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Development and validation of a predictive model for the assessment of potassium-lowering treatment among hyperkalemia patients

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World Journal of Emergency Medicine 2023年第3期14卷 198-203页

作者： Cong-ying Song jian-yong zhu Wei Huang Yuan-qiang Lu Department of Emergency Medicine the First Affi liated HospitalSchool of MedicineZhejiang UniversityHangzhou 310003China Key Laboratory for Diagnosis and Treatment of Aging and Physic-chemical Injury Diseases of Zhejiang Province Hangzhou 310003China

BACKGROUND:Hyperkalemia is common among patients in emergency department and is associated with ***,there is a lack of good evaluation and prediction methods for the effi cacy of potassium-lowering treatment,making the drug dosage adjustment quite diffi *** aimed to develop a predictive model to provide early forecasting of treating eff ects for hyperkalemia ***:Around 80%of hyperkalemia patients(n=818)were randomly selected as the training dataset and the remaining 20%(n=196)as the validating *** to the serum potassium(K+)levels after the fi rst round of potassium-lowering treatment,patients were classifi ed into the eff ective and ineff ective *** logistic regression analyses were performed to develop a prediction *** receiver operating characteristic(ROC)curve and calibration curve analysis were used for model ***:In the training dataset,429 patients had favorable eff ects after treatment(eff ective group),and 389 had poor therapeutic outcomes(ineff ective group).Patients in the ineff ective group had a higher percentage of renal disease(P=0.007),peripheral edema(P<0.001),oliguria(P=0.001),or higher initial serum K+level(P<0.001).The percentage of insulin usage was higher in the effective group than in the ineff ective group(P=0.005).After multivariate logistic regression analysis,we found age,peripheral edema,oliguria,history of kidney transplantation,end-stage renal disease,insulin,and initial serum K+were all independently associated with favorable treatment eff ***:The predictive model could provide early forecasting of therapeutic outcomes for hyperkalemia patients after drug treatment,which could help clinicians to identify hyperkalemia patients with high risk and adjust the dosage of medication for potassium-lowering.

关键词： Hyperkalemia Predictive model Potassium-lowering treatment Therapeutic outcome

Development and validation of a nomogram model for predicting the risk of gallstone recurrence after gallbladder-preserving surgery

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Hepatobiliary & Pancreatic Diseases International 2024年第3期23卷 288-292页

作者： Peng Liu yong-Wei Chen Che Liu Yin-Tao Wu Wen-Chao Zhao jian-yong zhu Yang An Nian-Xin Xia Faculty of Hepato-Pancreato-Biliary Surgery the First Medical CenterChinese PLA General HospitalBeijing 100853China Institute of Hepatobiliary Surgery of Chinese PLA Beijing 100853China Key Laboratory of Digital Hepetobiliary Surgery of Chinese PLA Beijing 100853China

Background:The high incidence of gallstone recurrence was a major concern for laparoscopic gallbladderpreserving *** study aimed to investigate the risk factors for gallstone recurrence after gallbladder-preserving surgery and to establish an individualized nomogram model to predict the risk of gallstone ***:The clinicopathological and follow-up data of 183 patients who were initially diagnosed with gallstones and treated with gallbladder-preserving surgery at our hospital from January 2012 to January 2019 were retrospectively *** independent predictive factors for gallstone recurrence following gallbladder-preserving surgery were identified by multivariate logistic regression analysis.A nomogram model for the prediction of gallstone recurrence was constructed based on the selected *** C-index,receiver operating characteristic(ROC)curve and calibration curve were used to evaluate the predictive power of the nomogram model for gallstone ***:During the follow-up period,a total of 65 patients experienced gallstone recurrence,and the recurrence rate was 35.5%.Multivariate logistic regression analysis revealed that the course of gallstones>2 years[odds ratio(OR)=2.567,95%confidence interval(CI):1.270-5.187,P=0.009],symptomatic gallstones(OR=2.589,95%CI:1.059-6.329,P=0.037),multiple gallstones(OR=2.436,95%CI:1.133-5.237,P=0.023),history of acute cholecystitis(OR=2.778,95%CI:1.178-6.549,P=0.020)and a greasy diet(OR=2.319,95%CI:1.186-4.535,P=0.014)were independent risk factors for gallstone recurrence after gallbladder-preserving surgery.A nomogram model for predicting the recurrence of gallstones was established based on the above five *** results showed that the C-index of the nomogram model was 0.692,suggesting it was valuable to predict gallstone ***,the calibration curve showed good consistency between the predicted probability and actual ***:The nomogram model for

