1.Risk factor analysis for postoperative pulmonary infections with multidrug-resistant bacteria in patients with oral squamous cell carcinoma undergoing flap repair surgery
WANG Qian ; PENG Hui ; ZHANG Liyu ; YANG Zongcheng ; WANG Yuqi ; PAN Yu ; ZHOU Yu
Journal of Prevention and Treatment for Stomatological Diseases 2025;33(7):554-562
Objective:
To investigate the distribution patterns and risk factors for multidrug-resistant bacterial pulmonary infections in patients with oral squamous cell carcinoma (OSCC) undergoing flap reconstruction surgery, and to provide evidence for infection prevention and treatment in this population.
Methods:
This study was approved by the institutional medical ethics committee. We retrospectively analyzed sputum culture results, antimicrobial susceptibility testing data, and clinical records of 109 OSCC patients undergoing flap reconstruction. Chi-square tests were employed to identify pathogens and risk factors for multidrug-resistant bacteria (MDR) in postoperative pulmonary infections. Multivariate logistic regression analysis was conducted to determine MDR risk factors and establish a nomogram prediction model. The model’s discriminatory power, accuracy, and clinical utility were evaluated using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA).
Results:
Among the 109 patients, 52 had negative sputum cultures and 57 tested positive, of whom 14 developed multidrug-resistant (MDR) pulmonary infections. Chi-square analysis revealed that blood transfusion, pre-existing pulmonary diseases, operation time ≥ 490 min, intraoperative blood loss ≥ 400 mL, and abnormal BMI were significant risk factors for postoperative MDR infections (P < 0.05). Multivariate logistic regression identified pre-existing pulmonary diseases, intraoperative blood loss ≥ 400 mL, abnormal BMI, and operative duration ≥ 490 min as independent risk factors for MDR infections (P < 0.05). The nomogram prediction model for MDR infections demonstrated an area under the ROC curve (AUC) of 0.874 (95% CI: 0.775-0.973). The calibration plot showed good agreement between predicted and observed outcomes. DCA indicated a net clinical benefit when the threshold probability for high-risk MDR infections ranged from 0.000 to 0.810. Common MDR pathogens included MDR Pseudomonas aeruginosa, MDR Klebsiella pneumoniae, carbapenem-resistant Acinetobacter baumannii (CRAB), and methicillin-resistant Staphylococcus aureus (MRSA).
Conclusion
Among OSCC patients undergoing flap reconstruction, MDR pulmonary infections were predominantly caused by gram-negative bacteria (including CRAB, MDR Pseudomonas aeruginosa, and MDR Klebsiella pneumoniae along with the gram-positive pathogen MRSA. Pre-existing pulmonary comorbidities, prolonged surgery duration (≥ 490 min), significant intraoperative blood loss (≥ 400 mL), and abnormal BMI were confirmed as independent risk factors for these MDR infections. The nomogram predictive model incorporating these four variables demonstrated clinically reliable accuracy in risk stratification for postoperative MDR pulmonary infections in this patient population.
