1.Effects of adenohypophysis function after treating with thyrotropin releasing hormone in patients with brain trauma
Bin LI ; Bao ZHAO ; Jingliang YE ; Feng YU ; Wenguo SHENG ; Guojun SU ; Qiang MA ; Xinglong XU
Chinese Journal of Biochemical Pharmaceutics 2014;(3):108-110
Objective To analyze the effects of adenohypophysis function after treating with thyrotropin releasing hormone and its clinical significance in patients with brain trauma. Methods There were 22 cases with traumatic brain injuries from July 2010 to September 2012 in Chinese people's Liberation Army nine eight hospital,after injuried within 4 to 12 hours,then 1 1 cases who were given thyrotropin-releasing hormone(TRH)were selected as experimental group,while 1 1 cases who were given the same amount of isotonic saline were selected as control group,then the score of GCS, ICS,RLS85 and the improvement of adenohypophysis function were observed. Results After treatment,the score of glasgow coma scale (GCS ), innsbruck coma scale (ICS),and the reaction level scale (RLS85)between two groups were significantly increased in three days compared with before treatment,and within three days after injury situation,the improvements of ICS and RLS85 in experimental group were better than control group(P<0.05 ). Compared with control group,the levels of each gland pituitary hormone in experimental group were significantly increased(P<0.05 ),and on the third day,the growth hormone (GH)was reduced significantly,finally 50%of that in control group. Conclusion Patients with brain injury treated with thyrotropin releasing hormone,has no significant adverse reactions,with the characteristics of safe and effective.
2.Diagnosis and treatment of spinal cord cavernous angioma.
Yongzhi SHAN ; Feng LING ; Meng LI ; Xinglong ZHI
Chinese Journal of Surgery 2002;40(4):287-289
OBJECTIVETo investigate the diagnosis and treatment of patients with spinal cord cavernous angioma.
METHODSClinical data on 23 patients with intramedually cavernous angiomas were analyzed. The function of the spinal cord was evaluated before and after treatment using the Aminoff & Logue scale.
RESULTSAll patients underwent resection of spinal cord cavernous angioma except two patients who refused surgical treatment. Complete removal was achieved in 18 patients, and subtotal removal in 3. Twenty-one patients with spinal cavernous angioma were confirmed pathologically. The postoperative neurological status was improved in 15 patients, remained unchanged in 4, and aggravated in 2. No deaths occurred.
CONCLUSIONSMRI is specific in diagnosis of intramedually cavernous angioma. The outcome of surgical treatment is better. Surgical treatment is suitable for patients with symptoms.
Adolescent ; Adult ; Female ; Hemangioma, Cavernous ; diagnosis ; surgery ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Spinal Cord Neoplasms ; diagnosis ; surgery ; Treatment Outcome
3.Clinical study of lactitol powder combined with piperacillin sodium and tazobactam sodium in the treatment of spontaneous bacterial peritonitis
Xinglong LUAN ; Qingshun MENG ; Feng SU ; Yuanyuan LI ; Yuanxing CHENG
Chinese Journal of Postgraduates of Medicine 2022;45(1):42-48
Objective:To investigate the effect of the lactitol powder combined with piperacillin sodium and tazobactam sodium in patients with spontaneous bacterial peritonitis (SBP), and the influence on the body microenvironment.Methods:The clinical data of 135 patients with SBP from January 2017 to December 2019 in Huxi Hospital Affiliated Jining Medical College were retrospectively analyzed. Among them, 68 patients were treated with lactitol powder combined with piperacillin sodium and tazobactam sodium (observation group), 67 patients were treated with piperacillin sodium and tazobactam sodium (control group). The curative effect was compared between 2 groups. The recovery time of clinical symptoms and signs (disappearance time of abdominal pain, disappearance time of abdominal distension, disappearance time of abdominal tenderness, recovery time of body temperature and recovery time of ascites white blood cell), liver function indexes (alanine aminotransferase, ALT; total bilirubin; albumin; aspartate aminotransferase, AST), microcirculation indexes (haptoglobin; procalcitonin; interleukin-6, IL-6; neutrophil gelatinase-associated lipocalin, NGAL), intestinal mucosal permeability indexes (endotoxin, blood ammonia, diamine oxidase) and adverse reactions (diarrhea, nausea and skin itching) were recorded.Results:The total effective rate in observation group was significantly higher than that in control group: 95.59% (65/68) vs. 82.09% (55/67), and there was statistical difference ( P<0.05). The disappearance time of abdominal pain, disappearance time of abdominal distension, disappearance time of abdominal tenderness, recovery time of body temperature and recovery time of ascites white blood cell in observation group were significantly shorter than those in control group: (6.15±1.34) d vs. (8.26±1.19) d, (5.34±1.29) d vs. (7.18±1.35) d, (7.59±1.65) d vs. (9.86±1.80) d, (5.28±1.20) d vs. (6.39±1.12) d and (10.87±2.25) d vs. (12.18±1.67) d, and there were statistical differences ( P<0.01). The ALT, total bilirubin, AST, haptoglobin, procalcitonin, IL-6, NGAL, endotoxin, blood ammonia and diamine oxidase 1 and 2 weeks after treatment in observation group were significantly lower than those in control group, and there were statistical differences ( P<0.01); there was no statistical difference in albumin between 2 groups ( P>0.05). There was no statistical difference in incidence of adverse reactions between2 groups ( P>0.05). Conclusions:The lactitol powder combined with piperacillin sodium and tazobactam sodium for SBP patients can more significantly improve the liver function and intestinal mucosal permeability, and promote the body microenvironment and the recovery of symptoms.
