1.Annual review of basic research on lung transplantation of China in 2024
Jier MA ; Junmin ZHU ; Lan ZHANG ; Xiaohan JIN ; Xiangyun ZHENG ; Senlin HOU ; Zengwei YU ; Yaling LIU ; Haoji YAN ; Dong TIAN
Organ Transplantation 2025;16(3):386-393
Lung transplantation is the optimal treatment for end-stage lung diseases and can significantly improve prognosis of the patients. However, postoperative complications such as infection, rejection, ischemia-reperfusion injury, and other challenges (like shortage of donor lungs) , limit the practical application of lung transplantation in clinical practice. Chinese research teams have been making continuous efforts and have achieved breakthroughs in basic research on lung transplantation by integrating emerging technologies and cutting-edge achievements from interdisciplinary fields, which has strongly propelled the development of this field. This article will comprehensively review the academic progress made by Chinese research teams in the field of lung transplantation in 2024, with a focus on the achievements of Chinese teams in basic research on lung transplantation. It aims to provide innovative ideas and strategies for key issues in the basic field of lung transplantation and to help China's lung transplantation cause reach a higher level.
2.Development and influential factor analysis of pharmacy outpatient departments in 714 Chinese tertiary healthcare institutions
Long MEI ; Sa LI ; Yuqing ZHANG ; Shuo ZHOU ; Zengwei ZHAO ; Wei ZHANG ; Qunhong SHEN ; Jiancun ZHEN
China Pharmacy 2024;35(4):385-389
OBJECTIVE To investigate the basic situation of developing pharmacy outpatient departments in Chinese tertiary medical institutions and analyze the influencing factors. METHODS The research targeted the pharmacy outpatient department managers of hospitals and conducted a survey through Sojump in March 2023. Various independent variables were selected from the hospital’s own characteristics, the management of the pharmacy outpatient departments, and the construction of the pharmacist team for Logistic and linear regression analysis, with the aim of separately analyzing the factors influencing the establishment of pharmacy outpatient departments and the factors affecting the total number of patients served by these departments throughout the year 2022. RESULTS & CONCLUSIONS A total of 1 304 medical institutions of different levels nationwide participated in this survey, with 714 tertiary hospitals. Among the tertiary hospitals, 377 (52.80%) had established pharmacy outpatient departments, including 321 grade-A tertiary hospitals, 48 grade-B tertiary hospitals and 8 other tertiary hospitals. The 377 tertiary hospitals collectively operated 1 739 pharmacy outpatient departments, covering 19 specialized fields, with the highest proportion found in the cardiovascular field (including anticoagulation) at 16.45%. Tertiary hospitals in North China, Central China, East China and South China regions had more pharmacy outpatient departments. The establishment of pharmacy outpatient departments was found to be influenced by tertiary grade-B status (P=0.010) and the annual outpatient volume of the hospital (P=0.008), although the impact was relatively small. The factors influencing the number of patients served by pharmacy outpatient departments were the annual outpatient volume of the hospital (P=0.042) and the number of pharmacists engaged in clinical pharmacy work (P=0.004). The proportion of tertiary hospitals in China that have established pharmacy outpatient departments is insufficient. It is necessary to further accelerate the construction of pharmacy outpatient departments and appropriately expand the talent pool of hospital pharmacy teams based on the needs of pharmacy outpatient departments and patients, in order to meet the requirements of medical practice and patient care.