2.The relationship of MRI features and clinical characteristics of subcortical ischemic vascular disease with cognitive impairment
Hebo WANG ; Peiyuan LV ; Zongcheng GUO ; Tianjun WANG ; Hezhen ZHANG ; Changlin LIU ; Wei JIN ; Yaqing FENG ; Ling LI ; Dawei ZHAO ; Jianhua WANG
Chinese Journal of Geriatrics 2009;28(7):573-576
Objective To investigate the relationship of lacunar infarction (LI) and white matter lesion with cognitive impairment in patients with subcortical ischemic vascular disease (SIVD) Methods Fifty-three patients were diagnosed as SIVD according to the criteria of Erkinjuntti. The symptoms and signs were recorded by an interview and examination, and neuropsychological assessment and magnetic resonance imaging (MRI) were performed. A semi-automated MRI quantitative method was used to measure the volume of white matter hyperintensity (WMH) and the number of LI was counted. Correlation and the partial correlation analysis were performed to examine the relationship of general cognitive function with the volume of WMH and the number of LI. Results The pseudobulbar paralysis symptom and the upper motoneuron injury sign were the most common in these patients (18.9% and 37.7%). Correlation analysis showed that there was positive correlation between the volume of WMH and age (r = 0. 518, P < 0. 05), and there was negative correlcction between mini-metal state examination (MMSE) scures and the volume of WMH (r=-0.514, P<0. 05), After controlling confounding factors, only age was positively correlated with the volume of WMH (r=0. 400, P=0. 004). There were negative correlation between the number of LI, the volume of WMH and MMSE scores(r=-0. 456,-0. 514,-0. 385,-0. 382;all P<0. 05), and the years of education was positively correlated with MMSE scores (r= 0. 518, P< 0. 001). Conclusions Age may not be the main risk factor for cognitive impairment in patients with SIVD. The volume of WMH and the number of LI are independent risk factors for cognitive impairment in patients with SIVD. Patients with severer SIVD or more LI show poorer performance on cognitive function.
3.Cloning of silkworm 3-hydroxyisobutyrate dehydrogenase gene and its expression patterns analysis in simulated weightless environment.
Zongcheng TIAN ; Bo ZHOU ; Airong QIAN ; Huiyun XU ; Shengmeng DI ; Yunpo ZHAO ; Yuping ZHANG ; Jia LIU ; Yongping HUANG ; Peng SHANG
Chinese Journal of Biotechnology 2008;24(12):2041-2048
The full length cDNA of silkworm hibadh gene was cloned by RT-PCR and RACE (Rapid amplification of cDNA ends) technique. The hibadh gene and its deduced amino acid sequences were analyzed. The tissue distribution of hibadh gene in 5th instar silkworm larvae was tested by RT-PCR. The expression patterns of hibadh gene in simulated weightless environment were analyzed by real time RT-PCR. The results showed that the full length hibadh cDNA sequence was 1074 bp in lenth, including an open read frame of 969 bp encoding the entire coding region of Hibadh (GenBank accession No. EU719652). The deduced amino acid sequence similarities of hibadh between silkworm and Burkholderia ambifaria, Drosophila melanogaster, Apis mellifera, Xenopus tropicalis, Mus musculus, Homo sapiens were 46%, 43%, 48%, 44%, 45%, 45%, respectively. Signal peptide analysis showed that Hibadh was a secretory protein. There wasn't glycosyl-phosphatidyl inositol anchor site in Hibadh amino acid sequence. Molecular weight and isoelectric point of Hibadh were 34.1 kD and 9.14 respectively. The RT-PCR tests indicated that the hibadh gene expressed in head, silk gland, midgut, cuticle, blood, fat body, tuba malpighii of the 5th instar silkworm larvae. There were different expression patterns of hibadh gene during different silkworm embryo period in simulated weightless environment. Simulated weightlessness resulted in the expression of silkworm hibadh gene up regulated 2.3-fold (P < 0.05), up regulated 4.6-fold (P<0.01), down regulated 7.6-fold (P < 0.01), down regulated 2.6-fold (P < 0.05) during apophysis formation period, inverse period, trachea formation period, and whole embryo period, respectively. There was no significant change of hibadh gene expression during other period of silkworm embryo between simulated weightless and control groups. There were different response patterns to simulated weightless environment between hibadh gene and whole body of silkworm. Gene showed much higher sensitivity compared to whole body in response to environment. This study is useful for the further research on the gravity biological mechanism of hibadh gene.
Alcohol Oxidoreductases
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genetics
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metabolism
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Amino Acid Sequence
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Animals
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Base Sequence
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Bombyx
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enzymology
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genetics
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Cloning, Molecular
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Computer Simulation
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Genes, Insect
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genetics
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Models, Biological
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Molecular Sequence Data
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Weightlessness
4.Intervention of xuezhikang on patients of acute coronary syndrome with different levels of blood lipids.
