1.Analysis of risk factors for postoperative new-onset cardiac complications in patients with esophageal cancer and concomitant coronary heart disease
Qianwei WANG ; Keping XU ; Cheng SHEN ; Yunyun CHEN ; Dafu XU
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(06):824-829
Objective To investigate the factors affecting the occurrence of new postoperative cardiac complications in patients undergoing esophageal cancer surgery with concomitant coronary heart disease. Methods Clinical data of patients who underwent esophageal cancer surgery with coronary heart disease at the Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University from December 2019 to June 2023 were collected. Patients were divided into two groups based on whether they experienced postoperative cardiac complications. Using the occurrence of cardiac complications as the dependent variable, a multivariate logistic regression model was established to identify related influencing factors. Results A total of 223 patients were included, comprising 148 males and 75 females, with an average age of (71.78±6.31) years (range 53-88 years). Seventy-one (31.84%) patients experienced at least one new cardiac complication postoperatively, including 2 acute coronary syndrome, 13 heart failure, and 59 new-onset postoperative arrhythmias. Univariate analysis showed that age, systemic immune-inflammation index, pulmonary infection, need for invasive mechanical ventilation due to respiratory failure, acute respiratory distress syndrome (ARDS), acute delirium, pleural effusion requiring drainage, and acute renal failure were risk factors for postoperative new-onset cardiac complications (all P<0.05). Multivariate logistic regression analysis identified age, postoperative length of hospital stay, ARDS, and systemic immune-inflammation index as independent risk factors for new cardiac complications in esophageal cancer patients with coronary heart disease. Conclusion Strengthening perioperative management of esophageal cancer patients, ranging from preoperative evaluation to postoperative complication treatment, is crucial. Particular attention should be paid to age, ARDS, and other indicators to improve postoperative prognoses in patients with coronary heart disease complicated by esophageal cancer.
2.Effect of sarcopenia on the perioperative clinical outcomes of esophageal squamous cell carcinoma
Wenze TIAN ; Zhenbing YOU ; Mingzhi ZHANG ; Mengzhou CHEN ; Xuechun LENG ; Dafu XU ; Chao JIANG ; Kang XU ; Keping XU
Chinese Journal of Digestive Surgery 2023;22(11):1322-1329
Objective:To investigate the effect of sarcopenia on the perioperative clinical outcomes of esophageal squamous cell carcinoma (ESCC).Methods:The retrospective case-control study was conducted. The clinicopathological data of 1 148 ESCC patients who were admitted to the Affiliated Huaian No.1 People′s Hospital of Nanjing Medical University from January 2020 to December 2021 were collected. There were 789 males and 359 females, aged (67±7)years. All patients under-went thoracoscopic and laparoscopic radical esophagectomy for esophageal cancer. Observation indicators: (1) incidence of sarcopenia in patients with ESCC; (2) comparison of general data between ESCC patients complicated with sarcopenia and those without sarcopenia; (3) comparison of clinical outcomes between ESCC patients complicated with sarcopenia and those without sarcopenia; (4) analysis of influencing