1.Perioperative renal function in patients undergoing heart transplantation versus left ventricular assist device implantation: A retrospective cohort study
Mingxiu WEN ; Shuanglei ZHAO ; Zhou LIU ; Yi HU ; Qianxian LI ; Jie HAN ; Hongjia ZHANG ; Ming GONG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2024;31(11):1594-1598
Objective To compare the perioperative renal function changes in patients undergoing heart transplantation (HT) and left ventricular assist device (LVAD) implantation. Methods Patients with end-stage heart failure who underwent surgical treatment at Beijing Anzhen Hospital, Capital Medical University from January 2019 to April 2024 were included. According to the surgical method, patients were divided into a HT group and a LVAD group, and the estimated glomerular filtration rate (eGFR) of patients before surgery and postoperative 1, 7, 30, 60 days was compared between the two groups. The patients with preoperative renal dysfunction were subdivided into subgroups for comparison of eGFR changes before surgery and 30 days after surgery between the two groups. Results A total of 112 patients were enrolled. There were 78 patients in the HT group, including 61 males and 17 females, aged (44.42±18.51) years. There were 34 patients in the LVAD group, including 30 males and 4 females, aged (54.94±11.37) years. Compared with the HT group, the average age of patients in the LVAD group was greater (P<0.001), body mass index was higher (P=0.008), preoperative eGFR was lower (P=0.009), and the proportions of smokers (P=0.017), alcohol drinkers (P=0.041), and diabetes mellitus (P=0.028) patients were higher. Among patients with preoperative renal dysfunction [eGFR<90 mL/(min·1.73 m2)], compared with the HT group, the postoperative eGFR of the LVAD group was significantly higher than that of the HT group, and it was significantly increased compared with that before surgery; the postoperative eGFR of the HT group was comparable to that before surgery, and more than half of the patients had a lower eGFR than before surgery. Among patients with preoperative renal dysfunction, 11 patients in the HT group received continuous renal replacement therapy, and 8 died early; 2 patients in the LVAD group received continuous renal replacement therapy, and 1 died early. Conclusion For end-stage heart failure patients with combined renal dysfunction, compared with HT, LVAD implantation enables patients to obtain better renal function benefits.
2.Application status and development of left ventricular assist devices in ischemic heart failure patients
Shuanglei ZHAO ; Mingxiu WEN ; Qianxian LI ; Yi HU ; Zhou LIU ; Hongjia ZHANG ; Ming GONG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2024;31(11):1663-1669
In China, more than half of heart failure patients are ischemic heart failure patients. And a large proportion of left ventricular assist device implantation patients are also ischemic heart failure patients. However, left ventricular assist device implantation in ischemic heart failure patients is facing with problems such as patient screening, coronary artery disease, small left ventricle, mitral insufficiency, and ventricular aneurysm. There are only a few retrospective studies with small sample sizes abroad trying to provide solutions to these problems. While there is a lack of systematic understanding of this issue in China. Therefore, we provide an overview of the application and progress of left ventricular assist devices in ischemic heart failure patients, aiming to help clinicians have a comprehensive understanding of this issue and provide some guidance.
