1.Clinical transfusion consultation investigation and typical case analysis
Junlong YANG ; Yanli BAI ; Xuli DU ; Bin ZHANG ; Bo WANG
Chinese Journal of Blood Transfusion 2024;37(5):561-566,574
Objective To analyze the characteristics of blood transfusion consultation cases and establish the consulta-tion route,so as to provide reference for blood transfusion doctors to participate in blood transfusion consultation practice.Methods The cases involved in clinical transfusion consultation in the blood transfusion department of our hospital from 2020 to 2023 were collected from the hospital information system(HIS),and then classified by department and consultation type to summarize the main points of transfusion consultation,formulate transfusion consultation routes,and conduct typical cases analysis.Results There were 315 clinical transfusion consultations from 2020 to 2023,with an increasing trend year by year(26 in 2020,67 in 2021,81 in 2022,141 in 2023).The consultations involved 24 departments,including cardio-vascular medicine 14.0%(44/315),orthopedics 12.7%(40/315),intensive care medicine 8.9%(28/315),general medi-cine 8.3%(28/315),cardiopulmonary disease 6.0%(19/315),etc.There were 8 categories of consultations,including 35.6%(112/315)autologous ozonized blood transfusion,23.8%(75/315)plasma exchange,14.9%(47/315)perioperative mass blood preparation(transfusion),11.4%(36/315)platelet-rich plasma therapy and 6.3%(20/315)autologous blood collection,etc.The clinical blood transfusion consultation route was formulated according to the consultation points.Six pa-tients with various diseases were treated by blood transfusion department.With effective treatment measures taken,all of them improved and were discharged.Conclusion The summary of key points of clinical blood transfusion consultation and formulation of the blood transfusion consultation route by department of blood transfusion are conducive to the implementation of blood transfusion consultation and guarantee the safety of patients.
2.KAP investigation on the risk of children using traditional Chinese patent medicine of medical staff and children's parents
Jie LIU ; Yuan SONG ; Fang LIU ; Xiaoxu SHI ; Biqing LIU ; Jianmin ZHANG ; Xuli ZHONG
China Pharmacist 2024;27(5):826-840
Objective To investigate the knowledge,attitude and practice(KAP)of medical staff and parents of children on the risk of using traditional Chinese patent medicine,analyze the similarities and differences between the two groups of people in their knowledge of traditional Chinese patent medicine,medication attitudes and medication behaviors,and analyze the influencing factors of traditional Chinese patent medicine medication risk from the perspective of"doctor-patient",so as to better guide clinical work.Methods From July to November 2023,the medical staff of Children's Hospital Affiliated to the Capital Institute of Pediatrics(hereinafter referred to as"our hospital")and other hospitals,as well as the parents of children who had visited our hospital and taken traditional Chinese patent medicine were taken as the subjects of the survey.The questionnaires were distributed and collected by Questionnarie Stars to analyze the KAP scores of medical staff and parents of children on the risk of children using traditional Chinese patent medicine,and the factors influencing the scores of KAP of taking traditional Chinese patent medicine were analyzed using Logistic regression analysis.And Spearman correlation analysis was used to explore the correlation among knowledge,attitude and practice.Results A total of 339 valid questionnaires(the effective recovery rate of 98.83%)were collected from the medical staff version of the questionnaire.The medical staff with excellent knowledge,attitude and practice scores accounted for 16.22%,7.08%and 83.19%,respectively.A total of 336 valid questionnaires(the effective recovery rate of 98.82%)were collected from the parents'version.The parents of the children with excellent knowledge,attitude and practice scores accounted for 25.87%,3.57%and 30.65%,respectively.Logistic regression analysis showed that different hospital locations and educational levels were important influencing factors for the KAP of medical personnel,while the age,education level,work status,occupation,and monthly income of parents were important influencing factors for their KAP(P<0.05).The Spearman correlation analysis results showed a significant positive correlation among medication knowledge,attitude,and behavior(P<0.01).Conclusion Medical staff and parents of children need to further improve their knowledge and attitude towards the use of traditional Chinese patent medicine.Parents need to pay special attention to standardizing drug use practice,so as to reduce the risk of children using traditional Chinese patent medicine.Physicians and pharmacists can carry out appropriate traditional Chinese patent medicine knowledge popularization and science popularization for parents of children combined with the results of this study.
