Time filter

Source Type

Yang X.-K.,General Hospital of Chengdu Command | Xu G.-S.,General Hospital of Chengdu Command
Medical Journal of Chinese People's Liberation Army | Year: 2013

Objective To evaluate the therapeutic effect of glucocorticoid in the treatment of HBV-related hepatic failure. Methods Literature was retrieved from Medline, PubMed, EMbase, OUP, Elesiver, BIOSIS, HMIC, CNKI, VIP, WANFANG Database and CBM Database from Jan. 1989 to Jan. 2012 to collect the papers concerning the clinical trials (published in English and Chinese) referring to glucocorticoid treatment and routine treatment for hepatic failure by meta-analysis method. Weighted mean (WM) was applied to evaluate the effect of glucocorticoid on prothrombin time (PT) and total bilirubin (TBil), and odds ratio (OR) was applied to evaluate the effect of glucocorticoid on survival rate, secondary infection and alimentary tract hemorrhage. Results Above-mentioned indexes included 24, 6, 9, 10, and 9 related articles. The effective indexes and 95% confidence interval (CI) were 3.12 (95%CI: 2.53-3.86), -0.48 (95%CI: -0.71--0.25), -1.01 (95%CI: -1.29--0.73), 0.80 (95%CI: -0.58-1.10) and 0.59 (95%CI: -0.41-0.85), respectively. Treatment with glucocorticoid decreased the mortality of patients with hepatic failure (Z=10.37, P=0.000), and improved PT and TBil levels (Z=4.10, P=0.000; Z=7.07, P=0.000), but no change was found in incidence of secondary infection and alimentary tract hemorrhage (Z=1.39, P=0.165; Z=1.69, P=0.095). Conclusion Glucocorticoid shows an obvious effect on the prognosis of patients with hepatic failure with no increase in complications.


Gao M.,Luzhou Medical College | Xiao Z.-L.,General Hospital of Chengdu Command | Li F.-X.,General Hospital of Chengdu Command
Medical Journal of Chinese People's Liberation Army | Year: 2013

Acute respiratory distress syndrome (ARDS) is closely correlated with infection. Severe infection, e.g., sepsis and septic shock, can result in ARDS. Ventilator associated pneumonia (VAP) is one of the common complications in ARDS related infection. As regards ARDS related infection, community acquired infection (CAI) is different from hospital acquired infection (HAI) in bacterial spectrum. The former is mainly caused by Streptococcus pneumonia, Hemophilus influenzae, Moraxelle catarrhalis, atypical pathogens and Klebsiella pneumoniae. However, HAI is mainly caused by Pseudomonas aeruginosa, Acinetobacter baumanii, methicillin- resistant Staphylococcus aureus (MRSA), and other drug-resistant bacteria. The drug-resistant bacterial infection not only makes treatment difficult, but also leads to an increase in mechanical ventilation time, length of ICU stay, mortality rate, and medical costs. The present paper has reviewed the relationship between ARDS and infection, therapeutic principles and measures of ARDS related infection, and introduced the optimal strategy of anti-infectious treatment of ARDS.


Li W.,General Hospital of Chengdu Command | Dan G.,General Hospital of Chengdu Command | Jiang J.,General Hospital of Chengdu Command | Zhao Y.,University of Sichuan | Deng D.,University of Sichuan
Journal of Surgical Research | Year: 2013

