1.The clinical application value of serum high sensitivity C-reactive protein for the acute exacerbation bronchial asthma patients
Xiaoting ZHANG ; Zhenshan WANG ; Chengyan ZHAO
Chinese Journal of Postgraduates of Medicine 2013;(10):7-11
Objective To study the correlation between the level of serum high sensitivity C-reactive protein (hs-CRP) and induced sputum cell counts,pulmonary function and asthma control test (ACT) in order to investigate the clinical application value of serum hs-CRP for the acute exacerbation bronchial asthma patients.Methods Thirty acute exacerbation bronchial asthma patients were collected as asthma group,14 healthy people during the same period were collected as control group.The fasting serum hs-CRP was examined in control group and before and after treatment of 5-7 d in asthma group.The induced sputum was obtained by ultrasonic atomizer 4.5% sodium chloride,and the percentage of eosinophils (EOS%),neutrophil,macrophages,lymphocytes was calculated.The pulmonary function index was determined in control group and before and after treatment in asthma group.ACT score was performed in asthma group.The correlation between the serum hs-CRP and induced sputum differential leukocyte count,the pulmonary function index and ACT score was analyzed by Spearman correlation analysis.The effect of the serum hs-CRP and induced sputum EOS% on inflammatory response of acute exacerbation bronchial asthma was evaluated by receiver operating characteristic (ROC) curve analysis.Results Two cases were excluded in asthma group.The serum hs-CRP before and after treatment in asthma group was higher than that in control group[4.18(2.12-11.12) and 3.40(2.02-8.91) mg/L vs.1.48(1.03-4.81) mg/L,H =18.939,P< 0.01].The serum hs-CRP before treatment was higher than that after treatment in asthma group (P < 0.01).In asthma group,the serum hs-CRP had positive relationship with induced sputum EOS% (r =0.849,P =0.000).There were negative correlations between the serum hs-CRP and the pulmonary function index such as one second forced expiratory volume percent predicted,one second forced expiratory volume occupied vital capacity ratio,maximum mid-expiratory flow percentage of predicted (r =-0.617,-0.559,-0.398,respectively,P =0.000,0.002,0.036,respectively).It was also found that the serum hs-CRP and ACT score had the remarkable Spearman linear correlation (r =-0.511,P =0.005).The area under the ROC curve of the serum hs-CRP was 0.713 (P =0.003).Conclusions There are significant correlations between the serum hs-CRP and induced sputum EOS%,pulmonary function,ACT score in the acute exacerbation bronchial asthma patients.It is found that hs-CRP could be considered as one of the potential marker to evaluate the systemic inflammation level of bronchial asthma.
2.Effects of smoking on lung mucociliary movement and pulmonary function in patients with chronic obstructive pulmonary disease and healthy people
Dan ZHANG ; Zhenshan WANG ; Lihua. CAO
Chinese Journal of Postgraduates of Medicine 2017;40(7):604-607
Objective To observe the effects of smoking on lung mucociliary movement and pulmonary function in patients with chronic obstructive pulmonary disease (COPD) and healthy people. Methods Ninety-two patients with COPD (COPD group) were selected, including 48 smoking patients (COPD smoking group) and 44 non-smoking patients (COPD non-smoking group). Another 76 healthy people (control group) were selected, including 37 smokers (control smoking group) and 39 non-smokers (control non-smoking group). The saccharin test and pulmonary function were carried out respectively, including mucociliary clearance time (MCT), forced vital capacity (FVC) and forced expired volume in 1 s (FEV1), and the ratio of FEV1 and FVC (FEV1/FVC) and FEV1 percentage of predicted (FEV1%pre) were calculated. Results The MCT in COPD group was significantly higher than that in control group:(26.17 ± 19.23) min vs. (15.28 ± 11.34) min, the FEV1/FVC and FEV1%pre were significantly lower than those in control group:(54.25 ± 12.76)%vs. (83.04 ± 5.98)%and (53.26±9.84)%vs. (85.38 ± 5.72)%, and there were statistical differences (P<0.05). The MCT in COPD smoking group was significantly higher than that in COPD non-smoking group and control smoking group: (30.72 ± 27.37) min vs. (18.25 ± 8.19) and (18.31 ± 8.17) min, the FEV1/FVC and FEV1%pre were significantly lower than those in COPD non-smoking and control smoking group: (49.98 ± 11.38)% vs. (58.00 ± 6.85)% and (80.15 ± 4.67)%, (50.24 ± 8.77)%vs. (61.31 ± 4.62)%and (82.13 ± 4.58)%, and there were statistical differences (P<0.05). The MCT in COPD non-smoking group was significantly higher than that in control non-smoking group, the FEV1/FVC and FEV1%pre were significantly lower than those in control non-smoking group, and there were statistical differences (P<0.05). The MCT in control smoking group was significantly higher than that in control non-smoking group: (18.31 ± 8.17) min vs. (11.26 ± 7.53) min, and there were statistical differences (P<0.05). There were no statistical differences in FEV1/FVC and FEV1%pre between control smoking group and control non-smoking group (P>0.05). The Pearson correlation analysis result showed that there was positive correlation between MCT and smoking intensity, age (r = 0.346 and 0.256, P<0.05), and there was negative correlation between MCT and FEV1/FVC, FEV1%pre (r = -0.327 and -0.414, P<0.05). Conclusions Smoking can destroy the mucociliary function and aggravate the deterioration of lung function in patients with COPD.