factors for sarcopenia in ESCC patients. Measurement data of normal distri-bution were represented by Mean± SD, and comparison between groups was conducted using the t test. Count data were represented as absolute numbers, and comparison between groups was conducted using the chi-square test. Ordinal data was analyzed using the Mann-Whitney U test. Logistic regression analysis was used to conduct univariate analysis. Logistic backward stepwise regression model was used to conduct multivariate analysis. Results:(1) Incidence of sarcopenia in patients with ESCC. Among 1 148 ESCC patients, 469 cases were complicated with sarcopenia, 679 were without sarcopenia. The incidence of sarcopenia was 40.854%(469/1 148). Among the 469 patients with sarcopenia, there were 313 males and 156 females. There were 125 cases <65 years old, 145 cases ≥65 years old but <70 years old, 106 cases ≥70 years old but<75 years old, 93 cases ≥75 years old, respectively. (2) Comparison of general data between patients with ESCC complicated with sarco-penia and those without sarcopenia. The age, tumor diameter, body mass index, cases in stage T1, T2, T3, preoperative albumin, preoperative serum prealbumin, psoas muscle index, psoas muscle density were (68±7)years, (3.3±1.5)cm, (22.4±2.9)kg/m 2, 100, 105, 264, (43±4)g/L, (193±38)mg/dL, (3.9±0.8)cm 2/m 2, (48±8)HU of 469 ESCC patients complicated with sarcopenia, versus (66±7)years, (3.2±1.4)cm, (23.8±3.0)kg/m 2, 173, 170, 336, (44±4)g/L, (206±37)mg/dL, (6.0±2.2)cm 2/m 2, (50±7)HU of 679 ESCC patients without sarcopenia, showing significant differences between the two groups ( t=5.74, 2.11, 7.57, Z=-2.93, t=2.25, 5.52,20.36, 4.18, P<0.05). (3) Comparison of clinical outcomes between patients with ESCC complicated with sarcopenia and those without sarcopenia. The duration of postoperative hospital stay, cases with postoperative hospital stay>30 days, pneumonia, acute respiratory failure, anastomotic fistula, and abnormal heart rhythm were (17±9)days, 32, 158, 39, 33, and 103 of 469 ESCC patients complicated with sarcopenia, respectively, versus (15±6)days, 15, 102, 18, 19, and 85 of 679 ESCC patients without sarcopenia, showing significant differences between the two groups ( t=4.89, χ2=15.04, 55.17, 18.86, 11.52, 18.06, P<0.05). (4) Analysis of influencing factors for sarcopenia in ESCC patients. Results of multivariate analysis showed that age ≥65 years was an independent risk factor for sarcopenia in ESCC patients ( odds ratio=1.64, 95% confidence interval as 1.26-2.14, P<0.05). Preoperative serum prealbumin ≥200 mg/dL, psoas muscle density ≥48 HU and body mass index >24 kg/m 2 were independent protective factors for sarcopenia in ESCC patients ( odds ratio=0.64, 0.72, 0.53, 95% confidence interval as 0.50-0.82, 0.56-0.92, 0.41-0.69, P<0.05). Conclusions:Age ≥65 years is an independent risk factor for sarcopenia in ESCC patients. Preoperative serum prealbumin ≥200 mg/dL, psoas muscle density ≥48 HU and body mass index >24 kg/m 2 are independent protective factors for sarcopenia in ESCC patients. Compared with patients without sarcopenia, ESCC patients with sarcopenia are more prone to postoperative compli-cations such as pneumonia, acute respiratory failure, anastomotic fistula, and arrhythmia, and have a longer postoperative hospital stay.
3.Circular RNA ame_circ_000115 regulates expression of genes in larval gusts of Apis mellifera ligustica stressed by Ascosphaera apis.