3.Summary of the best evidence of intracavitary electrocardiogram positioning guided PICC catheterization and its application status
Jing FU ; Minhua CHEN ; Miaoli LIANG ; Congmei ZHANG ; Xuli SHANG
Chinese Journal of Modern Nursing 2023;29(27):3681-3688
Objective:To summarize the best evidence of intracavitary electroencephalogram positioning in peripherally inserted central catheter (PICC) catheterization, and investigate the clinical application of the best evidence.Methods:The literature on the intracavitary electroencephalogram positioning technology in the head end positioning of PICC catheterization was searched through computers on websites or data bases such as Cochrane Library, Infusion Nursing Society, PubMed, ScienceDirect, China National Knowledge Infrastructure, WanFang Data, and VIP. The search period was from the establishment of the database to June 30, 2022. The literature evaluation standards and evidence grading system of the Joanna Briggs Institute Evidence-Based Health Care Center Database were used for literature quality evaluation and evidence grading, summarizing the best evidence. Based on the summary of evidence, the best evidence for intracavitary electrocardiogram positioning guided PICC catheterization was applied to the survey questionnaire. From November to December 2022, a snowball sampling method was used to select 119 PICC nurses for a questionnaire survey.Results:A total of 31 articles were included, consisting of 24 randomized controlled trials, two systematic reviews, four Meta-analysis, and one group standard. We summarized 20 pieces of evidence from 7 aspects, including preoperative evaluation and preparation, catheter delivery process, guidewire connection, guided intracavitary electroencephalogram, timing of catheter withdrawal, optimal position judgment, and effect evaluation. The survey results showed that more than half of the nurses were consistent with the evidence in terms of evaluation and preparation, catheter delivery process, guided intracavitary electroencephalogram, guidewire connection, and timing of catheter withdrawal. The selection of the optimal location judgment was relatively scattered and needed further research.Conclusions:This study provides evidence-based basis for the PICC catheterization positioning using intracavitary electroencephalogram. Based on clinical practice, specialized nurses select the best evidence and develop a management plan that suits individual circumstances, which can ensure maximum patient benefits and continuously improve nursing quality.
4.Differential bone metabolism and protein expression in mice fed a high-fat diet versus Daurian ground squirrels following natural pre-hibernation fattening.
Xuli GAO ; Shenyang SHEN ; Qiaohua NIU ; Weilan MIAO ; Yuting HAN ; Ziwei HAO ; Ning AN ; Yingyu YANG ; Yu ZHANG ; Han ZHANG ; Kenneth B STOREY ; Hui CHANG
Journal of Zhejiang University. Science. B 2022;23(12):1042-1056
This study compared the effects on bone metabolism and morphology of pathological obesity induced by excessive fat intake in a non-hibernator (mice) versus healthy obesity due to pre-hibernation fattening in a hibernator (ground squirrels). Kunming mice were fed a high-fat diet to provide a model of pathological obesity (OB group). Daurian ground squirrels fattened naturally in their pre-hibernation season (PRE group) were used as a healthy obesity model. Micro-computed tomography (micro-CT) and three-point bending tests were used to determine the microstructure and mechanical properties of bone. Western blots were used to analyze protein expression levels related to bone metabolism (Runt-related transcription factor 2 (RunX2), osteocalcin (OCN), alkaline phosphatase (ALP), osteoprotegerin (OPG), receptor activator of nuclear factor-κB ligand (RANKL), cathepsin K, matrix metallopeptidase 9 (MMP9), patched protein homolog 1 (Ptch1), phosphorylated β-catenin (P-β-catenin), and glycogen synthase kinase-3β (GSK-3β)). Compared with controls, there was no obvious bone loss in the OB mice, and the stiffness of the femur was increased significantly. Compared with summer active squirrels, bone formation was enhanced but the mechanical properties did not change in the PRE group squirrels. In OB mice, western blots showed significantly increased expression levels of all proteins except RunX2, OPG, and Ptch1. PRE ground squirrels showed significantly increased expression of most proteins except OCN and Ptch1, which decreased significantly, and P-β-catenin and OPG, which did not change. In conclusion, for non-hibernating mice, moderate obesity had a certain protective effect on bones, demonstrating two-way regulation, increasing both bone loss and bone formation. For pre-hibernating ground squirrels, the healthy obesity acquired before hibernation had a positive effect on the microstructure of bones, and also enhanced the expression levels of proteins related to bone formation, bone resorption, and Wnt signaling.
