1.Analysis the outcomes of traditional Chinese medicine clinical pathway in the treatment of cervical spondylotic radiculopathy
Di WANG ; Liheng ZHANG ; Kefei LIU
International Journal of Traditional Chinese Medicine 2014;(4):311-314
Objective To investigate the effect of treating cervical spondylotic radiculopathy with traditional Chinese medicine. Methods 110 patients with cervical spondylotic radiculopathy were treated with traditional Chinese medical pathway: Chinese herbal medicine soaking (incised notoptetygium rhizome, Chinese angelica, divaricate saposhnikovia root, safflower, dahurian angelica root, myrrh, common floweringqince fruit, and tuberculate speranskia herb, etc.)-Acupuncture-cervical traction-massage, once daily, 10 times as a course of treatment. After two courses, therapeutic effect score was analyzed. Results Of all 110 cases, 35 cases(31.82%)were cured; 53 cases(48.18%)had obvious effectiveness; 17 cases(15.45%)had effectiveness; 5 cases(4.55%)had no effectiveness. The total efficiency was 95.45%. The patient's age(χ2=0.296), sex(U=0.023), and duration of disease(χ2=0.577)had no significant effect on the efficacy(P>0.05);After the treatment, neck pain, upper extremity pain, upper extremity numbness, neck tenderness, intervertebral foramina compression test, sensory disturbances limbs, myodynamia of upper limbs, and tendon reflexes were significantly improved compared with before treatment, with significant difference(t=16.355、11.958、7.755、4.927、11.780、8.647、10.485、3.190、3.873、3.367,P<0.05). Conclusion The use of traditional Chinese medicine clinical pathway in treating cervical spondylotic radiculopathy was effective and it could improve the quality of medical care.
2.Relationship between Ankler-brachial Index and Extent of Intracranial Artery Stenosis
Xinjie SONG ; Kefei HUANG ; Yongjun WANG
Chinese Journal of Rehabilitation Theory and Practice 2010;16(1):55-55
ObjectiveTo evaluate the significance of ankler-brachial index (ABI) to predict the extent of intracranial artery stenosis in ischemic stroke patients. Methods243 ischemic stroke patients were enrolled, brain angiography were examined and all of the ABI and basic data were collected. ResultsABI≤0.9 was associated with a specificity of 84.6% and a sensitivity of 16.8% for predicting the presence of severe stenosis in intracranial artery. The area under receiver operating characteristic curve was (0.591±0.046) (P<0.05). ConclusionABI≤0.9 has a relative specificity and sensitivity for predicting the presence of severe stenosis of intracranial artery.
3.The value of ~(99m)Tc-MIBI scintimammography and breast X-ray in the diagnosis of breast cancer
Xuewei YANG ; Weiliang YANG ; Xiulan WANG ; Gang JIN ; Kefei WU
Chinese Journal of General Surgery 2000;0(11):-
Objective To evaluate the practical value of 99m Tc-MIBI scintimammography and breast X-ray in the detection of breast cancer. Methods 100 female patients with 106 suspected focuses of breast cancer on clinical examination underwent 99m Tc-MIBI scintimammography and breast molybdenum target X-ray, and the results were compared with the pathological diagnosis. Results Compared with the histopathologic diagnosis , the sensitivity of molybdenum target X-ray for detecting primary breast cancer was 44.6% and the positive predictability was 31.7%. The specificity of 99m Tc-MIBI was 87.8% and the positive predictability was 76.9%. Conclusions In comparison with breast X-ray, 99m Tc-MIBI scintimammography is of greater clinical value in the diagnosis of breast cancer.