4.Prediction model of perioperative risk of deep venous thrombosis in patients with acute multiple knee joint injuries based on Logistic regression and XGBoost algorithm
Jun LI ; Xia LIU ; Zifeng CHEN ; Xinglong FENG ; Yongsheng WANG
International Journal of Surgery 2021;48(6):371-377,F3
Objective:Based on Logistic regression and XGBoost algorithm, the prediction model of perioperative risk of deep venous thrombosis in patients with acute multiple knee joint injuries was constructed, and the prediction performance was compared.Methods:A total of 120 patients with acute multiple injuries around the knee treated in the Department of Orthopaedic Trauma, Guangzhou Panyu District Central Hospital from January 2017 to June 2020 were retrospectively selected. According to the proportion of 7∶3, the patients were randomly divided into training set ( n=84) and test set ( n=36). The prediction models of Logistic regression and XGBoost algorithm were constructed by training set data, to screen the predictors of perioperative deep venous thrombosis in patients with acute multiple injury around knee joint, and the prediction effect of the model was evaluated by test set data. The measurement data conforming to the normal distribution were expressed as mean±standard deviation ( Mean± SD), and the independent t-test was used for comparison between groups; the measurement data of non-normal distribution were expressed as the median (interquartile range) [ M( P25, P75)], the independent sample Mann-Whitney U test was used for comparison between groups; the Chi-square test was used for comparison of enumeration data between groups. Results:The results of Logistic regression model showed that age, hypertension, coronary heart disease, time from injury to operation, D-dimer at 1 day after operation and multiple injuries were predictive factors for perioperative deep venous thrombosis in patients with acute multiple injuries around the knee joint. The top five important feature scores of XGBoost algorithm model were combined multiple injuries (35 points), time from injury to operation (28 points), age (24 points), coronary heart disease (21 points) and D-dimer 1 day after operation (16 points). In the training set, the area under the curve of the Logistic regression model was 0.805 (95% CI: 0.637-0.912), and χ2=1.436, P=0.329 for Hosmer and Lemeshow test. The area under the curve of the XGBoost algorithm model was 0.847(95% CI: 0.651-0.920), and χ2=1.103, P=0.976 for Hosmer and Lemeshow test. Conclusion:Logistic regression model and XGBoost algorithm model are similar in predicting perioperative deep venous thrombosis in patients with acute multiple injuries around the knee, and multiple injuries, time from injury to operation, age, coronary heart disease and D-dimer 1 day after operation can be used as predictive factors.
5. Laparoscopic pancreaticoduodenectomy with a novel artery first and uncinate process first approach through Treitz ligament
Wentao GAO ; Chunhua XI ; Min TU ; Xinglong DAI ; Feng GUO ; Jianmin CHEN ; Jishu WEI ; Zipeng LU ; Junli WU ; Kuirong JIANG ; Yi MIAO
Chinese Journal of Surgery 2017;55(5):359-363
Objective:
To explore the clinical effect of a novel artery first and uncinate process first approach for laparoscopic pancreaticoduodenectomy(LPD), emphasizing the left lateral and posterior dissection of uncinate process (UP) via Treitz ligament approach.
Methods:
From April to November 2016, 18 patients received LPD with a novel approach in Pancreas Center of the First Affiliated Hospital with Nanjing Medical University. All patients were diagnosed as pancreatic head or peri-ampulla tumor, without major vessel invasion nor distant metastasis. For resection, routine caudal view was used in the first step, to dissect the anterior medial border between uncinate process and superior mesenteric vein(SMV). Lymphatic tissues were completely dissected form anterior surface of hepatoduodenal ligament. In the second step, left lateral view with camera from left para-umbilical trocar was used, Treitz ligament was incised, SMA root was exposed. After anticlockwise rotation and retraction of mesentery, the anatomic relationship between SMA trunk, inferior pancreaticoduodenal artery(IPDA), jejunal branch of SMV, and distal part of UP, could be perfectly exposed from left lateral view. SMA was dissected from its root until the position above the uncinate process and duodenum, IPDA was transected, distal part of UP was freed from SMA. In the third step, right lateral view and caudal view were alternatively used; proximal UP mesentery was completely dissected out from SMA root, CA root and posterior surface of hepatoduodenal ligament. Pancreaticoduodenectomy was completed in the forth step after transection of pancreatic neck and common hepatic duct.
