1.He Jia Treatment H-hypertension's Clinical Experience by Applying the Method of Buqi Zhuyu
Lijing ZHANG ; Yawen ZHANG ; Jia HE
Journal of Zhejiang Chinese Medical University 2016;40(3):170-172
Objective]The article summarizes the H-hypertension's clinical experience by professor He Jia. [Methods]From following professor He Jia clinical studies, summarize professor He Jia from different ages, the treatment by applying the method of tonifying qi by stasis H-hypertension qi deficiency blood stasis syndrome differentiation thinking and clinical experience, and for proven cases.[Result]The professor He Jia considers the method of Buqi Zhuyu as the basic therapeutic principle, with pathogenesis of qi deficiency and blood stasis in the collaterals. And also to make up for points and syndromes differentiation from youthes and older, in the young and middle-aged people and see blood stasis into collaterals, the treatment of blood stasis by the main,the old people see more Qi deficiency into the network, to make up for the deficiency of Qi.Her clinical medicine is characterized in paying equal attention to the Qi and blood, Buqi Zhuyu, using opportunely insect medicine,Soufeng Tongluo,using the mineral medicine, Ziyin Qianyang along with the disease change, with good effect.[Conclusion]Professor He Jia for H-hypertension treatment of qi deficiency blood stasis unique insights, obtains good effect, often with fellow mutual information.
2.Efficacy of hair removal by laser in different skin type and its complications
Qun ZHENG ; Yawen FU ; Baohua HE ; Xijuan YU ; Yu JIN
Chinese Journal of Medical Aesthetics and Cosmetology 2014;20(4):275-278
Objective To explore the effect and complication of diode laser and long-pulsed alexandrite laser for hair removal in different skin type.Methods A total of 1061 patients (1741 sites) were divided into 2 groups by skin type:one group were treated with diode laser,with wave length of 810 nm,and pulse width of 400 ms,with 12 mm × 10 mm spot size; another group were treated with long-pulsed alexandrite laser,with wave length of 755 nm,of pulse width of 20 ms,with 12.5 mm spot size,50-60 days intermitted between each treatment.Results The effect of hair removal by two lasers in different skin type was without divergence,but to darker skin,complication was lower when treated by diode laser.Conclusions The effect of hair removal by two lasers in different skin type is similar,but diode laser on hair removal is much safer to dark skin.
3.Clinical analysis of neuroendoscopy treatment of the third ventricle cysticercosis
Caixia AN ; Qiang LI ; Wentao LIANG ; Yawen PAN ; Xinding ZHANG ; Zhenhua HE
China Journal of Endoscopy 2016;22(7):94-97
Objective To investigate the surgical method of treating the third ventricle cysticercosis with neuroendoscopy and to discuss the related problems. Methods Clinical data of 7 cases of the third ventricle cysticercosis from July 2009 to December 2014 were retrospectively analyzed. Patients aged from 12 to 49 and all of them received endoscopic resection of the third ventricle cysticercosis and orally taken Albendazole after surgery. Results The symptoms of high intracranial pressure in patients show different levels of releasing, except 1 case with postoperative fever symptoms, the other patients had no other palpable complications. After rechecked by CT and MRI, the size and shape of ventricle of all patients improved to varying degrees and hydrocephalus symptoms was relieved that all cases were satisfactory. Conclusions The treatment of neuroendoscopy aimed to the third ventricle cysticercosis is simple, safe and with less postoperative complications, which should be the preferred treatmnt to the third ventricle.
