1.Effects of a structured exercise intervention on the healthy physical fitness in patients with leukemia receiving umbilical cord blood transplantation
Lu HUANG ; Yun WU ; Wenwen HU ; Ping QIANG ; Yaohua WU ; Yongliang ZHANG
Chinese Journal of Health Management 2024;18(12):899-904
Objective:To explore the effects of a structured exercise intervention on the healthy physical fitness in patients with leukemia receiving umbilical cord blood transplantation.Methods:It was a randomized controlled trial, conducted from August 2022 to October 2023 at the Department of Hematology of the First Affiliated Hospital of the University of Science and Technology of China (Anhui Provincial Hospital). Fifty leukemia patients undergoing umbilical cord blood transplantation were recruited and were randomly assigned to either the control group (24 cases) or the intervention group (26 cases) using a random number table method. The control group received routine nursing care, health education, and exercise guidance during hospitalization. The intervention group were given moderate-intensity structured exercise intervention, including aerobic, resistance exercises, and flexibility training, three times per week for 30 to 40 minutes per session, over a period of 6 to 8 weeks. During the study, 2 patients withdrew due to disease reasons, and finally, 22 patients in the control group and 26 patients in the intervention group were obtained. The paired t-test, Wilcoxon test, and covariance analysis were used to compare the indices of healthy physical fitness before and after the intervention between the two groups, aiming to explore the effects of a structured exercise intervention on the healthy physical fitness of leukemia patients undergoing umbilical cord blood transplantation. Results:Before the intervention, there was no significant differences in baseline characteristics, such as age, gender and disease status between the two groups (all P>0.05). During the hospitalization phase, the rate of exercise participation in the intervention group was 73.4%, the frequency of exercise was (2.20±0.41) sessions per week and the duration of each exercise session was (34.34±5.05) minutes, and the Borg′s rating of perceived exertion was (13.04±0.82) points. After intervention, the indicators including cardiovascular endurance, muscle fitness, and functional activity status in the two groups were all decreased, and the reduction degree of the indicators were all significantly lower in the intervention group when compared with those in the control group [6-minute walk distance (48.81±30.39) m vs (143.05±77.26) m, grip strength of left hand (2.57±1.30) kg vs (6.72±4.88) kg, grip strength of right hand (2.47±1.97) kg vs (6.34±5.70) kg, muscle strength of left upper limb (4.12±2.07) times vs (8.18±5.26) times, muscle strength of right upper limb (3.96±2.29) times vs (7.91±5.16) times, 30 second chair standing test (3.65±1.98) times vs (7.86±4.34) times, and timed-up-and-go test (0.65±0.53) s vs (2.35±1.79) s] (all P<0.05). The flexibility fitness was improved in the intervention group after the intervention [sit-and-reach 2.00(-4.75, 8.18) cm vs 0(-9.75, 6.43) cm] ( P=0.011), but no significant differences was found in the control group ( P>0.05). Conclusions:The structured exercise intervention has advantages in reducing the decline of healthy physical fitness in patients with leukemia receiving umbilical cord blood transplantation, and exerts a protective effect on healthy physical fitness.
