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Biomedical subjects

W X Zhu

Publications and source records attributed to W X Zhu.

At least 19 recordsLinked to original sources
PubMed1997

Health in China. Traditional Chinese medicine: one country, two systems.

China is the only country in the world where Western medicine and traditional medicine are practised alongside each other at every level of the healthcare system. Traditional Chinese medicine has a unique theoretical and practical approach to the treatment of disease, which has developed over thousands of years. Traditional treatments include herbal remedies, acupuncture, acupressure and massage, and moxibustion. They account for around 40% of all health care delivered in China. The current government policy of expansion of traditional facilities and manpower is being questioned because many hospitals using traditional Chinese medicine are already underutilized and depend on government subsidies for survival. Research priorities include randomised controlled trials of common treatments and analysis of the active agents in herbal remedies. As more studies show the clinical effectiveness of traditional Chinese medicine, an integrated approach to disease using a combination of Western medicine and traditional approaches becomes a possibility for the future.

China↗
PubMed1997

Maternal and child health in China.

China has made great progress in improving the health of women and children over the past two generations. The success has been attributed to improved living standards, public health measures, and good access to health services. Although overall infant and maternal mortality rates are relatively low there are large differences in patterns of mortality between urban and rural areas. The Chinese have developed a hierarchical network of maternal and child health services, with each level taking a supervisory and teaching role for the level below it. Maternal and child health in China came to international attention in 1995 with the promulgation of the maternal and child health law. In China this was seen as a means of prioritising resources and improving the quality of services, but in the West it was widely described as a law on eugenics.

Child↗
PubMed1997

The one child family policy: the good, the bad, and the ugly.

Rapid population growth in China during the 1950s and '60s led to the "late, long, few" policy of the 1970s and a dramatic reduction in the total fertility rate. However, population growth remained too high for the economic targets of Deng Xiao Ping's reforms, so the one child family policy was introduced in 1979 and has remained in force ever since. The strategy is different in urban and rural areas, and implementation varies from place to place depending on local conditions. The policy has been beneficial in terms of curbing population growth, aiding economic growth, and improving the health and welfare of women and children. On the negative side there are concerns about demographic and sex imbalance and the psychological effects for a generation of only children in the cities. The atrocities often associated with the policy, such as female infanticide, occur rarely now. China may relax the policy in the near future, probably allowing two children for everyone.

Attitude↗
PubMed1997

Health in China. The healthcare market.

It is now about 15 years since the introduction of the market into health care in China. This produced fundamental changes in the way that health care is financed and resulted in the disappearance of universal free basic health care. Responsibility for provision of health services has been devolved to the provincial and county governments, and healthcare providers have been given considerable financial independence. A fee for service system has been introduced, and several different payment mechanisms are now in operation. The new financing and pricing structures are responsible for greater inequity of access to services and more inefficient use of resources. These problems are widely acknowledged, and a range of solutions is being developed and tested. Since the introduction of the reforms the measurable health status of the population has not declined, probably as a result of overall improved socioeconomic conditions and a continued emphasis on prevention.

China↗
PubMed1997

Impact of volume loading and load reduction on ventricular refractoriness and conduction properties in canine congestive heart failure.

OBJECTIVES: This investigations was undertaken to examine the alteration of electrophysiologic properties, including refractoriness, strength-interval relations and conduction, with the development of heart failure and to characterize the impact of volume loading on these indexes in the cardiomyopathic setting. METHODS: Electrophysiologic properties in eight dogs with pacing-induced dilated cardiomyopathy were compared with those in six control dogs before and after rapid infusion of 800 ml of intravenous saline. RESULTS: The right ventricular (RV) and left ventricular (LV) effective refractory period (ERP) and absolute refractory period (ARP) were significantly longer in dogs with pacing-induced cardiomyopathy than in control dogs: RV ERP 181 +/- 11 ms versus 138 +/- 7 ms (mean +/- SD) (p < 0.0001) and anterior LV ERP 177 +/- 13 ms versus 128 +/- 11 ms (p < 0.0001), respectively; ARP 159 +/- 14 ms versus 114 +/- 7 ms (p < 0.0001) at the RV site and 153 +/- 12 versus 117 +/- 5 ms (p < 0.0001) at the anterior LV site. After volume loading in cardiomyopathic animals, posterior and anterior LV ERPs became prolonged to 178 +/- 5 ms (p = 0.004) and 189 +/- 14 ms (p = 0.065), respectively, shifting the strength-interval relation in the direction of longer S1S2 coupling intervals. Anterior LV monophasic action potential durations at 90% repolarization also became prolonged from 192 +/- 10 ms to 222 +/- 23 ms (p < 0.012) with volume loading. These findings were not altered by subsequent sodium nitroprusside. Local conduction times parallel and perpendicular to fiber orientation were not altered by development of cardiomyopathy or volume alterations. CONCLUSIONS: The development of dilated cardiomyopathy results in significant prolongation of refractoriness and repolarization that is increased further by volume augmentation but is not reversed by pharmacologic load reduction. Although these abnormalities may contribute to the environment needed for a non-reentrant, triggered or stretch-mediated arrhythmogenic process in cardiomyopathic states, additional studies will be required to demonstrate such a focal mechanism conclusively.