Background: Chylothorax is a pathologic condition defined by an accumulation of lymphatic fluid, the chyle, in the thorax. Postoperative chylothorax is a potentially lethal complication, with a reported mortality rate of 15.4%-25%. Patients and methods: Esophageal cancer patients hospitalized for elective radical esophagectomy by thoracotomy (n =10,574) were consecutively enrolled between January 1996 and December 2011. Patients (n =306) who experienced post-esophagectomy chylothorax were assigned to a 48-h (group A, n =186) or to a 2-wk (group B, n =120) conservative treatment regimen. For patients with a daily chylothorax output >1000 mL, thoracic duct ligation (TDL) was performed by thoracotomy. Measured outcomes included frequency of TDL, overall and treatment-specific morbidity and mortality rates, and the rate of chylothorax recurrence. Results: A total of 171 patients (171 of 306 [55.9%]) underwent TDL. A larger proportion of patients in group A required TDL compared with group B (72.6% versus 30.0%, P < 0.001). Group A had a significantly higher rate of overall morbidity compared with group B (31.7% versus 19.2%, P =0.02). Moreover, the overall mortality rate was significantly higher in group A (14.0% versus 4.2%, P =0.006). Chylothorax recurred in nine patients (9 of 306 [2.9%]), and there was no difference between the two groups (3.2% versus 2.5%, P =1.000). Conclusions: The 2-wk regimen reduced the requirement for TDL and the overall morbidity and mortality rates compared with the 48-h regimen. Importantly, this regimen does not increase the risk of chylothorax recurrence. © 2013 Elsevier Inc. All rights reserved.


Du F.-Z.,General Hospital of Chengdu Command | Gu M.,General Hospital of Chengdu Command | He C.,General Hospital of Chengdu Command | Jiang R.,General Hospital of Chengdu Command | Guan J.,General Hospital of Chengdu Command
Medical Journal of Chinese People's Liberation Army | Year: 2014

Objective The perfusion and vascular architecture features were investigated and evaluated by use of one-stop imaging technique with 320 rows CT for exploring the clinical value of one-stop imaging technique in the diagnosis of intracranial lesions. Methods The perfusion parameters and vascular architecture of intracranial high perfusion lesions of 52 patients were collected in General Hospital of Chengdu Command from Oct. 2010 to Apr. 2013, who were examined by one-stop imaging technique with 320 rows CT, were retrospectively analyzed. The perfusion values of normal contralateral cerebral tissue were used as control to analyze the perfusion and vascular architecture features of injured parts. Results Of the 52 patients, there were 16 cases of subacute cerebral infarction, 9 cases of arteriovenous malformation, 7 cases of hemangioma, 12 cases of meningioma, and 8 cases of glioma. All the patients showed elevated CBV and/or CBF and different changes in mean transit time (MTT), time to peak (TTP) and delay time (Delay). In the cases of subacute cerebral infarction, the parameters of MTT, TTP and Delay increased. In the cases of arteriovenous malformation, all the parameters decreased. In the cases of hemangioma, the MTT decreased, while TTP and Delay increased. In the cases of glioma, the TTP and Delay increased, while the change of MTT varied. Meanwhile, abnormality of vascular structures was found in all the cases by CT angiography. Conclusion With whole brain perfusion and one-stop vascular imaging with 320 rows CT, the perfusion characteristics of intracranial lesions can be revealed completely, including blood supply and microcirculation changes in the lesions, and it may be of benefit in guiding the clinical diagnosis and treatment.


Gong J.-Q.,Peoples Liberation Army General Hospital of Chengdu Command | Ren J.-D.,Peoples Liberation Army General Hospital of Chengdu Command | Tian F.-Z.,Peoples Liberation Army General Hospital of Chengdu Command | Jiang R.,General Hospital of Chengdu Command | And 2 more authors.
World Journal of Gastroenterology | Year: 2011

To propose a new classifcation system for sphincter of Oddi dysfunction (SOD) based on clinical data of patients. METHODS: The clinical data of 305 SOD patients documented over the past decade at our center were analyzed retrospect tively, and typical cases were reported. RESULTS: The new classifcation with two more types (double-duct, biliary-pancreatic reflux) were set up on the basis of the Milwaukee criteria. There were 229 cases of biliary-type SOD, including 192 (83.8%) cases cured endoscopically, and 29 (12.7%) cured by open abdominal surgery, and the remaining 8 (3.5%) cases observed with unstable outcomes. Eight (50%) patients with pancreatic-type SOD were cured by en-doscopic treatment, and the remaining 8 patients were cured after open abdominal surgery. There were 19 cases of double-duct-type SOD, which consisted of 7 (36.8%) patients who were cured endoscopically and 12 (63.2%) who were cured surgically. A total of 41 cases were diagnosed as biliary-pancreatic-reflux-type SOD. Twenty (48.8%) of them were treated endoscopically, 16 (39.0%) were treated by open abdominal surgery, and 5 (12.2%) were under observation. CONCLUSION: The newly proposed SOD classification system introduced in this study better explains the clinical symptoms of SOD from the anatomical perspective and can guide clinical treatment of this disease. © 2011 Baishideng. All rights reserved.


