1.THERAPEUTIC MANNERS AND TRENDS OF CERVICAL ESOPHAGEAL CARCINOMA
Qinfu FENG ; Zhixian ZHANG ; Guozhen XU
Chinese Journal of Radiation Oncology 1992;0(01):-
One hundred seventy of patients with cervical esophageal carcinoma (30 cases were treated by pre-operative radiation and surgery (combined group), 27 cases by surgery alone, 113 cases by radical radiation). The doses of the preoperative radiation and the radiacal radiation were D T40 Gy/4w and above D T 50 Gy/5w, respectively. The 5 year survival rates were 40% in the combined group, 15.3% in surgry alone, and 28% in radical radiation groups. The difference of survival rates in the combined group and surgery alone was significantly different statistically. Factors affecting the survivals were lymphnode metastasis in radical radiation and recurrent larygeal nerve paralysis in the combined group. The main causes of failure were local residual and recurrence (71%) in radical radiation and lymphnode metastasis (81%) in the combined group. The authors believe that pre-operative radiation combined with surgery could improve the survival of cervical esophageal carcinoma. Radical radiation is also one of effective treatment methods for cercical esophageal carcinoma.
2.The correlation of mild cognitive impairment and middle cerebral artery stenosis and effect of statins on mild cognitive dysfunction
Ke YU ; Junxian LIU ; Feng QI ; Zhixian ZHANG ; Yule HAN
The Journal of Practical Medicine 2014;(22):3603-3605
Objective To investigate the correlation of the middle cerebral artery stenosis (MCAS) and the mild cognitive function impairment (MCI),and the clinical efficacy of statins in patients with MCI. Methods Six hundred and thirty-six patientse,who received transcranial color doppler ultrasound (TCD)assay, were enrolled in our hospital hospitalization or outpatients. The simple mental state examination (MMSE) and clinical dementia rating scale (CDR) were used as cognitive function assessment indexes. Forty-four cases of MCI with MCAS and 58 cases of MCI with NMCAS were used as the treatment group , who received the atorvastatin 20 mg every day , 56 cases of MCI with NMCAS were used as the control group , who only received the routine and basic diseases treatment. One yearlater,we determined the changes of MMSE and CDRagain. Results We detected 124 patients with MCAS, 512 patients with NMCAS, and 44 cases of MCAS patients with MCI, the prevalence was 35.5%,114 cases of NMCAS in patients with MCI, with the prevalence of 22.3%, the prevalence between the two groups was statistically different. One year later, the patients in the treatment group, MMSE score was improved, the score of MCI of the MCAS group improved more significantly. Conclusion The middle cerebral artery stenosis correlated with the occurrence of MCI. Atorvastatin could improve cognitive function in patients with MCI, especially for MCI which was caused by middle cerebral artery stenosis.
3.Construction and operation of the evidence-based nursing team in the hospital
Meiyun ZHANG ; Zhixian FENG ; Lewen SHAO ; Lihua HUANG
Chinese Journal of Hospital Administration 2014;(10):768-770
The building and operation of the evidence-based nursing team of the hospital follow the elite,task-oriented,and team-based model,which is promoted from points to area.This paper described the organizational framework,selection of training contents and training methods of the team in the hospital.It also covered the outcomes achieved for the past year, and analyzed the focal points, difficulties and future emphasis during the team's construction and operation.
4.Effect of ventricle-peritoneal shunt in treatment of patients with post-traumatic hydrocephalus combined with severe consciousness disturbance
Zhixian FENG ; Quancheng LI ; Lin SU ; Jiangbiao GONG ; Liang WEN ; Xiaofeng YANG
Chinese Journal of Trauma 2013;29(9):824-826
Objective To investigate the effect of ventricle-peritoneal (V-P) shunt in treatment of patients who developed post-traumatic hydrocephalus (PTH) with no symptoms or with atypical symptoms due to an excessively severe traumatic brain injury (TBI).Methods A retrospective study was performed in patients who developed PTH with atypical symptoms undergone V-P shunt from January 2004 to June 2007.Patients' general information,TBI data,PTH severity and postoperative follow-up data were collected and applied to assay the improvement rate in prognosis and its associated factors.Results Thirty-one patients were involved in this study.After 12 months of follow-up,20 (65%) patients revealed significant improvements in clinical symptoms.Among 10 patients who developed PTH after decompressive craniectomy,cranioplasty was performed following V-P shunt and significant improvements were observed in nine patients.Patients' age and severity of PTH based on CT evaluation before shunt placement were strongly correlated with the surgical outcome.Conclusions Most PTH patients with atypical symptoms can benefit from V-P shunt.Additionally,younger patients and those with less severe PTH before V-P shunt are expected a better outcome.