4.Experimental study in detection of myocardial ischemia with stress dual-phase 18F-FDG myocardial PET/CT
Wei GAO ; Tie WANG ; Yan LI ; Kefei DOU ; Minfu YANG
Chinese Journal of Nuclear Medicine and Molecular Imaging 2014;34(6):470-474
Objective To explore the value of stress dual-phase (early and delayed phases)18 FFDG myocardial PET/CT in detection of myocardial ischemia.Methods Ten swine were prepared as ischemic models and underwent 3 imaging procedures:pre-model stress (8 swine),post-model rest (8 swine)and post-model stress dual-phase imaging (10 swine).To perform stress dual-phase imaging,the tested subjects were fasted for more than 12 h and underwent early-phase PET imaging at 50 min after the intravenous injection of 18F-FDG (5 MBq/kg) for 10 mins,and followed by a dobutamine stress test,and then delayed-phase PET imaging at 50 min after the stress test for another 10 mins.The post-model rest dual-phase imaging was performed in almost the same way except that there was no dobutamine-loading.18F-FDG uptake image was qualitatively analyzed and classified into 4 levels:1 =no uptake,2 =diffuse uptake,3 =focal uptake,4=focal on diffuse uptake.Level 1 or 2 was considered as normal.If the focal uptake (level 3 or 4)was found on anterior wall or septum,ischemia was diagnosed.x2 test was used to determine the difference of the rate of ischemic myocardium between the two phases.18F-FDG uptake ratio of the anterior wall to posterior wall (K) of the left ventricle was calculated (K1 for early phase and K2 for delayed phase).Wilcoxon rank sum test was applied to determine the difference between K1 and K2.Results CAG showed LAD stenosis >70% in all swine.In pre-model stress dual-phase imaging,no ischemia was detected at two phases (8/8 for level 1 or 2,0 for level 3 or 4).There was no significant difference between K1 and K2(1.08±0.10,1.11 ±0.10; Z =-1.48,P>0.05).In post-model rest dual-phase imaging,the rate of ischemic myocardium was not significantly different between early and delayed phases (1/8,3/8 ; x2 =0.50,P>0.05).There was no significant difference between K1 and K2(1.47±0.28,1.28±0.40; Z=-2.02,P>0.05).In post-model stress dual-phase imaging,the rate of ischemic myocardium between the two phases was statistically different (4/10,10/10;x2=4.17,P<0.05),and the difference between K1 and K2 was also significant (1.55±0.32,1.86±0.39; Z=-2.49,P<0.05).Conclusion Stress dual-phase 18F-FDG myocardial PET/CT might be useful for the diagnosis of ischemia.
5.Effects of IFN-?1b on morphology and the expression of connective tissue growth factor in hepatic stellate cells
Weifeng CHEN ; Qian WANG ; Kefei ZHANG ; Jiefu HUANG ; Hongxu XU
Chinese Journal of Pathophysiology 1989;0(06):-
AIM: To observe the effect of (IFN-?1b) on morphology and the expression of connective tissue growth factor (CTGF) in hepatic stellate cells (HSC). METHODS: HSC were cultured in vitro, and were treated with (IFN-?1b) and TGF-?_1. The changes of HSC on morphology were observed, and the expression of CTGF in HSC was assessed using reverse transcription-polymerase chain reaction (RT-PCR). RESULTS: Phenomenon of apoptosis were observed in HSC treated with IFN-?1b. The expression of CTGF in HSC was decreased after treatment with (IFN-?1b) in control and TGF-?1-triggered groups. CONCLUSION: (IFN-?1b) is able to induce the apoptosis and suppress the expression of CTGF in HSC.
