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Kuo TF, Wang ML, Hsu HH, Cheng YJ, Chen JS. Dexmedetomidine for enhanced recovery after non-intubated video-assisted thoracoscopic surgery. J Formos Med Assoc 2024:S0929-6646(24)00050-0. [PMID: 38307797 DOI: 10.1016/j.jfma.2024.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 12/06/2023] [Accepted: 01/14/2024] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND Non-intubated video-assisted thoracoscopic surgery combines a minimally invasive technique with multimodal locoregional analgesia to enhance recovery. The mainstay sedation protocol involves propofol and fentanyl. Dexmedetomidine, given its opioid-sparing effect with minimal respiratory depression, facilitates sedation in non-intubated patients. This study aimed to evaluate the efficacy of dexmedetomidine during non-intubated video-assisted thoracoscopic surgery. METHODS A total of 114 patients who underwent non-intubated video-assisted thoracoscopic surgery between June 2015 and September 2017 were retrospectively evaluated. Of these, 34 were maintained with dexmedetomidine, propofol, and fentanyl, and 80 were maintained with propofol and fentanyl. After a 1:1 propensity score-matched analysis incorporating sex, body mass index, American Society of Anesthesiologists classification, pulmonary disease and hypertension, the clinical outcomes of 34 pairs of patients were assessed. RESULTS The dexmedetomidine group showed a significantly lower opioid consumption [10.3 (5.7-15.1) vs. 18.8 (10.0-31.0) mg, median (interquartile range); P = 0.001] on postoperative day 0 and a significantly shorter postoperative length of stay [3 (2-4) vs. 4 (3-5) days, median (interquartile range), P = 0.006] than the control group. During operation, the proportion of vasopressor administration was significantly higher in the dexmedetomidine group [18 (53) vs. 7 (21), patient number (%), P = 0.01]. On the other hand, the difference of the hypotension and bradycardia incidence, short-term morbidity and mortality rates between each group were nonsignificant. CONCLUSIONS Adding adjuvant dexmedetomidine to propofol and fentanyl is safe and feasible for non-intubated video-assisted thoracoscopic surgery. With its opioid-sparing effect and shorter postoperative length of stay, dexmedetomidine may enhance recovery after surgery.
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Affiliation(s)
- Ting-Fang Kuo
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei City, 100225, Taiwan, ROC
| | - Man-Ling Wang
- Department of Anesthesiology, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei City, 100225, Taiwan, ROC.
| | - Hsao-Hsun Hsu
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei City, 100225, Taiwan, ROC; Department of Surgical Oncology, National Taiwan University Cancer Center, No. 57, Ln. 155, Sec. 3, Keelung Rd., Da' an Dist., Taipei City, 106037, Taiwan, ROC
| | - Ya-Jung Cheng
- Department of Anesthesiology, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei City, 100225, Taiwan, ROC; Department of Anesthesiology, National Taiwan University Cancer Center, No. 57, Ln. 155, Sec. 3, Keelung Rd., Da' an Dist., Taipei City, 106037, Taiwan, ROC
| | - Jin-Shing Chen
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei City, 100225, Taiwan, ROC; Department of Surgical Oncology, National Taiwan University Cancer Center, No. 57, Ln. 155, Sec. 3, Keelung Rd., Da' an Dist., Taipei City, 106037, Taiwan, ROC
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Chen YA, Po YJ, Wang ML, Huang HH. Manual resuscitator valve malfunction causing severe hypotension and a simple test to ensure safe function. Can J Anaesth 2024; 71:299-301. [PMID: 37989940 DOI: 10.1007/s12630-023-02663-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 10/19/2023] [Accepted: 10/23/2023] [Indexed: 11/23/2023] Open
Affiliation(s)
- Ying-An Chen
- Department of Anesthesiology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yueh-Jung Po
- Department of Anesthesiology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Man-Ling Wang
- Department of Anesthesiology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Hui-Hsun Huang
- Department of Anesthesiology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
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Pan H, Chen XF, Han J, Ji Y, Zeng MS, Wang ML. [Analysis of MRI features of hepatocyte nuclear factor 1α-inactivated hepatocellular adenoma]. Zhonghua Gan Zang Bing Za Zhi 2023; 31:1192-1197. [PMID: 38238954 DOI: 10.3760/cma.j.cn501113-20220718-00386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
Objective: To investigate the MRI imaging features of hepatocyte nuclear factor 1α- inactivated hepatocellular adenoma (H-HCA). Methods: Clinical data and MRI images of 19 H-HCA cases who were pathologically confirmed at Zhongshan Hospital Affiliated to Fudan University between August 2014 and July 2020 were retrospectively analyzed. Among them, there were 15 females and 4 males, aged 16-47 (32± 7) years old. Tumor number, location, shape, size, boundary, MRI plain scan signal intensity, dynamic enhancement features of each phase, presence or absence of intratumoral fat content, pseudocapsule, and others were analyzed. The differences in apparent diffusion coefficient (ADC) values between the lesion and the surrounding normal liver parenchyma were compared for statistical significance. t-test was used for statistical analysis. Results: There were a total of 24 lesions in 19 cases. 14 cases had solitary lesions, and five cases had multiple lesions. 15 and nine lesions were located in the right and left lobes of the liver, respectively. 20 lesions were round or quasi-round, and four were irregular or lobulated. The tumor's maximal diameter was 0.6-8.6 (3.5 ± 2.4) cm. T(1)-weighted image (WI) showed hyperintense to iso-intense signals in 20 lesions and hypointense signals in four. T(2)WI showed iso-to-slightly high signal intensity in 16 lesions, with two hyperintense and six hypointense signals. Diffusion-weighted image (DWI) revealed hyperintense to iso-intense signals. Lesions mean ADC value was (1.289 ± 0.222)×10(-3) mm(2)/s, while the adjacent normal liver parenchyma's mean ADC value was (1.307 ± 0.236)×10(-3) mm(2)/s, with no statistically significant difference between the two (P > 0.05). During the arterial phase, 15 of the 18 lesions that underwent dynamic contrast-enhanced scanning with gadoxetate disodium (Gd-DTPA) were mildly to moderately enhanced and three were strongly enhanced. The portal and hepatic venous phases had no continuous enhancement, while the delayed phase showed a hypointense signal. During the arterial phase, two of the six lesions scanned by gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid ((Gd-EOB-DTPA) dynamic enhancement were mildly to moderately enhanced, while four were strongly enhanced. The portal and hepatic venous phases had no continuous enhancement, while the transition and hepatobiliary-specific phases showed hypointense signals. Intracellular steatosis occurred in 21 lesions, of which 19 were diffuse steatosis and 16 formed pseudocapsules in the delayed phase. Conclusion: H-HCA often occurs in young females as solitary lesions and has certain MRI features. T1WI anti-phase diffuse signal reduction and post-enhanced hypovascular withdrawal enhancement patterns can aid in accurately diagnosing the disease condition.
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Affiliation(s)
- H Pan
- Department of Radiology, The Second Affiliated Hospital of Jiaxing University, Jiaxing 314000, China
| | - X F Chen
- Department of Radiology, The Second Affiliated Hospital of Jiaxing University, Jiaxing 314000, China
| | - J Han
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Y Ji
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - M S Zeng
- Department of Radiology, Zhongshan Hospital, Fudan University; Department of Radiology, Shanghai Geriatric Medical Center, Shanghai 200032, China
| | - M L Wang
- Department of Radiology, Zhongshan Hospital, Fudan University; Department of Radiology, Shanghai Geriatric Medical Center, Shanghai 200032, China
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Wang X, Qi XL, Wang ML, Su M, Li SX, Shi WY, Gao H. [Application of intraoperative optical coherence tomography in deep lamellar keratoplasty]. Zhonghua Yan Ke Za Zhi 2023; 59:723-729. [PMID: 37670655 DOI: 10.3760/cma.j.cn112142-20230130-00034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
Abstract
Objective: To evaluate the clinical application value of intraoperative optical coherence tomography (iOCT) in deep anterior lamellar keratoplasty (DALK) using the big-bubble technique to bare Descemet's membrane. Methods: Retrospective case series. Clinical data of 92 patients (92 eyes) with monocular stromal corneal diseases who underwent big-bubble DALK in the Eye Hospital of Shandong First Medical University from January 2020 to August 2021 were collected. There were 53 males and 39 females. The average age was (53.2±16.0) years old. All patients underwent iOCT scanning to determine the location and depth of the injection needle after initial removal of the corneal lesion, to observe the integrity of the recipient bed, Descemet's membrane, after complete lesion removal, and to observe the adhesion between the corneal graft and the recipient bed and check folds on the recipient bed after suturing of the corneal graft. The intraoperative perforation of Descemet's membrane, postoperative thickness of the cornea and the recipient bed, visual acuity, and corneal astigmatism were recorded. Results: By iOCT, the thickness of the recipient bed was found to be about 1/2 of the corneal thickness and relatively uniform in all directions in 62 eyes (67.4%), so the sterile air was injected from the center of the recipient bed to separate it from the stromal layer. In 30 eyes (32.6%) with an uneven thickness of the recipient bed, the sterile air was injected from the paracentral area of the recipient bed. Under the guidance of iOCT scanning, 89 eyes (96.7%) did not experience any perforation of Descemet's membrane during surgery. The Descemet's membrane folds in the central 5-mm area of the recipient bed was observed and flattened in 20 eyes with the assistance of iOCT scanning. The postoperative corneal thickness was (578.95±108.26) μm, and the recipient bed thickness was (36.06±23.11) μm. The best corrected visual acuity of all patients at 6 months after surgery was 0.57±0.25 logMAR, which was significantly better than that before surgery (1.61±1.27 logMAR; P<0.001). The average corneal astigmatism at 6 months after surgery was (2.72±2.44) diopters. Conclusions: The application of iOCT scanning in DALK surgery assisted by the big-bubble method can provide safe guidance for surgeons to adopt correct surgical procedures, decrease the risk of Descemet's membrane perforation, reduce the recipient bed folds, and facilitate corneal interlayer adhesion, thereby improving the visual prognosis.
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Affiliation(s)
- X Wang
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
| | - X L Qi
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
| | - M L Wang
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
| | - M Su
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
| | - S X Li
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
| | - W Y Shi
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
| | - H Gao
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
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Ben S, Fan LL, Cheng YF, Cheng G, Li SW, Wang ML. [Mechanism of piRNA in bisphenol A-promoted invasion and migration of prostate cancer cells]. Zhonghua Yu Fang Yi Xue Za Zhi 2023; 57:1440-1446. [PMID: 37743306 DOI: 10.3760/cma.j.cn112150-20220930-00948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Objective: To investigate the regulatory mechanisms of piwi-interacting RNA (piRNA) in bisphenol A (BPA)-induced prostate cancer cell invasion and migration. Methods: The Cancer Genome Atlas (TCGA) data was used to analyze and screen for piRNAs with significantly increased expression in prostate cancer tissues. PC-3 cells were treated with different concentrations of BPA for 12, 24, and 48 h, respectively, and the 20% inhibitory concentration (IC20) was measured using a CCK-8 assay. The expression levels of piRNAs before and after BPA treatment were determined by reverse transcription-quantitative PCR. Target genes regulated by BPA and associated with prostate cancer were screened in the Comparative Toxicogenomics Database (CTD). Dual-luciferase reporter gene assay was performed to verify the relationship between piRNA and target genes, and the expression change of the piRNA target gene was detected by Western blotting. Cell migration and invasion assays were used to determine the effects of piRNA on the malignant phenotype of prostate cancer cells. Results: After treatment of PC-3 cells with 160 μmol/L BPA, the expression of piR-sno48 was most significantly increased (P<0.05). Transfection of piR-sno48 antagomir resulted in decreased expression of endogenous piR-sno48 and a significant increase in the expression of its target gene GSTP1 (P<0.05). However, the expression of GSTP1 did not change significantly in BPA-treated PC-3 cells after transfection with piR-sno48 antagomir (P>0.05). The dual-luciferase reporter gene confirmed that piR-sno48 inhibited the expression of GSTP1 by forming an inversely complementary sequence with the 3'-UTR of GSTP1. The Transwell assay results showed that treatment with BPA significantly increased the invasion and migration ability of prostate cancer cells (P<0.01), whereas piR-sno48 antagonists significantly inhibited the effects above (P<0.01). Conclusion: BPA promotes the invasion and migration of prostate cancer cells by upregulating the expression of piR-sno48 and suppressing the expression of GSTP1. Interfering with the expression of endogenous piR-sno48 may inhibit the malignant phenotype of prostate cancer cells caused by BPA.
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Affiliation(s)
- S Ben
- School of Public Health, Nanjing Medical University,Nanjing 211166,China
| | - L L Fan
- School of Public Health, Nanjing Medical University,Nanjing 211166,China
| | - Y F Cheng
- School of Public Health, Nanjing Medical University,Nanjing 211166,China
| | - G Cheng
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - S W Li
- School of Public Health, Nanjing Medical University,Nanjing 211166,China
| | - M L Wang
- School of Public Health, Nanjing Medical University,Nanjing 211166,China
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Ge X, Yang ZH, Shen Y, Liu WX, Zhai XF, Ma WF, Wang ML, Zhang W, Wang XD. [Application of synthetic MRI in predicting isocitrate dehydrogenase 1 genotypes in gliomas]. Zhonghua Yi Xue Za Zhi 2023; 103:2619-2623. [PMID: 37650209 DOI: 10.3760/cma.j.cn112137-20230130-00137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
This study analyzed the clinical and imaging data of 81 glioma patients who underwent brain synthetic MRI and diffusion weighted imaging (DWI) examination in the General Hospital of Ningxia Medical University from August 2020 to September 2021 to explore the value of synthetic MRI relaxation quantitative value in predicting the genotype of isocitrate dehydrogenase 1 (IDH1) in gliomas. There were 44 males and 37 females, those patients with an aged 50.0 (36.5, 59.0) years. The tumor pre-T1, pre-T2, pre-PD, post-T1 and ADC values were obtained by outlining the region of interest (ROI). Univariate analysis was used to compare the differences of parameter values between groups, and the receiver operating characteristic was used to evaluate the diagnostic efficacy of each parameter value in predicting glioma IDH1 genotype. The results showed that the pre-T1 and pre-PD values [M (Q1, Q3)] of IDH1m glioma were lower than those of IDH1w glioma [1 462.75 (1 306.41, 1 567.75) ms vs 1 532.83 (1 434.67, 1 617.67) ms, 84.18 (82.28, 86.41) pu vs 85.85 (84.65, 86.90) pu] (all P<0.05). The post-T1 and ADC values of IDH1m glioma were higher than those of IDH1w glioma [1 054.50 (631.92, 1 262.63) ms vs 669.67 (535.17, 823.33) ms, 1.20 (0.86, 1.35) ×10-3 mm2/s vs 0.80 (0.76, 0.93) ×10-3 mm2/s] (all P<0.05). The AUC of the combined model (pre-T1+pre-PD+post-T1+ADC+Age) is 0.828 (95%CI:0.729-0.903). Synthetic MRI relaxation quantitative values are helpful to distinguish IDH1 genotypes in glioma. The diagnostic efficacy of the multi-parameter combined model based on pre-T1, pre-PD, post-T1, ADC, and age is better than that of the single parameter, and it can be used as an effective strategy to improve the differential diagnosis ability of gliomas molecular markers.
