Publications by authors named "W H Wilson Tang"

9,021 Publications

Application of a new serratus anterior plane block in modified radical mastectomy under ultrasound guidance: A prospective, randomized controlled trial.

J Clin Anesth 2021 Jun 9;74:110377. Epub 2021 Jun 9.

Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China. Electronic address:

Study Objectives: Post-operative pain is a significant concern following modified radical mastectomy in breast cancer patients. The serratus anterior plane block has recently been described as an effective technique for post-operative analgesia of modified radical mastectomy. The purpose of this study was to evaluate the analgesic efficacy and safety of a new serratus anterior plane (SAP) block for post-operative pain of mastectomy.

Design: A randomized controlled trial.

Setting: Single university teaching hospital, from October 2019 to April 2020.

Patients: Eighty-seven female breast cancer patients aged 30-81 years scheduled for unilateral modified radical mastectomy.

Interventions: Participants were randomly allocated to receive either general anesthesia plus SAP block (SAP block group, n = 43) or general anesthesia alone (Control group, n = 44). A single injection of 20 ml of 0.5% ropivacaine was administered into fascial plane between the pectoralis major and the serratus anterior in SAP block group. In the Control group, no block intervention was applied.

Measurements: The primary outcome measure of the study was the VAS pain scores at different time-points (1, 6, 12, 24, 48 h) after modified radical mastectomy whereas the secondary outcome measures were the consumption of opioid analgesics.

Main Results: Breast cancer patients in SAP block group had lower VAS pain scores compared with the Control group during the early post-operative period (1 h and 6 h after modified radical mastectomy), both at rest and with movement. In addition, the consumption of propofol was similar in two groups (P = 0.406), and the consumption of sufentanil and remifentanil in SAP block group were significantly lower than that of Control group (P = 0.000 and P = 0.000, respectively).

Conclusions: SAP block significantly attenuated post-operative pain and decreased opioids consumption in breast cancer patients undergoing modified radical mastectomy.

Trial Registration: This trial is registered in the Chinese Clinical Trial Registry (ChiCTR1900026989).
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http://dx.doi.org/10.1016/j.jclinane.2021.110377DOI Listing
June 2021

Early Drain Removal is Safe in Patients With Low or Intermediate Risk of Pancreatic Fistula After Pancreaticoduodenectomy: A Multicenter, Randomized Controlled Trial.

Ann Surg 2021 Jun 11. Epub 2021 Jun 11.

Department of General Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, P.R. China Department of General Surgery, Peking University First Hospital, Peking University, Beijing 100034, P.R China Department of General Surgery, Beijing Xuanwu Hospital, Capital Medical University, Beijing 100053, P.R China Department of Hepatobiliary & Pancreatic Surgical Oncology, Chinese People's Liberation Army, General Hospital, Beijing 100853, P.R China Department of Hepato-Biliary-Pancreatic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, P.R China Department of General Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, P.R China Department of Visceral, Vascular and Endocrine Surgery, Martin-Luther-University Halle-Wittenberg, 06120, Halle (Saale), Germany.

Objective: This multi-center randomized controlled trial (RCT) was designed to test the hypothesis that early drain removal (EDR) could decrease the incidence of grade 2-4 complications for patients undoing pancreaticoduodenectomy (PD) with low or intermediate risk of postoperative fistula (POPF).

Background: The safety and effects of EDR on postoperative complications after PD are still controversial.

Methods: A multi-center RCT at six tertiary referral hospitals was carried out (NCT03055676). Patients who met the inclusion criteria, including drain amylase level less than 5000 U/L on postoperative day (POD) 1 and POD 3, and drain output less than 300 ml per day within 3 days after surgery, were enrolled. Patients were then randomized to the EDR group or the routine drain removal (RDR) group. In the EDR group, all drainage tubes were removed on POD3. In the RDR group, drainage tubes were removed on POD 5 or beyond. Primary outcome was the incidence of Clavien-Dindo grade 2-4 complications. Secondary outcomes were comprehensive complication index (CCI), grade B/C postoperative pancreatic fistula (POPF), total medical expenses and post-operative in-hospital stay etc., within 90 days after surgery.

Results: A total of 692 patients were screened, and 312 patients were eligible for randomization. Baseline characteristics were well balanced between the two groups and 96.8% of these 312 patients had low or intermediate risk of POPF, according to the 10-point fistula risk score. A total of 20.5% of the patients in the EDR group suffered at least one grade 2-4 complication, versus 26.3% in the RDR group (P = 0.229). Multi-variate analysis showed older age (> 65 years old) and blood transfusion were independent risk factors for grade 2-4 complications. The rate of grade B/C POPF was low in either group (3.8% vs 6.4%, P = 0.305). The CCI of the two groups was also comparable (20.9 vs 20.9, P = 0.253). Total medical expenses were not significantly different. Post-operative in-hospital stay was clinically similar (15 d vs 16 d, P = 0.010).