Results:
The SMA root and distal UP were successfully dissected out via Treitz ligament approach in all 18 patients, among them, distal UP was completely excised in 8 patients from left view. Postoperative pathology showed R0 resection rate in 69%. Postoperative complication included intra-abdominal hemorrhage in 1 patient, pancreatic fistula in 7 patients(6 cases with grade A and 1 case with grade B), delayed gastric emptying in 4 patients (2 cases with grade A, 2 cases with grade B). Average postoperative hospital stay was (15.5±6.8)days.
Conclusion
The novel artery first and uncinate process first approach through Treitz ligament could help surgeons to completely dissect the full length of meso-pancreas along celiac axis-SMA axis in LPD.
6.Multiple modality endovascular treatment for intracranial venous thrombosis
Xunming JI ; Feng LING ; Jianping JIA ; Shenmao LI ; Zhongrong MIAO ; Fengshui ZHU ; Yingying SU ; Baoquan MIN ; Xiangbo WANG ; Hongqi ZHANG ; Peng ZHANG ; Xinglong ZHI ; Qingbin SONG ; Xiaohong QIN ; Xiangmei LIU ; Hong ZHANG
Chinese Journal of Radiology 2001;0(01):-
Objective To review the experience of multiple modality endovascular treatment for intracranial venous thrombosis, and to evaluate the efficacy and risk of endovascular thrombolysis for intracranial venous thrombosis.Methods From October, 2000 to October, 2001, 12 patients with intracranial venous thrombosis confirmed by CT, MRI, MRV, and/or DSA were treated with multiple modality endovascular thrombolysis including intravenous thrombolysis, mechanical thrombus maceration, intraarterial thrombolysis, and stenting.After thrombolysis, treatment aimed at the primary diseases was continued and warfarin was used for 6 months.The patients were followed-up for 17-29 months, averaged 23 months.Results Of the twelve patients, all underwent transvenous thrombolysis, ten underwent combined transvenous thrombolysis and clot maceration, seven underwent transvenous infusion of urokinase combined with transarterial infusion of urokinase.Two underwent transvenous infusion of urokinase combined with transarterial infusion of urokinase.The thrombolysis duration was from one to three days.The infusion dose of urokinase was 800 000 to 2 900 000 IU, the averaging dosage of urokinase was less than 1 000 000 IU per day.All patients achieved from recanalization of sinuses as confirmed on postprocedural angiography, MRI, and MRV studies prior to hospital discharge.At discharge, all the patients improved neurologically, and GCS improved from averaged 12 of pre-operation to 14 of post-operation.During the averaging 23 months follow-up, no patient recurred. Conclusion Combined multiple modality endovascular treatment is an effective and safe procedure for potentially catastrophic intracranial venous thrombosis.
7.Research on the"Package Payment"Problem of the Compact County Medical Community Based on Multi-Dimension-al Scale Analysis and Social Network Analysis
Lingbo HUANG ; Xinglong ZHANG ; Peiyun LIU ; Rong PENG ; Xianjing TAN ; Qiming FENG
Chinese Health Economics 2024;43(1):26-30
Objective:To explore the core issues in the implementation of"packaged payment"in China's compact county medi-cal community,in order to provide useful references for the innovative reform of medical insurance payment methods in compact coun-ty medical community.Methods:By constructing the problem system through the macro model of the health system,analyzing the re-lated literature using multidimensional scale analysis and social network analysis,and comprehensively evaluating the results using the entropy-weighted TOPSIS method,it summarizes the core issues of"packaged payment"in compact county medical community.Results:There are core issues in China's compact county medical community,such as inadequate distribution of benefits and incen-tive and constraint mechanisms within the medical community(Ci= 1.000),lack of effective supervision and assessment mechanism for medical communities(Ci= 0.732),suppressed quality and efficiency of medical services(Ci= 0.652),lagging medical informatiza-tion construction(Ci= 0.595),and incomplete supporting policy measures(Ci= 0.579).Conclusion:The"packaged payment"of com-pact county medical community can be optimized from the following three aspects:a multi-level collaborative incentive mechanism should be improved to ensure the service quality and efficiency;optimize the total amount calculation method and improve the de-tailed supporting measures;accelerate information construction and strengthen supervision and assessment management.
