1.Clinical efficacy of Qingyi decoction combined with DAR for the treatment of acute pancreatitis
Zhengliang ZHANG ; Zhenghai BAI ; Lifeng DU ; Shiyuan SUN ; Minlong LIU ; Fei MIAO ; Honghong PEI
Chinese Journal of Emergency Medicine 2013;22(7):760-764
Objective To explore the clinical efficacy of Qingyi decoction (a preparation of Chinese herbal medicine) combined with DAR (combined use of dexamethasone,anisodamine and rhubarb) for the treatment of acute pancreatitis.Methods A total of 387 eligible patients met the criteria of acute pancreatitis were enrolled from January 2005 to April 2012 for prospective study.All patients,mild acute pancreatitis (MAP) or severe acute pancreatitis (SAP),were divided (random niumber) into four groups,namely conventional therapy (T),DAR therapy (DAR),Qingyi decoction therapy (Q) and Qingyi decoction combined with DAR therapy (Q + DAR).Outcome,fasting time,serum amylase,abdominal pain relief time,pancreatic or peri-pancreatic complications and average hospital-stay were analvzed with SPSS 13.0 statistic software.P < 0.05 was considered statistically significant.Results None of MAP patients died.Of SAP patients,there was no difference in mortality among different groups (P > 0.05).length of fasting time,tine elapsed for abdominal pain relief,time required for normalized serum amylase level and length of hospital stay in MAP patients were significantly shorter than those in SAP patients regardless of different therapies (P < 0.05).Either patients of SAP or MAP treated with Q + DAR or DAR suffered shorter length of time than those treated with T or Q in respect of fasting,abdominal paiu relief,serum amylase level normalization and hospital stay (P < 0.05).For SAP or MAP patients,there was no difference in abdominal pain relief time between receiving DAR and Q + DAR treatment (P > 0.05),but the fasting time in Q + DAR was shorter than that in DAR (P < 0.05).Patients with SAP were more likely to suffer pancreatic or per-pancreatic complications than those with MAP,but there was no difference for SAP or MAP with different treatments.Conclusions DAR or Q + DAR was an alternative to conventional treatment for MAP or SAP,and they were both superior to conventional treatment.And Q + DAR was more advantageous than DAR when fasting time,hospital-stay time and cost were considered.
2.A clinical study on the application of different feeding formulas in early postnatal feeding of premature infants
LuYan HAN ; Miao LI ; YaNan GU ; LiFeng CUI ; LiYuan ZHANG ; XiaoJing XU
Chinese Journal of Clinical Nutrition 2024;32(3):160-166
Objective:To investigate the effects of different feeding formulas on the feeding and growth and metabolism of premature infants in the early postnatal period.Methods:Eligible premature infants with the gestational age of ≤ 34 weeks hospitalized from March 2023 to March 2024 were selected as per inclusion criteria, excluding those with congenital metabolic diseases, severe congenital heart disease and developmental malformations of digestive tract. According to the feeding formulas within 2 weeks after birth, premature infants were divided into three groups, namely donor human milk (DHM) group, preterm formula (PF) group and extensively hydrolyzed formula (eHF) group. The characteristics of premature infants, perinatal condition, feeding formulas, milk intake on the 7th and 14th day, the time to the daily milk intake of 120ml/kg and 150ml/kg respectively, the time on parenteral nutrition, the length of hospitalization, feeding intolerance, cholestasis, extrauterine growth retardation and biochemical metabolic indexes at 7 days, 14 days and discharge were collected. The