Gong J.,The Peoples Liberation Army General Hospital of Chengdu Command | Wang Y.,The Peoples Liberation Army General Hospital of Chengdu Command | Jiang R.,General Hospital of Chengdu Command | Zhang G.,The Peoples Liberation Army General Hospital of Chengdu Command | Tian F.,The Peoples Liberation Army General Hospital of Chengdu Command
Biochemical and Biophysical Research Communications | Year: 2013

Objective: The purpose of this study was to investigate the expression of collagen type I and the mRNA level of its regulatory factor, TGF-β1, in tissue samples of acute pancreatitis and to determine the significance of collagen type I in predisposition to pancreatic fibrosis during acute pancreatitis. Methods: Sprague-Dawley rats were divided into an experimental group (30 rats) and a control group (12 rats). The rats in the experimental group were intraperitoneally injected with cerulein to induce acute pancreatitis. The distribution and expression of collagen type I in the pancreatic tissues were examined by immunohistochemical staining. The mRNA level of TGF-β1 was determined by real-time polymerase chain reaction (PCR). Results: (1) Collagen type I was localized in the cytoplasm of pancreatic acinar cells. With pancreatitis progressed, strong positive staining for collagen type I covered whole pancreatic lobules, whereas, the islet tissue, interlobular area, and pancreatic necrotic area were negative for collagen type I. (2) The level of TGF-β1 mRNA in rats from the experimental group increased gradually the establishment of acute pancreatitis, and was significantly higher than that in the control group at every time point. Conclusions: (1) During acute pancreatitis, pancreatic acinar cells, not pancreatic stellate cells as traditionally believed, were the naïve effector cells of collagen type I. (2) TGF-β1 played a key role in regulating collagen I expression during acute pancreatitis. © 2013 Elsevier Inc.


Deng C.,General Hospital of Chengdu Command | Cao J.-Q.,General Hospital of Chengdu Command | Liang H.-Y.,General Hospital of Chengdu Command | Chen G.-Y.,General Hospital of Chengdu Command | And 3 more authors.
Medical Journal of Chinese People's Liberation Army | Year: 2016

Objective To study the protective effect of early peritoneal drainage against injury of intestinal mucosa in rats with severe acute pancreatitis. Methods Thirty-six SD rats were randomly and equally divided into three group, i.e. control group, model (SAP) group, drainage (APD) group. Severe acute pancreatitis was induced in rats by injecting 5% sodium taurocholate (2ml/h, 0.1ml/100g) into the common biliopancreatic duct. All the rats were sacrificed 24 hours after operation. The condition of abdominal cavity was observed, and pathological changes in ileum were detected by HE staining. The serum levels of TNF-α, IL-1β, diamine oxidase (DAO) and D-lactate were determined by ELISA. Results Compared with the control group, the histopathological changes in ileum were more marked, and serum levels of TNF-α, IL-1β, DAO and D-lactate were significantly higher in SAP group and APD group (P<0.05); Compared with SAP group, the histopathological changes in ileum were less marked, and serum levels of TNF-α, IL-1β, DAO and D-lactate were significantly lower in APD group (P<0.05). Conclusion Early peritoneal drainage can effectively improve the intestinal mucosal injury in acute pancreatitis rats, and reduce the systemic inflammatory response. © 2016, People’s Military Medical Press. All rights reserved.