3.Finite element analysis of biomechanical performance of atlanto-axial bony structure following artificial atlanto-odontoid joint arthroplasty
Yong HU ; Zhenshan YUAN ; Hongyong ZHAO ; Meichao ZHANG ; Yongjie GU
Chinese Journal of Trauma 2013;29(12):1204-1209
Objective To investigate the stress characteristics of atlanto-axial bony structure under conditions of anteflexion,posterior extension,lateral flexion,and rotation after artificial atlanto-odontoid joint arthroplasty using three-dimensional finite element method and to improve the orientation of artificial atlantoodontoid joint from perspective of stress.Methods A three-dimensional finite element model of prosthetic atlanto-odontoid joint arthroplasty was created from CT images of the artificial atlantoodontoid joint and cervical vertebrae using software Mimics,Freeform,and Ansys.Stress characteristics of the model dealt with proneness,posterior extension,lateral flexion,or rotation loads were observed.Biomechanical performance of the bony structure of the model was analyzed and the orientation in improving the prosthesis was discussed.Results Anteflexion loading produced a maximum stress of 0.138 ×l08 N/m2 at the junction of lateral mass and posterior arch of the atlas,and 0.201 × 108 N/m2 at axial nail hole,contact point of plates with the axis,and posterior arch of the axis.Posterior extension loading produced a maximum stress of 0.666 × 107 N/m2 at junction of lateral mass and posterior arch of the atlas and 0.254 × 108 N/m2 at arch of the axis.Besides,stress concentration occurred at atlantoaxis nail hole.Right bending produced a maximum stress of 0.124 × 108 N/m2 at nail hole of right mass of atlas and 0.178 × 108 N/m2 at right contact point of the axis with plates.Right rotation produced a maximum stress of 0.847 × 107 N/m2 at junction of lateral mass and posterior arch of the atlas and 0.170 × 109 N/m2 at contact point of the axis with plates.The finite element model comprised 28 620 nodes and 107 441 units and provided good defining of the structural properties of artificial atlanto-odontoid joint arthroplasty.Under different loading conditions,the stress was mainly distributed in contact point of the vertebral body with plates,nail holes,junction of lateral mass and posterior arch of the atlas,and axial pedicle.Conclusions Prosthetic atlanto-odontoid joint scatters a part of the stress and alters the stress distribution of the atlas and axis from the intact condition.Finite element method can obtain complete analysis of the stress distribution of the artificial atlanto-odontoid joint arthroplasty.
4.Identification of the type and the subtype of interferon with the application of protein biochips
Ping ZHANG ; Xiaoyan LIU ; Zhenshan XU ; Lihua SONG
Chinese Journal of Immunology 1985;0(06):-
Objective:To establish a protein biochip flat to identify the subtype of interfon by adopting the 6 mAb which we have prepared.Methods: Recombinant human interferon was onto the NHS modified gold biochips.then the protein biochips were incubated with the 6 mAb.Cy3 conjugated sheep anti-mouse IgG was used to detect the antigen-antibody.Arrays are imaged using a fluorescence scanner (GenePix4100A) at 532 nm for Cy3.This method was compared with the traditional ones:ELISA,Western blot.Results:The results showed that this flat had speciality to identify the subtype of interfon. Conclusion: The protein biochip plat can provide a practical method to identify the subtype of interfon.It also has some advantages:high quantities;simple operation;low sample dosage and high repetition.