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Affiliation(s)
- X Ge
- Clinical Medical College of Ningxia Medical University, Yinchuan 750004, China
| | - Z H Yang
- Department of Radiotherapy, General Hospital of Ningxia Medical University, Yinchuan 750004, China
| | - Y Shen
- Department of Rehabilitation Medicine, Second Affiliated Hospital of Air Force Military Medical University, Xi'an 710038, China
| | - W X Liu
- Clinical Medical College of Ningxia Medical University, Yinchuan 750004, China
| | - X F Zhai
- Department of Pathology, General Hospital of Ningxia Medical University, Yinchuan 750004, China
| | - W F Ma
- Clinical Medical College of Ningxia Medical University, Yinchuan 750004, China
| | - M L Wang
- Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan 750004, China
| | - W Zhang
- Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan 750004, China
| | - X D Wang
- Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan 750004, China
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Wang ML, Shyr BS, Chen SC, Wang SE, Shyr YM, Shyr BU. Comparison of robotic and open central pancreatectomy. Int J Med Robot 2023:e2562. [PMID: 37574857 DOI: 10.1002/rcs.2562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 07/01/2023] [Accepted: 07/20/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND Central pancreatectomy (CP) is an ideal parenchyma-sparing procedure. The experience of r robotic central pancreatectomy (RCP) is very limited. MATERIALS AND METHODS Patients undergoing CP were included. Comparisons were made between RCP and open central pancreatectomy (OCP) groups. RESULTS The most common lesion in patients undergoing CP was serous cystadenoma (35.5%). The median operation time was 4.2 h for RCP versus 5.5 h for OCP. The median blood loss was significantly lower in RCP, 20 c.c. versus 170 c.c., p = 0.001. Postoperative pancreatic fistula occurred in 19.4% of all patients, with 22.1% in RCP and 15.4% in OCP. There was no significant difference regarding other surgical complications between the RCP and OCP groups. Only one patient in the OCP group developed de novo diabetes mellitus (DM), and no steatorrhoea/diarrhoea occurred after either RCP or OCP. CONCLUSIONS RCP is feasible and safe without compromising surgical outcomes and pancreatic functions.
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Affiliation(s)
- Man-Ling Wang
- Departments of Surgery, Division of General Surgery, Taipei Veterans General Hospital, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Bor-Shiuan Shyr
- Departments of Surgery, Division of General Surgery, Taipei Veterans General Hospital, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shih-Chin Chen
- Departments of Surgery, Division of General Surgery, Taipei Veterans General Hospital, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shin-E Wang
- Departments of Surgery, Division of General Surgery, Taipei Veterans General Hospital, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yi-Ming Shyr
- Departments of Surgery, Division of General Surgery, Taipei Veterans General Hospital, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Bor-Uei Shyr
- Departments of Surgery, Division of General Surgery, Taipei Veterans General Hospital, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Han XT, Guo HY, Wang F, Gao XR, Liu L, Wang ML. [Analysis of the relationship between MRI imaging characteristics and clinical symptoms and therapeutic efficacy in adenomyosis patients]. Zhonghua Fu Chan Ke Za Zhi 2023; 58:343-350. [PMID: 37217341 DOI: 10.3760/cma.j.cn112141-20221130-00727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Objective: To investigate the relationship between magnetic resonance imaging (MRI) imaging characteristics and clinical symptoms and therapeutic efficacy in adenomyosis patients. Methods: The clinical characteristics of the adenomyosis questionnaire was self-designed. This was a retrospective study. From September 2015 to September 2020, totally 459 patients were diagnosed with adenomyosis and underwent pelvic MRI examination at Peking University Third Hospital. Clinical characteristics and treatment were collected, MRI was used to determine the lesion location, and to measure the maximum lesion thickness, the maximum myometrium thickness, uterine cavity length, uterine volume, the minimum distance between the lesion and serosa or endometrium, and whether combined with ovarian endometrioma. The difference of MRI imaging characteristics in patients with adenomyosis and its relationship with clinical symptoms and therapeutic efficacy were analyzed. Results: (1) Among the 459 patients, the age was (39.1±6.4) years. There were 376 patients (81.9%, 376/459) with dysmenorrhea. Whether patients had dysmenorrhea were related to uterine cavity length, uterine volume, ratio of the maximum lesion thickness to the maximum myometrium thickness, and whether patients had ovarian endometrioma (all P<0.001). Multivariate analysis suggested that ovarian endometrioma was the risk factor for dysmenorrhea (OR=0.438, 95%CI: 0.226-0.850, P=0.015). There were 195 patients (42.5%, 195/459) with menorrhagia. Whether patients had menorrhagia were related to age, whether patients had ovarian endometrioma, uterine cavity length, the minimum distance between lesion and endometrium or serosa, uterine volume, ratio of the maximum lesion thickness to the maximum myometrium thickness (all P<0.001). Multivariate analysis suggested that ratio of the maximum lesion thickness to the maximum myometrium thickness was the risk factor for menorrhagia (OR=774.791, 95%CI: 3.500-1.715×105, P=0.016). There were 145 patients (31.6%, 145/459) with infertility. Whether the patients had infertility were related to age, the minimum distance between lesion and endometrium or serosa, and whether patients had ovarian endometrioma (all P<0.01). Multivariate analysis suggested that young and large uterine volume were risk factors for infertility (OR=0.845, 95%CI: 0.809-0.882, P<0.001; OR=1.001, 95%CI: 1.000-1.002, P=0.009). (2) The success rate of in vitro fertilization-embryo transfer (IVF-ET) was 39.2% (20/51). Dysmenorrhea, high maximum visual analogue scale score and large uterine volume affected the success rate of IVF-ET (all P<0.05). The smaller the maximum lesion thickness, the smaller the distance between the lesion and serosa, the larger the distance between the lesion and endometrium, the smaller the uterine volume, and the smaller the ratio of the maximum lesion thickness to the maximum myometrium thickness, the better the therapeutic efficacy of progesterones (all P<0.05). Conclusions: Concomitant ovarian endometrioma increases the risk of dysmenorrhea in patients with adenomyosis. The ratio of the maximum lesion thickness to the maximum myometrium thickness is an independent risk factor for menorrhagia. Young and large uterine volume may increase the risk of infertility. Severe dysmenorrhea and large uterine volume affect the success rate of IVF-ET. The therapeutic efficacy of progesterones is relatively better when the lesion is small and far away from the endometrium.
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Affiliation(s)
- X T Han
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
| | - H Y Guo
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
| | - F Wang
- Department of Radiology, Peking University Third Hospital, Beijing 100191, China
| | - X R Gao
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
| | - L Liu
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
| | - M L Wang
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
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Wang ML, Kuo YT, Kuo LC, Liang HP, Cheng YW, Yeh YC, Tsai MT, Chan WS, Chiu CT, Chao A, Chou NK, Yeh YC, Ku SC. Early prediction of delirium upon intensive care unit admission: Model development, validation, and deployment. J Clin Anesth 2023; 88:111121. [PMID: 37058755 DOI: 10.1016/j.jclinane.2023.111121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 03/31/2023] [Accepted: 04/05/2023] [Indexed: 04/16/2023]
Abstract
STUDY OBJECTIVE To develop, validate, and deploy models for predicting delirium in critically ill adult patients as early as upon intensive care unit (ICU) admission. DESIGN Retrospective cohort study. SETTING Single university teaching hospital in Taipei, Taiwan. PATIENTS 6238 critically ill patients from August 2020 to August 2021. MEASUREMENTS Data were extracted, pre-processed, and split into training and testing datasets based on the time period. Eligible variables included demographic characteristics, Glasgow Coma Scale, vital signs parameters, treatments, and laboratory data. The predicted outcome was delirium, defined as any positive result (a score ≥ 4) of the Intensive Care Delirium Screening Checklist that was assessed by primary care nurses in each 8-h shift within 48 h after ICU admission. We trained models to predict delirium upon ICU admission (ADM) and at 24 h (24H) after ICU admission by using logistic regression (LR), gradient boosted trees (GBT), and deep learning (DL) algorithms and compared the models' performance. MAIN RESULTS Eight features were extracted from the eligible features to train the ADM models, including age, body mass index, medical history of dementia, postoperative intensive monitoring, elective surgery, pre-ICU hospital stays, and GCS score and initial respiratory rate upon ICU admission. In the ADM testing dataset, the incidence of ICU delirium occurred within 24 h and 48 h was 32.9% and 36.2%, respectively. The area under the receiver operating characteristic curve (AUROC) (0.858, 95% CI 0.835-0.879) and area under the precision-recall curve (AUPRC) (0.814, 95% CI 0.780-0.844) for the ADM GBT model were the highest. The Brier scores of the ADM LR, GBT, and DL models were 0.149, 0.140, and 0.145, respectively. The AUROC (0.931, 95% CI 0.911-0.949) was the highest for the 24H DL model and the AUPRC (0.842, 95% CI 0.792-0.886) was the highest for the 24H LR model. CONCLUSION Our early prediction models based on data obtained upon ICU admission could achieve good performance in predicting delirium occurred within 48 h after ICU admission. Our 24-h models can improve delirium prediction for patients discharged >1 day after ICU admission.
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Affiliation(s)
- Man-Ling Wang
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu-Ting Kuo
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
| | - Lu-Cheng Kuo
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Hsin-Ping Liang
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia
| | - Yi-Wei Cheng
- Taiwan AI Labs, Taipei, Taiwan; Department of Medical Education, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu-Chen Yeh
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming-Tao Tsai
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Wing-Sum Chan
- Department of Anesthesiology, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Ching-Tang Chiu
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
| | - Anne Chao
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
| | - Nai-Kuan Chou
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu-Chang Yeh
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan.
| | - Shih-Chi Ku
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
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10
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Yang SJ, Chang CH, Young TH, Wang CH, Tseng TH, Wang ML. Human serum albumin-based nanoparticles alter raloxifene administration and improve bioavailability. Drug Deliv 2022; 29:2685-2693. [PMID: 35975329 PMCID: PMC9387319 DOI: 10.1080/10717544.2022.2111479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Osteoporosis is a disease that reduces bone mass and microarchitecture, which makes bones fragile. Postmenopausal osteoporosis occurs due to estrogen deficiency. Raloxifene is a selective estrogen receptor modulator used to treat postmenopausal osteoporosis. However, it has a low bioavailability, which requires long-term, high-dose raloxifene administration to be effective and causes several side effects. Herein, raloxifene was encapsulated in human serum albumin (HSA)-based nanoparticles (Ral/HSA/PSS NPs) as an intravenous-injection pharmaceutical formulation to increase its bioavailability and reduce the treatment dosage and time. In vitro results indicated that raloxifene molecules were well distributed in HSA-based nanoparticles as an amorphous state, and the resulting raloxifene formulation was stabile during long-term storage duration. The Ral/HSA/PSS NPs were both biocompatible and hemocompatible with a decreased cytotoxicity of high-dose raloxifene. Moreover, the intravenous administration of the prepared Ral/HSA/PSS NPs to rats improved raloxifene bioavailability and improved its half-life in plasma. These raloxifene-loaded nanoparticles may be a potential nanomedicine candidate for treating postmenopausal osteoporosis with lower raloxifene dosages.
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Affiliation(s)
- Shu-Jyuan Yang
- Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan
| | - Chih-Hao Chang
- Department of Orthopedics, National Taiwan University Hospital Jin-Shan Branch, New Taipei City, Taiwan.,Department of Orthopedics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Tai-Horng Young
- Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan
| | - Chung-Hao Wang
- CYBER ELITE LIMITED, Vistra Corporate Services Centre, Apia, Samoa
| | - Tzu-Hao Tseng
- Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan.,Department of Orthopaedic Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Man-Ling Wang
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Anesthesiology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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11
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Wang ML, Chen EQ. [Impact of treatment compliance in chronic hepatitis B]. Zhonghua Gan Zang Bing Za Zhi 2022; 30:1266-1269. [PMID: 36891709 DOI: 10.3760/cma.j.cn501113-20201201-00635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
The incidence rate of chronic hepatitis B remains high in China. Antiviral therapy can significantly reduce the risk of progressive liver disease and hepatocellular carcinoma in patients with chronic hepatitis B. However, all current antiviral treatments can only inhibit HBV replication and not completely eliminate the hepatitis B virus, so antiviral therapy for chronic hepatitis B is probably a long-term or even lifelong treatment. Antiviral therapy compliance is essential for achieving long-term clinical benefits and preventing nucleot(s)ide drugs resistance. Herein, we analyzed the relevant factors of antiviral therapy compliance and their impact on CHB treatment and explored feasible programs that can improve compliance with nucleot(s)ide drug treatment by conducting a literature search using PubMed and Scopus with search terms including hepatitis B, compliance, nucleot(s)ide drugs, antiviral therapy, viral suppression, and drug resistance.
