1.Evaluation for the prognosis of the severe infected patients based on the fast cluster indicators score
Journal of Chinese Physician 2015;17(5):719-721
Objective To design fast cluster indicators (FCIs) and compare it with the acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) scoring to judge the value and prognosis of sepsis patients.Methods Based on 33 cases of severe infected patients as samples for this study from September 2013 to July 2014 in Intensive Care Unit (ICU) in the Second People's Hospital of YiYang,and with the Procalcitonin (PCT),lactic acid (LAC),D-Dimer (DD) and base excess (BE) as the indicators,as well as drawing on the APACHE Ⅱ scoring system ideological,as is to design the FCIs to evaluate the prognosis of patients with severe infection.Results After treatment,the survivals were 17 cases,16 patients were died out of 33,and the mortality rate was 48.5%.The sensitivity and specificity of fast cluster indicator that predict patient mortality rates were 75% and 71%,respectively.The area under the receiver operating characteristic curve (ROC) of FCIs assessing the prognosis of patients with severe infections was 0.895,which was higher than the value 0.721 of APACHE Ⅱ scoring.Conclusions FCIs scoring has a certain significance and guiding role in clinical practice.
2.Application of finite element analysis in the biomechanical evaluation of spine structure and lumbar fusion
Chinese Journal of Tissue Engineering Research 2007;0(30):-
Finite element analysis can analyze the stress and strain change of object with complex shape,structure,constitution and load condition,and is widely applied to spinal biomechanical studies due to its controllability,reproducibility and versatility in mechanics tests.The article briefly introduced several finite element analysis software,summarized the mechanical characteristics of vertebral body,intervertebral disc,accessories and the ligament and muscle around the spine,and summarized research achievements of finite element analysis in lumbar fusion,concerning the biomechanics of Cage,its influence on lumbar fusion and related surgery choice,dynamic fusion,artificial intervertebral disc and the biomechanical variation of different fusion style after spinal tumor vertebrectomy.Finite element analysis can help understand the spine biomechanics and provide biomechanical reference for lumbar fusion choice.
3.Study on the expression level of esophageal carcinoma P-gp and P27 and affecting survival in the patient
Xinghao NI ; Shenhua XU ; Gu ZHANG
China Oncology 2001;0(05):-
three years survival group,and those who died within 3 yrs had P-gp positive expression(24 cases,53.3%).Comparing of the two groups showed statistical significance(P3 year survival stage group,and the patients who died within three years group,the P27 expression was positive in 26 cases(56.5%)(P
4.The application value of vertebral body venography in performance of percutaneous vertebroplasty
Caifang NI ; Long CHEN ; Baoshan XU
Chinese Journal of Orthopaedics 2001;0(01):-
Objective To evaluate the clinical value of vertebral body venography in performance of percutaneous vertebroplasty(PVP). Methods 92 patients with 124 vertebraes underwent PVP. Before injecting the bone cement, venography was performed with injection of nonionic contrast material into vertebral body. 124 vertebraes were classified into four groups according to the results of vebgrophy. Group A: no draining veins displayed; group B: draining veins appeared late; group C: draining veins appeared ahead of time; group D: draining veins appeared ahead of time, then intervention such as adjusting the puncture needle's position or gelatin sponge embolization of vein was performed to delay the appearance of veins. Results 94 of 124 vertebraes displayed draining veins. According to the results of vebgrophy, there're 30 vertebraes in group A, 25 in group B, 30 in group C, 39 in group D. Thirty-seven vertebraes demonstrated cement extravasation, cement entering vein was observed in sixteen vertebraes and two patients among them had pulmonary embolism. Venograms showed all correlative venous extravasation. Bone cement extravasation rate of each groups was 20.0%, 24.0%, 56.7% and 20.5% respectively. Moreover, extravasation rate of group C was higher than any other group. Pain reduction was observed in 88 of 92 patients after 30 days of the operation, the rate of pain relief was 95.7%. Conclusion Vertebral body venography could describe the velocity of venous blood flow within vertebral body and predict the direction of bone cement leaking to veins effectively, which could provid valuable information in takeing some measures to prevent bone cement leaking into veins. Vertebral body venography has very impotant clinical value in improving the safety and preventing complication of PVP.
