26
|
Li L, Chen XJ, Cui MH, Feng LM, Fu C, Gu J, Ha CF, Huang XF, Lu Q, Ma XX, Shen DH, Tian QJ, Wang G, Wang SX, Wu LY, Xie MQ, Yang X, Zhang SL, Zhou XR, Zhu L. [Chinese guideline on the management of endometrial hyperplasia]. ZHONGHUA FU CHAN KE ZA ZHI 2022; 57:566-574. [PMID: 36008282 DOI: 10.3760/cma.j.cn112141-20220628-00418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
|
27
|
Wu HL, Chen L, Wei M, Lu Q, Li N, Wang GQ, Shi RH. [Effect and mechanism of glucocorticoids in preventing stenosis after esophageal endoscopic submucosal dissection]. ZHONGHUA YI XUE ZA ZHI 2022; 102:1506-1511. [PMID: 35692065 DOI: 10.3760/cma.j.cn112137-20210905-02024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To explore the role and specific mechanism of glucocorticoids in preventing stenosis after esophageal endoscopic submucosal dissection (ESD). Methods: Data of 81 patients [51 cases were male and 30 cases were female, aged (62.09±7.95) years] undergoing early esophageal cancer or precancerous lesions with a stripping range ≥3/4 circle hospitalized from January 2019 to February 2021 in Department of Gastroenterology, Zhongda Hospital, Southeast University. They were randomly divided into the control group (n=23), oral prednisone acetate group (n=28) and/or combined with local injection Triamcinolone acetonide group (n=30). Analysis the stenosis rates, endoscopic stent dilatation times, the scores of the Atkinson classification and QLQ-OES18 after 12 weeks. Also the expression of carbohydrate sulfotransferase15 (CHST15) mRNA, TGF-β1 and Collagen-Ⅰ protein were compared by real-time PCR or immunohistochemistry. Results: The stenosis rates of the control group, oral prednisone acetate group and/or combined with local injection Triamcinolone acetonide group were 82.6% (19/23), 46.4% (13/28) and 20.0% (6/30) (P<0.001); endoscopic stent dilatation times [M (Q1,Q3)] in these three groups were 2 (1, 3), 0 (0, 0) and 0 (0, 0) (P<0.001). After ESD, the scores of the Atkinson classification and QLQ-OES18 in the three groups were lower than before (P<0.001); and the expression of CHST15 mRNA in the three groups were 4.31±0.13, 3.44±0.07 and 2.84±0.21 respectively (P<0.001). Compared with the control group, the expression of CHST15 mRNA in oral prednisone acetate group was down-regulated (P<0.001), and was the lowest in oral prednisone acetate combined with local injection Triamcinolone acetonide group (P<0.001). As CHST15 mRNA was down-regulated, the expression of TGF-β1 and Collagen-I protein was also down-regulated (P<0.05). Conclusions: Oral prednisone alone or combined with local injection of triamcinolone acetonide both can prevent esophageal stenosis effectively. Oral combined with local injection of glucocorticoid is particularly more effective. Glucocorticoid can reduce the expression of CHST15 mRNA, thereby inhibiting the expression of TGF-β1 and Collagen-I protein.
Collapse
|
28
|
Zhao SY, Lu Q. [Raising awareness and practice of invasive pulmonary fungal infections in children]. ZHONGHUA ER KE ZA ZHI = CHINESE JOURNAL OF PEDIATRICS 2022; 60:271-273. [PMID: 35385929 DOI: 10.3760/cma.j.cn112140-20220224-00145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
|
29
|
Meng CY, Gong XL, Zhao R, Lu Q, Dong XY. [Effect of maternal exposure to lipopolysaccharide during pregnancy on allergic asthma in offspring in mice]. ZHONGHUA ER KE ZA ZHI = CHINESE JOURNAL OF PEDIATRICS 2022; 60:302-306. [PMID: 35385934 DOI: 10.3760/cma.j.cn112140-20220130-00100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To investigate the effect of maternal exposure to lipopolysaccharide during pregnancy on allergic asthma in offspring in mice. Methods: Animal experimental research was carried out from June 2019 to June 2021.Pregnant C57BL/6J mice were randomly divided into 2 groups by intraperitoneal injection with 7 μg/kg lipopolysaccharide (LPS) or phosphate buffered saline (PBS) at day 15.5 of gestation. After birth, 6 offspring were randomly chosen from each group at the age of 4 weeks, and stimulated with house dust mites (HDM) or PBS, further divided into 4 groups, such as LPS+PBS group, LPS+HDM group, PBS+PBS group, PBS+HDM group, with 3 mice in each group. The cough and wheezing were observed, the histological changes in lung tissue were examined after HE staining, and the expression of inflammatory factors including interleukin (IL)-4, IL-6, IL-17A, IL-23, interferon (IFN)-α and IFN-β in the lung tissue were detected by