1.Prevention and treatment of perioperative pulmonary hypertensive crisis in patients with serious pulmonary arterial hypertension relevant with ventricular septal defect
Huihui ZHANG ; Lingling WANG ; Chenqu YU ; Xiaoming XING ; Wenchao ZHI ; Ling LYU ; Haiyan FENG
Chinese Journal of Practical Nursing 2018;34(9):705-708
Objective To discuss key points of prevention and treatment of perioperative pulmonary hypertensive crisis in patients with serious pulmonary arterial hypertension associated with ventricular septal defect. Methods Retrospectively analyzed the nursing experience of perioperative pulmonary hypertensive crisis on 31 patients with serious pulmonary arterial hypertension associated with ventricular septal defect from March to December during 2016.Among these patients,7 patients occurred pulmonary hypertensive crisis.The prevention contained avoiding oxygen lack,keeping pH alkaloid in the body, application of pulmonary vasodilator, deep sedation. Results A total of 30 cases survived the perioperative period, and were discharged from the hospital, one died. Conclusions The patients with serious pulmonary arterial hypertension had more risks during the perioperative period,the main cause of death was pulmonary hypertensive crisis during this time.So prevention of pulmonary hypertension crisis is the key point of postoperative nursing.
2.Investigation on iodine nutrition level and prevalence of thyroid nodules in Harbin
Lixin LIAN ; Donghong WU ; Ming QI ; Baoshuai GUO ; Xueqi ZHAO ; Wenchao LYU ; Tao HU ; Xiaoyang LI
Chinese Journal of Endemiology 2018;37(6):473-476
Objective To investigate the iodine intake level and the prevalence of thyroid nodules in Harbin City,and to study the correlation between the concentration of urinary iodine and the prevalence of thyroid nodules.Methods In Harbin,18 communities were randomly selected and specimens were collected from fasting morning urine from 2015 to 2017.The urine iodine concentration (UIC) was detected by arsenic cerium catalytic spectrophotometry,and the thyroid nodule was examined by B ultrasound.Results A total of 2 552 residents aged (45.79 ± 12.06) years old agreed to participate in the study,including 371 males and 2 181 females.The median UIC in all participants was 159.8 μg/L,there was a significant difference in urine iodine frequency distribution among age groups (x2 =40.097,P < 0.01).Furthermore,the median UIC in male was 166.6 μg/L,and in female was 156.2 μg/L.There was a significant difference in UICs between male and female (U =2.122,P < 0.05).The prevalence of total thyroid nodules in all participants was 48.75% (1 244/2 552),and the standardized rate was 40.55%.Significant difference in the detection rate of thyroid nodules was observed among age groups (x2 =114.922,P < 0.01),and there was a positive and significant correlation between the detection rate of thyroid nodules and increasing age (xtrand =111.746,P < 0.01).Furthermore,in male,41.24% (153/371) had thyroid nodules,with standardized prevalence rate of 41.13%,and in female,50.02% (1 091/2 181) had thyroid nodules,with standardized prevalence rate of 49.20%.Likewise,there was a significant difference in the detection rate of thyroid nodules between male and female(x2 =9.790,P < 0.01).The detection rate of thyroid nodules in the iodine deficient population (urinary iodine was 0-< 100 μg/L) was 55.58% (244/439),and the incidence of thyroid nodules in the iodine adequate or optimal population (urinary iodine was 100-< 200 μg/L) was 46.68% (591/1 266).Conclusions The total iodine level of the population in Harbin City of Heilongjiang Province is at adequate level.The detection rate of thyroid nodules is high and it is increased with age.The detection rate of thyroid nodules is higher in female than male.Regular detection of urine iodine and adjusting iodine nutrition will help prevent thyroid nodules.
3.Mutation analysis of NTRK1 gene in a family affected with congenital insensitivity to pain with anhidrosis.
Bingxiao LI ; Zhanhui ZHANG ; Xia WU ; Wenchao CHEN ; Jianling CHEN ; Qian LYU ; Guosheng LIU
Chinese Journal of Medical Genetics 2017;34(5):646-649
OBJECTIVETo screen for mutations of NTRK1 gene in a Chinese family affected with congenital insensitivity to pain with anhidrosis (CIPA).
