1.Current status of needlescopic surgery in urology
Academic Journal of Second Military Medical University 2000;0(10):-
Needlescope is a laparoscopic equipment with a diameter of only 2 mm. It has been used in treatment of some general surgery and gynecology diseases. In urology .needlescopic techniques have also been applied in some procedures including adrenalectomy and pediatric orchiopexy. Although debates still exist about the definition of needlescopic surgery and the 2-mm instruments have their limitation,needlescopic technology has obvious advantages such as smaller traumas,superior cosmetic result, shorter hospital stay, and abbreviated convalescence. Needlescopic techniques represent a natural evolution of conventional laparoscopy.
2.Clinical significance of high sensitive C-reactive protein and brain natriuretic peptide level in patients with ST-segment elevation myocardial infarction
Chunxing SUI ; Xiaoqun ZHENG ; Xuchen ZHOU
Chinese Journal of Postgraduates of Medicine 2009;32(13):10-12
Objective To observe the levels of plasma high sensitive C-reactive protein (hs-CRP) and brain natriuretic peptide (BNP) in patients with ST-segment elevation myocardial infarction ( STEMI)and analyze their significance. Methods This study enrolled 80 patients who had first acute STEMI. Twenty-five patients were in the primary percutaneons coronary intervention (PCI) group, 27 patients were in the delayed PCI group and 28 patients were in the medical treatment group. The levels of hs-CRP, BNP and creatine kinase MB (CK-MB) were measured after treatment. Left ventricular function and ventricular wall thinning ratio were evaluated by echocardiography. Results The levels of plasma hs-CRP showed dynamic variation with time in all patients. The peak time of hs-CRP was significantly different among the three groups. The peak value of hs-CRP, BNP, wall motion score index ( WMSI ) and the incidence of left ventricular remodeling decreased, but the level of loft ventricular ejection fraction (LVEF) increased in the primary PCI group. Compared with the delayed PCI group and the medical lreatment group, there were significant difference. Correlational analysis showed that there were negative relationship between LVEF and hs-CRP, BNP,WMSI (r = -0.895, -0.940, -0.939,P < 0.01 ) and positive relationship between hs-CRP and BNP, CK-MB (r = 0.935,0.886, P < 0.01 ). Conclusions The associated measure of hs-CRP and BNP could preferably evaluate the inchoate prognosis of STEMI. hs-CRP might be an useful index of successful reperfusion and predict the stability of infarction related lesion.
3.Agreement between colposcopic diagnosis with 2011 international terminology of colposcopy and cervical pathology in cervical lesions
Yanyun LI ; Hongwei ZHANG ; Ruilian ZHENG ; Feng XIE ; Long SUI
Chinese Journal of Obstetrics and Gynecology 2015;(5):361-366
Objective To evaluate the agreement between colposcopic diagnosis with 2011 colposcopic terminology of the International Federation for Cervical Pathology and Colposcopy (IFCPC) and cervical pathology in cervical lesions. Methods A retrospective cohort study was performed, which included 376 patients who underwent colposcopy with 2011 international terminology of colposcopy at Obstetrics and Gynecology Hospital of Fudan University from September 2014 to November 2014. With conization or cervical biopsy pathology as the gold standard, the agreement between colposcopic diagnosis and pathologic diagnosis was calculated and correlations between variables were analyzed. Results With 2011 international terminology of colposcopy, agreement of colposcopic diagnosis and cervical pathology was 60.9%(229/376)perfectly matched, and the strength of agreement with weighted Kappa statistic was 0.401 (P<0.01), and agreement within one grade was 97.6%(367/376), which were improved compared with traditional methods. Colposcopic diagnosis were 19.9%(75/376) overestimated and 19.1%(72/376) underestimated. There were no significant difference between agreements in various grade lesions (χ2=1.996, P=0.573). Positive predictive value of high grade colposcopy or more was 84.4%, the negative predictive value of low grade colposcopy or less was 88.8%, whereas false positives were 3.5%and false negatives were 39.3%. A linear trend among three types of transformation zone and patient ages was found (χ2=45.910, P<0.01), whereas lesion sizes were not linearly correlated with lesion degrees (χ2=0.690, P=0.406). In grade 1, grade 2 and nonspecific findings, thin acetowhite epithelium, dense acetowhite epithelium and Lugol′s non-staining were most frequent, the Youden indexes of each were 0.170, 0.373 and 0.145, 0.069 respectively. Positive predictive value of some other findings (such as fine mosaic) and two new signs (inner border sign and ridge sign) were 100.0%. There were no significant difference between agreements in examiners with different levels of experience (χ2=1.197,P=0.550). Conclusions Compared to traditional methods (such as Reid index), 2011 international terminology of colposcopy could improve the agreement between colposcopic diagnosis and pathologic diagnosis, without significant differences by the severity of lesion and the level of examiners′experience. Common findings were classified reasonably, and some signs were highly reliable, which is important for guiding biopsy. However, the reproducibility of transformation zone types and the implication of lesion size need to be further discussed.
