1.Drug-coated balloon versus uncoated balloon angioplasty for femoropopliteal artery ischemic disease:a meta-analysis of curative effect and safety
Yili XIANG ; Wenkai ZHANG ; Yong YANG
Journal of Interventional Radiology 2017;26(6):500-507
Objective To conduct a meta-analysis of the curative effect and safety of the drug-coated balloon (DCB) and uncoated balloon (UCB) in treating femoropopliteal artery ischemic disease in order to provide more credible conclusion to guide clinical practice.Methods By retrieving relevant documents contained in Medline,EMbase,Cochrane library,EBSCO,Springer Link,Scopus,Web and other data pools,the research articles of clinical trials that met the inclusion and exclusion criteria were collected.According to the risk assessment standard of Cochrane collaboration network,the academic qualities of included articles were evaluated,the relevant data were extracted,then,the meta-analysis was conducted with RevMan5.3 software.Results A total of 8 papers were collected,which were originated from 6 clinical trials (from 2008 to 2015) and included 1188 patients in total.DCB group had 722 patients,and UCB group had 466 patients.Meta analysis showed that the target lesion revascularization (TLR) rates at 6,12 and 24 months after angioplasty in DCB group were significantly lower than those in UCB group.The late lumen loss (LLL) amount and re-stenosis rate at 6 month after angioplasty in DCB group were lower than those in UCB group.No statistically significant differences in amputation rate and mortality at 6,12 and 24 months after angioplasty existed between the two groups.Conclusion In treating femoropopliteal artery ischemic disease,the use of DCB is superior to the use of UCB in aspects of TLR rate,LLL amount and re-stenosis rate,besides,no significant difference in safety exists between DCB and UCB.Therefore,priority should be given to the use of DCB when the patient's economic conditions permit.
2.Correlation between severity of nausea and vomiting after thoracoscopic pulmonary surgery and quality of postoperative recovery and capacity of mobility
Xiang YAN ; Jia JIANG ; Yili FU ; Changwei WEI
The Journal of Clinical Anesthesiology 2024;40(2):139-143
Objective To assess the correlation between the severity of postoperative nausea and vomiting(PONV)with the quality of postoperative recovery and capacity of mobility in patients after video-assisted thoracoscopic surgery.Methods A total of 125 patients,80 males and 45 females,aged 18-64 years,BMI 18-35 kg/m2,ASA physical status Ⅰ-Ⅲ,undergoing video-assisted thoracoscopic surgery were observed.The severity of PONV was assessed using the simplified PONV impact scale day 1 after sur-gery.The patients were divided into three groups according to the severity of PONV:non-PONV group(n = 87),mild PONV group(n = 31),and moderate to severe PONV group(n = 7).The quality of recovery was assessed using the quality of recovery-15(QoR-15)on the first day after surgery,and the capacity of mobility was assessed using the 6-minute walk test(6-MWT)on the second day after surgery.The multiple linear regression model was used to analyze the correlation between the severity of PONV and quality of post-operative recovery and capacity of mobility.Results The results of the corrected multiple linear regression model showed that,compared with the patients without PONV,the QoR-15 scores of the patients with mild and moderate-severe PONV on the first day after surgery were reduced by 4.5 scores(95%CI-8.9 to-0.04 scores,P = 0.048)and 15.8 scores(95%CI-24.8 to-6.8 scores,P = 0.001),respectively.Mild(MD =-27.4 m,95%CI-70.1 to 15.4 m,P = 0.207)and moderate-severe PONV(MD =-57.0 m,95%CI-145.7 to 31.6 m,P = 0.204)were not significantly associated with 6-MWT distance shortening on the second day after surgery.Conclusion Increased PONV severity is associated with poorer recovery quality in patients undergoing pulmonary surgery.Active prevention and treatment of PONV may contribute to early recovery of patients.