high-throughput liquid protein chip detection. T test or rank sum test was used for the comparison among these groups. Results: The asthma-like airway inflammation was more obvious in PBS+HDM group after stimulated by HDM than that in PBS+PBS group, nevertheless, this manifestation in LPS+HDM group was milder than that in PBS+HDM group. HE staining showed that inflammatory cell aggregation in the lung tissue in PBS+HDM group was significantly higher than that in PBS+PBS group (4.0 (3.5, 4.0) vs. 0 (0, 0.5), Z=2.02, P=0.043), while it was much lower in LPS+HDM group compared to PBS+HDM group (1.0 (0.5, 1.5) vs. 4.0 (3.5, 4.0), Z=1.99, P=0.046). High-throughput liquid protein chip detection of lung tissue showed that IL-6, IL-23 and IFN-β levels were significantly higher in PBS+HDM group when compared to those in PBS+PBS group ((114±3) vs. (94±4) ng/L, (210±4) vs. (173±7) ng/L, (113±2) vs. (94±4) ng/L, t=4.37, 4.84, 3.96, all P<0.05), while the levels of IL-6, IL-23, IFN-α, IFN-β in LPS+HDM group were significantly lower than those in PBS+HDM group ((87±5) vs. (114±3) ng/L, (171±7) vs. (210±4) ng/L, (16.1±0.6) vs. (20.9±0.3) ng/L, (95±1) vs. (113±2) ng/L, t=5.07, 5.07, 7.28, 7.47, all P<0.05). Conclusions: Prenatal low dose LPS exposure can reduce offspring's airway inflammatory reactions and prevent the development of allergic disease. Maternal infection during pregnancy may affect the occurrence and development of allergic asthma in offspring.
Collapse
|
30
|
He YJ, Wang YQ, Dai YB, Zhou R, Lu Q, Liu GL, Wang JL. [Clinical outcomes analysis of fertility-preserving therapy for atypical endometrial hyperplasia and early endometrial carcinoma]. ZHONGHUA ZHONG LIU ZA ZHI [CHINESE JOURNAL OF ONCOLOGY] 2022; 44:291-296. [PMID: 35316880 DOI: 10.3760/cma.j.cn112152-20201014-00897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To analyze the clinical efficacy of fertility-preserving therapy in patients with atypical endometrial hyperplasia (AEH) and early endometrial carcinoma (EC). Methods: The general condition, pathological type, treatment plan, tumor outcomes and pregnancy outcomes of 110 patients with AEH and EC treated with fertility-preserving therapy in Peking University People's Hospital from December 2005 to September 2019 were retrospectively analyzed. Kaplan-Meier and Log rank tests were used for survival analysis. Results: The response rate of 110 cases of AEH (62 cases) and EC (48 cases) was 94.5% (104/110) after fertility-preserving therapy. There were 93 cases (84.5%) achieved complete response and 11 cases (10.0%) achieved partial response, and the recurrence rate was 29.0% (27/93). The complete response rates of AEH and EC were 90.3% (56/62) and 77.1% (37/48), respectively, without significant difference (P=0.057). The recurrence rates of EC were significantly higher than that of AEH (40.5% vs 21.4%; P=0.022). Forty-one patients with complete response had pregnancy intention, the pregnancy rate was 70.7% (29/41), and the live birth rate was 56.1% (23/41). The live birth rate of AEH was 68.2% (15/22) and that of EC was 42.1% (8/19), the difference was statistically significant (P=0.032). The pathological type was related with the recurrence (P=0.044). Conclusions: Patients with AEH and EC can obtain high complete response rate and pregnancy rate after fertility-preserving therapy. The recurrence rate of EC is higher than that of AEH, while the live birth rate of AEH is higher than that of EC.
Collapse
|
31
|
Chu L, Wang L, Wu Y, Yang H, Wang W, Lu Q, Deng H. REMOVED: Plasma Steroids and Endocannabinoids Used as Biomarkers to Assess the Pruritus Severity of Patients With Prurigo Nodularis. ACTAS DERMO-SIFILIOGRAFICAS 2022; 113:T244-T253. [PMID: 35331446 DOI: 10.1016/j.ad.2021.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 10/09/2021] [Accepted: 10/11/2021] [Indexed: 10/20/2022] Open
Abstract
This article has been retracted: please see Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy). This article has been retracted at the request of the first author and the approval of all of the co-authors. After publication, the author contacted the journal regarding errors affecting the statistical analysis: the incorrect identification of patients in the part of clinical information and biomarker's levels led to incorrect conclusions of the study. The data is lacking experimental verification due to data loss and errors. The editor in chief accepted the retraction. The authors offer their apologies.