关键词： Gallstone Gallbladder-preserving surgery Recurrence Risk factors Nomogram

Choice of approach for hepatectomy for hepatocellular carcinoma located in the caudate lobe:Isolated or combined lobectomy?

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World Journal of Gastroenterology 2012年第29期18卷 3904-3909页

作者： Peng Liu Bao-An Qiu Gang Bai Hong-Wei Bai Nian-Xin Xia Ying-Xiang Yang jian-yong zhu Yang An Bing Hu Department of Hepato-biliary Surgery anti Liver Transplantation Surgery Navy General Hospital Beijing 100048 China

AIM:To investigate the significance of the surgical approaches in the prognosis of hepatocellular carcinoma(HCC) located in the caudate lobe with a multivariate regression analysis using a Cox proportional hazard ***:Thirty-six patients with HCC underwent caudate lobectomy at a single tertiary referral center between January 1995 and June *** this series,left-sided,right-sided and bilateral approaches were *** outcomes of patients who underwent isolated caudate lobectomy or caudate lobectomy combined with an additional partial hepatectomy were *** survival curves of the isolated and combined resection groups were generated by the Kaplan-Meier method and compared by a log-rank ***:Sixteen(44.4%) of 36 patients underwent isolated total or partial caudate lobectomy whereas 20(55.6%) received a total or partial caudate lobectomy combined with an additional partial *** median diameter of the tumor was 6.7 cm(range,2.1-15.8 cm).Patients who underwent an isolated caudate lobectomy had significantly longer operative time(240 min vs 170 min),longer length of hospital stay(18 d vs 13 d) and more blood loss(780 mL vs 270 mL) than patients who underwent a combined caudate lobectomy(P < 0.05).There were no perioperative deaths in both groups of *** complication rate was higher in the patients who underwent an isolated caudate lobectomy than in those who underwent combined caudate lobectomy(31.3% vs 10.0%,P < 0.05).The 1-,3-and 5-year disease-free survival rates for the isolated caudate lobectomy and the combined caudate lobectomy groups were 54.5%,6.5% and 0% and 85.8%,37.6% and 0%,respectively(P < 0.05).The corresponding overall survival rates were 73.8%,18.5% and 0% and 93.1%,43.6% and 6.7%(P < 0.05).CONCLUSION:The caudate lobectomy combined with an additional partial hepatectomy is preferred because this approach is technically less demanding and offers an adequate surgical margin.

关键词： Hepatocellular carcinoma Hepatectomy Caudate lobectomy Caudate lobe Combined resection

A case report on indirect transmission of human rabies

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2015年第11期16卷 969-970页

作者： jian-yong zhu jian PAN Yuan-qiang LU Department of Emergency Medicine the First Affiliated HospitalSchool of Medicine Zhejiang University

At present, virus infection is still a common threat to public health in developing countries （Liu et al., 2013; Mao et al., 2013; Zhang and Wang, 2014） Human rabies remains a matter of great global concern with a case-fatality of almost 100% （Willoughby et al., 2005; Takayama, 2008）. The rabies virus belongs to the neurotropic type of virus of the Lyssavirus genus, and the disease presents as a deteriorating encephalomyelitis and is endemic throughout much of the world, particularly in Africa and Asia （Fooks et aL, 2014）. Previous data have shown that, globally, approximately 59000 human deaths are caused by rabies per year （Hampson et al., 2011）.