4.Correlations of maternal calcium supplementation and dietary calcium intake with preterm birth
Yawen SHAO ; Yan BAI ; Ru LIN ; Wenhua HE ; Huaiye SU ; Weitao QIU ; Baohong MAO
Chinese Journal of Clinical Nutrition 2018;26(5):272-277
Objective To study the association of maternal calcium supplementation and dietary calcium intake with the preterm birth so that to provide scientific basis for effective intervention of preterm birth. Methods Normal pregnant women who were followed up all through to childbirth in Gansu Provincial Maternity and Child Care Hospital were selected. Multivariate logistic regression was used to evaluate the associ-ation of calcium supplementation and intake with preterm birth. Results After confounding factors were adjus-ted, pregnant women who took calcium supplement for more than 3 months before and/or during pregnancy had the risk of preterm birth reduced by 14% which was dose-responding ( OR=0. 86, 95% CI=0. 77-0. 96, P<0. 05). Through stratifying by trimesters of pregnancy, it was found that calcium supplement in the third trimes-ter was a protective factor for preterm birth and especially significant in early and very early pregnancy ( OR=0. 75, 95% CI=0. 62-0. 92, P<0. 05). Through stratifying by dietary calcium intake, pregnant women who took dietary calcium more than 465. 55 mg/d had the risk of preterm birth significantly reduced which was shown by the reduction of preterm birth of different degrees, controlled preterm labor and spontaneous premature dilivery (OR=0. 66, 95% CI=0. 53-0. 82, P<0. 05). Conclusion Appropriate calcium supplementation or dietary calcium intake before and during pregnancy can reduce the risk of preterm birth, which is especially sig-nificant in late pregnancy.
5.The prevalence and related direct medical costs of chronic complications among patients with type 2 diabetes in China
Xiaoning HE ; Yawen ZHANG ; Zhen RUAN ; Lanting LI ; Jing WU
Chinese Journal of Endocrinology and Metabolism 2019;35(3):200-205
Objective To estimate the prevalence and related direct medical costs of chronic complications,especially cardiovascular diseases,cerebrovascular diseases,and nephropathy in patients with type 2 diabetes mellitus (T2DM) in China.Method Data were extracted from the hospital information system(HIS) database of 4 top level Chinese hospitals from January 1st,2012 to May 31st,2017.Patients with T2DM were identified through international classification of diseases,tenth version (ICD-10) diagnosis supplemented with Chinese descriptions.The prevalences of complications including cardiovascular diseases,cerebrovascular diseases,nephropathy,diabetic foot,lower extremity vascular diseases,diabetic retinopathy,and diabetic neuropathy were estimated among all identified patients with T2DM.The costs per hospitalization and per outpatient visit under the primary diagnoses of each chronic complication were further estimated.Results There were 61 139 patients with T2DM,with mean age of(62.1 ± 13.6) years,50.5% being males.66.8% of them had chronic complications,and patient suffered from more than 2 complications on average.The most common complication was nephropathy (30.5%),followed by diabetic neuropathy (26.8%),diabetic retinopathy (26.3%),cardiovascular disease (24.9%),and cerebrovascular disease (19.2%).The cost per hospitalization was highest for cardiovascular disease(21 176 yuan),followed by diabetic foot disease(18 999 yuan) and cerebrovascular disease (16 583 yuan).The cost per outpatients visit varied from 826 to 976 yuan across different complications except for lower extremity vascular diseases (522 yuan).Conclusions The majority of patients with T2DM suffered from chronic complications.The occurrence and development of chronic complications,especially cardiovascular diseases,cerebrovascular diseases,and nephropathy,led to increased direct medical costs among patients with T2DM.Effective interventions,such as regular physical examinations and proper glycemic control,should be implemented to prevent complications among the diabetic patients.
