol/L glyceraldhyde group and blank control group.Glyceraldhyde drops was topically administered in the right ryes 2 times per day for consecutive 7 days in the 0.005 mol/L and 0.050 mol/L glyceraldhyde groups,and no any eye drops was used in the blank control group.Seven days later,the rats were sacrificed.Transparency of corneal buttons in these different groups was evaluated.The central corneal strips of 2 mm×6 mm with 2 mm scleral tiasue were obtained for the biomeehanical stress-strain measurement,including ultimate stress ( MPa),ultimate strain (%) and 6% elastic modulus (MPa).Corneal collagen fibril density was assessed by histological examination under a light microscopy.The use of the animals followed the Regulations for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission.ResultsThe words could be clearly displayed transcorneally in all the three groups.When strain was 6%,the stress was (0.463±0.065 ) MPa in 0.005 mol/L glyceraldehyde group,(0.846±0.240) MPa in 0.050 mol/L glyceraldehyde group,both showing a significant increase in comparison with (0.195±0.103 ) MPa of the blank control group (P=0.029,0.000 ).Following the crosslinking treatment,the ultimate stress was significant elevated in 0.050 mol/L glyceraldehydes group compared with the blank control group ( ( 10.759 ± 3.337 ) MPa vs.(5.295± 1.313 ) MPa,P =0.007 ),but no significant change between the 0.005 mol/L glyceraldehydes group and the blank control group ( ( 6.043 ±2.084) M Pa vs.(5.295 ± 1.313 ) MPa,P =0.660 ).Corneal ultimate strain was lower in the 0.005 mol/L glyceraldehyde group and 0.050 mol/L glyceraldehyde group than the blank control group (36.57% ±3.09% vs.43.87% ± 1.89%,P =0.009;28.53% ±1.89% vs.43.87% ± 1.89%,P =0.000).However,significantly increased 6% elastic modulus were seen in the 0.005 mol/L glyceraldehyde group and 0.050 moL/L glyceraldehyde group compared with the blank control group ( ( 7.718 ± 1.076 ) MPa,( 14.102 ± 4.011 ) MPa vs.( 3.252 ± 1.717 ) M Pa),with statistically significant differences ( P =0.029,0.000).Histological examination showed a increase of collagen fiber density in the 0.050 mol/L glyceraldehyde group.Conclusions Corneal collagen crosslinking induced by glyceraldehyde strengthens biomechanical intensity and increases the density of corneal collagen fiber.But the safety of glyceraldehyde crosslinking for keratoconus needs further study.