3.Correlation analysis of AT1-AA,serum uric acid and blood urea nitrogen with hypertensive disorders complicating pregnancy
Chunyu WANG ; Mingxiu GUAN ; Shuhai LAN ; Shuwen TANG ; Xia ZHANG ; Yidan CAO
Chongqing Medicine 2024;53(9):1301-1306
Objective To analyze the relationship between angiotensin type Ⅱ 1 receptor autoantibodies (AT1-AA),blood uric acid and urea nitrogen with hypertensive disorder complicating pregnancy (HDCP). Methods A total of 125 patients with HDCP diagnosed in the obstetrics department of Tianjin Municipal Bao-di District People's Hospital from August 2021 to February 2023 were randomly selected as the HDCP group, and 55 healthy pregnant women admitted to this hospital during the same period were selected as the control group.The HDCP group was divided into the gestational hypertension subgroup (n=77) and preeclampsia group (n=48) according to the degree of disease progression.The levels of serum uric acid,blood urea nitro-gen and AT1-AA were detected and compared between the HDCP group and control group and between the gestational hypertension subgroup and preeclampsia subgroup.Results There were no statistically significant differences in the age,gestational time,D-dimer,serum calcium and serum creatinine between the control group and the HDCP group (P>0.05).The levels of peripheral blood AT1-AA,serum uric acid and blood u-rea nitrogen in the HDCP group were higher than those in the control group,and the differences were statisti-cally significant (P<0.05).The levels of peripheral blood AT1-AA,serum uric acid and blood urea nitrogen in the preeclampsia subgroup were significantly higher than those in the gestational hypertension subgroup, and the differences were statistically significant (P<0.05).The Spearman rank correlation coefficient analysis showed that the levels of peripheral blood AT1-AA (r=0.301),serum uric acid (r=0.380) and blood urea nitrogen (r=0.257) levels were positively correlated with the severity degree of HDCP (P<0.01).The area under the curve (AUC) of AT1-AA,serum uric acid and blood urea nitrogen detection alone and combined de-tection in the diagnosis of HDCP were 0.680,0.714,0.647 and 0.725,and the corresponding Youden coeffi-cients were 0.368,0.380,0.306 and 0.439,indicating that the value of combined testing was higher than that of single item detection in the diagnosis of HDCP.Conclusion AT1-AA,serum uric acid and blood urea nitro-gen are correlated with the occurrence and development of HDCP,and the 3-item combined detection has high-er value.
4.Etiological characteristics and drug resistance in people with multi-drug resistant bacterial infection after cardiac surgery
Jianwei REN ; Mingxiu WEN ; Jianye ZHANG ; Yulei LIU ; Guangfa ZHU
Chinese Journal of Microbiology and Immunology 2023;43(10):740-748
Objective:To investigate the etiological characteristics and drug resistance patterns of multidrug-resistant organism (MDRO) infection in patients after cardiac surgery, so as to help clinicians rationally prescribe antimicrobials recommended by guidelines, increase the success rate of empirical antibacterial therapy and improve the prognosis of inpatients.Methods:Clinical data of 409 patients diagnosed with nosocomial infection (NI) after cardiac surgery from January 2018 to October 2021 were retrospectively collected. According to the results of culture, these cases were divided into two groups: MDR bacterial infection group (MDR, n=176) and non-MDR bacterial infection group (non-MDR, n=233). The etiological characteristics of MDRO infection and the patterns of drug resistance to commonly used clinical antibiotics were analyzed. Meanwhile, the etiological distribution, drug resistance and clinical outcome corresponding to different surgical types and clinical infection types were statistically analyzed. Results:A total of 306 strains of MDR bacteria were detected. Among the 176 patients, 97 (55.1%) were infected with more than one kind of MDRO and the mix infections were mainly caused by Klebsiella pneumoniae, Acinetobacter baumannii and/or Pseudomonas aeruginosa. Carbapenem-resistant (CR) bacteria accounted for 69.6% (213/306). Regardless of surgical type and clinical infection type, Acinetobacter