1.Management of pseudomyxoma peritonei originated in the appendix
Jinghai SONG ; Jian CHEN ; Junmin WEI ; Xiuwen HE ; Donghui XIE
Chinese Journal of Digestive Surgery 2012;11(4):374-376
Objective To investigate the management of pseudomyxoma peritonei originated in the appendix.Methods The clinical data of 51 patients with pseudomyxoma peritonei originated in the appendix who were admitted to the Beijing Hospital from 1970 to 2010 were retrospectively analyzed.The results of operation,reoperation,adjuvant treatment and follow-up were analyzed.The time from pseudomyxoma peritonei recurrence to the reoperation between patients who did or did not receive chemotherapy was compared by two tailed t test.Results Of the 51 patients,48 received operation,and the operation time was (135 ± 72 )minutes.Tumor recurrence was observed in 34 patients,and 16 of them received cytoreduction procedure,and 33 cytoreduction procedures were performed in total.The median time of follow-up was 49.7 months (range,3-132 months).The disease-specific survival was observed in 25 patients and disease-free survival in 16 patients.Four patients died of tumor recurrence or progression.The results of postoperative pathological examination confirmed that 19 patients were with benign disseminated peritoneal adenomucinosis (DPAM),26 were with malignant peritoneal mucinous carcinomatosis (PMCA) and 6 were with intermediate subtype (PMCA-1).The 3-,5- and 10-year survival rates were 75% (38/51),55% (28/51) and 22% ( 11/51 ),respectively.The survival time and reoperation time interval for patients who received postoperative chemotherapy were ( 21 ± 4) months and ( 10 ± 6 ) months,which were longer than (19 ±7 )months and (7 ±4)months of those who did not receive postoperative chemotherapy (t =1.027,0.361,P > 0.05).The median survival time of patients with benign DPAM,PMCA-1 and malignant PMCA were 96,63,23 months,respectively.The tumor recurrence interval for patients with benign DPAM and those with malignant PMCA were ( 15 ± 5 ) months and (7 ± 4) months,with significant difference ( t =2.193,P < 0.05 ).Conclusions An active cytoreduction surgery is feasible for patients with pseudomyxoma peritonei originated in the appendix in improving survival.Repeated cytoreduction is a treatment of strategy to prolong the recurrence time and improve the prognosis of selected patients.
2.Effect of hand hygiene compliance on the incidence of ventilator-associated pneumonia in children
Xiuwen CHEN ; Qiuqing WAN ; Xiaohua WAN ; Zhiqiu ZHOU ; Sisi LI ; Chengfeng XIE
Chinese Journal of Infection Control 2015;(3):178-180
Objective To analyze the effect of hand hygiene compliance on the incidence of ventilator-associated pneumo-nia(VAP )in children,and explore the role of hand hygiene in the prevention and control of VAP .Methods Hand hygiene compliance among HCWs in a pediatric intensive care unit (PICU)was intervened,hand hygiene compliance rate of HCWs and incidence of VAP in children with mechanical ventilation from March 1,to October 31,2012 (before intervention)and from January 1,to August 31,2013 (after intervention)were compared.Results Hand hygiene compliance rate after in-tervention was higher than before intervention(37.31%[97/260]vs 24.17% [58/240])(χ2 =10.08,P <0.01);the con-sumption of hand washing liquid and alcohol-based handrub enhanced from 3.48mL /bed day before intervention to 4.49 mL/bed day after intervention,which increasing by 29.02%.The incidence of VAP after intervention was lower than be-fore intervention (2.21‰[5/2 261]vs 6.50‰[13/2 001])(χ2 =4.67,P <0.05).Conclusion Implementation of com-prehensive measures and improvement of HCWs’hand hygiene compliance can reduce the incidence of VAP in chil-dren.
3.Biomarkers for the diagnosis and prognosis of inflammatory bowel disease
Haohao XIE ; Xiuwen WU ; Junjun WANG
Chinese Journal of Laboratory Medicine 2018;41(10):716-719
Inflammatory bowel disease ( IBD) is a chronic disease including Crohn′s disease ( CD) and ulcerative colitis ( UC ) .There are no single diagnostic criteria for IBD .Biomarkers are an objective measurement and evaluation of physiological and pathological processes .And they have been widely used in the diagnosis and prognosis monitoring of IBD patients .
