1.Clinical Application of Ultrasound-guided RISS Plane Block for Postoperative Analgesia After Minimally Invasive McKeown Esophagectomy: A Prospective Randomized Controlled Study
Fuchao LUO ; Junhua ZHANG ; Peng CHENG ; Jing WU ; Bin ZHONG ; Bing LYU ; Guogang HUANG ; Yang LIU ; Zexue ZHANG ; Xiaohong WEI
Medical Journal of Peking Union Medical College Hospital 2023;15(3):624-631
To explore the clinical effect, safety and effectiveness of ultrasound-guided rhomboid intercostal and subserratus plane (RISS) block for postoperative analgesia after minimally invasive McKeown esophagectomy (MIE-McKeown), and provide new ideas for the selection of postoperative analgesia programs for minimally invasive esophageal cancer surgery patients. A prospective randomized controlled study design was used to collect data. Patients undergoing MIE-McKeown in the Department of cardiothoracic surgery of Fuling Hospital of Chongqing University from March 2022 to June 2023 were prospectively collected as research objects. They were divided into three groups by random number table method: Group A: continuous RISS plane block+patient controlled intravenous analgesia (PCIA), Group B: single RISS plane block+PCIA, and Group C: control group, simple PCIA. The outcome indicators of each group were recorded and compared: ①Analgesic effect [visual analogue scale (VAS) pain score for rest and cough at 2, 6, 12, 24, and 48 hours after surgery], ②Postoperative use of analgesics [the amount of sufentanil used within 24 hours after surgery, the number of effective presses of the analgesia pump and the number of additional rescue analgesia], ③Adverse reactions during postoperative analgesia [dizziness, lethargy, postoperative nausea and vomiting(PONV), hypotension, respiratory depression, urinary retention, etc.], ④Intraoperative hemodynamic indicators [mean arterial pressure (MAP) and heart rate (HR) at different time points], ⑤Analgesia satisfaction. ①②③ were the primary outcome indicators, and ④⑤were the secondary outcome indicators. A total of 96 patients who met the inclusion and exclusion criteria were enrolled, with 32 cases in each group. Group A patients had lower resting and cough VAS scores at 2, 6, 12, 24, and 48 hours after surgery compared to Group C. Group A had lower resting VAS scores at 2, 24 hours after surgery and lower cough VAS scores at 12, 24 hours after surgery compared to Group B. Group B patients had significantly lower resting VAS scores at 2, 6, 12 hours after surgery and lower cough VAS scores at 2, 6, 12, 24, and 48 hours after surgery compared to Group C (all Ultrasound guided RISS block can provide good postoperative analgesia for MIE-McKeown surgery. As an active exploration of multimodal analgesia, continuous RISS has better analgesic effects. It is safe, effective, and worthy of further clinical promotion and use.
2.Clinical features and prognosis of 243 young patients with cervical cancer
Meiyan LI ; Yingying DUAN ; Zhishuang SONG ; Shuhui ZHANG ; Fuling WANG
Clinical Medicine of China 2022;38(3):210-216
Objective:To analyze the clinical features, postoperative recurrence and prognostic factors of young patients with cervical cancer.Methods:The clinical data of hospitalized cervical cancer patients in the Affiliated Hospital of Qingdao University from January 2004 to March 2019 were retrospectively studied. 243 young cervical cancer patients ≤35 years old were selected as the study group. The method of case-control study was adopted. In the same period, 250 first and second cervical cancer patients aged >35 years were randomly selected as the control group. The clinical data of the two groups were compared, and the survival curves of the two groups were analyzed. The clinical data of patients with postoperative recurrence (17 cases) and patients without recurrence (164 cases) in the study group were compared, and the related data affecting the prognosis of young cervical cancer patients were analyzed by univariate and multivariate analysis. Statistical data were compared by χ 2 test or exact probability method. Kaplan-meier method was used to estimate survival rate and draw survival curve. Survival rate was compared by Long-Rank test. COX regression model was used for multivariate analysis. Results:Compared with the control group, the young cervical cancer patients had earlier age of marriage, menstruate, fewer pregnancies, no preoperative adjuvant therapy, more nerve infiltration and ovarian preservation, the difference was statistically significant (χ 2 values were 