Collapse
|
32
|
Chu L, Wang LK, Wu Y, Yang H, Wang W, Lu Q, Deng H. REMOVED: Plasma Steroids and Endocannabinoids Used as Biomarkers to Assess the Pruritus Severity of Patients With Prurigo Nodularis. ACTAS DERMO-SIFILIOGRAFICAS 2022; 113:244-253. [PMID: 35282859 DOI: 10.1016/j.ad.2022.02.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 10/11/2021] [Indexed: 12/16/2022] Open
Abstract
This article has been retracted: please see Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy). This article has been retracted at the request of the first author and the approval of all of the co-authors. After publication, the author contacted the journal regarding errors affecting the statistical analysis: the incorrect identification of patients in the part of clinical information and biomarker's levels led to incorrect conclusions of the study. The data is lacking experimental verification due to data loss and errors. The editor in chief accepted the retraction. The authors offer their apologies.
Collapse
|
33
|
Lu Q, Li P, Cao Q, Yang X, Yuan B. Robot assisted reconstruction of the ureteral and ileal outflow tract in patients with a history of radical cystectomy plus single stoma cutaneous ureterostomy-5 cases of initial experience. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)01329-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
34
|
Lu Q, Xie Y, Zhu Z, Huang G, Ashby C, Chen ZS. Zandelisib. Phosphatidylinositol 3-kinase delta (PI3Kdelta) inhibitor, Treatment of B-cell lymphomas. DRUG FUTURE 2022. [DOI: 10.1358/dof.2022.47.8.3427161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
|
35
|
Chen S, Wang Y, Wang Z, Zhang X, Deng C, Ma B, Yang J, Lu Q, Zhao Y. Sleep Duration and Frailty Risk among Older Adults: Evidence from a Retrospective, Population-Based Cohort Study. J Nutr Health Aging 2022; 26:383-390. [PMID: 35450995 DOI: 10.1007/s12603-022-1766-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Frailty and sleep duration complaints are both prevalent and often coexist among older adults. The purpose of this study was to examine the prospective association between sleep duration and frailty risk in a nationally representative cohort study. DESIGN Prospective cohort study, ten-year follow-up. SETTING Community-based setting in 23 provinces of China. PARTICIPANTS A total of 7623 older adults age 65 and over without frailty at baseline were included in the analysis. MEASUREMENTS The participants were divided into three groups according to self-reported sleep duration: short (≤6 hours per day), middle (>6 but <10 hours per day) and long (≥10 hours per day). Frailty was measured according to the accumulation of health deficits by the construction of a frailty index of 38 items with 0.25 as the cutoff. A Cox proportional hazard model, a competing risk model and a generalized estimating equation (GEE) model with multiple adjustments were performed to evaluate the association between sleep duration and frailty risk. RESULTS During a median follow-up period of 4.4 years (IQR 2.9-9.0), 2531 (33.2%) individuals developed frailty. Compared with participants with middle sleep duration, the risk of frailty was increased among participants with long sleep duration (HR 1.26, 95% CI 1.14-1.38) in the fully adjusted Cox proportional hazard model. However, short sleep duration was insignificantly associated with frailty risk. The competing risk model and the GEE model yielded similar results. CONCLUSION Long sleep duration is significantly associated with frailty incidence among older adults even after adjustment for confounding factors. This study provides reinforcing longitudinal evidence for the need to design sleep quality improvement interventions in health care programs to prevent frailty among older adults.