baumannii (114/306, 37.3%) was the most common pathogenic bacteria, followed by Klebsiella pneumoniae (72/306, 23.5%) and Pseudomonas aeruginosa (55/306, 18.0%). Most of the clinical specimens were sputum specimens (528/601, 87.9%) and most of the isolated strains were carbapenem resistant, MDR and extensively drug-resistant (XDR). The positive rates of MDR bacteria were 53.7% and 53.1% in patients undergoing coronary artery bypass grafting (CABG) and aortic surgery, respectively, while the positive rates of pandrug-resistant bacteria were relatively low. In vitro drug sensitivity test results showed that MDR bacteria were highly resistant to levofloxacin (64.4%) and cefepime (61.4%), and then to ciprofloxacin (54.6%), ceftazidime (53.9%) and cotrimoxazole (52.4%). However, the resistance rates to polycolistin (5.5%) and amikacin (7.2%) were low. Compared with non-MDR bacteria, MDR bacteria were less susceptible to ceftazidime (χ 2=156.663, P<0.001), ceftriaxone (χ 2=27.844, P<0.001), cefepime (χ 2=210.181, P<0.001), imipenem (χ 2=173.242, P<0.001), levofloxacin (χ 2=201.521, P<0.001), ciprofloxacin (χ 2=180.187, P<0.001), amikacin (χ 2=16.661, P<0.001), gentamicin (χ 2=46.047, P<0.001), tobramycin (χ 2=106.546, P<0.001), piperacillin (χ 2=7.325, P=0.007), ampicillin/sulbactam (χ 2=5.415, P=0.020), piperacillin/tazobactam (χ 2=139.506, P<0.001), cefoperazone/sulbactam (χ 2=102.832, P<0.001), cotrimoxazole (χ 2=121.217, P<0.001), aztreonam (χ 2=6.977, P=0.008) and minocycline (χ 2=53.107, P<0.001). Although there was no significant difference in the detection rates of pathogenic bacteria between patients undergoing different types of surgery or having different types of infection, the mortality rate of NI after cardiac surgery, especially MDR bacterial infection, was as high as 30.0%. Moreover, the mortality rate was closely related to the types of clinical infection. The all-cause mortality of common pulmonary infection and bloodstream infection (BSI) was 10.0% to 20.0%, and once the patient′s condition was not under control and progressed to severe infection or even septic shock, the all-cause mortality would double. Conclusions:MDR bacterial infections would bring great challenges to patients after cardiac surgery, especially gram-negative bacteria (GNB) such as Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa. More than half of the patients would have mixed infections caused by carbapenem resistant, XDR or even pandrug-resistant bacteria, resulting in limited choice of anti-infective drugs and poor prognosis in hospitalized patients.
5.Quality evaluation of bronchial asthma health information in Chinese internet
Panpan NI ; Chao WU ; Huimin LI ; Fangbing NIU ; Mingxiu YANG ; Ran NING ; Jing ZHANG ; Li ZHANG
Chinese Journal of Health Management 2021;15(3):243-247
Objective:To evaluate the quality of information about bronchial asthma in Chinese Internet Site.Methods:According to the traffic ranking of Alexa website, three Chinese keywords of “bronchial asthma”, “asthma” and “asthma treatment” were searched in two most common Chinese search engines: Baidu and Sohu, and the information quality was evaluated by DISCERN tool. The completeness and accuracy of the information were evaluated according to the “2019 Global Strategy For Asthma Management And Prevention”.Results:A total of 25 websites were obtained. The DISCERN evaluation showed that none of the evaluations had an average score of more than 3.40 points. More than 50% of the information on the websites was incomplete or incorrect, and 4% of the websites contained incorrect information. The website content scores were graded, and the grading results were: excellent 12%, good 40%, fair 36%, poor 12%. The website was evaluated according to the attributes of the owner. Professional websites had better accuracy and comprehensive websites had better comprehensiveness. Pearson correlation analysis showed that the content score was positively correlated with the reliability score, detail score, and total score in DISCERN score ( r=0.58, 0.63, 0.61, all P<0.001). Conclusion:The quality of asthma information on Chinese Internet Site is generally poor.
6.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.
