1.Estimation of postmortem interval by determination of K~+ concentration in aqueous humor
Guoli LV ; Yaping ZHOU ; Zhigang LI ; Xinshu XU ; Licong YU ; Xin WANG ; He SHI ; Chuanchao XU
Chinese Journal of Forensic Medicine 2010;25(1):24-26
Objective To investigate the applicability of the K~+ concentration in aqueous humor to estimate postmortem interval(PMI).Methods 30 White New-Zealand rabbit were sacrificed by air embolism and divided into 10 groups.Aqueous humor and vitreous humor were sampled at 0.5h,1h,3h,6h,8h,12h,16h,20h,and 24h after death.The concentration of potassium,sodium and calcium were analyzed by an autoanalyzer and the data were statistically processed by SPSS software for Windows.Results Increase in potassiam concentration in aqueous humor was correlated with the postmortem interval(R~2=0.956).Conclusion Measurement of potassium concentration in aqueous humor may be used for PMI estimation.
2.An outbreak of brucellosis in Chongqing municipality: data analysis of epidemiological survey results
Wenli HUANG ; Bangzhong XIAO ; Fei LUO ; Wei YAN ; Xinshu LI ; Shuang ZHOU
Chinese Journal of Endemiology 2016;35(10):750-753
Objective To master the epidemic prevalence and the risk factors of brucellosis in animals and human,and to provide a basis for making prevention strategies and measures to brucellosis in Chongqing Municipality.Methods Qijiang and Wansheng district of Chongqing Munipality were selected as investigation points.Feeding status of goats in feedlots was investigated,and blood samples of goats were collected for laboratory testing.Epidemiological survey in employees on feedlots,family members closely exposed with goats,and other focus groups such as stockbreeding and veterinary was conducted,and blood samples was collected for laboratory testing according to the principle of informed consent.Clinical features of infested persons were investigated.Blood samples were screened by plate agglutination test (RBPT) and tube agglutination test (SAT).Results A total of 582 households in the two districts were investigated.The number of positive households was 40 households.The positive rate of the households was 6.87%.A total of 20 105 goat blood samples were tested.Of them,989 blood samples tested positive.The positive rate was 4.92%.A total of 337 blood samples of the risk population from 22 towns of the two districts were tested.Of them,45 samples were positive,and the positive rate was 13.35%.Eleven people were active patients of brucellosis.The epidemic sites were distributed in 16 towns,which accounted for 73.73%.The difference of the positive rates between the two districts was not significant (x2 =0.37,P > 0.05).The positive rate of brucellosis among male and female was 11.57% (28/242) and 17.89% (17/95),respectively.The age of brucellosis infection distributed from 2 years old to 83 years old.One preschool child and 3 students were identified positive.The positive rate of brucellosis among feeder was the highest,which accounted for 31.75% (40/125).The difference of positive rate of brucellosis among different professions was significant (x2 =63.40,P < 0.05).Conclusions There is not a brucellosis case among animals or people reported in Chongqing non epidemic areas of brucellosis,but there are lots of infection.Surveillance and prevention of brucellosis should be strengthened in Chongqing.
3.Analysis on the survey results of iodine content in drinking water in Chongqing, 2017
Chunbei ZHOU ; Xinshu LI ; Jun XIE ; Shuang ZHOU
Chinese Journal of Endemiology 2019;38(2):134-139
Objective To understand the distribution of iodine content in drinking water of residents in Chongqing.Methods In 2017,according to the "Technical Plan for the Investigation of Iodine Content of Drinking Water in Chongqing",surveys on water iodine content,water source type,well depth and geographical situation were carried out in 38 districts (counties) and Wansheng Economic and Technological Development Zone in Chongqing,with township (town,street office) as a survey unit.Among them,the township (town,street office) with the median of water iodine > 10 μg/L was investigated with a administrative village (residential committee) as a survey unit.The "Method for Iodine Detection in Iodine-deficient and High-iodine Areas" recommended by the National Iodine Deficiency Disease Reference Laboratory was adopted for water iodine detection.The water iodine contents of different water source types,different well depths and different areas were compared and analyzed.Results In 2017,a total of 17 584 water samples were collected in Chongqing.The median of water iodine was 1.7 μg/L,ranging from 0.2 to 124.0 μg/L,with the content < 10 μg/L accounted for 96.13% (16 903/17 584),10-100 μg/L accounted for 3.86% (679/17 584),and > 100 μg/L accounted for 0.01% (2/17 584).Among the 1 023 townships (towns,street offices),1 020 townships (towns,street offices) were water iodine < 10 μg/L,and 3 townships (towns,street offices) were water iodine in 10-100 μg/L,they were Anfu Street (25.8 μg/L),Qingsheng Town (11.8 μg/L) and Longji Town (31.0 μg/L) of Rongchang District.The differences of iodine content between deep well water,tap water andshallow well water (4.2,1.5,1.2 μg/L) were statistically significant (H =2 008.4,P < 0.01).There was a positive correlation between well depth and water iodine (r =0.298,P < 0.01).The medians of water iodine in main,northeast,southeast,and western areas were 1.8,0.8,1.1 and 3.7 μg/L,respectively,and the differences of water iodine content between different regions were statistically significant (H =4 080.5,P < 0.01).The water iodine contents of northeast and southeast areas (both were mountainous areas) were relatively low.Conclusions Chongqing is an iodine deficiency area.In most areas,the iodine content of drinking water is low,and the risk of iodine deficiency in mountainous areas is greater than that in other areas.
