1.The comparison of MRCP and Gd-EOB-DTPA-enhance d MR in the diagnostic value for biliary obstruction disease
Journal of Chinese Physician 2014;(z2):20-22
Objective To evaluate the diagnostic value of MRCP and Gd -EOB-DTPA-enhanced MR for biliary obstruction dis -ease, and provide basis to choose the suitable method for this patient .Methods A respectively analysis was carried out from 2011 to 2013in 138 biliary obstruction cases.All the cases had undergone both MRCP and Gd -EOB-DTPA-enhanced MR examinations and fi -nally proven by pathology .A comparison was made in these two methods .Results All the 138 cases by MRCP and Gd-EOB-DTPA-enhanced MR were successful.The same diagnosis based on MRCP and Gd -EOB-DTPA-enhanced MR was 86 cases (62.3%).The different diagnosis was 52 cases.In the 52 different cases, MRCP was tumor, Gd-EOB-DTPA-enhanced MR was stone and MRCP was stone, Gd-EOB-DTPA-enhanced MR was normal.Conclusions MRCP is a noninvasive diagnostic modality capable of producing high quality imagines of bile duct and pancreatic tract .It has a high sensitivity and specificity in the evaluation of the bile duct and pancreatic tract.The efficacy of Gd-EOB-DTPA-enhanced MR is sufficient to justify its use in the diagnosis of bile duct and pancreatic tract diseases.Gd-EOB-DTPA-enhanced MR has a similar diagnosis effectiveness in bile duct obstruction .
2.Discussion on emergency equipment dynamic deployment assessment mode
Zhongwei JIANG ; Jun ZHANG ; Zhejun WU
China Medical Equipment 2015;(3):96-97
Objective:According to the existing hospital static mixing method, the problem of dynamic allocation model for half a year period is put forward, in order to solve emergency equipment safe are deployed in a timely manner. Methods: The hospital can allocate all emergency equipment evaluation, grade and tabulation, according to the score for sorting, system of sorting table provides emergency center allocate use half a year. Results: According to the deployment of table realized in emergency equipment safety in time in case of major events are deployed and able to skillfully use effect. Conclusion: The use of emergency equipment dynamic allocation model can not only improve the social benefit of the hospital, and reduce the pressure of the functions of the hospital departments.
3.The Effect of Right Ventricular Pacing on Left Ventricular Systolic Function
Xiaotao WANG ; Ping FANG ; Zhongwei WU ; Yuxiang WU
Academic Journal of Second Military Medical University 1985;0(06):-
The left ventricular systolic function before and after right ventricular pacing was studied in 26 patients by Doppler and M-mode echocardiography. The results showed that there were increases in cardiac output and heart rate, respectively (P
4.Effects of sufentanil combined with bupivacaine on postoperative analgesia and immunity function in elderly patients under lower extremity orthopaedic surgery
Huiping CHENG ; Cheng WU ; Zhongwei ZHANG ; Huigen LU
Chinese Journal of Geriatrics 2013;(3):308-311
Objective To investigate effects of intrathecal injection of sufentanil combined with bupivacaine on postoperative analgesia and immunity function in elderly patients under lower extremity orthopaedic surgery.Methods Totally 60 elderly patients with ASA Ⅰ or Ⅲ under lower extremity orthopaedic surgery were randomly divided into two groups:bupivacaine and sufentanil group (each n =30).3 ml bupivacaine (2 ml 0.75% bupivacaine plus 1 ml 0.9% normal saline) were given in bupivacaine after successful spinal anesthesia and 3 ml sufentanil (1 ml 0.75 % bupivacaine plus 1 ml 0.9% normal saline and 1 ml with 5 μg sufentanil) were used in sufentanil group respectively.The anesthetic feeling and block level before operation recovery time were recorded postoperation.Visual analogue scale (VAS) and adverse reaction were recorded at 1,6,12,24 and 48 h after surgery.Cellular and humoral immunity function were recorded at the following time points:T0,the day before surgery; T1,the day after surgery; T2,the first 5 postoperative days; T3,the first 10 postoperative days; T4,the first 15 postoperative days.Results The sensory and motor block levels in sufentanil group were T9~~T10 and T11~T12 respectively,which were higher than in bupivacaine (T7~T8 and T8~T10).The recovery time in sufentanil group was shorter than in the bupivacaine (P<0.05).There were no significant differences in VAS scale between the two groups at any postoperative time points (P<0.05).The incidence of skin pruritus was higher in sufentanil group (6 cases) than in bupivacaine (P<0.05).There were significant differences in the indexes for the immune condition including CD3+,CD4+/CD3+,CD4/HLADR,CD8/HLADR,B-cell,NK-cell between time points of T2[(48.7±2.3)%,(33.4±1.8)%,(10.2±1.8)%,(0.75±0.07)%,(1.02±0.16)%,(3.12 ±0.19) %,(2.53±0.14)%,respectively] and T0 in bupivacaine (P<0.05).There were significant differences in the indexes for the immune condition including CD3+,CD4+/CD3+,CD4/HLADR,CD8/HLADR,B-cell,NK-cell at T2 between sufentanil group [(54.5 ± 2.4) %,(36.3 ± 1.7) %,(15.1±1.6)%,(1.32±0.11)%,(1.25±0.14)%,(4.96±0.25)%,(4.17±0.10)%,respectively] and bupivacaine (P<0.05).Conclusions Intrathecal injection of 5 μg sufentanil combined with low concentration bupivacaine can be safely and effectively applied in elderly patients under lower extremity orthopaedic surgery,and can reduce local anesthetic concentration,shorten recovery time of anesthesia and accelerate the recovery of postoperative immunity function.
5.Nursing of children with refractory soft tissue infection in the limb using vacuum sealing drainage
Lisha HUO ; Weiwei WU ; Deming BAI ; Zhongwei JIA
Chinese Journal of Practical Nursing 2013;29(34):1-3
Objective To investigate the nursing points of the vacuum sealing drainage technology in children with refractory soft tissue infection in the limb.Methods A total of 9 children with refractory soft tissue infection in the limb were treated with vacuum sealing drainage technology from December 2010 to October 2012.Results All children who underwent vacuum sealing drainage technology were successful,among which 7 cases underwent continuous vacuum sealing drainage for 7 days and 2 cases replaced VSD material after continuous vacuum sealing drainage for 10 days and all wound with skin graft healed,without any complication.Conclusions Vacuum sealing drainage can remove thoroughly necrotic tissue of the wound and promote wound healing,the key points of nursing are to keep drainage tube unobstructed,adjust appropriate negative pressure and give close observation.
6.Drug release, morphology and cytotoxicity of enantiomeric poly(L-Lactic acid)-poly(ethylene glycol)-poly(L-Lactic acid)/poly(D-Lactic acid)-poly(ethylene glycol)- poly(D-Lactic acid) stereocomplex hydrogel
Zhili TIAN ; Yao WU ; Rong LIU ; Yanfeng XIAO ; Bin HE ; Zhongwei GU ; Fang WU
Chinese Journal of Tissue Engineering Research 2011;15(29):5501-5506
