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.Incidence of extrauterine growth retardation and its risk factors in very preterm infants during hospitalization: a multicenter prospective study.
Wei SHEN ; Zhi ZHENG ; Xin-Zhu LIN ; Fan WU ; Qian-Xin TIAN ; Qi-Liang CUI ; Yuan YUAN ; Ling REN ; Jian MAO ; Bi-Zhen SHI ; Yu-Mei WANG ; Ling LIU ; Jing-Hui ZHANG ; Yan-Mei CHANG ; Xiao-Mei TONG ; Yan ZHU ; Rong ZHANG ; Xiu-Zhen YE ; Jing-Jing ZOU ; Huai-Yu LI ; Bao-Yin ZHAO ; Yin-Ping QIU ; Shu-Hua LIU ; Li MA ; Ying XU ; Rui CHENG ; Wen-Li ZHOU ; Hui WU ; Zhi-Yong LIU ; Dong-Mei CHEN ; Jin-Zhi GAO ; Jing LIU ; Ling CHEN ; Cong LI ; Chun-Yan YANG ; Ping XU ; Ya-Yu ZHANG ; Si-Le HU ; Hua MEI ; Zu-Ming YANG ; Zong-Tai FENG ; San-Nan WANG ; Er-Yan MENG ; Li-Hong SHANG ; Fa-Lin XU ; Shao-Ping OU ; Rong JU
Chinese Journal of Contemporary Pediatrics 2022;24(2):132-140
OBJECTIVES:
To investigate the incidence of extrauterine growth retardation (EUGR) and its risk factors in very preterm infants (VPIs) during hospitalization in China.
METHODS:
A prospective multicenter study was performed on the medical data of 2 514 VPIs who were hospitalized in the department of neonatology in 28 hospitals from 7 areas of China between September 2019 and December 2020. According to the presence or absence of EUGR based on the evaluation of body weight at the corrected gestational age of 36 weeks or at discharge, the VPIs were classified to two groups: EUGR group (n=1 189) and non-EUGR (n=1 325). The clinical features were compared between the two groups, and the incidence of EUGR and risk factors for EUGR were examined.
RESULTS:
The incidence of EUGR was 47.30% (1 189/2 514) evaluated by weight. The multivariate logistic regression analysis showed that higher weight growth velocity after regaining birth weight and higher cumulative calorie intake during the first week of hospitalization were protective factors against EUGR (P<0.05), while small-for-gestational-age birth, prolonged time to the initiation of total enteral feeding, prolonged cumulative fasting time, lower breast milk intake before starting human milk fortifiers, prolonged time to the initiation of full fortified feeding, and moderate-to-severe bronchopulmonary dysplasia were risk factors for EUGR (P<0.05).
CONCLUSIONS
It is crucial to reduce the incidence of EUGR by achieving total enteral feeding as early as possible, strengthening breastfeeding, increasing calorie intake in the first week after birth, improving the velocity of weight gain, and preventing moderate-severe bronchopulmonary dysplasia in VPIs.
Female
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Fetal Growth Retardation
;
Gestational Age
;
Hospitalization
;
Humans
;
Incidence
;
Infant
;
Infant, Newborn
;
Infant, Premature
;
Infant, Very Low Birth Weight
;
Prospective Studies
;
Risk Factors
3.Comparative analysis of blood components distribution in 24 domestic prefecture-level blood stations
Cheng PENG ; Guanlin HU ; Li LI ; Zhenxing WANG ; Jinghan ZHANG ; Yugen CHENG ; Liping HUANG ; Qiuhong MUO ; Yang LIU ; Wenzhi WANG ; Haining WANG ; Hao LI ; Youhua SHEN ; Xiaojuan YANG ; Guoqian YANG ; Ling WU ; Feng YAN ; Ning LI ; Jing LIU ; Lin BAO ; Mengshang ZHANG ; Jing CUI ; Zhujun FU ; Helong GUO ; Shutao PANG
Chinese Journal of Blood Transfusion 2022;35(9):942-946
【Objective】 To understand the current situation of blood components distribution in domestic prefecture-level blood stations through analyzing the components distribution data of 24 prefecture-level blood stations in China. 【Methods】 The data of components distribution of 24 blood stations from 2017 to 2020 as well as the data of blood deployment of 24 blood stations from 2019 to 2020 were collected and analyzed. 【Results】 From 2017 to 2020, positive annual growth in red blood cells, plasma and cryoprecipitate was observed in 22, 19 and 15 out of the 24 blood stations, and the annual growth median rate of above three components was 5.24%, 3.80% and 3.25%, respectively. Among the 24 prefecture-level blood stations, 23 carried out the preparation of cryoprecipitate. 【Conclusion】 The distribution of red blood cells, cryoprecipitate and plasma in prefecture-level blood stations is increasing year by year. However, there is a overstock of plasma, and most blood stations need blood employment.
