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Liu X, Li ZR, Qi X, Zhou Q. Objective Boundary Generation for Gross Target Volume and Organs at Risk Using 3D Multi-Modal Medical Images. Int J Radiat Oncol Biol Phys 2023; 117:e476. [PMID: 37785510 DOI: 10.1016/j.ijrobp.2023.06.1689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Accurate delineation of Gross Target Volume (GTV) and Organs at Risk (OARs) in medical images is an essential but challenging step in radiotherapy. Deep-learning based automated delineation methods, which learn from manual annotations, are currently prevalent in academic research. However, the limited resolution of medical images and the fuzzy boundaries of lesions and organs present a challenge to the precision of manual annotations. By leveraging the complementary information from multi-modal medical images, this study proposed a novel method to generate objective boundaries of GTV and OARs. MATERIALS/METHODS We present a novel method of objective boundary generation, inspired by image matting primarily used for 2D RGB natural images, to process 3D grayscale medical images. The proposed method has the following advantages. 1) It allows for flexible input modalities and assigns weights to each modality according to their relative significance when computing information flows in the matting algorithm. 2) It computes 3D spatial information flow among voxels, which has more advantages over its 2D counterpart. 3) It has a closed-form solution that generates deterministic results. To evaluate the characteristics of the generated boundaries, patients with stage I nasopharyngeal carcinoma (NPC) were studied, with CT images and multi-modal MR images (T1, T1C, T2) aligned using deformable registration. Region of Interests (ROIs), i.e., GTV and parotid gland, were used, with a rough trimap marking extremely few foreground voxels, many background voxels, and a large unknown region. The proposed algorithm leverages the connection between each voxel and its nearest neighbors in the feature space, to propagate the opacity information. RESULTS We evaluated the results by employing both qualitative and quantitative methods. Using qualitative evaluation, experienced clinicians confirmed that the results were in agreement with the input data, especially for areas where borders were visible in most modalities (e.g., between air and tumor). For more challenging regions, where boundaries were unclear in the images, the results displayed fine-grained opacity transitions indicating the confidence of each voxel belonging to the ROI. When compared to the delineations made by clinicians, we found our results are usually more compact. We define a precision metric that evaluates the ratio of the matted foreground inside clinicians' delineations versus the entire matted foreground. Using a threshold of 0.4, our binarized result scored 0.95 for GTV and 0.92 for parotid gland. CONCLUSION The proposed method demonstrated satisfactory results on challenging ROIs. The objective boundaries generated by this method have advantages in many aspects, including improvement of delineation protocols, enhancement of manual annotation consistency, and increase of deep-learning based automated delineation accuracy.
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Kong L, Li Z, Liu Y, Zhang J, Chen M, Zhou Q, Qi X, Deng XW, Peng Y. A Generalized Deep Learning Method for Synthetic CT Generation. Int J Radiat Oncol Biol Phys 2023; 117:e472. [PMID: 37785502 DOI: 10.1016/j.ijrobp.2023.06.1681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The application of deep learning to generate synthetic CT (sCT) has been widely studied in radiotherapy. Existing methods generally involve data from two different image modalities, such as CBCT-CT or MRI-CT, the quality of sCT is adversely affected by source image quality. We propose a unique method of synthesizing MRI and CBCT into sCT based on single-modal CT for training, and call it SmGAN. MATERIALS/METHODS We used planning CT of a group of 35 head and neck cases to as training data. We then applied two different spatial transformations to the planning CT image to produce the transformed CT1 and CT2. And We used a random style enhancement technique (Shuffle Remap) to modify the image distribution of CT1 which we termed CT1+E. CT1+E was used to simulate the patient's "image of the day" while CT2 to simulate the "planning image". After feeding both CT1+E and CT2 into the generator, we obtained the sCT predicted by the generator. The generator was trained using the Mean Absolute Error (MAE) loss between sCT and CT1. In the actual clinical process, we use the patient's CBCT or MRI instead of CT1+E and the patient's planning CT instead of CT2 as the input of the generator. After processing, we get an sCT that can maintain the spatial position of the image taken on the day, while presenting features similar to the planning CT. The evaluation data we have includes 10 pairs of MRI-Def_CT and 10 pairs of CBCT-Def_CT Head and Neck patients. Def_CT is obtained from the planning CT based on the spatial position deformation of MRI and CBCT. To evaluate the accuracy of sCT based on MRI and CBCT with Def CT, we use a range of metrics, including Hounsfield Unit (HU) difference, peak signal-to-noise ratio (PSNR), structural similarity (SSIM) and gamma pass rate. All results will be benchmarks against the advanced method RegGAN for comparison. RESULTS Compared to RegGAN, the results of SmGAN were significantly better. The mean absolute errors within the body were (44.7±216.2 HU vs. 36.7±131.4 HU) and (64.9±123.7 HU vs. 58.2±152.8 HU) for the CBCT-SCT and MRI-SCT, respectively (Table 1). In addition, experimental results show that SmGAN also outperforms RegGAN in dose calculation accuracy. For example, under the 10% threshold, SmGAN's gamma pass rate of 1mm and 1% is 0.926±0.02, compared with gamma rate of 0.896±0.02 for RegGAN. CONCLUSION We proposed a generalized deep learning model for synthetic CT generation, based on CBCT or MRI images. The proposed algorithm achieved high accuracy of dosimetric metrics, as well as excellent IMRT QA verification results. Compared to other existing synthetic CT generation methods, the proposed SmGAN required a single-modal image for training, which is considered as a major breakthrough in the industry, and is expected to have wide spread of clinical applications.
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Liu Y, Chen Z, Zhou Q, Shang X, Zhao W, Zhang G, Xu S. A Feasibility Study of Dose Band Prediction in Radiotherapy: Predicting a Dose Spectrum. Int J Radiat Oncol Biol Phys 2023; 117:e691. [PMID: 37786031 DOI: 10.1016/j.ijrobp.2023.06.2164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Current deep learning-based dose prediction methods can only predict a specific dose distribution. If the predicted dose is inaccurate, no more options can be selected. We proposed a novel dose prediction method named dose band prediction, which outcomes a spectrum of predicted dose distribution for planning and quality assurance (QA). MATERIALS/METHODS Upper-Band and Lower-Band losses were involved in 3D convolution neural networks to establish the Upper-Band Network (UBN) and Lower-Band Network (LBN). Each voxel's ideal dose spectrum (dose band) was defined by the maximum/minimum rational dose predicted by UBN/LBN. 130 NPC cases with Tomotherapy (dataset 1), 49 cervix cases with IMRT (dataset 2) and 43 cervix cases with VMAT (dataset 3) were enrolled to establish and evaluate our dose band prediction method. RESULTS The dose band prediction method can successfully predict a spectrum of doses. Upper-Band/Lower-Band presents maximum/minimum rational dose; Middle-Line presents the average of Upper-Band and Lower-Band. The clinical implement dose was used as the reference dose. We evaluated the maximum interval between the reference and Upper-Band/Middle-Line/Lower-Band doses, and the percentage dose difference was used as the evaluation method. The differences in PTV for Upper-Band, Middle-Line and Lower-Band in dataset 1 were within 2.47%, 0.54%, and 2.8%; in dataset 2, they were within 0.37%, 1.15%, and 2.69%; in dataset 3, they were within 0.96%, 0.35%, and 1.66%. The mean difference of OARs for the Upper-Band, Middle-Line and Lower-Band in dataset 1 were within 8.13%, 4.97%, and 8.19%; in dataset 2, they were within 8.8%, 4.48%, and 5.52%; in dataset 3, they were within 4.01%, 3.13%, and 5.79% (shown in Table 1). CONCLUSION Dose Band prediction achieved high-accuracy dose prediction by the Middle-Line. More importantly, the Upper-Band/Lower-Band provided a spectrum of possible rational doses. Our Dose Band prediction method is based on a specific loss function, so it can easily be applied in various network and patient cases. Dose Band prediction towards a more robust plan QA and planning assistance. Table 1. The maximum interval of doses (percentage dose difference, %).
