2.Study on complication after noncardiac thoracotomy in hypothyroidism with ST segment change patients
Chinese Journal of Endemiology 2009;28(5):572-574
Objective To investigate complications in patients after noncardiac thoracotomy in hypothyroidism with ST changes. Methods Sixty one patients with hypothyroidism undergoing noncardiac thoracotomy were divided into ST segment change group(28 patients having ST segment depression≥0.05 mV) and controls(33 patients) according to the results of Holter. All patients were added with thyroid hormone, until the function of thyroid gland was normal before thoracotomy. The myocardial ischemia was measured by Holter within 48 hours after thoracotomy. Serum thyroid hormones was examined by radioimmunoassay during, before and after thoracotomy. And cardiovascular events were foliowed-up to hospital. Results Before and after thoracotomy serum TT3 in ST segment change group was (1.30±0.41), (2.09±0.45)nmol/L, TT4 was (80.56±30.28), (84.55±33.57) nmol/L, respectively; compared with the control group[TT3: (1.43±0.52), (2.38±0.51)nmol/L, TT4:(82.70± 29.43), (93.47±35.02)nmol/L], no significant differences were found(all P>0.05). After thoracotomy, 24 patients occurred myocardial ischemia, 10 patients occurred cardiovascular events in ST segment change group; 8 patients occurred myocardial ischemia, a patient occurred cardiovascular events in control group, there were significant differences between two groups(χ2=22.95,10.95, all P<0.05). The positive predictive value of ST segment change in Holter detection was 36% (10/28) recording in cardiovascular events of patients with cardiovascular disease undergoing noncardiac thoracotomy and hypothyroidism, negative predictive value was 97%(32/33). Conclusions Myocardial ischemia and other cardiovascular events tend to occur in hypothyroidism patients with ST segment change after noncardiac thoracotomy. ST segment change of preoperative Hoher detection recording cardiovascular events of hypothyroidism patients undergoing noncardiac thoracotomy has certain predictive value.
3.Genotypes and antimicrobial susceptibility of Rhizobium radiobacter isola-ted from pediatric patients with bacteremia
Yongjie CHANG ; Huadong XU ; Hongwei XU ; Yan XU ; Zhen ZHANG
Chinese Journal of Infection Control 2015;(1):10-15
Objective To investigate genotypes and antimicrobial susceptibility of Rhizobium radiobacter (R.radiobact-er)isolated from pediatric patients with bacteremia.Methods R.radiobacter strains from blood cultures of pediatric pa-tients with bacteremia from February 2013 through February 2014 were collected.16S rDNA fragment was amplified by polymerase chain reaction(PCR),bacterial genotypes were identified by pulsed-field gel electrophoresis (PFGE),antimi-crobial susceptibility testing were performed by Kirby-Bauer disk diffusion method.Results 13 isolates of R.radiobacter were isolated from 12 children with positive blood culture,which including 3 genotypes,the homology of 16S rDNA fragment and R.radiobacter IFM 10623 was up to 99%.According to CLSI 2003 standard,these 13 R.radiobacter were resistant to ceftazidime,piperacillin,ticarcillin,piperacillin/tazobactam,ticarcillin/clavulanic acid,aztreo-nam and polymyxin B,but sensitive to cefepime,doripenem,imipenem,meropenem,tobramycin,netilmicin,cip-rofloxacin,levofloxacin,and norfloxacin.In addition,cefotaxime and ceftriaxone showed larger inhibition zone. Conclusion Therapy of R.radiobacter infection should be based on antimicrobial susceptibility testing results;cefo-taxime and ceftriaxone are better selection for the therapy of R.radiobacter infection in pediatric patients.