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Affiliation(s)
- M L Wang
- Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu 610041, China
| | - E Q Chen
- Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu 610041, China
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12
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Shi S, Wang ML, Chen LL, Ji Y, Zeng MS. [MRI features of lymphoepithelioma-like intrahepatic cholangiocarcinoma]. Zhonghua Gan Zang Bing Za Zhi 2022; 30:1188-1193. [PMID: 36891696 DOI: 10.3760/cma.j.cn501113-20211123-00573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
Objective: To investigate the MRI manifestations of lymphoepithelioma-like intrahep cholangiocarcinoma (LEL-ICC). Methods: MR images of 26 cases with LEL-ICC confirmed pathologically at Zhongshan Hospital Affiliated with Fudan University between March 2011 and March 2021 were retrospectively analyzed. The number, location, size, morphology, edges of lesions, non-scan signal intensity, cystic necrosis, enhancement mode, peak, and capsule, vascular invasion, lymph node metastasis, and other MR images were included for analysis. The apparent diffusion coefficient (ADC) value of the lesion and the surrounding normal liver parenchyma were measured. A paired-sample t-test was used to statistically analyze the measurement data. Results: All 26 cases of LEL-ICC had solitary lesions. Mass-type LEL-ICC was the most common [n=23, lesion size (4.02±2.32) cm] with distribution along the bile duct [n=3, lesion size (7.23±1.40 cm)]. Among the 23 lesions of mass type LEL-ICC, most of the lesions were close to the liver capsule (n=20), round (n=22), clearly bordered (n=13), and cystic necrosis (n=22). In the three lesions of LEL-ICC distributed along the bile duct, most of them were close to the liver capsule (n=2), irregular (n=3), blurred edges (n=3), and cystic necrosis (n=3). All 26 lesions showed a low/slightly low signal on T1WI, a high/slightly high signal on T2WI, and a slightly high or high signal on DWI. Three lesions showed fast-in and fast-out enhancement modes, and 23 lesions showed continuous enhancement. Twenty-five lesions showed peak enhancement in the arterial phase, and one lesion appeared in the delayed phase. The ADC value of 26 lesions and adjacent normal liver parenchyma was (1.112±0.274)×10-3 mm2/s and (1.482±0.346)×10-3 mm2/s, respectively, and the both had a statistically significant difference (P<0.05). Conclusion: Certain manifestations of LEL-ICC in magnetic resonance imaging are advantageous for diagnosis and differential diagnosis.
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Affiliation(s)
- S Shi
- Department of Radiology, The Affiliated People's Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou 350004, China Department of Radiology, Zhongshan Hospital, Fudan University, Department of Radiology, Shanghai Geriatric Medical Center, Shanghai 200032, China
| | - M L Wang
- Department of Radiology, Zhongshan Hospital, Fudan University, Department of Radiology, Shanghai Geriatric Medical Center, Shanghai 200032, China
| | - L L Chen
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Y Ji
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - M S Zeng
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
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13
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Zheng RJ, Chen QL, Ma HM, Liu HD, Chen JP, Liang GS, Chen J, Zhang YY, Li S, Guo B, Wang ML, Du M. [Human chorionic gonadotropin-secreting gonadoblastomas in a girl of 45, X Turner syndrome: a case report and literature review]. Zhonghua Er Ke Za Zhi 2022; 60:1202-1206. [PMID: 36319158 DOI: 10.3760/cma.j.cn112140-20220429-00393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Objective: To summarize the experience in diagnosis and treatment of 45, X Turner syndrome (TS) with gonadal Y chromosome mosaicism and bilateral gonadoblastoma (Gb) secreting human chorionic gonadotrophin(HCG). Methods: A female patient aged 5 years and 3 months was admitted to the hospital with a complaint of "enlarged breasts for 27 months, and elevated blood β-HCG for 8 months". The clinical data were summarized, and related literature up to March 2022 with the key words"Turner syndrome" "Gonadoblastoma" "Y chromosome" "human chorionic gonadotropin" "precocious" in PubMed, CNKI and Wanfang databases were reviewed. Results: The girl went to the local hospital for 2-month breast development at age of 3 years, and was found with a heart murmur diagnosed with "pulmonary venous malformation and atrial septal defect (secondary foramen type)". Surgical correction was performed. She experienced the progressive breast development, rapid linear growth and markedly advanced skeletal age, which cannot be explained by partial activation in the hypothalamic-pituitary-gonadal axis determined at the age of 3 years and 7 months in local hospital. Then whole-exome sequencing revealed chromosome number abnormality 45, X, which was confirmed by Karyotyping. At the age of 4 years and 6 months, serum β-HCG was found to be elevated (24.9 U/L) with no lesion found at the local hospital. On physical examination, she was found with breast development, pubic hair development and clitoromegaly with elevated serum testosterone (1.96 μg/L) and β-HCG (32.3 U/L). Sex determining region Y(SRY) gene was negative in peripheral blood sample. Thoracic and abdominal CT, head and pelvic magnetic resonance imaging were normal. Exploratory laparotomy confirmed the presence of a left adnexal tumor and a right fibrous streak gonad. During surgery, simultaneous samples of bilateral gonadal and peripheral venous blood were obtained and serum β-HCG, estradiol and testosteron concentrations was higher to lower from left gonadal venous blood, right gonadal venous blood, to peripheral venous blood. Bilateral gonadectomy was performed. Histopathology revealed bilateral gonadoblastomas. SRY was positive in bilateral gonadal tissues. After surgery, serum E2, testerone and β-HCG returned to normal. So far 4 cases of HCG-secreting gonadoblastoma had been reported worldwide. The phenotypes of the 4 cases were all female, with virilization or amenorrhea, and the preoperative peripheral blood β-HCG concentrations were 74.4, 5.0, 40 456.0, and 42.4 U/L, respectively. Conclusions: There is a high risk of Gb in TS with Y chromosome components. Gb is infrequently presented with breast development, and Gb associated with HCG secretion is rare. Karyotyping should be performed in a phenotypic female with masculinization, and virilization in TS indicates the presence of Y chromosome material with concurrent androgen secreting tumors.
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Affiliation(s)
- R J Zheng
- Department of Pediatrics, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - Q L Chen
- Department of Pediatrics, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - H M Ma
- Department of Pediatrics, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - H D Liu
- Department of Pediatric Surgery,the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - J P Chen
- Department of Pediatric Surgery,the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - G S Liang
- Department of Medical Laboratory, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - J Chen
- Department of Pediatrics, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - Y Y Zhang
- Department of Pediatrics, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - S Li
- Department of Pediatrics, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - B Guo
- Department of Pediatrics, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - M L Wang
- Department of Pediatrics, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - Minlian Du
- Department of Pediatrics, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
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14
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Yu JP, Wang ML, Xu Y, Zhang JS, Wan J. [A study on the burden of myocarditis in China in 1990 and 2019]. Zhonghua Nei Ke Za Zhi 2022; 61:1247-1252. [PMID: 36323567 DOI: 10.3760/cma.j.cn112138-20211115-00812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Objective: To investigate Chinese myocarditis burden and trends in 1990 and 2019. Methods: Based on the Global Burden of Disease (GBD) 2019 data, the number of patients, the number of new cases, the number of deaths, the disability-adjusted life years (DALYs), as well as the morbidity, mortality, DALYs rate and their age-standardized rates were used to analyze the trend and the burden of myocarditis in the Chinese population in 1990 and 2019. Results: In 2019, the number of patients, the number of new cases and the number of deaths with myocarditis in China were 234 900, 275 100 and 13 100 respectively, increasing by 85.62%, 47.51% and 50.22% compared with 1990. The age-standardized incidence and mortality were 16.94/100 000 and 0.92/100 000, respectively. Compared with 1990, the age-standardized incidence in 2019 decreased by 6.06%, and the mortality decreased by 16.04% respectively. The age-standardized incidence and mortality of Chinese male patients with myocarditis were higher than that of female. Compared with 1990, the age group with the largest incidence and mortality of myocarditis in China in 2019 all shifted to the elder group. And, DALYs and age-normalized DALYs due to myocarditis in China showed a decreasing trend in 2019, from 458 600 and 42.51/100 000 in 1990 to 341 300 and 25.39/100 000 in 2019, respectively. The rate of DALYs and age-standardized DALYs in male patients was always higher than female. Conclusions: Compared with 1990, the overall burden of myocarditis in China showed a downward trend in 2019, and the burden of myocarditis in male patients was higher than female. More attention should be paid to the burden of myocarditis in Chinese elderly population.
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Affiliation(s)
- J P Yu
- Department of Cardiology, Renmin Hospital of Wuhan University, Cardiovascular Research Institute, Hubei Key Laboratory of Cardiology, Wuhan 430060, China
| | - M L Wang
- Department of Cardiology, Renmin Hospital of Wuhan University, Cardiovascular Research Institute, Hubei Key Laboratory of Cardiology, Wuhan 430060, China
| | - Y Xu
- Department of Cardiology, Renmin Hospital of Wuhan University, Cardiovascular Research Institute, Hubei Key Laboratory of Cardiology, Wuhan 430060, China
| | - J S Zhang
- Department of Cardiology, Renmin Hospital of Wuhan University, Cardiovascular Research Institute, Hubei Key Laboratory of Cardiology, Wuhan 430060, China
| | - J Wan
- Department of Cardiology, Renmin Hospital of Wuhan University, Cardiovascular Research Institute, Hubei Key Laboratory of Cardiology, Wuhan 430060, China
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15
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Yan CX, Qi XL, Wang ML, Zhang LJ. [Keratoconus after transepithelial photorefractive keratectomy: a case report]. Zhonghua Yan Ke Za Zhi 2022; 58:809-814. [PMID: 36220656 DOI: 10.3760/cma.j.cn112142-20220107-00005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
A 24-year-old male was treated with transepithelial photorefractive keratectomy for myopia in both eyes 5 years ago. He had allergic conjunctivitis for 3 years. The night vision of both eyes was decreased for 2 years. The clinical diagnosis was keratoconus binoculus. Therefore, corneal collagen cross-linking was performed in both eyes, and the follow-up was 6 months. Confocal microscopy showed that the cross-linking of riboflavin and fiber amino was successful, and the keratoconus did not progress during the follow-up. Although there have been few case reports of keratoconus after transepithelial photorefractive keratectomy at home and abroad, great importance should be attached to the early and comprehensive screening of keratoconus in the candidates of refractive surgery in order to improve the long-term safety.
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Affiliation(s)
- C X Yan
- Dalian Eye Hospital, The Third People's Hospital of Dalian affiliated to Dalian Medical University, Dalian 116033, China
| | - X L Qi
- Eye Institute of Shandong First Medical University,Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
| | - M L Wang
- Eye Institute of Shandong First Medical University,Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250021, China
| | - L J Zhang
- Dalian Eye Hospital, The Third People's Hospital of Dalian affiliated to Dalian Medical University, Dalian 116033, China
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16
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Wang ML, Murphy LA, Nakamura RK. Pneumopericardium after peritoneopericardial diaphragmatic hernia repair in a dog. J Vet Cardiol 2022; 43:101-103. [PMID: 36116206 DOI: 10.1016/j.jvc.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 08/10/2022] [Accepted: 08/11/2022] [Indexed: 11/30/2022]
Abstract
A one-year-old neutered Goldendoodle presented for evaluation. One week prior to presentation, surgical closure of a peritoneopericardial diaphragmatic hernia (PPDH) was performed via ventral midline celiotomy. Since the procedure, the dog had been lethargic and anorexic at home. Thoracic radiographs revealed a pneumopericardium. Pericardiocentesis was performed which evacuated approximately 100 mL of air from the pericardial sac. The dog recovered well and began eating in the hospital and resumed normal activity. This is the first reported case of a pneumopericardium post-PPDH repair requiring pericardiocentesis. Clinicians should be aware of this rare complication in postoperative PPDH patients.
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Affiliation(s)
- M L Wang
- VCA West Los Angeles Animal Hospital, 1900 S Sepulveda Blvd, Los Angeles, CA 90025, USA
| | - L A Murphy
- University of Wisconsin-Madison School of Veterinary Medicine, 2015 Linden Drive, Madison WI 53706, USA
| | - R K Nakamura
- Veterinary Specialty and Emergency Center of Thousand Oaks, 2967 North Moorpark Road, Thousand Oaks, CA 91360, USA.
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17
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Wang NN, Qin LJ, Liu K, Xing CY, Zhang J, Xiao YJ, Cui YG, Ning S, Yuan YG, Lu Y, Zhang ZH, Su ZL, Ye XX, Bian AN, Zeng M, Wang Q, Xu FY, Ren WK, Lyu XL, Wang L, Zhao J, Wang ML, Ma X, Liu CP, Wang XQ, Liang NX, Liu JY. [Multidisciplinary regenerative treatment and mechanisms for rescuing a severe calciphylaxis patient with human amnion-derived mesenchymal stem cells]. Zhonghua Yi Xue Za Zhi 2022; 102:2217-2221. [PMID: 35872588 DOI: 10.3760/cma.j.cn112137-20211218-02819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Calciphylaxis is a rare disease with severe pain and high-mortality due to cutaneous ischemic necrosis and infection that currently lacks proved effective therapies. The occurrence of calciphylaxis in end stage kidney disease (ESKD) patients is known as calcific uremic arteriolopathy (CUA), which is characterized histologically by dermal microvessel calcification, intimal fibroplasia and microthrombosis. Here we innovatively treated a severe CUA patient with human amnion-derived mesenchymal stem cells (hAMSCs). A 34-year-old uremic woman was presented with progressive, painful malodorous ulcers in buttocks and mummified lower limbs. Skin pathological features supported the diagnosis of calciphylaxis. The patient was refractory to conventional multidisciplinary symptomatic therapies. With the approval of our hospital ethics committee, she was treated with hAMSCs including intravenous and local intramuscular injection, and external application of hAMSC culture supernatant to the wound area. During 15-month follow-up, the patient had regeneration of skin and soft tissues, with improved blood biochemical, inflammatory, mineral and bone metabolic indices and immunoregulation effects. After 15-month hAMSC treatment, the score of pain visual analog scale (VAS) decreased from 10 to 0, Bates-Jensen wound assessment tool (BWAT) score decreased from 65 to 13, and wound-quality of life (Wound-QoL) questionnaire score decreased from 68 to 0. We propose that hAMSC treatment is promising for CUA patients. The therapy is potentially involved in the multiple beneficial effects of inhibiting vascular calcification, stimulating angiogenesis and myogenesis, modulating adverse inflammatory and immunologic responses, promoting re-epithelialization and restoring skin integrity.