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Li ZR, Weidhaas JB, Raldow A, Zhou Q, Qi X. Early Prediction of Radiation Treatment Response via Longitudinal Analysis of CBCT Radiomic Features for Locally Advanced Rectal Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e474-e475. [PMID: 37785506 DOI: 10.1016/j.ijrobp.2023.06.1686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Patients respond to the same radiation treatment course differently due to inter- and intra- patient variability in radiosensitivity. Despite widespread use of AI/ML in radiation oncology, there is a lack of monitoring strategies used during treatment courses to evaluate early predictors of treatment response in a systematic fashion. This work advances a straightforward, yet effective, method for the early detection of treatment response through systematically analyzing daily CBCT radiomic features. The goal is to aid clinicians in assessing the treatment efficacy routinely with a view towards optimizing personalized treatment. MATERIALS/METHODS We included a cohort of 30 patients diagnosed with locally advanced rectal cancer who underwent neo-adjuvant fractionated radiation treatment (RT) with a prescription dose of 50.4 Gy (28 fractions), followed by total mesorectal excision surgery after completion of ChemoRT. Daily IGRT imaging was acquired prior to each fraction resulting in a total of 840 CBCTs. Patients were divided into responder (14 patients) and non-responder (16 patients) groups based on post-RT pathological response. Mutual information algorithms were utilized to rigorously register daily CBCT images to the planning CT, and longitudinal radiomic features of the target were extracted from the daily CBCTs during the entire treatment course. All longitudinal features for a given patient were standardized with Z-Score normalization, followed by linear fitting using the least square method, resulting in radiomic feature trends (RFT) represented by slope values. Statistical significance was established via a two-sample U test and P-value with a threshold of 0.05. Logistic regression was performed to eliminate RFT with accuracy rates lower than 0.5. The final trending model was developed using random forest. For each patient at fraction N, our investigation involved independent 27 group experiments, where each experiment considered image group from fraction #1 to N, to confirm the effectiveness and stability of the model. RESULTS The proposed RFT demonstrated a high level of precision and consistency for post-RT response based on longitudinal CBCT images for LARC patients. The trending model yielded an accuracy of 0.9556, 95% CI (0.94, 0.972) when each daily image was considered, the prediction consistency was 0.964. Given the first 14 experiments (considering group images of fraction #1-15), the prediction accuracy was 0.9357, 95% CI (0.915, 0.956) and the prediction consistency was 0.952. CONCLUSION A strategy for monitoring and early prediction of LARC patients' radioresponse was evaluated via longitudinal CBCT assessment. Our trending models demonstrate a significant difference between the responder vs non-responder groups as early as the 15th fraction. Our strategy achieved superior accuracy and consistency to predict post-RT response of LARC patients.
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Wang J, He Q, Li ZR, Huang N, Huang R, Wang JY, Zhou Q, Wang XH, Han F. The Lyman Normal Tissue Complication Probability Model and Risk Prediction for Temporal Lobe Injury after Re-Irradiation in Patients with Recurrent Nasopharyngeal Carcinoma. Int J Radiat Oncol Biol Phys 2023; 117:e587. [PMID: 37785777 DOI: 10.1016/j.ijrobp.2023.06.1932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The risk of temporal lobe injury (TLI) in recurrent nasopharyngeal carcinoma (rNPC) patients with intensity-modulated radiation therapy (IMRT) is high. We aimed to construct the normal tissue complication probability (NTCP) model for TLI of rNPC and establish a risk predictive model. MATERIALS/METHODS We retrospectively analyzed 103 patients with rNPC who had received two courses of IMRT in our institution. The 206 temporal lobes (TLs) of these patients were randomly divided into a training (n = 144) and validation group (n = 62). We determined the mean value of the following parameters to construct the Lyman NTCP model: TD50(1) (the dose with a 50% probability of complications to an organ when all volumes are irradiated), m [steepness of the dose-response at TD50(1)], and n (the parameter related to volume effect). The most predictive dosimetric parameter and clinical variables were integrated in Cox proportional hazards models. A nomogram was developed for predicting risk of TLs. RESULTS The parameters of the fitted NTCP model were TD50(1) = 107.84 Gy (95% confidence interval (CI), [97.15, 118.54]), m = 0.16 (95% CI, [0.14, 0.19]), and n = 0.04 (95% CI, [0.01, 0.06]). The cumulative dose delivered to 0.1 cm3 of temporal lobe volume (D0.1cc-c) was the most predictive dosimetric parameter for TLI. The Kaplan-Meier curves showed a significant difference in 2-year TLI-free survival among different risk groups according to the total score of nomograms. CONCLUSION The TD50(1) of TLI in patients with rNPC is 107.84 Gy in Lyman NTCP model. The nomogram model can accurately predict the risk of TLI for individual.
