1.The clinical application of mirabilite abdominal hot compression bag for treating acute pancreatitis
Chinese Journal of Pancreatology 2016;16(5):320-325
Objective To explore the clinical application of mirabilite abdominal hot compression bag designed by ourselves for the moderately severe acute pancreatitis ( MSAP ) or severe acute pancreatitis ( SAP) .Methods Seventy MSAP and SAP patients were randomly divided into the observed and control groups according to the admission date.Each group included 35 patients.All the patients received the routine treatment.The patients in observed group received the treatment of compression action on abdomen by mirabilite abdominal continual hot compression bag designed by ourselves, while the traditional mirabilite hot compression action was used in the control group.The APACHEⅡscore and the levels of plasma CRP, IL-1, IL-6 and TNF-αof all patients on the 1st, 3rd, 6th, and 9th day after being admitted, the rate of complications including the intra-abdominal hypertension (IAH), pancreatic pseudocysts (PPC) and pulmonary infection, the recovery time of intestinal function and mean hospitalization time were all recorded and the therapeutic efficacy was compared between the two groups.Furthermore, the therapeutic effects of MSAP and SAP were compared between two groups.Results The APACHEⅡscore and the levels of plasma CRP, IL-1, IL-6 and TNF-αwere not statistically different between the two groups on the 1st day after hospitalization.The APACHEⅡscore and the levels of plasma CRP, IL-1 and TNF-αon the 3rd day in the observed group were significantly lower than those in the control group(P<0.05 or <0.01).The APACHEⅡ score and the levels of plasma CRP, IL-1 , IL-6 and TNF-αon the 6th day in the observed group were significantly lower, comparing to those in the control group.The levels of serum IL-1 and TNF-αin the observed groups were significantly lower than those in control group on the 9th day.All the differences above were statistically significant ( P<0.05 or <0.01).In the observed group, 4 cases (11.4%) had IAH and 7 cases (20.0%) developed other complications.The time of intestinal recovery and mean hospitalization was (4.9 ±0.8)d and (13.1 ±2.1)d, respectively, in the observed group.In the control group, 11 cases (31.4%) had IAH and 10 cases (28.6%) had other complications, and the time of intestinal recovery and mean hospitalization was (5.5 ±0.8) d and (15.4 ±3.9)d,respectively,.The rate of IAH, intestinal function recovery time and hospitalization time in the observed group were significantly less than those in control group (P<0.05 or <0.01).There was no statistical difference on other complications between the two groups.The intestinal function recovery time and hospitalization time of MSAPs in the observed group were significantly less than those in control group [(5.0 ± 0.8)d vs (5.5 ±0.8)d, P=0.03; (12.7 ±1.7)d vs (15.2 ±3.6)d, P=0.02].The APACHEⅡ score and the levels of plasma CRP, IL-1, IL-6 and TNF-αof SAPs were not statistically different between the two groups.Conclusions The application of the mirabilite abdominal continual hot compression bag could alleviate inflammatory response of MSAP and SAP, decrease the rate of IAH, improve the intestinal function recovery time,and shorten the hospitalization time.
2.INFLUENCE OF CORONARY DISEASE ON PERIOPERATIVE CARDIAC EVENTS IN PATIENTS UNDERGOING NONCARDIAC SURGERY
Yusheng ZHAO ; Yanmei MA ; Shiwe WANG
Medical Journal of Chinese People's Liberation Army 1981;0(04):-
To evaluate the influence of known coronary artery disease(CAD)on perioperative cardiac events in elderly patients undergoing noncardiac surgery,3028 consecutive patients who underwent major noncardiac procedures, with or without a history of CAD, were analyzed in terms of types and nature of surgery, clinical history and perioperative cardiac complications. Among the patients CAD, there were more urologic operations, and clinical history of internal diseases compared with the patients without CAD. Patients with CAD had an increased odds ratio for myocardial ischemia and arrhythmia (OR, 20 3 [95% CI, 6 5 to 65 7] and OR, 7 4 [CI, 4 4 to 12 3]) during operation, and also for postoperative myocardial ischemia, myocardial infarction, cardiogenic pulmonary edema and arrhythmia (OR, 8 3 [95% CI, 4 7 to 14 7], OR, 3 9 [95% CI, 1 2 to 12 2], OR, 7 9 [95% CI, 3 8 to 16 6] and OR, 1 7 [CI, 1 3 to 2 4]) compared with patients without CAD. The results indicated that elderly patients with CAD who underwent noncardiac surgery were more frequently associated with clinical history of internal diseases, and had a higher rate of major perioperative cardiac complications.