关键词：狂犬病传染病病毒预防接种

Impact of B-mode-ultrasound-guided transhepatic and transperitoneal cholecystostomy tube placement on laparoscopic cholecystectomy

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World Journal of Gastroenterology 2020年第36期26卷 5498-5507页

作者： Peng Liu Che Liu Yin-Tao Wu jian-yong zhu Wen-Chao Zhao Jing-Bo Li Hong Zhang Ying-Xiang Yang Department of Hepatobiliary Surgery The Sixth Medical Center of People’s Liberation Army General HospitalBeijing 100048China

BACKGROUND B-mode-ultrasound-guided percutaneous cholecystostomy(PC)may be performed by a transhepatic or transperitoneal approach,called percutaneous transhepatic gallbladder drainage(PHGD)and percutaneous transperitoneal gallbladder drainage(PPGD),*** compared the impact of PC related to the route of catheter placement on subsequent laparoscopic cholecystectomy(LC).AIM To compare the impact of PC related to the route of catheter placement on subsequent *** We retrospectively studied 103 patients with acute calculous cholecystitis who underwent scheduled LC after PC between January 2010 and January *** I included 58 patients who underwent scheduled LC after *** II included 45 patients who underwent scheduled LC after *** outcomes were analyzed according to each *** Baseline demographic characteristics did not differ significantly between both groups(P>0.05).Both PHGD and PPGD were able to quickly resolve cholecystitis *** I showed significantly higher efficacy than group II in terms of lower pain score during puncture(3.1 vs 4.5;P=0.001)and at 12 h follow-up(1.5 vs 2.2;P=0.001),lower rate of fever within 24 h after PC(13.8%vs 42.2%;P=0.001),shorted operation duration(118.3 vs 139.6 min;P=0.001),lower amount of intraoperative bleeding(72.1 vs 109.4 mL;P=0.001)and shorter length of hospital stay(14.3 d vs 18.0 d;P=0.001).However,group II had significantly lower rate of local bleeding at the PC site(2.2%vs 20.7%;P=0.005)and lower rate of severe adhesion(33.5%vs 55.2%;P=0.048).No significant differences were noted between both groups regarding the conversion rate to laparotomy,rate of subtotal cholecystectomy,complications and *** B-mode-ultrasound-guided PHGD is superior to PPGD followed by LC for treatment of acute calculous cholecystitis,with shorter operating time,minimal amount of intraoperative bleeding and short length of hospital stay.

关键词： Acute calculous cholecystitis Percutaneous transhepatic gallbladder drainage Percutaneous transperitoneal gallbladder drainage Laparoscopic cholecystectomy Bmode ultrasound Acute cholecystitis

Therapeutic effects of the extract of Sancao Formula, a Chinese herbal compound, on imiquimod-induced psoriasis via cysteine-rich protein 61

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Journal of Integrative Medicine 2022年第4期20卷 376-384页

作者： Wan-jun Guo Yi Wang Yu Deng Lin-yan Cheng Xin Liu Ruo-fan Xi Sheng-jie zhu Xin-yi Feng Liang Hua Kan Ze jian-yong zhu Dong-jie Guo Fu-lun Li Department of Dermatology Yueyang Hospital of Integrated Traditional Chinese and Western MedicineShanghai University of Traditional Chinese MedicineShanghai 200437China School of Medicine Chengdu UniversityChengdu 610106Sichuan ProvinceChina Institute of Cancer Biology and Drug Discovery Chengdu UniversityChengdu 610106Sichuan ProvinceChina Clinical Laboratory Medicine Center Yueyang Hospital of Integrated Traditional Chinese and Western MedicineShanghai University of Traditional Chinese MedicineShanghai 200437China

