1.Clinical and pathologic analyses of 28 cases of uterine papillary serous carcinomas
Yan ZHU ; Anna ZHU ; Ruijun ZHAN ; Congzhu LI
Journal of Chinese Physician 2014;16(10):1361-1363,1369
Objective To explore prognostic factors of the uterine papillary serous carcinoma (UPSC).Methods Twenty eight patients with UPSC in Cancer Hospital of Shantou University Medical College from January 2002 to August 2013 were analyzed retrospectively.Prognostic factors were analyzed by univariate analysis.Results Twenty eight cases of UPSC with 6.3% occurrence in the endometrial carcinoma admitted in the same period,including 14 cases of staging Ⅰ ~ Ⅱ,and 14 cases of staging Ⅲ.The univariate analysis showed that lymph-node metastasis and operative-pathological staging were significantly associated with the prognosis (P < 0.05),but were not associated with the menopausal,postoperative treatment,operation style,deep myometrial invasion,cervical involvement,and annex invasion (P > 0.05).Two cases of Ia-staging without myometrial infiltration and without added postoperative treatment were still alive.Conclusions Operative-pathological staging and retroperitoneal lymphadenectomy were independently prognostic factors of UPSC.The Ia-staging without myometrial infiltration might be without added postoperative treatment.
2.Clinical Observation of Relaxing Needling plus Joint Needling from the Internal Medicine for Post-stroke Spastic Hemiplegia
Ruijun YAN ; Bo CHENG ; Lusheng CHEN ; Xueyong SHEN ; Lei ZONG
Shanghai Journal of Acupuncture and Moxibustion 2016;35(8):930-934
ObjectiveTo observe the clinical efficacy of relaxing needling plus joint needling from the Internal Medicine in treating post-stroke spastic hemiplegia.MethodTotally 121 eligible subjects were randomized intoan ordinary acupuncture group (61 cases) and a relaxing-joint needling group (60 cases). The two groups were treated for 2 weeks, 5 sessions each week. The spasm of the lower limb was evaluated by using Fugl-Meyer Assessment Scale (FMA), modified AshworthScale (MAS), Tardieu Scale, and Activities of Daily Living (ADL) before and after treatment. Besides, 4 patients from each group were randomly selected for the three-dimensional gait analysis, and the dorsi-extension, range of motion (ROM) of ankle, strephenopodia, and heel-raising height were observed.Result and ConclusionRelaxing-joint needling and ordinary acupuncture both can produce significant efficacies in treating post-stroke spastic hemiplegia. The relaxing-joint needling produced more significant efficacies in improving the body balance, ROM, muscular tension, and lower limb spasticity compared to ordinary acupuncture. It’s plausible that relaxing-joint needling improves the strephenopodia and hemiplagia gait through renovating body balance, ROM, muscular tension, and lower limb spasticity. Since the three-dimensional gait analysis can analyze the dorsi-extension, strephenopodia, and heel-raising height, thus it can be used to evaluate the change of the spastic gait of post-stroke hemiplegia in amore objective, elaborate, and correct way.
3.Effects of Meliorated Renal Failure Decoction on Renal Function and Inflammatory Cytokines in Patients with Chronic Kidney Disease at 3-4 Stage
Jing YANG ; Ruijun YAN ; Chen WANG ; Liqun HE
Chinese Journal of Information on Traditional Chinese Medicine 2014;(12):15-18
Objective To investigate the effects of meliorated renal failure decoction (MRFD) on renal function and inflammatory cytokines in patients with CKD 3-4 stages. Methods Sixty-two patients with CKD 3-4 stages were divided into treatment group and control group through random number table method. Both groups were given conventional treatment of western medicine, and the treatment group was given MRFD additionally. After 6 months of treatment, the changes of TCM symptom scores, Hb, Scr, BUN, 24 h UP, IL-6, IL-8, TNF and eGFR were observed. Meanwhile, the clinical efficacy was evaluated. Results The total clinical effective rate in treatment group was 65.63%(21/32), and 30.00%(9/30) in the control group (P<0.01);the effective rate of TCM syndromes in treatment group was 96.88%(31/32), and 53.33%(16/30) in the control group (P<0.01). The symptoms were improved better in the treatment group than the control group except for the symptoms of dry mouth and throat, and diarrhea. The level of eGFR in treatment group increased obviously (P<0.05), while the levels of Scr, 24 h UP and BUN decreased (P<0.05, P<0.01), with statistical significance between the two groups ( P<0.01). The level of eGFR increased, and the levels of Scr decreased in the control group (P<0.01). The levels of IL-6, IL-8, and TNF in both groups were reduced, while the level of Hb increased in the two groups, without statistical significance (P>0.05). Conclusion MRFD can improve TCM syndrome and renal function, delay the progress of patients with CKD at 3-4 stage by means of reducing the inflammatory cytokines and inhibiting micro-inflammatory state.