Action Potentials↗
PubMed1996

Whole saliva and the diagnosis of Sjögren's syndrome: an evaluation of patients who complain of dry mouth and dry eyes. Part 1: Screening tests.

UNLABELLED: Sjögren's syndrome (SS) is a common autoimmune disorder characterised by generalised desiccation, exocrine hypofunction and serologic abnormalities, More than 90% of the patients are women. OBJECTIVE: To determine if whole saliva could be used to diagnose this disease. SETTING: The study was conducted at the School of Dental Medicine, SUNY, at Stony Brook. PATIENTS: There were 49 subjects (48 F; 1 M), the mean age was 54 +/- 13 years. In order to be admitted into the study, they had to complain of dry mouth and dry eyes. TESTS: Whole saliva was collected by the spitting method. "Screening Tests" were employed to measure the salivary flow rate, pH, buffer capacity; lactobacillus and yeast concentrations. Chemical tests were performed to determine protein, albumin, sodium and amylase activity. Lacrimal dryness was assessed by the Schirmer and Rose-Bengal methods. RESULTS: Based on the sialometric findings, the patients were divided into 3 groups: Group 1: those with abnormally low resting (RFR) and stimulated (SFR) flow rates; Group 2: those with a low RFR but normal SFR; and Group 3: those with normal salivary flow rates. The group 1 patients were unique: their saliva demonstrated a low pH and buffer capacity, high lactobacillus and yeast concentrations, decreased protein output and amylase activity, and elevated albumin and sodium. Moreover, virtually all of them had abnormally low lacrimal flow rates. CONCLUSIONS: The findings suggested that whole saliva could be used to provisionally diagnose SS. Critical to this diagnosis was an abnormally low stimulated whole saliva flow rate. Other requisites included a low resting flow rate, the presence of dry mouth and dry eyes and evidence of lacrimal hypofunction. All of these attributes can easily be obtained by dentists in their clinics.

Adult↗
PubMed1996

Whole saliva and the diagnosis of Sjögren's syndrome: an evaluation of patients who complain of dry mouth and dry eyes. Part 2: Immunologic findings.

UNLABELLED: Sjögren's syndrome (SS) is a multisystem, autoimmune disease characterised by generalised desiccation, exocrine hypofunction and serologic abnormalities. Last year we showed that the antibodies which are quasi-specific for diagnosis of SS, anti SS-A/Ro and anti SS-B/La, were present in the saliva of patients with this disease. OBJECTIVE: To determine their presence in patients who complain of dry mouth and dry eyes. SETTING: The study was conducted at the School of Dental Medicine, SUNY at Stony Brook. PATIENTS: There were 49 patients (Mean Age = 54 +/- 13 years). TESTS: Serum was analysed for the SS and other antibodies with "Western Blot Autoantibody Strips". RESULTS: The findings showed that there was a strong correlation between the presence of the SS antibodies in the serum and the saliva. The SS antibodies were primarily found in the saliva of the patients whose resting and stimulated, whole saliva, flow rates were abnormally low. Antibodies to other autoimmune disease (lupus, scleroderma and mixed connective tissue disease) were also found in whole saliva. CONCLUSIONS: The findings in Part 1 of this study, of patients who had complained of dry mouth and dry eyes, suggest that those patients, who demonstrated low resting and stimulated flow rates and had lacrimal hypofunction, suffered from SS. The observation in this paper, that the whole saliva of these patients contains the SS antibodies, confirms this diagnosis. The data suggest that whole saliva can be used to establish the diagnosis of SS and other autoimmune diseases.

