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.Preliminary investigation on indoor radon concentrations in urban and rural areas of Ningxia
Liang DONG ; Yunyun WU ; Yanchao SONG ; Shanshan KOU ; Xuli JI ; Hongcheng LI ; Meilin WANG
Chinese Journal of Radiological Medicine and Protection 2024;44(9):771-775
Objective:To investigate the indoor radon concentrations and to analyze their seasonal variations in urban and rural residential dwellings in Ningxia province.Methods:From March 2022 to March 2023, based on the administrative region division and population distribution in Ningxia, a total of 143 typical residential dwellings, including 82 urban houses and 61 rural houses, were selected to measure indoor radon concentration by CR-39 solid nuclear track detectors for 1 year in Ningxia, with detectors changed every 3 months.Results:The annual average indoor radon concentration in Ningxia was 88 Bq/m 3, range 39-226 Bq/m 3. The annual average indoor radon concentration was below 100 Bq/m 3 for 69.9% of the measured dwellings, and below 300 Bq/m 3 for all of surveyed dwellings. Indoor radon concentrations in rural areas were much higher than those in urban areas ( Z=5.85, P<0.05). Indoor radon concentration varied significantly with the seasons, higher in autumn and winter, but lower in spring and summer, in total ( χ2=63.97, P<0.05), urban ( χ2=24.74, P<0.05), and rural ( χ2=43.15, P<0.05). Conclusion:The annual average indoor radon concentrations in all the measured dwellings are below the reference level of 300 Bq/m 3 recommended by Indoor Air Quality Standard (GB/T 18883-2022) in China.
3.The risk factors and treatment of rituximab-induced interstitial pneumonia in patients with diffuse large B-cell lymphoma receiving R-CDOP regimen
Feng LI ; Xuli WANG ; Qian ZHAO ; Qing YAN ; Yongping ZHAI
Tumor 2023;43(5):428-435
Objective:To identify clinical features,possible risk factors and treatment related to rituximab-associated interstitial pneumonia(RTX-IP). Methods:The clinicopathological characteristics,immune phenotype and treatment of six patients with diffuse large B-cell lymphoma(DLBCL)develped after receiving R-CDOP treatment were retrospectively analyzed. Results:Six patients had agranulocytosis or granulocytopenia within 1 week before RTX-IP diagnosis,and the median interval time was 3 courses of treatment.All six patients had double-expressor lymphoma(DEL)or triple-expressor lymphoma(TEL).Of the six patients,four had germinal-center B-cell-like lymphoma(GCB),and two had non-GCB.The expression of Ki-67 was>70%,except for one patient with transformed lymphoma(TL).After treatment with methylprednisolone for about 1 week,all patients'chest CT showed inflammatory absorption.However,one patient developed pneumocystis carinii pneumonia during the process of hormone reduction,and recovered after 27 days of comprehensive treatment with hormones and anti-pneumocystosis therapy.All patients received CDOP regimen(a total of 8 courses)for the treatment of the primary disease,and the process was smooth. Conclusion:R-CDOP regimen may lead to a high incidence of RTX-IP in DLBCL patients(30.0%).The DLBCL patients with DEL or TEL,GCB subtype,TL and high Ki-67 expression were more liable to develop RTX-IP,and the recovery of agranulocytosis may be related to the pathogenesis of RTX-IP.High-resolution CT scan can provide valuable evidence for early diagnosis of RTX-IP.Metagenomic next-generation sequencing(mNGS)helps to distinguish IP from pathogen infections.High dose of glucocorticoids is effective treatment strategy.At the same time,it is necessary to strengthen the prevention and treatment of infection in the process of glucocorticoids application.