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Du L, Lei Q, Zhou Q, Du Y, Lin X, Guo J, Li C, Luo Q, Fan C, Guo Q. Effect of MTA3 Inhibition of Glutamine Synthetase-Mediated Glutaminolysis on Radiosensitivity of Patients with Esophageal Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e227-e228. [PMID: 37784918 DOI: 10.1016/j.ijrobp.2023.06.1138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Metastasis-associated protein 3 (MTA3) can serve as a tumor suppressor in many cancer types. However, the role of MTA3 in radiosensitivity of patients with esophageal squamous cell cancer (ESCC) remains unclear. We thus investigated the function of MTA3 in radiosensitivity for ESCC, one of the most common digestive cancers. MATERIALS/METHODS The colony formation assay and nude mice xenograft tumor assay were performed to investigate the effect of MTA3 on radiosensitivity in ESCC. Glutamine consumption assay kit and glutamate production assay kit were used to assess the glutaminolysis. Glutaminase (GLS) Activity Assay Kit and Glutamine Synthetase (GS) Activity Assay Kit were used to analyze the activity of specific metabolic enzymes dominate glutaminolysis. The regulatory mechanism of glutaminolysis by MTA3 was confirmed using Chromatin immunoprecipitation assay and Gaussia luciferase assay. The expression levels of MTA3 and GS in ESCC primary tissues were evaluated using immunohistochemistry. Survival curves were plotted with the Kaplan-Meier method and compared by log-rank test. RESULTS The colony formation assay showed that MTA3 depletion and overexpression caused significantly higher and lower clonogenic survival after different doses of irradiation (IR), respectively. When these cells were subcutaneously injected into nude mice, the tumors derived from the cells with MTA3 overexpression and MTA3 knockdown were significantly smaller and bigger after IR, respectively. These findings suggest that MTA3 can enhance radiosensitivity in vitro and in vivo. Meanwhile, overexpressed and knockdown MTA3 can repress and expedite glutamine consumption and glutamate production uniformly, respectively. To determine how MTA3 acts on glutaminolysis, the activity of two specific metabolic enzymes dominate this metabolism, GS and GLS, were evaluated. It found that overexpressed and knockdown MTA3 can restrain and enhance the activity of GS, respectively, but have less effect on GLS. Moreover, the decreased radiosensitivity mediated by MTA3 knockdown is significantly increased when treated with GS inhibitor, suggesting that GS plays a crucial role in MTA3-mediated radiosensitivity enhancement. Mechanistically, Chromatin immunoprecipitation assay and Gaussia luciferase assay showed that MTA3 was recruited to the promoter of GS and suppressed GS transcription. However, knockdown of GATA3 abolished MTA3's repressive effect on GS and inhibited the MTA3's occupation on the promoter region of GS. These results collectively demonstrated that, in ESCC cells, MTA3 is recruited by GATA3 to inhibit GS expression, then ultimately represses glutaminolysis and enhances radiosensitivity. Finally, we showed that the ESCC patients in the MTA3low/GShigh group is significantly associated with shorter overall survival. CONCLUSION MTA3 is capable of enhancing radiosensitivity through downregulating GS and MTA3low/GShigh might be a potential prognostic factor for ESCC patients.
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Zhang W, Ma Y, Ibrahim G, Qi X, Zhou Q. Unsupervised Domain Adaptation of Auto-Segmentation on Multi-Source MRIs. Int J Radiat Oncol Biol Phys 2023; 117:e497. [PMID: 37785564 DOI: 10.1016/j.ijrobp.2023.06.1736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Deep learning has achieved great success in medical image segmentation. Most existing deep learning (DL) approaches make no adjustments to the model prior to inference. These models can perform well on the data of the same distribution, but their performance usually degrades when applied to the images from different source, i.e., different scanners. To tackle the problem caused by domain shift, we proposed an unsupervised domain adaptation (UDA) method based on entropy minimization and physical consistency constraints. MATERIALS/METHODS The proposed method combines feature-level and instance-level domain adaptation techniques to transfer knowledge from the source to the target domain. Specifically, the feature-level adaptation technique uses a graph-based entropy minimization to reduce the discrepancy between the source and target domains. The instance-level adaptation technique employs a novel consistency loss to regularize the physical consistency of the same object, such as volume, length, and centroid, thus improving the segmentation accuracy of the target domain. A collection of 93 abdominal MR images, comprising 45 cases from a 0.35T MRI scanner (TRUFI) and 48 cases from a 1.5T MRI scanner (T2), was utilized to evaluate the effectiveness of the proposed method. The contours of 6 organs-at-risk were delineated by a senior radiation oncologist, serving as the ground truth. Three models, the source model (SRC) trained on the source domain, the target model (TGT) trained on the target domain, and the UDA model adapted from the source domain to the target domain, were compared on the target domain using the Dice Similarity Coefficient (DSC). RESULTS In the experiment of 0.35T-to-1.5T, the proposed UDA method outperformed the source model, achieving an average DSC score of 0.82 ± 0.11, compared to 0.58 ± 0.23 (SRC) and 0.85 ± 0.09 (TGT), respectively. In the inverse experiment 1.5T-to-0.35T, the UDA model achieved an average DSC score of 0.79±0.13, compared to DSCs of 0.52 ± 0.25 and 0.81 ± 0.11 for the SRC and TGT respectively. The UDA method yielded a significant improvement of 46%, compared to the SRC. Particularly, OARs (organ at risk) with higher deformability such as the stomach and duodenum achieved a 58% and 63% improvement in performance, respectively. CONCLUSION This work presents a compelling approach of UDA for auto-segmentation on multi-source MRIs. Experimental results demonstrate that the UDA effectively improve the segmentation performance of the source model in the target domain, resulting in a more robust segmentation model.