Collapse
|
36
|
Gao C, Ma X, Zhang Z, Lu Q, Ashby CJ, Wei L, Chen ZS. Asparaginase Erwinia chrysanthemi for acute lymphoblastic leukemia and lymphoblastic lymphoma. Drugs Today (Barc) 2022; 58:261-271. [DOI: 10.1358/dot.2022.58.6.3413459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
37
|
Mao LL, Zhang ZL, Xu B, Lu Q, Liu J. [A case of acute liver injury caused by atorvastatin in a patient with SLCO1B1*1b haplotype]. ZHONGHUA GAN ZANG BING ZA ZHI = ZHONGHUA GANZANGBING ZAZHI = CHINESE JOURNAL OF HEPATOLOGY 2021; 29:1205-1206. [PMID: 35045640 DOI: 10.3760/cma.j.cn501113-20200701-00359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
|
38
|
Zhang L, Wang Y, Zhuang B, Zhang T, Jin S, Lu Q, Zhao D, Zheng B, Xiao S, Sun Y, Gong L, Wang W. Cutoff values of reduced muscle mass in chinese patients with head and neck cancer during radiotherapy. Clin Nutr ESPEN 2021. [DOI: 10.1016/j.clnesp.2021.09.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
39
|
Li X, Li W, Dai X, Li W, Zhang J, Wang Z, Tong Y, Chen Y, Zhang L, Song C, Meng Q, Wei M, Liu Z, Lu Q. Thoracic Endovascular Repair for Aortic Arch Pathologies with Surgeon Modified Fenestrated Stent Grafts: A Multicentre Retrospective Study. J Vasc Surg 2021. [DOI: 10.1016/j.jvs.2021.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
40
|
Wang Y, Zhang L, Zhuang B, Zhang T, Jin S, Huang Z, Zhao D, Zheng B, Xiao S, Gong L, Sun Y, Lu Q. Predictive factors of crucial nutrition impact symptom clusters in patients with head and neck cancer with radiotherapy. Clin Nutr ESPEN 2021. [DOI: 10.1016/j.clnesp.2021.09.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
41
|
Zhang Y, Lu Q, Monsoor T, Hussain SA, Qiao JX, Salamon N, Fallah A, Sim MS, Asano E, Sankar R, Staba RJ, Engel J, Speier W, Roychowdhury V, Nariai H. Refining epileptogenic high-frequency oscillations using deep learning: a reverse engineering approach. Brain Commun 2021; 4:fcab267. [PMID: 35169696 PMCID: PMC8833577 DOI: 10.1093/braincomms/fcab267] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 09/29/2021] [Accepted: 10/04/2021] [Indexed: 11/12/2022] Open
Abstract
Intracranially recorded interictal high-frequency oscillations have been proposed as a promising spatial biomarker of the epileptogenic zone. However, its visual verification is time-consuming and exhibits poor inter-rater reliability. Furthermore, no method is currently available to distinguish high-frequency oscillations generated from the epileptogenic zone (epileptogenic high-frequency oscillations) from those generated from other areas (non-epileptogenic high-frequency oscillations). To address these issues, we constructed a deep learning-based algorithm using chronic intracranial EEG data via subdural grids from 19 children with medication-resistant neocortical epilepsy to: (i) replicate human expert annotation of artefacts and high-frequency oscillations with or without spikes, and (ii) discover epileptogenic high-frequency oscillations by designing a novel weakly supervised model. The ‘purification power’ of deep learning is then used to automatically relabel the high-frequency oscillations to distill epileptogenic high-frequency oscillations. Using 12 958 annotated high-frequency oscillation events from 19 patients, the model achieved 96.3% accuracy on artefact detection (F1 score = 96.8%) and 86.5% accuracy on classifying high-frequency oscillations with or without spikes (F1 score = 80.8%) using patient-wise cross-validation. Based on the algorithm trained from 84 602 high-frequency oscillation events from nine patients who achieved seizure-freedom after resection, the majority of such discovered epileptogenic high-frequency oscillations were found to be ones with spikes (78.6%, P < 0.001). While the resection ratio of detected high-frequency oscillations (number of resected events/number of detected events) did not correlate significantly with post-operative seizure freedom (the area under the curve = 0.76, P = 0.06), the resection ratio of epileptogenic high-frequency oscillations positively correlated with post-operative seizure freedom (the area under the curve = 0.87, P = 0.01). We discovered that epileptogenic high-frequency oscillations had a higher signal intensity associated with ripple (80–250 Hz) and fast ripple (250–500 Hz) bands at the high-frequency oscillation onset and with a lower frequency band throughout the event time window (the inverted T-shaped), compared to non-epileptogenic high-frequency oscillations. We then designed perturbations on the input of the trained model for non-epileptogenic high-frequency oscillations to determine the model’s decision-making logic. The model confidence significantly increased towards epileptogenic high-frequency oscillations by the artificial introduction of the inverted T-shaped signal template (mean probability increase: 0.285, P < 0.001), and by the artificial insertion of spike-like signals into the time domain (mean probability increase: 0.452, P < 0.001). With this deep learning-based framework, we reliably replicated high-frequency oscillation classification tasks by human experts. Using a reverse engineering technique, we distinguished epileptogenic high-frequency oscillations from others and identified its salient features that aligned with current knowledge.