2.Development and validation of a multi-modality fusion deep learning model for differentiating glioblastoma from solitary brain metastases
Shanshan SHEN ; Chunquan LI ; Yaohua FAN ; Shanfu LU ; Ziye YAN ; Hu LIU ; Haihang ZHOU ; Zijian ZHANG
Journal of Central South University(Medical Sciences) 2024;49(1):58-67
Objective:Glioblastoma(GBM)and brain metastases(BMs)are the two most common malignant brain tumors in adults.Magnetic resonance imaging(MRI)is a commonly used method for screening and evaluating the prognosis of brain tumors,but the specificity and sensitivity of conventional MRI sequences in differential diagnosis of GBM and BMs are limited.In recent years,deep neural network has shown great potential in the realization of diagnostic classification and the establishment of clinical decision support system.This study aims to apply the radiomics features extracted by deep learning techniques to explore the feasibility of accurate preoperative classification for newly diagnosed GBM and solitary brain metastases(SBMs),and to further explore the impact of multimodality data fusion on classification tasks. Methods:Standard protocol cranial MRI sequence data from 135 newly diagnosed GBM patients and 73 patients with SBMs confirmed by histopathologic or clinical diagnosis were retrospectively analyzed.First,structural T1-weight,T1C-weight,and T2-weight were selected as 3 inputs to the entire model,regions of interest(ROIs)were manually delineated on the registered three modal MR images,and multimodality radiomics features were obtained,dimensions were reduced using a random forest(RF)-based feature selection method,and the importance of each feature was further analyzed.Secondly,we used the method of contrast disentangled to find the shared features and complementary features between different modal features.Finally,the response of each sample to GBM and SBMs was predicted by fusing 2 features from different modalities. Results:The radiomics features using machine learning and the multi-modal fusion method had a good discriminatory ability for GBM and SBMs.Furthermore,compared with single-modal data,the multimodal fusion models using machine learning algorithms such as support vector machine(SVM),Logistic regression,RF,adaptive boosting(AdaBoost),and gradient boosting decision tree(GBDT)achieved significant improvements,with area under the curve(AUC)values of 0.974,0.978,0.943,0.938,and 0.947,respectively;our comparative disentangled multi-modal MR fusion method performs well,and the results of AUC,accuracy(ACC),sensitivity(SEN)and specificity(SPE)in the test set were 0.985,0.984,0.900,and 0.990,respectively.Compared with other multi-modal fusion methods,AUC,ACC,and SEN in this study all achieved the best performance.In the ablation experiment to verify the effects of each module component in this study,AUC,ACC,and SEN increased by 1.6%,10.9%and 15.0%,respectively after 3 loss functions were used simultaneously. Conclusion:A deep learning-based contrast disentangled multi-modal MR radiomics feature fusion technique helps to improve GBM and SBMs classification accuracy.
3.Analysis and management of coronary heart disease complicated by thrombocytopenia
Xingxia LI ; Yan HUO ; Xipeng SUN ; Yan CHEN ; Yaohua LU ; Cheng GUO
Journal of Pharmaceutical Practice 2020;38(1):77-80
Objective To summarize the factors and the corresponding treatments for patients with coronary heart disease (CHD) complicated by thrombocytopenia, and provide medical advises for clinical treatment. Methods Literatures and case reports were analyzed and summarized. Results Thrombocytopenia in patient with CHD could be mainly divided into two types, one group was induced by the antithrombotic therapies for CHD, and the other group was caused by some concurrent diseases or combined non-antithrombotic medications. There were different medical decisions and prognoses according to the causes in different groups. Conclusion The treatment strategies of CHD will be considered in the CHD patients with thrombocytopenia. Identifying thrombocytopenia by monitoring the platelet counts in early stage, finding out the causes quickly and providing proper treatments are the key for the prognosis of the patients.
