1.Assessment of the hemodynamics of left ventricle in ventricular aneurysm during the contraction phase by vector flow mapping
Xiaojing MA ; Juan XIA ; Xi ZENG ; Bin WANG ; Chunxia WU
Chinese Journal of Ultrasonography 2011;20(9):755-758
Objective To evaluate the systolic function of left ventricle in myocardial infarction(MI)patients with ventricular aneurysm and the changing law of blood flow in ventricle with regional abnormality of wall movement by vector flow mapping (VFM).Methods Tirty-one MI patients with ventricular aneurysm and 35 healthy participants were enrolled in this study.The characteristic of vector and streamline,and the changing of the velocity gradient in left ventricular outflow tract (LVOT), and the average flow quantity through aneurysm neck were detected in the isovolumic contraction period, the rapid ejection period and the slow ejection period by VFM.Results The distinction between aneurysm and control group was mainly the persistance of vortex in aneurysm.The size of vortex in aneurysm was highly correlated with that measured by 2-D ultrasound(P <0.01).The percentage of vortex duration to cardiac cycle in patients group was significantly greater than that in control group(P <0.01).In the early systolic contraction the velocity gradient in LVOT in patients with ventricular aneurysm was smaller than that of control group(P <0.05).The average flow through aneurysm neck was notablely decreased compared with control group(P <0.01).Conclusions VFM can reveal the hemodynamics of left ventricle with aneurysm directly as well as quantitively measure the regional velocity and flow quantity.VFM can evaluate the systolic function of left ventricle exactly.
2.Application of micro transesophageal echocardiography (micro-TEE) in neonat and infant cardiac surgery
Li DONG ; Xiaojing MA ; Xi YU ; Yuan YUAN ; Jingjing WANG
Chinese Journal of Ultrasonography 2015;24(11):948-950
Objective To evaluate the value of phased array probe of transesophageal echocardiography miniature (micro-TEE) in the neonatal and infant cardiac surgery intraoperation.Methods Micro-TEE probe was used in children with weight ≤5 kg undergoing cardiac surgery to detect the atrial and ventricular cavity size,the left and right ventricular outflow tract diameter were detected by transthoracic echocardiography(TTE) 3-7 d after operation,and compared with the measured value immediately after the TEE.Results Before and after intubation,airway index not statistically significant (P > 0.05).Preoperative TEE and TTE inspection results were consistent with intraoperative diagnosis.Postoperative TEE measuring intracardiac structural data (each room,chamber size and left and right ventricular outflow tract diameter) and postoperative TTE measurement value representing the difference was not statistically significant (P > 0.05).Conclusions Micro TEE intraoperative guardianship of low birth weight infants is safe and feasible,and can supplement and improve the preoperative diagnosis,and can accurately and timely evaluate postoperative curative effect.
3.Distribution and antimicrobial resistance of pathogens from intensive care unit patients’sputum obtained through fiberbronchoscope for four consec-utive years
Xiaomeng ZHU ; Yao LIU ; Yi WANG ; Xiaojing XI ; Xiangyou YU
Chinese Journal of Infection Control 2016;15(2):88-92
Objective To investigate the distribution and antimicrobial resistance of pathogens from lower respira-tory tract in patients in intensive care unit (ICU),so as to provide reference for clinical treatment.Methods Distri-bution and antimicrobial susceptibility of pathogens isolated from ICU patients’sputum obtained through fiberbron-choscope between 2011 and 2014 were analyzed retrospectively.Results A total of 3 454 pathogenic strains were isolated between January 1 ,2011 and December 31 ,2014,the percentage of gram-negative bacteria,gram-positive bacteria,and fungi were 84.11 %,14.50%,and 1 .39% respectively.The detection rates of extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella spp .in 2011 -2014 were 38.46% -73.33% and 26.95% -37.06% respectively. Enterobacteriaceae strains had low resistance rates to imipenem and meropenem (<20.00%);resistance of Acinetobacter baumannii was higher than Pseudomonas aeruginosa ,both had low resistance rates to amikacin(3.32%-37.16%);vancomycin-and linezolid-resistant strains were not found among Staphylo-coccus .In 2011 - 2014,detection rates of methicillin-resistant Staphylococcus aureus (MRSA)were 42.86% -61 .22%,methicillin-resistant coagulase-negative staphylococcus (MRCNS)were 86.96% - 91 .67%;resistance rates of Enterococcus faecium was higher than Enterococcus faecalis ,vancomycin-resistant strains were not found among Enterococcus faecalis and Enterococcus faecium ;the major fungus was Candida albicans .Conclusion Anti-microbial resistance of pathogens isolated from lower respiratory tract is getting more serious,clinicians should pay attention to non-antimicrobial infection control strategies in addition to rational use of antimicrobial agents.
