1.Treatment of perioperative complications in patients with cervical cord injury
Zhiyuan ZENG ; Wenyu PAN ; Jianhui SHI
Orthopedic Journal of China 2006;0(18):-
[Objective]To investigate the clinical treatments of perioperative complications in patients with cervical cord injury.[Method]Totally 155 cases of cervical cord injury associated with fracture of the cervical spine were enrolled in this study from January 1997 to December 2007.Eighty-five cases were treated with anterior internal fixation,66 with expansive open-door laminoplasty of the cervical spine,and 4 with one stage anterior and posterior approach operations.[Result]Forty-five cases were complicated with hyperpyrexia,31 with respiratory dysfunction,43 with pulmonary infection,70 with hyponatremia,25 with urinary system infection,3 with stress ulcer,10 with deep venous thrombosis,5 with palsy of the C5 nerve root,3 with injury of superior laryngeal nerve or recurrent nerve,1 with leakage of cerebrospinal fluid,2 with cervical hematoma,1 with loosening of interal fixation,1 with esophageal fislula,and 10 died.[Conclusion]There are many perioperative complications from cervical cord injury.To pay attention to the treatments of perioperative complications will bring a satisfactory clinical effect.
2.Effects and mechanisms of low-dose hydrocortisone on brain dysfunction in LPS- induced sepsis in rats
Zhiyuan WU ; Jiansheng ZENG ; Xunmei FAN
Chinese Journal of Emergency Medicine 2006;0(06):-
Objective To investigate the effects of low-dose hydrocortisone on brain dysfunction in LPS-induced sepsis rats and the role of nuclear factor kappa B (NF-?B) signal transcription pathway in the pathogenesis. Methods Fifty-four rats were randomly divided into 3 groups: control group (A group, n=6), model group (B group, n=24), low-dose HC treatment group(C group, n=24). The septic rat model was established by intra-peritoneal injection of LPS (1 mg/kg), the intervention was by caudal vein injection of low-dose HC (6 mg/kg), each of B and C group was subdivided into 2,8,16,24 hours after LPS injection (n=6).At serial time points,the animals in each group were sacrificed , brain tissue samples were harvested to determine NF-?B,I?B expression in hippocampus by immunohistochemistry. Also, the changes of behaviors were observed and the histopathological changes were investigated by Nissl stain.Results In model group (B group): lethargy, anorexia, tachypnea, piloerection, loss of body weight were all more obvious than control groups.Nissl stain showed significant histopathological changes; NF-?B expression was up regulated compared with control group(P
3.Therapeutic analysis of non-fracture and dislocation injury of cervical spinalcord
Zhiyuan ZENG ; Wenyu PAN ; Rongdong ZENG ; Jianhui SHI ; Zhaowen GAO
Chinese Journal of Orthopaedic Trauma 2002;0(02):-
Objective To explore the differences between the conservative treatment and the operative treatment in the management of cervical spinal cord injury, and the timing of the operation. Methods The therapeutic effectiveness o f the 45 cases who were treated from October 1996 to January 2002 was analyzed. 21 of them underwent conservative treatment and 24 operative treatment. The corr elation between the therapeutic effects of the operation and its timing was expl ored. Results The myeloid functional recovery was poor in the patients who had b een treated with conservative means but good in those who had been given an oper ation. The earlier the operation, the more effective it could be, and the higher the probability of the myeloid functional recovery. Conclusions The operative treatment promises better outcome than the conservative treatment. To get the be st effects, the operation should be done within one month after the injury, for the longer the lapse between the injury and the operation, the worse the effect.