3.The influence of group painting art therapy on the rehabilitation effect of patients with schizophrenia during rehabilitation
Tao WANG ; Zengwei LIU ; Liming ZHANG ; Yongwu MING
Chinese Journal of Practical Nursing 2021;37(10):775-779
Objective:To explore the effect of group painting art therapy on negative symptoms, the cognitive status and social function of patients with schizophrenia during rehabilitation.Methods:A total of 114 patients with schizophrenia recovered from May 2018 to May 2019 in Zhangjiakou Shalingzi Hospital. They were divided into two groups according to the random number table method with 57 case in each group, the control group was given routine nursing, and the observation group received group painting art therapy on the basis of routine nursing. The Positive And Negative Symptoms Scale (PANSS), MATRICS Consensus Cognitive Battery(MCCB), and Social Disability Screening Schedule (SDSS) were used to evaluate the symptoms, cognitive status, and social function improvement of the two groups before and after intervention.Results:There were no significant differences in the negative symptom scores and positive symptom scores of the PANSS between the two groups of patients before the intervention ( P>0.05). After the intervention, the scores of negative symptoms and general psychopathology were (11.83 ± 3.19), (17.30 ± 4.93) points in the observation group and (13.57 ± 2.85), (20.34 ± 5.12) points in the control group, the differences were significant ( t values were 2.789, 2.932, P<0.05). After the intervention, the 7-dimensional MCCB scores of the two groups of patients decreased, and the scores of the observation group were significantly lower than those of the control group ( t values were 2.046-3.238, P<0.05). After the intervention, the score of SDSS was (11.63±2.71) points in the observation group and (13.84 ±3.14) points in the control group, the differences were significant( t value was 3.653, P<0.01). Conclusions:The use of group painting art therapy in patients with schizophrenia during rehabilitation can promote the improvement of negative symptoms and improve the cognitive and social functions of patients.
4.Clinical characteristics and prognosis of 44 patients with Nocardia infection
Xushuo XIE ; Qingluan YANG ; Jianming ZHENG ; Wenting ZENG ; Zengwei LIANG ; Lingyun SHAO ; Wenhong ZHANG
Chinese Journal of Infectious Diseases 2021;39(1):35-39
Objective:To investigate the clinical characteristics and prognosis of the patients with nocardiosis.Methods:From January 2013 to July 2019, 44 patients with nocardiosis in Department of Infectious Diseases, Huashan Hospital, Fudan University in Shanghai were enrolled, and their clinical data were retrospectively analyzed, including baseline characteristics, clinical manifestations, underlying diseases history of glucocorticoid therapy, laboratory data (blood routine examination, procalcitonin, C-reactive protein, lymphocytes subsets, etc.), imaging changes, bacterial strain identification, treatment regimens and outcomes. According to the locations of infection, patients were divided into pulmonary nocardiosis, extrapulmonary single-organ nocardiosis and disseminated nocardiosis. The Mann-Whitney U test was used for comparison between two groups, and the Kruskal-Wallis H test was used for comparison among multiple groups. Results:Among the 44 cases of nocardiosis, 14 cases were pulmonary nocardiosis, 17 cases were extrapulmonary single-organ nocardiosis (including nine cases with central nervous system infection, six cases with skin and soft tissue infection, one case with abdominal abscess and one case with urinary tract infection) and 13 cases were disseminated nocardiosis (including four cases with bloodstream infection, six cases with central nervous system and lung or skin and soft tissue infection, three cases of lung and skin and soft tissue infection). Thirty-four cases had underlying diseases, and 27 cases received glucocorticoid or immunosuppressant treatment. The main symptom of 11 patients in pulmonary nocardiosis group was productive cough, while that of the patients in other two groups was fever. Nocardia species were mainly Nocardia brasiliensis, Nocardia nova and Nocardia farcinicaia. The white blood cell counts and neutrophils proportion were normal or slightly increased in 42 cases, and the platelets were normal or slightly decreased in 41 cases. Erythrocyte sedimentation rate increased in 19 cases, procalcitonin increased in 21 cases, C-reactive protein increased in 34 cases, and ferritin increased in 18 cases. A total of 34 patients were tested for lymphocyte subsets, of which 15 had CD4 + T lymphocytes decreased, 14 had CD8 + T lymphocytes increased, seven had B lymphocytes increased, seven had B lymphocytes decreased, and eight had natural killer cells decreased. The hemoglobin of patients with pulmonary nocardiosis was higher than that of patients with extrapulmonary infection, and the difference was statistically significant ( U=0.095, P=0.025). The imaging manifestations were mainly abscess and inflammatory exudation. Forty cases were cured or improved, one case was still on treatment, and three cases died. Conclusions:The clinical manifestations of nocardiosis involving various organs are non-specific. Standardized treatment could reduce the mortality of nocardiosis.