4.Analysis of the relationship between snoring and newly-diagnosed type 2 diabetes mellitus among elderly residents in Renqiu of Hebei province
Yan HE ; Yinglin YAN ; Ruijun JI ; Kai YU ; Yongjun WANG ; Hongna YANG ; Lihua XU
Chinese Journal of Primary Medicine and Pharmacy 2016;23(8):1149-1153
Objective To investigate the relationship between snoring and newly-diagnosed type 2 diabetes mellitus among elderly urban and rural residents in Renqiu of Hebei province.Methods By random clustered sam-pling inspection,the residents aged 60 to 70 years old were selected in the study,the questionnaire investigation by an-thropometric measurements and laboratory tests were performed in 5 010 elderly people.Screen for 3 604 people who had no previous history of diabetes and currently not to control blood sugar by diet,exercise,medication.The average age was (64.32 ±3.06)years,including 1 608 male(44.6%) and 1 996 female cases(55.4%),snorers 994 cases (27.6%),non-snorers 2 610 cases(72.4%).The patients were followed up for one year.The correlation between snoring and newly-diagnosed type 2 diabetes mellitus was analyzed.Results There were 217 cases(6.0%) of new-ly-diagnosed type 2 diabetes mellitus,which accounted for 79 cases of snoring(36.4%),3 387 cases of non-dia-betic group,which accounted for 915 cases of snoring(27.0%),the difference between the two groups was significant (χ2 =9.003,P<0.05).Took the newly-diagnosed type 2 diabetes mellitus as the dependent variable,univariate analysis showed that gender(OR=0.479,95% CI:0.639~0.852),history of hypertension(OR=1.463,95% CI:1.111~1.927),family history of diabetes(OR=1.768,95% CI:1.259~2.183),history of stroke or TIA(OR=1.549,95%CI:1.106~2.168),central obesity(OR=1.658,95% CI:1.016 ~1.448),BMI≥28kg/m2 (OR=1.063,95% CI:1.025 ~1.102),fasting glucose(OR=2.065,95% CI:1.854 ~2.299),fasting insulin levels (OR=1.021,95%CI:1.008 ~1.035),cholesterol(OR=1.216,95% CI:1.051 ~1.407),triglycerides(OR=1.188,95%CI:1.089~1.296),snoring(OR=1.547,95% CI:1.161 ~2.060) were related with newly-diag-nosed type 2 diabetes mellitus.Multivariate logistic regression analysis showed that gender(OR=0.595,95% CI:0.368~0.963),history of stroke or TIA(OR=1.586,95%CI:1.085~2.318),fasting glucose(OR=2.059,95%CI:1.833~2.312),snoring(OR=1.592,95% CI:1.089~2.328) were independent risk factor for newly-diag-nosed type 2 diabetes mellitus.Conclusion People aged 60 to 70 in Renqiu suffered newly-diagnosed type 2 diabe-tes mellitus population prevalence of snoring, snoring is closely related to the occurrence and development of type 2 diabetes,type 2 diabetes is increased independent risk factor.Positive and effective screening and control on snoring can effectively reduce the incidence of type 2 diabetes.
