1.Obstructive sleep apnea hyperpnoea syndrome and carotid artery arthrosclerosis
Ying WANG ; Zhiling ZHANG ; Mei YAN
Chinese Journal of General Practitioners 2009;08(6):401-402
Eighty-eight patients with obstructive sleep apnea hyperpnoea syndrome (OSHAS) were assigned to the mild (n =21 ), moderate (n =30), or severe group (n =37) according to apnea-hypopnea index( AHI ). Twenty-five healthy individuals were selected as normal controls. Color Doppler ultrasonography was used to measure the intimae-media thickness of the carotid coteries and the occurrence of sclerosis plagues. Our data found that increased severity of OSHAS led to the elevated intimae-media thickness of the carotid coteries and more sclerosis plagues, which suggests OSHAS may influence the development of the carotid artery arthrosclerosis.
2.Clinical analysis of 44 patients with aortic dissection
Zhiling GAO ; Li LI ; Haijun WANG
Clinical Medicine of China 2010;26(6):596-598
Objective To investigate the risk factors, clinical characteristics, treatment and prognosis of aortic dissection. Methods Forty-four patients with aortic dissection were analyzed from 2005 to 2008 in our hospital retrospectively. Results Hypertension was a common cause of aortic dissection. Aortic dissection showed diverse clinical manifestations. Chest pain was a common initial symptom, whereas some patients' initial symptoms were atypical(e. g. complications). CT and MRI examination could diagnose aortic dissection at a high accurate rate compared with echocardiography. However,ultrasound examination was cheap and convenient,thus could be used as routine examination when someone has suspected diagnosis. As to the treatment of aortic dissection, there were medical conservative, surgical and endovascular stent treatment Conclusions Hypertension is a major risk factor of aorticdissection. Aortic dissection showed diverse clinical manifestations, thus misdiagnosis may occur frequently. Medical treatment should combine a variety of antihypertensive drugs. Surgery or interventional therapy according to the clinical type and condition can reduce the fatality and improve the prognosis of patients.
3.Clinical significance of combined determination of the changes of serum insulin-like growth factor-Ⅱ,carbohydrate antigen 19-9 and alpha fetoprotein levels after intervention and percutaneons ethanol injection therapy in patients with primary hepatic cancer
Zhiling QIAN ; Shichang CUI ; Haiyan WANG
Chinese Journal of Postgraduates of Medicine 2008;31(27):1-4
Objective To investigate the clinical significance of changes of serum insulin-like growth factor-Ⅱ(IGF-Ⅱ),carbohydrate antigen 19-9(CA19-9)and alpha fetoprotein(AFP)levels after intervention and percutaneous ethanol injection therapy in patients with primary hepatic cancer.Methods Serum levels of IGF-Ⅱ,CA19-9 and AFP(with RIA)were repeatedly determined in 57 patients with primary hepatic cancer before intervention therapy,1 month after intervention and percutaneous ethanol injection therapy and 6 months after intervention and percutaneous ethanol injection therapy as well as in 42 controls.Results Before intervention therapy,serum leveh of IGF-Ⅱ,CA19-9 and AFP in the patients were significantly higher than those in the controls(P<0.01).One month after intervention and percutaneous ethanol injection therapy,all the serum levels were near to normal.Six months later,the levels in the patients without recurrence remained normal.However,the levels in the 10 patients with recurrence returned to those before intervention therapy again.Conclusion Changes of serum IGF-Ⅱ,CA19-9 and AFP levels are closely related to the tumor burden and may reflect the presence of recurrence.
