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2 results on '"Lyu, Rui"'

1. Effect of ischemic preconditioning and ulinastatin infusion on cardiopulmonary function in the elderly after single knee replacement

Author

LU Sunshan, CHEN Xingtong, HE Xinhai, TIAN Guoping, and LYU Rui

Subjects
aged, knee arthroplasty, cardiopulmonary function, ischemic preconditioning, ulinastatin, Medicine (General), R5-920
Abstract

Objective To observe the changes of cardiopulmonary function in elderly patients undergoing unilateral knee arthroplasty, and to explore the effects of ischemic preconditioning and ulinastatin infusion on them. Methods A total of 45 elderly patients undergoing knee arthroplasty under epidural combined subarachnoid anesthesia in our hospital from November 2012 to May 2018 were prospectively recruited in this study. They were randomly divided into control group (Group C, n=15, routine anesthesia management), limb ischemic preconditioning group (Group IP, n=15, the tourniquet pressurized to 480 mmHg followed by being opened 5 min later, 3 cycles before surgery) and ulinastati infusion group [Group U, n=15, venous infusion of 200 kU ulinastatin within 20 min after anesthesia, then continuously pumping at 20 U/(kg·min) until the end of surgery]. Iliac (femoral) arterial blood samples were collected at 5 min before (T0) and 1 (T1), 6 (T2) and 24 h (T3) after tourniquets were relaxed. Myocardial enzymes detection (CK, CKMB, LDH), blood gas analysis [respiratory index (RI), lactic acid (cLac)], inflammatory cytokines (TNF-α, IL-1, IL-6), malondialdehyde (MDA) and xanthine oxidase (XOD) measurement were carried out respectively. Results In Group C, CK were significantly increased at T2 and T3 (P < 0.05), RI remarkably rose at T1 and T2 (P < 0.05), cLac and OXD also elevated notably at T2 (P < 0.05) when compared with the levels at T0. These markers were significantly reduced in Group IP at T2 (P < 0.05) and tended to decline in Group U at the above time points (P>0.05). There were no obvious differences in the levels of CKMB, LDH, TNF-α, IL-1, IL-6 and MDA in intra- or inter-groups (P>0.05). Conclusion For the elderly patients undergoing knee arthroplasty, no significant changes are seen in cardiac function, but their pulmonary function may be impaired at different degrees due to oxidative stress instead of systemic inflammatory reaction. Lower limb ischemic preconditioning can improve pulmonary function by inhibiting oxidative stress.

Published
2019
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2. Chronic Lymphocytic Leukemia Prognostic Index: A New Integrated Scoring System to Predict the Time to First Treatment in Chinese Patients with Chronic Lymphocytic Leukemia

Author

Li, Heng, Yi, Shu-Hua, Xiong, Wen-Jie, Liu, Hui-Min, Lyu, Rui, Wang, Ting-Yu, Liu, Wei, Zhong, Shi-Zhen, Yu, Zhen, Zou, De-Hui, Xu, Yan, An, Gang, Li, Zeng-Jun, and Qiu, Lu-Gui

Subjects
Adult, Male, China, DNA Mutational Analysis, lcsh:Medicine, hemic and lymphatic diseases, 17p Deletion, Humans, Chronic Lymphocytic Leukemia, In Situ Hybridization, Fluorescence, Aged, Aged, 80 and over, Chromosome Aberrations, lcsh:R, Prognostic Index, Immunoglobulin Heavy Chain Variable Mutation, Time to First Treatment, Middle Aged, Prognosis, Leukemia, Lymphocytic, Chronic, B-Cell, Mutation, Original Article, Female, Immunoglobulin Heavy Chains, Chromosomes, Human, Pair 17
Abstract

Background: The established clinical staging systems (Rai/Binet) of chronic lymphocytic leukemia (CLL) cannot accurately predict the appropriate treatment of patients in the earlier stages. In the past two decades, several prognostic factors have been identified to predict the outcome of patients with CLL, but only a few studies investigated more markers together. To predict the time to first treatment (TTFT) in patients of early stages, we evaluated the prognostic role of conventional markers as well as cytogenetic abnormalities and combined them together in a new prognostic scoring system, the CLL prognostic index (CLL-PI). Methods: Taking advantage of a population of 406 untreated Chinese patients with CLL at early and advanced stage of disease, we identified the strongest prognostic markers of TTFT and, subsequently, in a cohort of 173 patients who had complete data for all 3 variables, we integrated the data of traditional staging system, cytogenetic aberrations, and mutational status of immunoglobulin heavy chain variable region (IGHV) in CLL-PI. The median follow-up time was 45 months and the end point was TTFT. Results: The median TTFT was 38 months and the 5-year overall survival was 80%. According to univariate analysis, patients of advanced Rai stages (P < 0.001) or with 11q- (P = 0.002), 17p- (P < 0.001), unmutated IGHV (P < 0.001), negative 13q- (P = 0.007) and elevated lactate dehydrogenase levels (P = 0.001) tended to have a significantly shorter TTFT. And subsequently, based on multivariate Cox regression analysis, three independent factors for TTFT were identified: advanced clinical stage (P = 0.002), 17p- (P = 0.050) and unmutated IGHV (P = 0.049). Applying weighted grading of these independent factors, a CLL-PI was constructed based on regression parameters, which could categorize four different risk groups (low risk [score 0], intermediate low [score 1], intermediate high [score 2] and high risk [score 3-6]) with significantly different TTFT (median TTFT of not reached (NR), 65.0 months, 36.0 months and 19.0 months, respectively, P < 0.001). Conclusions: This study developed a weighted, integrated CLL-PI prognostic system of CLL patients which combines the critical genetic prognostic markers with traditional clinical stage. This novel modified PI system could be used to discriminate among groups and may help predict the TTFT and prognosis of patients with CLL.

Published
2017

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