Mice
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Animals
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Hibernation
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Core Binding Factor Alpha 1 Subunit/metabolism*
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Glycogen Synthase Kinase 3 beta/metabolism*
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Diet, High-Fat
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X-Ray Microtomography
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Sciuridae/metabolism*
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Obesity
5.Effects of Different Doses of Tanshinone ⅡAon Hemodynamics in Patients Underwent Non-extracorporeal Circulation Coronary Artery Bypass Grafting
Tiejun LIU ; Shubo ZHANG ; Jie LIN ; Na YAN ; Xiaozeng GAO ; Xuli HAO ; Zhibin TAN ; Xiaoliang HAN ; Ling TONG
China Pharmacy 2018;29(6):805-808
OBJECTIVE:To investigate the effects of different doses of tanshinone ⅡAon hemodynamics in patients underwent non-extracorporeal circulation coronary artery bypass grafting(NECCABG). METHODS:A total of 66 patients underwent selective NECCABG during Nov. 2016-Apr. 2017 were selected and divided into control group(33 cases)and observation group(33 cases) according to random number tablet. Both groups were given Tanshinone ⅡAsodium sulfonate injection with loading dose of 0.4 μg/kg for 10 min at the beginning of surgery. Control group was given Tanshinone ⅡAsodium sulfonate injection 0.2 μg/(kg·h) continuously till the end of surgery;observation group was given 0.4 μg/(kg·h)continuously till the end of surgery. HR,MAP, central venous pressure(CVP),mean pulmonary arterial pressure(MPAP),pulmonary capillary wedge pressure(PCWP),cardiac index(CI),systemic vascular resistance index(SVRI),pulmonary circulation resistance index(PVRI)and the occurrence of ADR were observed in 2 groups before anesthesia induction(T0),5 min after tracheal intubation(T1),at the moment of sternum cut(T2),at the end of anastomosis of anterior descending branch(T3),at the end of anastomosis of right coronary artery(T4),at the end of operation(T5). RESULTS:At T0,there was no statistical significance in HR,MAP,CVP,MPAP,PCWP, CI,SVRI or PVRI between 2 groups(P>0.05). At T1-T5, HR,MAP,CVP,MPAP,PCWP,SVRI and PVRI of control group were significantly higher than at T0,with statistical significance(P<0.05). There was no statistical significance in CI of control group among at T1-T5and with at T0;there was no statistical significance in HR,MAP,CVP,MPAP,PCWP,SVRI or PVRI of observation group between at T1-T5with at T0 (P>0.05). At T1-T5,CI of observation group was significantly higher than at T0and than control group;HR,MAP,CVP, MPAP,PCWP,SVRI and PVRI were significantly lower than control group,with statistical significance(P<0.05). No obvious ADR was found in 2 groups during medication. CONCLUSIONS:Tanshinone ⅡA0.4 μg/(kg·h)is helpful to keep hemodynamics stable and improve heart function in patients with NECCABG with good safety.
