1.Quality of marriage and sexual function of cervical cancer patients following radical hysterectomy and vaginal extension
Journal of Chinese Physician 2015;17(6):834-837
Objective To investigate the quality of marriage and sexual function of cervical cancer patients following radical hysterectomy and vaginal extension.Methods Case-control and questionnairebased methods were used in this study.Forty patients of early-stage (Ⅰ b 1 ~ Ⅰ b2) cervical cancer who had undergone vaginal extension following classic radical hysterectomy were included in the observation group,while 40 patients with matching factors and radical hysterectomy only during the same period were included in the control group.The quality of marriage and sexual function were compared with OLSON marriage prolapse and incontinence sexual function questionnaire Shon Fonn (PISQ-12).Results The operation time and postoperative vaginal length in the observation group were higher than those in the control group (P < 0.05 or P < 0.01).The emotional,physical,and total scores during postoperation were lower than those during preoperation (P < 0.01).The emotional,physical,and total scores in the control group were lower than those in the observation group (P < 0.01).The marital satisfaction,husband and wife communication,conflict resolution methods,extracurricular activities and sex scores in the observation group were higher than those in the control group (P < 0.05 or P < 0.01).Conclusions Patients with peritoneovaginoplasty following radical hysterectomy had much longer vagina and less self-perceived short vagina.Vaginal extension following radical hysterectomy does not worsen the pelvic floor symptoms.
2.Comparison of ultrasonic cardiac output monitor and pulse indicated continuous cardiac output monitor on determination of hemodynamic parameters in critical patients
Liu ZHANG ; Fengxue ZHU ; Youzhong AN
Chinese Critical Care Medicine 2016;28(9):796-800
Objective To evaluate the difference and correlation between ultrasonic cardiac output monitor (USCOM) and pulse indicated continuous cardiac output (PiCCO) monitor on determination of hemodynamic parameters in critical patients.Methods A prospective observation self-control study was conducted.The critical patients who need hemodynamics monitoring,and admitted to Department of Critical Care Medicine of Peking University People's Hospital from March 2013 to December 2015 were enrolled.Cardiac output (CO),cardiac index (CI),stroke volume (SV),and stroke index (SI) were determined by PiCCO using thermodilution method at immediately (0 hour) and 24 hours after successful location of PiCCO catheter for 3 times then the above indexes were measured with USCOM,and the average values were chosen for statistical analysis.The differences in above parameters between the two methods,and the correlation of the parameters monitored by two methods were evaluated by Pearson linear correlation method,the consistency test was conducted by Bland-Altman method.Results In 31 critical patients enrolled,there were 18 males and 13 females,aging 29-89 years old with the mean of (48.1 ± 36.3) years,body mass of (68.7 ± 17.5) kg,and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score of 21.2 ± 3.1.CO,CI,SV,and SI detected by USCOM were significantly higher than those detected by PiCCO [CO (L/min):6.32 ± 1.98 vs.5.86 ± 1.72,t =4.887,P =0.000;CI (mL· s-1· m-2):61.68 ± 20.17 vs.56.84± 17.34,t =5.189,P =0.000;SV (mL):61.9 ± 19.7 vs.57.0± 16.9,t =3.977,P =0.000;SI (mL/m2):36.84 ± 12.67 vs.33.33 ± 10.79,t =4.278,P =0.000].It was shown by correlation analysis that CO,CI,SV,and SI monitored by USCOM and PiCCO was positively correlated (R2 value was 0.795,0.798,0.837,and 0.827,respectively,all P =0.000).It was shown by Bland-Altman analysis that the mean CO change (ΔCO) from 0 hour to 24 hours was 0.1 L/min,and the 95% confidence interval was-0.62 to 0.80.Conclusion There was significant difference in the comparison of hemodynamics parameters monitored by USCOM and PiCCO respectively in critical patients,the overall values monitored by USCOM were higher than those monitored by PiCCO monitoring,but the correlations were good.