Collapse
|
42
|
Lu Q, Elakkad M, Daak A, Choh C, Durrani A, Brent A. 1030 Paediatric Appendicectomy - Appropriateness of Operative Intervention. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aim
Acute appendicitis is one of the most common paediatric surgical emergencies. Prompt diagnosis and interventions reduce the risk of perforation and prevents complications. The aim of the audit was to determine the appropriateness of operative intervention and to improve patient care by implementing changes. We assessed several performance indicators including the percentage of appendicectomy performed within 12 hours of decision to operate, the percentage of negative appendicectomy and the 30 days re-admission rate.
Method
All consecutive paediatric patients who had appendicectomy in our district general hospital from Jan 2017 to 2019 were included in the initial audit. For re-audit, we collected data from July 2019 to March 2020. Patients were identified from the theatre system and ward notes, theatre charts and biochemistry and histology results were collected from the electronic patient records.
Results
A total of 193 patients were included in the initial audit. Results showed that 52.8% of patients were reviewed by a consultant prior to surgery, 92% of patients had surgery within 12 hours of the decision to operate. The rate of negative appendicectomy rate was 25%.
Conclusions
Following this audit, several changes have been implemented including improving consultant review of paediatric patients, increasing imaging done by radiologists for paediatric patient. Re-audit showed that 86.7% of patients were reviewed by a consultant preoperatively. Negative appendicectomy rate remained the same at 24.4%. Admissions within 30 days of discharge improved from 13.8% in the initial audit to 11.5% in re-audit.
Collapse
|
43
|
Lu Q, Huang H, Tang S, Wang Y, Yang DH. Tafasitamab for refractory/relapsed diffuse large B-cell lymphoma. Drugs Today (Barc) 2021; 57:571-580. [PMID: 34586105 DOI: 10.1358/dot.2021.57.9.3306767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Diffuse large B-cell lymphoma (DLBCL) is a common lymphoproliferative and invasive disease. The current first-line regimen for the treatment of DLBCL is R-CHOP, which is the combination of rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone. R-CHOP has significantly improved the outcome of DLBCL in the last decades. However, 30-40% of patients fail the therapy with R-CHOP. Salvage chemotherapy for relapsed/refractory DLBCL (R/R DLBCL) is extremely challenging, especially in elderly patients. In July 2020, a new monoclonal antibody, tafasitamab, was approved by the Food and Drug Administration (FDA) of the United States for the treatment of DLBCL. Tafasitamab is an anti-CD19 monoclonal antibody which is Fc-enhanced and humanized. CD19 is typically expressed in the developing B cells in non-Hodgkin's lymphomas. Tafasitamab has been proven to be a safe and valid treatment and recommended to be used in combination with lenalidomide in adults with R/R DLBCL who are ineligible for autologous stem cell transplantation (ASCT). This article evaluates the pharmacodynamics, pharmacokinetics, mechanism of action and the clinical application of tafasitamab in the treatment of DLBCL, particularly in R/R DLBCL. The advantages and disadvantages of using tafasitamab and chimeric antigen receptor T cells (CAR-T cells) targeting CD19 are also discussed.
Collapse
|
44
|
Lu Q, Chen YL. [Walk into the clinical practice guidelines for the diagnosis and treatment of cough]. ZHONGHUA ER KE ZA ZHI = CHINESE JOURNAL OF PEDIATRICS 2021; 59:715-716. [PMID: 34645209 DOI: 10.3760/cma.j.cn112140-20210726-00627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
45
|
Zhao Y, Wu L, Lu Q, Gao X, Zhu X, Yao X, Li L, Li W, Ding Y, Song Z, Liu L, Dang N, Zhang C, Liu X, Gu J, Wang J, Geng S, Liu Q, Guo Y, Dong L, Su H, Bai L, O'Malley JT, Luo J, Laws E, Mannent L, Ruddy M, Amin N, Bansal A, Ota T, Wang M, Zhang J. The efficacy and safety of dupilumab in Chinese patients with moderate-to-severe atopic dermatitis: a randomized, double-blind, placebo-controlled study. Br J Dermatol 2021; 186:633-641. [PMID: 34358343 PMCID: PMC9298048 DOI: 10.1111/bjd.20690] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Dupilumab is an antibody against interleukin 4 receptor α, used in treating atopic dermatitis (AD). OBJECTIVES To evaluate the efficacy and safety of dupilumab in adult Chinese patients with moderate-to-severe AD. METHODS In this randomized, double-blind, placebo-controlled, parallel-group, phase III study, conducted between December 2018 and February 2020, patients with AD received dupilumab (300mg) or placebo once every 2 weeks for 16 weeks, and were followed up for 12 weeks. The primary efficacy endpoint was the proportion of patients with both Investigator's Global Assessment (IGA) score of 0-1 and a reduction from baseline of ≥2 points at week 16. RESULTS Overall, 165 patients (mean age: 30.6 years; 71.5% male) were randomized: 82 to dupilumab and 83 to placebo. At week 16, 26.8% of patients in the dupilumab group and 4.8% of patients in the placebo group achieved the primary endpoint (difference, 22.0%; 95% confidence interval [CI], 11.37-32.65%; p<0.0001). Compared with placebo, higher proportions of patients in the dupilumab group achieved ≥75% reduction in the Eczema Area and Severity Index score (57.3% vs 14.5%; difference, 42.9%; 95% CI, 29.75-55.97%; p<0.0001) and had ≥3-point (52.4% vs 9.6%; difference, 42.8%; 95% CI, 30.26-55.34%; p<0.0001) and ≥4-point (39.0% vs 4.8%; difference, 34.2%; 95% CI, 22.69-45.72%; p<0.0001) reductions in weekly average daily peak daily pruritus numerical rating scale scores. The incidence of TEAEs during the treatment period was similar in the two groups. The incidence of conjunctivitis, allergic conjunctivitis, and injection site reaction was higher in the dupilumab group than in the placebo group. CONCLUSIONS In adult Chinese patients, dupilumab was effective in improving the signs and symptoms of AD and demonstrated a favorable safety profile.