6.Role of NR2B in rostal anterior cingulate cortex in development of pain-related aversion in a rat model of bone cancer pain: siRNA technique
Xuli ZOU ; Jiaqiang ZHANG ; Gongming WANG
Chinese Journal of Anesthesiology 2018;38(9):1086-1089
Objective To evaluate the role of 2B subunit-containing NMDA receptors ( NR2B) in the rostal anterior cingulate cortex ( rACC) in development of pain-related aversion in a rat model of bone cancer pain using siRNA technique. Methods Forty-five healthy male Wistar rats, weighing 220-250 g, were divided into 3 groups ( n=15 each) using a random number table method: normal saline blank control group ( group NS) , NR2B-siRNA lentivirus group ( group LV-NR2B) and pGC-FU-siRNA lentivirus group (group LV-NC). A total volume of MADB-106 cells 3μl (4. 8×109 cells∕ml) was inoculated into the bone marrow cavity of the right tibia of rats. At day 2 after inoculation, NR2B∕siRNA recombinant lentivirus 0. 2μl was injected into rACC in group LV-NR2B, and pGC-FU-siRNA negative recombinant lentivirus 0. 2μl was injected into rACC in group LV-NC. The mechanical paw withdrawal threshold ( MWT) was measured at 1 day before inoculation and 3, 7, 14 and 21 days after inoculation. Conditioned place avoidance test was performed at 1 day before inoculation and 14 days after inoculation, and the percentage of residence time in room A was calculated. The rats were sacrificed at 21 days after inoculation and the rACC was re-moved for detecting NR2B protein and mRNA expression by Western blot or real-time polymerase chain re-action. Results Compared with the baseline at 1 day before inoculation, the MWT was significantly de-creased at 7, 14 and 21 days after inoculation, and the percentage of residence time in room A was de-creased at 14 days after inoculation in NS and LV-NC groups (P<0. 05), and no significant change was found in the parameters mentioned above in LV-NR2B group (P>0. 05). Compared with group NS, the MWT was significantly increased at 14 and 21 days after inoculation, the percentage of residence time in room A was increased at 14 days after inoculation, and the expression of NR2B protein and mRNA was down-regulated in group LV-NR2B ( P<0. 05) , and no significant change was found in the parameters men-tioned above in group LV-NC (P>0. 05). Conclusion Up-regulated expression of NR2B in rACC is in-volved in development of pain-related aversion in a rat model of bone cancer pain.
7.Relationship between hippocampal CREB/BDNF signaling pathway and cognitive dysfunction in rats with chronic pathological pain
Li ZHANG ; Min WANG ; Xinli DING ; Zhe WU ; Ming TIAN ; Xuli ZHAO
Chinese Journal of Anesthesiology 2017;37(3):321-324
Objective To evaluate the relationship between hippocampal cyclic adenosine monophosphate response element-binding protein(CREB)/brain-derived neurotrophic factor(BDNF)signaling pathway and cognitive dysfunction in rats with chronic pathological pain.Methods Thirty-two healthy adult male Sprague-Dawley rats,weighing 220-250 g,were divided into 3 groups using a random number table:control group(group C,n=8),sham operation group(group S,n=8)and chronic pathological pain group(group CP,n=16).Chronic pathological pain model was established by injecting cobra venom 0.4 mg(4 μl)into the sheath of the infraorbital nerve.The mechanical pain threshold was measured at 3 days before establishment of the model(baseline)and 4 days and 1,2,3,4 and 8 weeks after establishment of the model.Morris water maze test was performed to evaluate the spatial learning and memory abilities at 5 and 9 weeks after establishment of the model.Eight rats were sacrificed at 5 and 9 weeks after establishment of the model in CP group,and rats were sacrificed after the end of Morris water maze test at 9 weeks after establishment of the model in C and S groups.The hippocampi were isolated for determination of the expression of phosphorylated CREB and BDNF in the hippocampal tissues using Western blot.Results Compared with group C,the mechanical pain threshold was significantly decreased at each time point after establishment of the model,the escape latency was prolonged at 5 and 9 weeks after establishment of the model,the rate of time of staying at the target quadrant was decreased,the frequency of crossing the original platform was decreased,and the expression of phosphorylated CREB and BDNF was down-regulated at 9 weeks after establishment of the model in group CP(P<0.05),and no significant change was found in the parameters mentioned above in group S(P>0.05).Conclusion The mechanism underlying cognitive dysfunction may be related to inhibited activation of CREB/BDNF signaling pathway in the hippocampus of rats with chronic pathological pain.