Adult↗
PubMed1996

The use of whole saliva in the differential diagnosis of Sjögren's syndrome.

Sjögren's Syndrome (SS) is a chronic, multisystem, autoimmune disorder. It is characterized by (1) generalized exocrine gland dysfunction, (2) serologic abnormalities, and (3) organ-system changes. Oral changes are a prominent feature of this disease. Among these are xerostomia and hypofunction of the salivary glands. Given the intimate relationship between SS and the salivary glands, it is reasonable to postulate that whole saliva (WS) contains the stigmata associated with the presence of this disease. But few studies have been conducted on this secretion. Indeed, WS has largely been neglected and ignored by physicians, dentists, and scientists. Objections to its use have included the fact that it is "impure", that it does not adequately represent what is present in the salivary glands, that no standards have been established for its rate of flow, and that findings based on it lack specificity. Yet, it is this secretion which coats and protects the hard and soft oral tissues, enables us to prepare our food for digestion, and assists our speech. This review will demonstrate that there is a uniqueness and constancy to whole saliva and that it may be used to diagnose the presence of SS. "Screening tests", which include several simple-to-perform sialometric, chemical, and microbiologic procedures, may be conducted in doctors' offices to establish the "profile" of an SS patient. Electrophoretic studies may be used to study the nature of the salivary proteins, and an immunologic test, which is performed on WS and utilizes Western Blot Autoantibody Strips (ImmunoVision, Springdale, AR), may be used to establish the definitive diagnosis of SS.

Adult↗
PubMed1995

Sodium dodecyl sulphate-polyacrylamide gel electrophoresis of human whole saliva.

The purpose of this study was to characterize the electrophoretic patterns of human resting and stimulated whole saliva. Pooled and individual, uncentrifuged, unprocessed whole saliva from 20 healthy, unmedicated individuals was run on sodium dodecyl sulphate-polyacrylamide gel electrophoresis and stained with Coomassie blue R-250. Similar and characteristic patterns for whole saliva were observed for all samples, consisting of over 34 blue- and pink-violet-staining bands. Individual differences were usually in the size (or density) of the bands, not in the number. Repeat sampling of stimulated whole saliva over a period of weeks from the same individuals revealed a striking consistency of protein patterns, indicating a profound physiological stability of whole saliva. These results provide baseline data for whole saliva and suggest its use for future studies.

Adult↗
PubMed1995

The preparation of an autologous saliva for use with patients undergoing therapeutic radiation for head and neck cancer.

PURPOSE: At the present time there is no general agreement about how to prevent the symptoms and clinical signs that accompany therapeutic irradiation for head and neck cancer. Because saliva is the principal protector of the oral tissues, it is logical to assume that many of these changes are due to the radiation-induced damage to the salivary glands. We have observed that the flow and composition of saliva is normal in most patients before their irradiation. Theoretically, it should, therefore, be possible to collect their saliva before they commence their course of radiation, store it in a "saliva bank," and give it back to them when they undergo radiation. The key to the use of such an autologous saliva is the fabrication of a technique that disinfects or sterilizes the saliva yet preserves its protective properties. The objective of this study was to prepare an autologous saliva that would be used by patients during their irradiation for head and neck cancer. MATERIALS AND METHODS: Stimulated saliva was obtained from healthy subjects; none of the subjects consumed any medications. The saliva was treated by a variety of techniques. Included among them were heat, radiation, filtration, centrifugation, and an antibacterial agent. The samples were analyzed for total protein, amylase, viscosity, and sterility; individual salivary proteins were assessed by sodium dodecylsulfate-polyacrylamide gel electrophoresis. RESULTS: The results showed that beta radiation (> 2.5 kGy) and lyophilization + chlorhexidine (0.03% to 0.12%) could be used to prepare a sterile autologous saliva that retained most of its protective properties.

Adult↗
PubMed1995

Effects of internal defibrillation on an implanted pacing system with programmable polarity.