4.The early survival rate and its influencing factors of extremely premature and extremely low birth weight infants
Dong CHEN ; 济南市儿童医院新生儿科 ; Zhaoe LIU ; Yonghui YU ; Feilin MA ; Ruihua YU ; Xiuwen XIE ; Gang LI
Chinese Journal of Neonatology 2017;32(6):401-405
Objective To study the early survival rate and its influencing factors of extremely preterm infants and extremely low birth weight ( ELBW ) infants.Method All extremely preterm infants and/or ELBW infants in Shandong Provincial Hospital from January , 2010 to December 2015 were studied retrospectively.The factors affecting their survival rate and their complications were analyzed retrospectively . All cases were assigned into the survival group and the death group .On the other hand , they were also assigned into two groups according to their birth , pre-2014 and post-2014.Result A total of 142 extremely preterm infants and/or ELBW infants were enrolled, their gestational age was 28 (27, 29) weeks, birth weight was 925 (830, 965) g.76 cases (53.5%) survived, 66 cases (46.5%) died.Factors associated with the survival rate were early onset sepsis , placental abruption , perinatal asphyxia , birth weight and pulmonary hemorrhage (P<0.05).There were 67 cases pre-2014 in which 30 cases survived (44.8%), while 75 cases post-2014 in which 46 cases survived ( 61.3%) .Comparative analysis between the two groups pre-2014 and post-2014 revealed that the survival rate was significantly different (χ2 =3.900, P=0.048).The top 2 underlying causes of death before 2014 were perinatal asphyxia and early onset sepsis . Furthermore, early onset infection became the first cause of death after 2014.Conclusion Along with the prevalence of neonatal resuscitation program and the optimization of respiratory support strategies in premature infants , the early survival rate of extremely preterm infants and /or ELBW infants has improved significantly.However, early onset sepsis may have been the crucial cause for their perinatal mortality .
5.Investigation of treatment and analysis of prognostic risk on intra-abdominal fistula in China: a multicenter prospective study
Haohao XIE ; Tao ZHENG ; Wei ZHOU ; Feng WANG ; Zhenhua YANG ; Qiang CHI ; Gefei WANG ; Guosheng GU ; Xiuwen WU ; Jian′an REN
Journal of Chinese Physician 2020;22(6):805-809
Objective:To investigate the diagnosis and treatment for intra-abdominal fistula in China, and to explore the prognostic factors.Methods:A multi-center cross-sectional study was conducted based on the Registration System of Chinese Gastrointestinal Fistula and Intra-Abdominal Infections to collect the clinical data of patients with intra-abdominal fistula from 18 medical centers from January 1, 2018 to December 31, 2018, including basic information, medical records and prognosis.Results:A total of 106 patients were enrolled in this study, including 57 males and 49 females, with an average age of (48.0±17.8)years. The most common type of intra-abdominal fistula was entero-vesical fistula (34.0%), followed by entero-vaginal fistula (31.1%), entero-enteric fistula (26.4%) and multiple fistula (8.5%). The direct causes of intra-abdominal fistula were mainly surgical operation (66.0%), followed by spontaneous fistula due to Crohn′s disease (18.9%), radiation intestinal injury (11.3%), and 4 cases (3.8%) of unknown reasons. During the whole treatment, 95 patients received nutritional support therapy, mainly EN+ PN (75.8%). Finally, 86 patients (81.1%) received surgical treatment, with a healing rate of 95.3%. After surgery, 8.1% of patients developed surgical site infections (SSI), and 10.5% had a relapse of fistula. 20 patients (18.9%) were treated conservatively, with a self-healing rate of 80.0%. The overall mortality rate was 8.5%, and the highest mortality (15.2%) was found in entero-enteric fistula. Statistical analysis showed that the age ( t=-4.664, P<0.001), leucocyte level ( U=663.000, P=0.010), sepsis ( P=0.002) and multiple organ dysfunction syndrome (MODS) ( P=0.019) were higher in the death group than those in the healing group. Multivariate analysis suggested that advanced age ( OR=1.073, 95% CI: 1.008-1.141, P=0.026) and complications of sepsis ( OR=11.806, 95% CI: 1.064-131.048, P=0.044) were independent risk factors of the death for patients with intra-abdominal fistula. Conclusions:The overall mortality rate of intra-abdominal fistula is still high, and malignant tumor is the most common primary disease. Advanced age and sepsis are independent risk factors for death in patients with intra-abdominal fistula.