3.Advances in the study of HIV-1 integrase inhibitors of alpha, gamma-diketo compounds.
Shenghui YU ; Yanmei TAN ; Guisen ZHAO
Acta Pharmaceutica Sinica 2010;45(2):215-23
HIV-1 integrase (IN) is an essential enzyme for retroviral replication. There is no analogue for this enzyme in human cells so that inhibition of IN will not bring strong effect on human body. Thus, HIV-1 IN has become a rational target for therapy of AIDS. This review provides a comprehensive report of alpha, gamma-diketo IN inhibitors discovered in recent years. Compilation of such data will prove to be beneficial in developing QSAR, pharmacophore hypothesis generation and validation, virtual screening and synthesis of compounds with higher activity.
4.Study on the neonatal outcomes and congenital malformations in children born after in-vitro fertilization
Xuemei WANG ; Yanmei CHANG ; Xiaoyan ZHAO
Chinese Journal of Perinatal Medicine 2000;0(04):-
Objective To evaluate the neonatal outcomes and the prevalence of congenital malformations in children born after in-vitro fertilization(IVF). Methods IVF children (211 cases) born of 156 mothers from July 1994 to October 2003 and 218 controls were studied. Those controls were randomly chosen from the same hospital matched for the time and season of birth and maternal age. Results The incidence of multi-gestation (37.2% vs 2.3%, OR =24.62, 95% CI : 9.1~72), preterm birth (37.2% vs 8.5%, OR =6.41, 95% CI : 3.5~12.0), cesarean section (97.0% vs 71.8%, OR =14.9,95% CI :5.0~49.5), pregnancy-induced hypetension (22.4% vs 10.8%, OR = 2.39, 95% CI :1.3~4.9), threatened abortion (4.5% vs 0%, OR =3.11,95% CI :2.0~4.8) were significantly higher in the IVF group, but the prevalcnce of fetal distress (14.6% vs 4.5%) was lower comparing with control group( P
5.Effect of early nasogastric tubing bile reinfusion on gastrointestinal function recovery for patients undergoing laparoscopic bileduct operation
Ling LI ; Xinyu DAI ; Huili LI ; Yanmei ZHAO
Chinese Journal of Practical Nursing 2016;32(8):601-603
Objective To explore the effect of early nasogastric tubing bile reinfusion on gastrointestinal function recovery for patients undergoing laparoscopic bileduct operation.Methods One hundred patients undergoing laparoscopic bileduct operation were divided into observation group and control group with 50 cases each by random digits table method.The control group received routine nursing,and the observation group received early nasogastric tubing bile reinfusion on the basis of routine nursing.The recovery of postoperative gastrointestinal function and the incidence of postoperative abdominal distention between the two groups were observed and compared.Results The length of time needed for intestinal voice restoration and exhausting were (17.12 ± 3.88),(33.92 ± 8.96) h in observation group,and (24.08 ± 7.25),(43.64 ± 11.18) h in control group,and the differences were statistically significant (t =5.99,4.80,P < 0.01).The incidence of postoperative abdominal distension was 22%(11/50) in observation group,and 42%(21/50) in control group,and the difference was statistically significant (x2=4.60,P< 0.05).Conclusions The early nasogastric tubing bile reinfusion in patients undergoing laparoscopic bileduct operation can effective promote their gastrointestinal function recovery and reduce the occurrence of postoperative abdominal distension.
6.Effects of acute normovolemic hemodilution plus tranexamic acid on bloodloss and blood transfusion in patients with total knee replacement
Jianxiang YANG ; Yanmei FAN ; Jie ZHAO ; Huanlai GUO ; Hongyang WU
International Journal of Laboratory Medicine 2017;38(17):2355-2356,2359
Objective To observe the effects of acute normovolemic hemodilution(ANH) plus tranexamic acid on blood loss and blood transfusion in patients with total knee replacement.Methods 98 cases of patients with total knee replacement were divided into ANH group and combination group by computer randomization,49 cases in each group.ANH was performed in ANH group,and ANH plus tranexamic acid was given in combination group.The changes of hemoglobin(Hb),red blood cells deposited(Hct),platelet count(PLT) were observed before and after autologous blood transfusion in two group.The changes of prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(FIB),D-dimer were observed at preoperative and postoperative in two group.The amount of blood loss and allogeneic blood infusion,the urine volume and the postoperative flow volume were recorded in two groups.Results The average levels of Hb,Hct after autologous blood transfusion in combination group were higher than those in ANH group,the differences were statistically significant(P<0.05).The average level of D-dimer at postoperative in combination group were higher than that in ANH group,the difference was statistically significant(P<0.05).The amounts of blood loss and allogeneic blood infusion,the postoperative flow volume were lower than those in ANH group,the differences were statistically significant(P<0.05).Conclusion The joint application of ANH and tranexamic acid can effectively reduce the amounts of blood loss and allogeneic blood infusion in patients with total knee replacement,and has a certain clinical value.