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Ablikim M, Achasov MN, Adlarson P, Ahmed S, Albrecht M, Aliberti R, Amoroso A, An Q, Bai Y, Bakina O, Ferroli RB, Balossino I, Ban Y, Begzsuren K, Berger N, Bertani M, Bettoni D, Bianchi F, Bloms J, Bortone A, Boyko I, Briere RA, Cai H, Cai X, Calcaterra A, Cao GF, Cao N, Cetin SA, Chang JF, Chang WL, Chelkov G, Chen G, Chen HS, Chen ML, Chen SJ, Chen XR, Chen YB, Chen ZJ, Cheng WS, Cibinetto G, Cossio F, Dai HL, Dai JP, Dai XC, Dbeyssi A, de Boer RE, Dedovich D, Deng ZY, Denig A, Denysenko I, Destefanis M, De Mori F, Ding Y, Dong J, Dong LY, Dong MY, Dong X, Du SX, Fang J, Fang SS, Fang Y, Farinelli R, Fava L, Feldbauer F, Felici G, Feng CQ, Fritsch M, Fu CD, Gao YN, Gao Y, Gao Y, Garzia I, Gersabeck EM, Gilman A, Goetzen K, Gong L, Gong WX, Gradl W, Greco M, Gu LM, Gu MH, Gu S, Gu YT, Guan CY, Guo AQ, Guo LB, Guo RP, Guo YP, Guskov A, Han TT, Hao XQ, Harris FA, He KL, Heinsius FHH, Heinz CH, Heng YK, Herold C, Himmelreich M, Holtmann T, Hou YR, Hou ZL, Hu HM, Hu JF, Hu T, Hu Y, Huang GS, Huang LQ, Huang XT, Huang YP, Hussain T, Imoehl W, Irshad M, Jaeger S, Janchiv S, Ji Q, Ji QP, Ji XB, Ji XL, Jiang XS, Jiao JB, Jiao Z, Jin S, Jin Y, Johansson T, Kalantar-Nayestanaki N, Kang XS, Kappert R, Kavatsyuk M, Ke BC, Keshk IK, Khoukaz A, Kiese P, Kiuchi R, Kliemt R, Kolcu OB, Kopf B, Kuemmel M, Kuessner MK, Kupsc A, Kurth MG, Kühn W, Lane JJ, Larin P, Lavania A, Lavezzi L, Lei ZH, Leithoff H, Lellmann M, Lenz T, Li C, Li CH, Li C, Li DM, Li F, Li G, Li H, Li HB, Li HJ, Li JQ, Li JW, Li K, Li LK, Li L, Li PL, Li PR, Li SY, Li WD, Li WG, Li XH, Li XL, Li ZY, Liang H, Liang H, Liang H, Liang YF, Liang YT, Liao GR, Liao LZ, Libby J, Limphirat A, Liu BJ, Liu CX, Liu D, Liu FH, Liu F, Liu F, Liu HB, Liu HM, Liu H, Liu H, Liu JB, Liu JY, Liu K, Liu KY, Liu L, Liu MH, Liu Q, Liu SB, Liu S, Liu T, Liu WM, Liu X, Liu YB, Liu ZA, Liu ZQ, Lou XC, Lu FX, Lu HJ, Lu JD, Lu JG, Lu XL, Lu Y, Lu YP, Luo CL, Luo MX, Luo T, Luo XL, Lusso S, Lyu XR, Ma FC, Ma HL, Ma LL, Ma MM, Ma QM, Ma RQ, Ma RT, Ma XX, Ma XY, Maas FE, Maggiora M, Maldaner S, Malde S, Malik QA, Mangoni A, Mao YJ, Mao ZP, Marcello S, Meng ZX, Messchendorp JG, Mezzadri G, Min TJ, Mitchell RE, Mo XH, Muchnoi NY, Muramatsu H, Nakhoul S, Nefedov Y, Nerling F, Nikolaev IB, Ning Z, Nisar S, Olsen SL, Ouyang Q, Pacetti S, Pan X, Pan Y, Pathak A, Patteri P, Pelizaeus M, Peng HP, Peters K, Ping JL, Ping RG, Pitka A, Poling R, Prasad V, Qi H, Qi HR, Qi M, Qi TY, Qian S, Qian WB, Qiao CF, Qin LQ, Qin XP, Qin XS, Qin ZH, Qiu JF, Qu SQ, Qu SQ, Ravindran K, Redmer CF, Rivetti A, Rodin V, Rolo M, Rong G, Rosner C, Sarantsev A, Schelhaas Y, Schnier C, Schoenning K, Scodeggio M, Shan DC, Shan W, Shan XY, Shao M, Shen CP, Shen PX, Shen XY, Shi HC, Shi RS, Shi X, Shi XD, Song WM, Song YX, Sosio S, Spataro S, Su KX, Sun GX, Sun JF, Sun L, Sun SS, Sun T, Sun WY, Sun YJ, Sun YK, Sun YZ, Sun ZT, Tan YH, Tan YX, Tang CJ, Tang GY, Tang J, Teng JX, Thoren V, Uman I, Wang B, Wang BL, Wang CW, Wang DY, Wang HP, Wang K, Wang LL, Wang M, Wang M, Wang WH, Wang WP, Wang X, Wang XF, Wang XL, Wang Y, Wang YD, Wang YF, Wang YQ, Wang Z, Wang ZY, Wang Z, Wang Z, Wei DH, Weidenkaff P, Weidner F, Wen SP, White DJ, Wiedner UW, Wilkinson G, Wolke M, Wollenberg L, Wu JF, Wu LH, Wu LJ, Wu X, Wu Z, Xia L, Xiao H, Xiao SY, Xiao ZJ, Xie XH, Xie YG, Xie YH, Xing TY, Xu GF, Xu JJ, Xu QJ, Xu W, Xu XP, Xu YC, Yan F, Yan L, Yan WB, Yan WC, Yan X, Yang HJ, Yang HX, Yang L, Yang SL, Yang YH, Yang Y, Ye M, Ye MH, Yin JH, You ZY, Yu BX, Yu CX, Yu G, Yu JS, Yu T, Yuan CZ, Yuan L, Yuan W, Yuan Y, Yuan ZY, Yue CX, Zafar AA, Zeng Y, Zhang BX, Zhang GY, Zhang H, Zhang HH, Zhang HH, Zhang HY, Zhang JJ, Zhang JQ, Zhang JW, Zhang JY, Zhang JZ, Zhang J, Zhang J, Zhang L, Zhang SF, Zhang XD, Zhang XY, Zhang Y, Zhang YT, Zhang YH, Zhang Y, Zhang Y, Zhang ZY, Zhao G, Zhao J, Zhao JY, Zhao JZ, Zhao L, Zhao L, Zhao MG, Zhao Q, Zhao SJ, Zhao YB, Zhao YX, Zhao ZG, Zhemchugov A, Zheng B, Zheng JP, Zheng YH, Zhong B, Zhong C, Zhou LP, Zhou Q, Zhou X, Zhou XK, Zhou XR, Zhu AN, Zhu J, Zhu K, Zhu KJ, Zhu SH, Zhu WJ, Zhu WJ, Zhu YC, Zhu ZA, Zou BS, Zou JH. Search for Λ[over ¯]-Λ Baryon-Number-Violating Oscillations in the Decay J/ψ→pK^{-}Λ[over ¯]+c.c. PHYSICAL REVIEW LETTERS 2023; 131:121801. [PMID: 37802947 DOI: 10.1103/physrevlett.131.121801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/14/2023] [Accepted: 08/29/2023] [Indexed: 10/08/2023]
Abstract
We report on the first search for Λ[over ¯]-Λ oscillations in the decay J/ψ→pK^{-}Λ[over ¯]+c.c. by analyzing 1.31×10^{9} J/ψ events accumulated with the BESIII detector at the BEPCII collider. The J/ψ events are produced using e^{+}e^{-} collisions at a center of mass energy sqrt[s]=3.097 GeV. No evidence for hyperon oscillations is observed. The upper limit for the oscillation rate of Λ[over ¯] to Λ hyperons is determined to be P(Λ)=[B(J/ψ→pK^{-}Λ+c.c.)/B(J/ψ→pK^{-}Λ[over ¯]+c.c.)]<4.4×10^{-6} corresponding to an oscillation parameter δm_{ΛΛ[over ¯]} of less than 3.8×10^{-18} GeV at the 90% confidence level.