Wei-Hua WANG ; Hui ZHANG ; Yan-Lin YU ; Zongcheng GE ; Cheng XUE ; Pingyang ZHANG
Chinese Journal of Integrated Traditional and Western Medicine 2004;24(12):1073-1076
OBJECTIVETo observe the intervention of Xuezhikang (XZK) on patients of acute coronary syndrome (ACS) with different levels of blood lipids.
METHODSAdopting the double blind randomized controlled method, 105 patients of ACS were divided into two groups. The 53 patients in the treated group, 26 with normal blood lipids (NBL) and 27 with hyperlipemia (HL) were treated with conventional western medicine plus XZK 1.2 g per day for 12 weeks. The 52 patients in the control group, 25 with NBL and 27 with HL, were treated with conventional western medicine alone. Besides, a healthy control group consisted of 40 subjects was set up. The changes of brachial arterial endothelium-dependent diastolic function (FMD) before and after treatment was observed, the changes of blood levels of nitric oxide (NO), endothelin-1 (ET-1), C-reactive protein (CRP) and lipids were also recorded.
RESULTSBefore treatment, FMD value and serum NO level were lower and ET-1 and CRP levels in ACS patients were higher than those in the healthy subjects, and a significant correlation existed between CRP, NO and FMD with LDL-C. After treated for 12 weeks, FMD value and serum NO level increased, levels of ET-1 and CRP decreased significantly in the treated group, showing significant difference to those in the control group (P < 0.05, P < 0.01). Serum levels of TC, TG and LDL-C in the treated group lowered significantly. HDL-C level in patients with HL increased significantly while in those with NBL, it showed a trend of increasing but with no statistical significance.
CONCLUSIONApplying XZK in ACS patients in early stage, either with NBL or with HL, could improve the endothelial function, antagonize inflammatory response to stabilize the atheromatous plaque.
Adult ; Aged ; Angina, Unstable ; blood ; complications ; drug therapy ; Biological Products ; Cholesterol ; blood ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Hyperlipidemias ; blood ; complications ; drug therapy ; Lipoproteins, LDL ; blood ; Male ; Middle Aged ; Myocardial Infarction ; blood ; complications ; drug therapy ; Phytotherapy
5.Changes of gastric mucosal blood flow and pH value during severe intraperitoneal infection in rats
Chao ZHANG ; Zhankui LIU ; Jun JIANG ; Zongcheng YANG ;
Journal of Third Military Medical University 2003;0(07):-
Objective To investigate the changes of gastric mucosal blood flow and intramucosal pH value (pHi) during severe intraperitoneal infection in rats and the related significance. Methods The intraperitoneal infection rat model was established by cecal ligation and puncture (CLP). Laser Doppler blood flow meter on micro circulation and the vitreous electrode were used to examine the gastric mucosal blood flow and the gastric mucosal pH value, respectively. Results The gastric mucosal blood flow (GMBF) in the infected group was significantly lower than that in the control group ( P
6.p38 kinase pathway mediated cardiomyocyte injury in rats due to hypoxia and burn serum
Jiaping ZHANG ; Yuesheng HUANG ; Zongcheng YANG ;
Journal of Third Military Medical University 2003;0(18):-
Objective To investigate the roles of the activated p38 kinase in cell injury by observation of the effects of hypoxia and burn serum on cardiomyocyte p38 kinase and JNK activation. Methods Phosphorylation of p38 kinase and JNK in primary cultured neonatal rat cardiomyocytes before and after hypoxia and burn serum was determined by Western blotting. Effects of pretreatment with SB203580 at the dose of 10 ?mol/L on the changes of phosphorylation of p38 kinase in cardiomyocytes, lactate dehydrogenase (LDH) activity, cell vitality and apoptosis were investigated, respectively. Results Exposure of rat neonatal cardiomyocytes to hypoxia and burn serum resulted in a rapid and long lasting activation of p38 kinase but no significant activation of JNK. SB203580(10 ?mol/l), a selective inhibitor of p38 kinase, could inhibit p38 kinase activation dramatically, decrease the LDH activity in culture media and cell apoptosis significantly and improve cell vitality. Conclusion In the two stress activated signal pathways of MAPKs family, p38 kinase pathway, but not JNK, is the major pathway activated by hypoxia and burn serum and participates in the cardiomyocyte injury.