5.Clinical application of short-segment pedicle instrument and vertebroplasty for thoracolumar fractures
Baoshan XU ; Tiansi TANG ; Caifang NI
Chinese Journal of Trauma 1993;0(05):-
Objective To modify the posterior procedures for severe thoracolumar fractures. Methods Twenty-one patients of thoracolumbar fractures with over 40% of anterior compression were studied. After reduction and fixation with short-segment pedicle instrumentation was performed, the transpedicular vertebroplasty of the fractured vertebrae with injectable self-setting calcium phosphate cement was carried out under fluoroscopic guidance. All patients were checked with X-ray and CT scanning before and after operation. They were followed up for 4-23 months (average 13 months). Results All patients obtained successful surgery without neurological complications or foreign body response. On CT scanning, the fractured vertebrae were well augmented in 13 cases and insufficiently augmented in 4 cases. Slight extrusion of cement into paravertebral tissue occurred in 4 cases without clinical symptoms. All patients were perfectly recovered without notable correction loss or implant failure during the follow-up. Conclusions Reduction and fixation with short-segment pedicle instrumentation followed by vertebroplasty with injectable self-setting calcium phosphate cement is a promising procedure for severe thoracolumbar fractures.
6.Electromyographic study of suprahyoid muscles and intrinsic laryngeal muscles in dogs
Ni ZHOU ; Zhiwen XU ; Wensheng WEN
Chinese Archives of Otolaryngology-Head and Neck Surgery 2006;0(07):-
OBJECTIVE To study the synchronous electromyograhic features of suprahyoid muscles [anterior digastric muscle(AD), posterior digastric muscle(PD),stylohyoid muscle(STH),mylohyoid muscle(MH)and geniohyoid muscle(GH)] and intrinsic laryngeal muscles [lateral cricoarytenoid muscle(LCA)and posterior cricoarytenoid muscle(PCA)]. METHODS Synchronous electromyograhic features of 13 dogs were observed under the circumstances of breath, swallowing and phonation. RESULTS ①AD, PD, STH, MH, GH and PCA discharged during inspiratory phase, while LCA discharged during expiratory phase. ②During swallow, suprahyoid muscles and LCA showed intensive synchronous discharge. The myoelectricity of PCA was suppressed while myopotential can be detected during intermission. ③During phonation, AD, PD, LCA and PCA showed an intensive synchronous discharge, while emergence time of PCA was later. GH and STH showed no myoelectricity activities. CONCLUSION①During phonation and swallowing, MH is synchronized with LCA. It can be chosen as the backup muscle for the reestablishment of glottic adduct function. ②During inspiratory phase, GH is synchronized with PCA. It can be chosen as the backup muscles for the reestablishment of vocal cord abduct function.
7.INFLUENCE OF IONOTROPIC GLUTAMATE RECEPTOR ANTAGONIST ON Fos PROTEIN EXPRESSION IN MEDULLA OBLONGATA OF THE RAT AFTER MECHANICAL DENTAL PULP EXPOSURE
Mohan XU ; Zhongying NIU ; Longxing NI
Medical Journal of Chinese People's Liberation Army 1981;0(04):-
To assess the roles of glutamate and its ionotropic receptor in processing noxious sensory input from dental pulp,glutamate NMDA receptor subtype antagonist,MK-801 and non-NMDA receptor subtype antagonist,CNQX were administrated separately into left lateral cerebral ventricle prior to exposing pulp cavity of left maxillary first molar tooth.The number of Fos-positive neurons in medulla oblongata was measured and compared with that of the group with simple exposure of dental after same survival time pulp.Fos protein expression was reduced dose-dependently by an administration of MK-801,but CNQX had little effect.The results showed that glutamate may be an excitatory transmitter of noxious dental pulp sensory input to neurons in medulla oblongata.In pain nodel of mechanical exposing dental pulp,NMDA receptor subtype has an important role in this process.
8.Clinical study of influence of low molecular weight heparin on coagulation function in elderly patients after thoracic surgery
Ni ZHANG ; Xiangning FU ; Qinzi XU
Chinese Journal of Postgraduates of Medicine 2010;33(32):1-4
Objective To compare the changes of blood coagulation system and the clinical interventional effect of low molecular weight heparin (LMWH) in elderly patients who had received thoracic surgery. Methods Ninety-six thoracic surgery patients (age≥70 years) were divided into control group ( 54 cases ) and experimental group ( 42 cases ) ( postoperative 1-7 days, subcutaneous injection with LMWH ) from September 2007 to December 2009 by random digits table. Observed perioperative changes in prothrombin time (PT),activated partial thromboplastin time (APTT),platelet (Plt),D-dimer (D-D),fibrinogen (Fib), anti- X a activity, and clinical performances. Also observed the influence of diabetes mellitus of surgery coagulation function. Results The preoperative indexes of coagulation function were no significant (P > 0.05 ). In control group PT prolonged, Fib and D-D increased, the differences between preoperative and postoperative each time were significant (P < 0.05 ). Fib and D-D in control group increased than those in experimental group postoperative each time (P < 0.05 ). In experimental group anti- X a activity increased postoperative each time (P < 0.05 ),compared with control group was also significant (P < 0.05 ). Diabetes mellitus had no significant influence on coagulation function. One patient appeared pulmonary thromboembolism in control group,and no one appeared venous thromboembelism and bleeding adverse reactions in experimental group. Conclusion Thoracic surgery in elderly patients have high blood coagulation state, prone to venous thromboembolism, LMWH given early postoperative prophylactic treatment is beneficial to improve the hypercoagulable state and have better security.