4.Pancreatic fistula secondary to abdominal operations:an analysis of 27 patients
Zhiyuan JIAN ; Mingyin LAN ; Min ZHANG ; Shaobo ZENG ; Bin JIANG
Chinese Journal of Pancreatology 2009;9(6):371-373
Objective To summarize the diagnosis and treatment experience of the pancreatic fistula secondary to abdominal operations.Methods The clinical data of 27 patients with pancreatic fistula due to abdominal operations were analyzed retrospectively.Results 25 patients were diagnosed by the amylase concentration of the drainage fluid and 2 patients were diagnosed by the percutaneous puncture fluid amylase concentration.Four patients underwent percutaneous puncture drainage by BS-guide.Five patients underwent re.operation drainage.Enteral feeding,total parenteral nutrition,total parenteral plus oral nutrition were applied to 15,6 and 6 patients,respectively.Altogether 3 patients died,all of these patients were in the total parenteral nutrition group.13 cases were discharged with draining tubes,including 2 patients who developed Dseudocyst and received surgical treatment,and the others 1 1 patients were discharged with tubes for(9.0±3.2)months.The mean hospital stays for oral feeding,jejunum tube nutrition and total parenteral nutrition groups were(36.3±10.2)d,(57.6±17.3)d and(63.3±33.4)d,respectively;and difference was statistically significant(F=3.49,P=0.049).The mean hospital stays for patients with or without somatostatin treatment were(53.5±20.3)d and(51.5 ±21.0)d,and difference was not statistically significant(t=0.207,P=0.838).Conclusions hereasingthe understanding ofpancreaticfistula,adequate drainage and rational nutrition phyed a key role in impmving the treatment effects of pancreatic fistula.
5.Design and application of special gowns for critical patients
Chunyan XIE ; Zheng LI ; Xiaocui ZENG ; Liqing XU ; Zhiyuan CHENG ; Chunchang LIN
Modern Clinical Nursing 2016;15(2):21-25
Objective To explore the effect of newly-designed gowns for critical patients. Methods Two hundred critical patients hospitalized for more than 3 days in the intensive care unit of our hospital during February 2013 to February 2015 were divided into the control group and observation group equally according to their odd or even registration number. The control group wore conventional dresses for patients (including a shirt and a pant) and the patients in the latter group were newly-designed gowns. The two groups were compared in terms of comfort, nursing manpower, nursing stuff and security. Result The observation group was significantly superior to the control group in terms of comfort, nursing manpower, nursing stuff and security (P<0.05). Conclusions The newly-designed gowns for critical patients can improve the comfort degree and save nursing manpower and stuff. It allows convenience in treatment and nursing.
6.Distribution of Genetic Polymorphisms about CYP2C19 Gene in the Elderly Chinese Han Populations of Guangzhou and the Comparison in Different Populations
Xuanhao XIAO ; Tao ZENG ; Xiuxia LEI ; Ze LI ; Jin ZHOU ; Zhiyuan WANG ; Xiaoping PAN
Journal of Sun Yat-sen University(Medical Sciences) 2017;38(2):307-314
[Objective]To investigate the genetic polymorphisms of the CYP2C19 gene in the elderly Chinese Han populations of Guangzhou,and compare the frequencies of CYP2C19 gene polymorphisms in different populations,in order to provide accurate data for the appropriate prescription.[Methods]To detect the genetic polymorphisms of the CYP2C19 gene by the DNA microarray,and compare the frequencies of CYP2C19 gene polymorphisms in Chinese Han populations from different areas and the different races.[Results]There were 2312 case samples in our study. The allele frequencies of CYP2C19*1,CYP2C19*2 and CYP2C19*3 were 64.27%,30.75%,and 4.98%,respectively. As the genotype,EM(*1/*1)was 41.44%(n=958),IM(*1/*2,*1/*3)was 45.67%(n=1056),and PM(*2/*2,*2/*3 and*3/*3)was 12.89%(n=298). The ratios of EM and IM in Chinese Han populations from different areas and all the subtypes of the CYP2C19 genotype in different minority were statistically significant. As the races,there were difference in all the subtypes of the CYP2C19 genotype when Asian populations were compared with white races(P<1304.64)and black races(P<0.01),which was also statistically significant.[Conclusions]The distributions of the CYP2C19 gene polymorphisms were significantly different in Chinese han populations and in different races,and the main subtypes of the CYP2C19 genotype in the elderly of Chinese han populations were IM and EM,which is beneficial for prescribing appropriate in the elderly populations.
7.Structure-based identification of drug-like inhibitors of p300 histone acetyltransferase.
