1.Impact of different diagnostic criteria for assessing mild micro-hepatic encephalopathy in liver cirrhosis: an analysis based on a prospective, multicenter, real-world study
Xiaoyan LI ; Shanghao LIU ; Chuan LIU ; Hongmei ZU ; Xiaoqing GUO ; Huiling XIANG ; Yan HUANG ; Zhaolan YAN ; Yajing LI ; Jia SUN ; Ruixin SONG ; Junqing YAN ; Qing YE ; Fei LIU ; Lei HUANG ; Fanping MENG ; Xiaoning ZHANG ; Shaoqi YANG ; Shengjuan HU ; Jigang RUAN ; Yiling LI ; Ningning WANG ; Huipeng CUI ; Yanmeng WANG ; Chuang LEI ; Qinghai WANG ; Hongling TIAN ; Zhangshu QU ; Min YUAN ; Ruichun SHI ; Xiaoting YANG ; Dan JIN ; Dan SU ; Yijun LIU ; Ying CHEN ; Yuxiang XIA ; Yongzhong LI ; Qiaohua YANG ; Huai LI ; Xuelan ZHAO ; Zemin TIAN ; Hongji YU ; Xiaojuan ZHANG ; Chenxi WU ; Zhijian WU ; Shengqiang LI ; Qian SHEN ; Xuemei LIU ; Jianping HU ; Manqun WU ; Tong DANG ; Jing WANG ; Xianmei MENG ; Haiying WANG ; Zhenyu JIANG ; Yayuan LIU ; Ying LIU ; Suxuan QU ; Hong TAO ; Dongmei YAN ; Jun LIU ; Wei FU ; Jie YU ; Fusheng WANG ; Xiaolong QI ; Junliang FU
Chinese Journal of Hepatology 2023;31(9):961-968
Objective:To compare the differences in the prevalence of mild micro-hepatic encephalopathy (MHE) among patients with cirrhosis by using the psychometric hepatic encephalopathy score (PHES) and the Stroop smartphone application (Encephal App) test.Methods:This prospective, multi-center, real-world study was initiated by the National Clinical Medical Research Center for Infectious Diseases and the Portal Hypertension Alliance and registered with International ClinicalTrials.gov (NCT05140837). 354 cases of cirrhosis were enrolled in 19 hospitals across the country. PHES (including digital connection tests A and B, digital symbol tests, trajectory drawing tests, and serial management tests) and the Stroop test were conducted in all of them. PHES was differentiated using standard diagnostic criteria established by the two studies in China and South Korea. The Stroop test was evaluated based on the criteria of the research and development team. The impact of different diagnostic standards or methods on the incidence of MHE in patients with cirrhosis was analyzed. Data between groups were differentiated using the t-test, Mann-Whitney U test, and χ2 test. A kappa test was used to compare the consistency between groups. Results:After PHES, the prevalence of MHE among 354 cases of cirrhosis was 78.53% and 15.25%, respectively, based on Chinese research standards and Korean research normal value standards. However, the prevalence of MHE was 56.78% based on the Stroop test, and the differences in pairwise comparisons among the three groups were statistically significant (kappa = -0.064, P < 0.001). Stratified analysis revealed that the MHE prevalence in three groups of patients with Child-Pugh classes A, B, and C was 74.14%, 83.33%, and 88.24%, respectively, according to the normal value standards of Chinese researchers, while the MHE prevalence rates in three groups of patients with Child-Pugh classes A, B, and C were 8.29%, 23.53%, and 38.24%, respectively, according to the normal value standards of Korean researchers. Furthermore, the prevalence rates of MHE in the three groups of patients with Child-Pugh grades A, B, and C were 52.68%, 58.82%, and 73.53%, respectively, according to the Stroop test standard. However, among the results of each diagnostic standard, the prevalence of MHE showed an increasing trend with an increasing Child-Pugh grade. Further comparison demonstrated that the scores obtained by the number connection test A and the number symbol test were consistent according to the normal value standards of the two studies in China and South Korea ( Z = -0.982, -1.702; P = 0.326, 0.089), while the other three sub-tests had significant differences ( P < 0.001). Conclusion:The prevalence rate of MHE in the cirrhotic population is high, but the prevalence of MHE obtained by using different diagnostic criteria or methods varies greatly. Therefore, in line with the current changes in demographics and disease spectrum, it is necessary to enroll a larger sample size of a healthy population as a control. Moreover, the establishment of more reliable diagnostic scoring criteria will serve as a basis for obtaining accurate MHE incidence and formulating diagnosis and treatment strategies in cirrhotic populations.