4.The research progress of traditional Chinese medicine inducing bone mesenchymal stem cells
Dongwei ZHANG ; Yan CHEN ; Xu LI
International Journal of Traditional Chinese Medicine 2015;(2):184-186
Through referring to relevant works and the latest literature, the application and research progress of the traditional Chinese medicine inducing mesenchymal stem cells were summarized. The researching results focusing on induction and proliferation of mesenchymal stem cell by salvia, notoginseng, tortoise plastron, pilose antler, ginseng, astragalus were introduced.
5.The clinical efficacy of rhubarb acupoint sticking joint liver qi stagnation diet for chronic functional constipation in patients with depressive anxiety
Yan XU ; Li ZHANG ; Yuehua TANG
Chinese Journal of Primary Medicine and Pharmacy 2016;23(22):3378-3382
Objective To investigate the clinical efficacy of rhubarb acupoint sticking joint shuganjieyu diet in the treatment of chronic functional constipation patients with depressive anxiety.Methods 120 patients of chronic functional constipation with depression anxiety were selected,they were randomly divided into control group and obser-vation group,60 cases in each group.The patients in the control group were given promoting gastrointestinal motility drugs mosapride capsules,and orally given laxatives rhubarb with sodium bicarbonate.The patients in the observation group were treated with topical rhubarb acupoint,and orally given medicated shuganjieyu diet.7 days for a course of treatment,the patients were treated for four courses.The clinical efficacy of the two groups,defecation interval and fecal nature,SAS,SDS scale score changes and quality of life (PAC -QOL)scale score changes before and after treatment and adverse reactions during treatment were recorded.Results The total effective rate of the observation group was 90.00%,which of the control group was 91.67%,the difference between the two groups was not significant (χ2 =0.32,P >0.05).Before treatment,the bowel movement and stool ratings between the two groups had no statis-tically significant differences (t =0.23,0.33,all P >0.05).After treatment,the two points of the two groups were significantly decreased,but the differences between the two groups were not significant (t =0.18,0.41,all P >0.05).Before treatment,the SAS,SDS scale scores between the two groups had no statistically significant differences (t =0.78,0.69,all P >0.05).After treatment,the SAS,SDS scores of the two groups were significantly decreased, which of the observation group decreased more significantly than those of the control group (t =4.18,4.72,all P <0.05).Before treatment,the PAC -QOL scale scores for each dimension level had no statistically significant differ-ences (t =0.16,0.21,0.42,0.20,all P >0.05).After treatment,the dimensions of the two groups showed a decline trend,and those of the observation group decreased more significantly than the control group (t =2.10,3.56,2.76, 2.34,all P <0.05).In the control group during the treatment,2 cases of diarrhea,three cases of dry mouth,the patients were improved after given symptomatic treatment.No serious adverse event occurred during therapy in the observation group.Conclusion Rhubarb acupoint joint shuganjieyu diet in the treatment of chronic functional constipation patients with depression anxiety has significant clinical effect,which can significantly improve patients'depression and anxiety scores,quality of life,and without significant adverse reactions,it is worthy of clinical applica-tion.
