1.Prognostic factors of papillary thyroid carcinoma in young people
Weiye DENG ; Yanfeng CHEN ; Hao LI ; Yunfei GAO ; Zhuming GUO
Chinese Journal of General Surgery 2015;30(2):115-118
Objective To analyze the treatment effect and factors affecting the prognosis in young people of papillary thyroid carcinoma (PTC).Methods A total of 69 PTC patients were reviewed retrospectively in Sun Yatsen University Cancer Center from Dec 1996 to Oct 2005.The prognostic status were compared using the Kaplan-Meier methods,the factors were analyzed by Log-rank test and the multiple factors were estimated by the Cox regression models.Results There were 26 males and 43 females.The median age was 24 years (mean:23.1 years).The average follow-up time was 113 months ranging from 73 to 174 months.20.3% patients (14/69) experienced recurrence during follow-up time and 1.4% patient (1/69) died.All the patients received levothyroxine after operation.The 10 year disease-free survival (DFS) rate of patients with or without extra thyroidal extension (ETE) of PTC was 29.6% and 80.1%,respectively (P < 0.01).Multivariate analysis showed that young PTC people with ETE had a worse prognosis (P =0.004).Conclusions Young papillary thyroid carcinoma patients had a favorable outcome.Surgical procedure was the first choice for this kind of patients.ETE was an independent factor for the recurrence of young PTC patients.
2.Prevalence of nutritional risk,undernutrition-overweight/obesity-and application of nutrition support in departments of neurology in metropolitan hospitals in Beijing
Liying CUI ; Haibo CHEN ; Yingying SU ; Kang YU ; Ming YAO ; Sainan ZHU ; Chen YAO ; Zhuming JIANG
Chinese Journal of Clinical Nutrition 2009;17(2):67-70
Objective To investigate the prevalence of nutritional risk,undemutrition,overweight/obesi-ty,and apphcation of nutrition support in departments of neurology in 3 metropolitan hospitals in Beijing. Methods Adult patients in the departments of neurology from 3 metropolitan hospitals in Beijing were consecutively en-rolled from March 2005 to March 2006.Nutritional Risk Screening 2002(NRS2002)score≥3 was defined a8 nu-tritian risk,while body mass index(BMI)<18.5 ks/m2 as undemutrition.NRS2002 was performed on the next morning of admission and nutritional support evaluation was performed on the 14th day of admission or discharge day.The relationship between nutrition risk and nutrition support was analyzed.Results A total of 753 patients were enrolled.NRS2002 scoring results were obtained in 461 patients.The prevalence of undemutrition was 4.2%and nutritional risk Was 21.2%.Among them 292 cases in undemutrition category were estimated by semm albu-min<30g/L without accurate BML If the cases without accurate BMl were excluded,the prevalence of undemutri-tion was 5.4%and nutritional risk Was 10.8%.Twenty-three patients(14.4%)with NRS2002≥3 received nutrition support.Thirteen patients(2.2%)with NRS2002<3 received nutrition support.The average PN:EN ratio Wag 1:2.Conclusions A large proportion of inpatients were at nutritional risk or undemutrition in the de-partments of neurology in metropolitan hospitals in Beijing.The application of nutrition support Wag somehow inap-propriate in these patients.Evidence-based guidelines are required to improve this situation
3.Power analyses for clinical study design in omega-3 fatty acid intervention trials
Yang WANG ; Zhuming JIANG ; Yanwu ZHANC ; Tao CHEN ; Kang YU ; Jin GUO
Chinese Journal of Clinical Nutrition 2012;20(4):195-199
Power analyses(samples size calculation)is critical in protocol design for clinical trials.Adequate power ensures the credibility and reliability of the clinical trial results.In this article,omega-3 fatty acid supplementation study is chosen as an example to explain the power analysis in practice during the study design.First,obtaine the parameter estimates from the high-quality literature review and relevant systematic review(meta analyses)results.Then,calculate the sample size under different parameter settings and select the final patient number according to the clinical practice.Based on the above information,statistical simulation is performed to assume diverse possible combination of the outcome in real clinical trial.Further,under the specific determined sample size,the simulation pointing out the different positive or negative results when the real clinical trial is conducted.The determination of sample size of a clinical trial should be based on both the clinical and statistical considerations.