4.Accuracy of different methods in predicting fluid responsiveness in septic patients: a comparison between ultrasound, PiCCO and traditional methods
Yun SUN ; Zhonghua LU ; Weili YU ; Hui LI ; Yao ZHENG ; Xueli JIA ; Xinshu ZHANG ; Lei HU
Chinese Journal of Anesthesiology 2017;37(8):979-984
Objective To compare the accuracy of ultrasound,pulse indicator continuous cardiac output monitoring (PiCCO) and traditional methods in predicting fluid responsiveness in septic patients.Methods Forty-six septic patients of both sexes,aged 18-72 yr,requiring mechanical ventilation treatment in the intensive care unit,were enrolled in the study.Venous blood samples were collected for determination of plasma B-type natriuretic peptide (BNP) concentrations by chemiluminescence assay,and central venous pressure (CVP) was recorded.Stroke volume variation (SVVTTE),distensibility index of inferior vena cava (dIVC) and velocity time integral changes of aortic blood flow (△VTI) were measured by ultrasound method.SVVPiCCO and global end-diastolic volume index (GEDVI) were measured by PiCCO method.The patients were divided into negative fluid responsiveness group and positive fluid responsiveness group according to the fluid responsiveness after volume expansion.The receiver operating characteristic curves of the parameters mentioned above in predicting fluid responsiveness were drawn.A consistency check for dIVC,△VTI and SVVPiCCO thresholds was conducted by using Kappa statistics.The agreement between SVVTTEand SVVPiCCO was analyzed by the Bland-Altman analysis.Results There were 24 patients in positive fluid responsiveness group and 22 patients in negative fluid responsiveness group.Compared with negative fluid responsiveness group,the plasma BNP concentration,CVP and GEDVI were significantly decreased,and SVVPiCCO,SVVTTE,dIVC and △VTI were increased before volume expansion in positive fluid responsiveness group (P<0.05).The area under the curve (95% confidence interval),sensitivity and specificity of the plasma BNP concentration were 0.894 (0.807-0.981),81.8% and 79.2%,respectively,of CVP 0.859 (0.752-0.965),81.8% and 79.2%,respectively,of GEDVI 0.772 (0.628-0.915),72.7% and 75.0%,respectively,of SVVPiCCO 0.965 (0.922-1.008),95.8% and 81.8%,respectively,of SVVTTE 0.940 (0.874--1.006),91.7% and 86.4%,respectively,of dIVC 0.964 (0.920-1.008),83.3% and 95.5%,respectively,and of △VTI 0.958 (0.909-1.008),87.5% and 90.9%,respectively.The Kappa value for dIVC threshold and SVVPiCCO threshold was 0.826,and for △VTI threshold and SVVPiCCO threshold was 0.743 (P<0.01).The mean deviation of SVVTTE and SVVPiCCO was 0.209,95% confidence interval (-2.967-3.385)%,and the limit of agreement (-2.46-2.62)% (P< 0.05).Conclusion Ultrasound and PiCCO methods can accurately predict fluid responsiveness,have a good agreement and are superior to the traditional method in septic patients.