4.Progress of intensive care unit delirium research from 2010 to 2020: analysis based on knowledge visualization
Zongqing LU ; Yaohua XU ; Jin ZHANG ; Wenyan XIAO ; Tianfeng HUA ; Min YANG
Chinese Critical Care Medicine 2020;32(7):785-791
Objective:To explored the progress of intensive care unit (ICU) delirium between 2010 and 2020 based on knowledge visualization analysis.Methods:The literatures related to ICU delirium included in Web of Sciences (WOS) and China National Knowledge Infrastructure (CNKI) databases from 2010 to 2020 were collected. A bibliometric analysis was performed. The growth trend was showed by Excel 2019 software. The information about country, institution and author were extracted by VOSviewer 1.6.15 for generating cooperative network, to find the main research power and each cooperative relation. At the same time, Citespace 5.0.R1 was used to analyze those high frequency keywords and bursting keywords and build the map of co-citation reference, in order to explore the evolution of research in the field of ICU delirium and the hotspots about this field in recent 10 years.Results:A total of 1 102 Chinese journal articles and 2 422 English "Articles" or "Reviews" from 2010 to 2020 were collected preliminarily, and the number of published literatures increased steadily. In the respect of quality, the impact factors of most articles were concentrated between 2 and 3, and the literatures with impact factor over 5 accounted for 27.9% (337/1 209). According to the knowledge visualization analysis, the United States published most of the related articles (total 1 152) in this field, while the England and Canada ranked second and third respectively, totaling 220 and 204. In terms of the distribution of research institutions, the Vanderbilt University School of Medicine was not only far ahead in the number of publication ( n = 149), but more importantly, top three high-impact authors located in this institution. The amount of domestic publications was lower than developed countries, however, the burst index, which reflected the sudden increase, ranked first (7.09), suggesting that the interest and investment of Chinese researchers was increasing recently. The most productive institution in China was Capital Medical University School of Nursing with totaling 23 articles. Wu Ying, who published most Chinese papers ( n = 14), belongs to this institution. However, it was a pity that there was no large scientific community be constructed in China, and the cooperation between institutions was deficient. By generating the co-occuring keyword mapping, the research hotpots mainly focused on the prevention, treatment and prevention of delirium in mechanically ventilated patients, the effect of dexmedetomidine and exploring the risk factor of ICU delirium. Finally, the results of co-citation reference analysis showed that Cluster 4 (risk assessment) was still in the process of development, in hence it was the frontier in this domain. Conclusions:There was a big gap between China and leading countries in the field of ICU delirium research. The main research power was located in the United States, and the trending of future studies mainly focus on delirium-related risk assessment.
5.Sexual behavior and related factors among middle school students in Chengdu
FAN Shuangfeng, LU Xiyao, ZHANG Yaohua
Chinese Journal of School Health 2019;40(10):1488-1490
Objective:
To investigate sexual behavior and related factors among middle school students in Chengdu,and to provide a reference for improving the content and the way of their sexual health education.
Methods:
Stratified cluster sampling was used to select 935 students from 11 schools in Chengdu. A self-designed questionnaire was implemented to estimate sexual behavior and related factors.
Results:
Thirty-six (3.9%) students reported sexual behavior during the past year. The difference between boys (5.6%) and girls (1.7%) was of statistical significance(χ2=9.79,P<0.01). 77.8% (28/36) of all the participants reported first sexual contact experience, 2.4% (22/935) reported homosexual behavior. Five out of 935 students had experienced unplanned pregnancy, four of them chose to have an abortion. Multivariate Logistic regression showed that masturbation experience, talking about sex-related things with friends, asking for help from friends when in sex-related troubles positively with higher risk of sextual behavior(OR=6.67,0.30,0.28,P<0.05).
Conclusion
There are multiple types of unsafe sexual behavior among middle school students in Chengdu. Strategies including positive behavior support, peer education, sustainable environment and youth-friend services are essential for health education in the future.
6.Albumin vs.Crystalloids in Fluid Resuscitation for Adults with Severe Spesis and Septic Shock:a Meta-analysis
Xipeng SUN ; Yaohua LU ; Xingxia LI ; Yan CHEN ; Cheng GUO
Herald of Medicine 2017;36(7):804-808
Objective To systematically evaluate the effects of albumin compared with crystalloids on fluid resuscitation for adults with severe sepsis and septic shock.Methods The six databases as follows:Cochrane Library,Pubmed,Embase,CNKI,VIP and Wanfang,were retrieved by computer,from their inception to November,2015.Randomized controlled trials(RCT) in the treatment of adult patients with severe sepsis and septic shock were included for quality assessment and Meta-analysis was performed by using RevMan5.3 software.Results A total of 4 RCTs involving 3 862 participants were included.No differences were found between albumin and crystalloids resuscitation with respect to 28-day mortality[RR=0.95,95%CI(0.86,1.05),P=0.33],90-day mortality[RR=0.95,95%CI(0.86,1.05),P=0.33],duration of stay in ICU,duration of hospital stay,duration of mechanical ventilation and renal replacement therapy.Conclusion In that meta-analysis,the effects of fluid resuscitation with albumin or crystalloids were not significantly different in adults with severe sepsis and septic shock.
