1.Analysis of factors associated with postoperative acute kidney injury in patients with colorectal cancer
Liu LI ; Xiaochen WAN ; Yonglei ZHANG ; Minghai ZHAO ; Jinjun REN ; Yongchao ZHANG
Chinese Journal of General Surgery 2023;38(3):202-206
Objective:To investigate factors associated with acute kidney injury(AKI) in postoperative colorectal cancer patients.Methods:The clinical data of 376 colorectal carcinoma (CRC) patients at Department of General Surgery, Affiliated Cancer Hospital of Zhengzhou University from Jan 2018 to Jun 2021 were retrospectively analyzed. Patients were divided into acute kidney injury (AKI) ( n=29) and non-AKI groups ( n=347). The demographic information, perioperative status, laboratory results and other relevant data of the two groups were compared . Binary logistic regression was used to analyze the independent risk factors for postoperative AKI. Results:Twenty-nine CRC patients (7.7%) had postoperative AKI. Binary Logistic regression analysis showed that preoperative hypertension ( OR=3.487, 95% CI: 1.081-11.251, P=0.037), anemia ( OR=3.158, 95% CI: 1.114-8.953, P=0.031), inadequate intraoperative crystalloid infusion ( OR=0.998, 95% CI: 0.997-0.999, P=0.007), low intraoperative mean arterial pressure ( OR=0.915, 95% CI: 0.863-0.970, P=0.003) and moderate to severe postoperative decline in hemoglobin levels ( OR=4.105, 95% CI: 1.487-11.335, P=0.006) were independent risk factors. Conclusion:Preoperative hypertension, anemia, inadequate intraoperative crystalloid infusion, low intraoperative mean arterial pressure, and moderate to severe postoperative decline in hemoglobin levels were independent risk factors for AKI development in colorectal cancer patients.
2.Clinical study of Yiqi Huoxue decoction on improving cancer pain and cancer-related fatigue in patients with malignant tumors
XU Heng ; ZENG Yonglei ; HAO Wanrong ; DING Yanqi ; XIA Kechun ; ZHOU Xianyang ; MA Li ; WU Yong ; LENG Yuling
Chinese Journal of Cancer Biotherapy 2023;30(12):1099-1104
[摘 要] 目的:探究益气活血汤对恶性肿瘤患者癌痛及癌因性疲乏(CRF)的疗效。方法: 选取2020年1月至2022年12月间安徽省中医药大学第二附属医院收治的82例确诊发生CRF的恶性肿瘤患者(气血亏虚证),采用随机数字表余数分组法将其分为对照组与观察组,每组各41例。对照组患者采用常规止痛、止吐、化痰等对症治疗及健康、心理指导,观察组患者在对照组干预的基础上联合益气活血汤治疗,4周为1个疗程。治疗前及治疗4周后,对两组患者进行中医证候积分评估,以积分变化评估中医临床疗效;采用修订版Piper疲乏量表(RPFS)评估CRF的改善情况;采用数字疼痛分级法(NRS)评分比较癌痛情况;检测患者外周血纤维蛋白原(FIB)、D-二聚体(D-D)评价凝血功能差异,检测患者肝、肾功能指标以评估益气活血汤治疗的安全性。结果:治疗前,两组患者在中医证候积分、RPFS评分、NRS评分及外周血FIB、D-D方面的差异均无显著统计学意义(均P>0.05)。治疗4周后,两组患者在神疲乏力、面色淡白或萎黄、自汗、失眠健忘、手足麻木的证候评分及总积分均较治疗前明显降低(均P<0.05),且观察组各项评分均低于对照组(均P<0.05),中医临床疗效明显高于对照组(P<0.05);两组患者RPFS各维度评分及总分均较治疗前降低(均P<0.05),观察组行为、情感、感觉维度RPFS评分及总分均低于对照组(均P<0.05),观察组CRF的改善明显优于对照组(P<0.05);两组患者NRS评分及外周血FIB、D-D指标均较治疗前降低(均P<0.05),且观察组均低于对照组(均P<0.05)。两组患者治疗期间均未发生肝功能、肾功能等明显异常,说明益气活血汤安全性良好。结论:益气活血汤可纠正气血亏虚之证,改善机体凝血功能,促进恶性肿瘤患者CRF及癌痛的减轻,临床应用价值较高。
3.Optimization of detection conditions of pre-donation ABO blood type screening by sliding methods in fixed blood donation sites
Dan LI ; Yonglei LYU ; Lili FENG ; Xu WANG ; Xiaotian ZHANG ; Yajuan LIU ; Panpan XU ; Lei ZHAO
Chinese Journal of Blood Transfusion 2022;35(2):161-163