4.Analysis of risk factors of pulmonary hypertension in healthy Chinese young males after rapid ascent to high altitude
Xiangjun LI ; Xiaojing WU ; Jun QIN ; Te YANG ; Shuangfei LI ; Xi LIU ; Lan HUANG
Military Medical Sciences 2014;(4):241-244
Objective To investigate the risk factors of pulmonary hypertension (PH) after rapid ascent to high altitude in healthy young Chinese men .Methods A total of 552 non high altitude natives ( healthy young Chinese men ) were recruited in the study between June to August in 2012.The subjects were delivered to high altitude (3700 m) in 2 h by plane from low altitude (450 m).Demographic data including smoking , alcohol consumption , high altitude exposure histo-ry, body mass index (BMI) and age were collected within 24 h after arrival at 3700 m.Furthermore, the oxygen saturation ( SaO2 ) , blood pressure , heart rate , pulmonary artery systolic pressure were measured using the echocardiography system . Analysis of risk factors of PH was performed by logistic regressions .Results The incidence of PH was 23.10%.SaO2 was significantly lower in the higher-pulmonary artery systolic pressure group (higher-PASP)[(86.10 ±3.34)%] than that in the normal-PASP group [(89.09 ±2.65)%, P<0.01].Smoking, alcohol consumption, high altitude exposure history, BMI, age, systolic blood pressure , diastolic blood pressure , heart rate were not significantly different between the two groups mentioned above .Logistic regressions revealed that lower SaO 2 (OR:0.711,95% CI:0.647-0.782, P<0.01) was an independent risks factor of PH .Conclusion Low SaO2 is an independent risk factor of PH upon rapid arrival at 3700 m in healthy young Chinese men .However, smoking, alcohol consumption , high altitude exposure history , BMI, age, blood pressure and heart rate are not risk of PH .These observations will provide valuable clues to theoretical studies on PH and prevention of PH .
5.Use of computer-assisted navigation system in reconstruction of unilateral old zygomatic complex fracture
Xi GONG ; Yi ZHANG ; Yang HE ; Zhiqiang FENG ; Jingang AN ; Xiaojing LIU ; Chuanbin GUO
Chinese Journal of Trauma 2013;(2):122-126
Objective To investigate whether the surgery resorting to computer-assisted navigation system (CANS) can enhance effects in managing unilateral old zygomatic complex (ZMC) fracture in comparison with conventional surgery.Methods Twenty-four patients with unilateral old ZMC fracture for which surgical correction was wanted were divided into study group (n =12,treated with navigational surgery) and control group (n =12,treated with traditional surgery) in the 1 ∶ 1 matched case-control study.Therapeutic effects of CANS were evaluated by postoperative CT measurement,subjective satisfaction questionnaire and clinical examination.Results According to postoperative three-dimensional CT measurement,the mean projection and width differentials of bilateral zygomatic bones were 1.58 mm and 1.47 mm in study group,3.58 mm and 3.63 mm in control group,with significant differences between groups.No complications occurred within three months of follow-up.Moreover,the patients in study group were all satisfied with the treatment,but two patients in control group desired further surgery to ameliorate zygomatic shape.Conclusion Surgery with application of CANS improves efficacy of treatment for unilateral old ZMC fracture.
6.Verification of the interaction between ASGPR and HBV preS1 protein
Xi ZHANG ; Xiaojing LIU ; Yunru CHEN ; Ying KONG ; Xueliang YANG ; Feng YE ; Shumei LIN
Journal of Xi'an Jiaotong University(Medical Sciences) 2016;(2):292-297
Objective To verify the interaction between asialoglycoprotein receptor (ASGPR)and hepatitis B virus (HBV)preS1 protein in vivo and in vitro ,and identify ASGPR as a cell-surface receptor for HBV,which could elucidate the molecular mechanism of HBV infection.Methods The preS1-ASGPR interaction was examined in mammalian two-hybrid and coimmunoprecipitation system by strictly following the manufacturer’s instructions.Results ASGPR interacted specifically and directly with the preS1 domain of HBV in vivo and in vitro .Conclusion ASGPR may be a candidate receptor for HBV that mediates further step of HBV entry.