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Affiliation(s)
- N N Wang
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - L J Qin
- State Key Laboratory of Reproductive Medicine, Center of Clinical Reproductive Medicine, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210036, China
| | - K Liu
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - C Y Xing
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - J Zhang
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - Y J Xiao
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - Y G Cui
- State Key Laboratory of Reproductive Medicine, Center of Clinical Reproductive Medicine, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210036, China
| | - S Ning
- State Key Laboratory of Reproductive Medicine, Center of Clinical Reproductive Medicine, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210036, China
| | - Y G Yuan
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - Y Lu
- Department of Dermatology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - Z H Zhang
- Department of Pathology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - Z L Su
- Department of Dermatology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - X X Ye
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - A N Bian
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - M Zeng
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - Q Wang
- Department of Rheumatology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - F Y Xu
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - W K Ren
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - X L Lyu
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - L Wang
- Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - J Zhao
- Department of Outpatient, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029 China
| | - M L Wang
- Department of Obstetrics, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029 China
| | - X Ma
- State Key Laboratory of Reproductive Medicine, Center of Clinical Reproductive Medicine, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210036, China
| | - C P Liu
- Department of Biological Specimen Repository, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029 China
| | - X Q Wang
- Department of International Cooperation, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - N X Liang
- Academy of Clinical and Translational Research, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - J Y Liu
- State Key Laboratory of Reproductive Medicine, Center of Clinical Reproductive Medicine, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210036, China
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Zhang HL, Wang ML, Yi LZ, Högger P, Arroo R, Bajpai VK, Prieto MA, Chen XJ, Simal-Gandara J, Cao H. Stability profiling and degradation products of dihydromyricetin in Dulbecco's modified eagle's medium. Food Chem 2022; 378:132033. [PMID: 35033717 DOI: 10.1016/j.foodchem.2021.132033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 12/20/2021] [Accepted: 12/31/2021] [Indexed: 11/30/2022]
Abstract
Dihydromyricetin has shown many bioactivities in cell level. However, dihydromyricetin was found to be highly instable in cell culture medium DMEM. Here, the underlying degradation mechanism was investigated via UPLC-MS/MS analysis. Dihydromyricetin was mainly converted into its dimers and oxidized products. At lower temperature, dihydromyricetin in DMEM showed higher stability. Vitamin C increased the stability of dihydromyricetin in DMEM probably due to its high antioxidant potential.
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Affiliation(s)
- H L Zhang
- Institute of Chinese Medical Sciences, University of Macau, Macao, China.
| | - M L Wang
- Institute of Chinese Medical Sciences, University of Macau, Macao, China.
| | - L Z Yi
- Faculty of Agriculture and Food, Kunming University of Science and Technology, Kunming, Yunnan 650500, China.
| | - P Högger
- Institut für Pharmazie und Lebensmittelchemie, Universität Würzburg, 97074 Würzburg, Germany.
| | - R Arroo
- De Montfort University - Leicester School of Pharmacy, The Gateway, Leicester LE1 9BH, UK.
| | - V K Bajpai
- Department of Energy and Materials Engineering, Dongguk University-Seoul, 30 Pildong-ro 1-gil, Seoul 04620, Republic of Korea
| | - M A Prieto
- Department of Analytical Chemistry and Food Science, Faculty of Food Science and Technology, University of Vigo - Ourense Campus, E-32004 Ourense, Spain.
| | - X J Chen
- Institute of Chinese Medical Sciences, University of Macau, Macao, China.
| | - J Simal-Gandara
- Department of Analytical Chemistry and Food Science, Faculty of Food Science and Technology, University of Vigo - Ourense Campus, E-32004 Ourense, Spain.
| | - H Cao
- Department of Analytical Chemistry and Food Science, Faculty of Food Science and Technology, University of Vigo - Ourense Campus, E-32004 Ourense, Spain; College of Food Science and Technology, Guangdong Ocean University, Zhanjiang 524088, China
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Wang FD, Zhou J, Zhang DM, Wang ML, Tao YC, Wu DB, Tang H, Chen EQ. [A study of the effectiveness of nucleos(t)ide analogues in the treatment of HBeAg- positive chronic hepatitis B with normal alanine aminotransferase and high level of HBV DNA]. Zhonghua Gan Zang Bing Za Zhi 2022; 30:389-394. [PMID: 35545563 DOI: 10.3760/cma.j.cn501113-20210705-00318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To investigate the effectiveness of nucleos(t)ide analogues in the treatment of HBeAg-positive chronic hepatitis B with normal alanine aminotransferase and high level of HBV DNA. Methods: Treatment-naïve chronic hepatitis B patients who were followed up at the Center of Infectious Diseases, West China Hospital of Sichuan University from January 2019 to January 2020 were selected as subjects. Demographic characteristics, the results of laboratory examination before treatment and one year after treatment were retrospectively collected. Patients were divided into tenofovir dipivoxil (TDF) and propofol fumurate tenofovir (TAF) treatment group according to different types of medication. The changes of serum HBV DNA level, HBeAg serological conversion and HBsAg quantitative level were analyzed and compared between the two groups. Results: A total of 38 cases were enrolled. Among them, there were 16 and 22 cases in the TDF and TAF group, respectively. There was no statistically significant difference in demographic characteristics, baseline HBV DNA levels and HBsAg quantitative levels between the two groups. Virological response was achieved in 60.5% (23/38) of patients after one year of antiviral therapy. Serum HBV DNA levels below the lower limit of detection [68.2% (15/22) vs. 50.0% (8/16), P=0.258] and higher HBeAg seroconversion rate [18.2%] (4/22) vs. 6.3% (1/16), P=0.374] was obtained in TAF than TDF group; however, there was no statistically significant differences between the two. Serum HBsAg quantitative level was significantly reduced with TDF and TAF treatment. In addition, alanine aminotransferase elevation was reduced in TAF than TDF treated group. Multivariate logistic regression analysis showed that patient age was an independent predictor of a virological response to antiviral therapy. Conclusion: HBeAg-positive CHB patients with normal alanine aminotransferase, and high HBV DNA level can obtain better curative effect after TDF and TAF treatment.
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Affiliation(s)
- F D Wang
- Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu 610041, China
| | - J Zhou
- Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu 610041, China
| | - D M Zhang
- Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu 610041, China
| | - M L Wang
- Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Y C Tao
- Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu 610041, China
| | - D B Wu
- Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu 610041, China
| | - H Tang
- Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu 610041, China
| | - E Q Chen
- Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu 610041, China
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20
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Wang SK, Wang ML, Luo JZ, He GY, Si MS, Zeng M. [The feasibility analysis of multi-slice spiral CT features of gastric stromal tumors in predicting pathological National Institutes of Health risk classification]. Zhonghua Yi Xue Za Zhi 2022; 102:954-960. [PMID: 35385968 DOI: 10.3760/cma.j.cn112137-20210831-01985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To investigate the feasibility of multi-slice spiral CT(MSCT) imaging features of gastric stromal tumor (GST) in predicting pathological NIH risk classification, providing imaging basis for patients with GST before treatment. Methods: The clinical and CT imaging data of 504 patients(506 GST lesions), 259males and 245 females, aged from 13 to 85(60±11) years, with GST confirmed by surgery and pathology collected in the Zhongshan Hospital Affiliated to Fudan University and the Affiliated TCM Hospital of Southwest Medical University. According to pathological NIH risk classification, 506 lesions were divided into low risk group (very low and low risk degree, 277 lesions) and high risk group (medium and high risk degree, 229 lesions).Clinical data and imaging characteristics were compared between two groups. Multivariate logistic regression analysis was performed to screen out independent risk factors for statistically significant imaging indicators. Receiver operating curve (ROC) was used to evaluate the predictive value of tumor length for risk classification. Resulst: Between low risk group and high risk group,there were significant differences in gender(male/female:131/146 vs 129/100), gastrointestinal bleeding(present/absent:39/238 vs 59/170), morphology(regular/Irregular:218/59 vs 95/134), calcification(present/absent:36/241 vs 53/176), degree of necrosis(0°/Ⅰ°/Ⅱ°/Ⅲ°:197/61/16/3 vs 58/98/32/41), ulceration(present/absent:32/245 vs 94/135), growth pattern(endophytic/exophytic/mixed:102/105/70 vs 44/98/87), tumor location(fundus/cardia/body/angle/antrum:98/7/135/12/25 vs 98/6/114/5/6), feeding artery(present/absent:32/245 vs 104/125), vascular enhancement(present/absent:19/258 vs 88/141), effusion of around the disease(present/absent:0/277 vs 13/216), positive sign of fat around the disease(present/absent:0/277 vs 30/199),maximum long diameter[2.82(2.04,3.80) cm vs 5.93(4.06,8.29) cm] and short diameter [2.31(1.60,2.88) cm vs 4.40(3.21,6.37) cm]of tumor(all P<0.05).The maximum long diameter of tumor (OR=2.08,95%CI:1.35-3.20) and ulceration positive(OR=2.01,95%CI:1.03-3.92) were independent risk factors of risk classification(all P<0.05).Gastric antrum was used as the reference for tumor location, gastric fundus(OR=7.77,95%CI:2.00-30.24) and gastric body(OR=3.93,95%CI:1.03-15.01) were independent risk factors of risk classification(all P<0.05).The area under curve(AUC) of the maximum long diameter of tumor for predicting risk classification was 0.87, and the optimal critical value, sensitivity and specificity were 4.98cm, 62.9% and 95.3% respectively. Conclusions: MSCT image features of GST had certain characteristics. MSCT has certain predictive value for pathological NIH risk classification of GST, which can provide certain imaging basis for patients before treatment.
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Affiliation(s)
- S K Wang
- Department of Radiology, the Affiliated TCM Hospital of Southwest Medical University, Luzhou 646000, China
| | - M L Wang
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - J Z Luo
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - G Y He
- Department of Radiology, the Affiliated TCM Hospital of Southwest Medical University, Luzhou 646000, China
| | - M S Si
- Department of Radiology, the Affiliated TCM Hospital of Southwest Medical University, Luzhou 646000, China
| | - Mengsu Zeng
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
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Wang R, Yang MY, Wang ML, Guo S. [Analysis of failure causes and countermeasures of automatic coagulation analyzer detection of thrombin time]. Zhonghua Yi Xue Za Zhi 2022; 102:808-812. [PMID: 35325961 DOI: 10.3760/cma.j.cn112137-20211223-02879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
To study the failure alarm information displayed on the automatic coagulation analyzer (coagulation method) of thrombin time (TT), and formulate the coping strategies combined with clinical information. Methods: A total of 233 failed TT blood samples [132 males, 101 females, with a median age of 73 (66, 79) years] were selected from 21 359 inpatients in Peking University First Hospital from January to June 2021. The statistical analysis was made and the failure causes and solutions were summarized according to the coagulation curve and the error codes displayed on the coagulation instrument, in combination with the clinical information, sample characteristics, medication status and other reasons. Meanwhile, a total of 96 TT detection failed lipid blood samples [56 males, 40 females, with a median age of 72 (65, 79) years] were analyzed from the inpatients in Peking University First Hospital from July to November 2021. TT results were obtained by artificial coagulation curve interpretation method, magnetic bead method and high-speed centrifugal re-detection method, respectively. The TT results of the three methods were compared. Results: The proportion of 233 failed TT tests from the total number of samples was 1.1% (233/21 359). There were 41.2% (96/233) samples with lipids, 23.2% (54/233) samples with heparin interference, 22.3% (52/233) samples with oral anticoagulant, and 13.3% (31/233) samples with micro-coagulation or insufficient plasma volume among these test failure samples. The classifications for these alarm information of coagulation curves showed on the instrument were as follows: 32.6% (76/233) of samples with higher changes in absorbance at baseline (SD>2 mAbs), 30.5% (71/233) of samples without peak values of second derivative, 25.8% (60/233) of samples with absorbance difference<35 mAbs between baseline and plateau period, 8.6% (20/233) samples with too low starting point or no starting point, and 2.6% (6/233) samples without coagulation curves. Among these 233 samples, there were 55.8% (130/233) samples that could be manually judged according to the reaction principle and standard coagulation curve pattern. Among the 96 samples that failed in coagulation method due to lipemia, there were 78 samples with sufficient blood volume tested by magnetic bead method. The TT results of the high-speed centrifugal redetection method, artificial coagulation curve interpretation method and magnetic bead method were 14.10 (14.80, 13.38) s, 14.30 (14.99, 13.60) s, and 15.65 (17.25, 14.65) s, respectively, but the difference was not statistically significant (P=0.055). For 78 lipid samples, there was a correlation between the results of the artificial coagulation curve interpretation method and the results of magnetic bead method (r=0.99,P=0.001). Conclusions: For those samples failed in TT detection by coagulation method on automatic coagulation instrument, the cause of failure can be analyzed through coagulation curve and alarm information. For the lipid samples, TT results can be obtained by manual interpretation method, high-speed centrifugation method and magnetic bead method.
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Affiliation(s)
- R Wang
- Department of Clinical Laboratory, Peking University First Hospital, Beijing 100034, China
| | - M Y Yang
- Department of Clinical Laboratory, Peking University First Hospital, Beijing 100034, China
| | - M L Wang
- Department of Clinical Laboratory, Peking University First Hospital, Beijing 100034, China
| | - S Guo
- Department of Clinical Laboratory, Peking University First Hospital, Beijing 100034, China
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Wang ML, Wei C, Xu Y, Zhang JS, Chen J, Wan J, Jiang H. [The disease burden of degenerative mitral valve disease in the Chinese population from 1990 to 2019]. Zhonghua Xin Xue Guan Bing Za Zhi 2022; 50:172-178. [PMID: 35172463 DOI: 10.3760/cma.j.cn112148-20211029-00933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To explore the trend of disease burden of degenerative mitral valve disease (DMVD) in the Chinese population from 1990 to 2019. Methods: Based on the 2019 Global Burden of Disease database (GBD 2019), the number of patients, the number of new cases, the number of deaths, the disability-adjusted life years (DALY) as well as the prevalence, incidence and death rate, DALY rate and their age-standardized rates were used to analyze the trend of the burden of DMVD in the Chinese population from 1990 to 2019. Results: In 2019, the number of patients, the number of new cases, and the number of deaths with DMVD in China were 461.2, 27.0 and 0.129 ten thousand, respectively, which increased by 209.0%, 199.1% and 13.2% when compared with 1990. In 2019, the age-standardized prevalence, incidence and death rate were 228.1/100 000, 12.7/100 000 and 0.075/100 000, respectively. Compared with 1990, the change of the age-standardized prevalence, incidence and death rate were 32.6%, 42.8% and -54.1%, respectively. In addition, the 2019 data also showed that the age-standardized prevalence and incidence were higher in females than in males (the age-standardized prevalence was 190.1 (181.5-198.9)/100 000 for males and 262.0 (250.3-273.9)/100 000 for females); the age-standardized incidence was 10.5 (10.0-11.0)/100 000 for males and 14.9 (14.3-15.6)/100 000 for females. The age group with the largest number of DMVD patients was 65 to 69 years old, and the highest incidence was 60 to 64 years old. From 1990 to 2019, DALY caused by DMVD showed an upward trend in China, from 46 439 person-years in 1990 to 69 402 person-years in 2019, with an increase of 49.4%. While the age-standardized DALY rate continued to decline, from 5.5/100 000 in 1990 to 3.8/100 000 in 2019, with a drop of 30.8%. The DALY and the age-standardized DALY rate of females were always higher than that of males in different years. Conclusion: From 1990 to 2019, DALY and the age-standardized prevalence and incidence of DMVD in China shows an increasing trend, and the disease burden caused by DMVD is severe in China.