94.58, 67.54, 60.53, 5.44, 13.64, 5.51, and 118.24, respectively; P values were <0.001, <0.001, <0.001, 0.025, 0.022, <0.001, respectively). The proportion of irregular vaginal bleeding in study group (13.17%(32/243)) was lower than that in control group (30.40%(76/250)), and the proportion of contact vaginal bleeding (52.26%(127/243)) was higher than that in control group (43.20%(108/250)). There were significant differences between the two groups (χ 2 values were 21.39 and 4.06, respectively; P values were < 0.001 and 0.044, respectively). There was no significant difference in Kaplan-Meier survival rate between the study group and the control group (χ 2=0.03, P=0.859). Univariate analysis showed that the International Federation of Gynecology and Obstetrics(FIGO), whether to retain ovary, depth of cervical invasion, nerve invasion, lymphatic vascular space invasion and pelvic lymph node metastasis were the influencing factors of 5-year survival rate of young cervical cancer patients ( P values were 0.016, 0.008, 0.014, 0.017, 0.004, <0.001, respectively). Multivariate analysis showed FIGO staging ( OR=2.073, 95% CI: 1.017-4.228, P=0.045), lymphatic vascular space infiltration ( OR=0.041, 95% CI: 0.005-0.341, P=0.019) and pelvic lymph node metastasis ( OR=0.027, 95% CI: 0.004-0.197, P<0.001) were risk factors affecting the prognosis of young cervical cancer. The patients with low FIGO stage, no lymphatic vascular space infiltration and pelvic lymph node metastasis have a good prognosis. Conclusion In young patients with cervical cancer, the first clinical feature is mainly contact vaginal bleeding. The prognosis of young patients with cervical cancer and 5 years survival rate there was no statistically significant difference compared with control group. The later FIGO staging , no ovarinan retention and the deeper cervical infiltration depth , with the nerve or between lymphatic vascular invasion and pelvic lymph node metastasis in young patients with cervical cancer had poor prognosis, and FIGO stage, lymphatic vessel space invasion and pelvic lymph node metastasis were the most significant factors.
3.Analysis on the current monitoring and management of blood donation adverse reaction in Chongqing
Binglingyi HU ; Junhong YANG ; Zaiyun CHEN ; Mingxiu WANG ; Chengyi HU ; Congmei ZHANG ; Jie SHI ; Xia HUANG ; Tao HE
Chinese Journal of Blood Transfusion 2021;34(12):1282-1285
【Objective】 To investigate the management of adverse reactions to blood donation(ARBD) in blood services, so as to promote the surveillance of ARBD and improve the quality of blood donation service in Chongqing. 【Methods】 A questionnaire, involving the staff and facilities in blood donation sites as well as the prevention and treatment, the record and report, the following up and data related to ARBD was developed by Chongqing Society of Blood Transfusion in February 2019, and was issued to 18 blood services(1 blood center and its sub-center, 6 central blood stations and 11 hospital blood banks) in the Chongqing via email. The questionnaire was filled in and submitted before March 31 by management personnel participating in the investigation, and the data was collected, collated, revised and analyzed by Excel 2011. 【Results】 A total 19 questionnaires were collected, with the valid rate at 100%(19/19). 78.95%(15/19) of the blood services met the requirements of medical personnel allocation(>6 medical staff) when the number of daily blood collection was more than 60, and 100%(19/19)met the requirements of medical personnel allocation(2 to 6 medical staff) when the number of daily blood collection was less than 60. 89.47%(17/19) of the blood services were equipped with epinephrine hydrochloride, and 84.21%(16/19) with dexamethasone(an anti-allergic drug). There were significant differences in the allocation of other types of drugs. 100.00%(19/19) of the blood services formulated prevention and treatment measures concerning ARBD. In 2019, the incidence of ARBD in Chongqing was reported to be 0.54%(1 958 / 359 871), with the highestas [1.35%(223/16 543)] in subcenters and the lowest [0.32%(179/56 299)] in central blood centers (P<0.05). There was statistical significances in the incidences of ARBD reported by different blood stations(P<0.05). 【Conclusion】 The monitoring and management of ARBD among blood services in Chongqing should be further standardized in terms of staffing allocation, emergency drugs allocation and reporting, so as to gradually realize regional homogenization and ensure blood safety.