4.Prognostic influencing factors of diffuse large B-cell lymphoma analyzed by time-dependent covariate Cox regression model
Zhiqiang ZHAO ; Lijun WANG ; Yu QIAO ; Xuli YAN ; Lieyang WANG
Cancer Research and Clinic 2023;35(12):919-923
Objective:To investigate the influencing factors of the prognosis of patients with diffuse large B-cell lymphoma (DLBCL).Methods:The clinical data of 431 DLBCL patients admitted to Shanxi Province Cancer Hospital from January 2013 to December 2020 were retrospectively analyzed. Univariate and multivariate time-dependent covariate Cox regression model were constructed. The relationship between the clinical characteristics and prognosis of patients was analyzed.Results:The age, tumor diameter, tumor width all met the proportion hazard hypothesis (correlation coefficients were 0.044, -0.015, and -0.680, respectively, all P > 0.05). The effects of disease grade, erythrocyte sedimentation rate (ESR) increased or not, and CD20 positive or not on survival time changed with time change. When the above indicators did not meet the proportional hazard hypothesis, they were time-dependent covariables (all P < 0.05). Time-dependent covariate Cox regression multivariate analysis showed that lactate dehydrogenase (LDH) increased or not ( χ2 = 13.78, P < 0.001), β 2 microglobulin (β 2-MG) increased or not ( χ2 = 5.36, P = 0.021), tumor diameter ( χ2 = 4.12, P = 0.042) and CD20 positive or not ( χ2 = 7.09, P = 0.008) and ESR increased or not ( χ2 = 5.46, P = 0.019) were independent influencing factors of the death of DLBCL patients. Conclusions:Patients with elevated LDH, increased β 2-MG, tumor diameter, increased ESR and CD20 positive have poor prognosis. Clinicians should take further treatment measures for these patients to reduce the mortality.
5.Identification of potential anti-pneumonia pharmacological components of Glycyrrhizae Radix et Rhizoma after the treatment with Gan An He Ji oral liquid
Xiaojuan JIANG ; Yihua LIN ; Yunlong WU ; Caixia YUAN ; Xuli LANG ; Jiayun CHEN ; Chunyan ZHU ; Xinyi YANG ; Yu HUANG ; Hao WANG ; Caisheng WU
Journal of Pharmaceutical Analysis 2022;12(6):839-851
Glycyrrhizae Radix et Rhizoma,a traditional Chinese medicine also known as Gan Cao(GC),is frequently included in clinical prescriptions for the treatment of pneumonia.However,the pharmacological com-ponents of GC for pneumonia treatment are rarely explored.Gan An He Ji oral liquid(GAHJ)has a simple composition and contains GC liquid extracts and paregoric,and has been used clinically for many years.Therefore,GAHJ was selected as a compound preparation for the study of GC in the treatment of pneumonia.We conducted an in vivo study of patients with pneumonia undergoing GAHJ treatments for three days.Using the intelligent mass spectrometry data-processing technologies to analyze the meta-bolism of GC in vivo,we obtained 168 related components of GC in humans,consisting of 24 prototype components and 144 metabolites,with 135 compounds screened in plasma and 82 in urine.After analysis of the metabolic transformation relationship and relative exposure,six components(liquiritin,liquiritigenin,glycyrrhizin,glycyrrhetinic acid,daidzin,and formononetin)were selected as potential effective components.The experimental results based on two animal pneumonia models and the in-flammatory cell model showed that the mixture of these six components was effective in the treatment of pneumonia and lung injury and could effectively downregulate the level of inducible nitric oxide synthase(iNOS).Interestingly,glycyrrhetinic acid exhibited the strongest inhibition on iNOS and the highest exposure in vivo.The following molecular dynamic simulations indicated a strong bond between glycyrrhetinic acid and iNOS.Thus,the current study provides a pharmaceutical basis for GC and reveals the possible corresponding mechanisms in pneumonia treatment.