3.Effects of photodynamic therapy with 5-aminolevulinic acid on human ovarian carcinoma 3AO cells in vitro
Hui JIAO ; Haiyan WANG ; Youzhong ZHANG
Journal of Xi'an Jiaotong University(Medical Sciences) 1982;0(04):-
Objective To study the effects of 5-aminolevulinic acid (5-ALA) mediated photodynamic therapy (PDT) on human ovarian carcinoma 3AO cells in vitro. Methods Morphological changes were examined by microscopy; the inhibitory effects of 5-aminolevulinic acid mediated photodynamic(5-ALA-PDT) on 3AO cells were examined by MTT assay; cell cycle of 3AO cells was observed by flow cytometry with PI staining; the modality of 3AO cell death induced by 5-ALA-PDT was determined by flow cytometry with Annexin V-PI staining. Results Typical morphological changes of apoptosis occurred after 5-ALA-PDT. The inhibition rate of cells increased gradually with the increase of 5-ALA concentration and laser irradiation dose (P
4.Clinical analysis of 498 papillary thyroid carcinoma cases at cNo stage
Dong WANG ; Cui ZHAO ; Youzhong LIU ; Mei ZHANG ; Wenchuan ZHAO
Chinese Journal of General Surgery 2012;27(1):17-20
Objective To explore the relationship between the status of the cervical lymphatic metastasis of papillary thyroid carcinoma(PTC)at cNo stage and tumor recurrence and the patient' s prognosis.Methods The clinical data of 498 cNo PTC patients admitted from 1986 to 1990 were retrospectively analyzed.Results All the patients were followed up for more than 10 years.16 patients died of PTC,among them 3 for metastasis,13 for local recurrence.The total cervical lymphatic metastasis rate in these 498 patients was 52.2%,in 260 cases in which detailed data were available: rate was 14.1% in zone Ⅱ,27.1% in zone Ⅲ,24.6% in zone Ⅳ,12.5% in zone Ⅴ,and 20.1% in zone Ⅵ respectively.According to the appearances of microscopic pathology,the cervical lymphatic metastasis rates in 498 cases of cNo PTC were collected as following: uncapsuled group was 65.6%,extracapsular group was 64.5%,extralobal group was 56.5%,involved the surrounding tissue and structure group was 52.0%,focal cancerous focus group was 33.3%,latent sclerosis group was 26.9%,encapsuled and introcapsule group was 0.The cervical recurrence rate was only 2% in the complete function neck dissection group and 9.9% in the selective center neck dissection group.Conclusions In cNo PTC the most common cause of death was local recurrence.Prophylactic function complete neck dissection should be performed for cNo PTC cases of highly invasive type such as without tumor capsule,extracapsular,extralobal or surrounding tissue invasion.
5.Expression and significance of chemokine CXC receptor 3, 4 and their ligands at the early pregnancy decidua and villi
Xiaoxia BAI ; Beihua KONG ; Youzhong ZHANG ; Xun QU ; Huali WANG
Chinese Journal of Obstetrics and Gynecology 2008;43(12):904-908
Objective To explore the expression and significance of chemokine CXC reeeptor (CXCR)3 and CXCR4 and their ligands(CXCL)at the early pregnancy decidua and villi.Methods Decidual mononuclear cells were isolated from the normal decidua of 5-8 weeks pregnant women by lymphocyte separation medium in vitro.CD56+natural killer(NK)cells were purified by dynabeads cell sorter kiL Purity and phenotype of CD56+decidua NK cells were analyzed by fluorescence-activated eell sorter (FACS).Gene expression of CXCR3 and CXCR4 in decidua NK cells and CXCL9,CXCL10 and CXCL12 in early pregnancy decidua and villi was assessed bv RT.PCIZ Protein expression of CXCL9,CXCL10 in normal endometrium and early pregnancy decidua was characterized and quantified by streptavidin-biotin pemxidase chain reaction(SP)immunohistochemistry and computered image analysis system.Correlations between the gray degree of CXCL9 and CXCL10 and the number of CD56+NK cells in upper tissue were analyzed by Spearman's correlation ceefficient rank tesL Results The phenotype of 98.7%decidua NK cells was CD56bright.The genes of CXCR3 and CXCR4 were expressed in decidua NK cells and that of CXCL9 and CXCL1O were expressed in early pregnancy decidua and CXCLI2 in early pregnancy villi.CXCL9 and CXCL10 were expressed in the cytoplasm of surface epithelia,glandular epithelia and stromal cells of early pregnancy deeidua and were not expressed in villi by immunohistochemistry.The gray degree of CXCL9 and CXCL10 in the secretory phase endometrium(56±43,59±47)was stronger than that in the proliferative phase(16±18,8±14,P<0.05)and reached the highest(143±35,158±29,P<0.05)in the early pregnancy decidua.The number of cD+56 NK cell in the secretory phase endometrium(60±20)was more than that in the proliferative phase endometrium(23±4,P<0.05)and was the most in the early pregnancy decidua(114±15,P<0.05).The gray degree of CXCL9 in upper tissue had a positive correlation with the number of CD+56 cells(r=0.88,P<0.05)and that of CXCL10 had a similar pattern to CXCL9(r=0.86,P<0.05).Condusion The interactions between CXCL9,CXCL10 and CXCL12 expressed in decidua and villi and CXCR3,CXCR4 expressed in CD+56 decidua NK cells may influence the CD+56 NK cell recruitment at the maternal-fetal interface.