4.Potential therapeutic effects of dipyridamole in the severely ill patients with COVID-19.
Xiaoyan LIU ; Zhe LI ; Shuai LIU ; Jing SUN ; Zhanghua CHEN ; Min JIANG ; Qingling ZHANG ; Yinghua WEI ; Xin WANG ; Yi-You HUANG ; Yinyi SHI ; Yanhui XU ; Huifang XIAN ; Fan BAI ; Changxing OU ; Bei XIONG ; Andrew M LEW ; Jun CUI ; Rongli FANG ; Hui HUANG ; Jincun ZHAO ; Xuechuan HONG ; Yuxia ZHANG ; Fuling ZHOU ; Hai-Bin LUO
Acta Pharmaceutica Sinica B 2020;10(7):1205-1215
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can cause acute respiratory distress syndrome, hypercoagulability, hypertension, and multiorgan dysfunction. Effective antivirals with safe clinical profile are urgently needed to improve the overall prognosis. In an analysis of a randomly collected cohort of 124 patients with COVID-19, we found that hypercoagulability as indicated by elevated concentrations of D-dimers was associated with disease severity. By virtual screening of a U.S. FDA approved drug library, we identified an anticoagulation agent dipyridamole (DIP) , which suppressed SARS-CoV-2 replication . In a proof-of-concept trial involving 31 patients with COVID-19, DIP supplementation was associated with significantly decreased concentrations of D-dimers ( < 0.05), increased lymphocyte and platelet recovery in the circulation, and markedly improved clinical outcomes in comparison to the control patients. In particular, all 8 of the DIP-treated severely ill patients showed remarkable improvement: 7 patients (87.5%) achieved clinical cure and were discharged from the hospitals while the remaining 1 patient (12.5%) was in clinical remission.
5.Efficacy of low-dose decitabine in the early relapse of malignant hematological diseases after allogeneic hematopoietic stem cell transplantation.
Guo Fa XU ; Ting CHEN ; Huan Feng LIU ; Shi Jia LIN ; Lei GAO ; Cheng ZHANG ; Yao LIU ; Xi ZHANG ; Pei Yan KONG
Chinese Journal of Hematology 2019;40(8):681-684
6.Implementation and effect evaluation of teacher training for Resident Planning Training
Zhen ZHOU ; Yanqing YE ; Li HE ; Zhiqiao CHEN ; Hong LEI ; Yingwen ZHANG ; Xuelan ZUO ; Fuling ZHOU
Chinese Journal of Medical Education Research 2018;17(4):424-428
Objective To understand the effect of teacher training to provide reference for teachers' teaching methods in the standardization of clinical resident training.Method The teachers carried out five days of teacher training.Teacher training adopted the method of theory teaching and group discussion.The main content of the training had a "daily rounds with teaching","the proper use of ORIME evaluation","feedback of sandwich type","a minute tutor teaching method","SOAP method to report cases".Before the training,100 residents were randomly selected to evaluate the teaching in teaching teachers through self-designed questionnaire.After the training,the questionnaire survey was conducted among 100 residents again.All data were statistically analyzed by SPSS 22.0.The measurement data were represented by (mean or + standard deviation),and the date were compared by t test.Results Residents believed that after the teacher training,teachers' teaching level improved (P<0.05).The three aspects of "general and phased learning goals","training students' clinical thinking ability through questions","requiring students to report cases and give guidance and feedback" were the most obvious.The pre training score was (3.28 ± 0.92) (3.31 ± 1.12) (3.55 ± 0.85),and the corresponding score was after training (3.98 ±0.85) (4.19 ± 0.85) (4.11 ± 0.74).Conclusion From the comparison of the survey results before and after the residents,the teachers' teaching modes,skills and methods have been improved after receiving teachers' training.