【Objective】 To explore the quantitative value of key points for ABO blood group initial screening in fixed blood donation sites, so as to provide reference for standardized testing process of sliding method. 【Methods】 Several groups of experiments were carried out to illustrate the optimal conditions, including the serum dosage of monoclonal reagent, red blood cell dosage of blood sample, and reaction time in ABO blood group initial screening, by sliding method, and the quantitative value of key points of sliding method was preliminarily determined. Blood typing tests of 310 blood donor samples including type A, B, O, AB, subtype A and subtype AB were conducted to evaluate the effects of quantitative value of key points in the initial screening procedure. The test tube method would be conducted if the results are inconsistent with the fully automated blood grouping analyzer. The ABO subtypes suspected are identified by serological and molecular biological methods. 【Results】 The quantitative value of key points in initial screening procedure of sliding methods was as follows: 2 drops of reagent serum, 5-10 μL of whole blood and 3 minutes of reaction time. The concordance rate of ABO blood type screening comparison experiment in 310 blood donors was 100%. 【Conclusion】 ABO blood group initial screening by sliding method with quantitative value can effectively standardize the pre-donation blood type screening in fixed blood donation sites, and can meet the requirements of ABO blood group initial screening.
4.NAT results of HBV and HCV under different vacuum collection tubes, storage temperature and storage time
Li ZHANG ; Yifang WANG ; Yonglei LYU ; Wenchao GE ; Tianning SI ; Xiaohong ZHU ; Lei ZHAO
Chinese Journal of Blood Transfusion 2021;34(12):1314-1317
【Objective】 To verify the results of HBV DNA and HCV RNA screening under different brands of vacuum collection tubes for blood samples, storage temperature and storage time. 【Methods】 Experiment 1 was conducted as follows: blood samples were collected simultaneously from 52 voluntary blood donors using two brands(divided into group A and group B) of vacuum collection tubes for blood samples. The plasma separation of group A and group B were compared, and the effects of storage time on the NAT yield of HBV DNA and HCV RNA were statistically analyzed. Experiment 2 was conducted as follows: the effects of different storage temperature, time and tubes on the NAT yield of HBV DNA and HCV RNA samples with low viral load in group A and B were verified and compared in the simulated phlebotomy condition. 【Results】 In Experiment 1: After centrifugation, blood plasma layer and cells layer were separated completely in group A(100%, 52/52), but one sample was not well separated in group B(1/52, 1.92%). After 4 to 10 h after collection, blood samples of two groups were centrifuged and screened for HBV DNA, HCV RNA within 24 h. No positive samples were yielded and the Ct values of internal control(IC-DNA and IC-RNA) were uniform. In Experiment 2: Whole blood samples, stored for either 4 h or 6~10 h at 4 ℃ or 25℃ before centrifugation, showed no difference on the NAT-yield of HBV DNA nor HCV RNA samples with low viral load(P>0.05). Ct values of HBV DNA and HCV RNA of group A was similar to those of group B as centrifuged samples were stored for 24 h or 72~104 h at 4℃(P>0.05), but all increased as the storage time prolonged. Ct values of HBV DNA in group A increased from 33.45±0.29(24 h) to 33.82±0.08(72~104 h) and HCV RNA from 35.21±0.20 to 36.12±0.43; HBV DNA from 33.46±0.25 to 34.30±0.60 and HCV RNA from 35.47±0.24 to 36.49±0.51 in group B. 【Conclusion】 Under certain laboratory condition, different storage time, storage temperature and tubes shed few effect on the NAT-yield of HBV DNA and HCV RNA samples with low virus loads. However, it is suggested that the blood sample be detected within 72 h after centrifugation at 4 ℃ storage.
