1.Clinical analysis and treatment strategy of ten cases of pancreatic duct stent displacement complicated with acute pancreatitis
Meina AI ; Fei GAO ; Shuren MA ; Yingchun ZHANG ; Ning ZHANG ; Bing WANG
Chinese Journal of Digestion 2014;34(11):748-751
Objective To investigate clinical features and treatment strategy for pancreatic duct stent displacement complicated with acute pancreatitis.Methods Ten cases of pancreatic duct stent displacement complicated with acute pancreatitis were retrospectively analyzed.All the cases were confirmed by lab examination,X-ray examination,endoscopy and computed tomography (CT) examination.After operation,the clinical symptoms of patients were observed.Time consumed for stent removing and blood amylase level before endoscopic retrograde cholargio-pancreatography (ERCP) and 1st,4th,7th day after ERCP were recorded.Clinical features,the time of stent displacement,time of clinical cure and therapeutic strategy were summarized.Results The average age of the ten cases (four male and six female) was 55.9 years.All the displaced pancreatic duct stents were pancreatic duct stent with side wing,length five to seven cm.Obstruction was observed in one case.The end of the pancreatic duct stent of two cases dislocated at the neck of pancreats,seven cases at the head of pancreas and one at the body of pancreas.Ten cases presented with abdominal pain,seven with nausea and vomiting and one with fever.The average time of the occurrence of pancreatic duct stent displacement was 2.9 months.All the stents were successfully taken out,which of two cases were removed with balloon,seven cases with forcep and one with snare,and the average time duration was 17.7 min.After the stents taken out,pancreatic duct stent was replaced in one case and the left nine cases received nasal-pancreatic drainage treatment.After the operation,no severe complications such as pseudocyst of pancreas,pancreatic abscesses,pancreatic necrosis and gastrointestinal bleeding were observed in all the patients.Average blood amylase level at 1st,4th and 7th day after ERCP was 508 U/L,137 U/L and 86 U/L,respectively.The average time of recovery was 6.7 days,and the average time of keeping the nasal-pancreatic tube was 8.6 days.Conclusions For patients with pancreatic duct stent displacement complicated with acute pancreatitis,it is safe and effective to take out the stent and perform pancreatic duct drainage by ERCP as soon as possible,which could improve the symptoms in a short time.
2.Efficacy and cost effectiveness analysis of endoscopic treatment for pancreatic cancer with obstructive jaundice
Jiewen WU ; Fei GAO ; Xi HE ; Zhunwen HAN ; Yingchun ZHANG ; Feng GAO ; Jing WANG ; Meina AI
Chinese Journal of Pancreatology 2019;19(2):110-113
Objective To investigate the therapeutic effect of endoscopic plastic stent and metal stent placement in relieving obstructive jaundice in patients with pancreatic cancer,and to analyse the cost effectiveness.Methods A retrospective review was performed on the clinical data of 102 pancreatic cancer patients with obstructive jaundice in General Hospital of Northern Theater Command between January 2013 to January 2014.The patients were divided into plastic stent group (n =26) and metal stent group (n =76)based on the type of biliary stent placed under endoscopy.The complication and short-term therapeutic effect were compared between two groups.The number of endoscopic stent placement,treatment interval,hospitalization cost and median survival time were recorded.Results The levels of alanine aminotransferase (ALT) and total bilirubin (TBiL) in the two groups 5-7 days after endotherapy were significantly lower than those before treatment,but the difference was not statistically significant between the two groups (P <0.05).No severe complication was observed.The average number of treatments in the metal stent group was significantly lower than that in the plastic stent group (1.7 times vs 2.9 times),and the treatment interval was significantly longer[(271.7 ± 42.3) d vs (113.4 ± 38.2) d].The difference above between these two groups was statistically significant (P<0.05).However,there was no significant difference on the average total hospitalization cost (84227.2 yuan vs 86906.8 yuan) or median survival time (15.6 months vs 13.1 months)between these two groups.Conclusions Primary placement of metal biliary stents for obstructive jaundice in adult patients with metastatic pancreatic carcinoma was cost-effective than plastic stents,and their effects were comparable.