Yaping YE ; Jie WANG ; Jiaxin ZHANG ; Kaiyao ZHANG ; Xiaoyu GU ; Yutong YAO ; Zhongmin REN ; Yang ZHANG ; Dafu CHEN ; Rui GUO
Chinese Journal of Biotechnology 2023;39(1):217-230
Circular RNAs (circRNAs) are a new class of non-coding RNAs, which have been confirmed to regulate insect gene expression and immune response through multiple manners such as competing endogenous RNA (ceRNA) regulatory network. Currently, function of circRNA in honey bee immune response remains unclear. In this study, PCR and Sanger sequencing were performed to validate the back splicing (BS) site of ame_circ_000115 (in short ac115). RT-qPCR was used to detect the expression profile of ac115 in larval guts of Apis mellifera ligustica stressed by Ascosphaera apis. Dual-luciferase reporter gene assay was conducted to verify the binding relationship between ac115 and ame-miR-13b. Interference of ac115 in larval guts was carried out by feeding specific siRNA, followed by determination of the effect of ac115 interference on expression of six genes relevant to host immune response. The results confirmed the existence of BS site within ac115. Compared with the un-inoculated group, the expression of ac115 in 4-day-old larval gut of the A. apis-inoculated group was up-regulated with extreme significance (P < 0.000 1), while that in 5- and 6-day-old larval guts were significantly up-regulated (P < 0.05). The brightness of specific band for ac115 in 4-, 5- and 6-day-old larval guts of the siRNA-circ_000115-fed group gradually became weak, whereas that of the siRNA-scrambl-fed group was pretty high without obvious variation. Compared with that of the siRNA-scramble-fed group, the expression of ac115 in 4-day-old larval gut of the siRNA-circ_000115-fed group was significantly down-regulated (P < 0.05), whereas that of the 5- and 6-day-old larval guts were down-regulated with extreme significance (P < 0.001). Ame-miR-13b was truly existed and expressed in A. m. ligustica larval guts, and there was true binding relationship between ac115 and ame-miR-13b. Compared with that of the siRNA-scramble-fed group, the expression of antimicrobial peptide genes hymenoptaecin and abaecin in 6-day-old larval gut of the siRNA-circ_000115-fed group was significantly up-regulated (P < 0.05), while that of ecdysone receptor (Ecr) was down-regulated with extreme significance (P < 0.01). These results indicate that ac115 is truly expressed in A. m. ligustica larval guts, BS site truly exists within ac115, and effective interference of ac115 in A. m. ligustica larval guts can be achieved via feeding siRNA. Moreover, ac115 potentially regulates Ecr expression through adsorption of ame-miR-13b and expression of hymenoptaecin and abaecin using a non-ceRNA manner, further participating in host stress-response.
Bees/genetics*
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Animals
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Larva/metabolism*
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RNA, Circular/genetics*
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RNA, Small Interfering/genetics*
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MicroRNAs/genetics*
4.Evaluation of total elbow arthroplasty for bone tumor around the elbow
Weifeng LIU ; Lin HAO ; Xiaohui NIU ; Yongkun YANG ; Tao JIN ; Yang SUN ; Zhiping DENG ; Yuan LI ; Qing ZHANG ; Renxian WANG ; Dafu CHEN
Chinese Journal of Orthopaedics 2020;40(13):828-839
Objective:To investigate the oncological efficacy and functional evaluation of total elbow arthroplasty (TEA) for the reconstruction of tumor around elbow joint.Methods:A retrospective case series study was made on the clinical data of 26 patients who underwent total elbow joint replacement after tumor resection in Beijing Jishuitan Hospital from June 1988 to June 2019. According to the inclusion and exclusion criteria, 23 patients were enrolled in the final study, there were 14 males and 9 females, the mean and median age was 37.6±19.9 and 35.0 years respectively. 