1.Electrocardiogram changes and early diagnosis of cardiac autonomic neuropathy in patients with type 2 diabetes mellitus with nocturnal asymptomatic hypoglycemia
Di LIU ; Zonglan ZHANG ; Fengqin LI
Chinese Journal of Diabetes 2024;32(5):336-342
Objective To investigate the characteristics of electrocardiogram changes during nocturnal asymptomatic hypoglycemia in type 2 diabetes mellitus(T2DM)patients and early diagnosis of cardiac autonomic neuropathy(CAN).Methods A total of 150 patients with T2DM who were admitted to our hospital from June 2015 to June 2022 were retrospectively selected and given 72 h dynamic blood glucose and dynamic electrocardiogram monitoring.According to whether asymptomatic hypoglycemia occurred at night,they were divided into hypoglycemia group(n=62)and non-hypoglycemia group(n=88).According to the Ewing experiment,150 T2DM patients with T2DM were divided into T2DM group(n=90)and CAN group(n=60).Results Compared with the non hypoglycemic group,the hypoglycemic group had an increase in DM duration,LF/HF(P<0.05),HbA1c,average blood glucose,collected heart rate deceleration force(DC),QT dispersion(QTD),end of peak T value(Tp-e),Tp-e/QT,percentage of beats with a difference of more than 50 ms between adjacent normal RR intervals(pNN50),root mean square difference between adjacent normal RR intervals(rMSSD),standard deviation of 24-hour normal sinus RR interval(SDNN),and standard deviation of mean normal RR interval every 5 minutes(SDANN)and the average heart rate decreased within 24 hours decreased(P<0.05).Logistic regression analysis showed that the duration of DM was a risk factor for CAN in T2DM patients,and DC,QTD,and pNN50 were protective factors for CAN in T2DM patients.The characteristic curve analysis of the participants showed that the area under the curve for predicting CAN was 0.811,0.842,0.786,0.801,and 0.886 for the DM duration,DC,QTD and pNN50 respectively.The combined diagnostic performance of these four items was the best.After internal verification,it was found that the model has good discrimination and accuracy.Conclusion T2DM patients with nocturnal asymptomatic hypoglycemia may exhibit elevated,ECG LF/HF and decreased DC,QTD,Tp-e,Tp-e/QT,pNN50,rMSSD,SDNN,SDANN,and 24-hour average heart rate decrease;DM duration,DC,QTD and pNN50 can serve as effective indicators for early diagnosis of CAN in T2DM patients.
2.Diagnosis and treatment of testicular epidermoid cyst
Chuanjiang DONG ; Zonglan XIE ; Lusheng ZHANG ; Qing PENG ; Xiaobo CHEN ; Ziqiang DONG
Journal of Regional Anatomy and Operative Surgery 2016;25(6):453-455
Objective To analyze and summarize the clinical manifestations,diagnosis and treatment of testicular epidermoid cyst pa-tients.Methods Combined with literature,the clinical data of 7 patients with testicular epidermoid cyst in our hospital from July 2005 to Au-gust 2015 were analyzed.Results Histological examination showed testicular epidermoid cyst,postoperative recovery was good,no recurrence during 12 to 36 months’follow-up.Conclusion The testicular epidermoid cyst is rare in clinic,the clinical manifestations is similar to tes-ticular cancer,so it is often misdiagnosed as testicular cancer,which should be diagnosed by pathology,treated by testis preserved testicular tumor resection,and the prognosis is good.
3.The clinical analysis of children's cardiac enzymes and neuron specific enolase in 152 cases of hand-foot-and-mouth disease
Meng ZHANG ; Zonglan WANG ; Xincun TIAN ; Dongchang YANG ; Jian WANG
Chinese Journal of Postgraduates of Medicine 2015;38(7):516-518
Objective To explore the clinical significance of detecting hand-foot-and-mouth disease (HFMD) children's cardiac enzymes and neuron-specific enolase (NSE).Methods One hundred and fiftytwo HFMD children were selected as observation group,and 56 cases of healthy children were selected as control group.Cardiac enzymes and NSE levels were compared between two groups.Results The levels of aspartic transaminase(AST),creatine kinase(CK),creatine kinase isozyme-MB(CK-MB),lactate dehydrogenase (LDH),alpha-hydroxybutyric dehydrogenase (α-HBDH),and NSE in observation group were (40.4 ± 14.8)U/L,(109.9 ± 87.5) U/L,(47.0 ± 29.4) U/L,(316.9 ± 119.2) U/L,(256.2 ± 96.1) U/L,(30.9 ± 18.2) μ g/L,and in control group were (24.5 ± 9.2) U/L,(77.4 ± 32.5) U/L,(15.4 ± 7.4) U/L,(134.0 ± 34.4) U/L,(131.1 ± 37.7)U/L,(9.8 ± 4.6) μ g/L.The differences between two groups were statistical significance(P < 0.01).Conclusion The heart and nervous system lesions of HFMD children can be found through detecting cardiac enzymes and NSE early,which provide evidence for early diagnosis and treatment.