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Gao Y, Zhao YJ, Li Y, Song JN, Zhang XZ, Sun Y, Yu M, Zhou Q. [The predictive value of melanin-concentrating hormone combined with other related biomarkers in cerebrospinal fluid in preoperative cognitive dysfunction of elderly patients]. ZHONGHUA YI XUE ZA ZHI 2023; 103:2772-2777. [PMID: 37723051 DOI: 10.3760/cma.j.cn112137-20230119-00112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
Objective: To explore the predictive value of cerebrospinal fluid melanin-concentrating hormone (MCH) combined with other related biomarkers in preoperative cognitive dysfunction of elderly patients. Methods: A total of 80 patients who underwent elective hip or knee replacement under intravertebral anesthesia in Chifeng Municipal Hospital, Inner Mongolia, from March to November 2022 were prospectively included, with 32 males and 48 females, and aged 65-85 (70.7±5.2) years old. According to the evaluation results of the Montreal Cognitive Assessment (MoCA), patients were divided into the preoperative cognitive dysfunction (n=23) and control (n=57) groups. The levels of MCH, amyloid-β 40 (Aβ40), amyloid-β 42 (Aβ42), and phosphorylated tau protein (p-tau) in cerebrospinal fluid were determined by enzyme-linked immunosorbent assay (ELISA). The receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of each biomarker separately or in combination for preoperative cognitive dysfunction. Spearman's rank correlation analysis was utilized to test the correlation between the level of each biomarker and MoCA scores. Results: The levels of MCH, Aβ40, Aβ42, p-tau, and Aβ42/p-tau in the preoperative cognitive dysfunction group were (35.53±5.94) μg/L, (39.21±9.18) ng/L, (221.83±43.17) ng/L, (42.64±9.74) ng/L, and 5.53±1.92, and the levels of these biomarkers in the control group were (28.74±4.90) μg/L, (36.37±7.87) ng/L, (280.23±45.67) ng/L, (35.00±9.27) ng/L, and 8.62±2.78, respectively. Compared with the control group, the levels of cerebrospinal fluid MCH and p-tau in the preoperative cognitive dysfunction group were significantly increased (all P<0.01), and the levels of Aβ42 and Aβ42/p-tau were significantly decreased (all P<0.001). MCH and Aβ42/p-tau provided higher predictive values. The area under the curve (AUC) of MCH and Aβ42/p-tau were 0.807 (95%CI: 0.703-0.911) and 0.842 (95%CI: 0.741-0.943), the sensitivity were 78.3% and 87.0%, and the specificity were 75.4% and 94.7%. MCH combined with Aβ42/p-tau have the higher AUC of 0.915 (95%CI: 0.837-0.992), the sensitivity (87.0%) and specificity (86.0%) were both high, which had a higher predictive value. The levels of cerebrospinal fluid MCH and p-tau were negatively correlated with MoCA score (r=-0.467, -0.321, all P<0.01), and the levels of Aβ42 and Aβ42/p-tau were positively correlated with MoCA score (r=0.480, 0.520, all P<0.001). Conclusion: The increase in cerebrospinal fluid MCH levels is associated with preoperative cognitive dysfunction in elderly patients. MCH combined with Aβ42/p-tau has the greatest predictive value.
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Jiang AF, Zhou SS, Zhou Q, Zhao J, Li XP, Zhou RR, Li B. [Clinical characteristics and their influences on the survival of leptomeningeal metastasis derived from lung adenocarcinoma harboring epithelial growth factor receptor mutation]. ZHONGHUA YI XUE ZA ZHI 2023; 103:2713-2719. [PMID: 37675543 DOI: 10.3760/cma.j.cn112137-20221221-02686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
Objective: To analyze the clinical characteristics of leptomeningeal metastasis (LM) patients from epithelial growth factor receptor (EGFR)-mutated lung adenocarcinoma, and their impacts on the survival of the patients. Methods: From July 2018 to July 2022, the clinicopathological data of 81 patients diagnosed as EGFR-mutated lung adenocarcinoma LM by cytopathology who admitted to the Department of Oncology of Xiangya Hospital of Central South University were retrospectively analyzed, including 33 males and 48 females. The age ranged from 31 to 76 years, with a median age of 54 years. All the 81 patients were followed up, with a median follow-up of 21.0 months (95%CI: 12.5 to 29.5 months). The Kaplan Meier method was used to draw survival curve. Cox proportional hazards regression model was used to analyze the impact of the factors on the survival of patients. Results: Among the 81 patients, the interval between the initial diagnosis of lung cancer and the pathological diagnosis of LM in cerebrospinal fluid (CSF) was 0-108 months, with a median interval of 14 months. Fifty-two patients (64.2%) used the third-generation epithelial growth factor receptor tyrosine kinase inhibitor (EGFR-TKIs), while 17 patients (21.0%) used EGFR-TKIs in combination with other drugs, and 12 patients (14.8%) were treated with best supportive care (BSC). Sixty patients (74.1%) had a Kanofsky performance status (KPS) score of less than 60 points, and 71 patients (87.7%) had brain parenchymal metastasis and/or spinal metastasis. Twenty-two patients (27.2%) used pemetrexed through intrathecal CSF, and 17 patients (21.0%) used pemetrexed through the Ommaya sac to the CSF of the ventricle. The incidence of adverse event related to the administration of pemetrexed through CSF was 64.1% (25/39), mainly manifested as myelosuppression, including 22 patients of leukocyte reduction, 25 patients of hemoglobin reduction, and 14 patients of platelet reduction. The median post-leptomeningeal metastasis overall survival (pLM-OS) in 81 patients was 11.0 (95%CI: 7.7-14.3) months. KPS score≥60 points (HR=0.407, 95%CI: 0.170-0.973, P=0.043), CSF cytology negative after treatment (vs persistent positive, HR=0.351, 95%CI: 0.155-0.792, P=0.012), intraventricular administration of pemetrexed (vs non intraventricular administration of pemetrexed, HR=0.319, 95%CI: 0.137-0.745, P=0.008) and the treatment with third-generation EGFR-TKIs after LM (vs EGFR-TKIs in combination with other drugs, HR=0.486, 95%CI: 0.237-0.998, P=0.049) were a factor affecting pLM-OS of patients. Conclusions: Brain parenchyma, or/and spine are the most sites where the LM patients concurrently metastasize. KPS score≥60 points and CSF cytology negative after treatment, intraventricular administration of pemetrexed and the treatment with third-generation EGFR-TKIs are indictors affecting pLM-OS of the patients.
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Wu SY, Lan H, Liu YL, Sun YJ, Ren MJ, Wang P, Chen ZJ, Zhou Q, Ke X, Li GB, Guo QQ, Chen YL, Lu SH. [Definition of severe pulmonary tuberculosis: a scoping review]. ZHONGHUA JIE HE HE HU XI ZA ZHI = ZHONGHUA JIEHE HE HUXI ZAZHI = CHINESE JOURNAL OF TUBERCULOSIS AND RESPIRATORY DISEASES 2023; 46:760-773. [PMID: 37536986 DOI: 10.3760/cma.j.cn112147-20230517-00247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
Objective: To clarify the definition of severe pulmonary tuberculosis and its inclusion criteria by summarizing and analyzing the studies of severe pulmonary tuberculosis (TB). Methods: A systematic search of Medline (via PubMed), Cochrane Library, Web of Science, Web of Science, Epistemonikos, Embase, CNKI, WanFang database, and CBM database was conducted to collect studies published between 2017 and 2022 on patients with severe pulmonary TB. Searches were performed using a combination of subject terms and free words. The search terms included: tuberculosis, severe, serious, intensive care, critical care, respiratory failure, mechanical ventilation, hospitalization, respiratory distress syndrome, multiple organ failure, pulmonary heart disease, and pneumothorax. The definitions and inclusion criteria for severe pulmonary TB in the included studies were extracted. Results: A total of 19 981 studies were identified and 100 studies were finally included, involving 8 309 patients with severe pulmonary TB. A total of 8 (8.00%) studies explicitly mentioned the definition of severe pulmonary TB, and 53 (53.00%) studies clearly defined the inclusion criteria for patients with severe pulmonary TB. A total of 5 definitions and 30 inclusion criteria were extracted. A total of 132 dichotomous variables and 113 continuous variables were included in the outcome indicators related to patients with severe pulmonary TB of concern in the studies. Conclusions: The definition and diagnostic criteria for severe TB are unclear, and there is an urgent need to develop a clear definition and diagnostic criteria to guide clinical practice.