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Affiliation(s)
- M L Wang
- Department of Cardiology, Renmin Hospital of Wuhan University, Cardiovascular Research Institute, Wuhan University, Hubei Key Laboratory of Cardiology, Wuhan 430060, China
| | - C Wei
- Department of Cardiology, Renmin Hospital of Wuhan University, Cardiovascular Research Institute, Wuhan University, Hubei Key Laboratory of Cardiology, Wuhan 430060, China
| | - Y Xu
- Department of Cardiology, Renmin Hospital of Wuhan University, Cardiovascular Research Institute, Wuhan University, Hubei Key Laboratory of Cardiology, Wuhan 430060, China
| | - J S Zhang
- Department of Cardiology, Renmin Hospital of Wuhan University, Cardiovascular Research Institute, Wuhan University, Hubei Key Laboratory of Cardiology, Wuhan 430060, China
| | - J Chen
- Department of Cardiology, Renmin Hospital of Wuhan University, Cardiovascular Research Institute, Wuhan University, Hubei Key Laboratory of Cardiology, Wuhan 430060, China
| | - J Wan
- Department of Cardiology, Renmin Hospital of Wuhan University, Cardiovascular Research Institute, Wuhan University, Hubei Key Laboratory of Cardiology, Wuhan 430060, China
| | - H Jiang
- Department of Cardiology, Renmin Hospital of Wuhan University, Cardiovascular Research Institute, Wuhan University, Hubei Key Laboratory of Cardiology, Wuhan 430060, China
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Wang ML, Hung MH, Hsu HH, Cheng YJ, Chen JS. Non-intubated Thoracoscopic Surgery to Minimize Contamination From Airway Secretions During the COVID-19 Pandemic. Front Surg 2022; 9:818824. [PMID: 35252335 PMCID: PMC8894440 DOI: 10.3389/fsurg.2022.818824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 01/27/2022] [Indexed: 01/08/2023] Open
Abstract
Background General anesthesia and tracheal intubation potentially pose a high risk to health care workers (HCWs) managing surgical patients during the coronavirus disease 2019 (COVID-19) pandemic. Non-intubated anesthesia is a rational way of managing patients undergoing thoracoscopic surgery that avoids tracheal intubation and minimizes the aerosols generated during airway instrumentation. The purpose of this study was to determine whether non-intubated anesthesia in combination with a face mask is safe and feasible in patients undergoing thoracoscopic surgery. Methods A total of 18 patients who underwent non-intubated thoracoscopic surgery with a face mask during the perioperative period between March 9, 2020 and April 6, 2020 were included. The main outcomes were anesthetic management and postoperative results. Results The 18 patients had a mean age of 64 years and a body mass index of 22.9 kg/m2. All patients wore a mask during induction of anesthesia and throughout surgery. Three patients underwent lobectomy, four segmentectomy, ten wedge resection, and one underwent anterior mediastinal tumor resection. No patient developed cough or vomiting during the perioperative period. All patients were transferred to the postoperative recovery unit within 15 min of the end of surgery (average 7.2 min). No patient required conversion to tracheal intubation or conversion to thoracotomy. Conclusion Non-intubated anesthesia with a mask was safe and feasible in patients undergoing thoracoscopic surgery. Avoidance of intubated general anesthesia and use of a lung separation device may reduce the risk to HCWs of contamination by airway secretions, thereby conserving personal protective equipment, especially during the COVID-19 pandemic.
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Affiliation(s)
- Man-Ling Wang
- Department of Anesthesiology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Ming-Hui Hung
- Department of Anesthesiology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Hsao-Hsun Hsu
- Division of Thoracic Surgery, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Ya-Jung Cheng
- Department of Anesthesiology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Anesthesiology, National Taiwan University Cancer Center, Taipei, Taiwan
| | - Jin-Shing Chen
- Division of Thoracic Surgery, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Surgical Oncology, National Taiwan University Cancer Center, Taipei, Taiwan
- *Correspondence: Jin-Shing Chen
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Wang R, Yang MY, Zhang JY, Su HQ, Duan J, Mi J, Wang ML. [Performance evaluation and validation of automated digital image analysis in peripheral blood cells morphology examination]. Zhonghua Yi Xue Za Zhi 2022; 102:261-266. [PMID: 35073674 DOI: 10.3760/cma.j.cn112137-20211007-02213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To verify and evaluate the performance of automated digital image(DIA) for peripheral blood cell morphology examination. Methods: Three hundred and seventy-nine routine peripheral blood smears and 18 plasmodium positive peripheral blood smears were collected. Blood smears were made and stained by Wright -Giemsa method.White blood cell (WBC) differentiation of blood smears were pre-classified by DIA (DIA direct classification), re-classified (manually reviewed after DIA classification), and artificially classified under microscope. the inter-assay and intra-assay coefficients of variation (CV) of DIA were respectively calculated for repeatability verification. Taking the artificial microscopy as the gold standard, the sensitivity、specificity and accuracy of DIA were calculated. The DIA ability of peripheral blood blast cell morphological count, platelet (PLT) morphological count and morphological examination of plasmodium were also verified. Results: Except for eosinophils and basophils, the inter-assay and intra-assay CV of WBC classification by DIA in normal samples were < 10%. The CV of WBC classification in abnormal samples increased with the decrease of cell percentage. The sensitivity, specificity and accuracy of DIA pre-classification were 90.5%, 99.2%, 98.2%. Through pre-classification and re-classification by DIA,the results of the blood smears which triggered blast cell alarm had a good correlation with manual classification(r=0.812, 0.983, both P<0.01). The PLT morphological count by DIA had high correlation with hematology analyzer (r=0.946, P<0.01). The deviation absolute value of two methods of PLT count was < 15%, while in PLT aggregation or giant thrombocytosis samples,the deviation absolute value of PLT count by two methods was > 15%. After image acquisition by DIA, 17 plasmodium trophozoites were detected in 18 plasmodium-positive peripheral blood smears, and the images were clear. Conclusions: The DIA system has good repeatability, high sensitivity, specificity and accuracy in peripheral blood WBC classification. Its pre-classification and re-classification results have high correlation with the manual classification results.
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Affiliation(s)
- R Wang
- Department of Clinical Laboratory, Peking University First Hospital, Beijing 100034, China
| | - M Y Yang
- Department of Clinical Laboratory, Peking University First Hospital, Beijing 100034, China
| | - J Y Zhang
- Department of Clinical Laboratory, Peking University First Hospital, Beijing 100034, China
| | - H Q Su
- Department of Clinical Laboratory, Peking University First Hospital, Beijing 100034, China
| | - J Duan
- Department of Clinical Laboratory, Peking University First Hospital, Beijing 100034, China
| | - J Mi
- Department of Clinical Laboratory, Peking University First Hospital, Beijing 100034, China
| | - M L Wang
- Department of Clinical Laboratory, Peking University First Hospital, Beijing 100034, China
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Zhang Y, Zhao XT, Wang ML, Han LJ, Mao L, Li XL, Liang CH, Liu ZY. [Value of radiomics model based on dynamic contrast-enhanced magnetic resonance imaging in differentiation fat-poor angiomyolipoma from alpha-fetoprotein-negative hepatocellular carcinoma in the background of non-cirrhotic liver]. Zhonghua Yi Xue Za Zhi 2022; 102:196-200. [PMID: 35042288 DOI: 10.3760/cma.j.cn112137-20211110-02495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To explore the value of radiomics model based on dynamic contrast-enhanced magnetic resonance imaging (MRI) in differentiation fat-poor angiomyolipoma (fp-AML) from alpha-fetoprotein-negative hepatocellular carcinoma (n-HCC) in the background of non-cirrhotic liver. Methods: The complete data of 121 patients from Guangdong Provincial People's Hospital, Zhongshan Hospital Affiliated to Fudan University and Sun Yat-sen University Cancer Center with hepatic fp-AML and n-HCC confirmed by pathology from October 2010 to July 2020 were retrospectively analyzed. Among them, 75 were males and 46 were females, aged from 23 to 80 (55±12) years. A total of 93 patients from Zhongshan Hospital Affiliated to Fudan University were divided into the training cohort (n=75) and internal test cohort (n=18) according to entry time, and the patients of other 2 hospitals were divided into external test cohort (n=28). The radiomics features were extracted from the preoperative triple-phase contrast-enhanced images. The feature selection algorithm based on Joint Mutual Information Maximisation (JMIM) was used to extract the optimal feature subset, and support vector machine (SVM) was used to build the radiomics model. The diagnostic performance of radiomics model was evaluated using the receiver operating characteristic (ROC) curve, and was compared with that of two radiologists. Results: In the internal cohort, the area under the curve (AUC) for the differential diagnosis between fp-AML and n-HCC of the radiomics model was 0.819 (with an accuracy of 72.2%), outperforming than radiologist 1 with 10 years of diagnostic experience (AUC=0.542, P=0.029) and radiologist 2 with 2 years of diagnostic experience (AUC=0.375, P=0.004). In the external cohort, the AUC of the radiomics model was 0.772 (with and accuracy of 71.4%), which was comparable to that of radiologist 1 (AUC=0.661, P=0.442) and better than that of radiologist 2 (AUC=0.400, P=0.008). Conclusion: The radiomics model based on dynamic contrast-enhanced MRI is of high accuracy for preoperatively differentiating hepatic fp-AML from n-HCC in the noncirrhotic liver.
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Affiliation(s)
- Y Zhang
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China Department of Radiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - X T Zhao
- Department of Radiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - M L Wang
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - L J Han
- Department of Radiology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - L Mao
- AI Lab, Deepwise Healthcare, Beijing 100080, China
| | - X L Li
- AI Lab, Deepwise Healthcare, Beijing 100080, China
| | - C H Liang
- Department of Radiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Z Y Liu
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China Department of Radiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
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Huang Z, Wang ML, Ji Y, Luo RK, Rao SX, Zeng MS. [Nodular regenerative hyperplasia of liver caused by chemotherapy: magnetic resonance imaging features]. Zhonghua Gan Zang Bing Za Zhi 2021; 29:873-877. [PMID: 34638207 DOI: 10.3760/cma.j.cn501113-20200304-00085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the MRI features of hepatic nodular regenerative hyperplasia (NRH) induced by chemotherapy. Methods: The clinical data and MRI of 20 cases with hepatic NRH induced by chemotherapy and confirmed by pathology in Zhongshan Hospital Fudan University from August 2014 to May 2019 were retrospectively analyzed. There were 13 males and 7 females, with an average age of 49.8 ± 9.7 years. Contrast-enhanced MR scan with Gd-DTPA was performed eighteen patients, and two patients underwent contrast-enhanced MR scan with hepatobiliary specific contrast (Gd-EOB-DTPA). The image analysis includes the number, location, size, shape, signal intensity in plain scan and enhancement pattern of lesions. The apparent diffusion coefficient (ADC) values of the lesions and adjacent hepatic parenchyma were measured on the ADC map, and the difference was compared with paired sample t test. Results: A total of 36 lesions in 20 patients were rounded or oval, including 23 (63.9%) lesions in the right lobe, 12 (33.3%) in the left lobe and 1 (2.8%) in the caudate lobe. The average diameter of all lesions was 15.4 ± 6.4 (7.0-37.0) mm. The boundary was clear in 9 (25.0%) lesions and blurred in 27 (75%) lesions. In T1WI, 35 (97.2%) lesions showed slightly hypointensity, and in 1 (2.8%) lesion was iosintensity. All 36 lesions showed slightly hyperintensity in T2WI. 33 (91.7%) lesions showed slightly hyperintensity in DWI, and 3 (8.3%) lesions showed iosintensity. 31 lesions with Gd-DTPA enhanced MR scan were significantly enhanced in the arterial phase and showed slightly high signal intensity in early portal vein phase, late portal vein phase and equilibrium phase. 5 lesions with Gd-EOB-DTPA enhanced MR scan were also significantly enhanced in the arterial phase and showed slightly high signal intensity in early portal vein phase, late portal vein phase and equilibrium phase, then all lesions showed circular high signal intensity in hepatobiliary specific phase. The average ADC value of 29 lesions was (1.471 ± 0.253) × 10(-3) mm(2)/s, and that of adjacent liver parenchyma was (1.460 ± 0.235) ×10(-3) mm(2)/s. There was no significant difference between the two groups (P > 0.05). Conclusion: MR findings of NRH induced by chemotherapy have certain characteristics, and the morphological manifestations, diffusion-weighted imaging, enhanced imaging and hepatobiliary specific phase features of the lesions can help to diagnose the disease.