23 patients included 3 cases of giant cell tumor, 4 cases of metastatic cancer, 4 cases of Ewing's sarcoma, 2 cases of osteosarcoma, 2 cases of aneurysmal bone cyst, 1 angiosarcoma, 1 primary malignacy in giant cell tumor, 1 low-grade central osteosarcoma, 1 parosteosarcoma, 1 synovial sarcoma, 1 plasma cell myeloma, 1 tendon sheath giant cell tumor and 1 case of mixed tumor. There were 6 cases of benign tumor, 4 cases of low grade sarcoma and 13 cases of high grade malignancy. With 19 cases of distal humerus, 3 cases of proximal ulna and 1 case of elbow. Each patient underwent tumor resection followed by restrictive tumor prosthesis and semi-restrictive of coonrad-morrey prosthesis were used for reconstruction.The duration of the operation, the amount of blood loss, epidemiological data, reconstruction length, oncology parameter, complications and functional evaluation were enrolled and statistical analyzed.Results:The mean length of the osteotomy followed by reconstruction was 12.5±3.9 cm, the mean operative time was 154.1±50.1 minutes, and the mean bleeding was 262.2±100.9 ml. Thirteen patients were treated with customized tumor limited prosthesis while 10 patients with Coonrad-Morrey semi-limited prosthesis. The 5-year survival rates of 23 patients was 64.3%, benign tumors, low-grade and high-grade malignancies were 100%, 100% and 39.7%, respectively. Three cases of lung cancer and three cases of Ewing's sarcoma died during the follow-up period (6/23, 26.1%), one case of giant cell tumor and one case of synovial sarcoma developed local recurrence (2/23, 8.7%). The median range of motion for the elbow increased from 35 to 85 degrees ( t=-13.787, P<0.05), the median NRS score decreased from 5.0 to 0.5 ( t=14.391, P<0.05). Postoperative complications occurred in 9 cases (9/23, 39.1%), the recent complications were nerve injury in 4 cases and infection in 1 case, late complications were prosthesis loosening and failure in 4 cases, the 5 year survival rate of prosthesis was 82.0%. The mean and median MSTS 93 score was 84.5%±11.0% and 88.3% respectively. Conclusion:The local control around the elbow is satisfactory after tumor resection. Total elbow arthroplasty can relieve pain and significantly improve function.
5.Combined detection of cerebrospinal fluid in diagnosis of intracranial infection
International Journal of Laboratory Medicine 2015;(14):2027-2028
Objective To investigate the application of pathogenic examination and biomarkers detection of cerebrospinal fluid in diagnosis of intracranial infection .Methods Pathogenic and biomarkers examination were performed in cerebrospinal fluid of 49 cases with intracranial infection (infection group) and 49 cases of craniocerebral trauma but without intracranial infection (control group) .Results Adenosine deaminase activity obviously increased in tuberculous meningitis cases ,glucose levels decreased in bac‐terial meningitis and cryptococcal meningitis cases ,protein and IgA content increased in bacterial meningitis cases ,IgG levels in‐creased in bacterial meningitis and tuberculous meningitis cases ,IgM levels increased in tuberculous meningitis cases (P<0 .05) . There were no significant differences of biomarkers levels between viral meningitis cases and control group (P>0 .05) .Conclusion Combined pathogenic detection and biomarker detection of cerebrospinal fluid could be helpful for the diagnosis and treatment of intracranial infection .
6.CLINICAL APPLICATION OF CLOSTRIDIUM DIFFICILE TOXIN A/B DETECTION IN THE OUTSIDE HOSPITAL AND NOSOCOMIAL INFECTION IN TAISHAN AREA
Modern Hospital 2015;(3):95-96
Objective To investigate the application of Clostridium difficile toxin A/B detection on the out-side hospital and nosocomial infection in Taishan area .Methods The stool samples of 528 diarrhea patients newly admitted from May 2013 to October 2014 were collected as the outside hospital suspicious group , and the patients were aged 8 to 75 years old, including 249 males and 279 females.Relatively, the stool samples of 523 patients hos-pitalized more than a week and treated with antibiotics more than 3 days were collected as the nosocomial suspicious group, and the patients aged 7 to 74 years, 209 males and 314 females.Clostridium difficile toxin A/B was detected, and the comprehensive statistical analysis combined with thebacterial culture results , clinical diagnosis and curative effect was made .Results The clostridium difficile infection rate outside the hospital was 4% and the infection rate in hospital after using antibiotics was 16%.By Clostridium difficile toxin A/B detection , the positive rate of outside hospital infection was 85%, and that of nosocomial infection was 90%.Conclusion The Clostridium difficile toxin A/B detection is worthy of clinical application for its rapid and accurate outside hospital and nosocomial infection de -tection in Taishan area .