5.Impact of surgical resection on stage Ⅱ-ⅢA small-cell lung carcinoma patients ’ prognosis
Yan YAN ; Xiguang LIU ; Kaican CAI ; Hua WU ; Ruijun CAI ; Dingwei DIAO
The Journal of Practical Medicine 2016;32(12):1959-1962
Objective To investigate the impact of surgical resection on patients with Ⅱ-Ⅲ A stage small cell lung carcinoma (SCLC). Method Data of 61 in-patients who diagnosed as Ⅱ-ⅢA stage SCLC from Jan 1st 2009 to Feb 1st 2014 were analyzed. 23 patients underwent surgical resections were enrolled as the treatment group, while 38 patients without surgical resection were enrolled as the control group. Disease progression was confirmed by monthly examination. The grouping is balanced by propensity score match. The progression-free survival (PFS) time and overall survival(OS) were analyzed with Kaplan-Meier survival method and Cox regression is applied to analyze the covariates. Fisher's exact test was applied to compare one-year survival rate and two-year survival rate. Results The PFS and OS of the treatment group is longer than that of the control group (P < 0.05). Both one-year and two-year survival rates of the treatment group outnumber those of the control group (P < 0.05). Cox regression indicates that surgical resection is an independent prognostic factor (P < 0.05). Conclusion Surgical resection on tolerable patients with stage Ⅱ-Ⅲ A small-cell lung carcinoma is effective on improving the progression-free survival time,one-year and two-year survival rates,and also shows a propensity of a higher overall survival time.
6.Comparison of preoperative PET-CT and pathological analyses in diagnosis of pulmonary tumors
Xiguang LIU ; Yan YAN ; Siyang FENG ; Kaican CAI ; Hua WU ; Ruijun CAI ; Dingwei DIAO
The Journal of Practical Medicine 2016;32(12):1938-1941
Objective To investigate the consistency in 18F-deoxyglucose positron emission tomography (18F-FDG PET-CT) examination and histopathological analyses in the diagnoses of resectable lung tumors. Methods Retrospective reviews over the clinical data of lung tumor patients by preoperative PET-CT diagnosis and postoperative histopathological diagnosis were conducted to investigate the effects of the two diagnostic methods in terms of lung tumor properties , mediastinal lymph node metastasis , and pulmonary hilar lymph node metastasis. Results The diagnoses by preoperative PET-CT was consistent in differentiation of non-malignancy and malignancy of pathologic lung tumors by 87.3%, at a medium level (κ = 0.401, P < 0.001). McNemar test showed P = 0.508, indicating the two diagnostic methods were insignificantly different in the diagnosis of pulmonary tumors. The preoperative PET-CT was consistent in the diagnosis of the metastasis of pathologic mediastinal lymph node by 85.9%, at a medium level (κ = 0.697, P < 0.001). McNemar test showed P =0.754, indicating no significant difference between the diagnostic methods. The preoperative PET-CT was consistent with postoperative pathological examinations in the differentiations of the metastasis of pulmonary and hilar lymph node by 77.4%, at a medium level (κ=0.523, P < 0.001). McNemar test showed P = 0.454, indicating the two diagnostic methods were no significantly different. Conclusion Preoperative PET-CT and histopathologic examinations may be consistent in lung tumor diagnosis , which provides a basis for a certain significance in the surgical options.