Objective: Psoriasis is a common chronic inflammatory skin disease that is prone to recurrence, and the proinflammatory factor, cysteine-rich protein 61(Cyr61), is important in its pathophysiology. Long-term clinical practice has shown that Sancao Formula(SC), a Chinese herbal compound, is effective in the treatment of psoriasis, but the precise mechanism remains unknown. In this study, we investigate the mechanism by which SC extract alleviates imiquimod(IMQ)-induced ***: The expression of Cyr61 in psoriatic lesions and normal healthy skin was detected using immunohistochemical analysis to investigate the biological role of Cyr61 in models of psoriatic inflammation. A psoriatic mouse model was established by topical application of IMQ, and the effect of topical application of SC extract was evaluated using the psoriasis area and severity index(PASI) score,hematoxylin-eosin staining, and histopathological features of the skin. Next, a HaCaT cell inflammation model was established using interferon-γ(IFN-γ), and the effect of SC extract on the mRNA and protein levels of Cyr61 and intercellular cell adhesion molecule-1(ICAM-1) was confirmed using Western blot and quantitative real-time polymerase chain reaction ***: Immunohistochemical staining showed that the expression of Cyr61 in psoriatic lesions was higher than that in normal skin samples(78.26% vs 41.18%, P < 0.05), and the number of Cyr61-positive cells in psoriatic lesions was also significantly higher than in normal skin(18.66 ± 2.51 vs4.33 ± 1.52, P < 0.05). Treatment in mice with IMQ-induced psoriasis showed that SC extract could significantly improve the inflammatory phenotype, PASI score(10.875 ± 0.744 vs 3.875 ± 0.582, P < 0.05),and pathological features compared with those in IMQ model group;SC treatment was also associated with decreased levels of Cyr61 and ICAM-1. In the IFN-γ-induced inflammatory cell model, the mRNA and protein levels of Cyr61 and ICAM-1 were upregulated, w

关键词： Traditional Chinese medicine Sancao Formula Psoriasis Plant extracts Cysteine-rich protein 61 Intercellular cell adhesion molecule-1

A Review of Compression, Ventilation, Defibrillation, Drug Treatment, and Targeted Temperature Management in Cardiopulmonary Resuscitation

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Chinese Medical Journal 2015年第4期128卷 550-554页

作者： jian Pan jian-yong zhu Ho Sen Kee Qing Zhang Yuan-Qiang Lu Department of Emergency Medicine First Affiliated Hospital School of Medicine Zhejiang University Hangzhou Zhejiang 310003 China School of Medicine Zhejiang University Hangzhou Zhejiang 310003 China

Objective：Important studies of cardiopulmonary resuscitation （CPR） techniques influence the development of new *** systematically reviewed the efficacy of some important studies of *** Sources：The data analyzed in this review are mainly from articles included in PubMed and EMBAS E,published from 1964 to *** Selection：Original articles and critical reviews about CPR techniques were selected for ***：The survival rate after out-of-hospital cardiac arrest （OHCA） is *** improvement is associated with the performance of uninterrupted chest compressions and simple airway management procedures during bystander ***-time feedback devices can be used to improve the quality of *** recommended dose,timing,and indications for adrenaline （epinephrine） use may *** appropriate target temperature for targeted temperature management is still ***：New studies over the past 5 years have evaluated various aspects of CPR in *** of these studies were high-quality randomized controlled trials,which may help to improve the scientific understanding of resuscitation techniques and result in changes to CPR guidelines.