4.Feature of clinic and imageology in patients with unstable angina pectoris after radiation therapy to chest
Chunxing SUI ; Wenmin LIU ; Xuchen ZHOU ; Xiaoqun ZHENG
Chinese Journal of Postgraduates of Medicine 2009;32(31):26-28
Objective To observe feature of clinic and imageology in patients with unstable angina pectoris after radiation therapy to chest. Methods The study enrolled 58 patients who had unstable angina pectoris. Twenty-eight patients were in the postradiation therapy to chest group, 30 patients were in the common unstable angina pectoris group. All patients underwent multislice spiral CT(MSCT) examination and coronary angiography (CAG). After one year follow-up, the levels of brain natriuretic peptide (BNP) and ventricular wall motion score index (WMSI) were measured , the incidence of cardiovascular events were observed in all patients. Results Calcific, multi-vessel, thrombotic disease and dissection were significantly different between the two groups, when one year follow-up , the levels of BNP were higher in the postradiation therapy to chest group than those in the common unstable angina pectoris group [ (234.31 ± 121.39) ng/L vs (124.74 ±37.81) ng/L] WMST, incidence of the first heart failure, angina pectoris recurrence and revascularization were significantly different too (P< 0.05 ). Conclusions The complex lesions are major in the postradiation therapy to chest. Moreover, because radiation injures the heart valves and myocardium,these patients' long-term prognosis are worst.
5.A study of serum interleukin 6 and interleukin 18 in acute coronary syndrom patients with type D personality
Shue NING ; Peng QU ; Gang WEI ; Meili ZHENG ; Zheng SUI ; Dafei ZONG ; Xing ZHANG
Chinese Journal of Behavioral Medicine and Brain Science 2011;20(2):122-124
Objective To explore what kind of role serum interleukin 6 (IL-6) and interleukin 18 ( IL-18) play in the relationship between type D personality and acute coronary syndrom (ACS)prognosis.Methods Serum levels of IL-6,IL-18 in all 214 ACS patients were measured with ELISA.According to the scores of type D personality scale(DS14) ,the subjects were divided into the group with type D personality (50 cases)and the one without type D personality ( 164 cases).The serum IL-6 and IL-18 level between the two groups were detected and analyzed.Results There were 23.36% ACS patients with type D personality.The serum IL-6, IL-18levels of the group with type D in ACS acute stage and ACS recovery stage were (2.340 ± 0.081 )OD, (2.016 ±0.023 ) OD and ( 1.460 ± 0.070 ) OD, ( 1.313 ± 0.012 ) OD respectively, significantly higher than those of the group without type D (2.178 ± 0.180)OD, ( 1.849 ± 0.159)OD and ( 1.387 ± 0.091 )OD, ( 1.196 ± 0.132 ) OD respectively(P<0.01).Conclusion At home and abroad ,there are similar amount of ACS patients with type D personality.The high serum IL-6 and IL-18 levels may play an important role in pathogenesis of relationship between type D personality and ACS poor prognosis.