7.Analysis of the effect of intravenous visualizer on first superficial vein puncture in obese children
Yuanzhen LU ; Yaohua LIU ; Jing DU ; Yuping WANG ; Lihua WANG ; Peng LIU
Chinese Journal of Primary Medicine and Pharmacy 2015;(24):3765-3766,3767
Objective To explore the effect and mechanism of superficial vein puncture for the first time in obese children auxiliary with venous enhancement.Methods From January 201 5 to July 201 5,1 20 children (3 -7 years old)with obesity were randomly divided into control group and observation group,60 cases in each group.The control group used conventional methods to select limbs superficial vein puncture,the observation group guided by visualizer to select limbs superficial vein puncture.Results The superficial vein puncture success rate of observation group was 96.67% for the first time,the puncture time was (78.95 ±6.68)s;Success rate of control group was 78.33%,the puncture time was (98.44 ±34.1 3)s,the differences between two groups were statistically significant (χ2 =1 0.385,t =21 .787,all P <0.05).Conclusion Obese children with venous visualizer superficial vein punc-ture success rate increased significantly,for the first time the puncture time shortened.
8.Meta-analysis of Capecitabine-platinum and S-1-platinum in the Treatment of Advanced Gastric Cancer
Xipeng SUN ; Yan CHEN ; Li YANG ; Yaohua LU ; Cheng GUO
China Pharmacist 2014;(10):1707-1713
Objective:To evaluate the efficacy and safety of capecitabine or S-1 combined with oxaliplatin or cisplatin in the treat-ment of advanced gastric cancer. Methods:Six databases including Cochrane Library, Pubmed, Embase, CNKI, VIP and WanFang were retrieved. Randomized controlled trials ( RCT) in the treatment of advanced gastric cancer were involved for the quality assess-ment and Meta-analysis. Results:A total of 14 RCT involving 1 051 patients were included. There were no significant differences in the total effective rate, complete remission rate and partial remission rate between the two groups(P>0. 05). In the safety evaluation, the incidence of hand-foot syndrome was higher in capecitabine-based regimens than that in S-1-based regimens[RR=2. 59,95%CI (1. 61,4. 17),P<0. 000 1], while the incidence of stomatitis was lower in capecitabine-based regimens[RR=0. 64,95%CI(0. 50, 0. 82),P=0. 000 4]. The other adverse reactions such as nausea and vomiting, diarrhea,neuropathy,dysfunction of liver and kidney, anemia, leukopenia, neutropenia and thrombocytopenia exhibited no significant differences between the two groups(P>0. 05). Con-clusion:Capecitabine combined with oxaliplatin or cisplatin has similar efficacy with S-1 combined with oxaliplatin or cisplatin in the treatment of advanced gastric cancer, and the incidence of hand-foot syndrome is higher in capecitabine-based regimens and the inci-dence of stomatitis is higher in S-1-based regimens.