4.Preliminary investigation of the current situation of postoperative fluid therapy in general surgery department of grade Ⅲ-A general hospitals in Beijing and Tianjin
Mingwei ZHU ; Yun TANG ; Yanjin CHEN ; Jingyong XU ; Xiansheng WU ; Changlin ZOU ; Hongyuan CUI ; Zhuming JIANG
Chinese Journal of Geriatrics 2008;27(11):868-871
ObjectiveTo investigate the current situation of postoperative fluid therapy in general surgery department of grade Ⅲ-A general hospitals in Beijing and Tianjin. Methods Postoperative patients in general surgery department who were fasting for 3 days were retrospectively investigated, and 600 cases were recruited without considering age, gender, denomination of disease and operation type.The general information of patients, laboratory examination before and after operation, postoperative fluid therapy for 3 days, postoperative complications and infusion reaction were collected.Results In total 588 valid cases, the volume of average fluids supplement was (3030±638)ml per day, With the prescribed glucose (142+67)g per day, potassium chloride (59.9±23.9) mmol per day and sodium chloride (179.5±66.7) mmol per day. 85.2 % of total patients received nutrition support and the ratio of parenteral nutrition/enteral nutrition (PN/EN) was 28/1.There were 549 patients with BMI>18.5 before operation, and among them, 470 cases (85.6%)received parenteral and enteral nutrition treatment. There were 39 patients with BMI < 18.5 and 27 cases (69.2%) received parenteral nutrition support without enteral nutrition treatment. During the 3 days after operation, there were 36 cases with fluid therapy without potassium chloride supplement.ConclusionsThe proportions of receiving nutrition support and parenteral nutrition treatment are relatively high in grade Ⅲ-A general hospitals in Beijing and Tianjin. Ready-to-use preparation canreduce mistake and will be benefit to patients.
5.Application of ultrasonically activated scalpel in open thyroid surgery
Dongkun ZHANG ; Zhuming GUO ; Quan ZHANG ; Wenkuan CHEN ; Hao LI ; Shunlan WANG
Chinese Archives of Otolaryngology-Head and Neck Surgery 2006;0(06):-
OBJECTIVE To investigate the use ofultrasonically activated scalpel (UAS) in open thyroid surgery. METHODS From February 2004 to March 2005, thyroidectomy were performed in 77 cases by the same operation team. Forty seven cases received UAS thyroidectomy and 30 cases underwent conventional thyroidectomy. The operation time, estimated blood loss in operation, postoperative draining volume within the 24 hours, the length of hospitalization and postoperative complications between two groups were compared. RESULTS The average operation time of lobectomy and total/subtotal thyroidectomy in the UAS group were 61?4.34 and 85?3.02 minutes, and in conventional group were 82?3.37 and 121? 2.51 minutes. There was a significant difference in average operation time (P0.05). CONCLUSION The use of UAS in thyroid surgery was safe and can reduce the operation time.
6.Prevalences of nutritional risk,undernutrition-overweight,and obesity as well as nutritional support in hospitalized general surgical patients in Beijing teaching hospitals
Xiaokun LIANG ; Zhuming JIANG ; T.nolan MARIE ; Kang YU ; Wei CHEN ; Xinjuan WU ; Haiyan ZHANG ; Yining ZHENG ; Huaping LIU ; Kondrup JENS
Chinese Journal of Clinical Nutrition 2009;17(2):75-78
Objecflve To determine the prevalences of nutritional risk,undemutrition,overweight,and obesity as well as nutritional support and the changes of nutritional risks from admission to discharge or over a two-week period.Methods A consecutive sampling was performed.Dam were collected from general surgical depart-ments in three Beijing teaching hospitals from March to July in 2007.Patients were screened using Nutritional Risk Screening 2002(NRS2002)on admission and two weeks after admission(or discharge).The nutritional supper apphcation during hospital stay was recorded.NRS2002 score≥3 was classified as nutritional risk.BMI<1 8.5kg/m2 with impaired genend condition was defined as undemutrition.Results Among 300 enrolled patients,the NRS2002 WaS completed by 99.0%(297/300)of all patients.The nutritional risk and the prevalence of under_nutrition,overweight,and obesity was 30.0%,8.1%,38.3%,and 9.4%,respectively at admission.Fifty of 90(62.2%)patients who were at nutritional risk received nutritional support while 40 of 210(19.O%)non-risk patients received nutritional support.Especially among major abdominal surgery patients,56 of 90(71.6%)pa-tients who were at nutritional risk received nutritional supper while 35 of 81(43.2%)non-risk pafients received nutritional support.The prevalence of nutritional risk changed from 30.0%to 35.8%(X2=2.271,P=0.132).Conclusions NRS2002 is a feasible nutritional risk screening tool among general surgical pafienm in selected Bei-jing teaching hospitals.Nutritional support is somehow inappropriately apphed in general surgical hospitalized pa-tients.The prevalence of nutritional risk remains unchanged in general surgical patients during hospitalization.