7.The value of serum bile acid in diagnosis of intrahepatic cholestasis of pregnancy
Xiaoli WANG ; Bo LI ; Yanmei ZHAO ; Xin WANG
Chinese Journal of Postgraduates of Medicine 2012;35(15):17-19
ObjectiveTo evaluate the application value of serum bile acid in diagnosing intrahepatic cholestasis of pregnancy (ICP).MethodsThe clinical data of 92 prepartal patients with ICP was analyzed retrospectively.The patients were divided into observation group ( > 40 μ mol/L ) and control group ( ≤40 μ mol/L) with 46 cases each according to serum bile acid level.The nccurrence time of skin pruritus,jaundice degree,serum alanine aminotransferase (ALT),aspartate aminotransferase (AST) and degree of polluted amniotic fluid of two groups were observed and compared.ResultsThe occurrence of skin pruritus in observation group was earlier than that in control group [(29.1 ± 3.4) weeks vs.(33.9 ± 3.2) weeks,P<0.05 ] ;the cases with severe jaundice,ALT > 100 U/L,AST > 100 U/L and amniotic fluid contamination Ⅲ degree in observation group were more than control group [27 cases vs.15 cases,28 cases vs.20 cases,28 cases vs.18 cases,23 cases vs.15 cases,P< 0.01 or < 0.05].ConclusionsSerum bile acid,as a sensitive indicator to assess TCP,has important value in determining the condition of pregnant women and prognosis analysis,and it can reflect the occurrence possibility of bad perinatal outcomes.
8.Diagnosis and treatment of 21 blunt pancreatic trauma patients
Zhiyuan JIAN ; Mingyin LAN ; Meng ZHOU ; Yanmei ZHAO
Chinese Journal of Pancreatology 2010;10(6):395-397
Objective To investigate the diagnosis and treatment of the blunt pancreatic injury.Methods The clinical data of 21 blunt pancreatic trauma patients admitted to our hospital in the past 5 years were analyzed retrospectively.Results 3 of 21 patients were simple blunt pancreatic injury, while the other 18 patients were complicated with other abdominal organs injuries.According to the grading criteria, the number of Ⅰ , Ⅱ, Ⅲ, Ⅳ, Ⅴ grade injury were 4, 7, 5, 3 and 2 cases, respectively, and only 9 patients were diagnosed by CT before operation, and the diagnosis was confirmed during the operation in 11 patients, and 1 was miediagnosed in the first operation.Single drainage or debridement and drainage were performed in 8 cases and distal pancreatectomy with and without spleen were performed in 5 and 3 cases, respectively, and 3patients received pancreaticojejunostomy, 1 received Whipple operation, the other 1 case underwent duodenorrhahy and diverticulation.The mortality rate was 9.5% (2/21), and the complications of pancreatic pseudocyst and fistula developed in 2 (9.5%, 2/21 ) and 5 (23.8%, 5/21 ) cases respectively, and they were cured by drainage, while the other 12 were cured completely.Conclusions The preoperative misdiagnosis rate of pancreatic trauma is high;CT scan should be used to confirm the diagnosis.Careful pancreatic exploration is mandatory and simple and effective surgical procedures with effective drainage is important for treatment success.