7.Biological evaluation of thermoplastic starch
Xiaochuan XU ; Yuan YAO ; Wei TIAN ; Rui SHI ; Dafu CHEN ; Xiuli ZHANG
Chongqing Medicine 2013;(22):2626-2628
Objective To evaluate the Biological properties of thermoplastic starch(TPS).Methods According the standard of the government,operate three biological evaluation(acute toxicity,haemocompatibility and short-time toxicity)compound with SPSS analyse.Results The rate of haemocompatibility was 2.06%,no more different weight between trail and control in acute toxicity or short-time toxicity in any key period time.Conclusion TPS is acceptable biology materials.
8.Preparation and characteristics of starch/polyvinyl alcohol compound bio-membrane
Aichen ZHU ; Rui SHI ; Dafu CHEN ; Runying YUAN ; Liqun ZHANG
Chinese Journal of Tissue Engineering Research 2010;14(8):1414-1417
BACKGROUND: There is no study on starch/polyvinyl alcohol (PVA) as guided tissue regeneration membranes. The guided tissue regeneration membrane with porous structure were prepared, which combined with the advantages of natural polymer and synthetic polymer. OBJECTIVE: To research the effects of the preparation conditions on the properties of starch/PVA membranes. METHODS: The porous membranes of guiding tissue regeneration were prepared mainly by starch and PVA through solution mixing, casting, freezing and drying. The effects of the mass ratio of PVA and starch, solution concentration, and pre-freezing temperature on the properties of the membrane were researched. The surface morphology, tensile strength, porous ratio, water absorbance and cell cytotoxicity were characterized. RESULTS AND CONCLUSION: The aperture of the membrane was 1-50 μm, the porosity was 60%-70%, and the tensile strength was 12-26 MPa. And this membrane had the excellent biocompatibility and hydrophilicity. The pores in the surface were evenly distributed with the solution concentration of 5% and the pre-freezing temperature of -30℃. The more content of starch was, and the larger of the aperture was.
9.Continuous Detection Method for Ractopamine with Surface Plasmon Resonance Biosensor
Hui LI ; Haoyuan CAI ; Xing CHEN ; Jianhai SUN ; Lulu ZHANG ; Dafu CUI
Chinese Journal of Analytical Chemistry 2010;38(3):381-384
The interaction between the anti-Ractopamine (Rac) monoclonal antibody and the Rac derivation immobilized on the sensor chip surface was studied with surface plasmon resonance (SPR) biosensor. A continuous detection method based on the linear response during the association phase was developed. The sensor chip surface was regenerated after several tests performed continuously, thus the detection step was simplified and the life span of the chip was prospected to be prolonged. The detection was performed as an inhibitive immunoassay. The mixture of anti-Rac monoclonal antibody and the sample flowed over the surface with Rac derivation was immobilized. The relative response was in inversely proportion to the concentration of Rac. The detection limit was less than 4 μg/L with a detection time of 15 min.
10.Micro-Electro-Mechanical Systems-based Gas Chromatography Columns with High Performance
Jianhai SUN ; Dafu CUI ; Haiyuan CAI ; Hui LI ; Zhanwu NING ; Xing CHEN ; Lulu ZHANG ; Yanfei REN
Chinese Journal of Analytical Chemistry 2010;38(2):293-295
The fabrication and experimental test results were presented for a micro-electro-mechanical systems (MEMS)-based gas chromatography column. Compared with conventional column, this micro-gas chromatography column is suitable for on-line analysis and monitoring because of the small size, rapid analysis and other characteristics. These 0.5, 1 and 3 m GC columns were fabricated using a deep reactive-ion etching (DRIE) and were coated the stationary phase via a dynamic coating procedure. These GC columns perfectly separated the mixture of benzene, toluene and o-xylene in less than 200 s, where, the 3.0 m of the GC column achieved) a high resolution of 14.3 between toluene and o-xylene and yielded approximately 6160 plates. Moreover, the effect of separation performance for different column length were examined and compared. These GC columns are suitable for the application of a variety of disciplines, including environmental analysis, methane gas probes and homeland security.

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