7.The advantages of bovine jugular vein tanned with hydrophilia crosslinking agent.
En CHEN ; Wenxiang DING ; Yanan LU ; Zhuming JIAN ; Xiaoqing YU ; Wenyan ZHOU
Journal of Biomedical Engineering 2004;21(1):66-71
The bovine jugular veins were divided into two groups and treated with 4% EX-313 and 0.5% glutaraldehyde respectively, and then they were examined with naked-eye, microscope and scanning electron microscope. Biomechnics test and dorsal implantation in rats were performed. The aquired data were processed and subjected to t-test. The EX-313 fixed material was more pliable than the glutaraldehyde treated material, and the former had higher anticalcification than the latter. In conclusion, the hydrophilia crosslinking agent EX-313 is superior to glutaraldehyde in treating biomaterials, and the bovine jugular vein tanned with EX-313 should be a promising material for repairing in cardiovascular surgery.
Animals
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Bioprosthesis
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Blood Vessel Prosthesis
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Cattle
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Cross-Linking Reagents
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pharmacology
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Glutaral
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pharmacology
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Jugular Veins
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drug effects
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Materials Testing
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Rats
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Rats, Sprague-Dawley
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Tissue Engineering
8.A cross-sectional survey on nutritional risk and prevalence of malnutrition per Global Leadership Initiative on Malnutrition criteria in patients with end-stage malignant gastrointestinal tumors in a tertiary (A) hospital in Changsha
Minjie ZENG ; Mengyou ZHANG ; Ming LIU ; Yu ZHANG ; Huan WAN ; Chen CHEN ; Yanping XIE ; Ke TANG ; Zhan LIU ; Liuqing YAN ; Han GU ; Xianna ZHANG ; Zhuming JIANG
Chinese Journal of Clinical Nutrition 2021;29(5):275-280
Objective:To investigate the nutritional risk and prevalence of malnutrition in patients with terminal stage gastrointestinal malignant tumors in a tertiary hospital in Changsha.Methods:Cluster sampling was used to conduct a cross-sectional survey of inpatients from Departments of Gastroenterology, Gastrointestinal Surgery, Hepatobiliary Surgery and Oncology in Hunan Provincial People's Hospital from January 2019 to July 2020. Nutritional Risk Screening 2002 (NRS 2002) was used to assess the prevalence of nutritional risk with malnutrition defined as concurrent presence of BMI < 18.5 kg/m 2, poor general condition and NRS 2002 nutritional impairment score of 3. Step 2 of Global Leadership Initiative on Malnutrition (GLIM) diagnostic criteria (without whole body muscle mass) was adopted to diagnose malnutrition. Step 3 of GLIM criteria was used to evaluate the prevalence of severe malnutrition. Results:A total of 802 patients registered in the 4 departments were selected for screening via cluster sampling and 514 were enrolled according to the inclusion/exclusion criteria. The prevalence of nutritional risk in patients with terminal stage gastrointestinal cancer was 49.8% (256/514). The prevalence of malnutrition and severe malnutrition per GLIM criteria were 41.6% (214/514) and 18.3% (94/514), respectively.Conclusions:Although nutritional support therapy is not recommended for patients with end-stage cancer. This paper suggests that the prevalence of nutritional risk and malnutrition in patients with end-stage gastrointestinal cancer is not as high as described in some articles.
