1.The value of serum pro-adrenomedullin for assessing prognosis of patients with closed rupture of small intestine
Yawei XIANG ; Heping XIANG ; Ming GAO ; He LI ; Wei WANG
Chinese Journal of Emergency Medicine 2016;25(3):356-361
Objective To explore the relationship between preoperative serum pro-adrenomedullin (pro-ADM) in the patients with closed rupture of small intestine,and postoperative secondary abdominal infection,and to study the value of postoperative serum pro-ADM in assessment of severity of postoperative secondary abdominal infection of this patients.Methods Eighty-five patients with closed rupture of small intestine treated in the emergency surgery from June 2014 to May 2015 were selected.According to the presence of postoperative abdominal infection or not,these patients were divided into infection group and non-infection group.The infection group was further divided into SIRS,sepsis,severe sepsis,septic shock subgroups as per the severity of infection.The levels of serum pro-ADM,interleukin-6 (IL-6),C-reactive protein (CRP) were determined and the acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score was calculated at admission and the first day、the second day and the third day after operation.Comparisons of these biomarkers were carried out to find out the factors associated with postoperative abdominal infection.In addition,ROC curve was used to verify the factors for predicting the abdominal infection of these patients after operation.The relationship between serum levels of pro-ADM and APACHE Ⅱ score after operation was analyzed.The severity of abdominal infection after operation was assessed with laboratory findings.Results Compared with non-infection group,preoperative and postoperative serum pro-ADM (P =0.03,P < 0.01),IL-6 (P =0.02,P <0.01) levels and APACHE Ⅱ scores (P < 0.01,P < 0.01) were significantly higher in infection group (P < 0.05).In the infection groups,the postoperative levels of serum pro-ADM and APACHE Ⅱ scores were increased with the severity of infection increased (r =0.924),and the difference between the groups was statistically significant (P < 0.05),but there were no significant differences in IL-6 and CRP levels between two groups.Conclusion (1) The serum levels of pro-ADM before operation has value in predicting the genesis of abdominal infection in these patients after operation.(2) The serum levels of pro-ADM after operation has value in severity assessment of abdominal infection in these patients after operation.
2.Analysis on the Change of NCMS Patients’ Hospitalization Costs Based on Structure Variation Degree
Yan XIAO ; Shaozhong WEI ; Li XIANG
Chinese Health Economics 2014;(5):24-27
Objective: To analyze the structure changes of New Rural Cooperative Medical System(NCMS) patients ’ hospitalization costs in a county-level city, and provide references for controlling hospitalization cost. Methods: Collect the cost details of NCMS patients in May from 2012 to 2013, and analyze the structure changes of hospitalization costs though the analysis method of structure variation degree. Results: Specialized hospital has the largest structure change of hospitalization cost, followed by first-level hospitals. Different cost items at hospital of different levels have a different direction of structure changes. Drug and examination are the major factors posing the changes in structure of hospitalization costs. Conclusion: There are significant results on the cost control since the implementation of new NCMS. Although the role of Chinese medicine to be prominent, there is still insufficient. The control of examination cost is a link which could not be ignored in future.
3.Comparison of the clinical effect of VATS and thoracotomy pulmonary wedge resection of in treatment pulmonary inflammatory pseudotumor
Kemin XIANG ; Wei LI ; Nengjun YANG
Chinese Journal of Primary Medicine and Pharmacy 2011;18(3):311-312
Objective To compare the clinical effect of VATS and thoracotomy pulmonary wedge resection in treatment of pulmonary inflammatory pseudotumor. Methods 46 patients with pulmonary inflammatory pseudotumor were randomly divided into the observation group(24 cases) and the control group(22 cases) ,the control group were treated by thoracotomy pulmonary wedge resection and the observation group were treated by VATS wedge resection,the intraoperative blood loss,hospital stay, prognosis and complications were compared. Results All patients of two groups were cured and discharged. The intraoperative blood loss of observation group[(46. 0±12. 3 ) ml] was significantly less than the control group [(95.2 ± 18. 6) ml] ( t = 3. 19, P < 0. 05 ), and the hospital stay was significantly shorter than the control group( t = 3.01,P < 0. 05 ), the difference of the incidence of complications of two groups was not statistically significant( P > 0. 05 ). Conclusion VATS wedge resection of pulmonary inflammatory pseudotumor had features of less bleeding and quicker healing characteristics,could be worthy of clinical application.