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Sun LJ, Fu Q, Di MJ, Zhou Q, Chen XD. [Mammary myofibroblastoma with extensive atypical/bizarre cells: report of a case]. ZHONGHUA BING LI XUE ZA ZHI = CHINESE JOURNAL OF PATHOLOGY 2023; 52:862-864. [PMID: 37527998 DOI: 10.3760/cma.j.cn112151-20221221-01053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
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Xu JX, Guo CY, Yuan P, Wang BZ, Zhou Q, Ying JM. [Mediastinal germ cell tumor with somatic-type malignancy: report of a case]. ZHONGHUA BING LI XUE ZA ZHI = CHINESE JOURNAL OF PATHOLOGY 2023; 52:733-735. [PMID: 37408409 DOI: 10.3760/cma.j.cn112151-20230212-00120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
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Wu QS, Mao SQ, Xu Y, Gong RJ, Zhou Q, Liu M, Liu JY, Zhu DH, Guo X. [Safety of delayed vaccination with the national immunization program vaccines in children aged 0-6 years from 2019 to 2021 in Xuhui District, Shanghai City in China]. ZHONGHUA YU FANG YI XUE ZA ZHI [CHINESE JOURNAL OF PREVENTIVE MEDICINE] 2023; 57:983-991. [PMID: 37482734 DOI: 10.3760/cma.j.cn112150-20220804-00787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Objective: To understand the incidence of delayed vaccination with the national immunization program vaccines among children aged 0-6 years in Xuhui District, Shanghai, and to evaluate the safety of delayed vaccination. Methods: A stratified random sampling was used to obtain six vaccination clinics in Xuhui District, Shanghai. The vaccination records of children 0-6 years from these six vaccination clinics were collected from the Shanghai Immunization Program Information Management System. Adverse events following immunization (AEFI) data were collected from the China Information System for Disease Control and Prevention. Descriptive epidemiology was used to analyze the data. Children were divided into the timely vaccination group and delayed vaccination group according whether they were delayed in vaccination (received one month or more after the recommended age among children aged ≤1 year; received three months or more after the recommended age among children aged >1 year). The safety of four vaccination methods-individual vaccination, simultaneous vaccination, routine vaccination and combined vaccination-were further compared. Differences between groups were compared using chi-square test. Results: From 2019 to 2021, six vaccination clinics in Xuhui District administered 124 031 doses of the national immunization program vaccines among children aged 0-6 years, and delayed vaccinations accounted for 25.99% (32 234/124 031) of these doses. In 2020, the delayed vaccination rate during the first-level COVID-19 public health emergency response period in Shanghai was significantly higher than that in the same period in 2019 (34.70% vs. 24.19%, χ2=136.23, P<0.05). The delayed vaccination rate during the COVID-19 vaccination campaign in 2021 was significantly higher than that in the same period in 2019 (25.27% vs. 22.55%, χ2=82.80, P<0.05). From 2019 to 2021, a total of 475 cases of AEFI were reported in six vaccination clinics, with a reported incidence of 382.97 per 100 000 doses, including 421 cases of common adverse reaction (88.63%, 339.43 per 100 000 doses), 51 cases of rare adverse reaction (10.74%, 41.12 per 100 000 doses) and 3 cases of coincidences (0.63%, 2.42 per 100 000 doses). The reported incidence of AEFI among delayed vaccinations was significantly lower than that among timely vaccinations (291.62 per 100 000 doses vs. 415.05 per 100 000 doses). The incidence of AEFI for the four delayed vaccination methods (individual vaccination, simultaneous vaccination, routine vaccination and combined vaccination) was lower than that for timely vaccination. There were significant differences between the groups except for the routine vaccination group (χ2=9.82, P<0.05; χ2=5.46, P<0.05; χ2=2.97, P>0.05; χ2=11.89, P<0.05). Conclusions: In Xuhui District of Shanghai, 25.99% of doses of the national immunization program vaccines administered to children 0-6 years were delayed. Delayed vaccination does not increase the risk of AEFI compared with timely vaccination.
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Zhu Y, Zhou Q, Yu Y, Cao Y, Chen C, Zhai XW, Wang J, Wang HS. [A case of neonatal multi-system Langerhans cell histiocytosis treated by dabrafenib]. ZHONGHUA ER KE ZA ZHI = CHINESE JOURNAL OF PEDIATRICS 2023; 61:655-658. [PMID: 37385813 DOI: 10.3760/cma.j.cn112140-20230301-00149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
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Zhang WH, Zhang ZY, Liu Y, Tan ZY, Zhou Q, Lin YZ. High-throughput miRNA sequencing and identification of a novel ICE1-targeting miRNA in response to low temperature stress in Eucalyptus camaldulensis. PLANT BIOLOGY (STUTTGART, GERMANY) 2023; 25:541-550. [PMID: 36971569 DOI: 10.1111/plb.13520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 03/14/2023] [Indexed: 05/17/2023]
Abstract
MicroRNAs (miRNAs) play a crucial role in the growth, development, morphogenesis, signal transduction, and stress response in plants. The ICE (Inducer of CBF expression)-CBF (C-repeat binding factor)-COR (Cold-regulated gene) regulatory cascade is an important signalling pathway in plant response to low temperature stress, and it remains unknown whether this pathway is regulated by miRNAs. In this study, high-throughput sequencing was employed for predicting and identifying the miRNAs that were likely to target the ICE-CBF-COR pathway in Eucalyptus camaldulensis. A novel ICE1-targeting miRNA, eca-novel-miR-259-5p (nov-miR259), was further analysed. A total of 392 conserved miRNAs and 97 novel miRNAs were predicted, including 80 differentially expressed miRNAs. Of these, 30 miRNAs were predicted to be associated with the ICE-CBF-COR pathway. The full-length of mature nov-miR259 was 22 bp and its precursor gene was 60 bp in length, with a typical hairpin structure. The RNA ligase-mediated 5' amplification of cDNA ends (5'-RLM-RACE) and Agrobacterium-mediated tobacco transient expression assays demonstrated that nov-miR259 could cleave EcaICE1 in vivo. Moreover, qRT-PCR and Pearson's correlation analysis further revealed that the expression levels of nov-miR259 were almost significantly negatively correlated with those of its target gene, EcaICE1, and the other genes in the ICE-CBF-COR pathway. We first identified the nov-miR259 as a novel ICE1-targeting miRNA, and the nov-miR259-ICE1 module may be involved in regulating the cold stress response in E. camaldulensis.