7.Relationship between the characteristics of atherosclerotic plaque of carotid artery and cardiovascular events in a senior cohort of Renqiu region,Hebei
Guangbo ZHENG ; Kai YU ; Ruijun JI ; Yongjun WANG ; Suying GAO ; Yinglin YAN
Chinese Journal of Primary Medicine and Pharmacy 2016;(1):95-101
Objective To investigate the potential relationship between the characteristics of atherosclerotic plaque of carotid artery and cardiovascular events in a senior cohort of Renqiu region,Hebei.Methods A random cluster sampling method was used to identify study population among 60 -70 years old residence in Renqiu region, Hebei.In the face of health questionnaire survey,neck vascular ultrasound examination,a total of 4 413 cases,inclu-ding 1 876 males and 2 537 females,the occurrence of carotid artery plaque and stenosis were detected by ultrasound. Carotid ultrasound was used to identify the characteristic of atherosclerotic plaque of bilateral carotid arteries,which were categorized as with and without plaque,single and multiple plaque,homogenous and heterogeneous plaque,and with and without stenosis.Cardiovascular events were defined as composite events of myocardial infarction,cardiovas-cular death,fatal or non -fatal stroke during the subsequent 2 years follow -up after initial evaluation.Multiple Logis-tic regression was performed to identify the association between the characteristics of bilateral carotid arteries and cardiovascular events.Results A total of 4 413 case enrolled in the study.With carotid ultrasound,2 438 cases (55.2%)were found to be with atherosclerotic plaque formation and 235(5.3%)were with carotid artery stenosis. The proportion of single,multiple,homogeneous and heterogeneous plaques were 1 024cases(23.2%),1 114cases (32.0%),1 106cases(25.1%)and 1 333cases(30.2%),respectively.Among them,the single plaque and new cardiovascular and cerebrovascular events occured in 83 cases(P =0.168),the multiple plaques and new cardiovascular and cerebrovascular events occured in 161 cases(P <0.001 ),the homogeneous patch and new cerebral vascular events occured in 98 cases(P =0.032),the non -homogeneous patch and new cerebral vascular events occured in 146 cases(P <0.001),the stenosis and cerebral vascular events occured in 42 cases(P <0.001).Taken the new onset cardiovascular and cerebrovascular events as dependent variable,the single factor analysis showed that the carotid plaques(χ2 =14.969,P <0.001 ),and the multiple plaque(χ2 =22.509,P <0.001 ),the carotid artery stenosis (χ2 =27.561,P <0.001),the homogeneous plaque(χ2 =4.606,P <0.050),the non -homogeneous plaque(χ2 =18.301,P <0.001),the history of hypertension(χ2 =33.709,P <0.001),the high blood fat disease(χ2 =11.262, P <0.001),and the history of diabetes(χ2 =5.525,P <0.050),the coronary heart disease history(χ2 =10.440, P <0.001),the gender(χ2 =5.606,P <0.050),the smoking(χ2 =4.823,P <0.050)and the systolic blood pressure value,were all associated with the new cardio cerebral vascular events.Multivariate analysis showed that,the heterogeneous plaque(β=0.371,P <0.050),the carotid artery stenosis(β=0.621,P <0.050),the history of hypertension(β=0.517,P <0.001)and smoking(β=0.264,P <0.050)were shown to be significantly associates with new onset cardiovascular events.Conclusion The characteristics of atherosclerotic plaque of carotid artery were significantly associated with the subsequent cardiovascular events among 60 -70 years old residence in Renqiu region,Hebei.Routine carotid ultrasound screening might be useful for identify those people with high risk of develo-ping cardiovascular events.
8.Application of ultrasound biomicroscopy on skin assessment in normal adults and psoriasis patients
Shuo, LI ; Xiaoning, LIANG ; Yan, ZHANG ; Cuixia, LIU ; Yali, HUANG ; Ruigang, LU ; Ruijun, GUO
Chinese Journal of Medical Ultrasound (Electronic Edition) 2015;(1):30-34
ObjectiveTo investigate the features of normal and psoriasis skin on ultrasound biomicroscopy (UBM) and explore the method of thickness measurement.MethodsUsing 50 MHz ultrasound probe of biological microscope, ultrasonographic observation and ultrasonic thickness measurement were conducted in 90 normal adults and 40 psoriasis patients. Innormal patients, ultrasound evaluations were performed at 10 different parts of the body skin.ResultsOn sonogram, the normal skin showed a “sandwich” structure with two parallel hyperechoic bands and the middle isoechoic dots and short liens. The sonograms of the psoriasis skin showed obviously thickened epidermis and dermis, disordered internal structure and clear boundary from adjacent normal skin. The range of the epidermis’ thickness measurement was between the medial forearm (0.12±0.03) mm and the palm (0.29±0.15) mm. The range of dermal thickness measurement was between the back hand (1.18±0.32) mm and parasternal (1.55±0.21) mm. Psoriasis skin was thicker than the uninvolved skin (P<0.001). And the dermis’ thickness of uninvolved skin in psoriasis patients was thicker than that of the normal adults (P<0.001).ConclusionNormal adult’s epidermis, dermis and skin appendages can be shown clearly using 50 MHz ultrasound biomicroscopy. And ultrasound biomicroscopy canaccurately measure the thickness of dermis and epidermis, which provides the basis for the diagnosis and treatment of psoriasis.