7.Physical and mechanical characteristic of bone cement mixed with antibiotics
Wei-Min FAN ; Xi CHEN ; Xiang LI ;
Chinese Journal of Orthopaedics 2001;0(06):-
Objective To investigate the physical and mechanical properties of home-made bone cement mixed with different antibiotics.Methods The specimens of bone cement each of 40g were divid-ed in to6groups depending on mixed antibiotics,groupⅠmixed with1g gentamicin,groupⅡwith2g gen tam icin,groupⅢwith1g cephradine,groupⅣwith1.5g cefuroxine,groupⅤwith1g ceftriaxone and groupⅥwith out any antibiotics served as control.The dough time,compressing depth,compressive strength,bending strength and bending elastic modulus were measured respectively,elution examination of antibiotics from bone ce ment was performed by chromatography.Results The dough time and compress-ing depth of the groups were better than that of ISO5833standard,and there was no significant difference a-mong the groups.The com pressive strength and bending strength of the groupⅡwere lower than that ISO5833standard,but there was no significant difference among the groups by analysis of variance.The bending elastic modulus of the groupⅡwas lower than the control group and other groups(P
8.MICROARRAY ANALYSIS OF DIFFERENT GENE EXPRESSION OF HUMAN CERVICAL CANCER SUBCLONE CELL LINES
Wei CHEN ; Xu LI ; Xiang WANG
Journal of Pharmaceutical Analysis 2006;18(1):49-52
Objective To examine the differentially expressed invasion-related genes in two anchorage-independent uterine cervical carcinoma cell lines derived from the same patient using a cDNA array. Methods Two human uterine cervical carcinoma subclonal cell lines CS03 and CS07 derived from a single donor line CS1213 were established by limited dilution procedure. The two cDNA samples retro-transcribed from total RNA derived from CS03 and CS07 cells were screened by a cDNA microarray carrying 234 human cell-cycle related genes and 1011 human signal transduction and membrane receptor -associated genes, scanned with a ScanArray 3000 laser scanner. Results The cDNA microarray analysis showed that 12 genes in CS03 were up-regulated compared to CS07, and 24 genes in CS07 were up-regulated. The function of a number of differentially expressed genes was consistently associated with cell-cycle, cell proliferation, migration, apoptosis, signal transduction and tumor metastasis, including p34cdc2, TSC22, plasminogen activator inhibitor I (PAI-1)and desmosome associated protein(Pinin). Conclusion Multiple genes are differentially expressed in uterine cervical carcinoma cell lines even came from the same patient. It is suggested that these genes are involved in the different phenotypic characteristics and development of cervical carcinoma.
9.Clinical features of moderate to severe asthma exacerbation in school-age children
Wei XU ; Li XIANG ; Kunling SHEN
Chinese Journal of Applied Clinical Pediatrics 2015;(21):1630-1633
Objective To understand the clinical features and current therapies on asthma exacerbation,so as to provide practical evidence for managing asthma episodes. Methods Two hundred and fourteen school - age(≥6 years old)cases who were admitted for asthma exacerbation in Beijing Children's Hospital,from January 2005 to De-cember 2013,were enrolled. All the cases were categorized into 2 groups:asthma with pneumonia group(group A,n =88)and asthma group(group B,n = 126). Results There were 214 cases enrolled,the median age was 9(6 - 18) years old,and the male - female ratio was 1. 5: 1. 0,78. 0%(167 / 214 cases)of the patients enrolled had moderate asthma exacerbation,and 22. 0%(47 / 214 cases)were defined as severe episodes,7. 0%(15 / 214 cases)were on me-chanical ventilation. Compared with group B,group A had more systemic corticosteroids use(53. 4% vs 38. 9% ,χ2 =4. 416,P = 0. 036),higher proportion of cases needing mechanical ventilation(12. 5% vs 3. 3% ,χ2 = 5. 476,P =0. 019),longer durations in hospital(9. 0 d vs 8. 0 d,Z = - 3. 063,P = 0. 002),and higher hospitalization expenses (10 000 yuan vs 9 000 yuan,Z = - 2. 058,P = 0. 000). The prescription of Aminophylline didn't help to shorten the duration of wheeze days(5. 7 d vs 5. 9 d,t = - 0. 233,P = 0. 817). Twenty - four cases received bronchial lavage through bronchoscope during wheezing days,in which 22 cases(91. 7% )of wheezing disappeared within 3 days after the lavage. There were more sensitized allergens detected in those patients who showed hypersecretion status under bronchos-copy(3. 3 ±1. 4 vs 2. 2 ±1. 2,t =2. 190,P =0. 036),compared with those without such signs. Conclusions Pneumonia may increase the demand for systemic use of corticosteroids in asthma exacerbations. The early use of systemic corticoste-roids may have an effect on reducing the severity of asthma attack,especially those with pneumonia. Multi - sensitization may contribute to the hypersecretion in bronchi. The bronchial lavage may help improve the bronchial ventilation caused by mucous plugin. The clinical usage of Aminophylline is still controversial,and it needs to be optimized.
10.The clinical analysis of nonalcoholic fatty liver and its correlation factors in type 2 diabetes mellitus
Wei LI ; Hongding XIANG ; Weixin DAI
Chinese Journal of Diabetes 1994;0(01):-
435 patients with type 2 diabetes were divided into 2 groups according to their fatty liver,then the relations between fatty liver and various parameters in two groups were observed and analyzed by statistical methods.Body mass index,HbA_1c and triglyceride were the risk factors for fatty liver.The prevalences of metabolic syndrome,hypertension and coronary heart disease in fatty liver group were significantly higher than those in the control group.