6.Determination of 4-Hydroxy-3-Methoxy Benzoic Acid by RP-HPLC and Inhibitory Effectof Phloroglucinol on Catecholamine-O-Methyl Transferase
Ruiling YANG ; Hong LIU ; Qi WANG ; Kefei JI ; Mengjiao SONG
Herald of Medicine 2014;(10):1303-1306
Objective To detect content of 4-hydroxy-3-methoxy benzoic acid by RP-HPLC and observe the inhibitory effect of phloroglucinol on catecholamine-O-methyl transferase (COMT). Methods This study used the principle of 3,4-dihydroxy benzoic acid transforming to 4-hydroxy-3-methoxy benzoic acid under COMT’ s catalytic action. COMT (20 μL) was extracted from mouse liver homogenate. In a reaction system,10 μL catecol (1í10-3 mol·L-1 ) and 10 μL phloroglucinol (5í10-3 , 1í10-3 and 2í10-4 mol·L-1 ,respectively) were added. Products were determined by RP-HPLC to analyze effects of 4-hydroxy-3-methoxy benzoic acid on COMT. Results Phloroglucinol had inhibitory effect on COMT activity at concentrations of 5í10-3 mol·L-1 ,1í10-3 mol·L-1 and 2 í10-4 mol ·L-1 ,with the inhibition rate being 25. 3% ,17. 6% and 8. 9% ,respectively. Conclusion Phloroglucinol has an inhibitory effect on COMT activity,which is weaker than the effect of catechol of the same concentration.
7.The value of shear wave elastography in the process of differential diagnosis of benign and malignant thyroid nodule with calcification
Bei, WANG ; Kefei, CUI ; Yuanyi, LIU ; Caifeng, SI
Chinese Journal of Medical Ultrasound (Electronic Edition) 2014;(9):759-762
Objective To investigate the impact of calcification on differential diagnosis of thyroid nodule using shear wave elastography (SWE). Methods One hundred and forty-six patients with thyroid nodules were prospectively enrolled in the study. Ultrasound observations included nodule size, boundary, shape, envelope, internal echotexture, posterior acoustic enhancement, and the relationship with surrounding tissue. According to the presence of internal calciifcation, patients were divided into calciifcation group (groupⅠ) and no calciifcation group (groupⅡ). Real-time shear wave elastography (young′s modulus value) were taken in both groups. Taking surgical pathologic results as the gold standard, receiver operating characteristic (ROC) curve of SWE in diagnosis of benign and malignant thyroid nodule were drawn for two groups respectively. Results In groupⅠ, 25 cases were benign and 38 cases were malignant. The malignant incidence was 60%. Among them the rate of malignant nodules in microcalcification group was 92%(24/26). The incidence of malignant nodules in coarse calcification group was 38%(14/37). The area under the curve (AUC) of SWE in groupⅠwas 0.564. In groupⅡ, 67 cases were benign and malignant had 16 cases. Using 30.43 kPa as the diagnostic point of young′s modulus value, the sensitivity, speciifcity, accuracy and AUC were 93.2%, 81.2%, 84.8%and 0.824. Conclusion In no calciifcation group, SWE is more meaningful in the differential diagnosis of benign and malignant thyroid nodules.
8.Transcatheter arterial embolization using hardening agent combined with oral propranolol for the treatment of giant hemangioma at maxillofacial region in infants
Song WANG ; Chuangao YIN ; Deng PAN ; Weiwei QI ; Gengwu LI ; Kefei HU ; Yue WANG ; Jing ZHANG
Journal of Interventional Radiology 2015;(10):853-856
Objective To discuss the therapeutic effect of transcatheter arterial embolization using hardening agent combined with oral propranolol in treating giant hemangioma at maxillofacial region in infants. Methods During the period from October 2013 to December 2014 at Imaging Center of Anhui Provincial Children's Hospital, transcatheter arterial embolization using hardening agent combined with oral propranolol was employed in a total of 27 infants with giant hemangioma at maxillofacial region. The age of the infants ranged from 2 months to 22 months (mean 5.9 months) and the body weight was 4.5-10 kg with a mean of 6.32 kg. Angiography via femoral artery was performed, which was followed by super-selective catheterization of hemangioma-feeding artery, and then pingyangmycin lipiodol emulsion was injected into the hemangiomas with subsequent injection of PVA particles to obstruct the hemangioma-feeding artery. After the embolization treatment, the patient received oral propranolol for 3-6 months. Results All the infant patients were followed up for 3-6 months. Clinical examination and ultrasonography indicated that the hemangioma was cured in 20 infants (75%) and the therapeutic result was effective in 7 infants (25%). Skin necrosis at hemangiomas site was observed in 2 infants (7.5%), which was cured after symptomatic treatment. No serious complications such as pulmonary embolism, cerebral embolism occurred, and no recurrence was observed. Conclusion For the treatment of giant hemangioma at maxillofacial region in infants, transcatheter arterial embolization using hardening agent combined with oral propranolol is minimally invasive, quickly effective and highly safe;and this treatment leaves no scar formation in most cases. Therefore, this technique is worthy of clinical application.