9.Preliminary application of virtual touch tissue quantification imaging in diagnosis of IgA nephropathy
Xiaoning, LIANG ; Ruijun, GUO ; Shuo, LI ; Ying, ZHANG ; Yan, ZHANG ; Hong, SUN
Chinese Journal of Medical Ultrasound (Electronic Edition) 2015;(7):559-563
Objective To evaluate the value of virtual touch quantization (VTQ) imaging in diagnosis of IgA nephropathy. Methods The clinical data of 85 patients with IgA nephropathy were analyzed, who were treated in Capital Medical University Affiliate Beijing Chaoyang Hospital from December 2013 to July 2014. The patients who was with critical condition, unable to cooperate and with other pathological types were excluded. Finally 108 kidneys of IgA nephropathy with mesangial cell hyperplasia in 54 cases were included into the study. Meanwhile 108 kidneys in 54 volunteers who took the health physical examination in our hospital were taken as healthy controls. VTQ was performed in middle part of kidney and the measurements of shear wave velocity (SWV) was recorded. The mean SWV of renal parenchyma and collecting system was compared in different groups. Results The mean SWV measurement of renal parenchyma and collecting system in control group were (2.13±0.13) m/s, (1.15±0.02) m/s;the results in IgA nephropathy group were (3.07±0.62) m/s, (1.12±0.29) m/s. The mean SWV of renal collecting system was lower than that of renal parenchyma (t=-14.481, P<0.001). The mean SWV of renal parenchyma and collecting system in IgA Nephropathy group was higher than that in control group (t=-54.01, P<0.001). The renal parenchyma VTQ value positively correlated with the degree of renal insufficiency for patients with chronic kidney disease (CKD) (F=798.70, P<0.001). The interlobular arterial resistance index (RI) increased gradually with CKD stage, but no statistical differences were found. Conclusion In terms of early diagnosis and clinical staging, VTQ technology has some diagnostic value in evaluation of renal parenchymal damage for patients with IgA nephropathy.
10.The correlation between cognitive impairment and anti N-methyl-D aspartate receptor antibody in patients with systemic lupus erythematosus
Yan ZHOU ; Ruijun ZHANG ; Yang LI ; Xiaofeng ZENG ; Zhenhai WANG ; Hong ZHU
Chinese Journal of Rheumatology 2016;20(5):312-316
Objective To investigate the serum level of anti N-methyl-D-aspartate (NMDA) receptor antibody in patients with cognitive dysfunction of systemic lupus erythematosus (SLE) and its clinical significance.Methods The levels of anti NMDA receptor antibody in blood samples from 36 patients with cognitive dysfunction of SLE,30 cases with normal cognitive function of neuropsychiatric lupus erythematosus (NPSLE) groups,64 patients with no-NPSLE,100 patients with other connective tissue diseases and 30 healthy controls were measured by enzyme linked immunosorbent assay,and the reports of Mini-Mental State Examination and the laboratory indexes were recorded in those groups,then these index were measured again when patients were treated for 2 weeks.The comparison of multi-group was conducted by means of single factor analysis of variance or rank test,the Pearson or Spearman correlation analysis was used to analyze the correlation between variables.Results ① The level of anti NMDA receptor antibody in the patients with cognitive dysfunction of the NPSLE group (1.30±0.27) was higher than those with normal cognitive function of NPSLE group (0.47±0.08),No-NPSLE group (0.47±0.07),the other connective tissue disease (0.42±0.04) and the healthy controls (0.35±0.06) (P<0.05),the difference was statistically significant.The levels of anti NMDA receptor antibody before treatment were higher than those after the treatment,and the difference was statistically significant (t =2.296,P<0.05).② The serum levels of anti NMDA receptor antibody in patients were negatively correlated with the intelligent score (r=-0.330,P<0.01),and were positively correlated with the levels of IgG (r=0.684,P<0.05).Conclusion The anti NMDA receptor antibody can be used as a new autoantibody in the early diagnosis of cognitive dysfunction in patients with SLE,and can be used for monitoring the activity of disease in cognitive dysfunction of SLE.