1.Detection of autoimmune antibody in patients with SLE after autologous hematopoietic stem cell transplantation
Jianhua LI ; Jing SUN ; Xuebiao PENG ; Dan XU ; Ledong SUN ; Liang HUANG ; Fanyi MENG ; Jie ZHAO ; Kang ZENG
Journal of Chinese Physician 2002;0(S1):-
Objective To study changes of the autoimmune antibody level in patients after autologous hematopoietic stem cell transplantation(CD_(34)~+).Methods Twelve patients with SLE received autologous hematopoietic stem cell transplantation.All they survived and their immune system were recoverd after a period of time.The serum autoimmune antibody levels were measured before and after the transplantation,Results The antibody levels became normal 6 months after transplantation.Conclusion Autologous hematopoietic stem cell transplantation can effectively reduces the level of autoimmune antibody in patients with SLE.
2.Risk factors of ureteral stricture after ureteroscopic holmium laser lithotripsy
Feifei PAN ; Sen MA ; Xuebiao SUN ; Jiawei MA
International Journal of Surgery 2022;49(6):387-392,F3
Objective:To investigate the ureteral stricture after ureteroscopic holmium laser lithotripsy in patients with ureteral calculi and its effect on prognosis.Methods:The clinical data of 406 patients who underwent ureteroscopic holmium laser lithotripsy in Nanjing Tongren Hospital from January 2018 to August 2019 were analyzed retrospectively, according to postoperative ureteral stricture, the patients were divided into stricture group ( n=28) and non-stricture group ( n=378). The independent risk factors of postoperative ureteral stricture in patients with ureteral calculi were evaluated by univariate and multivariate Logistic regression analysis, and the postoperative recurrence rate and prognosis of the two groups were compared.The nomogram model was constructed according to independent risk factors, and the accuracy of the model was verified by receiver operating characteristic (ROC) curve, GiViTI calibration band and clinical decision curve. Measurement data were expressed as mean±standard deviation ( ± s), comparison between groups used t-test, and comparison of count data between groups used Chi-square. Results:Univariate analysis showed that there were significant differences in course of ureteral calculi, stone diameter, polyp wrapping, degree of hydronephrosis, incarcerated stone, ureteral injury and operation time between non-stricture group and stricture group ( P<0.05). Multivariate Logistic regression analysis showed that the course of ureteral calculi, stone diameter, polyp wrapping, degree of hydronephrosis, incarcerated stone and ureteral injury were independent risk factors for postoperative ureteral stricture in patients with ureteral calculi ( P<0.05). The patients with ureteral calculi were followed up for 1 year by telephone, outpatient reexamination and medical record inquiry. During the follow-up period, 106 cases of ureteral calculi recurred. The recurrence rate of 1 year (21.43% vs 8.99%) and 2 years (35.71% vs 14.81%) in the stricture group was significantly higher than that in the non-stricture group, the differences were statistically significant ( χ2=4.54, 8.36, P<0.05). Compared with the non-stricture group, the physiological function score [(79.28±8.17) vs (65.22±10.53)], physiological function score [(78.54±9.33) vs (69.23±7.86)] and overall health score [(81.03±10.54) vs (70.43±7.38)] in the stricture group were significantly lower, the differences were statistically significant ( t=7.70, 5.29, 5.43, P<0.05). The area under curve of the constructed nomogram model ROC curve was 0.882 (95% CI: 0.774-0.928). In the 80%-90% confidence interval area of the GiViTI calibration curve belt, it does not pass through the 45° angle bisector ( P=0.176). The clinical decision curve indicates that the net benefit rate was high. Conclusions:The course of ureteral calculi, stone diameter, polyp wrapping, degree of hydronephrosis, incarcerated stone and ureteral injury are independent risk factors for postoperative ureteral stricture in patients with ureteral calculi. Clinicians should actively take intervention measures to reduce the incidence of postoperative ureteral stenosis, improve the prognosis and improve the quality of life of patients.
3.4D-FLOW cardiovascular MR in assessment of right ventricular flow in patients with pulmonary hypertension
Ran YAN ; Jinzhu DAI ; Haiyi MA ; Xuebiao SUN ; Xincao TAO ; Xiaopeng LIU ; Yanan ZHEN ; Min LIU
Chinese Journal of Radiology 2021;55(10):1048-1053
Objective:To investigatethe relationship between right ventricular blood flow components and right ventricular function in patients with pulmonary hypertension (PH) by 4D-FLOW cardiovascular MR (4D-FLOW CMR).Methods:Thirty patients with PH were prospectively enrolled in this study. All patients underwent right heart catheterization to measure hemodynamics and CMR to measure right ventricular blood flow and right ventricular function within 1 week. The long-axis 4-chamber and contiguous short axis cineslices were acquired with balanced steady-state free precession sequence to calculate RV functional metrics including right ventricular end diastolic volume, end systolic volume, ejection fraction, stroke output and other functional parameters. Ventricular flow was acquired in sagittal direction, using a 3D retrospectively ECG-triggered, navigator-gated prototype sequence to analyze.RV function and flow parameters were correlated with Spearman correlation analysis.Results:Right ventricular percent of direction flow(RVPDF),percent of delayed eject flow (RVPDEF),percent of retained flow (RVPRI) and percent of residual volume(RVPRV) of PH patients measured with 4D-FLOW were 16.4%±9.2%, 16.1%±5.6%, 16.8%±6.1%, and 50.5%±12.3%, respectively. RVPDF negatively correlated with RVPRVo ( r=-0.703, P<0.001) while RVPDEF positively correlated with RVPRI( r=0.955, P<0.001). RVPDF was positively correlated with right ventricular stroke volume index (RVSVI)( r=0.38, P=0.041) and right ventricular eject fraction(RVEF)( r=0.69, P<0.001), and negatively correlated with right ventricular end systolic volume index(RVESVI)( r=-0.65, P<0.001) and right ventricular mass index(RVMI)( r=-0.45, P=0.004). RVPRVo was negatively correlated with RVEF( r=-0.58, P=0.007). The sum of RVPDF and RVPDEF (RVPDF+RVPDEF) was 35.2%±11.4%. RVEF correlated with RVPDF+RVPDEF ( r=0.825, P<0.001) and comparable to RVPDF+RVPDEF ( t=1.427, P=0.164). RVPDF was negatively correlated with pulmonary vascular resistance (PVR) ( r=-0.52, P=0.007) while RVPRVo was positively correlated with PVR ( r=0.54, P=0.004). Conclusions:4D-FLOW CMR can be used to measure right ventricular ejection fraction in PH patients without respiratory control. In PH patients, the right ventricular direct blood flow was significantly decreased, while the residual blood flow was significantly increased. The right ventricular direct blood flow and residual blood flow were related to the right ventricular function and pulmonary vascular resistance, which were important parameters to evaluate the right ventricular function and afterload in PH.