5.Sphenopalatine ganglion stimulation with acupuncture for perennial allergic rhinitis:a non-randomized traditional Chinese acupuncture (verum acupuncture) controlled pilot trial
Lu ZHANG ; Peijun LIN ; Lei LI ; Kejian WANG ; Zhixian XU ; Mengmeng GUO ; Jianwu SHEN ; Feng XU
International Journal of Traditional Chinese Medicine 2015;(5):396-400
ObjectiveTo evaluate the efficacy of sphenopalatine ganglion stimulation with acupuncture for moderate-to-severe perennial allergic rhinitis.MethodsA total of 50 patients were recruited into a sphenopalatine ganglion stimulation group and a routine acupuncture group according to order of presentation, with 25 in each group. The sphenopalatine ganglion stimulation group received sphenopalatine ganglion stimulation with filiform needle, 1-2 sessions/week for 4 weeks. The routine acupuncture group received traditional acupuncture, withyingxiang(LI 20),yintang(GV29),fengchi(GB20),fengfu(GB16),zusanli(ST36) as the maln points, andyingxiang(LI 20),yintang(GV29),fengchi(GB20),fengfu(GB16),zusanli(ST36) as the adjunct points, 1-2 points from both the maln and adjunct points in each session, 2 sessions/week for 4 weeks. The nasal symptom score (2004 version), the total nasal symptom score (TNSS) and the total non-nasal symptom score (TNNSS) were used to evaluate symptom improvement. The Rhinoconjunctivitis Quality of Life Questionnalre (RQLQ) was used to assess the patients’ quality of life. The time to symptom alleviation, duration of symptom alleviation in every session and the recurrence duration during 1 month after the treatment were compared between the two groups.Results After the treatment, the score of the nasal symptom score (99.74 ± 31.89vs.196.83 ± 31.22;t=-4.912,P=0.001), TNSS (33.63 ± 12.37vs.71.82 ± 19.21;t=-3.463,P=0.003), TNNSS (33.63 ± 12.37vs.71.82 ± 19.21,t=-3.463,P=0.003) in the sphenopalatine ganglion stimulation were significant lower than those in the routine acupuncture group. Compared with the routine acupuncture group, the time to symptom alleviation was significant shorter (13.85 ± 4.21 minvs.45.63 ± 7.87 min;t=-1.763,P=0.008), while the duration of symptom alleviation was significant longer (37.92 ± 9.94 hvs.3.35 ± 1.23 h;t=7.637,P<0.01) after each session in the sphenopalatine ganglion stimulation group. Four weeks after the treatment, RQLQ score in the sphenopalatine ganglion stimulation group was significant lower than that in the routine acupuncture group (8.48 ± 3.71vs.37.68 ± 12.46;F=-7.312,P<0.01). The recurrence duration during 1 month after the treatment in the sphenopalatine ganglion stimulation group was significant longer than that in the routine acupuncture group (4.12 ± 2.15 dvs.23.53 ± 4.63 d;t=-8.879,P=0.003).ConclusionSphenopalatine Ganglion stimulation is superior to routine acupuncture in treatment of patients with moderate-to-severe perennial allergic rhinitis.
