1.Integrated TCM and Western Treatment Development of Anterior Ischemic Optic Neuropathy
Yu LIANG ; Lixia ZHANG ; Jiansheng GAO ; Xinlu GUO ; Chengyuan LIU
Chinese Journal of Information on Traditional Chinese Medicine 2015;(3):134-136
Anterior ischemic optic neuropathy (AION) is the ciliary artery-circulatory disorders for the supply of optic nerve head area before the sieve plate prozone and sieve plate district, result in the insufficient blood supply of the optic nerve head and ischemia hypoxia, edema. Clinical manifestations of the type with non-artery inflammatory neuropathy and artery inflammatory neuropathy, which would both eventually lead to the irreversible damage to the optic nerve. In the early phase of AION, the main method is giving a glucocorticoids intravenous drip and a periglomerular injection (or retrobulbar injection) in time, but using the glucocorticoids for a long time or in quantity can cause a series of complications. Therefore, the combination of traditional Chinese and western medicine treatment of AION has become more and more significant in clinic.
2.Early Hematoma Growth in Patients with Intracerebral Hemorrhage
Bin YUAN ; Weisheng ZHAO ; Dongsong GUO ; Xinlu WANG
International Journal of Cerebrovascular Diseases 2008;16(7):516-518
Objective:To explore the incidenee of early hematoma growth in patients with intracerebral hemorrhage,and the correlation between early hematoma growth and early neurological deterioration.Methods:The evaluation of nervous system and CT scan in patients with intracerebral hemorrhage within 3 hours after the omet of symptoms were performed respectively at baseline,and 1,2,3,and 20 hours after the baseline.Results:In 106 patients,CT scan shelwed that the volume of intraparenehymal hemorrhage inereased significantly in 26% of patients at baseline and within 1 hour.CT scan showed that the bleeding volume increased in 12% of patients at 1,2,3,and 20 hours.By measuring baseline,1-hour Glasgow Coma Scale (GCS)score,and the changes of the National Institutes of Health Stroke Scale(NIHSS),it had found that the baseline status and the increased bleeding volume within 1 hour vdgre closely correlated with the clinical neurological deterioration.Conclusions:The early bleeding volume often inereases significantly in patiems with intracerebral hemorrhage,which is complicated with neurological deterioration.In order to determine whether these therapeutic measures improve the natural course of this early hematoma growth and decrease its occurrence,it is necessary to make a randomized clinical trial.
3.Topology Optimization of Bionic Porous Structure Based on Biomechanical Properties of Trabecular Bone
Xinlu GUO ; Rong LIU ; Yongxuan WANG
Journal of Medical Biomechanics 2018;33(5):E402-E409
Objective Based on structure of animal trabecular bone, implants with porous structure were designed to describe mechanical properties of trabecular structure and explain significance of bionic trabecular porous implants in clinical treatment. Methods Based on anisotropic mechanical properties of animal trabecular bone, a porous structure was designed using the topology optimization method. The principles of partition and block reconstruction were first proposed according to bone function theory. The trabecular structure was then reconstructed based on micro-CT images. The boundary constraint and external load were applied on this model according to the respective-volume-element (RVE) method. Taking the solved mechanical properties as objective functions of optimization, the porous structure design and optimization were conducted using the variable density method and the homogenization method. Results The trabecular bone possessed the anisotropic mechanical properties. It was found that the volume fraction showed an increasing trend from the edge to the middle across the same section of trabecular bone. But there was no obvious regular pattern in Poisson’s ratio, which was evenly distributed in the range between 0.17 and 0.30. As to the values of elastic modulus and shear modulus, they were both significantly higher in the main pressure position compared with those in the other positions. After topography optimization based on these mechanical properties, the Poisson’s ratio of the optimized model was in the same range as the animal trabecular bone. The elastic modulus error was less than 14%, with the minimum being only 3%. In addition, the shear modulus error was below 8%, which ultimately complied with criteria of the original goal. Conclusions The designed porous structure based on topology optimization had the same anisotropic characteristics as animal trabecular bone, while reducing the stress concentration phenomenon, which could achieve the specific design for porous structure, thus providing a reasonable and effective method for clinical porous implants.