6.Expression and clinical significance of plasma methylated SEPT 9 gene in patients with primary liver cancer
Na HE ; Gong FENG ; Fenna ZHANG ; Shuai HAO ; Rong LI ; Ziqi ZHAO ; Yawen TIAN ; Honglin YAN
Chinese Journal of Hepatology 2023;31(3):265-270
Objective:To investigate the expression and clinical significance of plasma methylated SEPT9 (mSEPT9) gene in patients with primary liver cancer.Methods:393 cases who visited our hospital from May 2016 to October 2018 were selected. Among them, 75 cases were in the primary liver cancer (PLC) group, 50 cases were in the liver cirrhosis (LC) group, and 268 cases were in the healthy control group (HC). The three groups' positive rates of mSEPT9 expression in the peripheral plasma were detected by the polymerase chain reaction (PCR) fluorescent probe method. The correlational clinical features of liver cancer were analyzed. At the same time, the electrochemiluminescence detection method was used to compare the AFP positive rate. Statistical analysis was conducted using chi-square tests or continuity-corrected chi-square tests.Results:367 cases actually had valid samples. There were 64, 42, and 64 cases in the liver cancer group, cirrhosis group, and healthy control group, respectively. Among them, 34 cases of liver cancer were verified from pathological tissues. The positive rate of plasma mSEPT9 was significantly higher in the liver cancer group than that in the liver cirrhosis and healthy control groups [76.6% (49/64), 35.7% (15/42), and 3.8% (10/261), respectively], and the differences were statistically significant ( χ2 = 176.017, P < 0.001). The sensitivity of plasma mSEPT9 detection (76.6%) was significantly better in liver cancer (76.6%) than that of AFP patients (54.7%), and the difference was statistically significant ( χ2 = 6.788, P < 0.01). Compared with the single detection, the sensitivity and specificity of plasma mSEPT9 combined with AFP were significantly improved (89.7% vs. 96.3%, respectively). Patients with liver cancer aged≥50 years, with clinical stage II or above, and those with pathological signs of moderate to low differentiation had higher levels of plasma mSEPT9 positive expression, and the differences were statistically significant ( χ2 = 6.41, 9.279, 6.332, P < 0.05). During the follow-up period, the survival time of liver cancer patients with positive plasma mSEPT9 expression was significantly shorter than that of those with negative expression (310 ± 26 days vs. 487 ± 59 days, respectively), with statistically significant differences (Log Rank P = 0.039). Conclusion:In China, the positive rate of plasma mSEPT9 detection in liver cancer patients is higher than that of AFP in relation to age, clinical stage, and degree of tissue differentiation; additionally, it has certain survival predictive values. As a result, detecting this gene has important clinical significance and potential clinical application value in the non-invasive diagnosis and prognosis assessment of patients with primary liver cancer.
7.Research progress on brain structure and function in patients with major depressive disorder after modified electroconvulsive therapy
Yiyi YANG ; Yawen HONG ; Yongguang HE ; Jijun WANG ; Tianhong ZHANG
Chinese Journal of Nervous and Mental Diseases 2024;50(8):503-507
Modified electroconvulsive therapy(MECT)has a good therapeutic effect on major depressive disorder(MDD),but its mechanism of action is still unclear.In recent years,accumulated studies have confirmed the effects of MECT on brain structure and function using neuroimaging techniques and large datasets obtained through global collaborations and the conclusions are becoming increasingly consistent.For example,there is an increase in gray matter volume in specific brain regions such as the hippocampus and amygdala,an increase in white matter microstructural integrity and normalization of brain functional connections associated with MDD,such as the hippocampus-amygdala-subgenual anterior cingulate cortex-prefrontal cortex network,hippocampus-thalamus-temporal cortex-parietal cortex network,etc.However,the relationship between these changes and the mechanism of MECT action still needs further investigation.This review provides an overview of the research progress on the structural and functional changes of the brain by MECT to provide methodological support and theoretical basis for its better application in clinical diagnosis and treatment.