2.Changes of coagulation / fibrinolysis factors in patients with type A aortic dissection after operation
Aizezi MAIMAITIAILI ; Yisireyili MAIMAITI ; Weimin ZHANG ; Yongzhong GUO ; Zonggang ZHANG
Journal of Chinese Physician 2020;22(7):1009-1013
Objective:To investigate the changes of coagulation/fibrinolysis factors in patients with type A aortic dissection (AD) at early and middle stages after ascending aorta replacement+ total arch replacement+ elephant nose stenting.Methods:According to the inclusion and exclusion criteria, patients with type A AD who underwent cardiac surgery in Xinjiang Uygur Autonomous Region People′s Hospital from August 2017 to August 2018 were selected as the study group. According to the duration of onset, patients were divided into acute AD group (course <2 weeks) and chronic AD group (course ≥2 weeks). Both groups were treated with ascending aorta replacement + total arch replacement + elephant nose stenting. Fasting venous blood was drawn from the two groups, and the blood indexes [prothrombin time (PT), activated partial thrombo plastin time (APTT), fibrinogen (Fib), bone morphogenetic proteins (BMP)] and fibrinolysis indexes [D-dimer, tissue-type plasminogen activator (t-PA), plasminogen activator inhibitor (PAI)] were detected by enzyme-linked immunosorbent assay (ELISA).Results:The ELISA result showed that changes of PT, APTT, Fib, BMP, D-dimer, and PAI in patients with acute and chronic AD at 12 months after operation were significantly lower than those before operation ( P<0.05). The changes of t-PA in patients with acute and chronic AD at 12 months after operation were significantly higher than those before operation ( P<0.05). There was no significant difference in postoperative effective rate, in-hospital mortality, length of stay, incidence of complications and early and mid-term survival rate between the two groups ( P>0.05). Conclusions:Ascending aorta replacement+ total arch replacement+ elephant nose stent is effective in the treatment type A AD, and can significantly improve the expression of coagulation/ fibrinolysis markers in early and middle period after operation.
3.Analysis of clinical effects, inflammatory stress and immune cell levels in patients with acute aortic dissection after TEVAR
Aizezi MAIMAITIAILI ; Yisireyili MAIMAITI ; Jun LIU ; Yongzhong GUO ; Zonggang ZHANG
Journal of Chinese Physician 2020;22(9):1322-1326
Objective:To investigate the clinical effects, inflammatory stress and immune cell levels of patients with acute aortic dissection (AD) after thoracic aortic endovascular repair (TEVAR).Methods:A retrospective analysis of 60 patients with acute aortic dissection admitted to our hospital from April 2014 to January 2016 were divided into conservative group ( n=30) and TEVAR group ( n=30) according to different treatment methods. The conservative group was given drug therapy, and the TEVAR group was given a thoracic aortic endovascular repair therapy. The inflammatory cytokines and immune cell levels of the two groups were measured before and after treatment. The therapeutic effects and the long-term effects of the two groups were analyzed. Results:Before treatment, there was no significant difference in serum interleukin (IL)-6, IL-8 and tumor necrosis factor-α (TNF-α) levels between the two groups ( P>0.05). After treatment, the levels of inflammatory cytokines in the two groups were significantly lower than those before treatment ( P<0.05); The levels of IL-6, IL-8 and TNF-α in the TEVAR group were significantly lower than those in the conservative group ( P<0.05). Before treatment, there was no significant difference in white blood cell count, neutrophil count, lymphocyte count and monocyte count between the two groups ( P>0.05). After treatment, the number of white blood cells and neutrophils decreased significantly in the two groups; and the number of lymphocytes in the two groups was significantly increased ( P<0.05). The number of white blood cells and neutrophils in the TEVAR group was significantly lower than that in the control group, and the number of lymphocytes was significantly higher than that in the conservative group ( P<0.05). The effective rate of the TEVAR group was significantly higher than that of the conservative group ( P<0.05). There was no significant difference in hospital mortality, hospitalization time and hospitalization complication between the two groups ( P>0.05). The 2-year survival rate of the TEVAR group was significantly higher than that of the conservative group. The postoperative complication rate was significantly lower than the conservative group ( P<0.05). There was no significant difference in the 1-year survival rate and secondary intervention rate between the two groups ( P>0.05). Conclusions:TEVAR has a better therapeutic effect, and improve survival rate to some extent.