4.Correlation analysis of perfused lung volumes and visual scores using perfusion SPECT/CT and hemodynamic parameters in patients with chronic thromboembolic pulmonary hypertension
Peng HOU ; Siyan LIN ; Min WANG ; Penghao CHEN ; Jingwei YI ; Yuxiang LI ; Dayong HUANG ; Jielong LIN ; Fengcheng LIN ; Wenliang GUO ; Chengxin XIE ; Cheng HONG ; Xinlu WANG
Chinese Journal of Nuclear Medicine and Molecular Imaging 2021;41(2):82-87
Objective:To investigate the correlations between perfused lung volumes, visual scores (using perfusion SPECT/CT) and right-heart catheter (RHC) hemodynamic parameters in patients with chronic thromboembolic pulmonary hypertension (CTEPH).Methods:A total of 51 consecutive CTEPH patients (17 males, 34 females, age (59±12) years) in the First Affiliated Hospital of Guangzhou Medical University between March 2015 and July 2019 were retrospectively analyzed. All patients underwent lung perfusion SPECT/CT imaging and RHC examinations. Perfused lung volumes were determined using threshold-based (15%-85%) segmentation. Visual semiquantitative scoring in each lung segment was performed using Begic method. RHC hemodynamic parameters including pulmonary artery systolic pressure (PASP), pulmonary arterial diastolic pressure (PADP), mean pulmonary artery pressure (mPAP), pulmonary arteriolar wedge pressure (PAWP), pulmonary vessel resistance (PVR), cardiac output (CO), cardiac index (CI) were recorded. Spearman correlation analysis was used to evaluate the correlations between perfused lung volumes, visual scores and hemodynamic parameters.Results:There were significant correlations between perfused lung volumes (30%-70% threshold) and mPAP ( rs values: from -0.414 to -0.302, all P<0.05). Among them, perfused lung volumes under the threshold of 40% and 45% were moderately correlated with mPAP ( rs values: -0.414, -0.412, both P<0.05). Perfused lung volume (40% threshold) was moderately negatively correlated with PASP, PADP ( rs values: -0.402, -0.440, both P<0.05), and slightly negatively correlated with PVR ( rs=-0.352, P<0.05). Visual scores were slightly positively correlated with the PADP ( rs=0.311, P<0.05), while there was no correlation between visual scores and other RHC hemodynamic parameters ( rs values: from -0.201 to 0.275, all P>0.05). Conclusion:Perfused lung volumes based on threshold-based segmentation in lung perfusion SPECT/CT imaging can accurately reflect hemodynamic status and may provide useful information for severity assessment of CTEPH.
5.Mechanism of lumen loss of the left circumflex ostium after main vessel stent implantation: observations by intravascular ultrasound.
Jiancheng XIU ; Weiming LIAO ; Bo LIU ; Xinlu ZHANG ; Yuqing HOU ; Zheng HUANG ; Zhigang GUO ; Zhongjiang ZHOU ; Shiping CAO ; Kai CUI
Journal of Southern Medical University 2013;33(7):1045-1048
OBJECTIVETo explore the mechanism of lumen loss of the left circumflex ostium after main vessel stent implantation.
METHODSTwenty-eight patients undergoing provisional T technique were enrolled in this study. Intravascular ultrasound (IVUS) examination was performed before and after main vessel stenting and kissing balloon post-dilatation to evaluate the geometrical changes of the vessels.
RESULTSThe CSA of LCX ostium lumen decreased significantly from 5.9∓2 mm(2) to 4.9∓1.9 mm(2) (P<0.01) after the procedure, and the CSA of LCX ostium P and M increased from 5.4∓2.9 mmmm(2) to 5.7∓2.9 mm(2) (P=0.21) after the main vessel stenting. The changes in LCX ostium lumen CSA was correlated with the changes of LCX ostium EEM CSA but not the LCX ostium P and M CSA. After kissing balloon post-dilatation, the CSA of LCX ostium lumen increased from 4.9∓1.9 mm(2) to 5.5∓1.9 mm(2) (P<0.01) , and the CSA of LCX ostium P and M showed no obvious changes (5.7∓2.9 mmmm(2) vs 5.7∓2.6 mmmm(2), P=0.89). The changes of LCX ostium lumen CSA were correlated with the those of the LCX ostium EEM CSA (R=0.432, P=0.02).
CONCLUSIONAfter stent implantation from the LMCA to the LAD, most of lumen losses of the LCX are due to carina shift, and in occasional cases, plaque shift occurs from the distal LMCA to the ostium of the LCX. Kissing balloon technique can adjust carina shift but can not improve plaque shift.
Aged ; Angioplasty, Balloon, Coronary ; Coronary Artery Disease ; diagnostic imaging ; therapy ; Coronary Stenosis ; diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Stents ; Treatment Outcome ; Ultrasonography, Interventional
6.Construction and in vitro evaluation of an LNP system for mRNA delivery
Xinlu CHEN ; Yuan GAO ; Juanjuan LI ; Huanhuan GUO ; Zhuo WANG ; Shen GAO
Journal of Pharmaceutical Practice 2023;41(5):291-295
Objective To construct lipid nanoparticles DLin-LNP for mRNA delivery. Methods DLin-LNP was prepared by thin film hydration method, and DLin-LNP/mRNA was further constructed by using EGFP-mRNA as model drug. The particle size, zeta potential, and appearance morphology were measured. Furthermore, the intracellular distribution and transfection of DLin-LNP/mRNA in RM-1 cells was investigated by laser scanning confocal microscope. Results DLin-LNP was successfully prepared. The average particle size was about (151.1±2.1) nm, the no-load potential was (23.7±0.5) mV. The cytotoxicity of DLin-LNP was far lower than that of the commercially available liposomal Lipo8000. The results of transfection experiment indicated that DLin-LNP has high transfection efficiency for mRNA delivery with low cytotoxicity and good stability. Conclusion DLin-LNP could become a potential mRNA vector for gene therapy.