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Affiliation(s)
- Z Huang
- Department of Medical Imaging, The Affiliated Zhangjiagang Hospital of Soochow University, Suzhou 215600, China
| | - M L Wang
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Department of Medical Imaging, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Y Ji
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - R K Luo
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - S X Rao
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Department of Medical Imaging, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - M S Zeng
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, Department of Medical Imaging, Shanghai Medical College, Fudan University, Shanghai 200032, China
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Wang ML, How CH, Hung MH, Huang HH, Hsu HH, Cheng YJ, Chen JS. Long-term outcomes after nonintubated versus intubated thoracoscopic lobectomy for clinical stage I non-small cell lung cancer: A propensity-matched analysis. J Formos Med Assoc 2021; 120:1949-1956. [PMID: 33994233 DOI: 10.1016/j.jfma.2021.04.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 03/08/2021] [Accepted: 04/26/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Nonintubated thoracoscopic lobectomy has been described as a feasible surgical treatment for early-stage lung cancer since 2011. Despite promising perioperative results, studies on tumor recurrence and long-term survival are very limited. This study was aimed to compare outcomes after thoracoscopic lobectomy with versus without intubation for stage I non-small cell lung cancer. METHODS A retrospective data set including 115 and 155 patients who underwent nonintubated and intubated thoracoscopic lobectomy, respectively, between January 2011 and December 2013 was used to identify matched nonintubated and intubated cohorts (n = 97 per group) using a propensity score matching algorithm that accounted for confounding effects of preoperative patient variables. Primary outcome variables included freedom from recurrence and overall survival. Factors affecting survival were assessed using Cox regression analysis and Kaplan-Meier survival estimates. RESULTS No perioperative mortality occurred in both groups. At an average follow-up of 74 months, comparing nonintubated thoracoscopic lobectomy with intubated procedure, no differences were observed in recurrence rates (14.4% vs. 25.8%, respectively; p = .057). Furthermore, no significant differences were noted in overall survival (97.9% vs. 93.8%, respectively; p = .144). Nonintubated thoracoscopic lobectomy was not found to be an independent predictor of recurrence (hazard ratio, .53; 95% confidence interval [CI], .28-1.02) or overall survival (hazard ratio, .33; 95% CI, .07-1.61). CONCLUSIONS In this propensity-matched comparison, nonintubated thoracoscopic lobectomy was not associated with an increased risk for recurrence and overall survival during the 5-year follow-up. However, more randomized trials should be conducted for further validation of these results.
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Affiliation(s)
- Man-Ling Wang
- Department of Anesthesiology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Cheng-Hung How
- Division of Thoracic Surgery, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Ming-Hui Hung
- Department of Anesthesiology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Hui-Hsun Huang
- Department of Anesthesiology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Hsao-Hsun Hsu
- Division of Thoracic Surgery, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Ya-Jung Cheng
- Department of Anesthesiology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Department of Anesthesiology, National Taiwan University Cancer Center, Taipei, Taiwan
| | - Jin-Shing Chen
- Division of Thoracic Surgery, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Department of Surgical Oncology, National Taiwan University Cancer Center, Taiwan.
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Wang ML, Min J, Sands LP, Leung JM. Midazolam Premedication Immediately Before Surgery Is Not Associated With Early Postoperative Delirium. Anesth Analg 2021; 133:765-771. [PMID: 33721875 DOI: 10.1213/ane.0000000000005482] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Postoperative delirium is common among older surgical patients and may be associated with anesthetic management during the perioperative period. The aim of this study is to assess whether intravenous midazolam, a short-acting benzodiazepine used frequently as premedication, increased the incidence of postoperative delirium. METHODS Analyses of existing data were conducted using a database created from 3 prospective studies in patients aged 65 years or older who underwent elective major noncardiac surgery. Postoperative delirium occurring on the first postoperative day was measured using the confusion assessment method. We assessed the association between the use or nonuse of premedication with midazolam and postoperative delirium using a χ2 test, using propensity scores to match up with 3 midazolam patients for each control patient who did not receive midazolam. RESULTS A total of 1266 patients were included in this study. Intravenous midazolam was administered as premedication in 909 patients (72%), and 357 patients did not receive midazolam. Those who did and did not receive midazolam significantly differed in age, Charlson comorbidity scores, preoperative cognitive status, preoperative use of benzodiazepines, type of surgery, and year of surgery. Propensity score matching for these variables and American Society of Anesthesiology physical status scores resulted in propensity score-matched samples with 1-3 patients who used midazolam (N = 749) for each patient who did not receive midazolam (N = 357). After propensity score matching, all standardized differences in preoperative patient characteristics ranged from -0.07 to 0.06, indicating good balance on baseline variables between the 2 exposure groups. No association was found between premedication with midazolam and incident delirium on the morning of the first postoperative day in the matched dataset, with odds ratio (95% confidence interval) of 0.91 (0.65-1.29), P = .67. CONCLUSIONS Premedication using midazolam was not associated with higher incidence of delirium on the first postoperative day in older patients undergoing major noncardiac surgery.
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Affiliation(s)
- Man-Ling Wang
- From the Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
| | - Jie Min
- Virginia Tech, Center for Gerontology, Blacksburg, Virginia
| | - Laura P Sands
- Virginia Tech, Center for Gerontology, Blacksburg, Virginia
| | - Jacqueline M Leung
- Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, California
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He ZK, Wang J, Sun H, Su J, Liu X, Gu WP, Yu DS, Luo LZ, Wang ML, Hu B, Hu WF, Tong J, Yang M, Wang SL, Wang CX, Wang YL, Zhan ZF, Duan R, Qin S, Jing HQ, Wang X. [Characteristics and diversity of infectious diarrheal caused by various pathogens]. Zhonghua Liu Xing Bing Xue Za Zhi 2020; 41:1328-1334. [PMID: 32867445 DOI: 10.3760/cma.j.cn112338-20200213-00093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To understand the characteristics and differences of diarrhea-related symptoms caused by different pathogens, and the clinical features of various pathogens causing diarrhea. Methods: Etiology surveillance program was conducted among 20 provinces of China from 2010 to 2016. The acute diarrhea outpatients were collected from clinics or hospitals. A questionnaire was used to survey demographics and clinical features. VFeces samples were taken for laboratory detection of 22 common diarrhea pathogens, to detect and analyze the clinical symptom pattern characteristics of the patient's. Results: A total of 38 950 outpatients were enrolled from 20 provinces of China. The positive rates of Rotavirus and Norovirus were the highest among the five diarrhea-causing viruses (Rotavirus: 18.29%, Norovirus: 13.06%). In the isolation and culture of 17 diarrhea-causing bacterial, Escherichia coli showed the highest positive rates (6.25%). The clinical features of bacterial diarrhea and viral diarrhea were mainly reflected in the results of fecal traits and routine examination, but pathogenic Vibrio infection was similar to viral diarrhea. Conclusion: Infectious diarrhea presents different characteristics due to various symptoms which can provide a basis for clinical diagnosis.
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Affiliation(s)
- Z K He
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - J Wang
- Dongcheng District Center for Disease Control and Prevention, Beijing 100009, China
| | - H Sun
- Dongcheng District Center for Disease Control and Prevention, Beijing 100009, China
| | - J Su
- Henan Center for Disease Control and Prevention, Zhengzhou 450016, China
| | - X Liu
- Ningxia Center for Disease Control and Prevention, Yinchuan 750004, China
| | - W P Gu
- Yunnan Center for Disease Control and Prevention, Kunming 650022, China
| | - D S Yu
- Gansu Provincial Center for Disease Control and Prevention, Lanzhou 730000, China
| | - L Z Luo
- Sichuan Center for Disease Control and Prevention, Chengdu 610041, China
| | - M L Wang
- Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
| | - B Hu
- Shandong Center for Disease Control & Prevention, Jinan 250014, China
| | - W F Hu
- Anhui Provincial Center for Disease Control and Prevention, Hefei 230601, China
| | - J Tong
- Xuzhou Municipal Center for Disease Control and Prevention, Xuzhou 221006, China
| | - M Yang
- Jiangxi Province Center for Disease Control and Prevention, Nanchang 330029, China
| | - S L Wang
- Hainan Center for Disease Control and Prevention, Haikou 570203, China
| | - C X Wang
- Qing Hai Center for Diseases Prevention & Control, Xining 810000, China
| | - Y L Wang
- Tianjin Jizhou District Center for Disease Control and Prevention, Tianjin 301999, China
| | - Z F Zhan
- Hunan Provincial Center for Disease Control and Prevention, Changsha 410000, China
| | - R Duan
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - S Qin
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - H Q Jing
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - X Wang
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
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Liu HY, Chiang XH, Hung MH, Wang ML, Lin MW, Cheng YJ, Hsu HH, Chen JS. Nonintubated uniportal thoracoscopic segmentectomy for lung cancer. J Formos Med Assoc 2020; 119:1396-1404. [DOI: 10.1016/j.jfma.2020.03.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 02/25/2020] [Accepted: 03/23/2020] [Indexed: 11/16/2022] Open
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Guo XK, Gao HJ, Wang ML, Han B, Wang B, Ge N, Shi GD, Wei YC. [Comparison of short-term and long-term outcomes between thoracoscopic pneumonectomy and open pneumonectomy for non-small cell lung cancer: a study based on propensity score matching]. Zhonghua Wai Ke Za Zhi 2020; 58:131-136. [PMID: 32074813 DOI: 10.3760/cma.j.issn.0529-5815.2020.02.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To compare the short-term and long-term results of thoracoscopic and open pneumonectomy for non-small cell lung cancer. Methods: The clinical data of patients with non-small cell lung cancer who underwent pneumonectomy in the Department of Thoracic Surgery, Qingdao University Hospital from January 2008 to December 2016 were collected. Totally 142 patients (55 in the thoracoscopic group and 87 in the open group) were included in the study. A total of 29 pairs of patients were successfully matched by propensity score matching (PSM). Perioperative outcomes and overall survival were compared between the two groups using t test, χ(2) test, Kaplan-Meier curve and Log-rank test, respectively. Results: Camparion with open group, the thoracoscopic group had longer operative time ((209.7±70.2) minutes vs. (171.3±43.5) minutes, t=2.50, P=0.02), more mediastinal lymph node dissection (M(Q(R)): 17(9) vs. 11(10), W=388, P=0.02) and shorter postoperative hospital stay (7.0(3.5) vs. 9.0(3.0), W=285, P=0.03). There was no significant difference in estimated blood loss, postoperative drainage time, dissected lymph node number, dissected lymph node station and perioperative complications. After PSM, there were no signifificant differences found in 3-year survival (71.4% vs. 48.1%, P=0.10) and 3-year disease-free survival (67.4% vs. 47.2%, P=0.13) between the two groups. Conclusion: Thoracoscopic pneumonectomy is safe and feasible for the treatment of non-small cell lung cancer with more mediastinal lymph node dissection and accelerating recovery, and equivalent long-term prognosis when compared with open approach.
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Affiliation(s)
- X K Guo
- Department of Thoracic Surgery, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - H J Gao
- Department of Thoracic Surgery, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - M L Wang
- Department of Thoracic Surgery, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - B Han
- Department of Thoracic Surgery, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - B Wang
- Department of Thoracic Surgery, Changyi People's Hospital, Changyi 261300, Shandong Province, China
| | - N Ge
- Department of Thoracic Surgery, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - G D Shi
- Department of Thoracic Surgery, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - Y C Wei
- Department of Thoracic Surgery, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
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Liu CW, Chang WC, Lee CC, Shau WY, Hsu FS, Wang ML, Chen TC, Lo C, Hwang JJ. The net clinical benefits of febuxostat versus allopurinol in patients with gout or asymptomatic hyperuricemia - A systematic review and meta-analysis. Nutr Metab Cardiovasc Dis 2019; 29:1011-1022. [PMID: 31378626 DOI: 10.1016/j.numecd.2019.06.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Revised: 02/26/2019] [Accepted: 06/18/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS Systemic reviews and meta-analyses suggest hyperuricemia is a cardiovascular risk factor. The effects of xanthine oxidase inhibitors on cardiac outcomes remain unclear. We assessed the effects of febuxostat and allopurinol on mortality and adverse reactions in adult patients with hyperuricemia. METHODS AND RESULTS PubMed and EMBASE were searched to retrieve randomized controlled trials of febuxostat and allopurinol from January 2005 to July 2018. The meta-analysis consisted of 13 randomized controlled trials with a combined sample size of 13,539 patients. Febuxostat vs. allopurinol was not associated with an increased risk of cardiac-related mortality in the overall population (OR: 0.72, 95% CI: 0.24-2.13, P = 0.55). Regarding adverse skin reactions, the patients receiving febuxostat had significantly fewer adverse skin reactions than those receiving allopurinol treatment (OR: 0.50, 95% CI: 0.30-085, P = 0.01). Compared with allopurinol, febuxostat was associated with an improved safety outcome of cardiac-related mortality and adverse skin reactions (OR: 0.72, 95% CI: 0.55-0.96, P = 0.02). The net clinical outcome, composite of incident gout and the safety outcome, was not different significantly in the patients receiving febuxostat or allopurinol (OR: 1.04, 95% CI: 0.76-0.1.42, P = 0.79). In sensitivity analyses, a borderline significance was found in the patients randomized to febuxostat vs. allopurinol regarding cardiac-related mortality (OR: 1.29, 95% CI: 1.00-1.67, P = 0.05) after the CARES study was included. CONCLUSION Febuxostat vs. allopurinol was associated with the improved safety outcome and have comparable mortality and net clinical outcome in patients with hyperuricemia. REGISTRATION NUMBER PROSPERO(CRD42018091657).
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Affiliation(s)
- Cheng-Wei Liu
- Department of Internal Medicine, Tri-Service General Hospital Songshan Branch, National Defense Medical Center, Taipei, Taiwan; Cardiology Division of Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Wei-Cheng Chang
- Department of Internal Medicine, Tri-Service General Hospital Songshan Branch, National Defense Medical Center, Taipei, Taiwan
| | - Chiao-Chin Lee
- Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Wen-Yi Shau
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Fu-Shun Hsu
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Urology, New Taipei City Hospital, Taiwan
| | - Man-Ling Wang
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Anesthesiology, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan
| | - Tsung-Chih Chen
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chiao Lo
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Surgery, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan
| | - Juey-Jen Hwang
- Departments of Internal Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan.
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Zhao J, Yu HY, Zhao Y, Li SQ, Fu XL, Zhou W, Xia BB, Wang ML, Chen J. Pharmacokinetics of the recombinant ovine interferon-tau in lambs. Pol J Vet Sci 2019; 22:75-82. [PMID: 30997764 DOI: 10.24425/pjvs.2018.125610] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
In the current study, twenty lambs, aged 4 months, half male and half female, were classified into four groups, with five in each group. The experimental three groups of lambs were given intravenous (IV), intramuscular (IM) and subcutaneous (SC) administrations of recombinant ovine interferon-τ (roIFN-τ). The fourth group (normal control) of lambs was given normal saline injections in the same way. After administrations, blood samples were collected from the tested animals at different time points post injection, and the serum titers of roIFN-τ were measured using cytopathic effect (CPE) inhibition bioassay. The results of calculating pharmacokinetic (PK) parameters using DAS software showed that the PK characteristics of roIFN-τ through IV injection conformed to the two-compartment open model, whose half-life of distribution phases (T1/2α) was 0.33±0.034 h and the elimination half-life(T1/2β) was 5.01±0.24 h. However, the PK features of IM injection and SC injection of roIFN-τ conformed to the one compartment open model, whose Tmax were 3.11±0.26 h and 4.83±0.43 h, respectively, together with an elimination half life(T1/2β) of 9.11±0.76 h and 7. 43±0.58 h, and an absorption half-life (T1/2k(a)) of 1.13±0.31 h and 1.85±0.40 h, respectively. The bioavailability of roIFN-τ after IM administration reaches 73.57%, which is greater than that of SC administration (53.43%). These results indicate that the drug administration effect can be preferably obtained following a single dose IM administration of the roIFN-τ aqueous preparation. This study will facilitate the clinical application of roIFN-τ as a potential antiviral agent in future work.