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Liu HS, Wu Z, Yang RY, Chen GZ, Li Y, Zhou Q, Yuan HP, Yang Z, Sun L. [Association between serum lysophosphatidylcholine level and elderly health index in older people from longevity areas of Guangxi Province]. ZHONGHUA YU FANG YI XUE ZA ZHI [CHINESE JOURNAL OF PREVENTIVE MEDICINE] 2023; 57:649-653. [PMID: 37165812 DOI: 10.3760/cma.j.cn112150-20221124-01144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Objective: To investigate the relationship between serum lysophosphatidylcholine (LPC) level and the health index of the elderly. Methods: A total of 251 subjects were selected from the 2016 baseline survey of the Yongfu Longevity Cohort in Guangxi Province among whom 66, 63 and 122 were in the young and middle-aged group (≤59 years old), the young group (60-89 years old) and the longevity group (≥90 years old), respectively. Demographic data were collected and related indicators of height, weight, blood pressure and lipid metabolism were measured. The cognitive and physical functions of the elderly were assessed by the results of the simple mental state scale and the daily living activity scale to construct the health index of the elderly. The serum levels of LPC16∶0, LPC18∶0, LPC18∶1 and LPC18∶2 were determined by liquid chromatography-tandem mass spectrometry, and the differences among different ages and health status groups were compared. The logistic regression model was used to analyze the relationship between the serum LPC level and the health index of the elderly. Results: With the increase in age, the proportion of female subjects increased, and the rate of smoking and drinking decreased. BMI, TC, TG, LDL-C, diastolic blood pressure, and the four LPCs levels decreased with the increase of age, and systolic blood pressure levels increased with the increase of age (all P values<0.05). There was no significant difference in HDL-C levels among age groups (P>0.05). With the decline of health status in the elderly, serum levels of LPC16∶0, LPC18∶0, LPC18∶1 and LPC18∶2 showed a downward trend (all P values<0.001). After adjusting for age and gender, only LPC18∶0 was associated with the health status in old age [OR (95%CI): 0.48 (0.25-0.92)]. For every 1 standard deviation (16.87 nmol/L) increase in serum LPC18∶0 concentration, the risk of poor health status in old age decreased by 52%. Conclusion: Serum LPC18∶0 was associated with the health status in old age independent of age and sex.
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Liu HS, Wu Z, Yang RY, Chen GZ, Li Y, Du SC, Zhou Q, Yuan HP, Yang Z, Sun L. [Research progress on main disease-related factors of healthy life expectancy]. ZHONGHUA YU FANG YI XUE ZA ZHI [CHINESE JOURNAL OF PREVENTIVE MEDICINE] 2023; 57:654-658. [PMID: 37165813 DOI: 10.3760/cma.j.cn112150-20221124-01146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
International research on healthy life expectancy (HALE) focuses on inequality of socioeconomic status and individual natural attributes. With the acceleration of population ageing and the increase in average life expectancy, the extension of unhealthy life expectancy and the increase of social and economic burden caused by diseases have gradually attracted the attention of countries around the world. Therefore, the evaluation of disease factors affecting HALE is a meaningful direction in the future. This study introduces the development process and commonly used measurement methods of HALE. According to the definition of health from the Global Burden of Disease Study and World Health Organization, physical and mental diseases such as cardiovascular and cerebrovascular diseases, chronic respiratory diseases, diabetes, malignant tumors and depression were selected to summarize the impact of these diseases and pre-disease states on HALE. It is expected to provide a theoretical basis for the formulation of relevant public health policies and the improvement of quality of life in China.
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Du ZQ, Jiang Y, Lu RR, Zhou Q, Shen Y, Zhu HH. Pharmaceutical care of vascular dementia patients with drug-induced liver injury caused by the Compound Congrong Yizhi Capsules: a case report. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2023; 27:4693-4697. [PMID: 37259753 DOI: 10.26355/eurrev_202305_32481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Drug-induced liver injury (DILI) is a newly discovered adverse drug reaction of Compound Congrong Yizhi Capsules (CCYC) in the treatment of vascular dementia (VD), and targeted pharmaceutical care is urgently needed to be explored. CASE REPORT DILI was found in a patient who was admitted to the hospital with a diagnosis of VD after treatment with Compound Congrong Yizhi Capsules. According to the guidelines, the patient was initially treated with magnesium isoglycyrrhizinate injection. After 4 days, the clinical pharmacist monitored liver function: alanine aminotransferase (ALT): 153 IU/L, aspartate aminotransferase (AST): 160 IU/L, total bilirubin (TBil): 4.5 µmol/L, and alkaline phosphatase (ALP): 551 IU/L, which indicated that DILI was further aggravated. In addition, the increased blood pressure (156/65 mmHg) indicated the requirement to adjust the medication. Then, the hepatoprotective drugs were adjusted with reduced glutathione combined with ursodeoxycholic acid. After 12 days of treatment, the liver function was significantly improved, the clinical treatment was effective, and the blood pressure was controlled stably with no obvious adverse drug reactions. CONCLUSIONS With pharmaceutical care guided by clinical pharmacists, the DILI caused by Compound Congrong Yizhi capsules could be reversed to improve the clinical outcome and avoid the occurrence of serious complications.
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Xu YY, Su ZZ, Zheng LM, Zhang MN, Tan JY, Yang YL, Zhang MX, Xu M, Chen N, Chen XQ, Zhou Q. [Read-through circular RNA rt-circ-HS promotes hypoxia inducible factor 1α expression and renal carcinoma cell proliferation, migration and invasiveness]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2023; 55:217-227. [PMID: 37042131 PMCID: PMC10091263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
OBJECTIVE To identify and characterize read-through RNAs and read-through circular RNAs (rt-circ-HS) derived from transcriptional read-through hypoxia inducible factor 1α (HIF1α) and small nuclear RNA activating complex polypeptide 1 (SNAPC1) the two adjacent genes located on chromosome 14q23, in renal carcinoma cells and renal carcinoma tissues, and to study the effects of rt-circ-HS on biological behavior of renal carcinoma cells and on regulation of HIF1α. METHODS Reverse transcription-polymerase chain reaction (RT-PCR) and Sanger sequencing were used to examine expression of read-through RNAs HIF1α-SNAPC1 and rt-circ-HS in different tumor cells. Tissue microarrays of 437 different types of renal cell carcinoma (RCC) were constructed, and chromogenic in situ hybridization (ISH) was used to investigate expression of rt-circ-HS in different RCC types. Small interference RNA (siRNA) and artificial overexpression plasmids were designed to examine the effects of rt-circ-HS on 786-O and A498 renal carcinoma cell proliferation, migration and invasiveness by cell counting kit 8 (CCK8), EdU incorporation and Transwell cell migration and invasion assays. RT-PCR and Western blot were used to exa-mine expression of HIF1α and SNAPC1 RNA and proteins after interference of rt-circ-HS with siRNA, respectively. The binding of rt-circ-HS with microRNA 539 (miR-539), and miR-539 with HIF1α 3' untranslated region (3' UTR), and the effects of these interactions were investigated by dual luciferase reporter gene assays. RESULTS We discovered a novel 1 144 nt rt-circ-HS, which was derived from read-through RNA HIF1α-SNAPC1 and consisted of HIF1α exon 2-6 and SNAPC1 exon 2-4. Expression of rt-circ-HS was significantly upregulated in 786-O renal carcinoma cells. ISH showed that the overall positive expression rate of rt-circ-HS in RCC tissue samples was 67.5% (295/437), and the expression was different in different types of RCCs. Mechanistically, rt-circ-HS promoted renal carcinoma cell proliferation, migration and invasiveness by functioning as a competitive endogenous inhibitor of miR-539, which we found to be a potent post-transcriptional suppressor of HIF1α, thus promoting expression of HIF1α. CONCLUSION The novel rt-circ-HS is highly expressed in different types of RCCs and acts as a competitive endogenous inhibitor of miR-539 to promote expression of its parental gene HIF1α and thus the proliferation, migration and invasion of renal cancer cells.