Management of multiple cardiac arrhythmias in some patients with both an implantable cardioverter defibrillator (ICD) and a pacemaker has demonstrated several advantages. In such circumstances, it is imperative that pacemaker function and its programmed parameters be preserved following a defibrillation shock. This article describes the effects encountered by a specific programmable polarity pacemaker (RelayR 294-03) when subjected to electrical defibrillation in a canine model. Three pacemakers were repeatedly tested in three separate dog experiments. Each pacemaker, with its leads implanted in the right atrium and the right ventricle, was subjected to a minimum total number of 24 high energy biphasic and monophasic shocks (600-700 V) delivered by a coexisting ICD system using three different defibrillating lead configurations. None of the pacemaker systems showed any failure in function; all pacemakers continued to function within preshock specification and conversion to unipolar pacing and/or backup mode was not observed in any of the tests. Intracardiac electrical potentials measured directly off the ICD and the pacemaker leads, during a defibrillation shock (mean 566.6 V; 23.7 J), showed that potentials measured in a bipolar configuration (tip-ring: mean 21.0 V in atrium, 12.0 V in ventricle) were significantly less than potentials measured in a unipolar configuration (tip-can: mean 387.9 V in atrium, 394.0 V in ventricle; ring-can: mean 405.6 V in atrium, 395.4 V in ventricle). Our compatibility tests demonstrate that use of this programmable-polarity pacemaker in concert with an ICD system appears to be safe. Testing similar to the present study should be conducted prior to complete clinical acceptance of combined ICD and pacemaker implantation.

Animals↗
PubMed1995

[Trend and prediction of cancer mortality in Beijing, China, during 1980-2001].

Mortality data gathered through registration system were analyzed systematically to predict the trend of cancer mortality. A grey-system model was established to forecast the epidemic trend for cancer mortality of Beijing in 2001. In result, the mortality of cancer in Beijing will increase annually upto 2001. The composition of various malignant tumer will charge notably. Rapid increase will occure in lung cancer. Liver cancer and colon-rectal cancer will aslo increase. Cancers of esophagus and cervix uteri will steadly decline. Stomach cancer begin to decrease. These information on the change of cancer mortality will provide scientific reference for the study of cancer prevention and control in Beijing.

Adolescent↗
PubMed1994

Predischarge exercise radionuclide angiography in predicting multivessel coronary artery disease and subsequent cardiac events after thrombolytic therapy for acute myocardial infarction.

The value of exercise testing in postinfarction patients receiving thrombolytic therapy has not been established. Ninety-four patients treated acutely with thrombolytic therapy without angioplasty who underwent exercise radionuclide angiography and coronary angiography before hospital discharge were studied. Thirty patients underwent early revascularization, often for multivessel disease. During a median follow-up period of 3.5 years, only 5 patients had "hard" events (cardiac death, cardiac arrest, or myocardial infarction) and 5 other patients underwent late (> 90 days) revascularization. The results of radionuclide angiography did not predict multivessel disease. Peak exercise ejection fraction was the only significant (p = 0.003) independent predictor of events. Among the 65 patients with a peak exercise ejection fraction > or = 40%, the 3-year hard and "combined" event-free survival were 98% and 91%, respectively. Among the 29 patients with a peak exercise ejection fraction < 40%, the 3-year hard and combined event-free survival were 74% and 69%, respectively. Postinfarction patients treated with thrombolytic therapy, who often underwent early revascularization, had an excellent prognosis through 3.5 years of follow-up. Although exercise radionuclide angiography had little value for identifying multivessel disease, a reduced peak exercise ejection fraction was associated with subsequent events.

Aged↗
PubMed1994

Improvement of neonatal care in Zhejiang Province, China through a self-instructional continuing education programme.