7.Systematic review on the reform of disease prevention and control system in China
Mingxiu LIANG ; Shasha YUAN ; Zijin SHAO ; Fei TIAN ; Zhenwei ZHANG ; Kun HAN ; Xiangzheng LYU
Chinese Journal of Preventive Medicine 2021;55(11):1332-1338
Objective:To systematically understand the reform progress of disease prevention and control system in China.Methods:The literature regarding the reform of China′s disease prevention and control system was searched by using the keywords including disease prevention and control, center for disease prevention and control (CDC), disease control, reform, and system from 2003 to 2020 in China CNKI, Wanfang Data knowledge service platform, VIP information and China biomedical literature database. The language is limited to Chinese. A total of 25 studies were included to analyze the information about the organizational structure, functional orientation, financing mechanism and personnel system of China′s disease prevention and control system.Results:The 25 studies described the specific changes and reform suggestions of China′s disease prevention and control system, including key policies (7 studies), organizational structure transformation (4 studies), institutional function transformation (7 studies), financing mechanism transformation (5 studies), personnel system reform (2 studies), and performance-based salary system reform (4 studies). Meanwhile, the reform suggestions were concluded at the top-level design system reform (two aspects), organization structure (three aspects), functioning (four aspects), and personnel guarantee mechanism (three aspects).Conclusions:This study indicates that there is a lack of empirical evidence regarding specific reform effects and content analysis at the micro level of disease prevention and control system in China. Future study should strengthen the rigorousness of study design and focus on the quantitative impacts of reform implementation in China.
8.Systematic review on the reform of disease prevention and control system in China
Mingxiu LIANG ; Shasha YUAN ; Zijin SHAO ; Fei TIAN ; Zhenwei ZHANG ; Kun HAN ; Xiangzheng LYU
Chinese Journal of Preventive Medicine 2021;55(11):1332-1338
Objective:To systematically understand the reform progress of disease prevention and control system in China.Methods:The literature regarding the reform of China′s disease prevention and control system was searched by using the keywords including disease prevention and control, center for disease prevention and control (CDC), disease control, reform, and system from 2003 to 2020 in China CNKI, Wanfang Data knowledge service platform, VIP information and China biomedical literature database. The language is limited to Chinese. A total of 25 studies were included to analyze the information about the organizational structure, functional orientation, financing mechanism and personnel system of China′s disease prevention and control system.Results:The 25 studies described the specific changes and reform suggestions of China′s disease prevention and control system, including key policies (7 studies), organizational structure transformation (4 studies), institutional function transformation (7 studies), financing mechanism transformation (5 studies), personnel system reform (2 studies), and performance-based salary system reform (4 studies). Meanwhile, the reform suggestions were concluded at the top-level design system reform (two aspects), organization structure (three aspects), functioning (four aspects), and personnel guarantee mechanism (three aspects).Conclusions:This study indicates that there is a lack of empirical evidence regarding specific reform effects and content analysis at the micro level of disease prevention and control system in China. Future study should strengthen the rigorousness of study design and focus on the quantitative impacts of reform implementation in China.
9.The citation analysis of the publications in Chinese Journal of Preventive Medicine from 2014 to 2017
Zhenwei ZHANG ; Mingxiu LIANG ; Yuanzheng FU ; Kun HAN ; Xiangzheng LYU
Chinese Journal of Preventive Medicine 2020;54(8):867-874
Objective:To analyze the characteristics and citations of articles in Chinese Journal of Preventive Medicine from 2014 to 2017, and discuss the academic level and quality of the journal. Methods:All the literatures published in Chinese Journal of Preventive Medicine from 2014 to 2017 were retrieved through the Chinese Medical Citation index, and the citation frequency data in China′s core journals of science and technology from 2014 to 2018 was obtained through Institute of Scientific and Technical Information of China. The citation status of articles published in Chinese Journal of Preventive Medicine was statistically analyzed by the scientometric method. The main indicators included the citation rate of articles published in each year, the citation frequency of all articles, the citation status of individual papers and authors, the regional and high-yield institution distribution of cited authors, and the main citation