Collapse
|
46
|
Zhou YL, Liu JR, Yi QW, Chen LN, Han ZY, Xu CD, Liu SY, Hao CL, Liu J, Li QL, Wang LJ, Wang C, Che GH, Zhang YY, Tong L, Liu YQ, Zhao SY, Zheng YJ, Li S, Liu HM, Chang J, Zhao DY, Zou YX, Zhang XX, Nong GM, Zhang HL, Pan JL, Chen YN, Dong XY, Zhang YF, Wang YS, Yang DH, Lu Q, Chen ZM. [A multicenter retrospective study on the etiology of necrotizing pneumonia in children]. ZHONGHUA ER KE ZA ZHI = CHINESE JOURNAL OF PEDIATRICS 2021; 59:658-664. [PMID: 34333918 DOI: 10.3760/cma.j.cn112140-20210126-00072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the etiology of necrotizing pneumonia (NP) in children and the clinical characteristics of NP caused by different pathogens in China. Methods: A retrospective, case-control study was performed in children with NP who were admitted to 13 hospitals in China from January 2008 to December 2019. The demographic and clinical information, laboratory data, etiological and radiological findings were analyzed. The data were divided into three groups based on the following years: 2008-2011, 2012-2015 and 2016-2019, and the distribution characteristics of the pathogens in different period were compared. Meanwhile, the pathogens of pediatric NP in the southern and northern China were compared. And the clinical characteristics of the Mycoplasma pneumoniae (MP) NP and the bacterial NP were also compared. T-test or Mann-Whitney nonparametric test was used for comparison of numerical variables, and χ2 test was used for categorical variables. Results: A total of 494 children with NP were enrolled, the median ages were 4.7 (0.1-15.3) years, including 272 boys and 222 girls. Among these patients, pathogens were identified in 347 cases and the pathogen was unclear in the remaining 147 cases. The main pathogens were MP (238 cases), Streptococcus pneumoniae (SP) (61 cases), Staphylococcus aureus (SA) (51 cases), Pseudomonas aeruginosa (13 cases), Haemophilus influenzae (10 cases), adenovirus (10 cases), and influenza virus A (7 cases), respectively. MP was the most common pathogen in all three periods and the proportion increased yearly. The proportion of MP in 2016-2019 was significantly higher than that in 2012-2015 (52.1% (197/378) vs. 36.8% (32/87), χ2=6.654, P=0.010), while there was no significant difference in the proportion of MP in 2012-2015 and that in 2008-2011 (36.8% (32/87) vs. 31.0% (9/29), χ²=0.314, P=0.575).Regarding the regional distribution, 342 cases were in the southern China and 152 in the northern China. Also, MP was the most common pathogen in both regions, but the proportion of MP was higher and the proportion of SP was lower in the north than those in the south (60.5% (92/152) vs. 42.7% (146/342), χ2=13.409, P<0.010; 7.9% (12/152) vs. 14.3% (49/342), χ2=4.023, P=0.045). Comparing the clinical characteristics of different pathogens, we found that fever and cough were the common symptoms in both single MP and single bacterial groups, but chest pain was more common (17.0% (34/200) vs. 6.1% (6/98), χ2=6.697, P=0.010) while shortness of breath and wheezing were less common in MP group (16.0% (32/200) vs. 60.2% (59/98), χ2=60.688, P<0.01; 4.5% (9/200) vs. 21.4% (21/98), χ2=20.819, P<0.01, respectively). The white blood cell count, C-reactive protein and procalcitonin in the bacterial group were significantly higher than those in the MP group (14.7 (1.0-67.1)×109/L vs. 10.5 (2.5-32.2)×109/L, 122.5 (0.5-277.3) mg/L vs. 51.4 (0.5-200.0) g/L, 2.13 (0.05-100.00) μg/L vs. 0.24 (0.01-18.85) μg/L, Z=-3.719, -5.901 and -7.765, all P<0.01). Conclusions: The prevalence of pediatric NP in China shows an increasing trend during the past years. MP, SP and SA are the main pathogens of NP, and the most common clinical symptoms are fever and cough. The WBC count, C-reactive protein and procalcitonin in bacterial NP are significantly higher than those caused by MP.