5.Characteristics of NAT reactive voluntary blood donors, Zhengzhou from 2018 to 2019
Wenchao GE ; Lei ZHAO ; Yifang WANG ; Xu WANG ; Hecai YANG ; Junying LI ; Yonglei LV
Chinese Journal of Blood Transfusion 2021;34(10):1137-1140
【Objective】 To investigate the characteristics of NAT reactive(R) population among voluntary blood donors in Zhengzhou, and analyze the residual risk of NAT and the infection in different ages, educational levels, and occupations. 【Methods】 The samples of voluntary blood donors in Zhengzhou from 2018 to 2019 were comprehensively screened (samples reactive by duplicate ELISA reagents excluded), and the occupation, gender, education level and marital status of voluntary blood donors were analyzed. 【Results】 A total of 488 365 samples were detected, 323 were NAT R samples (0.66‰), including 318 HBV R samples (0.65‰) and 5 HIV R samples (0.01‰), but no HCV R was detected. Statistical analysis showed that NAT R rate in male voluntary blood donors was 0.78‰ (252/321 196), higher than 0.42‰ (71/167 439) in female (P<0.05); the NAT R rates of 18~25, 26~35, 36~45, 46~55, and over 55 years old group were, 0.21‰ (39/187 816), 0.56‰ (61/108 481), 1.03‰ (101/97 872), 1.27‰ (112/87 943), and 1.53‰ (10/6 523), respectively, showing an upward trend with age(P<0.05). The NAT R rate of donors of junior middle school education and below, high school education, secondary vocational education, college education, undergraduate education and above were 1.00‰(27/26 921), 0.99‰(62/62 375), 0.97‰(28/28 908), 0.37‰(43/117 643)and 0.43‰(55/126 992), respectively, showing a downward trend (P<0.05). Among different occupations, the NAT R rate of farmers was the highest as 1.10‰ (49/44 430), and those of medical personnel and students were rather low as 0.32‰ (4/12 666) and 0.21‰ (31/145 563), respectively (P<0.05). The NAT R rate in repeated blood donors was 0.75‰ (192/257 077), which was higher than 0.57‰ (131/231 558) in first-time blood donors (P<0.05), but no significant difference was noticed in blood group and ALT (P>0.05). 【Conclusion】 Some blood samples were negative by ELISA but reactive by NAT. Therefore, NAT is an effective supplement to missed detection of ELISA and can reduce the risk of transfusion transmitted infection diseases. The characteristics of NAT R population in Zhengzhou are worth studying, which can provide reference for health consultation and further improve blood safety.