5.Application effect of timing theory in alcohol abstinence intervention for patients with alcoholic liver disease
Nannan SU ; Shuteng FAN ; Qingqiang YI ; Na WANG ; Huan HE ; Zengwei ZHANG
Chinese Journal of Practical Nursing 2021;37(20):1527-1533
Objective:To explore the effect of alcohol abstinence intervention based on timing theory on patients with alcoholic liver disease.Methods:A total of 106 patients with alcoholic liver disease hospitalized in the Department of liver disease of Taian Medical District, 960th Hospital of Chinese PLA from July 2018 to June 2019 were selected by convenience sampling method and divided into observation group and control group by random digits table method, 53 cases in each group. The control group received routine nursing, and through the improvement of patients' cognition and support system, implemented short abstinence intervention during hospitalization; the observation group received abstinence intervention based on timing theory on the basis of the control group intervention. At 1 month and 6 months after discharge, the differences of rehydration rate, alcohol dependence and physical and mental status between the two groups were compared.Results:Finally, 49 cases in the control group completed the study, and 51 cases in the observation group completed the study. The rehydration rates of the observation group were 21.57%(11/51) and 15.69%(8/51) respectively at 1 month and 6 months after discharge, while those of the control group were 40.82%(20/49) and 36.73%(18/49) respectively at 1 month and 6 months after discharge. The difference was statistically significant ( χ2 values were 4.328, 5.754, P<0.05). The alcohol dependence scores were 0(2,3), 0(1,2) in the observation group and 2(0,3), 3(1,4) in the control group at 1 month and 6 months after discharge, and the difference was statistically significant ( Z values were -6.719, -7.345, P<0.01). There was no significant difference in the score of Symptom Checklist-90(SCL-90) before intervention and 1 month after discharge between the two groups ( P>0.05). Six months after discharge, the score of SCL-90 was 8.26 ± 1.37 in the observation group and 10.11 ± 1.68 in the control group, and the difference was statistically significant( t value was 6.046, P<0.01). Conclusions:The application of timing theory in alcohol abstinence of patients with alcoholic liver disease can significantly reduce the relapse rate and the degree of alcohol dependence of patients with alcoholic liver disease, improve the physical and mental state of patients.
6.Long term evaluaction of cardiopulmonary function in 20 years after Fontan surgery
Chunzhen ZHANG ; Huishan WANG ; Zengwei WANG ; Minhua FANG ; Zongtao YIN ; Guoxu ZHANG ; Yan JIN
Chinese Journal of Thoracic and Cardiovascular Surgery 2019;35(2):68-71
To evaluate the long term cardiopulmonary function after Fontan operation. Methods 10 patients who received Fontan operation were followed for(26 ±4) years in our hospital. 7 males and 3 females,(30. 7 ± 13. 2) years old(20 -60 years). All patients were diagnosed by echocardiography, CTA, 24 h ECG, cardiac catheterization, pulmonary angiography, radionuclide pulmonary blood perfusion and cardiopulmonary exercise test. Results Echocardiography shows: LVEF(0. 49 ± 0. 04), more than moderate atrioventricular valve regurgitation in 7 cases. CTA shows: there was no anastomotic stenosis, arteriovenous fistula in 4 cases. 24 h ECG shows: sinus rhythm in 7 cases, frequent paroxysmal atrial tachycardia in 1 case, atrial flutter in one and atrial fibrillation in one. Cardiac catheterization and pulmonary angiography show: the average pulmonary artery pressure(17. 8 ±2. 0)mmHg, average pulmonary resistance(4. 17 ±0. 56) woods. Radionuclide pulmonary blood perfusion shows: pulmonary blood of upper lung was reduced significantly with unbalanced distribution. Cardiopulmonary exercise test shows: both of lung ventilation function and heart reserve function decreased moderately or severely. Protein losing enteropathy was found in 1 case. Conclusion The decrease of cardiopulmonary function is found after Fontan operation during the long-term follow up for 20 years, especially for cardiac function. More attention should be paid to the early postoperative atrioventricular valve regurgitation. Unbalanced distribution of pulmonary blood is Found in long term. The incidence of arrhythmia after extra conduit Fontan operation is lower than other methods.