7.Effectiveness of TCM Health Management for Myocardial Infarction based on Tertiary Management System: A Single-arm Cohort Study of 255 Patients
Hongxin GUO ; Mingjun ZHU ; Rui YU ; Xingyuan LI ; Guangcao PENG ; Xinlu WANG ; Jianru WANG ; Bin LI ; Qifei ZHAO ; Yongxia WANG
Journal of Traditional Chinese Medicine 2024;65(8):821-829
ObjectiveTo evaluate the efficacy of TCM health management based on tertiary management system for patients with myocardial infarction (MI). MethodsA total of 277 patients with non-acute MI were enrolled and given comprehensive TCM health management strategies including health education, lifestyle adjustment, risk factors control, medication and TCM appropriate techniques management through a tertiary management system with "the patient as the core, village/community physicians as the main executive body, and tertiary TCM hospital specialists as the leading body", for a period of 12 months by using a prospective single-arm cohort study. Through patient reporting and medical records surveys, various indicators before and after 12-month management were collected and compared. The primary efficacy indicators were readmission rate and recurrent exacerbation rate, and the secondary efficacy indicators included disease awareness-related indicators, lifestyle behavior-related indicators, cardiovascular risk factor-related indicators and Canadian cardiovascular society (CCS) cardiac function classification. ResultsA total of 255 patients completed the study and were included in the final analysis. The recurrent exacerbation and readmission rates of patients after management were 23.14% (59 cases) and 20.25% (49 cases), respectively, significantly lower than 36.08% (92 cases) and 53.72% (130 cases) before management (P<0.05). Except for knowledge on diabetes diagnostic criteria with no significant difference before and after management (P>0.05), awareness of other knowledge with regard to the prevention and treatment of cardiovascular and cerebrovascular diseases were improved after management (P<0.01), as well as the total score (P<0.01). In terms of daily life behaviors, the rates of salty diet, sweet diet and greasy diet were significantly lower than baseline, while the rate of moderate exercise was significantly higher (P<0.05 or P<0.01); the rates of ongoing smoking and vigorous exercise were not significantly changed (P>0.05). For cardiovascular risk factors, patients' total cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, fasting glucose, total depression assessment scale score, and total anxiety assessment scale score were significantly reduced after management (P<0.01). Systolic blood pressure and body mass index (BMI) were both higher after management (P<0.05 or P<0.01), and there was no statistically significant difference in diastolic blood pressure (P>0.05). In terms of the cardiovascular disease risk factors reaching the standard levels, the rate of LDL cholesterol <1.8 mmol/L significantly increased (P<0.01), while the rate of BMI <24 kg/m2 and the rate of systolic blood pressure <140 mmHg both decreased significantly (P<0.05 or P<0.01) from baseline; the diastolic blood pressure and rate of fasting glucose <7.0 mmol/L were not significantly changed (P>0.05). The patients' CCS cardiac function classification was significantly reduced (P<0.05). ConclusionTCM health management based on the tertiary management system can enhance MI patients' awareness of the disease, change poor lifestyle habits, reduce risk factors such as blood lipids and blood glucose, improve anxiety and depression, increase activity tolerance, and reduce their recurrence exacerbation and readmission rates, which is worthy of clinical promotion.
8.Expert consensus on clinical application of 177Lu-prostate specific membrane antigen radio-ligand therapy in prostate cancer
Guobing LIU ; Weihai ZHUO ; Yushen GU ; Zhi YANG ; Yue CHEN ; Wei FAN ; Jianming GUO ; Jian TAN ; Xiaohua ZHU ; Li HUO ; Xiaoli LAN ; Biao LI ; Weibing MIAO ; Shaoli SONG ; Hao XU ; Rong TIAN ; Quanyong LUO ; Feng WANG ; Xuemei WANG ; Aimin YANG ; Dong DAI ; Zhiyong DENG ; Jinhua ZHAO ; Xiaoliang CHEN ; Yan FAN ; Zairong GAO ; Xingmin HAN ; Ningyi JIANG ; Anren KUANG ; Yansong LIN ; Fugeng LIU ; Cen LOU ; Xinhui SU ; Lijun TANG ; Hui WANG ; Xinlu WANG ; Fuzhou YANG ; Hui YANG ; Xinming ZHAO ; Bo YANG ; Xiaodong HUANG ; Jiliang CHEN ; Sijin LI ; Jing WANG ; Yaming LI ; Hongcheng SHI
Chinese Journal of Clinical Medicine 2024;31(5):844-850
177Lu- prostate specific membrane antigen (PSMA) radio-ligand therapy has been approved abroad for advanced prostate cancer and has been in several clinical trials in China. Based on domestic clinical practice and experimental data and referred to international experience and viewpoints, the expert group forms a consensus on the clinical application of 177Lu-PSMA radio-ligand therapy in prostate cancer to guide clinical practice.