Fanqi ZENG ; Shiming PENG ; Li LI ; Libing MU ; Zhenhua ZHANG ; Zhiyuan ZHANG ; Niu HUANG
Acta Pharmaceutica Sinica 2013;48(5):700-8
A growing body of evidence suggests that p300 histone acetyltransferase plays important roles in cancer cell differentiation and proliferation. Here, we employed structure-based hierarchical virtual screening method to identify novel lead compounds of p300 histone acetyltransferase. From a screening library containing approximate 100 000 diverse druglike compounds, 33 compounds were chosen for experimental testing and one compound, 4-acetyl-2-methyl-N-morpholino-3,4-dihydro-2H-benzo[b][1, 4]thiazine-7-sulfonamide (17), showed as micromolar inhibitor. Based on its predicted binding pose, we investigated its binding characteristics by designing two series of structural modifications. The obtained structure-activity relationship results are consistent with the predicted binding model. We expect that the identified novel p300 histone acetyltransferase inhibitors will serve as starting points for further development of more potent and specific histone acetyltransferase inhibitors.
8.Morphological characteristics of bone marrow and peripheral blood in 1 151 cases diagnosed with de novo acute leukemia
Haiyang WANG ; Zengtian SUN ; Xiaorui XU ; Jing YAN ; Wei SANG ; Zhenyu LI ; Jinrong LI ; Mengdi XU ; Jiulian YUAN ; Zhiyuan WANG ; Lingyu ZENG
Chinese Journal of Laboratory Medicine 2023;46(3):295-303
Objective:To observe and analyze the morphological characteristic of bone marrow and peripheral blood in patients diagnosed with de novo acute leukemia.Methods:From October 1, 2015 to December 31, 2021, 1151 patients aged 47 (26, 62) years, consisting of 602 males and 549 females with newly diagnosed acute leukemia in the Department of Hematology, Affiliated Hospital of Xuzhou Medical University, were collected to preform the morphological analysis in bone marrow and peripheral blood smears. Based on the comprehensive diagnosis results of morphology, immunology, cytogenetics, and molecular biology, comparison between acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL), AML with RUNX1-RUNXITI gene, AML with CBFβ/MYH11 gene, acute promyelocytic leukemia (APL) with PML/RARA gene, AML with NPM1 gene, the rest of the AML, Ph+ALL and Ph-ALL were performed by Chi-square test along with analysis of the differences in the ratio of wood bundle cells, pseudo-Chediak-Higashi (PCH) inclusions, cytoplasmic small particles, nuclear notches, leukemia cells with cup-like changes (cup cells); as well as the differences in the micromeganuclei, early immature granulocytes, plasma cells, high eosinophils and other accompanying cells and the distribution of "grape-like" aggregation. Finally, the morphological characteristics of acute leukemia cells, the appearance and arrangement of accompanying cells were summarized.Results:Between AML and ALL, there were statistically significant differences in cytoplasmic Auer bodies[(45.5%, 0%), χ 2=211.400, P<0.01], PCH inclusion bodies[(28.9%, 0%), χ 2=114.100, P<0.01], cytoplasmic fine particles[(20.7%, 2.9%), χ 2=53.798, P<0.01], nuclear notches[(0.7%, 6.1%), χ 2=30.906, P<0.01], and goblet cells[(4.9%, 0.3%), χ 2=13.495, P<0.01], micromegakaryus [(22.4%, 0.3%), χ 2=80.398, P<0.01], plasma cells[(87.6%, 10.6%), χ 2=604.241, P<0.01], hyperacidophils[(15.3%, 1.0%), χ 2=46.116, P<0.01] showed significant differences in the "grape-like" aggregation distribution. In AML with RUNX1-RUNXITI gene, the changes of vacuoles and PCH inclusion bodies are more obvious; in AML with CBFβ/MYH11 gene, the increase of hypereosinophils is more obvious; in APL with PML/RARA gene, the increase of woodbundle is more obvious. The morphology of nuclei chromatin, nucleolus, and vacuoles were also different among the groups. Comparison between Ph+ALL and Ph-ALL showed that Ph+ALL was more prone to develop early immature granulocytes and plasma cells (all P<0.05). Conclusion:There are significant differences between AML and ALL in the characteristics of leukemia cells, the regularity of accompanying cells, and the aggregation and distribution patterns. The subtypes of AML with specific genetic abnormalities have their own characteristics in the appearance of vacuoles, PCH inclusions, hypereosinophils, woodbundle cells, and goblet cells. Ph+ALL is more prone to present early immature granulocytes and plasma cells.