5.Biomechanical study on effect of upper cervical spine structural injury on stability of C1-C2 and C2-C3 segments
Yong HU ; Weixin DONG ; Zhenshan YUAN ; Xiaoyang SUN ; Jiao ZHANG
Chinese Journal of Trauma 2015;31(4):360-365
Objective To evaluate the effect of type Ⅱ odontoid fracture,type Ⅰ Hangman fracture,C2-C3 disc injury on stability of C1-C2 and C2-C3 segments and investigate the clinical significance.Methods Ten fresh-frozen cadaveric cervical specimens (5 men and 5 women; 25-45 years of age,mean 35.7 years) were selected to test the stability of C1-C2 and C2-C3 segments in the settings of intact condition (control group),type Ⅰ Hangman fracture,type Ⅱ odontoid fracture,type Ⅰ Hangman fracture + type Ⅱ odontoid fracture,type Ⅰ Hangman fracture + type Ⅱ odontoid fracture + C2-C3 disc injury.Range of motion (ROM) and neutral zone (NZ) of those segments were measured.Results Compared with the intact condition,type Ⅰ Hangman fracture produced no significant variations in C1-C2 ROM in all loading modes and C2-C3 ROM during left and right lateral bending; type Ⅱ odontoid fracture produced no significant variations in C2-C3 ROM in all loading modes and C1-C2 ROM during left and right rotation; type Ⅰ Hangman fracture + type Ⅱ odontoid fracture revealed no significant variations in C1-C2 ROM during left and right rotation and C2-C3 ROM during extention; type Ⅰ Hangman fracture + type Ⅱ odontoid fracture + C2-C3 disc injury produced no significant variations in C1-C2 ROM during left and right lateral bending and extension-flextion and C2-C3 ROM in all loading modes (P < 0.05).Conclusions Type Ⅰ Hangman fracture can reserve C1-C2 segmental left and right rotation and extension-flextion; type Ⅱ odontoid fracture can reserve C1-C2 segmental left and right lateral bending and extension-flextion; type Ⅰ Hangman fracture + type Ⅱ odontoid fracture + C2-C3 disc injury can reverse atlantoaxial rotationary stability and C1-C3 segmental stability in all directions.This study provides the biomechanical basis for clinical treatments and the related researches of internal fixation.
6.Diagnostic value of magnetic resonance cholangiopancreatography in low choledochal joint and its complications
Xin ZHAO ; Ming XIE ; Zhuqing CHEN ; Zhenshan WANG ; Shuze ZHANG
Chinese Medical Equipment Journal 2015;(9):81-83,125
To investigate the diagnostic value of magnetic resonance cholangiopancreatography (MRCP) for di-agnosing low choledochal joint and its complications. MRCP results of 29 low choledochal joint patients con-firmed were analyzed retrospectively, and then compared with those by endoscopic retrograde cholaniopancreatography (ERCP). MRCP could display clearly the location of low choledochal joint, and the patients with complications involved 4 ones with cholecystolithiasis, 5 ones with cholangiolithiasis, 15 ones with cholecystolithiasis and cholangiolithi-asis, 3 ones with Mirizz syndrome, 2 ones with pancreatitis, 1 case with carcinoma of head of pancreas after cholecystec-tomy and 1 case of Vater ampullary carcinoma. Interoperative and ERCP findings proved that MRCP could be used for the diagnosis of low choledochal joint and its complications with no missed diagnosis. MRCP can be involved for the diagnosis of low choledochal joint and its complications, and thus can be used for preoperative planning and treat-ment of the complications.
7.Magnetic resonance spectroscopic study on regional cerebral metabolic changes of rabbits with explosive brain injury
Yanyan YANG ; Jiachuan LIU ; Yongming ZHANG ; Wenjiang SUN ; Hong TANG ; Zhenshan HUANG ; Bingcang LI ; Liangchao ZHANG
Chinese Journal of Trauma 2011;27(4):375-378
Objective To evaluate the regional cerebral metabolic changes in different episodes by magnetic resonance spectroscopy (MRS) after explosive brain injury in rabbits. Methods Fortyfive New Zealand white rabbits were randomly divided into eight groups, ie, normal control group( 10 rabbits) and trauma group (35 rabbits). The explosive injury in trauma group was induced by explosion of 600 mg TNT equivalent of paper detonators at 6.5 cm above the rabbit brain. The rabbits in trauma group was divided into 1,6, 12, 24 hours, 3, 7, 14 days subgroups (6 rabbits per group). The survival rate was observed at different time points after explosive injury. The MRS was used to detect the regional cerebral metabolic changes including N-acetylaspartate (NAA)/creatine (Cr) ratio and choline(Cho)/Cr ratio as well as evolution of blast injuries over time. Results The rabbits survived for overseven days in the trauma groups, with typical brain contusion manifested by pathological and conventional MRI. Compared with the normal control group, the NAA/Cr ratio was markedly decreased at one hour after injury, slightly rose again at 24 hours and fell again after seven days. The Cho/Cr ratio was markedly increased at one hour after injury, slightly fell again at 12 hours and rose again at three days after injury.Conclusions MRS can manifest the regional cerebral metabolic changes of rabbits with explosive injury at different time points and hence provide a theoretical basis for understanding the local tissue changes and determining the type of tissue damage after blast injury.