5.The ultrasonic monitoring coupled with passive leg raising test for evaluation of fluid responsiveness in critical patients
Yun SUN ; Zhonghua LU ; Weili YU ; Hui LI ; Yao ZHENG ; Xueli JIA ; Xinshu ZHANG ; Lei HU
Chinese Journal of Emergency Medicine 2017;26(11):1300-1306
Objective To explore the value of predicting fluid responsiveness using velocity time index variation (△VTI) and stroke volume variation (△SV) before and after passive leg raising (PLR)monitored by bedside temporary test equipment (TTE).Methods A cohort of 42 patients supported with mechanical ventilation in our hospital admitted from October 2014 to October 2015 were prospectively selected.The hemodynamic variables including heart rate (HR),mean arterial pressure (MAP),central venous pressure (CVP),VTI,SV and other parameters were monitored before and after after undergoing PLR.Fluid resuscitation volume expansion test was carried out after stroke volume index (SVI) monitored by pulse indicator continuous cardiac output monitoring (PICCO).Patients were divided into fluid responsiveness positive group and fluid responsiveness negative group according to presence or absence of SVI ≥ 15% after fluid resuscitation volume expansion.Results Of 42 patients,22 belonged to fluid responsiveness positive group,20 got into fluid responsiveness negative group.There were no significant differences in basic clinical data between two groups.Before and after PLR,there were no distinct changes in HR and CVP (P > 0.05),while MAP,VTI and SV increased significantly (P < 0.05) after PLR in fluid responsiveness positive group.Contrarily,there were no noticeable changes in MAP and SV after PLR (P > 0.05),but HR,CVP and VTI increased significantly (P < 0.05) in fluid responsiveness negative group.The degrees of △VTI and △SV in fluid responsiveness positive group were much higher than those in fluid responsiveness negative group (P <0.05).According to SVI ≥ 15% monitored by PICCO after fluid resuscitation volume expansion test as a standard,the area under the ROC (AUC) of △VTI between prePLR and post-PLR was 0.75 (95% CI:O.593-0.907,P < 0.01),the sensitivity and specificity were 63.6% and 95% respectively using △VTI 15.6% as threshold value.The AUC of △SV was 0.844 (95%CI:O.716-0.972,P <0.01),the sensitivity and specificity were 81.8% and 85.0% respectively using △SV 10.5% as threshold value.Conclusion △VTI and △SV monitored by TTE before and after PLR could be employed for predicting fluid responsiveness of critical patients under the status of spontaneous respiration.Their value for prediction of critical patients could be further improved by combined employment of these two indexes of variation.
6.Analysis of surveillance results of iodine deficiency disorders in Chongqing, 2017
Shuang ZHOU ; Xinshu LI ; Jun XIE ; Chunbei ZHOU
Chinese Journal of Endemiology 2019;38(3):207-212
Objective To master the current status of iodine deficiency disorders in Chongqing,and provide evidence for scientific prevention and treatment of iodine deficiency disorders.Methods In 2017,a cross-sectional survey method was adopted.In 26 districts (counties) in Chongqing,each district (county) was divided into five sampling areas by east,west,south,north and middle.One township/street (including at least one street) was selected in each area and one primary school was selected in each township/street.Forty non-boarding students aged 8 to 10 years old (half males and half females) were selected from each primary school.Their salt and instant urine samples were collected for salt iodine and urine iodine detection.At the same time,thyroid volume was measured in 8 to 10 years old students in 14 districts (counties).Results A total of 5 546 edible salt samples were collected,including 5 520 iodized salts,5 094 qualified iodized salts and 26 non-iodized salts.The average salt iodine content was 26.1 mg/kg and the range was 23.2 to 30.7 mg/kg.Iodized salt coverage rate,iodized salt pass rate,qualified iodized salt consumption rate,and non-iodized salt rate were 99.53% (5 520/5 546),92.28% (5 094/5 520),91.85% (5 094/5 546),and 0.47% (26/5 546),respectively.A total of 5 565 urine samples were tested,the median urinary iodine was 221.9 μg/L,urinary iodine < 50 μg/L accounted for 2.98% (166/5 565),50-99 μg/L accounted for 8.09% (450/5 565),100-199 μg/L accounted for 31.66% (1 762/5 565),200-299 μg/L accounted for 30.03% (1 671/5 565),and ≥300 μg/L accounted for 27.24% (1 516/5 565).A total of 3 111 children were tested for thyroid volume.The median thyroid volume was 2.6,2.9,3.1 ml in the 8th,9th,and 10th years,and the thyroid enlargement rate was 1.93% (60/3 111).The districts (counties) had a goiter rate ranging from 0.45% to 2.74%.Conclusions The consumption rates of qualified iodized salt and the median urinary iodine in Chongqing have reached the national standard for eliminating iodine deficiency disorders.The rate of goiter in children has remained at a low level,but the consumption rate of qualified iodized salt in some areas has shown a downward trend.The monitoring of the presence of non-iodized salt districts (counties) should be emphasized.