6.The Clinical Application of SpO_2-Allen's Test in Radial Artery Cannulation for Invasive Blood Monitor
Genshen ZHEN ; Wenxiong LI ; Xiaowen WANG ; Song ZHAO ; Guichen ZHANG ; Yue ZHENG ; Yang SONG ; Feng SUI ;
Journal of Medical Research 2006;0(11):-
Objective To observe the safety and efficiency of SpO_2 -Allen's test in peri -puncture radial artery cannulation for invasive blood monitor. Methods 50 patients were selected for the radial artery cannulation in surgical intensive care unit(SICU). All of them were still sober. All of the patients were examined by SpO_2 -Allen's test and Allen's test before radial artery cannulation, 3 days after puncture and after pulling out the cannula. Resluts The results of Allen's test of 42 patients were negative,while those of 49 patients were negative in SpO_2 - Allen's test. Statistics difference existed between group of SpO_2 - Allen's text and group of Allen's text(P
7.Effects of Zibu Piyin Recipe on Protein Expression of PDHE1α in Peripheral Tissues and Brain of Rats with Spleen Yin Deficiency Diabetes
Lina LIANG ; Wei MA ; Libin ZHAN ; Shouyu HU ; Luping ZHENG ; Hua SUI ; Hong XIANG
Chinese Journal of Information on Traditional Chinese Medicine 2014;(11):52-55
Objective To explore the mechanism of Zibu Piyin Recipe (ZBPYR) on spleen yin deficiency diabetes-associated cognitive disorder (DACD). Methods The rats were randomly divided into control group, diabetes mellitus (DM) group, spleen yin deficiency group, spleen yin deficiency DM group and spleen yin deficiency DM+ZBPYR group (treatment group). Type 2 DM models were established by high-fat food feeding and low dose STZ intraperitoneal injection for 4 weeks. Then the classical compound method was used to construct spleen yin deficiency rat models by improper diet, over exertion and yin fluids exhaustion. The treatment group was given ZBPYR by gavage for 15 days, and the other groups were given the same amount of normal saline. Then cerebral cortex, hippocampus, stomach and liver were obtained and the changes of protein expression of PDHE1α in them were observed by Western Blot. Results The protein expression of PDHE1αin cortex of DM group and spleen yin deficiency DM group were lower than control group (P<0.05). PDHE1α expression of treatment group in cortex and stomach increased more significantly than spleen yin deficiency DM group (P<0.05). The expression of PDHE1α protein showed no significant difference among all groups in hippocampus and liver. Conclusion ZBPYR improved spleen yin deficiency DACD by regulating PDHE1αin cortex and stomach.
8.Renal protective effect and its related mechanisms of targeted abdominal perfusion pressure treatment in intra-abdominal hypertension
Feng SUI ; Wenxiong LI ; Yue ZHENG ; Wei LIU ; Guichen ZHANG ; Xiaowen WANG ; Song ZHAO
International Journal of Surgery 2013;(2):77-81,封3
Objective To evaluate the renal protective effect of targeted abdominal perfusion pressure (APP) treatment in intra-abdominal hypertension (IAH) and further investigate its related mechanisms.Methods Twelve healthy pigs were randomly divided into experimental group and control group,each group had 6 pigs.All animals were collected urine volume each hour,continuously monitored mean arterial pressure (MAP) and renal cortical blood flow after anesthesia.IAH models were established by intraperitoneally injecting carbon dioxide in all animals,the baseline MAP,intra-abdominal pressure (IAP)and APP were obtained before IAH models established.In both groups,IAP was raised gradually from 0 mm Hg to 10 mm Hg,20 mm Hg and 30 mm Hg.In control group,IAP was maintained at 30 mm Hg for 8 hours with-out any other interventions.In experimental group,the animals were intravenously given with norepinephrine in order to get a target level of APP equal to its baseline values after 15 minutes of the onset of 30 mm Hg IAP.Changes of renal cortical blood flow,serum creatinine,TNF-α,IL-6 and urine IL-18 with the alteration of IAP in both groups were explored.Animals were then sacrificed for renal histopathology after 8 hours of the onset of 30 mm Hg IAP.Results With the increase of IAP,renal cortical blood flow in both groups was significantly decreased (P < 0.01).Compared to its baseline,serum Cr and urinary IL-18 were significantly up-regulated after the maintenance of IAP at 30 mm Hg for 6 hours in both groups (P < 0.05).However,in experimental group,which utilized a strategy of targeted APP,significant improvement of the renal cortical blood flow was observed (P < 0.01),and urinary IL-18 was significantly lower than the control group (P < 0.05).Renal histopathological examination found no obvious abnormalities either in control group or in experimental group.Conclusions The targeted APP treatment may have some renal protective function within the first 8 hours of IAH by improving renal cortical blood flow rather than affecting systemic inflammatory response.