METHODSGenomic DNA was extracted from the proband and her family members. All of the 17 exons and intron-exon boundaries of the NTRK1 gene were analyzed by direct Sanger sequencing. For the deletional mutation, the PCR products were subjected to T-A cloning and sequencing to verify the mutation.
RESULTSNTRK1 gene analysis revealed that proband has carried a c.1786C>T (p.Arg596*) nonsense mutation inherited from her mother and a novel deletional mutation c.1928-2028+23del from her father. Her elder brother only carried the deletional mutation.
CONCLUSIONThe diagnosis of CIPA relied on typical clinical symptoms of no pain, anhidrosis and intellectual disability and detection of the biallelic NTRK1 mutations. The novel deletional mutation has enriched the spectrum of NTRK1 mutations.
Child, Preschool ; DNA Mutational Analysis ; Exons ; Female ; Hereditary Sensory and Autonomic Neuropathies ; diagnosis ; genetics ; Humans ; Mutation ; Receptor, trkA ; genetics
4.Residual risk of hepatitis C virus in blood screening among voluntary blood donors in Zhengzhou
Wenchao GE ; Yonglei LYU ; Mingjun CHEN ; Yifang WANG ; Yan ZHANG ; Yongchao SHI ; Hongna ZHAO ; Lei ZHAO
Chinese Journal of Blood Transfusion 2022;35(5):546-549
【Objective】 To evaluate the residual risk of hepatitis C virus (HCV) in blood screening among voluntary blood donors in Zhengzhou. 【Methods】 The ELISA and NAT screening results of 497 171 voluntary blood donors in Zhengzhou from January 2019 to December 2020 were collected through the information management system of our blood center.The residual risk of HCV was assessed using the Prevalence-Window Period Residual Risk Model. 【Results】 The residual risk among repeated and first-time blood donors was 1∶132 280 (95% CI: 1∶95 520~1∶188 820) and 1∶44 090 (95% CI: 1∶31 840~1∶62 940), respectively. The overall residual risk of blood donors screening was 1∶68 540 (95% CI: 1∶65 910~1∶130 290). The reactive rate of HCV screening in first-time blood donors (0.144%, 334/231 168) was significantly higher than that in repeated blood donors (0.014%, 36/266 003) (P<0.05), and the reactive rate of repeated blood donors in 2019 (0.019%, 26/135 267) was significantly higher than that in repeat blood donors in 2020 (0.008%, 10/130 736) (P<0.05). 【Conclusion】 The residual risk of HCV among voluntary blood donors in Zhengzhou is low.The publicity and recruitment should be further strengthened to establish a stable team of voluntary blood donation, and health consultation and physical examination should also be strengthened to further reduce the residual risk of blood transfusion.
5.NAT results of HBV and HCV under different vacuum collection tubes, storage temperature and storage time
Li ZHANG ; Yifang WANG ; Yonglei LYU ; Wenchao GE ; Tianning SI ; Xiaohong ZHU ; Lei ZHAO
Chinese Journal of Blood Transfusion 2021;34(12):1314-1317
【Objective】 To verify the results of HBV DNA and HCV RNA screening under different brands of vacuum collection tubes for blood samples, storage temperature and storage time. 【Methods】 Experiment 1 was conducted as follows: blood samples were collected simultaneously from 52 voluntary blood donors using two brands(divided into group A and group B) of vacuum collection tubes for blood samples. The plasma separation of group A and group B were compared, and the effects of storage time on the NAT yield of HBV DNA and HCV RNA were statistically analyzed. Experiment 2 was conducted as follows: the effects of different storage temperature, time and tubes on the NAT yield of HBV DNA and HCV RNA samples with low viral load in group A and B were verified and compared in the simulated phlebotomy condition. 【Results】 In Experiment 1: After centrifugation, blood plasma layer and cells layer were separated completely in group A(100%, 52/52), but one sample was not well separated in group B(1/52, 1.92%). After 4 to 10 h after collection, blood samples of two groups were centrifuged and screened for HBV DNA, HCV RNA within 24 h. No positive samples were yielded and the Ct values of internal control(IC-DNA and IC-RNA) were uniform. In Experiment 2: Whole blood samples, stored for either 4 h or 6~10 h at 4 ℃ or 25℃ before centrifugation, showed no difference on the NAT-yield of HBV DNA nor HCV RNA samples with low viral load(P>0.05). Ct values of HBV DNA and HCV RNA of group A was similar to those of group B as centrifuged samples were stored for 24 h or 72~104 h at 4℃(P>0.05), but all increased as the storage time prolonged. Ct values of HBV DNA in group A increased from 33.45±0.29(24 h) to 33.82±0.08(72~104 h) and HCV RNA from 35.21±0.20 to 36.12±0.43; HBV DNA from 33.46±0.25 to 34.30±0.60 and HCV RNA from 35.47±0.24 to 36.49±0.51 in group B. 【Conclusion】 Under certain laboratory condition, different storage time, storage temperature and tubes shed few effect on the NAT-yield of HBV DNA and HCV RNA samples with low virus loads. However, it is suggested that the blood sample be detected within 72 h after centrifugation at 4 ℃ storage.