6.The protective effect of interleukine-33 on mouse warm hepatic ischemia-reperfusion injury by regulating Th1/Th2 cells
Shu LI ; Fengxue ZHU ; Hui LI ; Hongbin ZHANG ; Youzhong AN
Chinese Journal of General Surgery 2013;(5):382-385
Objective To study the protective effect of interleukin-33 (IL-33) on mouse warm hepatic ischemia-reperfusion (I/R) injury.Methods On a mouse warm hepatic I/R injury model IL-33 mRNA and protein levels during hepatic ischemia and reperfusion period were determined,and then mice were divided into control group,model group,recombinant IL-33 intervention group and anti ST2L antibody intervention group,and mice were sacrificed after 6 hours of reperfusion.Serum aspartate aminotransferase (AST),alanine aminotransferase (ALT) protein levels were determined.Liver pathology was observed by transmission electron microscopy and serum cytokine level (tumor necrosis factor-α,interferon-γ,IL-4,IL-5,IL-13) were measured by flow cytometry CBA method.Results The level of IL-33 mRNA and protein were significantly higher in the reperfusion stage (t2 h =-3.574,t6 h =-4.147 ; P < 0.05).After intervention by recombinant IL-33,the level of serum ALT and AST decreased significantly (tALT =4.592,tAST =3.471 ; P < 0.05),the severity of pathological damage was reduced,the levels of IL-4,IL-5,IL-13 increased and that of IFN-γ decreased,with statistically significant difference in comparison with the control groups (tIL-4 =-4.995,tIL-5 =-4.584,tIL-13 =-4.431 ; P < 0.05).Anti-ST2L antibody intervention effected the opposite.Serum TNF-α level did not change in intervention groups compared with that in model group (tTNF-α =0.261,P > 0.05).Conclusions IL-33 mRNA and protein level increased in mice with hepatic I/P injury.IL-33 exerts a protective effect on the I/R injured liver after binding to its receptor ST2L.
7.Enhancement of photodynamic therapy sensitivity by cisplatin in human cervical carcinoma cell lines
Haiyan WANG ; Youzhong ZHANG ; Kan JIANG ; Hui JIAO ; Zhaojing WANG
Journal of Xi'an Jiaotong University(Medical Sciences) 2004;0(05):-
Objective To investigate the mechanism of small-dose cisplatin in enhancing photodynamic therapy sensitivity and apoptosis in human cervical carcinoma cell lines.Methods The Hela and Siha cells were divided into four groups(blank control group,photodynamic therapy only,cisplatin only,photodynamic therapy and cisplatin).The effects on proliferation of Hela and Siha cells in the four groups were examined by MTT assay.The expression of P185c-erbB-2 in Hela and Siha cells affected was detected by immunocytochemistry.Results The degree of apoptosis caused by the joint application of cisplatin and photodynamic therapy was greater than that caused by cisplatin or photodynamic therapy alone.The expression of P185c-erbB-2 in cells declined correspondingly.However,the order of cisplatin and photodynamic therapy did not cause obvious differences in the effect.Conclusion The in vitro proliferation of Hela and Siha cells is restrained obviously by cisplatin combined with photodynamic therapy;the effect is greater than that of cisplatin or photodynamic therapy only.The mechanism of cispatin's enhancement of photodynamic therapy sensitivity may be related to inhibiting P185c-erbB-2 expression.
8.Risk factors of major adverse cardiac events of critical care patients after non cardiac surgery
Xiujuan ZHAO ; Fengxue ZHU ; Shu LI ; Hongbin ZHANG ; Liu ZHANG ; Kun WU ; Youzhong AN
Chinese Journal of General Surgery 2015;30(11):875-878
Objective To investigate the incidence and the risk factors of major adverse cardiac events of critical care patients after noncardiac surgery.To study the incidence of myocardial injury after noncardiac surgery (MINS).Methods A retrospective analysis of critical care patients (n =1 087) after noncardiac surgery from January 2012 to January 2013 in our hospital was carried out.The clinical data of the medical history, intraoperative conditions, postoperative conditions and cardiac troponin Ⅰ (cTNI) were collected.Major adverse cardiac events included unstable angina, non fatal myocardial infarction, severe arrhythmia, heart failure and cardiovascular death.Risk factors of major adverse cardiac events of critical care patients after noncardiac surgery were analyzed using Logistic regression.Results The 30 d non cardiac surgery incidence of major adverse cardiac events was (94/1 087) 8.6%, the incidence of MINS was (168/1 087) 15.5%, Logistic regression analysis showed that the risk factors of major adverse cardiac events after non cardiac surgery were age (OR 1.03,95% CI 1.01-1.05, P =0.002), a history of chronic renal insufficiency(OR 3.12,95% CI 1.44-6.74,P =0.004), rise of cTNI 24 h after operation (OR 2.04,95% CI 1.16-3.58,P =0.014) and use of vasopressor drugs within 24 h after operation (OR 2.34,95% CI 1.25-4.38,P =0.008).Conclusions The incidence of major adverse cardiac events and the MINS of critical care patients after noncardiac surgery is high.Old age, history of chronic renal insufficiency, rise of cTNI 24 h after operation and vasopressor drugs within 24 h after operation are the independent risk factors.