7.The relationship between apoptosis of the cardiac myocytes and myocardial dysfunction in severely scalded rats.
Jiaping ZHANG ; Yuesheng HUANG ; Xin ZHOU ; Jing LIU ; Zhonghua LUO ; Zongcheng YANG
Chinese Journal of Burns 2002;18(5):272-275
OBJECTIVETo investigate relationship between apoptosis of the cardiac myocytes and myocardial dysfunction in severely scalded rats.
METHODSWistar rats inflicted by 40% TBSA III degree scalding were employed as the model. The myocardial tissue was obtained from the left ventricle at different postburn time points. Apoptosis was determined by the determination of myocardial tissue Caspase-3 activity and TUNEL staining (terminal deoxynucleotidyl transferase (TdT)-mediated dUTP-biotin nick end labeling). The LVSP (left ventricular systolic pressure), LVEDP (left ventricular end-diastolic pressure) and +dp/dtmax (the rate of the rise of left ventricular pressure) and -dp/dtmax (the rate of the fall of left ventricular pressure) were all monitored by four-channel physiological recorder. In addition, myocardial activities of MPO and SOD were detected.
RESULTSThe TUNEL staining of rat myocardial cells was positive at 6 postburn hour (PBH) and reached top level at 12 PBH. The change in Caspase-3 activity was earlier than that of apoptotic morphology and reached peak values at 3 and 6 PBHs. The left ventricular function (systolic and diastolic function) was significantly impaired after the scalding and dropped to the lowest levels at 12 PBHs. The increase in myocardial tissue MPO activity was accompanied by the decrease in SOD activity.
CONCLUSIONMyocardial cellular apoptosis was one of the reasons of postburn myocardial injury in scalded rats. Caspase protease cascade pathway might be involved in the process of apoptosis, which suggested that the initiation of apoptosis was closely related to the infiltration of neutrophils and to the release of large amounts of oxygen free radicals in myocardial tissue.
Animals ; Apoptosis ; Burns ; pathology ; physiopathology ; Caspase 3 ; Caspases ; metabolism ; Female ; Male ; Myocytes, Cardiac ; pathology ; Peroxidase ; metabolism ; Rats ; Rats, Wistar ; Superoxide Dismutase ; metabolism ; Ventricular Function, Left
8.The role of the change in glucocorticoid receptor in stress-induced gastric ulcer in severely burned rats.
Chao ZHANG ; Zongcheng YANG ; Ao LI
Chinese Journal of Burns 2002;18(3):163-165
OBJECTIVETo investigate the role of the change in glucocorticoid receptor in stress-induced gastric ulcer in severely burned rats.
METHODSWistar rats inflicted with 30% TBSA full-thickness burn were employed as the model. The dynamic postburn change in the glucocorticoid receptor in gastric mucosal tissue and gastric mucosal injury (injury index) were observed.
RESULTSThe gastric mucosal cortisol content increased as of 3 postburn hours (PBHs) and peaked at 12 PBHs. But the cytoplasmic glucocorticoid receptor content in the gastric mucosal cells decreased evidently. In addition, the gastric mucosal injury index increased obviously at 12 and 24 PBHs.
CONCLUSIONThe decrease of gastric mucosal cytoplasmic glucocorticoid receptor content might be closely related to the stress-induced gastric mucosal injury.