8.Comparison of the efficacy of different surgical strategies in the treatment of patients with initially resectable gastric cancer liver metastases
Li LI ; Yunhe GAO ; Lu ZANG ; Kan XUE ; Bin KE ; Liang SHANG ; Zhaoqing TANG ; Jiang YU ; Yanrui LIANG ; Zirui HE ; Hualong ZHENG ; Hua HUANG ; Jianping XIONG ; Zhongyuan HE ; Jiyang LI ; Tingting LU ; Qiying SONG ; Shihe LIU ; Yawen CHEN ; Yun TANG ; Han LIANG ; Zhi QIAO ; Lin CHEN
Chinese Journal of Surgery 2024;62(5):370-378
Objective:To examine the impact of varied surgical treatment strategies on the prognosis of patients with initial resectable gastric cancer liver metastases (IR-GCLM).Methods:This is a retrospective cohort study. Employing a retrospective cohort design, the study selected clinicopathological data from the national multi-center retrospective cohort study database, focusing on 282 patients with IR-GCLM who underwent surgical intervention between January 2010 and December 2019. There were 231 males and 51 males, aging ( M(IQR)) 61 (14) years (range: 27 to 80 years). These patients were stratified into radical and palliative treatment groups based on treatment decisions. Survival curves were generated using the Kaplan-Meier method and distinctions in survival rates were assessed using the Log-rank test. The Cox risk regression model evaluated HR for various factors, controlling for confounders through multivariate analysis to comprehensively evaluate the influence of surgery on the prognosis of IR-GCLM patients. A restricted cubic spline Cox proportional hazard model assessed and delineated intricate associations between measured variables and prognosis. At the same time, the X-tile served as an auxiliary tool to identify critical thresholds in the survival analysis for IR-GCLM patients. Subgroup analysis was then conducted to identify potential beneficiary populations in different surgical treatments. Results:(1) The radical group comprised 118 patients, all undergoing R0 resection or local physical therapy of primary and metastatic lesions. The palliative group comprised 164 patients, with 52 cases undergoing palliative resections for gastric primary tumors and liver metastases, 56 cases undergoing radical resections for gastric primary tumors only, 45 cases undergoing palliative resections for gastric primary tumors, and 11 cases receiving palliative treatments for liver metastases. A statistically significant distinction was observed between the groups regarding the site and the number of liver metastases (both P<0.05). (2) The median overall survival (OS) of the 282 patients was 22.7 months (95% CI: 17.8 to 27.6 months), with 1-year and 3-year OS rates were 65.4% and 35.6%, respectively. The 1-year OS rates for patients in the radical surgical group and palliative surgical group were 68.3% and 63.1%, while the corresponding 3-year OS rates were 42.2% and 29.9%, respectively. A comparison of OS between the two groups showed no statistically significant difference ( P=0.254). Further analysis indicated that patients undergoing palliative gastric cancer resection alone had a significantly worse prognosis compared to other surgical options ( HR=1.98, 95% CI: 1.21 to 3.24, P=0.006). (3) The size of the primary gastric tumor significantly influenced the patients′ prognosis ( HR=2.01, 95% CI: 1.45 to 2.79, P<0.01), with HR showing a progressively increasing trend as tumor size increased. (4) Subgroup analysis indicates that radical treatment may be more effective compared to palliative treatment in the following specific cases: well/moderately differentiated tumors ( HR=2.84, 95% CI 1.49 to 5.41, P=0.001), and patients with liver metastases located in the left lobe of the liver ( HR=2.06, 95% CI 1.19 to 3.57, P=0.010). Conclusions:In patients with IR-GCLM, radical surgery did not produce a significant improvement in the overall prognosis compared to palliative surgery. However, within specific patient subgroups (well/moderately differentiated tumors, and patients with liver metastases located in the left lobe of the liver), radical treatment can significantly improve prognosis compared to palliative approaches.