differences of feeding and biochemical metabolic parameters were compared across the three groups.Results:A total of 108 cases were enrolled ,of whom 39 were in DHM group, 37 in PF group and 32 in eHF group. There was no significant difference in gestational age, birth weight, head circumference and maternal complications across the three groups. The milk intake in the DHM group was (50.7±29.1) ml/(kg·d) on the 7th day, compared with (34.2±27.3) ml/(kg·d) in PF group ( P=0.031), and (103.1±36.7) ml/(kg·d) on the 14th day, compared with (73.9±39.2) ml/(kg·d) in the PF group. Compared with the PF group, the DHM group reached the daily milk intake of 120 ml/(kg·d) earlier [(18.5±10.4) days vs. (24.1±10.3) days, P=0.020], had shorter duration of parenteral nutrition [(17.9±10.9) days vs. (23.2±11.2) days, P=0.042], and lower incidence of feeding intolerance (28.2% vs. 48.6%). The length of hospitalization in DHM group was shorter than that in PF group [(33.8±15.5) days vs. (37.8±17.6) days], but there was no significant difference ( P>0.05). There was no significant difference between the DHM group and the eHF group in terms of the milk intake on the 7th and 14th day, the time to the daily milk intake of 120 ml/(kg·d), the time on parenteral nutrition, the length of hospitalization and feeding intolerance. At 1 and 2 weeks after birth, alkaline phosphatase in DHM group was higher than that in PF group and eHF group ( P<0.05), but there was no significant difference in biochemical nutritional metabolism parameters (hemoglobin, urea nitrogen, albumin, prealbumin, alkaline phosphatase and total bile acid) across the three groups at discharge( P>0.05). Conclusion:Early use of DHM in premature infants is better tolerated than PF and can help achieve complete enteral nutrition earlier and shorten the use of parenteral nutrition, while not affecting the growth and development of premature infants.
3.A clinical comparative study of axillary mastoscopic mastectomy and traditional areola incision in treatment of gynecomastia
Tao LIN ; Mengsheng CUI ; Junheng BAI ; Haidong ZHAO ; Lifeng MIAO ; Wenwen DONG
Chinese Journal of Endocrine Surgery 2020;14(2):110-114
Objective:To compare the clinical effects of the two methods in surgical treatment of gynecomastia.Methods:The clinical data of 46 patients with gynecomastia were retrospectively analyzed, who received total removal of the glands through mastoscopic assistance (mastoscopic group) or traditional areola incision (traditional group) from Mar. 2017 to Mar. 2018. The two groups were compared in terms of blood loss, the mean operation duration, extubation time, the average hospitalization time, postoperative complications, the total cost and patients’ satisfaction at 6 month after operation. Chi-square test was used to compare the count data between groups, paired t test was used to compare the measurement data between groups, and SPSS18.0 statistical software was used for statistical analysis.Results:The operation was completed in both groups. There were no differences between the two group in age (0.473) , BMI (0.353) , lesion location (0.198) , Simon classification (0.683) , the mean blood loss ( P=0.999) , mean operation duration ( P=0.596) , extubation time ( P=0.755) , the average hospitalization time ( P=0.676) , postoperative complications and ( P=0.370) or the total cost ( P=0.486) . The difference of patients’ satisfaction at 6 month after operation had statistical significance ( P=0.012) . conclusion:Compared with traditional open surgery, mastoscopic surgery for gynecomastia is minimally invasive, beautiful and safe, which can be widely used in clinical practice.