6.Effects of preoperative administration of parecoxib sodium on stress reaction and postoperative nausea and vomiting score in patients undergoing laparoscopic cholecystectomy
Xuli TANG ; Hongwei LI ; Bilian ZHENG ; Fang WANG
Chinese Journal of Primary Medicine and Pharmacy 2022;29(10):1485-1489
Objective:To investigate the effects of preoperative administration of parecoxib sodium on stress reaction and postoperative nausea and vomiting score in patients undergoing laparoscopic cholecystectomy.Methods:A total of 112 patients undergoing laparoscopic cholecystectomy in Lishui City People's Hospital from January 2020 to January 2021 were included in this study. They were randomly divided into observation group and control group, with 56 patients per group. The observation group was intravenously administered 40 mg parecoxib sodium 30 minutes before surgery, and the control group was identically administered equal amount of 0.9% sodium chloride injection. At 1, 6, 12 and 24 hours after surgery, Visual Analogue Scale (VAS) score, cortisol and adrenocorticotropic hormone levels and postoperative nausea and vomiting score were compared between the two groups.Results:At 1, 6 and 12 hours after surgery, VAS score in the observation group was (3.23 ± 0.85) points, (2.44 ± 0.76) points, (2.37 ± 0.69) points, respectively, which were significantly lower than (4.06 ± 1.12) points, (3.24 ± 0.95) points, (3.10 ± 1.07) points in the control group ( t = 4.41, 4.92, 4.29, all P < 0.001). At 1, 6, 12 and 24 hours after surgery, cortisol level in the observation group was (287.79 ± 35.46) ng/L, (303.55 ± 34.77) ng/L, (368.58 ± 31.22) ng/L, (397.16 ± 32.60) ng/L, respectively, which were significantly lower than (337.64 ± 39.52) ng/L, (364.18 ± 36.90) ng/L, (405.56 ± 37.29) ng/L, (455.51 ± 37.81) ng/L in the control group ( t = 7.02, 8.94, 5.69, 8.74, all P < 0.05). At 1, 6, 12 and 24 hours after surgery, adrenocorticotropic hormone level in the observation group was (59.25 ± 7.63) ng/L, (65.27 ± 8.23) ng/L, (72.29 ± 7.49) ng/L, (83.63 ± 8.57) ng/L, which were significantly lower than (64.48 ± 8.06) ng/L, (71.44 ± 8.59) ng/L, (79.79 ± 8.15) ng/L, (90.08 ± 8.26) ng/L in the control group ( t = 3.52, 3.88, 5.07, 4.05, all P < 0.05). Within 24 hours after surgery, the incidence of postoperative nausea and vomiting in the observation group was significantly lower than that in the control group [12.50% (7/56) vs. 28.57% (16/56), χ2 = 4.43, P < 0.05). Within 2 hours, 2-6 hours, and > 6-24 hours, postoperative nausea and vomiting score in the observation group was (1.31 ± 0.26) points, (1.43 ± 0.32) points, and (1.46 ± 0.41) points, respectively, which was significantly lower than (1.67 ± 0.41) points, (1.83 ± 0.39) points, (1.88 ± 0.44) points in the control group ( t = 2.12, 2.37, 2.14, all P < 0.05). Conclusion:Preoperative administration of parecoxib sodium exhibits a good postoperative analgesic effect in patients undergoing laparoscopic cholecystectomy. It can effectively reduce postoperative stress reactions, decrease the incidence of postoperative nausea and vomiting, and lower the severity of postoperative nausea and vomiting, and thereby can be widely used in clinical practice.