7.A comparative study on the efficacy and adverse reactions of nituzumab and bevacizumab combined with synchronous ra-diotherapy and chemotherapy in the treatment of locally advanced cervical cancer
Liangfang XUE ; Xinshu WANG ; Yunyan ZHANG ; Haiyan CHENG ; Hong JIN ; Yaoxian WANG ; Shanshan YANG ; Qi LI
Practical Oncology Journal 2023;37(5):416-421
Objective The objective of this study was to compare the short-term efficacy and adverse reactions of nituzum-ab combined with synchronous radiotherapy and chemotherapy and bevacizumab combined with synchronous radiotherapy and chemo-therapy in the treatment of locally advanced cervical cancer.Methods A total of 100 locally advanced cervical cancer patients with pathological type of squamous cell carcinoma were collected from 1 September 2020 to 31 December 2021.They were divided into a control group(synchronous radiotherapy and chemotherapy group),a nituzumab group(nituzumab combined synchronous radiotherapy group)and a bevacizumab group(bevacizumab combined synchronous radiotherapy and chemotherapy group).The total effective rate of short-term treatment,changes in tumor volume before and after treatment,serum squamous cell carcinoma antigen(SCC)levels be-fore and after treatment,and adverse reactions after treatment were compared among patients of the three groups.Results The short-term total effective rates of the Nitro group,Bevar group and control group were 90.3%,87.2%and 60.0%,respectively.The total effective rates of the Nitro and Bevar groups were significantly higher than those of the control group,and the differences were statisti-cally significant(P<0.001).There was no statistically significant difference in the total effective rates of the Nitro and Bevar groups(P>0.05);The degree of tumor volume reduction and SCC reduction in the Nituo group and Bevac group after treatment was higher than those in the control group(P<0.05),and there was no statistically significant difference between the two groups(P>0.05).The incidence of hypertension in the Bevar group was 33.4%,significantly higher than that in the control group(10.0%)and the Ni-tro group(12.9%)(P<0.05).There was no statistically significant difference in the incidence of hypertension between the Nito group and the control group(P>0.05);There was no statistically significant difference in the incidence of adverse reactions among the three groups except hypertension(P>0.05).Conclusion Nituzumab combined with synchronous radiotherapy and chemothera-py,as well as bevacizumab combined with synchronous radiotherapy and chemotherapy,can improve the short-term efficacy of locally advanced cervical cancer,effectively reduce tumor volume and inhibit the expression of tumor markers,both of which are superior to synchronous radiotherapy and chemotherapy alone.Compared to bevacizumab,nituzumab has fewer adverse reactions.For patients with locally advanced cervical cancer,the combination of nituzumab and concurrent radiotherapy and chemotherapy is more reliable in terms of safety.
8. Changes of peripheral blood leukocyte in Behçet uveitis patients with different stages
Xinshu LIU ; Chunmei HUANG ; Yongzhe LI ; Meifen ZHANG
Chinese Journal of Experimental Ophthalmology 2019;37(12):971-975
Objective:
To analyze the changes of peripheral blood leukocyte in patients with Behçet uveitis (BU) at different stages.
Methods:
Case control study was performed.Twenty active stage BU patients and 21 quiet stage BU patients were enrolled from July to November 2015 in Peking Union Medical College Hospital.Ten active stage BU patients treated with glucocorticoid and/or immunosuppressive agents were served as improvement stage BU patients.Meanwhile, 82 healthy controls were collected from the physical examination center.Peripheral blood was obtained and then analyzed by using Hematoflow method.The percentages of leukocytes in peripheral blood of different stage BU patients were compared.This study was approved by the Ethics Committee of Peking Union Medical College Hospital (ZS-1341) and all participants signed informed consent.
Results:
The percentage of mature neutrophils, eosinophils, basophils, B lymphocytes, non-cytotoxic T and NK lymphocytes, granular T and NK lymphocytes, T blasts, B blasts and immature granulocytes were all significantly different among active stage BU group, quiet stage BU group and healthy control group (