5. High resolution 3D intraosseous vascular model of the scaphoid bone reconstructed by micro CT
Zhong-Cheng SHEN ; Ding-Yu WANG ; Xuan FANG ; Huai-Cun LIU ; Wei-Guang ZHANG ; Zhong-Cheng SHEN ; Ding-Yu WANG ; Dong JIANG ; Jia-Kuo YU
Acta Anatomica Sinica 2020;51(4):557-560
[Abstract] Objective The purpose of this study is to construct a high-resolution model focusing on the vascular pattern of the scaphoid by using micro CT and to provide anatomical reference for the daily clinical use. Methods The lead-based contrast was perfused from the brachial artery and then the scaphoid bone was harvested. 3D models of the scaphoid bones were constructed by using micro CT to show how arteries distributed in and on the bones. Results The arteries on the surface stretched from the distal radius covered with scaphoid fossa to the radial side of the waist and then head back to the distal ulna along the dorsoradial ridge, formed like a letter “Ⅴ”. The arteries gathered at the inflection point of the letter “Ⅴ” and the dorsal region. The tubercle region was anastomosed extensively with 3 to 5 major intraosseous vessels originated from the extraosseous vessels covering the waist and the tubercle. There are only 1 to 2 major intraosseous vessels entering the bone via a long route from the ulnar side. The vessels running in the scapholunate ligament didn’t spilt into any intraosseous branches. Conclusion The superficial vascularity formes a “Ⅴ”-like pattern. The inflection point of the letter “Ⅴ” and the dorsal region display a dense vascularization and these vessels contributed a lot to the intraosseous vascularity.
6.Clinical observation of different courses of hyperbaric oxygen in the treatment of spinal cord injury
Dantong SHEN ; Jing GU ; Shuilin YE ; Cheng ZHANG ; Huai HUANG ; Wei ZHAO
The Journal of Practical Medicine 2018;34(9):1472-1475,1494
Objective To investigate the relation between course and effect of hyperbaric oxygen therapy on patients with spinal cord injuries. Methods The retrospective study of 147 patients with spinal cord injuries were reviewed and on the basis of comprehensive treatment the control group was not treated with hyperbaric oxygen (NHBO group,39 cases),whereas Hyperbaric oxygen treatment group(HBO group,108 cases)were treated with hyperbaric oxygen therapy. According to courses of HBO treatment ,from short term to long term ,the HBO group was divided into 3 subgroups,HBO1,HBO2 and HBO3 subgroup. Evaluation based on the result all selected patients assessed on the six months after the date of surgery. Results There was no significant difference in baseline data between the NHBO group and the HBO group and the overall effectiveness of the HBO group was better than the NHBO group(P<0.01). The efficacy of HBO2 and HBO3 subgroup was better than that of HBO1 subgroup. From the perspective of spinal cord function before and after treatment ,the efficacy of the HBO group was better than that of the NHBO group(P < 0.05).The efficacy of HBO2 and HBO3 subgroup was superior to that of HBO1 subgroup (P < 0.05). However there was no significant difference in total effective rate and spinal cord score between the HBO2 and the HBO3 subgroups. Conclusions Hyperbaric oxygen therapy is effective in the treatment of spinal cord injuries. The treatment for 3~4 courses play the best therapeutic effect.
7.Application of the Peak Area Ratio of STR Loci to Amelogenin Locus in the Estimation of DNA Degradation.
Ya-ling XIE ; Lu LI ; Cheng-chen SHAO ; Yi-hui WU ; Tie-shuai DU ; Huai-gu ZHOU ; Hui LI ; Jian-hui XIE ; Yi-wen SHEN
Journal of Forensic Medicine 2016;32(2):105-108
OBJECTIVE:
To explore the change rules of peak area ratio of STR loci to Amelogenin (AMEL) locus (STR/AMEL), a sex-determining gene in DNA degradation, and to evaluate the application of STR/AMEL value in the estimation of DNA degradation degree.