7.Effects of can walking anterior and posterior capsule polishing combined with tension ring implantation on lens capsular stability after phacoemulsification for ultra-high myopia cataract
Xuli ZHAO ; Lu WANG ; Ting LONG ; Ge HUANG ; Guang YANG
Chinese Journal of Microsurgery 2022;45(3):310-314
Objective:To observe the effects of polishing the anterior and posterior capsule with irrigation/aspiration (I/A) injection needle and capsular tension ring (CTR) implantation on intraocular lens (IOL) capsular stability after phacoemulsification for ultra-high myopia with 2.0 mm coaxial micro incision.Methods:This is a prospective randomized controlled study. There were 40 patients(80 eyes) aged 46-72 years old with ultra-high myopia cataract. The grade of lens opacity was grade II-IV, and the diopter was -10 D - -24 D. During 2.0 mm coaxial micro incision phacoemulsification, adopt coin tossing method randomly, 1 eye was operated using the anterior and posterior capsule polishing 360° with I/A injection needle combined with CTR implantation as the experimental group(40 eyes), the other eye was neither polished nor CTR implantated as the control group(40 eyes). The operation interval of both eyes was less than 1 week. The size of anterior capsular orifice, effective intraocular lens position(ELP), IOL eccentricity and posterior capsular opacification(PCO) were recorded at 1 week, 1, 3 and 6 months after operation in outpatient clinic. Two independent sample t-test and Fisher exact probability test were used to compare the differences between the 2 groups. P<0.05 was defined significant difference. Results:During the follow-up period, there were no significant change in the anterior capsule area, IOL eccentricity and ELP in the experimental group. However in the control group, the anterior capsular area decreased gradually with time, and gradually IOL eccentricity increased and ELP decreased. There was no significant difference between the 2 groups in each observation index at 1 week after operation, but it was ELP that first showed the difference tendency( P<0.01). The ELP of the control group was significantly lower than that of the experimental group at 1, 3 and 6 months after operation( P<0.05). There was no significant difference in anterior capsule area and IOL eccentricity between the 2 groups at 1 and 3 months after operation( P>0.05), but there was a significant difference at 6 months( P<0.05). In terms of PCO, the incidence of PCO was 0%, 2.5% and 7.5% in the experimental group and 5.0%, 17.5% and 32.5% in the control group respectively at 1, 3 and 6 months after operation. The incidence of PCO in the experimental group was significantly lower than that in the control group( P<0.05). Conclusion:Ultra-high myopia with cataract are prone to have capsular contraction after operation, which is characterized by IOL instability and anterior capsular orifice narrowing gradually. Combined 360° anterior and posterior capsular polishing with tension ring implantation in operation can effectively maintain the stability of ELP, reduce the degree of contraction of anterior capsular orifice, reduce the eccentricity of IOL and the incidence of PCO. Polishing the anterior and posterior capsule with I/A injection needle combined with CTR implantation, is safe and effective for patients with ultra-high myopia cataract.
8.Clinical characteristics and survival analysis of primary thyroid lymphoma
Zhiqiang ZHAO ; Meng XING ; Yu QIAO ; Xuli YAN ; Qinchuan YU ; Likun ZAN ; Liping SU ; Lieyang WANG
Cancer Research and Clinic 2022;34(11):835-838
Objective:To investigate the clinical characteristics of primary thyroid lymphoma (PTL) and the differences in clinical manifestations and survival between the two main pathological subtypes of PTL.Methods:The clinical data of 52 patients with PTL diagnosed in Shanxi Province Cancer Hospital from January 2011 to January 2022 were retrospectively analyzed. The clinical characteristics and survival between the two main pathological subtypes [diffuse large B-cell lymphoma (DLBCL) and mucosa-associated lymphoid tissue lymphoma (MALT)] were compared.Results:Among 52 PTL patients, there were 12 males and 40 females, with a median age of 65 years old (34-83 years old). All patients presented with anterior cervical mass at the time of visit. MALT was diagnosed in 12 cases (23.1%). DLBCL was diagnosed in 37 cases (71.2%), of which 5 cases were double/triple expression lymphoma. B-cell lymphoma (unclassified) was diagnosed in 2 cases (3.8%). Follicular lymphoma (FL) was diagnosed in 1 case (1.9%). There was statistical difference in the proportion of patients with cervical lymph node enlargement between MALT and DLBCL patients [66.7% (8/12) vs. 94.6% (35/37), χ2 = 4.23, P < 0.05]. The 3-year OS rates of MALT and DLBCL patients were 90.9% and 73.9%, and the difference in OS between the two groups of patients was statistically significant ( χ2 = 5.11, P = 0.024). Conclusions:Pathological subtypes of PTL are related to the prognosis of patients.