4.Prevalence and Molecular Characterization of Echinococcus granulosus Sensu Stricto in Northern Xinjiang, China
Baoping GUO ; Zhuangzhi ZHANG ; Xueting ZHENG ; Yongzhong GUO ; Gang GUO ; Li ZHAO ; Ren CAI ; Bingjie WANG ; Mei YANG ; Xi SHOU ; Wenbao ZHANG ; Bin JIA
The Korean Journal of Parasitology 2019;57(2):153-159
Echinococcus granulosus is an important zoonotic parasite globally causing cystic echinococcosis (CE) in humans and animals. In this study, prevalence of CE and variation of cox1 gene sequence were analyzed with isolates E. granulosus collected from different areas in northern Xinjiang, China. The survey showed that 3.5% of sheep and 4.1% of cattle were infected with CE. Fragment of cox1 was amplified from all the positive sheep and cattle samples by PCR. In addition, 26 positive samples across the 4 areas were included. The isolates were all E. granulosus sensu stricto (s.s.) containing 15 haplotypes (Hap1-15), and clustered into 2 genotypes, G1 (90.1%, 91/101) and G3 (9.9%, 10/101). Hap1 was the most common haplotype (48.5%, 49/101). Hap9 were found in humans samples, indicating that sheep and cattle reservoir human CE. It is indicate that E. granulosus may impact on control of CE in livestock and humans in the region.
Animals
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Cattle
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China
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Cross-Sectional Studies
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Echinococcosis
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Echinococcus granulosus
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Echinococcus
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Genotype
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Haplotypes
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Humans
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Livestock
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Parasites
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Polymerase Chain Reaction
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Prevalence
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Sheep
5.Correlation analysis between meteorological factors and onset of acute cerebral infarction in Dalian
Yanan LIN ; Yan GUO ; Xi YANG ; Mengxing TAO ; Yongzhong LIN ; Qiang MA ; Xiaopei SUN
Chinese Journal of Cerebrovascular Diseases 2018;15(3):113-118
Objective To provide more reference base for the prevention and treatment of acute cerebral infarction through the correlation study between the onset of acute cerebral infarction and meteorological factors during the same period in Dalian area.Methods From January 1,2015 to December 31,2015,the data of hospitalized medical records and meteorological data during the same period in 3 5 7 8 consecutive patients with acute cerebral infarction admitted to three tertiary hospitals in Dalian were analyzed retrospectively.The seasonal regularity of acute cerebral infarction in Dalian area was analyzed descriptively.A single retrospective 1 ∶ 1 matched case-crossover study design was used to analyze the effect of mean air temperature lag 0-3 days on the onset of acute cerebral infarction.Pearson correlation analysis was used to analyze the influence of meteorological factors of the day on the onset of acute cerebral infarction,at the same time,the relationship between stroke subtypes and meteorological factors was investigated.Results (1) The incidence of acute cerebral infarction was higher in winter (December,January,and February) and it was lower in summer (from June to August).(2) Hysteresis analysis:when the temperature was reduced by 1 ℃each time,the OR values of acute cerebral infarction lagging behind 0 and 1 d were 1.034 (95% CI 1.012-1.056) and 1.025 (95% CI 1.008-1.042) respectively.There was significant difference (all P < 0.05).The correlation between the temperature of the day of onset and the onset of acute cerebral infarction was the highest.(3) The onset of cerebral infarction was negatively correlated with the average temperature of the day and hours of sunshine (r =-0.392,-0.260,all P < 0.01),and it was positively correlated with the daily average air pressure (r =0.403,P < 0.01).Among them,the correlation of the type of cardiogenic embolism and each meteorological factor was the highest.The correlation coefficients of daily average temperature,daily air pressure,and hours of sunshine were-0.836,0.733,and-0.629,respectively (all P < 0.01).Conclusion A cold and high air pressure may trigger the onset of acute cerebral infarction,especially cardiogenic cerebral infarction.