6. Clinical pathological characteristics of resectable papillary thyroid microcarcinoma
Chenlei SHI ; Yong GUO ; Yichen LYU ; Abiyasi NANDING ; Wenchao GAO ; Tiefeng SHI ; Huadong QIN ; Shaoyan LIU
Chinese Journal of Oncology 2017;39(5):361-366
Objective:
To investigate the difference of prognostic factors and recurrence rates between papillary thyroid microcarcinoma (PTMC) and lager papillary thyroid carcinoma (PTC) and analyze the clinical pathological characteristics of PTMC suitable for surgery.
Methods:
A retrospective analysis on the clinicopathological features, expression level of of v-raf murine sarcoma viral oncogene homolog B1 (BRAF) V600E gene mutation and pigment epithelium-derived factor (PEDF), and postoperative follow-up results of the 251 PTC patients who underwent surgical treatment from October 2011 to October 2013, including 169 cases with PTMC and 82 with lager PTC (Tumor diameter>1 cm).
Results:
The BRAF V600E mutation rates of PTMC and lager PTC patients are 65.1%(110/169)and 78.0% (64/82) respectively, and the difference is statistically significant (
7. Anatomical relationship between fascia propria of the rectum and visceral pelvic fascia in the view of continuity of fasciae
Yi CHANG ; Hailong LIU ; Huihong JIANG ; Ajian LI ; Wenchao WANG ; Jian PENG ; Liang LYU ; Zhihui PAN ; Yong ZHANG ; Yihua XIAO ; Moubin LIN
Chinese Journal of Gastrointestinal Surgery 2019;22(10):949-954
Objective:
To perform an anatomical observation on the extension of the mesocolon to the mesorectum and the continuity of the fasciae lining the abdomen and pelvis, in order to clarify the appropriate surgical plane of total mesorectal excision.
Methods:
This is an descriptive study. The operation videos of 61 cases (28 males, 33 females, median age of 61) were collected. All the patients underwent laparoscopic colorectal surgery from January 2018 to December 2018 in Yangpu Hospital, including low anterior resection for rectal cancer in 25 cases, left hemicolectomy for descending colon cancer in 15 cases, and subtotal resection of the colon for intractable constipation in 21 cases. Among these 21 constipation patients, 8 received additional modified Duhamel surgeries. Gross anatomy was performed on 24 adult cadavers provided by Department of Anatomy, Shanghai Jiaotong University School of Medicine, including 23 formalin-fixed and 1 fresh cadaver (12 males, 12 females). Sixty-one patients and 24 cadavers had no previous abdominal or pelvic surgical history. The anatomy and extension of fasciae related to descending colon, sigmoid colon and rectum, especially the morphology of Toldt fascia, and the continuities of mesocolon and mesorectum were observed carefully. The distribution characteristics of the fasciae and anatomical landmarks during laparoscopic surgery were recorded and described.