BACKGROUND: Recently biodegradable hydrogel has been extensively used to delivery anticancer drug and bioactive macromolecule. However, to protect the activity of the bioactive macromolecule, we need to obtain series of hydrogel which have milder hydrogelation conditions and shorter hydroglation time.OBJECTIVE: To prepare enantiomeric poly(L-Lactic acid) (PLLA)-poly(ethylene glycol (PEG)-PLLA/ poly(D-Lactic acid) (PDLA)-PEG-PDLA stereocomplex hydrogel which has shorter hydroglation time, to physically encapsulate a model drug-lysozyme and sustained release it from the hydrogel. METHODS: Triblock copolymers of PLLA-PEG-PLLA and PDLA-PEG-PDLA were synthesized by ring-opening polymerization of L(D)-lactide using PEG as the initiator and Sn(Oct)2 as the catalyst. The triblock copolymers were characterized by 1H nuclear magnetic resonance, FT-IR and X-Ray diffractometry. A hydrogel was prepared from an aqueous mixture of PLLA20-PEG227-PLLA20 and PDLA21-PEG227-PDLA21 (10 wt% concentration) at room temperature for 12 hours. X-Ray diffractometry test was used to research the gelation mechanism. The release profile of the lysozyme as a model drug from the hydrogel was tested. The morphology of the freeze-dried hydrogel was investigated by scanning electron microscope. The cytotoxicity of the hydrogel was evaluated by 3-(4,5-dimethylthiazol-2-yl-2,5-diphenyl tetrazolium bromide) assay.RESULTS AND CONCLUSION: Triblock copolymers of PLLA-PEG-PLLA and PDLA-PEG-PDLA were obtained. Both the PEG and PLA blocks in the copolymers could crystallize, but the crystallization of the PEG block was predominant. The stereocomplex formation between the PLLA and PDLA blocks within the hydrogel was confirmed by the X-Ray diffractometry analysis. The release profile of the lysozyme from the hydrogel exhibited a sustained-release pattern with a duration period of 7 days. The hydrogel exhibited a 3D interconnected porous structure with 50-100 μm pore size after being freeze-dried. The mouse fibroblast cell viability percentage was 99.3% after the cells contacted with the 100% extracted liquid for 72 hours.
7.Glucocorticoids+cyclophosphamide+tacrolimus capsules in type Ⅲ+Ⅴ and Ⅳ+Ⅴ lupus nephritis
Xuelian WU ; Zhongwei YE ; Xiaoyuan MAO ; Lu YANG ; Ying ZHU ; Xiaochun ZHU
Chinese Journal of Biochemical Pharmaceutics 2017;37(1):188-190
Objective To explore the efficacy and safety of glucocorticoids+cyclophosphamide+tacrolimus capsules (GC+CTX+FK506) in the treatment of patients with type Ⅲ+V and Ⅳ+Vlupus nephritis. Methods The 31 cases with first diagnosis as systemic lupus erythematosus (SLE) with type Ⅲ+V and Ⅳ+Vlupus nephritis (LN) were selected, then divided into group A (CTX+GC) with 16 cases and group B (FK506+CTX+GC) with 15 cases. The group A received CTX+GC during treatment, group B received GC+CTX+FK506 for the first three months, and received FK506+GC for the last three months. The patients were followed up once monthly to observe the efficacy and safety,the efficacy was analysed after 6 months. Results After treatment, the total efficacy in group B was significantly higher than group A (86.7%vs.50.0%, P<0.05). The 24 h urine protein of group B was lower than group A(P<0.05). The plasma albumin of group B was higher than group A (P<0.05). After treatment, the systemic lupus erythematosus disease activity index (SLEDAI) in two groups were lower and C3 level was higher than those pre-treatment(P<0.05), but there was no significant difference in above indicators between two groups. There was one case menelipsis in group A, and one case with transient increasing of creatinine. Conclusion The FK506+CTX+GC could reduce urine protein sifnificantly compared with CTX+GC without serious adverse reaction.