9.Nutritional support therapy after GLIM criteria may neglect the benefit of reducing infection complications compared with NRS 2002-Re analysis based on a prospective cohort study
Xianna ZHANG ; Haofen XIE ; Zhuo LI ; Bin JIE ; Jingyong XU ; Cheng CHEN ; Weiming KANG ; Xin YE ; Zhuming JIANG
Chinese Journal of Clinical Nutrition 2023;31(2):106-112
The inconsistency of diagnostic criteria for malnutrition has confused clinicians since the 1980s. After the implementation of disease diagnosis related group payment (DRG) in China's public hospitals, the diagnosis of malnutrition and the correct documentation of nutrition-related diagnosis on the front sheet of medical records are related to the correct classification of the disease group and the medical insurance payment. Therefore, the reliable diagnostic criteria for malnutrition, especially disease-related malnutrition, is urgently needed in clinical practice. In September 2018, The global leadership Iinitiative on malnutrition (GLIM) diagnostic criteria consensus was launched. GLIM aimed to provide the explicit and unified diagnostic criteria for malnutrition in adult hospitalized patients. However, GLIM criteria was based on the voting by nutritional experts and was merely a consensus in nature. The clinical validity of GLIM criteria needs prospective verification, i.e., to demonstrate that patients with malnutrition as per GLIM criteria could have improved clinical outcomes with reasonable nutritional interventions. In November 2020, the article titled Nutritional support therapy after GLIM criteria may neglect the benefit of reducing infection complications compared with NRS 2002 was published on the journal Nutrition. It was the first study comparing nutritional risk screening 2002 (NRS 2002) and GLIM malnutrition diagnostic criteria among Chinese patients for the indication of nutritional support therapy. The clinical effectiveness of the two tools was retrospectively verified as well. Here we discussed the key points of this retrospective study, including the critical research methods, to inform the currently ongoing prospective validation of the GLIM malnutrition diagnostic criteria (the item of reduced muscle mass not included).
10.Clinical application of carbon nanoparticles in surgery for papillary thyroid carcinoma in young patients.
Weiye DENG ; ; Hao LI ; ; Yanfeng CHEN ; ; Yunfei GAO ; ; Haiyan HUANG ; ; Shaojian LIN ; ; Jianwei WANG ; ; Zhuming GUO ;
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2014;49(10):812-816
OBJECTIVETo investigate the number of dissected lymph nodes and the incidence of injury to parathyroid glands during surgery for papillary thyroid carcinoma (DTC) in young patients.
METHODSThis study collected clinicopathological data of 51 young patients with PTC. Of the 51 patients, 18 patients were classified into carbon nanoparticles group (CNP group) and 33 patients into traditional surgical group (TS group). The number of dissected lymph nodes and the incidence of injury to parathyroid glands were analyzed using Wilcoxon rank sum test and chi-square test.
RESULTSThere were 16 males and 35 females, with a male/female ratio of 1: 2.19. The age ranged from 14 to 29 (25 ± 3.9) years. There was no statistically significant difference in age, gender, T-classification, TNM stage and surgical procedures between two groups (P > 0.05). The total number of dissected lymph nodes in CNP group was higher than that in TS group (Z = -2.258, P < 0.05) . However, significant difference in the total number of metastatic lymph nodes between the two groups was not found (Z = -0.396, P > 0.05). In level VI, the detected lymph node number of group CNP was higher than that of TS group (Z = -2.461, P < 0.05) but there was no significant difference in the detected number of metastatic lymph nodes (Z = -1.396, P > 0.05) . The rates of injury to parathyroid gland were 5.5% in CNP group and 18.2% in TS group, respectively (χ(2) = 1.568, P > 0.05).
CONCLUSIONCarbon nanoparticles could be an effective lymph nodes tracer applying to PTC operation in young patients.
Carbon ; Carcinoma ; therapy ; Carcinoma, Papillary ; Female ; Humans ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Metastasis ; Male ; Nanoparticles ; Nanotubes, Carbon ; Parathyroid Glands ; Thyroid Neoplasms ; therapy