6.Single-ELISA reactive rate of four blood screening items in 18 blood station laboratories: Henan, 2019
Yan ZHANG ; Mingjun CHEN ; Hongna ZHAO ; Yonglei LV ; Jianhua FANG ; Qi JIANG ; Shanhua CHEN ; Dan CHEN ; Jia WU ; Nan CHEN ; Yu MENG ; Huiyun HAN ; Dengfeng WANG ; Xiaozhen ZHANG ; Yue ZHANG ; Fengyong MA ; Bin JIA ; Junjie LI ; Sili SUN ; Fei ZHAO ; Yongqing ZHOU ; Suneng ZHANG
Chinese Journal of Blood Transfusion 2021;34(8):878-882
【Objective】 To analyze the cause of single-ELISA reactive of four blood screening items in 18 blood stations in Henan, so as to provide the basis for improving the quality of blood screening. 【Methods】 The single-ELISA reactive rate of HBsAg, anti-HCV, HIV Ag/Ab and anti-TP of 18 blood station laboratories in Henan throughout 2019 was calculated, and the causes were analyzed according to different ELISA reagent combinations and gray area settings in each laboratory. 【Results】 The overall single-ELISA reactive rates of HBsAg, anti-HCV, HIV Ag/Ab and anti-TP were 1.740(2 154/1 237 789), 0.564‰(698/1 237 789), 1.421‰(1 759/1 237 789) and 1.561‰(1 932/1 237 789), respectively, showing significant differences by detection items (P <0.05). Person correlation analysis showed that the single-ELISA reactive rate was independent of the gray area settings.but dependent on laboratories and reagent combinations. The single-ELISA reactive rate of HBsAg, anti-HCV, HIV Ag/Ab and anti-TP in D laboratory was the highest and higher than that in other labs using the same reagent.The laboratories with high HBsAg single-ELISA reactive rate were mostly those using a combination of imported reagents and domestic reagents, including the top 6 laboratories. The laboratories with high anti-HCV single-ELISA reactive rate were mostly those using certain domestic reagents. No obvious rules was noticed by single-ELISA reactive for anti-HIV. Laboratories with high anti-TP single-ELISA reactive rate were mostly those using combination 4. 【Conclusion】 The HBsAg single-ELISA reactive rate was the highest in the four blood screening items of blood station laboratories in Henan. The single-ELISA reactive rate is related to the laboratory itself and the reagent manufacturer, suggesting that laboratory quality control should be strengthened and proper reagent combination should be selected to reduce the waste of blood.
7.Effects of aerobic exercise and nutrition education on blood lipids, physical fitness and exercise behavior among students high cholesterol level
HUANG Zhenhai, XIE Yonglei, LI Yan
Chinese Journal of School Health 2020;41(1):58-61
Objective:
To investigate the effects of aerobic exercise and nutritional education on blood lipids, physical fitness and exercise behavior among students with high cholesterol level.
Methods:
A total of 140 male college students with total cholesterol higher than 200 mg/dl were randomly divided into cycling + nutrition education (BE) group; control group (C). The BE group received 6-weeks intervention (3 times a week, 60 minutes each time, exercise intensity of 50%-70% HRR and 60 minutes of nutrition education per week). Blood lipids, physical fitness, daily dietary intake, and exercise behavior before and after intervention was assessed.
Results:
BMI and waist-to-hip ratio in the BE group were significantly lower than those in the group C[(25.57±1.77) kg/m2 vs (28.88±2.10) kg/m2], [(0.81±0.03) vs (0.87±0.06)]; Cardiopulmonary fitness was significantly better than group C [(54.45 ± 5.31) vs (50.00 ± 5.29)]. The level of TC of group C was significantly higher than that of group BE [(229.90±25.63) mg/dL vs (195.90±34.79) mg/dL], and the HDL-C of group BE was significantly better than group C [(70.30±8.06) mg/dL vs (58.60±10.42) mg/dL]. The conscious activity of the group BE was significantly better than that of the group C[(78.90±4.58) vs (74.10±5.48)], and the conscious dyskinesia in the group C was significantly higher than that in the group BE[(57.30±5.54) vs (51.40±4.87)], group BE The exercise self-efficacy was better than that of group C [(66.80±8.75) vs (57.10±9.09)], and the difference was statistically significant(t=5.33,4.11,6.22,P<0.05). The daily intake of potato, vegetables, fruits, livestock and poultry, fish and shrimp, eggs, milk and beans in the group BE was in a reasonable range, which was significantly better than that before intervention and group C(P<0.01).