journals. Results:From 2014 to 2017, a total of 929 articles were published in 19 columns of Chinese Journal of Preventive Medicine,and the number of each year was 253 (27.23%), 231 (24.87%), 224 (24.11%) and 221 (23.79%), respectively. The total number of published pages was 3 564, and the average number of articles was 3.45 pages. A total of 28 key topics have been published. The total citation was 3 861 times, with 4.16 times per paper. Among them, 161 papers were not cited,accounting for 17.33%. The maximum citation frequency of a single paper was 49 times. There were good citations in the columns of original article and methodology introduction. There was no correlation between fund project support and paper citation. But the cited rate (93.67%) and cited frequency of special issue [ M ( P25, P75)=3 (1, 6)] were higher compared with the cited rate (80.42%; χ 2=16.08, P<0.001) and cited frequency [ M ( P25, P75)=2 (1, 6); Z=2.56, P=0.010] of free-lance articles. A total of 15 authors were cited more than 25 times, and 15 articles were cited more than 20 times. There were 213 institutions involved in the 768 cited papers, among which 12 institutions were cited more than 50 times. The authors of the cited papers were distributed in 28 provinces (autonomous regions, municipalities directly under the central government). From 2014 to 2018, a total of 281 journals cited the papers published in our journal, of which 12 journals cited more than 50 times. Conclusion:The quality of the literature in Chinese Journal of Preventive Medicine is high and the journal has a strong influence in the field of preventive medicine and public health in China. The editorial department should adjust the column setting timely, strengthen the planning of key topic selection and the solicitation and publicity of excellent papers, reduce the number of papers cited by zero, and further improve the influence of the magazine.
10.The citation analysis of the publications in Chinese Journal of Preventive Medicine from 2014 to 2017
Zhenwei ZHANG ; Mingxiu LIANG ; Yuanzheng FU ; Kun HAN ; Xiangzheng LYU
Chinese Journal of Preventive Medicine 2020;54(8):867-874
Objective:To analyze the characteristics and citations of articles in Chinese Journal of Preventive Medicine from 2014 to 2017, and discuss the academic level and quality of the journal. Methods:All the literatures published in Chinese Journal of Preventive Medicine from 2014 to 2017 were retrieved through the Chinese Medical Citation index, and the citation frequency data in China′s core journals of science and technology from 2014 to 2018 was obtained through Institute of Scientific and Technical Information of China. The citation status of articles published in Chinese Journal of Preventive Medicine was statistically analyzed by the scientometric method. The main indicators included the citation rate of articles published in each year, the citation frequency of all articles, the citation status of individual papers and authors, the regional and high-yield institution distribution of cited authors, and the main citation journals. Results:From 2014 to 2017, a total of 929 articles were published in 19 columns of Chinese Journal of Preventive Medicine,and the number of each year was 253 (27.23%), 231 (24.87%), 224 (24.11%) and 221 (23.79%), respectively. The total number of published pages was 3 564, and the average number of articles was 3.45 pages. A total of 28 key topics have been published. The total citation was 3 861 times, with 4.16 times per paper. Among them, 161 papers were not cited,accounting for 17.33%. The maximum citation frequency of a single paper was 49 times. There were good citations in the columns of original article and methodology introduction. There was no correlation between fund project support and paper citation. But the cited rate (93.67%) and cited frequency of special issue [ M ( P25, P75)=3 (1, 6)] were higher compared with the cited rate (80.42%; χ 2=16.08, P<0.001) and cited frequency [ M ( P25, P75)=2 (1, 6); Z=2.56, P=0.010] of free-lance articles. A total of 15 authors were cited more than 25 times, and 15 articles were cited more than 20 times. There were 213 institutions involved in the 768 cited papers, among which 12 institutions were cited more than 50 times. The authors of the cited papers were distributed in 28 provinces (autonomous regions, municipalities directly under the central government). From 2014 to 2018, a total of 281 journals cited the papers published in our journal, of which 12 journals cited more than 50 times. Conclusion:The quality of the literature in Chinese Journal of Preventive Medicine is high and the journal has a strong influence in the field of preventive medicine and public health in China. The editorial department should adjust the column setting timely, strengthen the planning of key topic selection and the solicitation and publicity of excellent papers, reduce the number of papers cited by zero, and further improve the influence of the magazine.

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