4.Clinical Study on Efficacy of Transcatheter Arterial Chemoembolization Combined with Radiofrequency Ablation in Treating Hepatocellular Carcinoma
Zhiling QIAN ; Shichang CUI ; Haiyan WANG
Chinese Journal of Bases and Clinics in General Surgery 2008;0(09):-
Objective To evaluate the efficacy of transcatheter arterial chemoembolization(TACE) combined with radiofrequency ablation(RFA) in treating primary hepatocellular carcinoma(HCC).Methods From March 2004 to March 2006,137 patients with primary HCC underwent TACE alone(n=87) and TACE+RFA(n=50),respectively,after the interventional treatment,all patients periodically received CT reexaminations and alpha fetoprotein(AFP) measurement.The therapeutic efficacy,AFP level and survival rate between two groups were compared with each other.Results In TACE group the effective rate(CR+PR) was 34.5%,AFP decreasing amplitude was 54.2%,and 2 years survival rate was 43.7%.While in TACE+RFA group,the effective rate(CR+PR) was 70.0%,AFP decreasing amplitude was 78.0%,and 2 years survival rate was 62.0%,there were significant differences between two groups(P
5.The Therapeutic Effects of the Cord Blood Stem Cell Transplantation in Patients with Severe Hepatitis
Zhiling WANG ; Yingjie MA ; Jiao HAN
Tianjin Medical Journal 2013;(11):1086-1088
Objective To study the effect of the cord blood stem cell transplantation therapy in patients with severe hepatitis. Methods Forty patients with severe hepatitis were randomly divided into control groups (n=20) and observed group (n=20). The patients in two groups were treated with the conventional liver protective therapy respectively, such as compound glycyrrhizin and glutathione. The patients in observed groups were performed with the cord blood stem cell trans-plantation therapy. After isolation and purification, the cells were transplanted into the liver via hepatic artery and then were transplanted via peripheral veins. The biochemical indices of albumin (ALB), prothrombin activity (PTA),alpha-fetoprotein (AFP)and clinical symptoms were detected at different times after therapy. Results After 4-week therapy, the levels of PTA (%)and AFP(μg/L)were significantly increased in observed group compared with those of control group (53.56 ± 5.15 vs 48.26±5.53,92.16±9.09 vs 43.57±11.33,P<0.01). After 8-week therapy, the levels of alanine aminotransferase (ALT), total bilirubin (TBIL) and AFP were significantly decreased in observed group than those of control group. The level of PTA was sig-nificantly higher in observed group than that of control group (62.61±4.35 vs 54.95±3.01,P<0.05 or P<0.01). There were no significant differences in levels of ALB and blood ammonia between two groups (P>0.05). There were no serious complications and adverse reactions in two groups of patients. There was no significant difference in mortality between two groups ( 20%vs 35%,χ2=0.818,P>0.05). Conclusion Cord blood stem cell therapy has a good effect on treating severe hepatitis, which is safe and no significant adverse reactions, and can be used as a new method for treating the severe hepatitis.
6.Application of joint fixation with breast bracket and body phantom to breast cancer radiotherapy after breast-conserving operation
Senlin YE ; Zhiling WANG ; Ting LIANG
Chinese Medical Equipment Journal 2015;36(5):79-81
Objective To apply joint fixation with breast bracket and body phantom to breast cancer radiotherapy after breast-conserving operation.Methods Totally 36 patients after breast-conserving operation underwent joint fixation with breast bracket and body phantom, whose cone beam computed tomography (CBCT) images were obtained with on board imager (OBI) before radiotherapy. The errors between the CBCT images and planning CT images were acquired by matching.Results The setup errors in the directions of left-right (X), head-foot (Y) and belly-back (Z) were (2.6±0.783), (3.0± 1.027) and (1.6 ±0.872)mm respectively, and the percentages that the setup errors were more than 5 mm were 16.5%, 20.7% and 9.1% respectively.Conclusion Joint fixation with breast bracket and body phantom may decrease the setup error in radiotherapy after breast-conserving operation, especially in the belly-back direction, and thus has high clinical values.
7."Interaction between gut microbiota and ""gut-lung"" axis"
Weiran LI ; Zhiling WANG ; Chaomin WAN
Chinese Journal of Applied Clinical Pediatrics 2017;32(7):548-551
Gut microbiota means a highly diverse and dense microbiota which inhabits in the gastrointestinal tract of humans.It plays a vital role in many important physiological processes including exerting nutritional and metabolic activities,regulating the immune system,and protecting against pathogens.Recent studies suggested that the gut microbiota was associated with the development of many lung diseases,such as pneumonia,asthma and tuberculosis.There is a gut-lung axis in human body.Now,the relationship between the gut microbiota and the gut-lung axis is reviewed.
8.The changes of plasma levels of cytokines in patients of hypoxic-ischemic encephalopathy and its clinical significance
Zhiling ZHAO ; Weiyuan ZHANG ; Mei GU ; Qi WANG
Chinese Journal of Postgraduates of Medicine 2008;31(36):19-21
Objective To explore the role of cytokines on the pathogenesis of hypoxic-ischemic en-cephalopathy (HIE). Method The levels of peripheral blood interleukin (IL)-6, IL-8, tumor necrosis factor-alpha (TNF-α) in 40 HIE and 40 healthy neonates were detected at the 1st, 3rd and 7th day after birth by using radioimmunoassay. Results Compared with healthy neonates, at the 1 st, 3rd after birth, the level of peripheral blood IL-6 was decreased [(52.3±24.5)ng/L vs (80.1±28.6)ng/L and (56.9±28.5) ng/L vs (78.6±28.9)ng/L, respoctively], but IL-15 and TNF-α were increased [IL-8:(0.68±0.23)ng/L vs (0.47±0.13)ng/L and (0.63±0.22)ng/L vs (0.40±0.16)ng/L, TNF-α: (1.17±0.30)ng/L vs (0.91± 0.30) ng/L and (1.14±0.29)ng/L vs (0.96±0.34)ng/L]in HIE infants. Conclusion The changes of plas-ma levels of IL-6, IL-8 and TNF-α in neonatal HIE possibly play an important role in the pathophysiologic mechanisms of HIE.