9. Advances in understanding the role of IKKβ in tumorigenesis and its inhibitors
Xuli CHEN ; Jing WEI ; Jiabing WANG
Chinese Journal of Clinical Pharmacology and Therapeutics 2021;26(3):350-360
In recent years, the role of inhibitor kappa B kinaseβ (IKKβ) in the process of tumorigenesis has gradually been elucidated. IKK is involved in tumor cell proliferation and survival by acting on multiple molecular pathways. Inhibition of IKKβ has been identified as a promising treatment for cancer. Researchers have developed a series of IKKβ inhibitors and found that they can effectively inhibit tumor growth, but no IKKβ inhibitors have been used clinically to treat cancer. We discuss progress in understanding the role of IKKβ in tumorigenesis and review the recent development of main inhibitors of IKKβ.
10.Study on screening for 274 suspected cases of corona virus disease 2019
Xuli YANG ; Zhihui WANG ; Xing LIU ; Shanshan WU ; Xiaoping WU ; Guilan WEN ; Xianjun ZENG ; Huawei XIONG ; Jie LIU ; Tao HONG
Chinese Journal of Infectious Diseases 2020;38(4):199-203
Objective:To evaluate the diagnostic efficacies of computed tomography (CT), clinical manifestations and 2019 novel coronavirus (2019-nCoV) nucleic acid test results for the screening and diagnosis of novel coronavirus pneumonia.Methods:The clinical data of suspected cases with corona virus disease 2019 (COVID-19) visited fever clinic or stayed in emergency room of the First Affiliated Hospital of Nanchang University from January 23 to February 9, 2020 were collected. Totally 274 cases who met the inclusion criteria were enrolled. Four screening schemes including chest CT screening, scoring, chest CT and scoring series screening, chest CT and scoring parallel screening were designed. The statistical analysis was performed by using chi-square test. The sensitivities, specificities and the areas under the receiver operator characteristic curve of the four screening schemes were calculated, and the diagnostic efficacies were evaluated.Results:Among the 274 cases, 93.80%(257/274) presented with typical clinical symptoms, 47.81%(131/274) had epidemiological history, and the blood routine examination results of 45.26%(124/274) cases met the positive criteria of the scoring , and chest CT results of 43.07%(118/274) cases met the positive criteria of chest CT screening. The 2019-nCoV nucleic acid test positive rate of cases with epidemiological history was 30.53%(40/131), which was higher than that of cases without epidemiological history (9.09%(13/143)), and that of cases with typical imaging performance on chest CT was 40.68%(48/118), which was higher than cases without typical imaging performance (3.21%(5/156)). The differences between the above groups were both statistically significant ( χ2=20.150、60.468, respectively, both P<0.01). The positive rates of viral nucleic acid detection in cases with positive findings of chest CT screening, scoring, series screening, and parallel screening were 40.68%(48/118), 23.74%(47/198), 44.68%(42/94) and 23.87%(53/222), respectively, while those in cases with negative findings of the four screening schemes were 3.20%(5/156), 7.89%(6/76), 6.11%(11/180) and 0(0/52), respectively. The positive rates of the four screening schemes were all significantly different from that of viral nucleic acid detection ( κ=0.402, 0.100, 0.431, 0.106, all P<0.01). The chest CT screening method had a sensitivity of 90.57%and a specificity of 68.33%, and an area under the operating characteristic curve of the subject was 0.794, which had higher diagnostic value than those of the other three screening schemes. Conclusions:For the screening and diagnosis of COVID-19 cases, epidemiological history, positive 2019-nCoV nucleic acid test with ≥2 typical clinical manifestations have highly diagnostic value. On the basis of the preliminary screening of chest CT examination, flexible analysis of the diagnostic results could improve the diagnostic value of each detection method.

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