Animals ; Burns ; complications ; metabolism ; Disease Models, Animal ; Male ; Rats ; Rats, Wistar ; Receptors, Glucocorticoid ; metabolism ; physiology ; Stomach Ulcer ; complications ; metabolism ; Stress, Physiological ; complications
9.The change in apoptosis and proliferation of pulmonary tissue cells in rats with smoke inhalation injury.
Wenjun LI ; Zongcheng YANG ; Xiaodong YANG ; Tianpeng JI ; Hong ZHANG ; Erhong LI ; Guanghe ZHAO ; Bin ZHANG ; Xia LIU
Chinese Journal of Burns 2002;18(3):139-141
OBJECTIVETo observe the rule of the change of apoptosis and proliferation of pulmonary tissue cells in rats with inhalation injury, so as to explore the significance of apoptosis in the repairing process of pulmonary tissue injury.
METHODSSmoke inhalation injury model was established in rats. The rats were randomly divided into normal control (NC) and smoke inhalation injury (SI) groups. TUNEL and immunohistochemistry methods were employed to determine the changes in cellular apoptotic and proliferating cell nuclear antigen (PCNA) indices of the pulmonary tissue at different postburn time points.
RESULTS(1) The apoptotic index increased at 2 postburn hours (PBHs) and remained at high levels thereafter. (2) The PCNA index increased at 12 PBHs, reaching top level at 3 postburn days (PBDs), remaining kept at relativly high level later.
CONCLUSIONApoptosis not only played roles in the early pulmonary injury after smoke inhalation injury, but also participated in the repair and modification of the proliferated tissue during later reconstruction.
Animals ; Apoptosis ; Cell Division ; Disease Models, Animal ; Female ; Lung ; pathology ; Male ; Proliferating Cell Nuclear Antigen ; metabolism ; Rats ; Rats, Wistar ; Smoke Inhalation Injury ; metabolism ; pathology
10.Investigation of overall Wiener spectrum measurement in a computed radiography system
Jindong XIE ; Zongcheng WANG ; Changyuan WANG ; Yude YUAN ; Jian WANG ; Menglong ZHANG
Chinese Journal of Radiology 2001;0(05):-
Objective To study the effect of image processing on overall Wiener spectrum (WS) in a computed radiography system. Methods Imaging plate was exposed using conventional X-ray equipment. Overall WS sampling films were made by changing 3 parameters of spatial frequency processing, including frequency rang(RN), frequency type(RT), and degree of enhancement(RE), and by changing 1 of 4 parameters of gradation processing(rotation amount,GA).WS values were calculated by scanning on micro-densimeter for every film proceeded as discrete signal using fast Fourier transform. Results (1) The WS value of subscan direction was 7.26?10 -5 mm 2 when the spatial frequency was 1.0 LP/mm, it was 1.57 times larger than that of scan direction. The WS had peaks under high spatial frequency at sunscan direction. (2) The WS value of RN with 0 at scan direction was 7.90?10 -5 mm 2 when the spatial frequency was 1.0 LP/mm, it was 1.70 times larger than that of RN with 5, and 3.30 times larger than that of RN with 9. (3) The WS value of RE with 1.5 at scan direction was 1.05?10 -4 mm 2when the spatial frequency was 1.0 LP/mm, it was 2.27 times larger than that of RE with 1.0, and 2.92 times larger than that of RE with 0.5. (4) The WS value of GA with 1.5 at scan direction was 1.25?10 -4 mm 2 when the spatial frequency is 1.0 LP/mm, it was 2.70 times larger than that of GA with 0.8. (5) The WS value of RT with T at subscan direction was 9.80?10 -5 mm 2 when the spatial frequency was 1.0 LP/mm, it was 1.02 times larger than that of RT with F, and 1.35 times larger than that of RT with R, and also 1.55 times larger than that of RT with P. Conclusions RN, RE, and GA contributed strongly to Wiener spectra, but the contribution of RT was small. When processing the clinical images, adequate processing parameters should be chosen to reduce the image noise, so as to meet the clinical diagnostic need.


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