METHODS:
DNA was extracted from iliopsoas, and the variations of STR/AMEL value (Penta E/AMEL, Penta D/AMEL, FGA/AMEL) were analyzed after the artificial degradation was made by DNase I, and the changes of these three ratios of the iliopsoas naturally degraded in an outdoor environment were also analyzed. The regression curves were analyzed using the periods of DNA degradation and outside the body as the independent variable (x) and the STR/AMEL value as the dependent variable (y) and three curve equations under two conditions were established.
RESULTS:
Both under the conditions of artificial and natural degradation, STR/AMEL value had a negative relationship with the degradation time. The relationship between STR/AMEL and degradation time can be well simulated by the cubic function. R2 was over 0.99 under controlled degradation condition and over 0.86 under natural degradation condition.
CONCLUSION
The STR/AMEL value (Penta E/AMEL, Penta D/AMEL, FGA/AMEL) is negatively related with the DNA degradation degree, which follows mathematical regression models strictly, and it might be applied to evaluate the DNA degradation degree.
Amelogenin/genetics*
;
DNA Damage/genetics*
;
DNA Primers
;
Humans
;
Microsatellite Repeats
;
Regression Analysis
;
Time Factors
9.A clinical report of 58 cases of split liver transplantation
Zhijun ZHU ; Wei GAO ; Chong DONG ; Lin WEI ; Tao YANG ; Zhongyang SHEN ; Liying SUN ; Wentao JIANG ; Jianjun ZHANG ; Mingsheng HUAI ; Yamin ZHANG ; Junjie LI ; Cheng PAN
Chinese Journal of Organ Transplantation 2012;33(4):195-199
Objective To summarize the clinical experience in 58 cases of split liver transplantation (SLT).Methods A retrospective analysis was conducted on 58 cases of SLT during June 2006 to January 2011.There were 13 cases performed at the first phase (2006.6-2008.12),and 45 cases at the second phase (2009.1 2011.1). The survival rate of patients,recovery of liver function,re-transplantation rate,incidence of vascular complications and biliary complications were observed,and the causes of death were analyzed.Results The median follow-up time of all the patients was 11.4 months (0-48 months).The 1- and 2-year cumulative survival rate was 77.4% and 68.3% respectively,re-transplantation rate was 6.9%,the incidence of vessel complications was 13.8%,and biliary complication rate was 32.1%.Fifteen cases died,including 8 deaths which were related to surgical complications.Conclusion With the donor split technology improvements and refinements in partial liver transplantation, the survival rate of SLT recipients is significantly increased,but selection of recipients is still the key factor that impacts survival rate of recipients receiving SLT.SLT can expand the resource of liver donors,and adequate selection of recipients can obtain better results.
10.Biliary complication following split liver transplantation
Wei GAO ; Zhijun ZHU ; Lin WEI ; Mingsheng HUAI ; Wentao JIANG ; Jianjun ZHANG ; Yamin ZHANG ; Cheng PAN ; Hong ZHENG ; Yonglin DENG ; Zhongyang SHEN
Chinese Journal of Hepatobiliary Surgery 2011;17(11):912-915
ObjectiveTo determine the incidence,risk factors and measures to prevent biliary complications after ex vivo split liver transplantation (SLT).Method33 ex vivo SLT were performed between June 2006 and September 2010.One patient was excluded from this analysis because of early postoperative death.There were 18 males and 14 females,with a mean age of 33.4 yr (range,6 mo to 65 yr).Biliary reconstruction was carried out by duct-to-duct anastomosis in 20 and Roux-en-Y hepaticojejunostomy in 12 patients.Biliary complication was defined as either bile leak or bile duct stricture which required surgery,interventional radiology or endoscopic treatment.These biliary complications were confirmed by percutaneous tranahepatic cholangiography,endoscopic retrograde cholangiopancreatography,or T-tube cholangiography.ResultThe median follow-up was 13.5 months (3 to 54 mo).Twelve (37.5 % ) biliary complications occurred in 11 patients:hepatic parenchymal leak from the transeeted liver surface in 9.3% (3/32),anastomotic leaks in 12.5% (4/32),anastomotic strictures in 3.1% (1/32),stump leaks from the left bile duct in 3.1 % (1/32),and ischemic biliary strictures in 9.3% (3/32).Two patients died of abdominal sepsis in the 8 patients who had biliary leaks.Univariate analysis showed that graft type and biliary reconstruction were not significant risk factors for biliary leaks.ConclusionCompared with whole liver transplantation and living donor liver transplantation,biliary complications of SLT are more common.Prevention and treatment of biliary complications are important factors to improve the result of SLT.

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