4.Sinicization, cross-cultural adjustment and reliability and validity test of the Burnt Hand Outcome Tool
Juan ZHANG ; Xuejun CHAI ; Lifeng GUAN ; Yuelan MA ; Xiaowen ZHANG ; Miao YAO
Chinese Journal of Burns 2021;37(10):978-986
Objective:To introduce the Burnt Hand Outcome Tool (BHOT) into China to conduct sinicization, cross-cultural debugging, and test the reliability and validity, thus provide a reference for the evaluation of treatment effect and making of medical decisions of hand burn patients.Methods:The cross-sectional research was conducted. After obtaining the authorization of the original author, the Brislin translation mode was used to literally translate, synthesize, back-translate, and be checked by experts to form the Chinese version of BHOT (C-BHOT) 2. Ten experts in the field of burn rescue and treatment were invited by purpose sampling method to conduct cross-cultural debugging to form C-BHOT 3. A total of 21 hand burn patients who were treated in General Hospital of Ningxia Medical University from January to March 2020 and conformed to the inclusion criteria were selected by accidental sampling method for pre-testing. Then the final version of C-BHOT 4 was formed. Hospitalized patients who met the selection criteria were recruited using accidental sampling, multi-site and cross-regional survey method from May 2020 to March 2021 in General Hospital of Ningxia Medical University, the First Affiliated Hospital of Air Force Medical University, the First Affiliated Hospital of Army Medical University (the Third Military Medical University), and the First Affiliated Hospital of Nanchang University. The survey was performed with the general information questionnaire and C-BHOT 4. Critical ratio method and correlation coefficient method were used for item analysis, Cronbach's α coefficient test tool was used to test internal consistency, test-retest reliability was used to judge the stability of the tool, content validity index analysis tool was used to analyze the content validity, and exploratory factor analysis was used to test the validity of the structure. Data were statistically analyzed with independent sample t test or Pearson correlation analysis. Results:After the sinicization, cross-cultural debugging, and pre-testing, C-BHOT 4 was formed with a total of 20 items. All items were adjusted to positive scoring, and 7 modifications were made on the basis of the original tool. A total of 353 questionnaires were issued in the formal survey, and 344 valid questionnaires were returned, with an effective response rate of 97.45%. In the 344 patients, there were more male patients (297 patients) than female patients (47 patients), with ages of 23 to 57 years. The critical ratios of each item in the item analysis ranged from 5.48 to 12.59 ( P<0.05). There were statistically significant differences in the scores between patients in high-score group and low-score group ( t=-10.72--2.84, P<0.05 or P<0.01). There was significant positive relationship among the scores of each two items and between scores of each item and the overall tool score ( r=0.68-0.71, 0.47-0.63, P<0.05 or P<0.01). In reliability test, the Cronbach's α coefficient of the whole tool was 0.837, and the test-retest reliability was 0.702-0.793. In validity test, the content validity index of whole tool was 0.923. The exploratory factor analysis extracted 3 common factors, and the cumulative variance contribution rate was 76.162%. The comparative fit index in the confirmatory factor analysis was 0.924. Conclusions:After the BHOT tool being sinicized, cross-culturally debugged, pre-tested, and tested for reliability and validity, it was verified that C-BHOT 4 has good reliability and validity in assessing the outcome of Chinese hand burn patients, and therefore can be used as an effective tool for the evaluation.
5.Peptide-drug conjugates (PDCs): a novel trend of research and development on targeted therapy, hype or hope?
Chen FU ; Lifeng YU ; Yuxi MIAO ; Xinli LIU ; Zhaojin YU ; Minjie WEI
Acta Pharmaceutica Sinica B 2023;13(2):498-516
Peptide-drug conjugates (PDCs) are the next generation of targeted therapeutics drug after antibody-drug conjugates (ADCs), with the core benefits of enhanced cellular permeability and improved drug selectivity. Two drugs are now approved for market by US Food and Drug Administration (FDA), and in the last two years, the pharmaceutical companies have been developing PDCs as targeted therapeutic candidates for cancer, coronavirus disease 2019 (COVID-19), metabolic diseases, and so on. The therapeutic benefits of PDCs are significant, but poor stability, low bioactivity, long research and development time, and slow clinical development process as therapeutic agents of PDC, how can we design PDCs more effectively and what is the future direction of PDCs? This review summarises the components and functions of PDCs for therapeutic, from drug target screening and PDC design improvement strategies to clinical applications to improve the permeability, targeting, and stability of the various components of PDCs. This holds great promise for the future of PDCs, such as bicyclic peptide‒toxin coupling or supramolecular nanostructures for peptide-conjugated drugs. The mode of drug delivery is determined according to the PDC design and current clinical trials are summarised. The way is shown for future PDC development.