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Affiliation(s)
- J Zhao
- Department of Microbiology, Anhui Medical University, Hefei, Anhui Province, 230032, China.,Anhui JiuChuan Biotech Co., Ltd., Wuhu, Anhui Province, 241007, China.,Wuhu Overseas Students Pioneer Park, Wuhu, Anhui Province, 241000, China.,Wuhu Interferon Bio-products Industry Research Institute Co., Ltd., Wuhu, Anhui Province, 241000, China
| | - H Y Yu
- Department of Microbiology, Anhui Medical University, Hefei, Anhui Province, 230032, China
| | - Y Zhao
- Anhui JiuChuan Biotech Co., Ltd., Wuhu, Anhui Province, 241007, China
| | - S Q Li
- Anhui JiuChuan Biotech Co., Ltd., Wuhu, Anhui Province, 241007, China
| | - X L Fu
- Anhui JiuChuan Biotech Co., Ltd., Wuhu, Anhui Province, 241007, China
| | - W Zhou
- Anhui JiuChuan Biotech Co., Ltd., Wuhu, Anhui Province, 241007, China
| | - B B Xia
- Anhui JiuChuan Biotech Co., Ltd., Wuhu, Anhui Province, 241007, China
| | - M L Wang
- Department of Microbiology, Anhui Medical University, Hefei, Anhui Province, 230032, China.,Anhui JiuChuan Biotech Co., Ltd., Wuhu, Anhui Province, 241007, China.,Wuhu Overseas Students Pioneer Park, Wuhu, Anhui Province, 241000, China.,Wuhu Interferon Bio-products Industry Research Institute Co., Ltd., Wuhu, Anhui Province, 241000, China
| | - J Chen
- Department of Microbiology, Anhui Medical University, Hefei, Anhui Province, 230032, China.,Department of Pathology and Cell Biology, Columbia University, New York 10032, USA
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Hung WT, Hung MH, Wang ML, Cheng YJ, Hsu HH, Chen JS. Nonintubated Thoracoscopic Surgery for Lung Tumor: Seven Years’ Experience With 1,025 Patients. Ann Thorac Surg 2019; 107:1607-1612. [DOI: 10.1016/j.athoracsur.2019.01.013] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 12/05/2018] [Accepted: 01/02/2019] [Indexed: 10/27/2022]
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Wang YC, Wang ML, Guo JC, Lai YH, Wang PJ, Sun WZ, Huang CH. Transesophageal Echocardiography Examination in Ailuropoda melanoleuca. Asian J Anesthesiol 2019; 57:4-9. [PMID: 31088089 DOI: 10.6859/aja.201903_57(1).0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Cardiac function analysis for Ailuropoda melanoleuca, also called giant panda, with transthoracic echocardiography has several limitations, such as limited probe position area and poor echo window. We want to determine the feasibility of transesophageal echocardiography (TEE) for cardiac examination in Ailuropoda melanoleuca. METHODS Eight-year-old male Ailuropoda melanoleuca was anesthetized by intramuscular ketamine and followed by inhalation isofl urane with spontaneous respiration. TEE probe was inserted through mouth. Comprehensive examinations were done by two-dimensional (2D), Doppler method, 3D zoom and 3D full volume mode for their cardiac evaluation. RESULTS The structure of heart was similar to human. We found mild mitral regurgitation. Right ventricle and pulmonary artery were free of any organic lesions. We did comprehensive multiplane examination by American Society of Echocardiography/Society of Cardiovascular Anesthesia guideline, but transgastric (TG) and deep TG view were not approachable. 3D reconstruction offered high quality image and quantitative calculations. Complete examinations took less than 30 minutes. There was no significant hemodynamic change during probe insertion, and no oropharyngeal trauma certifi ed by dentist. CONCLUSIONS TEE is a reasonable semi-invasive tool for cardiac function evaluation. Though some anatomical limitations prohibited comprehensive 2D views, improvements such as 3D images help to give detailed cardiac examination.
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Affiliation(s)
- Yi-Chia Wang
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
| | - Man-Ling Wang
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
| | | | | | | | - Wei-Zen Sun
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chi-Hsiang Huang
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
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Wang ML, Hung MH, Hsu HH, Chan KC, Cheng YJ, Chen JS. Non-intubated thoracoscopic surgery for lung cancer in patients with impaired pulmonary function. Ann Transl Med 2019; 7:40. [PMID: 30906744 DOI: 10.21037/atm.2018.11.58] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background Patients with impaired lung function or chronic obstructive pulmonary disease (COPD) are considered high-risk for intubated general anesthesia, which may preclude them from surgical treatment of their lung cancers. We evaluated the feasibility of non-intubated video-assisted thoracoscopic surgery (VATS) for the surgical management of lung cancer in patients with impaired pulmonary function. Methods From August 2009 to June 2015, 28 patients with impaired lung function (preoperative forced expiratory volume in 1 second <70% of the predicted value) underwent non-intubated VATS using a combination of thoracic epidural anesthesia or intercostal nerve block, and intra-thoracic vagal block with target-controlled sedation. Results Eighteen patients had primary lung cancers, 4 had metastatic lung cancers, and 6 had non-malignant lung tumors. In the patients with primary lung cancer, lobectomy was performed in 4, segmentectomy in 3 and wedge resection in 11, with lymph node sampling adequate for staging. One patient required conversion to intubated one-lung ventilation because of persistent wheezing and labored breathing. Five patients developed air leaks more than 5 days postoperatively while subcutaneous emphysema occurred in 6 patients. Two patients developed acute exacerbations of pre-existing COPD, and new-onset atrial fibrillation after surgery occurred in 1 patient. The median duration of postoperative chest tube drainage was 3 days while the median hospital stay was 6 days. Conclusions Non-intubated VATS resection for pulmonary tumors is technically feasible. It may be applied as an alternative to intubated general anesthesia in managing lung cancer in selected patients with impaired pulmonary function.
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Affiliation(s)
- Man-Ling Wang
- Graduate Institute of Clinical Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Anesthesiology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Ming-Hui Hung
- Graduate Institute of Clinical Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Anesthesiology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Hsao-Hsun Hsu
- Division of Thoracic Surgery, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Kuang-Cheng Chan
- Department of Anesthesiology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Ya-Jung Cheng
- Department of Anesthesiology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Jin-Shing Chen
- Division of Thoracic Surgery, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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Wang ML, Lin PL, Huang CH, Huang HH. Decreased Parasympathetic Activity of Heart Rate Variability During Anticipation of Night Duty in Anesthesiology Residents. Anesth Analg 2018; 126:1013-1018. [PMID: 29200073 DOI: 10.1213/ane.0000000000002439] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND In residency programs, it is well known that autonomic regulation is influenced by night duty due to workload stress and sleep deprivation. A less investigated question is the impact on the autonomic nervous system of residents before or when anticipating a night duty shift. In this study, heart rate variability (HRV) was evaluated as a measure of autonomic nervous system regulation. METHODS Eight residents in the Department of Anesthesiology were recruited, and 5 minutes of electrocardiography were recorded under 3 different conditions: (1) the morning of a regular work day (baseline); (2) the morning before a night duty shift (anticipating the night duty); and (3) the morning after a night duty shift. HRV parameters in the time and frequency domains were calculated. Repeated measures analysis of variance was performed to compare the HRV parameters among the 3 conditions. RESULTS There was a significant decrease of parasympathetic-related HRV measurements (high-frequency power and root mean square of the standard deviation of R-R intervals) in the morning before night duty compared with the regular work day. The mean difference of high-frequency power between the 2 groups was 80.2 ms (95% confidence interval, 14.5-146) and that of root mean square of the standard deviation of R-R intervals was 26 milliseconds (95% confidence interval, 7.2-44.8), with P = .016 and .007, respectively. These results suggest that the decrease of parasympathetic activity is associated with stress related to the condition of anticipating the night duty work. On the other hand, the HRV parameters in the morning after duty were not different from the regular workday. CONCLUSIONS The stress of anticipating the night duty work may affect regulation of the autonomic nervous system, mainly manifested as a decrease in parasympathetic activity. The effect of this change on the health of medical personnel deserves our concern.
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Affiliation(s)
- Man-Ling Wang
- From the Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan.,Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Pei-Lin Lin
- From the Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chi-Hsiang Huang
- From the Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
| | - Hui-Hsun Huang
- From the Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
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Lai CJ, Yeh KC, Wang ML, Tai WH, Cheng YJ. Heated humidified high-flow nasal oxygen prevents intraoperative body temperature decrease in non-intubated thoracoscopy. J Anesth 2018; 32:872-879. [PMID: 30324221 DOI: 10.1007/s00540-018-2567-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 10/07/2018] [Indexed: 11/25/2022]
Abstract
PURPOSE In patients receiving non-intubated video-assisted thoracic surgery (NIVATS), transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) has been applied instead of oxygen mask for better oxygenation. However, the THRIVE effects on intraoperative temperature decrease have not been investigated. METHODS Pre- and postoperative temperatures, measured by an infrared tympanic ear thermometer, taken before sending patients to the operation room and immediately upon their arrival in the postoperative anesthesia unit, were collected from medical records of patients who received NIVATS either with oxygen mask or THRIVE. Intraoperative temperature decrease, calculated by preoperative temperature minus postoperative temperature, was compared between different groups. Multiple linear regression analysis was performed to determine factors associated with intraoperative temperature decrease. RESULTS Records of 256 adult patients with forced-air warming were retrospectively analyzed. 172 patients of them received THRIVE and 84 patients received oxygen mask. Preoperative temperatures were comparable between groups (THRIVE: 36.25 ± 0.46 °C; mask: 36.30 ± 0.39 °C, p = 0.43). Postoperative temperatures were significantly higher in patients using THRIVE than those using oxygen masks (36.05 ± 0.59 vs 35.87 ± 0.62 °C, p = 0.025). Significantly less intraoperative temperature decrease was shown in THRIVE group (THRIVE: 0.20 ± 0.69 °C; mask: 0.43 ± 0.69 °C, p = 0.04). According to the multiple linear regression analysis, significant temperature decrease was associated with the advanced age (βage = 0.01) but not the anesthetic duration. Using THRIVE was correlated with significantly less body temperature decrease (βTRIVE = - 0.24). CONCLUSIONS THRIVE effectively prevents intraoperative temperature decrease during NIVATS, especially in old patients.
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Affiliation(s)
- C J Lai
- Department of Anesthesiology, National Taiwan University Hospital, National Taiwan University College of Medicine, Jen-Ai Road, Section 1, Taipei, 10051, Taiwan, Republic of China
| | - K C Yeh
- Department of Anesthesiology, National Taiwan University Hospital, National Taiwan University College of Medicine, Jen-Ai Road, Section 1, Taipei, 10051, Taiwan, Republic of China
| | - M L Wang
- Department of Anesthesiology, National Taiwan University Hospital, National Taiwan University College of Medicine, Jen-Ai Road, Section 1, Taipei, 10051, Taiwan, Republic of China
| | - W H Tai
- Department of Anesthesiology, National Taiwan University Hospital, National Taiwan University College of Medicine, Jen-Ai Road, Section 1, Taipei, 10051, Taiwan, Republic of China
| | - Ya-Jung Cheng
- Department of Anesthesiology, National Taiwan University Hospital, National Taiwan University College of Medicine, Jen-Ai Road, Section 1, Taipei, 10051, Taiwan, Republic of China.
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Wang ML, Wang YP, Hung MH, Hsu HH, Chen JS, Yang FS, Cheng YJ. Is fibre-optic bronchoscopy necessary to confirm the position of rigid-angled endobronchial blockers before thoracic surgery? A randomized controlled trial. Eur J Cardiothorac Surg 2018; 53:241-246. [PMID: 28950380 DOI: 10.1093/ejcts/ezx260] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Accepted: 06/09/2017] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To determine the success rate of blind insertion and the usefulness of fibre-optic bronchoscopy for directing rigid-angled endobronchial blockers (EBs) to the correct side and achieving satisfactory surgical fields. METHODS A randomized trial was designed to determine the extent to which the Coopdech Endobronchial Blocker Tube (Daiken Medical Co., Ltd) could successfully be placed through either auscultation (n = 57) or fibre-optic bronchoscopy (n = 55) in patients scheduled for thoracic surgery. The placement time was recorded and quality of the thoracoscopic operation field was determined by the thoracic surgeon. Anaesthesiologists with varying thoracic experience levels were enrolled. RESULTS The success rates of insertion through auscultation were 100% (32 of 32) for the right side and 88% (22 of 25) for the left side. Placement through auscultation was faster than that through bronchoscopy (mean 89.6 vs 141.1 s, P = 0.008) in the right-sided procedure but non-significant in the left-sided procedure (mean 138.5 vs 130 s, P = 0.795). Surgical grading of the operation field was not significantly different between both techniques (P = 0.502). Experienced anaesthesiologists took less time to position EBs (mean 91.0 vs 138.0 s, P = 0.015). Surgical grading was comparable between specialists and residents (P = 0.058). CONCLUSIONS Once an EB was correctly inserted and confirmed through auscultation, the corresponding surgical satisfaction was comparable to that through bronchoscopy. In the majority of cases, bronchoscopy is unnecessary for correct and efficient EB positioning. However, bronchoscopy is still mandatory in left-sided EB insertion and in patients with deviated tracheobronchial anatomy. Clinical registration number NCT02133235, registered at ClinicalTrials.gov [https://clinicaltrials.gov/ct2/show/NCT02133235 (8 July 2017, date last accessed)].