8.Analysis of genetic mutation of UGT1A1 * 28 and UGT1A1 * 6 in renal transplant patients with unconjugated hyperbilirubinemia
Zhihao YANG ; Zhenshan DING ; Guan ZHANG ; Haixin CHEN ; Pengmei LI ; Xiaoxing WANG ; Wangjun QIN ; Xianglin ZHANG
Chinese Journal of Organ Transplantation 2017;38(2):108-111
Objective To explore the clinical significance and gene mutation profiles of renal transplant patients with unconjugated hyperbilirubinemia (Gilbert's syndrome).Methods Genomic DNA was extracted from peripheral blood samples of 8 renal transplant patients with Gilbert'S syndrome.UGT1A1 * 6 and UGT1A1 * 28 genotypes were identified through digital fluorescence molecular hybridization and DNA sequencing.Results There are 2 cases of UGT1A1 * 28 heterozygous mutant,3 cases of UGT1A1 * 6 homozygous mutant,2 case of UGT1A1 * 6 heterozygous mutant,1 case of UGT1A1 * 28 heterozygous mutant combined with UGT1A1 * 6 heterozygous mutant.Conclusion There is a higher heterozygous or homozygous gene mutation rate of UGT1A1 * 6 and UGT1A1 * 28 in renal transplant patients with Gilbert's syndrome.Genetic mutation of UGT1A1 * 6 and UGT1A1 * 28 may be the reason of Gilbert's syndrome after renal transplant.
9.Association of OSAS in patients with type 2 diabetes with levels of tumor necrosis factor-α and plasminogen activator inhibitor
Hongxia ZHU ; Zhenshan WANG ; Xin XUE ; Ping ZHANG ; Chunmei YANG ; Benli SU
Chinese Journal of Endocrinology and Metabolism 2013;29(8):679-682
Objective To investigate the changes in tumor necrosis factor-α(TNF-α) and plasminogen activator inhibitor(PAI) in the presence of obstructive sleep apnea syndrome(OSAS) in patients with type 2 diabetes mellitus,and to investigate if that 2 inflammatory factors is associated with hypoxemia during sleep.Methods Fiftyfour patients with type 2 diabetes mellitus hospitalized for glycemic control were subgrouped into 27 patients with OSAS (group O) and 27 patients without OSAS (group N).26 people without diabetes and OSAS were selected from a health check-up program to serve as control group (group C).Serum TNF-α and PAI levels were measured by commercial ELISA kits.Apnea hypopnea index (AHI),the lowest pulse oxygen saturation (LSpO2) at night were detected by portable sleep monitor.The relativity regarding TNF-α,PAI,homeostasis model assessment for insulin resistance (HOMA-IR),fasting blood glucose(FBG),AHI,LSpO2,and age was discussed.TNF-α and PAI were regard as dependent variables,and FBG,HOMA-IR,AHI,LSpO2,and age as independent variables in multivariate stepwise linear analysis.Results The levels of HOMA-IR,TNF-α,PAI in group O [2.69 ± 1.53,(1.97 ±0.13) ng/ml,and (2.27 ± 0.85) ng/ml] were higher than the those in other 2 groups,and those in group N [1.70 ± 0.88,(1.09 ±0.29) ng/ml,and (1.59 ± 0.13) ng/ml] were higher than group C [1.15 ± 0.67,(0.73 ± 0.19) ng/ml,and (0.89 ±0.25) ng/ml].The levels of FBG in the 2 diabetic groups were higher than those in group C.The level of AHI in group O was higher than that in group N and group C,while LSpO2 in group O was lower than that in group N and group C.Spearman univariate analysis showed that TNF-α and PAl both were associated positively with HOMA-IR,FBG,and AHI,while negatively with LSpO2.Multivariate stepwise linear analysis denoted that TNF-α was independently associated with AHI,FBG,while PAI was independently associated with AHI and HOMA-IR.Conclusions Patients with diabetes and OSAS manifest raised level of chronic inflammatory activity,and therefore,OSAS might be implicated in the pathogenesis of chronic complication of patients with type 2 diabetes.
10.Relation between antidiuretic hormone and nocturnal polyuria in patients with spinal cord injury
Decheng WANG ; Zhenshan YU ; Yakui ZHANG ; Xueming CHEN ; Tao GUO ; Hui CHEN ; Hua GUAN
Chinese Journal of Trauma 2003;0(07):-
Objective To evaluate the relationship of diurnal variation of antidiuretic hormone (ADH) with urinary output,serum osmolality and blood pressure in spinal cord injury (SCI) patients. MethodsThe study was prospective,random and contrastive. Twenty complete SCI patients (two females and 18 males,Complete SCI group) and ten healthy controls (two females and eight males,control group) were studied. Urinary output and osmolality in the day time (8:00-20:00) and at night (20:00-8:00) were recorded. Blood samples for the measurement of serum osmolality and ADH were drawn at 14:00 and 2:00. Results There was very significant difference in regard of urinary output between day time and night time in complete SCI Group and control Group ( P 0.05). However,ADH level increased in the healthy Group at night,with a very significant difference ( P