9.Efficacy of Shikani laryngoscope-guided nasotracheal intubation in patients undergoing maxillofacial surgery
Ni ZENG ; Junmei XU ; Ruping DAI
Chinese Journal of Anesthesiology 2010;30(8):984-987
Objective To evaluate the efficacy of Shikani laryngoscope-guided nasotracheal intubation in patients undergoing maxillofacial surgery. Methods One hundred ASA Ⅰ or Ⅱ patients with body mass index <25 kg/m2 , aged 18-64 yr, undergoing maxillofacial surgery under general anesthesia requiring nasotracheal intubation were included in this study. Fifty patients without anticipated difficult airway in preoperative assessment were randomly divided into 2 groups ( n = 25 each): Macintosh luyngoscope group ( group M ) and Shikani Optical Stylet (SOS) group (group S1 ). The other 50 patients with mouth opening < 3 cm but without difficult ventilation by mask were randomly divided into 2 groups ( n = 25 each): fiberoptic bronchoscope group (group F) and SOS group (group S2 ). Tracheal intubation was performed under the guidance of laryngoscopes after induction of anesthesia, and then the patients were mechanically ventilated. The degree of glottis exposure and epistaxis was evaluated. The rate of successful intubation, rate of successful intubation at first attempt, intubation time and complications were recorded. Results Compared with group M, the rate of successful intubation, rate of successful intubation at first attempt, and degree of glottis exposure were significantly increased, the intubation time was significantly shortened, and the degree of epistaxis was significantly decreased ( P < 0.05), but no significant change was found in the complications in group S1 ( P > 0.05). Compared with group F, the intubation time was significantly shortened ( P < 0.05), but no significant change was found in the rate of successful intubation, rate of successful intubation at first attempt and complications in group S2 ( P > 0.05). Conclusion Shikani laryngoscope can expose glottis better and the rate of successful intubation at first attempt is higher, thus it is more suitable for nasotracheal intubation in patients undergoing maxillofacial surgery.
10.Knowledge of chronic stable coronary artery disease management among general practitioners in Shanghai Pudong New Area
Lan NI ; Jinhua XUE ; Qi XU
Chinese Journal of General Practitioners 2016;15(7):519-523
Objective To survey the knowledge of chronic stable coronary artery disease management among general practitioners (GPs) in Shanghai Pudong New Area.Methods The survey was conducted among 363 GPs with at least 2-year work experiences from community health service centers in Shanghai Pudong New Area from July to September in 2014.A self-designed questionnaire based on the guidelines/consensus of chronic stable coronary artery disease management were used in the survey.The questionnaire consisted of 4 parts:diagnosis,drug therapy,revascularization and treatment of special types.Results Among 363 participants 362 questionnaires were completed.History taking,physical examination and electrocardiogram were applied for diagnosis in all participants,49.2% (178/362) also used coronary computed tomography angiography,26.5% (96/362)used exercise testing for assistant examination.More than 95.0% of participants recognized that smoking,obesity,hyperlipidemia,hypertension,diabetes were risk factors.75.7% (274/362) of participants used aspirin,91.4% (331/362) knew the dose of aspirin as 75-150 mg;for aspirin intolerance 14.6% (53/362)would use clopidogrel alternatively.50.6% (183/ 362) of participants sometimes used statins;and 39.2% (142/362) did not use stain because of not knowing the contraindication.Facing increases of alanine aminotransferase or aspartate aminotransferase levels 95.3% (345/362) of participants would immediately discontinue stain;80.4% (291/362) discontinued statins as creatine kinase increased.32.0% (116/362) of participants gave enough drug-free period avoiding nitrates resistance.79.6% (288/362) seldom used β-blockers and 42.5% (154/362) failed to use β-blockers because not knowing the contraindication.78.7% (285/362) knew percutaneous coronary intervention but did not know its indications;83.1% (301/362)knew coronary artery bypass but did not know its indications.27.6% (100/362) knew calcium antagonists were first-line drugs for variant angina and 93.6% (339/362) never heard of microvascular angina.Conclusion The survey shows that GPs from community health service centers in Shanghai Pudong are not well familiar with examination of coronary heart disease and lack of sufficient knowledge of drugs recommended by the guideline,not well understand the indications for revascularization and the diagnosis and treatment of special types of coronary heart disease.