1.Controversies about glucocorticoid for prevention and treatment of bronchopulmonary dysplasia in premature infants
Chinese Pediatric Emergency Medicine 2022;29(6):423-427
Bronchopulmonary dysplasia(BPD) is an important cause of premature infant mortality and long-term organ dysfunction in survivors.There is currently no fundamental treatment for BPD, and glucocorticoids are often used clinically to reduce the risk and severity of BPD.There are systemic administration, inhalation administration and transtracheal administration of glucocorticoids for the prevention and treatment of BPD.Glucocorticoids provide benefits such as anti-inflammatory, but may also cause side effects such as neurodevelopmental impairment.There are various schemes for the dosage form, timing of administration, and cumulative dose of glucocorticoids administration.The clinical advantages and disadvantages of different schemes are inconsistent and controversial.Higher quality clinical trials are needed to provide evidence to support the use of glucocorticoids for the prevention and treatment of BPD.
2.Application of pulsed electromagnetic fields in the treatment of orthopedic diseases
Hairui LIANG ; Zhencun CAI ; He ZHANG ; Siyu DUAN ; Beibei CHEN
Chinese Journal of Tissue Engineering Research 2024;28(12):1944-1949
BACKGROUND:Pulsed electromagnetic field is a non-invasive and non-radiative treatment method.Clinical use of pulsed electromagnetic fields in the treatment of orthopedic diseases has achieved certain results. OBJECTIVE:To review the current clinical application of the pulsed electromagnetic field in the treatment of orthopedic diseases,providing a scientific theoretical basis for the clinical treatment of orthopedic diseases. METHODS:The first author used a computer to search PubMed,CBM,Cochrane Library,CNKI,and WanFang Data for related studies on the pulsed electromagnetic field in the treatment of orthopedic diseases,using the keywords of"pulsed electromagnetic field,orthopedics,osteoarthritis,osteoporosis,bone healing,electromagnetic navigation"in English and Chinese.For the literature related to the same content,recent publications were selected.A total of 69 articles were selected from the search results for review. RESULTS AND CONCLUSION:Pulsed electromagnetic field has a definite curative effect on fracture healing.It can be used in the treatment of osteomyelitis by antibacterial,bactericidal,anti-inflammatory and promoting bone healing,and can inhibit osteoporosis and its progress.In addition,the treatment of early osteoarthritis,femoral head necrosis and postoperative rehabilitation of late joint replacement through various ways can become a treatment for orthopedic diseases.However,the therapeutic mechanism of the pulsed electromagnetic field for a variety of orthopedic diseases is still unclear,and most of the research is still in the primary stage.In the future,it is still necessary to obtain more reliable evidence from high-quality research and clinical trials to provide a more perfect basis for the clinical treatment of orthopedic diseases.
3.The value analysis of shear wave velocity combined with thyroid stimulating hormone in diagnosis of hyperthyroidism
Xinping LIU ; Kaicheng DUAN ; Maosheng SUN ; Yanyan WANG ; Siyu CHENG
Chinese Journal of Postgraduates of Medicine 2020;43(6):527-531