9.Investigation of Mobidity, Prognosis and the Effect of Myocardial Infacfion in Patieuts With Small Side Branch Occlusion During Coronary Bifurcation Intervention
Jun ZHANG ; Dong ZHANG ; Zhiyong ZHAO ; Hao WANG ; Dong YIN ; Kefei DOU
Chinese Circulation Journal 2015;(10):941-945
Objective: To investigate the prognostic factor for small side branch (SB) occlusion during coronary bifurcation intervention with the incidence rate of peri-procedural myocardial injury (PMI) in relevant patients.
Methods: A total of 925 consecutive patients who received coronary bifurcation intervention were enrolled and there were 949 SB lesions ≤ 2.0 mm conifrmed by quantitative coronary angiography (QCA). The patients were divided into 2 groups: SB occlusion group,n=85, including 86 bifurcation lesions and Non-SB occlusion group,n=840, including 863 bifurcation lesions. The clinical characteristics, QCA findings and PCI procedural conditions were studied by Multivariate logistic regression analyses to explore the independent predictors of SB occlusion and to compare the incidence rate of PMI.
Results: The total SB occlusion rate was 9.1% (86/949). SB occlusion group had the higher incidence rate of PMI (26/83, 31.3%) vs (77/821, 9.4%) and peri-operative MI mortality(6/83, 7.2%) vs (11/821, 1.3%) than Non-SB occlusion group, both P<0.001. In SB occlusion group, the diameter ratio of main vessel (MV)/SB was obviously higher than Non-SB occlusion group,P<0.001. The independent predictors of SB occlusion included in true bifurcation lesion, irregular plaque, pre-dilation of SB, TIMI lfow grade of pre-procedural SB, stenosis degrees of distal MV and bifurcation core, bifurcation angle, diameter ratio of MV/SB and the stenosis degree of SB before MV stenting.
Conclusion: Coronary bifurcation lesion patients with SB occlusion had the higher risk of PMI during the interventional procedure.
10.Analysis for the Cause of Peri-procedural Myocardial Infarction and Risk Factors in Patients After Elective Percutaneous Coronary Intervention
Lei FENG ; Dong ZHANG ; Dong YIN ; Hao WANG ; Zhiyong ZHAO ; Guofeng GAO ; Kefei DOU
Chinese Circulation Journal 2017;32(5):431-435
Objective: To assess the risk factors for peri-procedural myocardial infarction (PMI) occurrence in patients after percutaneous coronary intervention (PCI) based on the new standard of US Society for cardiovascular angiography and interventions (SCAI). Methods: According to SCAI standard, a total of 3371 relevant patients with 3516 elective PCI in our hospital were enrolled. The baseline clinical features, coronary angiography (CAG) findings and PCI procedural elements were retrospectively studied, the independent risk factors for PMI occurrence were identified by multivariate Logistic regression analysis. Results: There was 108/3516 (3.1%) PMI occurred in all patients. Multivariate Logistic regression analysis presented that age (OR=1.037, 95% CI 1.016-1.058), treating multi-vessel lesions (OR=1.697, 95% CI 1.095-2.629), treating at least 1 bifurcation lesion (OR=1.869, 95% CI: 1.213-2.878) and the total length of lesion (OR=1.016, 95%CI 1.009-1.024) were the independent risk factors for PMI occurrence. Conclusions: Age, treating multi-vessel lesions, at least one bifurcation lesion and the total length of lesion were the independent risk factors for PMI occurrence in patients after elective PCI.