8.Primary clinical application of Y-shaped jogged stent in patients with malignant hilar biliary obstruction
Zufei WANG ; Jingjing SONG ; Jiansong JI ; Xiaoxi FAN ; Jianfei TU ; Fazong WU ; Hongyuan YANG ; Zhongwei ZHAO
Chinese Journal of Radiology 2017;51(5):377-381
Objective To evaluate the feasibility, safety, and efficacy of Y-shaped jogged stent in patients with malignant hilar biliary obstruction. Methods During the period of January 2010 to June 2015,We retrospectively reviewed 98 cases of malignant hilar biliary obstruction who were received implantation of biliary tract stent. 17 consecutive patients who were treated with Y-shaped jogged stent were identified (group A) during January 2012 to June 2015. Group A was carefully matched according to patients' age, sex, type of tumor, stage, type of biliary obstruction, level of bilirubin at diagnosis, presence of metastasis and treatment, and 17 patients who were underwent unilateral stent placement alone with PTCD were chosen as control group (group B). Patients' baseline characteristics, stenting strategy, complications, stent patency time and survival rates were analyzed, and continuous variables of the two groups were compared using Student's t-test. Categorical variables were analyzed using the Fisher exact test. Results Y-shaped jogged stent implantation group and control groups were closely matched in terms of patients' age, sex, type of tumor, stage, type of biliary obstruction, level of bilirubin at diagnosis, presence of metastasis and treatment ( P>0.05). The bilirubin decreased rate in the two groups was 88.2%and 53.0%respectively (P<0.05). The median time of stent patency after stent implantation was(7.3 ± 1.0)months and(5.7 ± 0.9) months respectively (χ2=4.04,P=0.044), and the median survival time was(9.1 ± 1.5)months and(7.2 ± 1.1)months (χ2=4.60,P=0.032), with significant difference according to Kaplan-Meier analysis. There were no severe complications such as massive hemorrhage, perforation, biliary fistula and severe pancreatitis, which were associated with stent implantation. Conclusions The application of Y-shaped jogged stent is safe, feasible and effective in patients with malignant hilar biliary obstruction. It can relieve the clinical symptoms of biliary obstruction effectively with prolongation of stent patency time and survival rate significantly.
9.Effect of Exercise Preconditioning on Apoptosis and Expression of P53 in Ischemic Penumbra in Rats after Cerebral Ischemia-Reperfusion
Xiaojun WU ; Tao YE ; Hongyu LI ; Yunfei JIANG ; Zhongwei ZHANG ; Luwen ZHU
Chinese Journal of Rehabilitation Theory and Practice 2016;22(10):1117-1120
Objective To explore the effect of exercise preconditioning on apoptosis and expression of P53 protein in ischemic penum-bra in rats after cerebral ischemia-reperfusion. Methods Thirty-six Sprague-Dawley rats were randomly divided into sham group, model group and exercise preconditioning group, with twelve rats in each group. The middle cerebral artery occlusion (MCAO) model was estab-lished with modified Longa's method. TUNEL method was used to observe the apoptosis of neural cells in the ischemic penumbra. Western blotting was used to detect the expression of P53 protein in the ischemic penumbra. Results Twenty-four hours after cerebral ischemia-reper-fusion, the number of TUNEL positive cells was more in the model group than in the sham group (P<0.01), and was less in the exercise pre-conditioning group than in the model group (P<0.01). The expression of P53 protein was higher in the model group than in the sham group (P<0.01), and was lower in the exercise preconditioning group than in the model group (P<0.01). Conclusion Exercise preconditioning coud down-regulate the expression of P53 protein in the ischemic penumbra, and inhibit the apoptosis of cortical cells.
10.Effectiveness of operating room environment in preventing artificial joint replacement infection
Qiuji WU ; Qiang LI ; Shao ZHANG ; Zhongwei GUO ; Shilong LI ; Tao YU
Chinese Journal of Tissue Engineering Research 2013;(39):6902-6907
BACKGROUND:Laminar flow operating room used in artificial joint replacement can improve the aseptic conditions and can effectively prevent the infections after joint replacement.
OBJECTIVE:To compare the number of colonies during artificial joint replacement in laminar flow operation room and traditional operation room.
METHODS:300 patients with artificial joint replacement in hundred-level laminar flow operation room and 300 patients with artificial joint replacement in traditional operation room were selected, and al the patients had no infection. Then 100 patients with artificial joint replacement were randomly selected from the hundred-level laminar flow operation room and traditional operation room respectively. The number of colonies in operation room of two groups was compared before and after replacement.
RESULTS AND CONCLUSION:There was no significant difference in the number of colonies between two groups before replacement, and the settling bacteria number of the artificial hip replacement patients in the hundred-level laminar flow operation room was significantly smal er than that in the traditional operation room (P<0.05). The results indicate that compared with the traditional operation room, the hundred-level laminar flow operation room for artificial joint replacement has higher safety and can effectively prevent infections after replacement.