Objective:To analyze the value of shear wave velocity (SWV) combined with thyroid stimulating hormone (TSH) in the diagnosis of hyperthyroidism.Methods:Thirty-five patients with hyperthyroidism who were treated and confirmed in the Fuyang Affiliated Hospital of Anhui Medical University from December 2017 to September 2019 were selected as hyperthyroidism group, and 30 cases of normal health check-up patients in the outpatient department were selected as control group. All of the patients and medical persons were checked by conventional two-dimensional ultrasound and SWV, and the SWV and serum TSH, thyrotrophin receptor antibody(TRAb), thyroglobulin antibody (TGAb), thyroid peroxidase antibody (TPOAb) expression levels of two groups were tested and compared. The correlation relationship in SWV value and serum TSH, TRAb, TGAb, TPOAb levels of hyperthyroidism patients was analyzed by Pearson methods. The receiver operating characteristic curve (ROC curve) method was used to analyze the value of SWV, serum TSH and SWV combined with serum in diagnosis of hyperthyroidism.Results:The SWV values of upper pole, middle pole and lower pole in the hyperthyroidism group had no significant differences ( P>0.05). The SWV values of upper hole, middle pole and lower pole of the left and right lobe of thyroid in the hyperthyroidism group were significantly higher than those in the control group [left lobe: (2.41 ± 0.34) m/s vs. (2.07 ± 0.28) m/s, (2.44 ± 0.39) m/s vs. (2.08 ± 0.25) m/s, (2.46 ± 0.43) m/s vs. (2.04 ± 0.30) m/s; right lobe: (2.47 ± 0.42) m/s vs.(2.01 ± 0.25) m/s, (2.41 ± 0.40) m/s vs. (1.95 ± 0.23) m/s, (2.43 ± 0.35) m/s vs. (2.06 ± 0.24) m/s] ( P<0.01). The serum TSH level in the hyperthyroidism group were significantly lower than that in the control group [(0.05 ± 0.03) kU/L vs. (2.74 ± 1.17) kU/L], while serum TRAb, TGAb and TPOAb levels were significantly higher than those in the control group [(15.82 ± 5.54) U/L vs. (0.55 ± 0.13) U/L, (290.63 ± 145.03) kU/L vs. (25.63 ± 7.12) kU/L, (627.17 ± 250.33) kU/L vs. (34.32 ± 5.95) kU/L], and the differences were statistically significant ( P<0.01). In the hyperthyroidism group, the SWV was negatively correlated with serum TSH ( r=- 0.862, P<0.05), but positively correlated with serum TRAb, TGAb and TPOAb ( r=0.763, 0.837, 0.804, P<0.05). The area under curve(AUC), sensitivity and specificity of combined diagnosis of hyperthyroidism with SWV value and serum TSH were 0.936, 94.29% and 91.43%, which was better than that of SWV (0.803, 80.00%, 74.29%) and serum TSH (0.842, 82.86%, 77.14%). Conclusions:SWV combined with TSH has a high clinical value in the diagnosis of hyperthyroidism.
4.Evaluation of scientific research efficiency based on Data Envelopment Analysis in a third-class hospital in Xinjiang
Yang ZHAO ; Ming HOU ; Siyu DUAN ; Junqin LIANG
Chinese Journal of Medical Science Research Management 2023;36(5):389-394
Objective:To understand the overall development and dynamic change trend of scientific research input-output efficiency of a tertiary hospital in Xinjiang from 2016 to 2021, so as to provide reference and basis for optimizing hospital scientific research configuration and improving scientific research efficiency.Methods:The BCC model of Data Envelopment Analysis (DEA) method is combined with Malmquist index method for analysis and evaluation.Results:Within 6 years, the average value of comprehensive technical efficiency of nursing units has not reached 1.The total factor productivity of nursing units was unstable, showing an alternating rise and fall trend, with a fluctuation range of 0.749~1.140.Conclusions:The overall efficiency of scientific research in clinical departments of hospitals is not high. Hospitals should implement multi-level scientific research evaluation, form a dynamic evaluation system for scientific research, reasonably optimize and supervise the investment and utilization of scientific research resources, improve the scientific research management system, enhance the scientific research awareness of researchers, promote technological progress of researchers, and thereby improve scientific research efficiency.