9.Anti-Müllerian hormone:its significance in female lupus patients and relatin with anti-ovarian antibody
Yanmei LI ; Yi ZHAO ; Chunzeng CI ; Zhanguo LI
Chinese Journal of Rheumatology 2010;14(5):305-307
Objective To evaluate the serum anti-Müllerian hormone(AMH)level in female patients with systemic lupus erythematosus (SLE),and to explore the association between AMH and anti-ovarian antibody(AOAB).Methods Serum levels of AMH and AOAB were measured with ELISA in 84 female SLE patients and 90 age-matched healthy women.The patients were not treated with steroids or immunosuppressive agents before their blood samples were collected.Clinical and laboratory data of the SLE patients were also analyzed by two independent samples t-test.Results The mean serum AMH level of 84 female SLE patients was (3.2±1.5)ng/ml,which was higher than that of 90 age-matched healthy women[(2.6±1.4)ng/ml,P<0.05].Moreover,the serum AMH level was closely associated with rash,lupus nephritis,and disease activity in the 84 SLE patients.The results showed that the serum AMH levels increased first,then decreased with aging,both in SLE patients and healthy women,but the appearance of peak serum AMH level in SLE patients was delayed.The frequency of AOAB wilts higher than that in healthy women.Interestingly,the mean serum AMH level of the AOAB-positive group[(4.1±1.8)ng/ml]was higher than that of the AOAB-negative group [(2.7±1.1)ng/ml,P<0.01].Conclusion The mean level of serum AMH in female SLE patients is higher than that in age-matched healthy women,and its high level in SLE patients is closely associated with rash,lupus nephritis,disease activity and serum AOAB level.
10.The effects of music intervention on physiological and psychological responses of patients with cancer: a Meta- analysis
Yanmei SHI ; Hongle ZHAO ; Jing ZHUANG ; Cong LIU ; Shuxiang ZHANG
Chinese Journal of Practical Nursing 2017;33(20):1595-1600
Objective To assess the effects of music intervention on physiological and psychological responses of patients with cancer. Methods A computerized search in China Biology Medicine, China National Knowledge Infrastructure,Wanfang data ,VIP, Cochrane library, Web of Science and PubMed was performed for relevant randomized control trials comparing the effects of music intervention on physiological and psychological responses of patients with cancer. The quality of studies was critically appraised and data were extracted by two reviewers independently. The Cochrane-Handbook5.0 was used to evaluate the quality of studies. Data was analyzed by RevMan5.0 software. Results A total of 29 randomized control trials were involved. Eleven studies about the effects of music intervention on anxiety level of patients with cancer were assessed with Self-rating Anxiety Scale,Meta analysis confirmed that music intervention could effectively reduce the anxiety level of patients with cancer (WMD=-11.74, 95%CI-11.94--8.53, P<0.01). Four studies about the effects of music intervention on anxiety level of patients with cancer were assessed with state-trait anxiety inventory,Meta analysis confirmed that music intervention could effectively reduce the anxiety level of patients with cancer (WMD=-8.24, 95%CI-9.44--7.04, P<0.01). Meta-analysis showed that music intervention was able to relieve anxiety, depression, pain of patients with cancer. Two studies about the effects of music intervention on anxiety level of patients with cancer were assessed with Hamilton Anxiety Scale,Meta analysis confirmed that music intervention could effectively reduce the anxiety level of patients with cancer (WMD=-3.37, 95%CI-4.93--1.82, P<0.01). Fourteen studies about the effects of music intervention on depression level of patients with cancer were assessed with Self-rating Depression Scale,Meta analysis confirmed that music intervention could effectively reduce the depression level of patients with cancer (WMD=-8.12, 95%CI-10.75--5.49, P<0.01). Three studies about the effects of music intervention on depression level of patients with cancer were assessed with Hamilton Depression Scale,Meta analysis confirmed that music intervention could effectively reduce the depression level of patients with cancer (WMD=-3.27, 95%CI-6.34--0.21, P=0.04). A total of 9 studies were conducted to evaluate the effects of music intervention on patients with the pain Visual Analogue Scale,Meta analysis confirmed that music intervention could effectively reduce the pain level of patients with cancer (WMD=-0.83, 95%CI-1.23--0.44, P<0.01).A total of 6 studies were conducted to evaluate the effects of music intervention on heart rate in cancer patients,Meta analysis confirmed that music intervention could stabilize the heart rate of patients (WMD=-3.38, 95%CI-5.13--1.62, P=0.002).A total of 6 studies were conducted to evaluate the effects of music intervention on systolic blood pressure in patients with cancer,the results of Meta analysis showed that music intervention could stabilize the systolic pressure in patients (WMD=-5.34, 95%CI-7.95--2.73, P<0.01). Conclusions Music intervention has effects on reducing potentially harmful psychological responses of patients with cancer,which deserve to be explored and spread in clinical practice.