Conclusion
In summary, intervention combined with moderate-intensity exercise and nutrition education shows significant effects in improving cardiopulmonary fitness, HDL-C level, and lowering BMI, waist-to-hip ratio, and total cholesterol value; 6-week exercise intervention improves self-conscious sports interests, conscious movement disorders and cognitive self-efficacy; nutrition education intervention helps guide college students to take reasonable dietary behavior and reasonable intake of food.
8.Analysis of the effect and prognostic factors of minimally invasive hard channel intracranial hematoma aspiration
Changfu LIU ; Yusheng YANG ; Yonglei LI ; Kun LI
International Journal of Surgery 2020;47(11):748-752,f3
Objective:To investigate the specific effect of minimally invasive hard channel intracranial hematoma crush suction flow on patients with cerebral hemorrhage, and to analyze the prognostic factors.Methods:A total of 80 patients with primary intracerebral hemorrhage who were treated in Bengbu First Peopl′s hospital from Aug. 2014 to Aug. 2018 were selected, with 52 males and 28 females, aged from 48 to 81 years and averaged (66.07±13.34) years. The prognosis of patients was assessed using the Bathel Index (BI), and the patients were divided into a control group (BI≥ 60 point considered a good prognosis, n=54) and an experimental group (BI<60 point considered a poor prognosis, n=26). Suspicious prognostic factors were formulated, including gender, age, average drainage time, average puncture needle indwelling time, average hospital stay, Glasgow score, time from injury to operation, bleeding volume, cause of disease, bleeding site, postoperative rebleeding to carry out univariate analysis between groups, and incorporate the difference items in univariate analysis into multivariate logistics regression analysis to explore related prognostic factors were compared by single factor analysis, and the difference items in the single factor analysis were included into the multivariate logistics regression analysis for the related prognostic factors exploring. Results:The hemorrhages was successfully cleared in all patients, and the average drainage time was (5.07±1.25) days. Mean needle retention time was (4.84 ± 1.37) d. Mean length of stay time was (15.26±1.44) days. Allpatients completed follow-up after operation. During 1 year of follow-up, 12 patients showed obvious brain atrophy, subdural broadening and effusion. All patients were followed up for 3 years, and their symptoms completely disappeared and their daily living ability recovered. No death was occured during the follow-up. According to the BI assessment results, the scores of 54 patients were ≥60, with an average score of (74.57±4.36). The scores of 26 patients were <60, with an average score of (48.24±5.12). The age, time from injury to operation and amount of blood loss of control group were significantly lower than those of experiment group, and Glasgow scores were significantly higher than those of experiment group, with statistically significant differences ( P<0.05). The percentage of patients in control group with infratentorial hemorrhage (14.81%) was significantly lower than that in experiment group (34.62%), and the rate of postoperative re-bleeding (1.85%) was significantly lower than that in experiment group (23.08%), with statistically significant differences ( P<0.05). Glasgow score was positively correlated with the prognosis of patients ( OR=3.449, P=0.005). The time from injury to operation was negatively correlated with the prognosis ( OR=0.580, P=0.023). Supratente hemorrhage was a protective factor for patient prognosis ( OR=3.813, P=0.024). Postoperative re-bleeding was correlated with the patients ( OR=19.963, P=0.008). A ROC curve was drawn with Glasgow score and the time from injury to operation. Glasgow score was selected as cut-off point at 7.5 point, with sensitivity of 96.30% and specificity of 88.46%. The time from injury to operation was selected as the cut-off point at 8.35 h, with sensitivity of 84.62% and specificity of 92.59%. Conclusion:Minimally invasive hard channel crush suction flow is effective and safe in the treatment of intracranial hematoma. The severity of cerebral hemorrhage, infratentorial hemorrhage and postoperative re-bleeding are prognostic factors.
9.Statistics and analysis on acupuncture and moxibustion projects of the National Natural Science Foundation of China of traditional Chinese medicine universities and colleges in recent 10 years: taking the General Program and National Science Fund for Young Scholars as examples.