6.Teaching experience of cardiac surgery rotation for standardized training residents not majoring in cardiac surgery
Weimin ZHANG ; Zonggang ZHANG ; Dongqing CHANG ; Yongzhong GUO
Chinese Journal of Medical Education Research 2017;16(10):1046-1049
Cardiac surgery is the latest and fastest growing subject in surgery, which is character-ized by complex diseases and strong specialization.The standardized training of non cardiac surgery is short of time for the residents in cardiac surgery, and the teaching has certain complexity and particularity. The department of cardiac surgery of the Xinjiang Uygur Autonomous Region people's Hospital has analyzed the subject characteristics of the major, and explored the reform of cardiac surgery teaching. We adopted a variety of teaching forms to enhance clinical thinking ability and clinical practice ability as the focus of training, and strengthen clinical operation skills according to individual differences among residents. We improved the enthusiasm and initiative of the non-cardiac surgery residents to learn, training residents standardized,standardized diagnosis and treatment behavior,improve the quality of training.
7.Observation on clinical efficacy of recombinant human B-type natriuretic peptide in treating dilated cardiomyopathy complicating heart failure
Xinhua GUO ; Yongzhong YANG ; Jianxiu LI ; Shujie CHEN ; Lei ZHANG ; Wei LIU
Chongqing Medicine 2014;(36):4875-4877,4880
Objective To evaluate the short term clinical efficacy of recombinant human B‐type natriuretic peptide(rhBNP) in the treatment of dilated cardiomyopathy complicating heart failure .Methods 121 patients with dilated cardiomyopathy complicating heart failure were selected ,the cardiac function grade Ⅲ - Ⅳ ,and randomly divided into the conventional treatment group(control group ,n= 61) and the rhBNP treatment group(rhBNP group ,n = 60) .The disease history was recorded and clinical symptoms , heart color echocardiography ,cardiac function ,renal function and plasma NT‐proBNP levels were observed before and after treat‐ment .Results The NT‐proBNP level after 72 h treament in the rhBNP group was significantly lower than that in the control group (P< 0 .01) ;LVEDd after 1 week treatment in the rhBNP group was significantly lower than that in the control group ( P =0 .033) ;LVEF was increased in the both groups ,but the increase in the rhBNP group was more significant compared with the con‐trol group (P< 0 .01) .The total effective rate was 91 .6% in the rhBNP group and 72 .1% in the control group with statistical dif‐fernece between the two groups(P= 0 .005) ;the average hospital stay time in the rhBNP group was significantly shorter than that in the control group(P= 0 .041) .The proportion of the major adverse cardiovascular events(MACE) occurrence had no statistical difference between the two groups(P= 0 .492) .Conclusion rhBNP is safe and effective in treating the acute decompensation of di‐lated cardiomyopathy .
8.Imaging features of breast echinococcus granulosus
Li ZENG ; Fanming LIU ; Yue GONG ; Jinmei GE ; Xianjun LI ; Minxin SHI ; Yongzhong GUO
Chinese Journal of Radiology 2012;46(2):127-129
Objective To demonstrate the X-ray and CT features of breast hydatid disease.Methods Of 11 patients with pathologically confirmed breast Echinococcus hydatid disease were collected and the X-ray and CT image data were analyzed.Results Of 11 patients with hydatid cysts,single cyst was found in 9 patients which one cyst was ruptured due to trauma,multiple cyst in 2 patients.Mammography showed small or large shadow in different size,with low or high density and smooth margin.Calcification was found in 5 and 2 patients with egg shell-like calcification along the wall of cyst,3 patients with spotted calcification within cyst.One case had cavity-like change (annular solar eclipse sign).Cystic lesion with a complete capsule was demonstrated on CT scan in 1 patient.Conclusion Molybdenum target mammography can accurately display the imaging characteristics of hydatid cyst and improve the diagnostic ability of breast hydatid cyst in combination with clinical and epidemiological data.
9.The preventative effects of protein tyrosine kinase on the inflammation and airway remondeling in lung of guinea pigs with bronchial asthma.
Yun-fu ZHU ; Ai-guo DAI ; Rui-cheng HU
Chinese Journal of Applied Physiology 2009;25(2):151-154
AIMTo investigate the effects of protein tyrosine kinase on the inflammation and airway remodeling in lung of guinea pigs with bronchial asthma.