9.Factors Affecting Embryogenic Callus Production and Plant Regeneration in Anther Culture of Bupleurum chinense
Chengmin YANG ; Yukai ZHAO ; Jianhe WEI ; Lizi ZHAO ; Chun SUI ; Zheng ZHANG ; Luying CUI
Chinese Herbal Medicines 2011;03(3):214-220
Objective To evaluate the influences of the genotypes,anther developmental stages,and cultural conditions on the efficiency of embryogenic callus induction and plant regeneration in the anthers culture of Bupleurum chinense.Methods The different effects such as four genotypes,plant growth regulators,and temperature condition were compared in the experiments.The histological study was performed with the process of the anther culture.Results The highest inducing rate of embryogenic calli were achieved for the genotypes Zhongcaiyihao(ZCYH),Z4,and Z5 at the early-to middle-uninucleate stages,except for genotype ZPM1 at the tetrad stage.Cold pretreatment increased the production of the embryogenic callus,in which 4-day cold pretreatment improved the production of embryogenic callus from 0% to 2.2% and 5.0% for genotypes ZPM1 and ZCYH,respectively.No embryogenic callus was induced in the medium containing less than 0.75 mg/L 2,4-dichlorophenoxyacetic acid(2,4-D).The highest regeneration rate (34.6%)was obtained in 1/2 MS salts regeneration medium supplemented with 0.1 mg/L 6-benzylmaminopurine (BA).The low concentration of BA was able to promote the embryogenic callus formation and subsequent plantlet regeneration via somatic embryogenesis.Chromosome counting of regenerated plantlets showed mostly diploid plant (2n = 12)with only one haploid plant(n = 6).Because of the low rate of microspore embryo formation,we only tracked the process of embryogenesis from the connective tissue,instead of microspore by histological observations.Conclusion This study establishes an efficient system for embryogenic callus induction and plant regeneration system.This is the first report on the haploid plantlet through the anther culture orB.chinense.
10.Diagnosis and treatment value of colposcopy and loop electrosurgical excision procedure in microinvasive cervical cancer:analysis of 135 cases
Fengyi XIAO ; Qing WANG ; Ruilian ZHENG ; Min CHEN ; Tingting SU ; Long SUI
Chinese Journal of Obstetrics and Gynecology 2016;51(3):186-191
Objective To explore the sensitivity and specificity of colposcopy directed biopsy (CDB) and the value of loop electrosurgical excision procedure (LEEP) for the diagnosis and treatment of microinvasive cervical cancer (MCC). Methods One hundred and thirty five patients with MCC were diagnosed with LEEP in Obstetrics and Gynecology Hospital, Fudan University from April 2008 to November 2010, and were retrospectively analyzed on CDB diagnoses and following treatment after LEEP. According to patient′s desire for preservation of fertility and cone margin status, following strategies after LEEP included follow-up, second LEEP, hysterectomy, modified radical hysterectomy and radical hysterectomy. Single and multiple factors related to residual lesions after LEEP were analysed with Pearson Chi-square test and logistic regression model, respectively. Results CDB diagnosed MCC with a sensitivity of 4.4%(6/135), specificity of 100.0%(4 680/4 680), and false negative rate of 95.6%(129/135). Among the 135 patients, 29 did not receive further treatment in our hospital and lost contact. One hundred and six patients had secondary treatment or follow-up in our hospital, 4 of among which were closely followed up;one hundred and two received further treatment, which included 6 cases with second LEEP (3 received extrafascial hysterectomy after repeat LEEP), 59 cases hysterectomy, 14 cases modified radical hysterectomy and 26 cases radical hysterectomy. For factors related to residual lesions after LEEP, single factor analysis showed that the ratio of residual lesion in patients aged 27-39, 40-49 and 50-65 years were respectively 19.0%(11/58), 15.4%(10/65) and 5/12 (χ2=4.505, P=0.105). Residual lesions occurred in 24.7%(23/93) of patients with positive LEEP margins, which was more than that 7.1%(3/42) of patients with negative LEEP margins (χ2=5.756, P=0.016). The ratio of residual lesions in patients with positive endocervical, ectocervical and deep stromal margins were respectively 29.6%(8/27), 17.1%(7/41)and 30.6%(11/36;χ2=2.275, P=0.321). Residual lesions in patients with or without lymph vascular space invasion (LVSI) were 2/7 and 18.8%(24/128), respectively (χ2=0.412, P=0.521). The ratio of residual lesions in patients with invasion depth of<1 mm was 17.1%(7/41), 1-<3 mm was 19.0%(16/84), and 3-5 mm was 3/10, with no significant difference among three groups (χ2=0.870, P=0.647). Logistic regression analysis showed positive cone margin (OR=5.069, P=0.014) and age (OR=1.080, P=0.024) were the independent risk factors of residual lesions after LEEP conization. Conclusions CDB alone is not adequate for the diagnosis of MCC. For young patients who desire to preserve fertility with a negative cone margin, close follow-up is acceptable. Cone margin status and age are two independent risk factors for residual lesions after LEEP.