7.The clinical study of using DLI+IL-2 after Mixed-HSCT in acute myelogenous leukemia
Cunbang WANG ; Hai BAI ; Yingxian OU ; Yaozhu PAN ; Qian ZHANG ; Rui XI ; Xiaojing WANG
Chinese Journal of Postgraduates of Medicine 2006;0(03):-
Objective To approach curative effect of using DLI +IL-2 as immunobiotherapy after Mixed-HSCT in acute myelogenous leukemia.MethodAfter times of chemotherapy,8 cases of patients with acute myelogenous leukemia received Mixed-HSCT,then were treated with DLI +IL-2 for 2-7 times.Observed clinical effect for 1 to 5 years.Result DFS in 8 cases of patients with acute myelogenous leukemia received Mixed-HSCT and treated with DLI +IL-2 for 2-7 times were 62.5%.There were no GVHD.Conclusion Immuno-biotherapy with DLI +IL-2 after Mixed-HSCT in patients of acute myelogenous leukemia may be a method to increase DFS efficiently.
8.A survey of present basic constructive situation of intensive care units in second and tertiary grade hospitals in Xinjiang Uygur Autonomous Region
Yi WANG ; Xiaojing XI ; Hua ZHONG ; Yunlin SONG ; Xiaopeng LI ; Qingli DOU ; Xiangyou YU
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care 2015;22(3):317-321
Objective To collect the data of present basic constructive situation of intensive care units (ICUs) in second and tertiary grade hospitals in Xinjiang Uygur Autonomous Region and to provide a data base beneficial to the construction of ICUs in the whole region.Methods The information including basic situation of ICUs in a total of 49 second and tertiary grade hospitals as samples in Xinjiang Uygur Autonomous Region were investigated by questionnaire survey from December 2012 to April 2013. The contents of questionnaire chiefly included the basic situations of hospitals, ICU constructions, ICU human resources and allocation of equipments.Results Forty-nine questionnaires were sent out, and all of them gave answers, the recovery rate being 100%. In the whole region of Xinjiang, there were 49 second and tertiary grade hospitals with establishment of 66 various types of ICUs. ① Medical unit basic situation: the second grade A hospitals accounted for 59.2%, and the tertiary grade A hospitals, 34.7%. There was a larger proportion of local hospitals (67.3%); most of the hospitals had beds over 500 (57.14%), the designed hospital bed number was 41 403, and 35 442 beds were open up for service (85.60%). ② The ICU basic construction situation: the construction of ICUs concentrated mainly after the year 2000, from 2000 to 2010, a total of 37 units, and from 2010 to 2012, 12 units were constructed; when they opened to the public, the beds were relatively few, and the ICUs containing less than 10 beds occupied 79.00%. In the 66 ICUs surveyed, there were 43 general ICUs, accounting the largest proportion, followed by 7 emergency ICUs, and the least were 1 neurosurgery and 1 cardiac surgery ICU. In the 66 ICUs, all together 765 beds were prepared, but actually 808 beds were opening up to public; most of ICUs had 5 - 20 beds, accounting for 71% in all the ICUs. At present, in the whole Xinjiang region, the rate of beds in ICUs in various grades of hospitals opening to the outside for use accounted for more than 80% of which 56% ICUs were almost turning round fully. ③ ICU human resources situation: totally, there were 484 doctors in ICUs in the whole region, the ratio of full-time doctor to nurses was 1:3.50, the ratio for bed to physician 1:0.55 and the ratio for bed to nurse 1:0.92. The title of doctor was primarily resident, and the various title gradient levels were good. Most doctors graduated from a regular medical college, and the doctors having obtained a master degree were few. The physician professional backgrounds were mainly critical disease medicine, emergency medicine and respiratory medicine, the professional relevance being good; the chief way of ICU physicians to engage in advanced study of their professional training was in China, and generally they joined professional continuing education programs poorly, mostly joining once a year or non at all. The physicians who obtained the identification of Chinese critical care medicine specialist accounted only for 23.56%. ④ ICU equipment allocation situation: according to the requirements of ICU construction guidelines, the equipments must be allocated including bedside monitors (703 units), ventilators (516 units) and infusion pumps (702 units), occupying the highest proportion. In the optional equipments, there were enteral nutritional pump (89 stations), blood glucose monitoring device (57 units) and anti-decubitus mattresses (54 units), the proportion being the largest, bispectral index monitor (2 units), extracorporeal membrane oxygenation (ECMO, 1 table) and gastric mucosal carbon dioxide tension pHi meter (0 unit), the proportion being the least or non at all.Conclusions In the whole Xinjiang region, the construction of ICUs is still at the developing stage, and needs to further strengthen the standardized construction. The human resources, equipments, etc. are not distributed in balance, and it is necessary to move forward the adjustment to benefit the development of ICUs in the whole region.