3.Application of nutritional risk screening and the outcome of nutrition support in hospitalized patients
Jin ZHOU ; Ping GAO ; Ning MA ; Dandan CAO ; Ying XIE ; Wenwen CAO ; Meiqi ZHOU ; Meina YUAN ; Hui YANG ; Lei ZHANG ; Shurong DING
Parenteral & Enteral Nutrition 2017;24(1):13-17
Objective:The present study was aimed to evaluate the nutritional risk using nutritional risk screening 2002 (NRS2002) score and to investigate the impact of nutrition support on clinical outcome in hospitalized patients.Methods:Six hundred and ninety four hospitalized patients were recruited.NRS 2002 was applied to evaluate the nutritional risk of patients.Meanwhile,the effect of nutrition support on complication rate was evaluated between different types of patients.Results:14.0% of patients had malnutrition and the incidence of nutritional risk was 27.5%.Patients with nutritional risk had a higher complication rate (P <0.01).Totally,22.0% (153/694) patients received nutrition support,including 81.7% patients with nutritional risk and 18.3% patients without nutritional risk.Patients with nutritional risk benefited from nutrition support,as shown by lower complication rate and shorter length of hospital stay.In patients with nutritional risk,complication rate was lower in enteral fed patients compared to parenteral fed patients.Conclusion:With nutritional risk screening,patients' nutritional status can be evaluated and appropriate nutrition support can be performed.Compared to those without nutritional risk,patients with nutritional risk will benefit more from nutrition support,as indicated by lower complication rate and reduced length of hospital stay.
4.Correlation between depressive symptoms and frailty in elderly inpatients
Huiying GAO ; Xiuli CHENG ; Meina JIANG ; Yanru LI ; Yuli PAN ; Xiuying LI
Chinese Journal of Geriatrics 2019;38(6):631-634
Objective To explore the correlation between depressive symptoms and frailty,in order to provide evidence for prevention and relief of depressive symptoms in elderly inpatients.Methods A cross-sectional survey and comprehensive geriatric assessment(CGA)were conducted with 248 eligible elderly inpatients from December 2015 to February 2017 in our hospital.Depressive symptoms were assessed by the 5-Item Geriatric Depression Scale(GDS-5),and frailty was identified by the frailty phenotype method.Results In all respondents,50 (20.2 %)patients showed depressive symptoms,93(37.5 %)patients had pre-frailty and 39 (15.7 %)patients had frailty.Correlation analysis showed that frailty degree,low grip strength,slow gait speed,low physical activity,fatigue,and weakness were all positively correlated with depressive symptoms in elderly inpatients (r =0.441,0.315,0.426,0.316,0.395 and 0.151,respectively,P < 0.05).Logistic regression analysis showed that patients who had more severe frailty faced a much higher risk of developing depressive symptoms (OR=2.608,P<0.05).Of the 5 indicators of frailty,slow gait speed and frailty also increased the risk of having depressive symptoms (OR =2.801 and 3.484,P < 0.05).Conclusions Frailty degree,gait speed and fatigue are associated with increased risk of depression in the elderly.Depressive symptoms can be reduced in elderly inpatients with prevention and intervention of pre-frailty and frailty.
5.Role of SIRT1/FoxO1 signaling pathway in trilobatin-induced reduction of cerebral ischemia-reperfusion injury in rats
Meina GAO ; Lei WANG ; Yanling DING
Chinese Journal of Anesthesiology 2024;44(2):182-186
Objective:To evaluate the role of the SIRT1/FoxO1 signaling pathway in trilobatin-induced reduction of cerebral ischemia-reperfusion (I/R) injury in rats.Methods:Eighty clean-grade healthy male Sprague-Dawley rats, aged 6-8 weeks, weighing 230-280 g, were divided into 4 groups ( n=20 each) using a random number table method: sham operation group (group S), cerebral I/R group (group CIR), trilobatin+ cerebral I/R group (group T) and trilobatin+ cerebral I/R+ SIRT1/FoxO1 signaling pathway inhibitor EX527 group (group E). The model of focal cerebral I/R injury was established by middle cerebral artery occlusion in anesthetized animals. Trilobatin 15 mg/kg was given by gavage twice a day for 3 consecutive days starting from 3 days before ischemia in T and E groups. EX527 5 mg/kg was intraperitoneally injected before each gavage in group E. Modified Longa scoring scale was used to assess neurological function at 24 h of reperfusion, then the rats were sacrificed and whole brain tissues were obtained for determination of cerebral infarct size (using TTC staining), apoptosis rate and level of reactive oxygen species (ROS) in the hippocampus (by flow cytometry), expression of SIRT1 and acetylated FOXO1 (Ac-FOXO1) (by Western blot) and contents of superoxide dismutase (SOD) and malondialdehyde (MDA) (by enzyme-linked immunosorbent assay) and for microscopic examination of pathological changes in the hippocampal CAI area after HE staining. Results:Compared with group S, Longa score, cerebral infarct size, apoptosis rate of hippocampal neurons, and levels of ROS and MDA were significantly increased, the content of SOD was decreased, the expression of SIRT1 was down-regulated, and the expression of Ac-FOXO1 was up-regulated in group CIR ( P<0.05). Compared with group CIR, Longa score, cerebral infarct size, apoptosis rate of hippocampal neurons, and levels of ROS and MDA were significantly decreased, the content of SOD was increased, the expression of SIRT1 was up-regulated, and the expression of Ac-FOXO1 was down-regulated in group T ( P<0.05). Compared with group T, Longa score, cerebral infarct size, apoptosis rate of hippocampal neurons, and levels of ROS and MDA were significantly increased, the content of SOD was decreased, the expression of SIRT1 was down-regulated, and the expression of Ac-FOXO1 was up-regulated in group E ( P<0.05). Conclusions:Trilobatin may inhibit oxidative stress responses and neuronal apoptosis in hippocampi by activating the SIRT1/FoxO1 signaling pathway, thus alleviating cerebral I/R injury in rats.