6.Expression of nerve growth factor produced by ectopic endometrium from patients with adenomyosis and its relationship with pain scales and innervation
Yan LI ; Shaofen ZHANG ; Linna XU
Chinese Journal of Obstetrics and Gynecology 2014;49(2):120-124
Objective To investigate the expression of neive growth factor (NGF) in the ectopic endometrium in adenomyosis patients,and explore the relationship between NGF expression and innervation or pain scales.Methods From Mar.2009 to Oct.2009,45 adenomyosis patients undergoing hysterectomy in Obstetrics and Gynecology Hospital of Fudan University were enrolled in this study,which were classified into 33 cases in pain group and 12 cases in non-pain group based on symptom.The degree of dysmenoreal,chronic pelvic pain and dyspareunia was evaluated by visual analogue scale,including no pain,mild to moderate pain and severe pain group.In the mean time,26 patients with leiomyoma or cervical intraepithelial neoplasia Ⅲ (CIN Ⅲ)undergoing hysterectomy were defined as control group.Ectopic endometrium from experimental group and eutopic endometrium from control group were collected in the surgery.The expression of NGF was examined by immunohistochemistry.The density of protein gene product (PGP)9.5 positive nerve fibers was detected by immuno-fluorescence.Results The NGF level and the density of PGP 9.5 positive nerve fibers in adenomyosis pain group (0.25 ± 0.08,16 ± 8) were higher than adenomyosis painless (0.19 ± 0.05,P =0.007 ; 11 ± 5,P =0.018) and control group (0.18 ± 0.05,P =0.000;9 ± 4,P =0.000).The NGF level and the density of PGP9.5 positive nerve fibers in severe dysmenorrheal group(0.29 ± 0.07,19 ± 10) were higher than mild to moderate dysmenorrheal (0.22 ± 0.07,P =0.018 ; 13 ± 4,P =0.035) and painless group (0.18 ± 0.05,P =0.000 ; 11 ± 5,P =0.006) of adenomyosis patients.There was no difference of NGF level and the density of PGP 9.5 positive nerve fibers in chronic pelvic pain group and no chronic pelvic pain group of adenomyosis patients,so was dyspareunia group and no dyspareunia group.Conclusion The increased NGF level of adenomyosis nodules and improving innervation might be involved in the mechanism of adenomyosis related pain.
7.Clinical observation of treatment of acute myocardial infarction by simvastatin with low molecular weight heparin
Qian QIN ; Yan XU ; Zhiwei ZHANG
Chinese Journal of Primary Medicine and Pharmacy 2009;16(5):804-806
Objective To observe the clinical effect and side-effect of low molecular weight beparin (LMWH) and simvastatin on patients with acute myocardial infarction(AMI). Methods 80 cases of AMI were randomly divided into simvastatin with low-molecular-weight heparin treatment (joint group) 40 cases and nitrates drug treatment( conventional group) 40 cases Au the patiants were observed before and after treatment for serum inflammatory factor,quantitative gated tomography,Holter and analysis of the effectbefore and after treatment. Results The conventional group and joint group after the treatment of TC, TG, LDL, HDL-C, hs-CRPs, CD40L levels were decreased than before treatment (t=2. 131, t = 2. 211, t = 2. 235, t = 2. 211, t = 2. 115, t = 2. 274, both P<0. 05 ) ; the joint group after treatment bs-CRP, sCD40L significantly declined than conventional group (t = 2. 231, t = 2. 245, both P<0. 05 ) ;conventional group of IMT dropped 1.1% lower than the 3.4% of the joint group ( X2 = 4. 01,P<0. 05 ) ; conventional treatment group plaque score 11.5% higher than the combined group plaque score decreased 16. 9% (X2 =4. 25 ,P<0. 05) ;joint group after treatment,a few soft spots(7. 7 %) lower than before treatment(28.2%) (X2 = 6. 78,P<0. 01) ;the joint group of EDV,ESV,EF after treatment decreased significantly than before treatment (t =2. 221 ,t =2. 342 ,t = 2. 245, P<0. 05) ; conventional treatment group and joint group after the number of ischemic attack, ST above the largest decrease, ST segment depression was significantly lower than the time before treatment(t=2. 731 ,t=2. 781, t=2. 785,t=2. 781, t=2. 815, t=2. 874, both P<0. 01);joint total effective rate 90. 0% higher than the conventional group 67.4% (X2=4. 25,P<0. 05 ). Conclusion Simvastatin combined with LMWH have good effect in the treatment of acute myocardial infarction.