7.Application of combined detection of serum CEA,CA199 ,CA125,AFP and fecal occult blood in diagnosis of Dukes B stage colon carcinoma
Jun TANG ; Liping OU ; Ling CHEN ; Yaguang WENG ; Zengwei XU ; Minghao ZHANG
Chongqing Medicine 2017;46(22):3073-3076
Objective To study the diagnostic value of combined detection of serum CEA,CA199,CA125,AFP and fecal occult blood(FOB) in Dukes B stage colon carcinoma.Methods The above indicators in 56 patients with colon carcinoma (colon carcinoma group),35 patients with colonic polyp benign disease and 41 healthy individuals undergoing physical examination were measured.Then the sensitivity,and specificity of single index detection and their combined detection were analyzed.Results The levels and positive rates of CEA,CA199,CA125 and FOB in the colon cancer group were significantly higher than those in the colonic polyp group and healthy control group (P<0.05),but the AFP level and positive rate had no statistical difference compared with the colonic polyp group.Serum CEA,CA125,CA199 and FOB were selected into the Logistic regression equation.The corresponding areas under the curve (AUC) were 0.745,0.886,0.792 and 0.864 respectively;the positive detection rates were 48.2 %,35.7 %,39.3 % and 78.6 % respectively.The combined detection could increased the specificity,sensitivity and AUC to 87.5 %,92.1% and 0.957,which were more superior to that in the single index detection.Conclusion The combined detection of serum CEA,CA199,CA 125 and FOB can provide the powerful basis for early diagnosing colonic cancer.
8.The analysis of results in the young children with tetralogy of Fallot: one-stage versus staged repair
Minhua FANG ; Huishan WANG ; Zengwei WANG ; Zhenlong WANG ; Chunzhen ZHANG ; Bo LI
Chinese Journal of Thoracic and Cardiovascular Surgery 2017;33(5):267-270
Objective The study aimed to evaluate the short and middle term results in the patients with tetralogy of Fallot(TOF) after one-stage repair and staged repair.Methods A total of 459 TOF younger children less than five-year-old between January 2009 and December 2013 had received surgical repair,including 416 patients by one-stage repair(group Ⅰ)and 43 patients by staged repair(group Ⅱ).Among them,245 were male and 214 were female.The average repair surgical age was 27.8 ranged from 4 to 60 months,average palliation age was 15.4 ranged from 3 to 40 months.23 perioperative and follow-up parameters were assessed including sex,age,weight,preoperative clinic symptom,ratio of McGoon,pulmonary artery index,Z score of pulmonary annulus,cardiopulmonary bypass time,aortic cross-clamping time,type of VSD repair,type of RVOT procedure,Peak RV/LV pressure radio,RV-PA pressure grade,mortality,severely low cardiac output syndrome,hypoxemia,extubation time,ICU time,fellow-up time,left ventricular eject faction,RV index of myocardial performance (MPI),tricuspid annular plane systolic excursion(TAPSE) and pulmonary regurgitation.Results Compared with group Ⅰ,age and weight were significantly lower in patients in group Ⅱ[(19.1 ± 16.4) months vs.(21.1 ± 11.2) months,P < 0.05) and(19.1 ±16.4) kgvs.(21.1 ±11.2) kg,P <0.01].The Z score of pulmonary annulus of patients in group Ⅱ were significantly less than those in group Ⅰ (-3.69 ± 2.36 vs.-2.50 ± 1.95,P < 0.01).The ratio of repairing VSD by RV incision and using TAP in patient of group Ⅱ were significantly more than those in group(27/43 vs.71/413,P <0.01),(41/43 vs.221/413,P <0.01).There was no difference of mortality,complication,extubation time and ICU time bewteen two groups.All patients followed up 12-52 months,there was no difference of LVEF,MPI and TAPSE between two groups.However,the severity of pulmonary regurgitation in patients of group Ⅱ was significant more than those of group Ⅰ (47.6% vs.32.1%,P < 0.01).Conclusion The early and mid-term results in the the young children patients with TOF after one-stage repair or staged repair were good.Although the prior palliative shunt could promote the development of the hypoplasia pulmonary arteries in the young children patient,it may related to the technique of repairing operations and the postoperative pulmonary regurgitation.