METHODS30 adult male guinea pigs were randomly divided into 3 groups (n=3): control group (C group), asthmatic group(A group)and genistein group (B group). Asthmatic model was established by ovalbumin intraperitoneal injection and ovalbumin inhalation. The total cell and the proportion of inflammatory cell in bronchial alveolar lavage fluid(BALF), inflammatory cell infiltration and index of remodeling of bronchiole were measured, respectively. The expression of p-tyrosine in lung tissue was examined by immunohistochemistry.
RESULTSThe total cell and proportion of eosinophil in BALF of A group were significantly higher than that of C group (P < 0.01), but compared with A group, the total cell and proportion of eosinophil in BALF of B group were much lower (P < 0.01). The number of eosinophile and lymphocyte of bronchiole in A group were significantly higher than that of C group (P < 0.01), but compared with A group, the number of eosinophile and lymphocyte in bronchiole of B group were much lower (P < 0.01). Compared with A group, the remodeling of bronchiole of B group was significantly relieved (P <0.01), there was no difference between B and C group (P > 0.05). Immunohistochemistry indicated that in A group the p-tyrosine was more positively expressed at the bronchial smooth muscle, bronchial epithelium, smooth muscle of vessel and inflammatory cell, especially at smooth muscle of bronchi and vessel and inflammatory cell than that of C group (P <0.01), there was no difference between B group and C group (P > 0.05).
CONCLUSIONPTK played a key role in inflammation and bronchial remodeling in lung of guinea pigs with bronchial asthma. The Protein tyrosine kinase inhibitor genistein could prevent and inhibit the inflammation and bronchial remodeling in lung of guinea pigs with bronchial asthma.
Airway Remodeling ; physiology ; Animals ; Asthma ; physiopathology ; prevention & control ; Genistein ; pharmacology ; Guinea Pigs ; Inflammation ; prevention & control ; Male ; Ovalbumin ; Protein-Tyrosine Kinases ; antagonists & inhibitors ; physiology ; Random Allocation
10.Belladonna alkaloid combined with morphine for morphine-addicted mice
Xinhua GUO ; Changyi MA ; Yongzhong YANG ; Zheng YUAN ; Yuning LIU ; Liguang WANG
Chinese Journal of Tissue Engineering Research 2005;9(12):238-240
BACKGROUND: Belladonna drugs have been widely used in clinic in our country to improve microcirculation, or as a herbal anesthetic drug. However,there are few reports regarding the animal experiments on belladonna alkaloid against morphine addiction further OBJECTIVE: To observe the effects of belladonna alkaloid combined with morphine on morphine(Mor)-addicted mice so as to provide an experimental basis for development of belladonna to morphine addiction.DESIGN: A completely randomized-controlled study based on the experimental animals.SETTING: Laboratory of physiology of a medical college.MATERIALS: The study was performed at the Laboratory of Physiology of Medical Department of Hebei Engineering College from June 2004 to August 2004. Fifty 2-month old male healthy Kunming mice of clean grade with a body mass of(20±2) g were obtained from Experimental Animal Centre of Hebei Medical University.METHODS: According to evaluation index of dependence in Morphine-addicted animals, we chose pain threshold and naloxone-urged jumping response as items to observe. Fifty mice were randomly divided into 5 groups with 10 mice each, which were the control group (saline), the morphine group, the scopolamine(Sco)group, the anisodamine(Ani), atropine(Atr)group. The corresponding drugs or saline was administered by intraperitoneal (I. P.) injection once a day for 7 days. The pain threshold at 1 hour after I. P. Injection of drugs was observed from day 1 to day 7 by hot-plate method. Mice were given I.p. Injection of naloxone (Nal, 5 mg/kg ) 6hours after the last injection. The jumping times within 30 minutes were observed to evaluate the ,formation of the Morphine addiction.Nal-urged mice.RESULTS: The pain threshold of the mice in Morphine group was decreased significantly, and the jumping times and jumping rate were obviously increased compared with that of the control group( P < 0.05 or P < 0.01).The co-administration of Sco-Mor mixtures for 7 days significantly increased the pain threshold of Mor-dependent mice( P < 0.01) and markedly decreased the jumping times and the jumping rate( P < 0. 05) . Atr-Mor and Ani-Mor had a weak effect on the elevation of the pain threshold of Mor-dependent mice, but had strong effects on the decrease of the jumping times and the jumping rate( P < 0. 01 ).CONCLUSION: Belladonna alkaloids all could antagonize Mor-dependence in mice at different degrees, which provide an important experimental evidence to develop belladonna drugs for preventing opium addiction.

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