6.Gut microbiota-derived short-chain fatty acids ameliorate methamphetamine-induced depression- and anxiety-like behaviors in a Sigmar-1 receptor-dependent manner.
Kaikai ZHANG ; Lijian CHEN ; Jianzheng YANG ; Jiali LIU ; Jiahao LI ; Yi LIU ; Xiuwen LI ; Long CHEN ; Clare HSU ; Jiahao ZENG ; Xiaoli XIE ; Qi WANG
Acta Pharmaceutica Sinica B 2023;13(12):4801-4822
Methamphetamine (Meth) abuse can cause serious mental disorders, including anxiety and depression. The gut microbiota is a crucial contributor to maintaining host mental health. Here, we aim to investigate if microbiota participate in Meth-induced mental disorders, and the potential mechanisms involved. Here, 15 mg/kg Meth resulted in anxiety- and depression-like behaviors of mice successfully and suppressed the Sigma-1 receptor (SIGMAR1)/BDNF/TRKB pathway in the hippocampus. Meanwhile, Meth impaired gut homeostasis by arousing the Toll-like receptor 4 (TLR4)-related colonic inflammation, disturbing the gut microbiome and reducing the microbiota-derived short-chain fatty acids (SCFAs). Moreover, fecal microbiota from Meth-administrated mice mediated the colonic inflammation and reproduced anxiety- and depression-like behaviors in recipients. Further, SCFAs supplementation optimized Meth-induced microbial dysbiosis, ameliorated colonic inflammation, and repressed anxiety- and depression-like behaviors. Finally, Sigmar1 knockout (Sigmar1-/-) repressed the BDNF/TRKB pathway and produced similar behavioral phenotypes with Meth exposure, and eliminated the anti-anxiety and -depression effects of SCFAs. The activation of SIGMAR1 with fluvoxamine attenuated Meth-induced anxiety- and depression-like behaviors. Our findings indicated that gut microbiota-derived SCFAs could optimize gut homeostasis, and ameliorate Meth-induced mental disorders in a SIGMAR1-dependent manner. This study confirms the crucial role of microbiota in Meth-related mental disorders and provides a potential preemptive therapy.
7. Investigation of treatment and analysis of prognostic risk on enterocutaneous fistula in China: a multicenter prospective study
Tao ZHENG ; Haohao XIE ; Xiuwen WU ; Qiang CHI ; Feng WANG ; Zhenhua YANG ; Chaowu CHEN ; Wei MAI ; Suming LUO ; Xiaofei SONG ; Shimin YANG ; Wei ZHOU ; Haiyan LIU ; Xinjian XU ; Zheng ZHOU ; Chuanyuan LIU ; Lian′an DING ; Kai XIE ; Gang HAN ; Hongbin LIU ; Jianzhong WANG ; Shichen WANG ; Peige WANG ; Gefei WANG ; Guosheng GU ; Jian′an REN
Chinese Journal of Gastrointestinal Surgery 2019;22(11):1041-1050
Objective:
To investigate the diagnosis and treatment for enterocutaneous fistula (ECF) in China, and to explore the prognostic factors of ECF.
Methods:
A multi-center cross-sectional study was conducted based on the Registration System of Chinese Gastrointestinal Fistula and Intra-Abdominal Infections to collect the clinical data of ECF patients from 54 medical centers in 22 provinces/municipalities from January 1, 2018 to December 31, 2018. The clinical data included patient gender, age, length of hospital stay, intensive care unit (ICU) admission, underlying diseases, primary diseases, direct causes of ECF, location and type of ECF, complications, treatment and outcomes. All medical records were carefully filled in by the attending physicians, and then re-examined by more than two specialists. The diagnosis of ECF was based on the clinical manifestations, laboratory/imaging findings and intraoperative exploration.
Results:
A total of 1521 patients with ECF were enrolled, including 1099 males and 422 females, with a median age of 55 years. The top three primary diseases of ECF were malignant tumors in 626 cases (41.2%, including 540 gastrointestinal tumors, accounting for 86.3% of malignant tumors), gastrointestinal ulcers and perforations in 202 cases (13.3%), and trauma in 157 cases (10.3%). The direct causes of ECF were mainly surgical operation in 1194 cases (78.5%), followed by trauma in 156 (10.3%), spontaneous fistula due to Crohn