关键词： Cardiopulmonary Resuscitation Defibrillation Epinephrine Ventilation

Blood hemoperfusion with resin adsorption combined continuous veno-venous hemofiltration for patients with multiple organ dysfunction syndrome

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World Journal of Emergency Medicine 2012年第1期3卷 44-48页

作者： Lu-yi Liu yong-jian zhu Xiao-li Li Ya-feng Liang Zuo-peng Liang yong-hong Xia ICU Yuhuangding Hospital

BACKGROUND:Blood hemoperfusion with resin adsorption can clean larger molecules that exceed the molecular weight cutoff of combined continuous veno-venous hemofiltration(CWH).Hence blood hemoperfusion with resin adsorption combined CWH(HP+CWH) has higher ability of mediator clearance,and can improve clinical outcomes in *** study aimed to investigate the effect of blood hemoperfusion with resin adsorption combined continuous veno-venous hemofiltration(HP+CWH) on plasm cytokines like TNF-α,IL-1β,IL-6,cellular immunity and prognosis in patients with multiple organ dysfunction syndrome(MODS).METHODS:This was a prospective,randomized clinical trial.A total of 30 patients who had been diagnosed with MODS were enrolled in this *** were randomly allocated to routine treatment+HP+CWH group(treatment group) and routine treatment+only CWH group(control group).In the treatment group,patients received blood hemoperfusion with resin adsorption for 2hours,and then received CWH for 10 hours every *** the control group,patients received CWH for 12 hours only every *** patients in the two groups received blood purification therapy for three *** plasma of patients in the treatment group was obtained at 0,2,12,24,26,36,48,50,60 hours,5th day,7th day and 10 th day,*** plasma of patients in the control group was obtained at 0,12,24,36,48,60 hours,5th day,7th day and 10 th day,*** Ⅱscore,T-lymphocytes subpopulations,blood lactate acid concentration,heart rate,breathing rate,and oxygenation index were ***:Plasma cytokines like TNF-α,IL-1β,IL-6 decreased markedly after HP(P<0.01);T-lymphocytes subpopulations CD3+,CD4+,CD8+,CD4+/CD8+ increased after HP+CWH or only *** plasma concentrations of TNF-α,IL-1β and IL-6 in the two groups were not markedly different at 12,36,and 50 *** on the 5th day,the plasma concentrations of TNF-α,IL-1β and IL-6 in the treatment group were lower than those in the control group(P<

关键词： Hemoperfusion with resin adsorption Continuous veno-venous hemofiltration Multiple organ dysfunction syndrome Cytokines

A multivariate analysis of the prognostic factors of grade Ⅲ gliomas

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Chinese Medical Journal 2008年第12期121卷 1072-1075页

作者： zhu yong-jian zhu Xiang-dong WANG Sheng-hu SHEN Fang SHEN Hong LIU Wei-guo Department of Neurosurgery Second Affiliated Hospital of Zhejiang University School of Medicine Hangzhou Zhejiang 310009 China

Background Glioma is the most common type of malignant brain tumor and the prognosis of glioma is still poor. Moreover, the prognosis of patients diagnosed with grade Ⅲ gliomas varies significantly. In this study, we assessed the factors that contribute to the prognosis of patients with grade Ⅲ gliomas.Methods Data from 97 patients with grade Ⅲ glioma who received surgery from 2000 to 2005 were included in this study. Kaplan-Meier survival analysis and Cox regression analysis were used to analyze the prognostic effects of 16 different factors selected from clinical characteristics, results from neuroimaging and pathological examinations, as well as different treatment schemes.Results The results indicated that age, preoperative Karnofsky Performance Scale score, extent of tumor invasion, tumor resection degree, residual tumor shown by postoperative magnetic resonance imaging （MRI）, and postoperative radiotherapy and chemotherapy all correlated with patient prognosis. Furthermore, Cox multivariate analysis also showed the age （P 〈0.01）, extent of tumor invasion （P 〈0.01）, residual tumor shown by postoperative MRI （P 〈0.05）, and postoperative radiotherapy （P 〈0.05） significantly correlated with patients＇ prognosis.Conclusions Age, postoperative radiotherapy and residual tumor indicated by MRI after surgery correlated significantly with the prognosis of patients with grade Ⅲ glioma. The extent of tumor invasion may be an independent prognostic factor for patients with grade Ⅲ glioma.

关键词： grade Ⅲ glioma prognosis Cox model