3.Early and late interventional embolization can improve neurological function, mental state and living ability of patients with intracranial aneurysm
Yangkai ZHAO ; Bangxuan ZHU ; Yili XIANG ; Mingliang WU ; Shouyi WANG
Chinese Journal of Primary Medicine and Pharmacy 2022;29(9):1320-1324
Objective:To investigate the application value of early and late interventional embolization in intracranial aneurysms.Methods:Eighty-two patients with intracranial aneurysm who received treatment in Wenzhou People's Hospital from October 2015 to February 2020 were included in this study. These patients were divided into early (≤ 3 days) and late (> 3 days) groups, with 41 patients in each group, according to time from disease onset to surgery. The early group was subjected to early interventional embolization, and the late group was treated with late interventional embolization. The effects of embolization and National Institutes of Health Stroke Scale score pre- and post-treatment, as well as modified Barthel index, Mini-Mental State Exam score, matrix metalloproteinase-9 level, and soluble intercellular adhesion molecule-1 level post-treatment and prognosis were compared between the two groups.Results:The embolization effects in the early group were statistically superior to those in the late group ( P = 0.046). After treatment, National Institutes of Health Stroke Scale score in the early group was significantly lower than that in the late group [(4.02 ± 1.64) points vs. (6.81 ± 2.02) points, t = 6.86, P < 0.01]. Mini-Mental State Exam score and modified Barthel index in the early group were (28.09 ± 1.35) points and (81.12 ± 9.67) points, respectively, which were significantly higher than (26.01 ± 1.19) points and (73.02 ± 8.19) points in the late group ( t = 7.40, 4.09, both P < 0.001). After treatment, matrix metalloproteinase-9 and soluble intercellular adhesion molecule-1 levels in the early group were (420.33 ± 29.40) μg/L and (403.70 ± 23.28) ug/L, respectively, which were significantly lower than (491.30 ± 31.19) μg/mL and (496.37 ± 30.46) μg/L in the late group ( t = 10.60, 15.47, both P < 0.001). Prognosis in the early group was superior to that in the late group ( P = 0.049). Conclusion:Early interventional embolization has better efficacy than late interventional embolization in the treatment of intracranial aneurysm. The former can effectively improve neurological function and mental state, enhance living ability, and improve prognosis, which may be related to the regulation of matrix metalloproteinase-9 and soluble intercellular adhesion molecule-1 levels.
4.Research progress of radiolabeled FAPIs in the tumor targeted diagnosis and therapy
Yili XIANG ; Zhongbao RUAN ; Jun ZHANG ; Li ZHU
Chinese Journal of Nuclear Medicine and Molecular Imaging 2021;41(11):683-688
Cancer-associated fibroblasts (CAFs) are essential parts of tumor stroma. Fibroblast activation protein (FAP), overexpressed in CAFs, is closely related to tumor growth, invasion, metastasis, immunosuppression and prognosis, which is a vital target for tumor targeted diagnosis and therapy. In recent years, a variety of new radiolabeled quinoline-based FAP inhibitors (FAPIs) have been used for tumor targeted diagnostic and therapeutic research. A number of studies have confirmed that radiolabeled FAPIs plays an important role in tumor diagnosis, staging and treatment, which have a good clinical application prospect. This review summarizes the research status of radiolabeled FAPIs and discusses their potential in the accurate diagnosis and therapy of tumors.
5.Evaluation of Anticoagulant Effects of Clinical Pharmacist Management in Anticoagulation Clinic
Shuyue LI ; Xiang HUI ; Yuanxiang JIN ; Juan WANG ; Huan ZHANG ; Baoyan WANG ; Hang XU
China Pharmacy 2020;31(18):2289-2293
OBJECTIVE:To eva luate the anticoagulant effect of clinical pharmacist management in clinic. METHODS :Retro- spective analysis was performed on medical records of 481 patients in anticoagulant clinic of Nanjing Drum Tower Hospital (herein- after referred as “our hospital ”)from Aug. 2019 to Jan. 2020. The general information (gender,age,patient grading )of patients , anticoagulant drug ,anticoagulant causes ,anticoagulant examination [prothrombin time ,international standardized ratio results (INR)],warfarin dose ,NOACs usage and ADR were recorded. RESULTS :Totally 481 patients visited anticoagulant clinic of our hospital for 1 587 times in total. The case number of primary ,secondary and tertiary patients were 401,547 and 639,respectively. 470 patients received warfarin ,and 11 patients received NOACs (including 6 cases of riva roxaban,5 cases of dabigatran etexi - . The valve replacement was the main cause of anticoagu - lation(65.28%),followed by atrial fibrillation (14.97%), valve ring repairment (12.47%). The main detection method NDYG2017012) of prothrombin time was POCT (83.44%). Their average dose of warfarin was (3.03±1.28)mg. The average INR of outpa - tients receiving warfarin was 1.99±0.56,and time within treat - E-mail:xiaochongzi78@sina.com ment range (TTR)was 72.79%. The average INR of the first grade was 2.12±0.84 and the TTR was 44.33%;the average INR of the second grade was 1.95±0.52 and the TTR was 72.34%; the average INR of the third grade was 1.94±0.33 and the TTR was 90.42%. There were 102 cases(6.43%)of small bleeding , and 2 cases(0.13%)of clinical related non major bleeding ;no major bleeding and thromboembolism was observed. CONCLU - SIONS:Clinical pharmacists of anticoagulant clinic in our hospital formulate scientific management and provide individualized con - sultation for patients through implementing hierarchical management of patients. Patients show mild symptoms and low incidence of adverse reactions ;the patients taking warfarin have higher TTR ;clinical pharmacist management has significant anticoagulant effect.