Wei S.-J.,Chongqing Medical University | Wei S.-J.,General Hospital of Chengdu Command | Ma S.-T.,General Hospital of Chengdu Command | Zhang Y.,General Hospital of Chengdu Command | And 4 more authors.
Medical Journal of Chinese People's Liberation Army | Year: 2016

Objective To investigate the correlation of the expression level of mammalian target of rapamycin (mTOR) gene in peripheral blood lymphocyte with the degree of stenosis of the coronary artery. Methods One hundred and seventy consecutive patients (male 86, female 84, aged from 18 to 82) who received coronary angiography (CAG) in the General Hospital of Chengdu Command were divided into coronary stenosis group and coronary normal group according to the result of CAG, and the Gensini scores were calculated based on the result of selective CAG. For the two groups, the age, gender, ethnic group, height and weight were collected, and the fasting glucose, lipids, liver and renal function parameters were measured, the total RNA was extracted from peripheral blood lymphocytes, and the mTOR expression level was measured, the correlation between mTOR expression level and other cardiovascular risk factors with Gensini score was then analyzed. Results Among the 170 patients, the age, body mass index, triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and the expression level of mTOR gene in peripheral blood lymphocyte were significantly higher in coronary stenosis group than in normal group (P<0.05). Positive correlation was found between the Gensini score with the age, the levels of plasma TG and TC, and the expressions level of mTOR gene, and the correlation coefficients (r) were 0.207, 0.254, 0.236 and 0.343, respectively (P<0.01). Conclusions The mTOR expression level in peripheral blood lymphocytosis is positively correlated with the degree of coronary artery stenosis, implying that the monocyte mTOR may play an important role in the generation and development of coronary atherosclerosis. © 2016, People's Military Medical Press. All rights reserved.


Li W.,General Hospital of Chengdu Command | Dan G.,General Hospital of Chengdu Command | Jiang J.,General Hospital of Chengdu Command | Yang L.,General Hospital of Chengdu Command | Huang X.,Chongqing Medical University
Chinese Journal of Lung Cancer | Year: 2010

Background and objective: 125I seed implantation treatment of pulmonary metastases, often because of complicated structure of the chest, was considered as restricted areas. The aim of this study is to evaluate the effectiveness of CT guided radioactive 125I seed implantation in treating lung metastatic tumors. Methods: Totally 115 metastatic masses were found in 30 patients with CT guiding. 125I seeds were implanted into lung metastatic masses. The approach of implantation was determined according to the location of the lesions (hilar masses, peripheral masses and masses covered by skeletal thorax). The therapeutic effects were evaluated by CT. Results: Uniform distribution were achieved by single puncture in 84.3% of patients. The rest patients (15.7%) were received replanting. The follow-up period was 6-24 months (mean 14.6). Among 115 lesions in 30 cases, complete response (CR) was achieved in 80 nodes, partial response (PR) in 20 nodes, No change (NC) in 8 nodes and progressive disease (PD) in 7 nodes. The total response rate was 86.9%. The one-year local control rate were 93.9% (108/115). No severe perioperative complications occurred. Conclusion: CT guided radioactive seed 125I implantation is a safe and effective procedure in treating multiple lung metastatic tumor with minimal invasion.


PubMed | General Hospital of Chengdu Command
Type: Journal Article | Journal: Zhongguo fei ai za zhi = Chinese journal of lung cancer | Year: 2010

125I seed implantation treatment of pulmonary metastases, often because of complicated structure of the chest, was considered as restricted areas. The aim of this study is to evaluate the effectiveness of CT guided radioactive 125I seed implantation in treating lung metastatic tumors.Totally 115 metastatic masses were found in 30 patients with CT guiding. 125I seeds were implanted into lung metastatic masses. The approach of implantation was determined according to the location of the lesions (hilar masses, peripheral masses and masses covered by skeletal thorax). The therapeutic effects were evaluated by CT.Uniform distribution were achieved by single puncture in 84.3% of patients. The rest patients (15.7%) were received replanting. The follow-up period was 6-24 months (mean 14.6). Among 115 lesions in 30 cases, complete response (CR) was achieved in 80 nodes, partial response (PR) in 20 nodes, No change (NC) in 8 nodes and progressive disease (PD) in 7 nodes. The total response rate was 86.9%. The one-year local control rate were 93.9% (108/115). No severe perioperative complications occurred.CT guided radioactive seed 125I implantation is a safe and effective procedure in treating multiple lung metastatic tumor with minimal invasion.

Loading General Hospital of Chengdu Command collaborators
Loading General Hospital of Chengdu Command collaborators