9.Early non-invasive positive pressure ventilation in treatment of serious hypoxemia following acute left heart failure
Changqi ZHANG ; Dayong ZHOU ; Zhiling GAO ; Feng HONG ; Yuyu WANG
Clinical Medicine of China 2011;27(1):77-79
Objective To observe the effect of early non-invasive positive pressure ventilation(NIPPV)on the treatment of serious hypoxemia induced by acute left heart failure. Methods Forty patients with acute left heart failure( Grade Ⅳ heart function)were randomly divided into two groups. Patients in both groups accepted supportive treatment included cardiotonics, diuretics, vasodilators, in additional to these high concentrations of oxygen were given in conventional group, and non-invasive positive pressure ventilation were given in NIPPV group by biphasic positive airway pressure(BiPAP). Systolic blood pressure, heart rate, respiratory rate, blood-gas analysis( pH, PaO2, PaCO2, SaO2 )and clinical signs were observed at 2 hours after treatments. Results Compared to control,RR( [ 19.55 ± 1.88] vs [21.85 ±3.51 ] ) BPM] ,HR ( [96.40 ±2.80] vs[ 103.20 ±6.78 ] BPM), SBP ( [ 116.30 ± 8.95 ] mm Hg vs [ 122.50 ± 6.13 ] mm Hg), pH (7.404 ± 0.027 vs 7.358 ±0.05) ,SaO2 ( [93.57 ± 1.18]% vs [91.97 ± 1.85]% ) ,PaO2 ( [75.58 ±4.61 ]mm Hg vs [68.38 ±7.95]mm Hg), PaCO2 ( [ 38.69 ± 3.06 ] mm Hg vs [ 43.61 ± 2.65 ] mmHg) were significantly different in NIPPV group( t = 2.582,4.146,2.558,3.534,3.256,3.505,5.428, Ps < 0.05 ). We found no significant differences in the comparisons before treatments. Hypoxia improved in NIPPV group,and the total effective rate was 95% in NIPPV group and 70% in control group,which showed significant difference( x2 =4.329 ,P <0.05 ) Conclusion BiPAP non-invasive positive pressure ventilation combined with routine treatment in treating heart failure, could promptly correct hypoxia, improve heart function and shortening disease course.
10.Use of serum complement C5a as a predictive indicator of fiver injury severity in traumatic rats with hemorrhagic shock
Zhiling ZHAO ; Shuhua CAO ; Yongqiang WANG ; Xinnv XU
Chinese Journal of Emergency Medicine 2011;20(5):498-501
Objective To discuss the feasibility of using serum complement C5a and C5b-9 as predictive indicators of liver injury severity in traumatic rats with hemorrhagic shock.Method Fifry healthy male Wistar rats were randomly(random number)divided into normal group,model 1 hour group,model 3 hours group,model 6 hours group,and model 24 hours group.Plasma CH50,C5a and C5b-9 were detected by using enzyme-linked immunosorbent assay,and rate method was used for determination of plasma aspartate aminotransferase.Paraffin sections of hepatic tissues were used to observe the damage of liver.Results In the model l h group,the CH50 increased significantly and reached the highest value,it began to decline in 3 hours group,and it reached the lowest point in 24 hours group.Compared with the model 3 hours group,6 hours group,and 24 hours group,the level of CH50 in model 1 hour group increased more significantly(respectively P<0.05).A small amount of C5b-9 in the normal group was detected.In the model 1 h group,C5b-9 increased significantly and reach the peak compared with 3hours group,6hours group and 24 hours group,respectively(P<0.05),but in the model 3hours,it began to decline,and in 24 hours group,it reduced to minimum.C5a increased insignificantly in the model 3 hours group,6 hours group and 24 hours group,and peaked in 24 hours group compared with normal group(P<0.05).Aspartate aminotransferase in the model 1 hour group increased significantly and peaked in 24 hours group compared with other groups(P<0.05).Conclusions A large number of complements are activated in the seRing of hemorrhagie shock.C5b-9 and CH50 increase significantly in the early stage,and C5a.increases significantly in the later stage.C5b-9 can be considered as,an initiative factor of liver injury.The low levels of C5a in the early stage may be a mechanism of self-protection of the body.The high levels of CSa in the later stage may be a kind of decompensation,and C5a can be used as a late predictor of disease severity.