6.Evaluation on allergic rhinitis treated by sphenopalatine ganglion stimulation with acupuncture:a systematic review
Lihe CHEN ; Lu ZHANG ; Wenhong MAO ; Jianwu SHEN ; Bo LI ; Zhixian XU ; Mengmeng GUO ; Kejian WANG ; Lijuan ZHANG ; Feng XU
International Journal of Traditional Chinese Medicine 2016;38(3):254-260
Objective The advantages of the treating allergic rhinitis (AR) by sphenopalatine ganglion stimulation with acupuncture were evaluated.Methods Databases including CBMDisk, CNKI, WanFang, VIP, Cochrane Library, PubMed, ProQuest, ChiCTR, ISRCTN, ClinicalTrials.gov and CENTRAL were searched from the beginning of database established to Jan 2015. All issues from Jan 2004 to Jan 2015 published onjournals Chinese Acupuncture & Moxibustion,Shanghai Journal of Acupuncture and Moxibustion, Acupuncture Research,Journal of Clinical Acupuncture and Moxibustion,Chinese Journal of Integrated Traditional and Western Medicine and Chinese Journal of Otorhinolaryngology in Integrative Medicine were searched by hand at meantime. All data were extracted based on the inclusive and exclusive criteria which was pre-designed, the Revman5.3 was applied for meta-analysis, and the studies qualities were analyzed by grade score.Results 118 articles were collected, 7 studies that involving 1 230 patients met the inclusive criteria. The result indicated that the sphenopalatine ganglion stimulation with acupuncture as the main treatment of AR showed the better total response rate compared to conventional drugs, theOR(95%CI) was 3.22(1.81 - 5.75); however the change of total symptom score had no statistical significant difference, the MD(95%CI) was 0.69 (-0.56 - 1.93), the change of IgE had no statistical significant difference,theSMD(95%CI) was -0.07 (-0.97 - 0.83).Conclusion The main treatment on AR by sphenopalatine ganglion stimulation with acupuncture may has better efficacy than western medicine. But due to the methodological biases existed in most studies, future high-quality RCTs were needed to be included into Meta-analysis to test today’s study conclusion.
7.Construction of sensitive index for perioperative nursing quality in liver transplantation
Chinese Journal of Practical Nursing 2018;34(27):2120-2126
Objective To build a scientific, practical and sensitive index for liver transplantation perioperative nursing quality, and to provide reference for liver transplantation perioperative nursing evaluation and monitoring. Methods Based on the"structure-process-result"three dimensional quality evaluation model, the methods of literature review and evidence based analysis were adopted to summarize the sensitive index for perioperative nursing quality in liver transplantation, including name, connotation, calculation formula and data collection methods. The indicators were discussed and adjusted using Delphi method. Results Nineteen liver transplantation perioperative nursing quality sensitivity indexes were established, including the correct use of immunosuppressive agents, the qualified rate of transplanted liver function monitoring method, nutritional risk screening ration, incidence of low body temperature, etc. For the two rounds of questionnaire, the valid rate was 88.89%and 91.67%, the authority score was 0.88 and 0.89, coefficient of variation of the importance of index was 0.06-0.28. Conclusion The liver transplantation perioperative nursing quality sensitivity indexes based on Delphi method are scientific and practical,which could be applied to clinical utilization.
8.Management practice of COVID-19 prevention in transplant patients based on crisis leadership model
Zhixian FENG ; Mingyan SHEN ; Xiang CHEN ; Zhangfei SHOU ; Li ZHUANG ; Rufen SHEN ; Jianfang LU ; Guoping SHENG ; Jinghui YE
Chinese Journal of Hospital Administration 2020;36(6):457-461
In the COVID-19 epidemic prevention and control work, not only the safety management of in-hospital organ transplantation is facing severe challenges, but also a large number of patients at home after transplantation are in immunosuppressive state, and professional protection management is urgently needed. Since the outbreak of the epidemic, Shulan(Hangzhou)hospital fully identified the risks of transplant patients, established a special team, and formulated and implemented the control management plan for organ transplant patients based on the crisis leadership model. The control management plan has achieved staged results.From January 15 to March 2, 2020, 29 liver transplants and 31 kidney transplants were performed in our hospital. The remote health education of 1 002 patients after liver and kidney transplantation was completed. The goal of " zero infection" was achieved, and the protection management quality indicators were ideal.