8.Chinese expert consensus on diagnosis, treatment and prevention of venous thrombus embolism associated with chest trauma (2022 version)
Kaibin LIU ; Yi YANG ; Hui LI ; Yonten TSRING ; Zhiming CHEN ; Hao CHEN ; Xinglong FAN ; Congrong GAO ; Chundong GU ; Yutong GU ; Guangwei GUO ; Zhanlin GUO ; Jian HU ; Ping HU ; Hai HUANG ; Lijun HUANG ; Weiwei HE ; Longyu JIN ; Baoli JING ; Zhigang LIANG ; Feng LIN ; Wenpan LIU ; Danqing LI ; Xiaoliang LI ; Zhenyu LI ; Haitao MA ; Guibin QIAO ; Zheng RUAN ; Gang SUI ; Dongbin WANG ; Mingsong WANG ; Lei XUE ; Fei XIA ; Enwu XU ; Quan XU ; Jun YI ; Yunfeng YI ; Jianguo ZHANG ; Dongsheng ZHANG ; Qiang ZHANG ; Zhiming ZHOU ; Zhiqiang ZOU
Chinese Journal of Trauma 2022;38(7):581-591
Chest trauma is one of the most common injuries. Venous thromboembolism (VTE) as a common complication of chest trauma seriously affects the quality of patients′ life and even leads to death. Although there are some consensus and guidelines on the prevention and treatment of VTE at home and abroad, the current literatures lack specificity considering the diagnosis, treatment and prevention of VTE in patients with chest trauma have their own characteristics, especially for those with blunt trauma. Accordingly, China Chest Injury Research Society and editorial board of Chinese Journal of Traumatology organized relevant domestic experts to jointly formulate the Chinese expert consensus on the diagnosis, treatment and prevention of chest trauma venous thromboembolism associated with chest trauma (2022 version). This consensus provides expert recommendations of different levels as academic guidance in terms of the characteristics, clinical manifestations, risk assessment, diagnosis, treatment, and prevention of chest trauma-related VTE, so as to offer a reference for clinical application.
9.Prevalence and associated risk factors of diabetes among ethnic Han residents in Guizhou.
Yibing FENG ; Ke WANG ; Dingming WANG ; Fen DONG ; Yangwen YU ; Li PAN ; Ling LI ; Tao LIU ; Xianjia ZENG ; Liangxian SUN ; Guangjin ZHU ; Kui FENG ; Bo PING ; Ke XU ; Xinglong PANG ; Ting CHEN ; Hui PAN ; Jin MA ; Yong ZHONG ; Lu WANG ; Email: WANGLU64@163.COM. ; Guangliang SHAN ; Email: GUANGLIANG_SHAN@HOTMAIL.COM.
Chinese Journal of Epidemiology 2015;36(11):1220-1225
OBJECTIVETo understand the fast plasma glucose (FPG) level and the epidemiologic characteristics of diabetes in ethnic Han residents of Guizhou province.
METHODSThe survey was conducted among the ethnic Han residents aged 20-80 years, who were selected through multi stage cluster sampling in Guizhou. Basic laboratory test, physical examination were performed for each subject.
RESULTSA total of 2 967 subjects were surveyed. The average FPG level was 5.21 mmol/L for urban residents and 5.03 mmol/L for rural residents, (P<0.001) and the average FPG level was higher in males than in females (5.23 mmol/L vs. 5.09 mmol/L, P=0.003). The FPG level increased with age (P<0.001). In urban residents, the standardized prevalence of diabetes was 6.01% (crude prevalence: 7.45%), higher in males than in females (P<0.001) and increased with age. In rural residents, the standardized prevalence of diabetes was 3.47% (crude prevalence: 3.77%) and increased with age, but there was no sex specific difference in diabetes prevalence. The awareness rate of self diabetes status was 56.59%, the treatment rate was 84.47% and the plasma glucose control rate was 41.38%. Multiple logistic regression analysis indicated that risk factors for diabetes included being male, older than 40 years, family history of diabetes, frequent physical exercise, hypertension, high triglycerid level.
CONCLUSIONThe prevalence of diabetes was high in ethnic Han residents in Guizhou, the differences in diabetes prevalence between urban area and rural area was statistical significant. More than half of the patients' FPG level had not been under control after treatment. The awareness rate of self diabetes status, the treatment rate and the control rate of diabetes should be improved.
Adult ; Aged ; Aged, 80 and over ; China ; epidemiology ; Diabetes Mellitus ; epidemiology ; Ethnic Groups ; Exercise ; Female ; Humans ; Hypertension ; Male ; Middle Aged ; Prevalence ; Risk Factors ; Rural Population ; Surveys and Questionnaires ; Young Adult