9.Autologous hematopoietic stem cell transplantation for peripheral T cell lymphoma
Yaozhu PAN ; Hai BAI ; Cunbang WANG ; Rui XI ; Qian ZHANG ; Xiaojing WANG
Chinese Journal of Tissue Engineering Research 2015;(10):1603-1607
BACKGROUND:The incidence rate of peripheral T cel lymphoma is high in Asia, and peripheral T cel lymphoma is aggressive with generaly poor prognosis. However, there is no standard treatment strategy. OBJECTIVE:To retrospectively analyze the therapeutic effect of autologous hematopoietic stem cel transplantation on peripheral T cel lymphoma as wel as relevant toxic and side effects. METHODS:A retrospective review was conducted in 35 patients with peripheral T cel lymphoma who underwent autologous hematopoietic stem cel transplantation from March 2003 to April 2014, including 22 cases of extranodal NK/T-cel lymphoma (nasal type), 1 case of angioimmunoblastic T-cel lymphoma, 8 cases of peripheral T cel lymphoma (non-specific), 3 cases of ALK-positive anaplastic large cel lymphoma, and 1 case of ALK-negative anaplastic large cel lymphoma. Al of 35 patients were classified pathologicaly according to WHO pathological type in 2001 and 2008, and received the high-dose chemotherapy with vincristine, cytarabine, etoposide, mitoxantrone, semustine, cyclophosphamide, and total body irradiation. RESULTS AND CONCLUSION: After a median folow-up of 54 (9-120) months, the probabilities of overal survival and disease-free survival after transplantation were 80% (n=28) and 71% (n=25), respectively. Eight cases (23%) relapsed after transplantation, seven of which died. It was safe with mild and moderate transplantation related side-effects on opportunistic infections, oral cavity mucosa and bladder responses and so on, and there were no severe, life-threatening late complications. Autologous hematopoietic stem cel transplantation may be an effective and safe treatment for peripheral T cel lymphoma, and there is a better benefit in peripheral T cel lymphoma patients with first complete remission.
10.Etiological agents distribution and epidemiology of viral diarrhea in children below 5 years old in He′nan ;province,2008-2015
Jiayong ZHAO ; Xiaojing SHEN ; Baifan ZHANG ; Jia SU ; Jingjing DUAN ; Xi WANG ; Shengli XIA
Chinese Journal of Infectious Diseases 2016;34(12):738-742
Objective To investigate the infectious status,etiological spectrum and epidemiological characteristics of rotavirus (group A/B/C),calicivirus (novovirus Ⅰ/Ⅱ,sapovirus),astrovirus and enteric adenovirus in diarrhea cases below 5 years old from 2008 to 2015 in Henan provinces.Methods Totally 2541 stool samples were collected from cases below 5 years old in four sentinel hospitals.All stool specimens were tested for group A rotavirus by double antibody sandwich ELISA method.G/P genotyping of group A rotavirus was determined by nested multiplex PCR.Viral RNA was extracted from all samples and rotavirus (group B/C),calicivirus,astrovirus and enteric adenovirus were detected by two-step reverse transcription-polymerase chain reation (RT-PCR)/PCR.Results One thousand four hundred and twenty-one out of 2 541 samples were positive with a total positive rate of 55 .9%,among which,102 were mixed infection.The isolation rate of rotavirus was 36.0% (914 samples)(group A:785 cases,group B:36 cases,group C:93 cases),calicivirus was 12.1 % (308 samples)(novovirus Ⅰ:64 cases,novovirusⅡ:193 cases,sapovirus:51 cases),astrovirus was 5 .9% (151 samples),enteric adenovirus was 1 .9%(48 samples).The group A rotavirus gene type combinations were composed mainly of G9P[8],G2P[4], G3P[8 ],G1P [8 ]and most cases were identified from September to November and March to May. Novovirus Ⅱ was predominant in calicivirus and most cases were identifed between March and May. Rotavirus or calicivirus infection was mainly among children aged 4—12 months or 3—5 years, respectively.Clinical manifestations included fever,diarrhea,vomiting,dehydration.Gender and region distributions differed according to the types of pathogen.Conclusions Group A rotavirus and novovirus Ⅱare the major viral pathogen in diarrhea cases younger than 5 years old in Henan province.Different viral infections exhibit extinct epidemiologic and clinical characteristics.