9.The midterm results of total Maze radiofrequency ablation procedure with vagal denervation in treatment of atrial fibrillation accompanied rheumatic heart valve disease
Zongtao YIN ; Huishan WANG ; Zengwei WANG ; Yong ZHANG ; Jinsong HAN ; Yu LIU ; Hongguang HAN
Chinese Journal of Thoracic and Cardiovascular Surgery 2017;33(3):179-182
Objective To study the radiofrequency ablation (RA) and vagal denervafion (VD) in surgical treatment of long-standing atrial fibrillation (AF) associated with rheumatic heart disease (RHD).Methods Retrospective analysis the cardiac rhythm by 24-hour Holter monitoring during 5-year follow-up after total Maze procedure accompanied rheumatic mitral valve replacement.Between June 2006 and December 2007,a total of 173 consecutive patients with long-standing AF-associated RHD underwent mitral valve replacement and ablation maze procedure,92 cases had RA alone and 81 had RA + VD.Results Although Kaplan-Meier curve shows that the freedom from AF at 5 years follow-up time were similar(P =0.718),the percentage of antiarrhythmic drug therapy was significant higher in the RA group during early postoperative period(4th month,54.1% vs.34.7%,P=0.017;5th month,39.2% vs.21.3%,P=0.018;6th month,23.0% vs.10.7%,P =0.044),and the percentage of those free by AF was significant lower(6th month,82.2% vs.93.8%,P =0.023;1st year,76.1% vs.89.9%,P=0.019).Conclusion Total maze procedure with bipolar radiofrequency ablation is effective to treat longstanding AF associated with rheumatic valve disease.Vagal denervation helped to maintain stable sinus rhythm and lower antiarrhythmic drug therapy at the early stage,but there was no additional benefit after the 1 st year of follow-up,it may be caused from the reactivation of vagal plexus electrical activity.
10.The surgical strategy and outcomes for pulmonary valve preservation in repair of tetralogy of Fallot in young children
Minhua FANG ; Huishan WANG ; Zengwei WANG ; Zhenlong WANG ; Chunzhen ZHANG ; Hongjiang WU
Chinese Journal of Thoracic and Cardiovascular Surgery 2017;33(11):666-669
Objective To evaluate the surgical strategy for pulmonary valve preservation in repair of tetralogy of Fallot (TOF) and analyze the outcomes in young children patients.Methods A total of 211 TOF younger children less than threeyear-old between January 2009 and December 2015 had received pulmonary valve-sparing(PVS) surgical repair.At the end of the procedure,the peak RV/LV pressure ratio(PRV/PLV) and transannular pressure gradient were performed in all patients.114 patients had higher PRV/PLV rati ≥ 0.8.The former 54 patients,right ventricle infundubulum sparing (RVIS) stragery were made to relieve the RVOTO.However,only 8 patinets of the later 60 cases had received RVIS in TOF repair,whose systemic blood pressure was instable with the large dose of dopamine≥10 μg · kg-1 · min-1 and epinephrine≥0.05 μg · kg-1 · min-1 or the transannular pressure gradient≥30 mmHg (1 mmHg =0.133 kPa).114 patients were divided by two group(52 cases in PVS group and 62 cases in RVIS group) and compared by the early outcomes.Results The median cardiopulmonary bypass time of RVIS group was significantly more than that of PVS group[(110.3 ± 12.0)min vs(77.7 ± 10.0)min].The postoperative index of the patients in PVS group,including transannular pressure gradient [(21.0 ± 5.4) mmHg vs (16.0 ± 3.6) mmHg,P < 0.05],PRV/PLV ratio(0.82 ± 0.03 vs.0.67 ± 0.12,P < 0.01),median using time of dopamine and epinephrine[(6.03 ±9.60)days vs.(4.20 ±1.90)days,P<0.01],median extubation time[(81.2 ±27.6)h vs.(38.5 ±33.0) h,P < 0.01],ICU stay time [(6.3 ± 1.7) days vs.(4.3 ± 1.9) days,P < 0.01],using of peritoneal dialysis (8/52 vs 4/62,P < 0.01)were more than those in RVIS group.There was no difference of mortality between two groups.Fellow up 12-50 months,there was no difference of LVEF,MPI and TAPSE between two groups.However,the severity of pulmonary regurgitation in patients of PVS group was significant less than those of RVIS group.Conclusion PVS and RVIS in TOF repair could decrease the severity of pulmonary regurgitation after operation.

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