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Chen N, Zhou Q. [The 5th WHO classification of prostate tumors: an update and interpretation]. ZHONGHUA BING LI XUE ZA ZHI = CHINESE JOURNAL OF PATHOLOGY 2023; 52:321-328. [PMID: 36973190 DOI: 10.3760/cma.j.cn112151-20221208-01030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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Fu Y, Cai J, Chen Y, Zhou Q, Xu YM, Shi J, Fan XS. [Concordance between three integrated scores based on prostate biopsy and grade-grouping of radical prostatectomy specimen]. ZHONGHUA BING LI XUE ZA ZHI = CHINESE JOURNAL OF PATHOLOGY 2023; 52:353-357. [PMID: 36973195 DOI: 10.3760/cma.j.cn112151-20221125-00992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
Objective: To analyze three different integrated scoring schemes of prostate biopsy and to compare their concordance with the scoring of radical prostatectomy specimens. Methods: A retrospective analysis of 556 patients with radical prostatectomy performed in Nanjing Drum Tower Hospital, Nanjing, China from 2017 to 2020. In these cases, whole organ sections were performed, the pathological data based on biopsy and radical prostatectomy specimens were summarized, and 3 integrated scores of prostate biopsy were calculated, namely the global score, the highest score and score of the largest volume. Results: Among the 556 patients, 104 cases (18.7%) were classified as WHO/ISUP grade group 1, 227 cases (40.8%) as grade group 2 (3+4=7); 143 cases (25.7%) as grade group 3 (4+3=7); 44 cases (7.9%) as grade group 4 (4+4=8) and 38 cases (6.8%) as grade group 5. Among the three comprehensive scoring methods for prostate cancer biopsy, the consistency of global score was the highest (62.4%). In the correlation analysis, the correlation between the scores of radical specimens and the global scores was highest (R=0.730, P<0.01), while the correlations of the scores based on radical specimens with highest scores and scores of the largest volume based on biopsy were insignificant (R=0.719, P<0.01; R=0.631, P<0.01, respectively). Univariate and multivariate analyses showed tPSA group and the three integrated scores of prostate biopsy were statistically correlated with extraglandular invasion, lymph node metastasis, perineural invasion and biochemical recurrence. Elevated global score was an independent prognostic risk factor for extraglandular invasion and biochemical recurrence in patients; increased serum tPSA was an independent prognostic risk factor for extraglandular invasion; increased hjighest score was an independent risk factor for perineural invasion. Conclusions: In this study, among the three different integrated scores, the overall score is most likely corresponded to the radical specimen grade group, but there is difference in various subgroup analyses. Integrated score of prostate biopsy can reflect grade group of radical prostatectomy specimens, thereby providing more clinical information for assisting in optimal patient management and consultation.
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Wu YL, Zhang L, Fan Y, Zhou J, Zhang L, Zhou Q, Li W, Hu C, Chen G, Zhang X, Zhou C, Arenas C, Chen Z, Yu W, Mok T. 42P Pembrolizumab vs chemotherapy in Chinese patients with non-small cell lung cancer (NSCLC) and PD-L1 TPS ≥1%: 5-year update from KEYNOTE-042. J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00296-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
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Liu SY, Zhou Q, Lu C, Deng JY, Wang Z, Li YS, Zheng MM, Xu BF, Dong XR, Du YY, Cui JW, Chu Q, Bai XY, Sun YL, Li A, Xu CR, Wang BC, Chen HJ, Yang JJ, Wu YL. 20P Efficacy and safety of AZD3759 in previously untreated EGFR-mutant non-small cell lung cancer with central nervous system metastases in a multi-center, phase II umbrella trial (CTONG1702). J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00274-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
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Xu R, Zhou D, Liu M, Zhou Q, Xie L, Zeng S. Impaired ascending aortic elasticity in fetuses with tetralogy of Fallot. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2023; 61:497-503. [PMID: 36173559 DOI: 10.1002/uog.26079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 09/05/2022] [Accepted: 09/06/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES Aortic wall stiffness has been reported in infants with tetralogy of Fallot (ToF) and may contribute to long-term aortic dilation even after corrective repair surgery. However, little is known about aortic elasticity in fetuses with ToF and the association with neonatal aortic dilation. The objectives of this study were to assess measures of elasticity of the ascending aorta (AAo) in fetuses with ToF and explore the association with neonatal aortic annular dilation in this population. METHODS Seventy-six singleton fetuses with ToF and 76 control fetuses of singleton low-risk pregnancies were enroled into this prospective study. Fetal measures of AAo elasticity, including mean longitudinal strain (MLS), global circumferential strain (GCS) and fractional area change (FAC), were assessed by velocity vector imaging. The z-score of the aortic valve (AV) diameter at the level of the annulus, as a measure of aortic annular dilation, was determined in newborns. Logistic regression analysis was used to investigate the association between fetal measures of AAo elasticity and neonatal aortic annular dilation (defined as an AV annular z-score > 2) in cases with ToF identified prenatally. RESULTS Median MLS, GCS and FAC in fetuses with ToF were lower than those in normal fetuses (7.52% vs 12.15% for MLS, 22.05% vs 29.73% for GCS and 34.2% vs 48.3% for FAC, all P < 0.001). Aortic annular dilation was present in 53/76 (69.7%) newborns with ToF. After adjustment for gestational age at fetal echocardiography and birth weight, fetal MLS, GCS and FAC were independently associated with aortic annular dilation neonatally, with odds ratios of 0.66, 0.78 and 0.82, respectively (P < 0.05). The best cut-off values of these prenatal measures of AAo elasticity for predicting neonatal aortic annular dilation in fetuses with ToF were 9.02% for MLS, 23.56% for GCS and 37.2% for FAC (P < 0.001), with areas under the receiver-operating-characteristics curves of 0.94, 0.91 and 0.93, respectively. CONCLUSION Measures of AAo elasticity are decreased in fetuses with ToF. Impaired AAo elasticity in the fetal period is associated with aortic annular dilation postnatally. Additional research is needed to evaluate the relationship between the AAo elasticity injury pattern and degeneration of AAo elasticity under stress as well as the long-term outcome in this population. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.
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