8.Effects of Zuogui Jiangtang Jieyu Formula on Hippocampal Neuronal Apoptosis in Diabetic ;Rats with Depression
Pan MENG ; Hongqing ZHAO ; Qing DU ; Yuhong WANG ; Hui YANG ; Xuli ZHANG ; Yalan XU
Chinese Journal of Information on Traditional Chinese Medicine 2016;23(9):78-81
Objective To observe the effects of Zuogui Jiangtang Jieyu Formula (ZJJF) on the ability of learning and memory and the expressions of JNK, Bcl-2 and Bax in hippocampus in diabetic rats with depression; To explore the protective mechanism of hippocampal damage in diabetic rats with depression. Methods High-fat gavage combined with intravenous injection of STZ was used to establish the model of diabetic rats. 28 days of chronic stress was given continuously and diabetic rats complicated with depression were built successfully. Then rats were randomly divided into 6 groups, including normal, model, positive medicine, high-, medium-, and low-dose of ZJJF groups. After the last administration, Morris water maze was used to detect escape latency time;Western blot was used to disclose the protein expressions of JNK, Bcl-2 and Bax in rat hippocampaus;RT-PCR was used to test the gene expressions of JNK and Bcl-2 and Bax. Results Compared with the normal group, escape latency time in model rats was significant longer (P<0.01), the protein and gene expression of JNK and Bax in rat hippocampaus significantly increased, Bcl-2 was markedly decreased (P<0.05, P<0.01);Compared with the model group, escape latency time in positive medicine group and high-dose of ZJJF group was significant shorter (P<0.01), the protein and gene expressions of JNK and Bax significantly decreased, and Bcl-2 markedly increased (P<0.05, P<0.01). Conclusion ZJJF can significantly improve the ability of learning and memory in diabetic rats with depression, which might be associated with preventing neuronal apoptosis in hippocampus.
9.Therapeutic efficacy of extended therapy with interferon and a nucleoside analogue for treating patients with HBeAg-positive chronic hepatitis B
Xuli BAO ; Yachao QU ; Fang XIONG ; Feifei ZHANG ; Lei ZHANG ; Jun LU
Clinical Medicine of China 2016;32(8):673-676
Objective To observe the therapeutic efficacy of extended therapy with interferon and a nucleoside analogue for treating patients with HBeAg?positive chronic hepatitis B( CHB)?Methods Sixty cases patients diagnosed with CHB in You′an Hospital of Beijing Affiliated to Capital Medical University from March 2012 to May 2015 were retrospectively analyzed?They were divided into group A with 29 cases and group B with 31 cases according to different treatment methods?Group A were treated with pegylated interferonα?2a( Peg?IFNα?2a) combined with adefovir dipivoxil for 96 weeks,group B were treated with Peg?IFN α?2a combined with adefovir and lamivudine for 96 weeks?The patients'recovery rate of ALT,hepatitis B virus( HBV) DNA response rate and HBeAg and HBsAg seroconversion rate and conversion rate of 12,24,48,96 weeks in the treatment were observed?Results There were no significant differences in recovery rate of ALT,hepatitis B virus( HBV) DNA response rate,HBeAg seroconversion rate and HBsAg seroconversion rate between the two groups at differenct time points( P>0?05)?HBeAg seroconversion rates in group A were 34?5% at 48 weeks,62?1% at 96 weeks, and the difference was significant( P=0?036)?HBeAg seroconversion rates in group B were 35?5% at 48 weeks, 61?3% at 96 weeks,and the difference was significant ( P=0?042)?Conclusion The treatment of peginterferonα?2a in combination with adefovir dipivoxil and lamivudine is not more efficacious than peginterferon α?2a in combination with adefovir dipivoxil?The extended treatment of Peg? IFNα?2a plus a nucleoside analogue can achieve high rates of HBeAg seroconversion in patients with HBeAg?positive CHB.
10.Survey on serum free fatty acids levels in patients with hyperlipidemia
Xuli XIN ; Guihua YANG ; Jing HAN ; Man ZHANG
International Journal of Laboratory Medicine 2015;(1):10-11
Objective To explore the differences of serum free fatty acids (FFA)between the hyperlipidemia group and the healthy people with different ages and genders.Methods 912 healthy individuals of physical examination (healthy control group) and 1 061 patients with hyperlipidemia were selected and detected the serum FFA,total cholesterol,triglyceride,high density lipo-protein-cholesterol,low density lipoprotein-cholesterol,fasting plasma glucose and body mass index.The covariance analysis was used to investigate the differences in the level of serum FFA among different genders and age groups.The relationship between ser-um FFA and other serum lipids index in the patients with hyperlipidemia was analyzed by the multiple correlation analysis.Results The serum FFA level in the middle-aged females,middle-aged males and young males with hyperlipidemia was higher than that in the corresponding control groups;the serum FFA level in the young females with hyperlipidemia was lower than that in the other groups with hyperlipidemia;in the population groups with normal blood lipid,the serum FFA level in the old-age group was signifi-cantly higher than that in the middle-age and young group.Conclusion There is a difference in the serum FFA level in the hyperlip-idemia group with different ages and genders.

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