4.Comparative study of clinical effect on open and laparoscopic partial nephrectomy treatment for small renal cell carcinoma
Zonglan XIE ; Chuanjiang DONG ; Ziqiang DONG ; Lusheng ZHANG
Journal of Regional Anatomy and Operative Surgery 2015;24(6):634-636
Objective To compare the safety and clinical effect of laparoscopic partial nephrectomy ( LPN) on small renal cell carcino-ma. Methods The records of 65 patients who underwent partial nephrectomy in our hospital from March 2008 to March 2013 were retrospec-tively analyzed. 35 patients were given open partial nephrectomy and the other 30 patients were given LPN. Compared the operative time,blood loss,warm ischemia time,length of stay,positive marginrate,and occurance rate of complications between the two groups. Results There was no statistical difference in the mean size of tumor in the two groups. Compared to the OPN group,there was less blood loss,operative time, hospital stays and warm ischemia time in the LPN group. There was neither positive surgical margin nor renal function damage in the two groups. And during the follow-up period ranged from 6 to 18 months,there was no local recurrence. Conclusion Laparoscopic partial ne-phrectomy has a shorter operation time,less blood loss,shorter length of hospital stay compared with open partial nephrectomy,and it wouldn 't extend the time of warm ischemia,while the clinical effect of the two methods are similar.
5.Intraperitoneal hyperthermal chemotherapy combined with general chemotherapy after surgery for malignant gastrointestinal tumors
Junli CAO ; Zonglan HU ; Zhanzhao FU ; Tao GU ; Shaohui CHENG ; Haixia HUA ; Sen YANG ; Lijiao ZHANG ; Yanhong YANG ; Lixin DONG
Chinese Journal of General Practitioners 2009;8(3):185-186
A total of 101 patients undergoing operations for malignant gastrointestinal tumors (stage Ⅱ to Ⅲ) were enrolled and randomly assigned to receive intraperitoneal hyperthermal chemotherapy plus intravenous chemical injection (treatment group, n=51) or routine intravenous chemical injection (control group, n=50). Our results indicated that the recurrence rate and the metastatic rate in the treatment group were significantly lower than those in the control group (25.5% vs. 50.0%, 13.7% vs. 30.0%, both P< 0. 05), although the 3-and 5 year-survival rates were significantly higher (both P < 0. 05). Our data suggest that intraperitaneal hyperthermal chemotherapy plus general chemotherapy after surgery for malignant gastrointestinal tumors could effectively reduce tumor recurrence and metastases and improve long-term survival.
6.Short-term effects of combinant intraperitoneal hyperthermal chemotherapy with general chemotherapy in malignant ascites
Zonglan HU ; Junli CAO ; Zhanzhao FU ; Tao GU ; Shaohui CHENG ; Haixia HUA ; Sen YANG ; Lijiao ZHANG ; Yanhong YANG ; Lixin DONG
Chinese Journal of General Practitioners 2008;7(10):701-702
Sixty-one patients with moderate to severe malignant ascites were enrolled and randomly assigned to receive intraperitoneal hyperthermal chemotherapy+intravenous chemical injection (treatment group; n=31) or routine intravenous chemical injection (control group; n=30). Short-term response and reverse effects were observed. Our results indicated that the complete remission rate, part remission rate,and clinical benefit rate in the treatment group was significantly higher than those in the control group (38.71% vs 13.33% ,41.94% vs 16. 67%, and 90.32% vs 66.67%, respectively). No difference in reverse effects was found between the two groups. Our data suggest that intraperitoneal hyperthermal chemotherapy plus general chemotherapy may effectively control the malignant ascites, and the reverse effects might be well tolerated.

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