5.Predictive value of MR myocardial strain in predicting recent adverse cardiovascular events after primary PCI in patients with acute ST-segment elevation myocardial infarction
Siyu PEI ; Hao MIAO ; Xin LIU ; Chengwen CHEN ; Yang DUAN ; Min ZHANG ; Yuan LU ; Wu XU ; Cheng WANG
Chinese Journal of Radiology 2023;57(8):897-903
Objective:To investigate the clinical application value of left ventricular myocardial strain obtained by cardiac MR (CMR) in recent major adverse cardiovascular events (MACE) in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI).Methods:From January 2020 to December 2020, a total of 163 patients successfully underwent primary PCI and underwent CMR examination within one week after surgery at Affiliated Hospital of Xuzhou Medical University. The scan sequences included rapid balance-fast field echo and late-gadolinium enhancement. CVI42 post-processing software was used to analyze and measure the left ventricular myocardial strain indices, including left ventricular global longitudinal strain (GLS), left ventricular global circumferential strain (GCS), and left ventricular global radial strain (GRS). According to the results of the 1-year follow-up after surgery, the patients were divided into the MACE group ( n=28) and the non-MACE group ( n=135). For continuous variables with a normal distribution, the t test of two independent samples was used for comparisons between groups. For continuous variables with an abnormal distribution, the variables were compared and analyzed by the rank sum test. For categorical variables, the χ 2 tests were used for between-group comparisons. Cox regression was used to analyze the prognostic value of myocardial strain on the development of MACE in patients with STEMI. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic efficacy of myocardial strain parameters, and the optimal cut-off value was evaluated by calculating the Youden index. Results:The GLS, GCS, and GRS of the MACE group were (-10.4±3.3)%, [-11.9 (-14.5, -9.3)]%, and (18.3±6.3)%, respectively, and those of the non-MACE group were (-13.7±3.4)%, [-14.6 (-16.4, -11.7)]%, and (22.3±6.1)%, respectively. The difference between the two groups was statistically significant ( t/ Z=-4.71, -3.04, 3.21, P<0.05). Multivariate Cox regression analysis showed that GLS was an independent predictor of MACE (HR=1.546, 95%CI 1.180-2.027, P=0.002). The ROC curve analysis showed that GLS had the largest area under the curve (AUC) (AUC=0.754, 95%CI 0.658-0.851, P<0.001), with a cut-off value of -12.45%. Its diagnostic sensitivity was 71.4%, and the specificity was 67.4%. The value was better than that of the traditional predictor of STEMI prognosis, namely, left ventricular ejection fraction (AUC=0.680, 95%CI 0.567-0.793, P=0.003). Conclusion:GLS of CMR is an independent predictor of MACE in STEMI patients undergoing primary PCI.
6.Short-term clinical outcomes of different courses of antenatal corticosteroids for preterm twins
Dongmei SUN ; Zhiye QI ; Qinghua ZHONG ; Siyu LIU ; Baowen FAN ; Xiaoxiao TANG ; Yi HE ; Wanxin LI ; Zhuoyi GAO ; Yunbo XIE ; Li YANG ; Yue NING ; Kun LIANG ; Jiang DUAN
Chinese Journal of Neonatology 2023;38(9):539-544
Objective:To study the short-term clinical outcomes of different courses of antenatal corticosteroids (ACS) for preterm twins.Methods:From January 2017 to December 2021, preterm twins with gestational age (GA) 24-34 weeks admitted to the neonatal ward of our hospital and received ACS were retrospectively studied. The infants were assigned into single-course group, partial-course group and multiple-course group according to ACS courses. The short-term clinical outcomes were compared among the groups. SPSS software version 25.0 was used for statistical analysis.Results:A total of 286 infants were enrolled in this study, including 128 in single-course group, 89 in partial-course group and 69 in multiple-course group. Compared with single-course group, the risks of neonatal respiratory distress syndrome (RDS) in both partial-course group ( OR=2.332, 95% CI 1.028-5.293, P=0.043) and multiple-course group ( OR=3.872, 95% CI 1.104-13.584, P=0.034) were higher. The birth length in multiple-course group ( β=-0.016, 95% CI -0.029 - -0.002, P=0.024) was lower than single-course group. Conclusions:The risks of neonatal RDS in preterm twins are higher in partial-course and multiple-course of ACS. A full course of ACS should be used to prevent neonatal RDS until further evidence of effectiveness is available.
7.Ginsenoside Rg1 ameliorates blood-brain barrier disruption and traumatic brain injury
Kefeng ZHAI ; Hong DUAN ; Wei WANG ; Siyu ZHAO ; Ghulam Jilany KHAN ; Mengting WANG ; Yuhan ZHANG ; Kiran THAKUR ; Xuemei FANG ; Chao WU ; Jianbo XIAO ; Zhaojun WEI
Acta Pharmaceutica Sinica B 2021;11(11):3493-3507
During the traumatic brain injury (TBI), improved expression of circulatory miR-21 serves as a diagnostic feature. Low levels of exosome-miR-21 in the brain can effectively improve neuroinflammation and blood-brain barrier (BBB) permeability, reduce nerve apoptosis, restore neural function and ameliorate TBI. We evaluated the role of macrophage derived exosomes-miR-21 (M-Exos-miR-21) in disrupting BBB, deteriorating TBI, and Rg1 interventions. IL-1