9.Comparison of the efficacy of different surgical strategies in the treatment of patients with initially resectable gastric cancer liver metastases
Li LI ; Yunhe GAO ; Lu ZANG ; Kan XUE ; Bin KE ; Liang SHANG ; Zhaoqing TANG ; Jiang YU ; Yanrui LIANG ; Zirui HE ; Hualong ZHENG ; Hua HUANG ; Jianping XIONG ; Zhongyuan HE ; Jiyang LI ; Tingting LU ; Qiying SONG ; Shihe LIU ; Yawen CHEN ; Yun TANG ; Han LIANG ; Zhi QIAO ; Lin CHEN
Chinese Journal of Surgery 2024;62(5):370-378
Objective:To examine the impact of varied surgical treatment strategies on the prognosis of patients with initial resectable gastric cancer liver metastases (IR-GCLM).Methods:This is a retrospective cohort study. Employing a retrospective cohort design, the study selected clinicopathological data from the national multi-center retrospective cohort study database, focusing on 282 patients with IR-GCLM who underwent surgical intervention between January 2010 and December 2019. There were 231 males and 51 males, aging ( M(IQR)) 61 (14) years (range: 27 to 80 years). These patients were stratified into radical and palliative treatment groups based on treatment decisions. Survival curves were generated using the Kaplan-Meier method and distinctions in survival rates were assessed using the Log-rank test. The Cox risk regression model evaluated HR for various factors, controlling for confounders through multivariate analysis to comprehensively evaluate the influence of surgery on the prognosis of IR-GCLM patients. A restricted cubic spline Cox proportional hazard model assessed and delineated intricate associations between measured variables and prognosis. At the same time, the X-tile served as an auxiliary tool to identify critical thresholds in the survival analysis for IR-GCLM patients. Subgroup analysis was then conducted to identify potential beneficiary populations in different surgical treatments. Results:(1) The radical group comprised 118 patients, all undergoing R0 resection or local physical therapy of primary and metastatic lesions. The palliative group comprised 164 patients, with 52 cases undergoing palliative resections for gastric primary tumors and liver metastases, 56 cases undergoing radical resections for gastric primary tumors only, 45 cases undergoing palliative resections for gastric primary tumors, and 11 cases receiving palliative treatments for liver metastases. A statistically significant distinction was observed between the groups regarding the site and the number of liver metastases (both P<0.05). (2) The median overall survival (OS) of the 282 patients was 22.7 months (95% CI: 17.8 to 27.6 months), with 1-year and 3-year OS rates were 65.4% and 35.6%, respectively. The 1-year OS rates for patients in the radical surgical group and palliative surgical group were 68.3% and 63.1%, while the corresponding 3-year OS rates were 42.2% and 29.9%, respectively. A comparison of OS between the two groups showed no statistically significant difference ( P=0.254). Further analysis indicated that patients undergoing palliative gastric cancer resection alone had a significantly worse prognosis compared to other surgical options ( HR=1.98, 95% CI: 1.21 to 3.24, P=0.006). (3) The size of the primary gastric tumor significantly influenced the patients′ prognosis ( HR=2.01, 95% CI: 1.45 to 2.79, P<0.01), with HR showing a progressively increasing trend as tumor size increased. (4) Subgroup analysis indicates that radical treatment may be more effective compared to palliative treatment in the following specific cases: well/moderately differentiated tumors ( HR=2.84, 95% CI 1.49 to 5.41, P=0.001), and patients with liver metastases located in the left lobe of the liver ( HR=2.06, 95% CI 1.19 to 3.57, P=0.010). Conclusions:In patients with IR-GCLM, radical surgery did not produce a significant improvement in the overall prognosis compared to palliative surgery. However, within specific patient subgroups (well/moderately differentiated tumors, and patients with liver metastases located in the left lobe of the liver), radical treatment can significantly improve prognosis compared to palliative approaches.
10.Role of oxidative stress in acute liver injury
Yue LIAO ; Yihuai HE ; Yawen LUO
Journal of Clinical Hepatology 2022;38(10):2402-2407
Acute liver injury (ALI) is often caused by virus infection, alcohol, drugs, toxin, and metabolic disorder, and oxidative stress is a common pathophysiological mechanism in the development and progression of ALI and other liver diseases. Hepatocyte function is impaired after ALI, which further causes oxidative stress, and persistent or high-intensive oxidative stress may increase the risk of hepatocyte death and thus result in a series of liver diseases. Oxidative stress is mainly associated with the signaling pathways including nuclear factor erythroid 2-related factor 2 and nuclear factor-kappa B. Therefore, it is of great importance to understand the mechanism of oxidative stress in the development and progression of liver injury and related pathways. This article introduces oxidative system and antioxidative system, oxidative stress and damage factors, and oxidative stress and pathways associated with liver injury, so as to provide a reference for the selection of therapeutic targets for ALI and related clinical research.