Collapse
|
47
|
Yao Z, Bao B, Qian S, Li Z, Lu Q, Min S, Li M, Wang H. [Correlation of serum ADAMTS13 and TSP1 levels with myocardial injury and prognosis in patients with acute coronary syndrome]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2021; 41:710-715. [PMID: 34134958 DOI: 10.12122/j.issn.1673-4254.2021.05.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To investigate serum levels of von Willebrand factor lytic protease (ADAMTS13) and thrombospondin-1 (TSP1) in patients with different types of acute coronary syndrome (ACS) and their correlation with the patients' clinical prognosis. OBJECTIVE According to their disease history, results of angiography and clinical biochemical tests, a total of 405 patients undergoing coronary angiography, were divided into unstable angina (UAP) group (n=215), acute myocardial infarction (AMI) group (n=96), and angiographically normal group (n=94). Serum ADAMTS13 and TSP1 levels were detected in all the patients, who were followed up for 15 months to evaluate the occurrence of long-term major cardiac adverse events (MACE). OBJECTIVE Serum ADAMTS13 level was significantly lower and TSP1 level was significantly higher in AMI group and UAP group than in the normal group (P < 0.001). Serum ADAMTS13 and TSP1 levels were negative correlated in ACS patients (R=-0.577, P < 0.001). The patients experiencing MACE had significantly different serum TSP1 level from those without MACE (P < 0.05). Cox proportion regression model analysis showed that TSP1 was a risk factor affecting the occurrence of MACE in ACS patients; Kaplan-Meier survival analysis showed that the patients with high levels of TSP1 had a higher incidence of longterm MACE than those with low TSP1 levels. OBJECTIVE A lowered serum ADAMTS13 level and an elevated TSP1 level can support the diagnosis of ACS. An elevated TSP1 level may serve as an indicator for predicting the risk of MACE in patients with ACS.
Collapse
|
48
|
Lu Q, Zhang H, Dong XY, Liu HM, Jiang YM, Zou YX, Shen YM, Zhao DY, Chen HB, Ai T, Liu CG, Shen ZB, Yang JM, Zheng YJ, Chen YS, Chen WG, Zhu YF, Zhang CL, Tian LJ, Wu GR, Li L, Zheng AB, Gu M, Wei YY, Wei LM. [Consistency of peripheral whole blood and venous serum procalcitonin in children: a multicenter parallel controlled study]. ZHONGHUA ER KE ZA ZHI = CHINESE JOURNAL OF PEDIATRICS 2021; 59:471-477. [PMID: 34102820 DOI: 10.3760/cma.j.cn112140-20210224-00153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the consistency of peripheral whole blood and venous serum procalcitonin (PCT) levels, and the value of peripheral whole blood PCT in evaluating pediatric bacterial infection. Methods: This multicenter cross-sectional parallel control study was conducted in 11 children's hospital. All the 1 898 patients older than 28 days admitted to these hospitals from March 2018 to February 2019 had their peripheral whole blood and venous serum PCT detected simultaneously with unified equipment, reagent and method. According to the venous serum PCT level, the patients were stratified to subgroups. Analysis of variance and chi-square test were used to compare the demographic characteristics among groups. And the correlation between the peripheral blood and venous serum PCT level was investigated by quantitative Pearson correlation analysis.The PCT resultes were also converted into ranked data to further test the consistency between the two sampling methods by Spearman's rank correlation test. Furthermore, the ranked data were converted into binary data to evaluate the consistency and investigate the best cut-off of peripheral blood PCT level in predicting bacterial infection. Results: A total of 1 898 valid samples were included (1 098 males, 800 females),age 27.4(12.2,56.7) months. There was a good correlation between PCT values of peripheral whole blood and venous serum (r=0.97, P<0.01). The linear regression equation was PCTvenous serum=0.135+0.929×PCTperipheral whole blood. However, when stratified to 5 levels, PCT results showed diverse and unsatisfied consistency between the two sampling methods (r=0.51-0.92, all P<0.01). But after PCT was converted to ordinal categorical variables, the stratified analysis showed that the coincidence rate of the measured values by the two sampling methods in each boundary area was 84.9%-97.1%. The dichotomous variables also showed a good consistency (coincidence rate 96.8%-99.3%, Youden index 0.82-0.89). According to the severity of disease, the serum PCT value was classified into 4 intervals(<0.5、0.5-<2.0、2.0-<10.0、≥10.0 μg/L), and the peripheral blood PCT value also showed a good predictive value (AUC value was 0.991 2-0.997 9). The optimal cut points of peripheral whole blood PCT value 0.5、1.0、2.0、10.0 μg/L corresponding to venous serum PCT values were 0.395, 0.595, 1.175 and 3.545 μg/L, respectively. Conclusions: There is a good correlation between peripheral whole blood PCT value and the venous serum PCT value, which means that the peripheral whole blood PCT could facilitate the identification of infection and clinical severity. Besides, the sampling of peripheral whole blood is simple and easy to repeat.