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Affiliation(s)
- Man-Ling Wang
- Department of Anesthesiology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.,Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yi-Ping Wang
- Department of Anesthesiology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Ming-Hui Hung
- Department of Anesthesiology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.,Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Hsao-Hsun Hsu
- Department of Surgery, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Jin-Shing Chen
- Department of Surgery, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Traumatology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Fu-Sui Yang
- Department of Anesthesiology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Ya-Jung Cheng
- Department of Anesthesiology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
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Wang ML, Hung MH, Chen JS, Hsu HH, Cheng YJ. Nasal high-flow oxygen therapy improves arterial oxygenation during one-lung ventilation in non-intubated thoracoscopic surgery†. Eur J Cardiothorac Surg 2017; 53:1001-1006. [DOI: 10.1093/ejcts/ezx450] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 11/18/2017] [Indexed: 11/12/2022] Open
Affiliation(s)
- Man-Ling Wang
- Department of Anesthesiology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Ming-Hui Hung
- Department of Anesthesiology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Jin-Shing Chen
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Traumatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Hsao-Hsun Hsu
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Ya-Jung Cheng
- Department of Anesthesiology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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Hung MH, Wang ML, Cheng YJ, Hsu HH, Chen JS. Nonintubated thoracoscopic anatomical segmentectomy for lung cancer: a single-center experience with consecutive 89 cases. Video-assist Thorac Surg 2017. [DOI: 10.21037/vats.2017.08.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Wang ML, Galvez C, Chen JS, Navarro-Martinez J, Bolufer S, Hung MH, Hsu HH, Cheng YJ. Non-intubated single-incision video-assisted thoracic surgery: a two-center cohort of 188 patients. J Thorac Dis 2017; 9:2587-2598. [PMID: 28932566 DOI: 10.21037/jtd.2017.08.96] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Non-intubated single-incision procedures are slowly expanding because of high experience and skill required, and stricter selection criteria. The aim of this study is to present the first retrospective two-center series in Taiwan and Spain. METHODS We performed a retrospective analysis of 188 patients undergoing non-intubated single-incision video-assisted thoracic surgery (NI-SI-VATS) procedures between July 2013 to November 2015 in two centers in Taiwan (170 patients) and Spain (18 patients) with two different anesthetic methods. Demographic data, clinicopathological features, preoperative tests, and final outcomes were analyzed to compare the outcomes with the two different techniques. RESULTS Of the 188 patients, 147 (78%) were women, with a mean body mass index (BMI) of 22.7. Of the 196 specimens, 145 (74%) were malignancies with a mean size of 9.7 mm. Wedge resection was performed in 172 patients (91.4%), anatomical segmentectomy with lymphadenectomy in 8 (4.7%), and lobectomy with lymphadenectomy in 5 (2.6%). Three patients (1.6%) required conversion to orotracheal intubation, while 5 patients (2.7%) required additional ports. Complications appeared in 16 patients (8.5%) with air leak as the most frequent in 7 cases (3.7%). Median chest drainage was 1 day, and median postoperative stay was 3 days. There was neither perioperative death nor postoperative readmission. CONCLUSIONS Non-intubated single-incision procedures can be feasible and safe in expert hands and experienced teams, even for anatomical resections. Strict selection criteria, skill and experience are mandatory. Comparative cohorts and randomized trials are needed.
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Affiliation(s)
- Man-Ling Wang
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
| | - Carlos Galvez
- Department of Thoracic Surgery, University General Hospital of Alicante, Alicante, Spain
| | - Jin-Shing Chen
- Division of Thoracic Surgery, Department of Surgery, National Taiwan University, Taipei, Taiwan
| | - Jose Navarro-Martinez
- Department of Anesthesiology and Surgical Critical Care Department, University General Hospital of Alicante, Alicante, Spain
| | - Sergio Bolufer
- Department of Thoracic Surgery, University General Hospital of Alicante, Alicante, Spain
| | - Ming-Hui Hung
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
| | - Hsao-Hsung Hsu
- Division of Thoracic Surgery, Department of Surgery, National Taiwan University, Taipei, Taiwan
| | - Ya-Jung Cheng
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
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Yang SM, Wang ML, Hung MH, Hsu HH, Cheng YJ, Chen JS. Tubeless Uniportal Thoracoscopic Wedge Resection for Peripheral Lung Nodules. Ann Thorac Surg 2017; 103:462-468. [DOI: 10.1016/j.athoracsur.2016.09.006] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/11/2016] [Indexed: 12/31/2022]
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44
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Wang ML, Dzievit M, Chen Z, Morris JB, Norris JE, Barkley NA, Tonnis B, Pederson GA, Yu J. Genetic diversity and population structure of castor (Ricinus communis L.) germplasm within the US collection assessed with EST-SSR markers. Genome 2017; 60:193-200. [PMID: 28094539 DOI: 10.1139/gen-2016-0116] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Castor is an important oilseed crop and although its oil is inedible, it has multiple industrial and pharmaceutical applications. The entire US castor germplasm collection was previously screened for oil content and fatty acid composition, but its genetic diversity and population structure has not been determined. Based on the screening results of oil content, fatty acid composition, and country origins, 574 accessions were selected and genotyped with 22 polymorphic EST-SSR markers. The results from cluster analysis, population structure, and principal component analysis were consistent, and partitioned accessions into four subpopulations. Although there were certain levels of admixtures among groups, these clusters and subpopulations aligned with geographic origins. Both divergent and redundant accessions were identified in this study. The US castor germplasm collection encompasses a moderately high level of genetic diversity (pairwise dissimilarity coefficient = 0.53). The results obtained here will be useful for choosing accessions as parents to make crosses in breeding programs and prioritizing accessions for regeneration to improve germplasm management. A subset of 230 accessions was selected and will be planted in the field for establishing a core collection of the US castor germplasm. Further evaluation of the US castor germplasm collection is also discussed.
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Affiliation(s)
- M L Wang
- a USDA-ARS, Plant Genetic Resources Conservation Unit, 1109 Experiment Street, Griffin, GA 30223, USA
| | - M Dzievit
- b Department of Agronomy, Iowa State University, 2014 Agronomy Hall, Ames, IA 50011, USA
| | - Z Chen
- c Department of Crop and Soil Sciences, University of Georgia, 1109 Experiment Street, Griffin, GA 30223, USA
| | - J B Morris
- a USDA-ARS, Plant Genetic Resources Conservation Unit, 1109 Experiment Street, Griffin, GA 30223, USA
| | - J E Norris
- d Emory University Hospital, Emory University, 1364 Clifton Road, Atlanta, GA 30322, USA
| | - N A Barkley
- a USDA-ARS, Plant Genetic Resources Conservation Unit, 1109 Experiment Street, Griffin, GA 30223, USA
| | - B Tonnis
- a USDA-ARS, Plant Genetic Resources Conservation Unit, 1109 Experiment Street, Griffin, GA 30223, USA
| | - G A Pederson
- a USDA-ARS, Plant Genetic Resources Conservation Unit, 1109 Experiment Street, Griffin, GA 30223, USA
| | - J Yu
- b Department of Agronomy, Iowa State University, 2014 Agronomy Hall, Ames, IA 50011, USA
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Fan YJ, Dai CY, Huang DC, Wang ML. Does tracheal intubation really matter? Discrepant survival between laryngeal mask and endotracheal intubation during out-of-hospital cardiac arrest. J Formos Med Assoc 2016; 116:134-135. [PMID: 28003114 DOI: 10.1016/j.jfma.2016.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Revised: 11/06/2016] [Accepted: 11/08/2016] [Indexed: 11/29/2022] Open
Affiliation(s)
- Yu-Jiun Fan
- Department of Surgery, National Taiwan University Hospital Taipei, Taiwan
| | - Chun-Yi Dai
- Center for Emergency Medical Service, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - De-Ching Huang
- New Taipei City Fire Department, New Taipei City, Taiwan
| | - Man-Ling Wang
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan.
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Wang ML, Ni CH, Xia YK. [The founding analysis of national natural science foundation in the field of occupational and environmental health]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2016; 34:704-706. [PMID: 27866559 DOI: 10.3760/cma.j.issn.1001-9391.2016.09.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Wang ML, Hung MH, Chan KC, Chen JS, Cheng YJ. Intraoperative multiple intercostal nerve blocks exert anesthetic-sparing effect: A retrospective study on the effect-site concentration of propofol infusion in nonintubated thoracoscopic surgery. ACTA ACUST UNITED AC 2016; 54:77-80. [DOI: 10.1016/j.aat.2016.07.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 06/03/2016] [Accepted: 07/11/2016] [Indexed: 11/28/2022]
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Lemon SC, Wang ML, Haughton CF, Estabrook DP, Frisard CF, Pagoto SL. Methodological quality of behavioural weight loss studies: a systematic review. Obes Rev 2016; 17:636-44. [PMID: 27071775 PMCID: PMC5996374 DOI: 10.1111/obr.12412] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 02/29/2016] [Accepted: 03/01/2016] [Indexed: 11/30/2022]
Abstract
This systematic review assessed the methodological quality of behavioural weight loss intervention studies conducted among adults and associations between quality and statistically significant weight loss outcome, strength of intervention effectiveness and sample size. Searches for trials published between January, 2009 and December, 2014 were conducted using PUBMED, MEDLINE and PSYCINFO and identified ninety studies. Methodological quality indicators included study design, anthropometric measurement approach, sample size calculations, intent-to-treat (ITT) analysis, loss to follow-up rate, missing data strategy, sampling strategy, report of treatment receipt and report of intervention fidelity (mean = 6.3). Indicators most commonly utilized included randomized design (100%), objectively measured anthropometrics (96.7%), ITT analysis (86.7%) and reporting treatment adherence (76.7%). Most studies (62.2%) had a follow-up rate > 75% and reported a loss to follow-up analytic strategy or minimal missing data (69.9%). Describing intervention fidelity (34.4%) and sampling from a known population (41.1%) were least common. Methodological quality was not associated with reporting a statistically significant result, effect size or sample size. This review found the published literature of behavioural weight loss trials to be of high quality for specific indicators, including study design and measurement. Identified for improvement include utilization of more rigorous statistical approaches to loss to follow up and better fidelity reporting.
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Affiliation(s)
- S C Lemon
- UMass Worcester Prevention Research Center, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - M L Wang
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
| | - C F Haughton
- UMass Worcester Prevention Research Center, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - D P Estabrook
- UMass Worcester Prevention Research Center, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - C F Frisard
- UMass Worcester Prevention Research Center, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - S L Pagoto
- UMass Worcester Prevention Research Center, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, USA
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Wang FW, Wang ML, Guo C, Wang N, Li XW, Chen H, Dong YY, Chen XF, Wang ZM, Li HY. Cloning and characterization of a novel betaine aldehyde dehydrogenase gene from Suaeda corniculata. Genet Mol Res 2016; 15:gmr7848. [PMID: 27420939 DOI: 10.4238/gmr.15027848] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Glycine betaine is an important quaternary ammonium compound that is produced in response to several abiotic stresses in many organisms. The synthesis of glycine betaine requires the catalysis of betaine aldehyde dehydrogenase (BADH), which can convert betaine aldehyde into glycine betaine in plants, especially in halotolerant plants. In this study, we isolated the full-length cDNA of BADH from Suaeda corniculata (ScBADH) using reverse transcriptase-polymerase chain reaction and rapid amplification of cDNA ends. Next, we analyzed the expression profile of ScBADH using real-time PCR. The results showed that ScBADH expression was induced in the roots, stems, and leaves of S. corniculata seedlings under salt and drought stress. Next, ScBADH was overexpressed in Arabidopsis, resulting in the transgenic plants exhibiting enhanced tolerance over wild-type plants under salt and drought stress. We then analyzed the levels of glycine betaine and proline, as well as superoxide dismutase (SOD) activity, during salt stress in WT and transgenic Arabidopsis. The results indicated that overexpression of ScBADH produced more glycine betaine and proline, and increased SOD activity under NaCl treatment. Our results suggest that ScBADH might be a positive regulator in plants during the response to NaCl.
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Affiliation(s)
- F W Wang
- College of Life Sciences, Engineering Research Center of the Chinese Ministry of Education for Bioreactor and Pharmaceutical Development, Jilin Agricultural University, Changchun, Jilin, China
| | - M L Wang
- College of Life Sciences, Engineering Research Center of the Chinese Ministry of Education for Bioreactor and Pharmaceutical Development, Jilin Agricultural University, Changchun, Jilin, China
| | - C Guo
- College of Life Sciences, Engineering Research Center of the Chinese Ministry of Education for Bioreactor and Pharmaceutical Development, Jilin Agricultural University, Changchun, Jilin, China
| | - N Wang
- College of Life Sciences, Engineering Research Center of the Chinese Ministry of Education for Bioreactor and Pharmaceutical Development, Jilin Agricultural University, Changchun, Jilin, China
| | - X W Li
- College of Life Sciences, Engineering Research Center of the Chinese Ministry of Education for Bioreactor and Pharmaceutical Development, Jilin Agricultural University, Changchun, Jilin, China
| | - H Chen
- College of Life Sciences, Engineering Research Center of the Chinese Ministry of Education for Bioreactor and Pharmaceutical Development, Jilin Agricultural University, Changchun, Jilin, China
| | - Y Y Dong
- College of Life Sciences, Engineering Research Center of the Chinese Ministry of Education for Bioreactor and Pharmaceutical Development, Jilin Agricultural University, Changchun, Jilin, China
| | - X F Chen
- Jilin Technology Innovation Center for Soybean Region, Jilin Agricultural University, Changchun, Jilin, China
| | - Z M Wang
- Jilin Technology Innovation Center for Soybean Region, Jilin Agricultural University, Changchun, Jilin, China
| | - H Y Li
- College of Life Sciences, Engineering Research Center of the Chinese Ministry of Education for Bioreactor and Pharmaceutical Development, Jilin Agricultural University, Changchun, Jilin, China
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Lu H, Peng ZH, Zhao LP, Tang SW, Zhou M, Wang JM, Zhang J, Wang ML, Yi HG, Li Z, Hu ZB. [Study on learning experiences and influence factors of public health problem-based learning course]. Zhonghua Yu Fang Yi Xue Za Zhi 2016; 50:373-376. [PMID: 27029374 DOI: 10.3760/cma.j.issn.0253-9624.2016.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- H Lu
- PBL Education Center, School of Public Health, Nanjing Medical University, Nanjing 211166, China
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