7.Experience of professor treating tic disorder with acupuncture.
Hanrui ZHANG ; Mao LIU ; Yu WANG ; Yingkun LI
Chinese Acupuncture & Moxibustion 2018;38(11):1209-1211
Professor establishes "scalp acupuncture line" guided by the scalp acupuncture points of international standardization and traditional meridian theory, which can be used to treat tic disorder. With a case, professor 's needling experience for tic disorder is introduced in detail and summarized in order to provide reference for the treatment of the disease.
Acupuncture Therapy
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Meridians
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Tic Disorders
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therapy
8."One of the Series of ""Life Dignity"": What is ""Human Dignity"""
Xinqing ZHANG ; Yuehong HAN ; Yongfu CAO ; Miao HE ; Fuling WANG ; Li LIANG
Chinese Medical Ethics 2017;30(2):151-157
9.The relationship among job satisfaction,work engagement and organizational citizenship behavior of nurses
Zhenya LIU ; Wanhong WEI ; Lu WANG ; Huizhen CUI ; Yingying LI ; Fuling ZHANG
Chinese Journal of Behavioral Medicine and Brain Science 2017;26(8):747-750
Objective To explore the relationship among job satisfaction,work engagement and organizational citizenship behavior (OCB) of nurses.MethodsA total of 497 nurses in 5 tertiary level general hospitals in Zhengzhou selected by convenience sampling,were investigated by Minnesota satisfaction questionnaire,nurses' OCB scale and the Utrecht Work Engagement Scale.ResultsThe scores of job satisfaction,work engagement,OCB were (78.63±11.34),(38.31±7.78),(106.33±10.26) respectively.Nurses' job satisfaction was positively correlated with work engagement and OCB(r=0.529,0.481,P<0.01),and work engagement was positively correlated with OCB(r=0.456,P<0.01).The job satisfaction and work engagement had a positive prediction effect on OCB(changed R2=34.8%),and work engagement played a partial moderation effect between job satisfaction and OCB,the mediating effect accounted for 30.77% of the total effect.ConclusionManagers should take measures to improve job satisfaction and work engagement to promote OCB of nurses.
10.Relationship between TRX1 and JAB1 in acute myelogenous leukemia
Lingyun HUI ; Qiuju SHEN ; Ting WANG ; Shan MENG ; Chenyang LU ; Tielin YANG ; Wanggang ZHANG ; Fuling ZHOU
Journal of Xi'an Jiaotong University(Medical Sciences) 2017;38(1):62-65,70
ABSTRACT:Objective To detect the expressions of thioredoxin (TRX1)and c-jun-activation-domain binding protein-1 (JAB1)in patients with acute myelogenous leukemia (AML)and healthy controls,and measure the TRX1 level in AML patients at different stages for evaluating its clinical significance.Methods The expressions of TRX1 and JAB1 in leukemia samples were analyzed by RT-PCR and Western blot at mRNA and protein levels, respectively.The correlation between TRX1 and JAB1,and the relationship between the gene expression and peripheral blood leukocytes count were also analyzed.Furthermore,serum TRX1 was measured by ELISA.Results TRX1 and JAB1 expressions at both mRNA and protein levels were obviously upregulated in leukemia patients (P<0.05). TRX1 was positively related to JAB1 in both newly diagnosed and recurrent AML patients.And high levels of TRX1 and JAB1 expressions were associated with white blood cell (WBC)counts in AML patients (P<0.05).Moreover, abundance of TRX1 in serum was significantly greater in AML patients,especially in the patients with recurrent AML,than in healthy donors (P<0.05).Conclusion There is a positive correlation between the expressions of TRX1 and JAB1 ,which is closely related to the occurrence and progression of AML.

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