Results:
The anatomical study on 24 cadavers showed that visceral fascia was the densest connective tissue in the pelvic, posterolateral to the rectum, and stretched as a hammock to lift all pelvic organs. Among 61 patients undergoing laparoscopic surgery, 36 (59.0%) needed to free the left colon during operation, and Toldt fascia in the descending colon segment presented as potential, avascular and extensible loose connective tissue plane between the mesocolon and posterior Gerota fascia; 33 (54.1%) needed to free the rectum during operation, and Toldt fascia extended downward to pelvis as loose connective tissue between the fascia propria of the rectum and visceral fascia; the fascia propria of the rectum exposed completely in 32 (32/33, 97.0%) cases, which ran downward and fused with visceral fascia at the level of the fourth sacral vertebra. The anatomy of 24 cadavers also showed that fascia propria of the rectum fused with visceral fascia at the level of Waldeyer fascia. The fusion line of these two fasciae was supposed to be the extension of Waldeyer fascia. There were two avascular planes behind the rectum: one between the fascia propria of the rectum and visceral fascia, and the other between the visceral fascia and parietal fascia. In 8 constipation cases undergoing laparoscopic subtotal colon resection plus modified Duhamel operation, both mesocolon and mesorectum needed to be mobilized. It was obvious that the mesocolon of descending colon extended and became the mesocolon of sigmoid colon, and ran further into the pelvic and became the mesorectum. The colon fascia of descending colon served as the natural boundary of mesocolon extended downward as the fascia of sigmoid colon and the fascia propria of the rectum, respectively. Toldt fascia locating between mesocolon of descending colon and Gerota fascia extended to pelvis as the 'presacral space’ between the fascia propria of the rectum and visceral fascia. Gerota fascia in descending colon segment extended as urogenital fascia in sigmoid colon segment and visceral fascia in the pelvis, respectively. In the cadaver anatomy study, the visceral fascia served as a corridor carrying the hypogastric nerve, and ureter was observed in 23 (23/24, 95.8%) cases. The visceral fascia passed from posterior to anterior lateral of rectum, fusing with Denonvilliers fascia in a fan shape. The pelvic plexus located exactly external to the junction of visceral fascia and Denonvilliers fascia. Pelvic splanchnic nerves went through the parietal fascia toward to the inferolateral of the pelvic plexus.
Conclusion
Fascia propria of the rectum and the visceral pelvic fascia are two independent layers of fascia, and the TME surgical plane is between the fascia propria of the rectum and visceral pelvic fascia instead of between the visceral and the parietal pelvic fascia.
8. Impact of hypertensive disorder complicating pregnancy on neonatal mortality and major complications in preterm infants
Meiyu WANG ; Xiangyong KONG ; Zhichun FENG ; Fengdan XU ; Hongyan LYU ; Lihong YANG ; Sujing WU ; Rong JU ; Jin WANG ; Li PENG ; Zhankui LI ; Xiaolin ZHAO ; Shujuan ZENG ; Huixian QIU ; Weixi WEN ; Hui WU ; Ying LI ; Nan LI ; Xuefeng ZHANG ; Wenzheng JIA ; Guo GUO ; Weipeng LIU ; Feng WANG ; Gaimei LI ; Fang LIU ; Wei LI ; Xiao-ying ZHAO ; Hongbin CHENG ; Yunbo XU ; Wenchao CHEN ; Huan YIN ; Yanjie DING ; Xiaoliang WANG ; Ruiyan SHAN ; Ping XU ; Meiying HAN ; Chunyan YANG ; Tieqiang CHEN ; Xiaomei TONG ; Shaojun LIU ; Ziyuan LIU
Chinese Journal of Applied Clinical Pediatrics 2018;33(14):1065-1070
Objective:
To investigate the effect of hypertensive disorder complicating pregnancy (HDCP) on the mortality and early complications of premature infants.
Methods:
The general clinical data of preterm infants with gestational age 24-36+ 6 weeks were collected from the cooperative units in the task group from January 1, 2013 to December 31, 2014.According to the severity of HDCP, the infants were divided into 4 groups: HDCP group, preeclampsia group, eclampsia group and non HDCP group, the mortality and major complications of preterm infants were compared, and the influencing factors were analyzed.
Results:
The mortality rate of preterm in the HDCP group was significantly higher than that of non HDCP group, and there was statistical significance (