9.Immunological mechanism of exfoliative tongue fur in children with asthma
Fufeng LI ; Guogang LI ; Youzhong WU ; Jing LI ; Xiaoying ZHANG ; Huifang WANG ; Yiqin WANG
Journal of Integrative Medicine 2005;3(6):446-9
OBJECTIVE: To explore the immunological mechanism of exfoliative tongue fur in children with asthma. METHODS: Thirty-nine children with asthma, twenty-eight children with repetitive respiratory tract infection (non-asthma) and eleven healthy children were divided into five groups, which were asthma with exfoliative fur or with non-exfoliative fur groups, non-asthma with exfoliative fur or with non-exfoliative fur groups and normal control group. The concentrations of keratin 13 and bcl-2 in cells exfoliated from tongue fur were detected by immunohistochemical method. The expression levels of blood cell chemokine receptor-3 (CCR-3) and CD4(+) were examined by flow cytometry, and the levels of serum cortisol and IgE were detected by radioimmunoassay. RESULTS: The levels of blood CD4(+) and CCR-3 of children with asthma and exfoliative fur were higher than those in the asthma with non-exfoliative fur group and the normal control group (P<0.05). The serum level of cortisol in the groups of asthma with exfoliative fur and non-asthma with exfoliative fur were lower than that in the other groups (P<0.05). The serum levels of IgE in asthma with exfoliative fur or with non-exfoliative fur groups were higher than that in the other groups (P<0.05). Concentrations of keratin 13 in the cells exfoliated from tongue fur in the groups of asthma or non-asthma with exfoliative fur were lower than that of the other groups (P<0.05). There was no significant difference of expression level of bcl-2 in the cells exfoliated from tongue fur among these five groups. CONCLUSION: There is a reasonably close relationship between the formation of exfoliative tongue fur and the immune system such as low level of serum cortisol and high levels of blood CD4(+) and CCR-3, which may all promote the formation of exfoliative fur. The disability of keratinization and apoptosis of epithelial cells of tongue may also be one cause for its formation.
10.Mutilpe goals directed periopertive fluid strategy in patients of retroperitoneal tumors
Liu ZHANG ; Weixin CHENG ; Hongxun YUAN ; Jian SHEN ; Fang LIU ; Fengxue ZHU ; Youzhong AN
Chinese Journal of General Surgery 2016;31(10):824-827
Objective To evaluate perioperative fluid infusion strategies in retroperitoneal tumor patients.Method Data of 89 retroperitoneal tumor patients in Peking University People's Hospital and Peking University International Hospital were collected and devided into intraoperative minor haemorrhage group (761 ml) and massive haemorrhage group (4 813 ml),including postoperative fluid treatment,input and output volume,serum brain natriuretic peptide level and postoperation complications.Results Fluid input on the 1st day after operation,the 2nd day,the 3rd day respectively were (7 565 ±4 757),(3 869 ± 727),(3 289 ± 897),(3 096 ± 567) ml in the minor haemorrhage group,and (13 927 ± 5 612),(5 192 ± 1 274),(3 786 ± 1 137),(3 797 ± 719) ml in the massive haemorrhage group (t =-4.637,-3.117,-2.460,-2.982,P =0.04,0.048,0.36,0.038).BNP level respectively were (33 ±25),(82 ±66),(116 ± 54),(145 ± 75) ng/ml in the minor haemorrhage;respectively,(70 ± 65),(165 ± 153),(256 ± 220),(442 ± 412) ng/ml in the massive haemorrhage group (t =-4.637,-3.117,-2.460,-2.982,P =0.041,0.038,0.046,0.04).The accumulative percentage of negative fluid balance was 100% in 3 days after operation.Acute kidney injury (AKI),cardiac,respiratory events,major intraabdominal complications deep venous thrombosis developed in minor and massive haemorrhage group were 4.7%,7.1%,4.7%,14.3%,9.5% vs.25.1%,27.6%,46.8%,10.6%,17.0% respectively (x2 =2.89,5.89,19.96,0.044,0.674,P=0.049,0.015,0.001,0.834,0.412).Conclusions Multiple goals directed fluid strategy leads to a better outcome by decreasing the AKI rate.BNP level could be used as a goal marker in fluid treatment.