9.The time-dependent evolution spectrum of acute care surgery patients: a real world study based on 23 795 electronic admission medical records
Lu FENG ; Hua JIANG ; Mingwei SUN ; Yunpeng MA ; Jing PENG ; Zhiyuan ZHOU ; Bin CAI ; Zhongning JIANG ; Hao YANG ; Lu Damien CHARLES ; Jun ZENG
Chinese Journal of Emergency Medicine 2017;26(12):1427-1431
Objective One of the major challenges to emergency department is to provide high quality and time sensitive service under limitation of human/material resources,along with patients population with extremely complex conditions.We presented a study that based on a big data got from real world and used wavelet transform technique to analyze time-dependent diseases spectrum patterns and evolution patterns,which will provide solid methodological support for optimizing resources configuration for acute care surgery service.Methods Record data of patients admitted to acute care surgery from 2007-2014 were collected by using data management tool (Avaintec,Helsinki,Finland).The data were cleansed and were transformed to continuing spectrum according to time series of admission time points (per 9 hours).Matlab was used for wavelet transform,and applied five levels of wavelet decomposition and calculated the best decomposition levels by K-mean algorithm for each level.Then we used aprori algorithm for data mining (frequent patterns mining).Results A total of 23 795 cases were enrolled and acute abdomens were made up biggest proportion of admission.Meanwhile,it is found that the spectrum of acute care surgery admission frequency was a complex rising sequence.After wavelet decomposition,signal wave A reflexed trends evolution in a given time scale,and noise wave D reflexed minutia at relevant time scale.In another words,a principal wave A1 represented fluctuation at a cycle of 16 days.Noise wave D1 reflected intensity level in this 16 days' cycle.For example,the 5 · 12 episodes of massive earthquake in 2008 were included in the study,it is found that a significant noise wave at D3 level that indicated a 4 days' cycle.Clinically,it indicated explosive admissions to acute care surgery in 4 days.Conclusions The admission spectrum to acute care surgery is a phenomenon of multi-scale.Based on wavelet decomposing,we can easily analyze the rule of admission spectrum from electronic records of patients and can be used for optimization the emergency medicine resources.
10.Epidemiological study on antibiotic resistance among Helicobacter pylori in Taizhou district, Zhejiang, 2010-2013.
Tiangan YANG ; Hongzhang LI ; Jiaoe CHEN ; Wanli ZENG ; Junliang MAO ; Zhihua ZHANG ; Junhua YANG ; Ningmin YANG ; Miaoying TU ; Jianzhong ZHANG ;
Chinese Journal of Epidemiology 2014;35(6):704-707
OBJECTIVETo study the infection status of Helicobacter pylori (H. pylori) and sensitivity to commonly used antibiotics in Taizhou district,Zhejiang province.
METHODS39 099 cases aged between 5 and 95 years old (mean as 48.42 years) were involved during January 2010 to December, 2013 for this study. Sex ratio was 1 : 0.95. Yearly distribution of the number of cases were 5 031, 6 709, 11 902 and 15 457 in 2010, 2011, 2012 and 2013, respectively. Gastric mucosal specimens were collected and H. pylori strains were isolated and cultured in the same platform in Zhiyuan Medical Inspection Institute of Hangzhou. Resistance tests of all the H. pylori isolates were performed to 6 commonly used antibiotics:metronidazole, clarithromycin, amoxicillin, gentamicin, levofloxacin and furazolidone with the agar dilution method. The antibiotic resistance rates of H. pylori strains isolated during year 2010-2013 and the changing trends were analyzed.
RESULTSResistance rates to levofloxacin and clarithromycin kept at higher level and the highest was in 2011 and then decreased in both 2012 and 2013 (P < 0.01). The resistance rates to both levofloxacin and clarithromycin reached the highest in 2011 (P < 0.01), and decreased thereafter, with no significant change in 2013 to 2012 (P > 0.05).
CONCLUSIONAntibiotic resistance rate against metronidazole for HP isolate was highest. Resistance rate against amoxicillin and furazolidone, gentamicin was low. Clinical treatment should choose amoxicillin and furazolidone, gentamicin. The resistance rates to levofloxacin and clarithromycin had been seen at a significantly downward trend since 2011. However, the combined resistance rates to levofloxacin and clarithromycin did not seem to reduce since 2012.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents ; pharmacology ; Child ; Child, Preschool ; Drug Resistance, Multiple, Bacterial ; Helicobacter pylori ; drug effects ; isolation & purification ; Humans ; Middle Aged ; Young Adult