Qingling LI ; Qiang MA ; Dan LI ; Nana LIU ; Jiahui YANG ; Chun SUN ; Cheng CHENG ; Xuezhao JIA ; Jing WANG ; Yonglei ZENG
Chinese Acupuncture & Moxibustion 2018;38(3):325-330
To analyze statistically the situation of the National Natural Science Foundation of China (NSFC) from 2007 to 2016 in the field of acupuncture and moxibustion for supporting the national Universities colleges of traditional Chinese medicine on the General Program (GP) and the National Science Fund for Young Scholars (NSFYS). In view of five aspects, named fund, supporting units, key words, method, disorder and signal path, the differences were compared between GP and NSFYS, the following characteristics were summarized. ① The fund aid was increased from 2007 through 2013 and down-regulated from 2013 through 2016. In recent ten years, the funding condition was fluctuated, but increasing in tendency generally. ② The relevant projects of the same research direction had been approved continuously for over 3 years in a part of TCM universities, in which, the research continuity was the hot topic. ③ Regarding the therapeutic methods, acupuncture was the chief therapy; electroacupuncture, moxibustion and acupoints were involved as well. ④ The disorders involved in the research were cerebral ischemia, myocardial ischemia and reperfusion injury. It is suggested that the ischemic disorder is predominated in the research. ⑤ The signal path occupied the main research index system, including cell proliferation, metabolism, immune, apoptosis and autophagy. The researches on the other aspects were less.
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10.Pharmacodynamics of a combination of remifentanil and propofol for ultrasound-guided transvaginal oocyte retrieval
Hai YU ; Xin MA ; Lin SONG ; Yonglei HUANG ; Chunhua LI ; Xiwei DONG
The Journal of Clinical Anesthesiology 2017;33(6):562-566
Objective To evaluate the clinical anesthetic efficacy of a combination of propofol and remifentanil for ultrasound-guided transvaginal oocyte retrieval.Pharmacodynamic (PD) model was established and its characteristics were analyzed based on the simulated concentrations of propofol and remifentanil in respective pharmacokinetic models, so as to guide further study.Methods Forty-two female patients undergoing transvaginal oocyte retrieval were divided into groups PR15 (n=24) and PR10 (n=18), who were received intravenous bolus of remifentanil 1.5 μg/kg + propofol 1.5 mg/kg and remifentanil 1.0 μg/kg+propofol 1.0 mg/kg, respectively.The anesthesia quality evaluation was based on the following indicators: onset time (loss of eyelash reflex), recovery time of orientation, the incidence of hypoxemia (SpO2 < 92%) and adverse reactions.Nonlinear mixed-effects model was used to evaluate the time courses of the simulated propofol and remifentanil concentrations-effect and to establish the PD model with NONMEM software.Results The time of recovering orientation in the patients of group PR10 was significantly faster compared with the patients in group PR15;the time of loss of eyelash reflex , incidence of hypoxemia (12.5% vs 16.7%) and cough (16.7% vs 11.1%) had no significant differences between the both groups.With the final PD model, the estimated parameters as following: EC50 of propofol and remifentanil for effective sedation and analgesia were 1.71 μg/ml and 2.57 ng/ml, respectively.EC95 of propofol and remifentanil for effective sedation and analgesia were 4.30 g/ml and 4.57 ng/ml, respectively.The effect site concentration of propofol 1 mg/kg was lower than EC50, but the effect site concentration of 1.5 mg/kg was higher than EC50.The peak effect site of 1.0 μg/kg and 1.5 μg/kg remifentanil was higher than EC50, and 1.5 μg/kg concentration was close to EC95.Conclusion Based on patients' recovery time, propofol 1.0 mg/kg combined with fentanyl 1.0 μg/kg is appropriate in patients undergoing transvaginal oocyte retrieval.


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