Major upheavals have taken place in medical education in the last three decades in China. This has meant that at every level there are personnel with a wide range of training backgrounds. Continuing education programmes to ameliorate the situation have been seen as a priority of the Ministry of Public Health (MOPH). However, many of the training courses offered are too academic in approach and do little to raise standards of clinical care. The shortcomings in neonatal education are particularly acute and this is reflected in the relatively high neonatal mortality rate. At the request of Zhejiang Provincial Bureau of Public Health (BOPH), Project HOPE, an American non-governmental organization (NGO), collaborated with Zhejiang Medical University (ZMU) on the development of a neonatal outreach programme. The programme was self-instructional in approach with individual hospitals having autonomy in the mode of implementation of the programme. There were 225 participants in four county level hospitals. Cognitive knowledge test scores improved by an average of 56%. Observation of clinical practices showed that 54% improved following the programme, with 34% meeting the criteria set by the modules. An inventory of facilities showed that of a list of essential items an average of 38% were present before the programme compared with 76% after completion of the programme. As a result of the success of the programme it is being expanded into a comprehensive teaching and evaluation package for use throughout Zhejiang Province and Eastern China.

China↗
PubMed1993

[Clinical study of the treatment of endometriosis with promoting blood circulation and stasis removing method].

The treatment of endometriosis by blood circulation promoting and stasis removing method is based on the experience carried in the "Ji Yin Gang Mu" and the fact that this disease belongs to the category of pelvic stagnant blood. The study group consisted of 53 women with endometriosis. They were manifested as dysmenorrhea, menoxenia, ovarian chocolate cysts and enlarged uterus. The control group consisted of ten women with normal regular menstrual cycle. This article deals with the method of using the hemodynamic index of uterus arterial blood flow. After treatment the blood flow amount of uterus arteries of 53 cases (study group) obviously decreased and their uterus arterial blood flow speed reduced markedly as compared with pretreatment status, (P < 0.001 and P < 0.01) respectively, while pre-treatment group was significantly higher than that of control group (P < 0.001). After medical treatment for 3.5 months, symptoms such as dysmenorrhea and menstrual disorder basically disappeared. 22 ovarian chocloate cysts became smaller and 16 disappeared. The pregnancy rate was 45%. The data of this study suggest that the mechanism of treatment of promoting blood circulation to remove stasis might be closely related to the regulation of physico-chemical characteristics of blood and the adjustment of the function of hemodynamics.

Adult↗
PubMed1992

Mitral regurgitation due to ruptured chordae tendineae in patients with hypertrophic obstructive cardiomyopathy.

Mitral valve regurgitation in association with hypertrophic obstructive cardiomyopathy is usually caused by the systolic anterior motion of the anterior mitral leaflet. Recently, five patients were encountered with hypertrophic obstructive cardiomyopathy who had mitral regurgitation due to ruptured chordae tendineae. The diagnosis was confirmed in all patients during operation for left ventricular septal myectomy-myotomy (Morrow procedure). Preoperative identification of ruptured chordae tendineae as the cause of mitral regurgitation was established by transesophageal echocardiography in the three most recent cases. All patients had successful septal myectomy-myotomy for relief of left ventricular outflow obstruction, and mitral valve competence was restored by valve repair rather than by prosthetic valve replacement. The clinical course of these patients illustrates important management considerations as well as the utility of transesophageal echocardiography for diagnosis. Chordal rupture should be considered in the differential diagnosis of mitral regurgitation in patients with hypertrophic obstructive cardiomyopathy, especially in those with acute hemodynamic deterioration.

Adult↗
PubMed1991

An ultrasonic method for measuring tissue displacement: technical details and validation for measuring myocardial thickening.

We have developed a method for measuring myocardial thickening from a single ultrasonic transducer attached to the epicardium. Displacement of the underlying myocardial tissue is measured by following the phase of the echoes within a sample volume range-gated across the myocardium. The output is in the form of an analog signal. To verify the accuracy, resolution, and limitations of the system, we derived the equations relating the position of a reflector to the phase of its echo and compared the system output in vitro to a known input using a single moving target and a random distribution of scatterers, and in vivo to that of an ultrasonic transit-time dimension gauge. The results demonstrate that the 10 MHz system can accurately follow the motion of single or multiple targets with a resolution of 0.02 mm. In 25 dogs myocardial thickening measured with the displacement system compared favorably in both waveform and magnitude with thickening measured by the two-crystal transit-time method. Applications for the displacement method include: quantification of regional ventricular function in animal models of cardiovascular diseases, measurement of endocardial to epicardial differences in the deformation of regional myocardium during the cardiac cycle, and evaluation of regional cardiac function in patients during and after corrective cardiac surgery.

Animals↗