Collapse
|
49
|
Shao H, Gao S, Lu Q, Zhao X, Hua Y, Wang X. Effects of delayed cord clamping on neonatal jaundice, phototherapy and early hematological status in term cesarean section. Ital J Pediatr 2021; 47:115. [PMID: 34039384 PMCID: PMC8157738 DOI: 10.1186/s13052-021-01069-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 05/13/2021] [Indexed: 11/30/2022] Open
Abstract
Background Delayed cord clamping in full-term neonates is widely recommended, while in practice, it is rarely implemented in cesarean section due to the fear of neonatal jaundice and excessive maternal blood loss. The optimal timing of cord clamping remains uncertain. This study was to fully evaluate the effects of delayed cord clamping on short-term hematological status and jaundice in term neonates delivered by cesarean section. Methods This retrospective study enrolled 796 women, who were allocated into the early cord clamping group (n = 377) and the delayed cord clamping group (n = 419). The latter group was further divided into two subgroups (30–60 s, 61–120 s). The outcomes were neonatal transcutaneous bilirubin levels on 0 to 5 days of life and the rate of phototherapy. For neonates who had blood tests on the first three days of life, their hemoglobin and hematocrit were compared among groups. Results Compared with the early cord clamping group, delayed cord clamping merely increased the transcutaneous bilirubin level of neonates on the day of birth rather than that on the following five days. The heel peripheral blood sample size of 1–3 days in the early cord clamping group was 61, 25 and 33, and in the delayed cord clamping group was 53, 46 and 32, respectively. Delayed cord clamping at 30–60 s resulted in the higher neonatal hemoglobin level on day 3 and an increased rate of neonatal polycythemia, without a higher rate of phototherapy. Delayed cord clamping beyond 60 s did not further improve hematological status in term neonates born by cesarean section. Conclusion In cesarean section, delayed cord clamping for 30–60 s improved the early hematological status of term neonates without the enhanced requirement of phototherapy for neonatal jaundice.
Collapse
|
50
|
Lin Y, Lu Q, Jiang YQ, Meng QX, Wang XY, Liu C, He YL, Han XM, Zhou K, Du JB, Ma HX, Jin GF, Li H, Ling XF, Shen HB, Hu ZB. [A sub-cohort study design of the maternal and infant microbes in China National Birth Cohort]. ZHONGHUA LIU XING BING XUE ZA ZHI = ZHONGHUA LIUXINGBINGXUE ZAZHI 2021; 42:597-601. [PMID: 34814436 DOI: 10.3760/cma.j.cn112338-20201211-01406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The importance of gut microbes to human health has gradually attracted attention. With the use of animal models, it has been revealed that maternal microbes during pregnancy could influence their children's health outcomes through shaping their microbial composition and regulating the development of their metabolic and immune system. However, the physiological mechanism of the human body is more complex and is affected by the interaction of multiple factors. The research results obtained from animal models are often inconsistent with human studies. At present, the influence of maternal intestinal microbes during pregnancy on the microbial colonization in their offspring and on a series of children's health outcomes is still unclear. Establishing a sub-cohort to detect the microbiome of the women across pregnancy and of their offspring, and further to integrate with variety of environmental and behavioral exposures can better provide reliable support for the research on the mechanism of children's health and diseases. This paper briefly introduces the research objectives, content, progress, strength and limitations of the sub-cohort study.
Collapse
|