9.Expression of human beta-defensins in ocular surface tissue
Zhensheng GU ; Yaohua SHENG ; Zhaorong ZHU ; Jianzhen ZHOU ; Shanglin LU
Chinese Journal of Tissue Engineering Research 2009;13(50):9826-9831
BACKGROUND: Human β-defensin is mainly located in various tissues epidermis or epithelium, also exists in ocular surface, but its ocular surface and its role of ocular surface diseases remain poorly understood.OBJECTIVE: To observe the distribution of human β-defensins in ocular surface tissue, and to analyze their potential effects on ocular surface disease. DESIGN, TIME AND SETTING: In vitro controlled observation with regard to ocular surface tissue was performed at the Central Laboratory, Xinhua Hospital, Medical College of Shanghai Jiao Tong University and Cell Biochemistry Institute, Chinese Academy of Sciences Shanghai Branch, between October 2006 and December 2007.MATERIALS: A total of 18 inflammatory conjunctival specimens consisted of 6 pterygium surface bulbar conjunctiva, 4 bulbar conjunctival cysts, 4 acid burn conjunctiva, 2 thermal burn conjunctiva and 2 conjunctival granuloma; 15 inflammatory corneal specimens included 6 viral keratitis, 4 fungal keratitis, 3 bacterial keratitis and 2 eye removal following corneal perforation; 9 cadaver normal bulbar conjunctiva samples, 8 cadaver normal corneal samples. METHODS: RT-PCR method and immunohistochemistry were applied to detect human β-defensin expression in 50 samples. MAIN OUTCOME MEASURES: Distribution and location of human β-defensin proteins in normal and inflammatory ocular surface tissues. RESULTS: RT-PCR showed that human β-defensin 1 and human β-defensin 3 were positive in all of the tested samples, whereas human β-defensin 2 existed in a majority of inflammatory ocular surface tissues and no expression was observed in normal ocular surface tissues. Immunohistochemistry analysis revealed most of inflammatory ocular surface tissues expressed human β-defensins 1 and 2, distributing in epithelial cell layer and predominantly in basal lamina, occasionally infiltration of stromal cells was observed, only a small number of human β-defensin 2 expression was absent; normal cornea and conjunctiva samples presented with human β-defensin 1 expression, distributing in epithelial cells and predominantly in basal lamina, only few expressed human β-defensin 2.CONCLUSION: Human β-defensin 1 and 3 appear to be constitutively expressed in surface epithelial cells and basal lamina of normal and inflammatory ocular surface tissues, while human β-defensin 2 may be induced to express in the majority of inflammatory ocular surface tissues. Three human β-defensins expression plays a pivotal role in preventing ocular surface infection and promoting ocular surface injury repair.
10.Arthroscopic augmentation technique with 4-strand semitendinosus tendon for partial tears of the anterior cruciate ligament
Xiaoqiao HUANGFU ; Jinzhong ZHAO ; Yaohua HE ; Xingguang YANG ; Cailong LIU ; Zhenfei LU
Chinese Journal of Trauma 2009;25(7):630-633
Objective To introduce an augmentation technique with 4-strand semitendinesus ten-don in treatment of partial anterior cruciate ligament (ACL) injury of under arthroscope and investigate the clinical outcome of the technique. Methods A total of 26 patients with posterolateral bundle rup-tures of ACL were treated arthroscopically with 4-strand semitendinosus tendon augmentation. The Inter-nationnal Knee Documentation Committee (IKDC) and Lysholm knee score scale were used for evaluation of knee function. The side-to-side difference in anterior knee laxity was examined by KT-1000 (25 de-grees flexion and 301b). Results There was no knee extension limitation, with knee flexion of 130°-150 °(average 142°). The patients were followed up for 12-18 months, which showed grade A in 25 pa-tients (96%) and grade B in one (4%) according to IKDC grade at final follow-up. The subjective IK-DC score was increased from preoperative (71.4±3.7) points to (95.8±3.4) points at final follow-up (t =9.836,P <0.01). The average side-to-side difference in maximal manual test with KT-1000 ar-thrometer at 25° flexion decreased from preoperative (5.1±1.2) mm to (2.1±1.3)mm at final follow-up (t = 10.48 ,P < 0.01). The Lysholm score of all patients was (76.7±3.2) preoperatively and (95. 7±2.4) at final follow-up (t =7.356,P<0.01). Conclusion Augmentation with 4-strand semiten-dinosus tendon under arthroscope can attain excellent clinical results and good anterior stability in treat-ment of partial tears of posterolateral bundle of ACL.


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