6. Nursing care of a patient with gaucher′s disease complicated with infection after hip replacement
Yanru LI ; Xiuying LI ; Chaohong WANG ; Meina JIANG ; Huiying GAO
Chinese Journal of Practical Nursing 2019;35(15):1163-1167
Objective:
To summarize the nursing experience of postoperative infection of hip joint replacement combined with gaucher′s disease.
Methods:
According to the characteristics of the disease, nursing intervention and symptomatic treatment were given, including infection control, nursing of complications, nursing of joint puncture, medical treatment and nursing, and strengthening psychological nursing and safety nursing.
Results:
Through targeted nursing, the patient′s infection was controlled, the condition was stable, the symptoms were relieved, and the patient was discharged.
Conclusions
In view of the patient′s condition, the development and implementation of comprehensive and integrated targeted nursing measures can effectively reduce the complications, alleviate the progress of the disease, improve the understanding of gaucher′s disease and the quality and effect of the disease nursing.
7.The clinical effect of Yaotongning capsule combined with etoricoxib in the treatment of lumbar pain and inflammatory status in elderly patients with lumbar osteoarthritis
Pengfei LI ; Qiang JIAN ; Meina QIAO ; Changgui SUN ; Junfeng GAO
Journal of Pharmaceutical Practice 2020;38(4):368-372
Objective To study the clinical effect of Yaotongning capsule combined with etoricoxib for the pain and inflammation of lumbar vertebrae in elderly patients with lumbar osteoarthritis. Methods 120 elderly patients with lumbar osteoarthritis admitted to our hospital from January 2016 to June 2018 were randomly divided into the control group and the observation group, with 60 patients in each group. Patients in the control group were treated with etoricoxib, while patients in the observation group were treated with etoricoxib plus Yaotongning capsule orally. Both groups received medications for 2 weeks. Spinal pain and quality of life score changes were recorded. The inflammatory cytokines in serum TNF-α, GM-CSF, COX-2 and BMP-2 levels were monitored. The clinical efficacy was compared and drug safety profile was evaluated for two groups. Results The effective rates of the control group and the observation group were 78.33% and 91.67% respectively. The effective rate in the observation group weas significantly higher (P<0.05). After treatment, the VAS score for the patients in the observation group was significantly lower than that in the control group (P<0.05). The SF-36 score in the observation group was significantly increased (P<0.05), and the levels of TNF-α,GM-CSF and COX-2 in the serum were significantly lower than those in the control group (P<0.05), and the levels of BMP-2 were significantly increased (P<0.05). Conclusion Yaotongning capsule combined with etoricoxib in the treatment of senile lumbar osteoarthritis has definite curative effect. It significantly reduced lumbar pain, improved quality of life, inhibited inflammatory reaction, and had a better drug safety profile. The further clinical investigation for the combination therapy is warranted.
8. Efficacy of femoral triangle versus adductor canal approach to saphenous nerve block for postoperative analgesia in patients undergoing knee arthroplasty
Chunguang WANG ; Zhiqiang ZHANG ; Yanjun LI ; Yanhui BAI ; Yuanyuan WANG ; Qinghui LI ; Jiayun LIU ; Jinning LIU ; Meina GAO ; Xiaoyu GUO
Chinese Journal of Anesthesiology 2019;39(8):953-956
Objective:
To compare the efficacy of femoral triangle versus adductor canal approach to saphenous nerve block for postoperative analgesia in the patients undergoing knee arthroplasty.
Methods:
Sixty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of both sexes, aged 53-68 yr, scheduled for elective total knee arthroplasty under general anesthesia, were assigned into 2 groups (