9.Immunoproteasome inhibitors regulate the balance of T helper cells 17/regulatory T cells on hypoxic-ischemic brain injury of neonatal rats
Lin HUANG ; Yue ZHOU ; Zhixian GOU ; Xing HU ; Feng ZHANG ; Liqun LU
Chinese Journal of Applied Clinical Pediatrics 2020;35(23):1821-1824
Objective:To explore the effects and mechanism of PR-957 on hypoxic-ischemic brain damage(HIBD) of newborn rats.Methods:A total of 54 rats aged seven days were recruited and randomly divided into sham operation group, HIBD group and PR-957 intraperitoneal group.HIBD model was established according to modified Rice method.PR-957 group was given intraperitoneal injection PR-957(20 mg/kg) after hypoxic-ischemic.Model group was intraperitoneally injected with equal volume of DMSO.Ligation or hypoxic treatment were not given in sham operation group.HE staining was applied to observe inflammation in cortex.Immunohistochemical analysis was adopted to observe the expression of interleukin(IL)-17 and IL-10 in brain tissue.Western blot was carried out to test the protein level of low molecular poly peptide 7 (LMP7), forkhead box P3(FOXP3), and retinoic acid-recepter-related orphan receptor gamma t(RORγt). The proportion of T helper cells 17(Th17)/Treg was detected by flow cytometry.Results:HE staining displayed that sham operation group brain structure was basically normal, HIBD group revealed significant inflammation in the left cerebral cortex, while some pathological improvement was observed in PR-957 group.Immunohistochemistry: IL-10 positive cells in left cortex of HIBD group [(12.11±3.73)%] were lower than sham operation group[(29.12±3.95)%] and PR-957 group[(22.61±6.59)%], and the differences were statistically significant (all P<0.05). IL-17 positive cells in the left cortex of HIBD group [(35.55±4.85)%] were higher than sham operation group [(8.48±2.58)%] and PR-957 group [(19.16±4.31)%], and the differences were statistically significant (all P<0.05). Western blot: the expression of LMP7 and RORγt in HIBD group (1.01±0.12, 0.71±0.10) were higher than those in sham operation group (0.50±0.10, 0.34±0.07) and PR-957 group (0.65±0.13, 0.54±0.07), and the differences were statistically significant ( P<0.05). The expression of FOXP3 in HIBD group (0.44±0.10) was lower than sham operation group (0.93±0.07) and PR-957 group (0.68±0.09), and the differences were statistically significant (all P<0.05). The flow cytometry of peripheral blood: the Th17/Treg ratio of HIBD group (0.66±0.24) was higher than sham operation group (0.20±0.09) and PR-957 group (0.45±0.18), and the differences were statistically significant (all P<0.05). Conclusion:PR-957 can regulate the immune balance of Th17/Treg cells and reduce the inflammatory in the brain tissues of HIBD newborn rats.
10.Visualized analysis of research on the information management of pressure injury care in hospitals of China
Mingyan SHEN ; Linqiu HAN ; Zhixian FENG
Chinese Journal of Burns 2023;39(11):1083-1089
Objective:To investigate the current status and evolutionary trajectory of research on the information management of pressure injury care in hospitals of China.Methods:The bibliometric method was used for analysis. Using the China National Knowledge Infrastructure (CNKI) database as the data source, the literature on information management of pressure injury care in hospitals was retrieved, covering the time period from the establishment of the CNKI database to July 31, 2022, and various types of literature such as guidelines, expert consensus, case studies, reviews, and survey reports, etc. Visualized analysis of clustering and co-occurrence on the keywords, authors, publishing institutions, and number of journals of the included literature were performed using CiteSpace 6.1.R2 software.Results:A total of 378 articles were retrieved, and 323 articles were included after collation. The number of literatures related to nursing information management of pressure injury in hospitals showed a significantly upward trend since 2012. Ten core authors published two or more articles as the first author. There were eight groups of co-authors with ≥3 people. Furthermore, 306 institutions contributed articles related to the information management of pressure injury care, with Peking University Shenzhen Hospital as the institution publishing the most articles (4 articles). Cooperation between institutions was relatively decentralized. The 323 included literature were sourced from 142 journals, six of which had published ten or more articles. A comprehensive co-occurrence analysis of 282 Chinese keywords was performed, with the top three keywords in terms of frequency being pressure ulcer, nursing management, and nursing. A total of 13 clusters were formed, and the persistent clusters were #1 quality of care, #2 nursing, and #6 surgical patients. The top 8 emergent keywords of emergence intensity in the database included early warning intervention, early warning management, early warning mechanism, information system, nursing safety, adverse events, operating room, and quality of care. In the past three years (2020-2022), the top two emergent keywords in terms of emergy intensity included operating room and quality of care. The key word with the longest duration (2005-2012) and the highest intensity was early warning intervention.Conclusions:The research hotspots on information management of pressure injury care in domestic hospitals have been formed. Early studies focus on the intervention after the pressure injury developed, while later studies focus more on the overall management of pressure injuries. Collaboration between institutions within research areas and correlations between studies are still lacking.