Conclusions: Nearly half of the patients undergoing PD met the inclusion criteria, predicting low incidence of grade B/C POPF and major complications. EDR was safe in these patients but did not significantly decrease major complications.
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http://dx.doi.org/10.1097/SLA.0000000000004992DOI Listing
June 2021

The impact of formal and informal support on emotional stress among non-co-resident caregivers of persons with dementia.

Aging Ment Health 2021 Jun 11:1-9. Epub 2021 Jun 11.

Graduate School of Social Service, Fordham University, New York, NY, USA.

Objectives: The purpose of this study was to examine the prevalence of formal and informal support between non-co-resident and co-resident family caregivers of persons with dementia and to investigate the impact of receiving formal or informal assistance on family caregivers' residential status and their perceived emotional stress.

Method: We used secondary data from the 2018 National Survey of Older American Act conducted by the Administration for Community Living. We selected 751 primary family caregivers of persons with dementia and conducted regression analyses to explore our research questions.

Results: Non-co-resident caregivers of persons with dementia were younger, racially and ethnically diverse, employed, and had higher income than co-resident caregivers. They were less likely to utilize formal support, such as caregiver training or education ( = .005) and respite care ( = .019) but more likely to rely on informal support in their social networks ( = .002), compared to co-resident caregivers. Non-co-resident caregivers who had better informal support systems showed less emotional stress than co-resident caregivers ( = .024).

Conclusion: Findings from our study suggest the importance of engaging informal networks to alleviate emotional stress of non-co-resident caregivers of persons with dementia. Furthermore, it is critical to help them utilize adequate caregiver training and education as well as respite care before their loved ones experience dramatic functional and health declines.
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http://dx.doi.org/10.1080/13607863.2021.1935460DOI Listing
June 2021

Assessment of droplet digital polymerase chain reaction for measuring BCR-ABL1 in chronic myeloid leukaemia in an international interlaboratory study.

Br J Haematol 2021 Jun 10. Epub 2021 Jun 10.

Faculty of Medicine Dentistry and Health, Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK.

Measurement of BCR activator of RhoGEF and GTPase -ABL proto-oncogene 1, non-receptor tyrosine kinase (BCR-ABL1) mRNA levels by reverse transcription quantitative polymerase chain reaction (RTqPCR) has been critical to treatment protocols and clinical trials in chronic myeloid leukaemia; however, interlaboratory variation remains a significant issue. Reverse transcriptase droplet digital PCR (RTddPCR) has shown potential to improve testing but a large-scale interlaboratory study is required to definitively establish this. In the present study, 10 BCR-ABL1-positive samples with levels ranging from molecular response (MR) -MR were tested by 23 laboratories using RTddPCR with the QXDX BCR-ABL %IS kit. A subset of participants tested the samples using RTqPCR. All 23 participants using RTddPCR detected BCR-ABL1 in all samples to MR . Detection rates for deep-response samples were 95·7% at MR , 78·3% at MR and 87·0% at MR . Interlaboratory coefficient of variation was indirectly proportional to BCR-ABL1 level ranging from 29·3% to 69·0%. Linearity ranged from 0·9330 to 1·000 (average 0·9936). When results were compared for the 11 participants who performed both RTddPCR and RTqPCR, RTddPCR showed a similar limit of detection to RTqPCR with reduced interlaboratory variation and better assay linearity. The ability to detect deep responses with RTddPCR, matched with an improved linearity and reduced interlaboratory variation will allow improved patient management, and is of particular importance for future clinical trials focussed on achieving and maintaining treatment-free remission.
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http://dx.doi.org/10.1111/bjh.17521DOI Listing
June 2021

Manipulation of the Magnetic Properties of Janus WSSe Monolayer by the Adsorption of Transition Metal Atoms.

Nanoscale Res Lett 2021 Jun 10;16(1):104. Epub 2021 Jun 10.

Department of Physics, OSED, Fujian Provincial Key Laboratory of Semiconductors Materials and Applications, Xiamen University, Xiamen, 361005, People's Republic of China.

Two-dimensional Janus materials have great potential for the applications in spintronic devices due to their particular structures and novel characteristics. However, they are usually non-magnetic in nature. Here, different transition metals (TMs: Co, Fe, Mn, Cr, and V) adsorbed WSSe frameworks are constructed, and their structures and magnetic properties are comprehensively investigated by first-principles calculations. The results show that the top of W atom is the most stable absorption site for all the TM atoms, and all the systems exhibit magnetism. Moreover, their magnetic properties significantly depend on the adsorbed elements and the adsorbent chalcogens. A maximal total magnetic moment of 6 μB is obtained in the Cr-adsorbed system. The induced magnetism from S-surface-adsorption is always stronger than that for the Se-surface-adsorption due to its larger electrostatic potential. Interestingly, the easy magnetization axis in the Fe-adsorbed system switches from the in-plane to the out-of-plane when the adsorption surface changes from Se to S surface. The mechanism is analyzed in detail by Fe-3d orbital-decomposed density of states. This work provides a guidance for the modification of magnetism in low-dimensional systems.
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http://dx.doi.org/10.1186/s11671-021-03560-9DOI Listing
June 2021