8.Clinical significance of the change of electrocardiogram and cardiac markers for myocardial damage after on-pump and off-pump coronary artery bypass grafting
Yan ZHANG ; Jinzhi XU ; Xiuju WANG
Chinese Journal of Postgraduates of Medicine 2008;31(21):14-17
Objective To investigate the clinical significance of the changes of electrocardiogram (ECG) and cardiac markers for myocardial damage after on-pump coronary artery bypass grafting (CABG) and off-pump coronary artery bypass grafting (OPCABG). Method Monitoring 25 patients of OPCABG (OPCABG group) and 25 patients of CABG (CABG group) R wave amplitude of V4 and V5 on antorior electrocardiographic lead and simultaneously determining cardiac markers for myocardial damage creatine phosphokinase isoenzyme MB (CPK-MB), tropenin I (cTnI) and heat-shock protein 70 (HSPT0) on different lime. Results R wave amplitude of V4 and V5 on anterior electrocardiographic lead had no significant changes on 0, 6, 18 and 24 hours after OPCABG. On the contrary, R wave amplitude of V4 and V5 on anterior electrocardiographic lead decreased significantly on 0, 6 and 18 hours after CABG (P<0.01), and came back to preoperative values 24 hours after operation. The levels of CPK-MB and cTnI reached its peak and higher significantly for CABG than those for OPCABG on 24 hours after operation, 29.29 μg/L vs 5.98 μg/L and 6.74 μg/L vs 1.91 μg/L respectively. HSP70 increased significantly on 6 hours after operation in two groups, but median of HSP70 was higher significantly in CABG group (11044.5 pmol/L vs1702.0 pmol/L). In the first day after operation the HSP70 peak was correlated significantly with the level of CPK-MB(r=0.370, P<0.01) and cTnI (r=0.458,P<0.01). Conclusions Myocardial damage is significantly alleviated for patients of OPCABG comparing with those of CABG. The HSF70 in circulation may indicate the degree of myocardial damage.
9.Impact analysis of comorbidities on prognosis of myelodysplastic syndromes patients.
Wei YAN ; Wen-xu HU ; Rong ZHANG
Chinese Journal of Hematology 2012;33(7):574-576
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10.Distribution characteristics of blood culture pathogens
Airong ZHANG ; Yan LIU ; Qingxia XU
Clinical Medicine of China 2016;32(2):123-126
Objective To investigate distribution characteristics of blood culture pathogens,and provid a basis for clinical prevention and control in bloodstream infections.Methods The data of the patients with positive blood culture and the nonduplicate strains were retrospectively analyzed with WHONET 5.6 software in the First People's Hospital of Shangqiu from January 2011 to December 2014.Results The total number of positive strains of blood culture was 1 306 from 25 397 blood cultures,and the positive rates were 5.1%,of which gram positive cocci and gram negative organisms accounted for 64.8% (846/1 306) and 31.2% (408/1 306),respectively.Candida accounted for 4.0% (52/1 306).Gram positive bacteria were mainly Coagulase negative Staphylococcus (CNS) of 564 (43.2%) strains,Staphylococcus aureus of 96 (7.4%) strains,Enterococcus faecium of 48 (3.7%) strains and Streptococcus pneumoniae of 31 (2.4%) strains.The isolated rate of Enterococcus faecium was more than Enterococcus faecalis 20 strains (1.5%).The isolated rate of Escherichia coli,Klebsiella pneumoniae,Acinetobacter Bauman and Pseudomonas aeruginosa were 12.5% (163 strains),6.2%(81 strains),2.0%(26 strains) and 1.8%(23 strains),respectively.Conclusion The isolated rate of Enterococcus faecium more than Enterococcus faecalis in blood culture,the main pathogens are gram positive cocci in children group.Isolates of gram positive bacteria in the proportion of infants,children and adults with blood culture were 85.2%,87.0%,46.5%.There were 264 strains bacteria isolated in infants and young children's intensive care unit,accounting for 67.3% of all bacteria isolated from infants and young children.There were 122 strains bacteria isolated in pediatric intensive care unit,accounting for 56.7% of all bacteria isolated from childen.There were 255 strains bacteria isolated in adult intensive care unit,accounting for 36.5% of all bacteria isolated from adult.Severe basic diseases were the vulnerable groups of bloodstream infections.