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Li L, Yuan L, Liu J, Mei J, Lei C. The Expression of Vascular Endothelial Growth Factor-C and Its Relationship with Lymphangiogenesis and Lymphatic Metastasis in Colorectal Cancer Tissues. J BIOMATER TISS ENG 2018. [DOI: 10.1166/jbt.2018.1895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Yuan LL, Li L, Liu JN, Mei J, Lei CJ. Down-regulation of miR-29a facilitates apoptosis of colorectal carcinoma cell SW480 and suppresses its Paclitaxel resistance. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2018; 22:5499-5507. [PMID: 30229821 DOI: 10.26355/eurrev_201809_15810] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE PTEN can suppress PI3K/AKT activity, and regulate cell proliferation, apoptosis, and drug resistance. The previous study showed that up-regulation of miR-29a played an essential role in the occurrence of colorectal carcinoma. This study aimed to investigate the role and related mechanism of miR-29a in mediating Paclitaxel sensitivity of colorectal carcinoma cells. MATERIALS AND METHODS Bioinformatics analysis was performed to study the existence of binding sites between miR-29a and targeting gene mRNA. Dual luciferase reporter assay was conducted to validate the targeted regulation. The expressions were compared between CCD841 CoN cells, colorectal carcinoma cell line SW480, and drug-resistant cell line SW480/Paclitaxel. Cell apoptosis and proliferation were measured by flow cytometry. In vitro cultured SW480/Paclitaxel cells were transfected with miR-29a or pcDNA3.1-PTEN. MiR-29a and PTEN expressions were measured by quantitative Reverse Transcription-Polymerase Chain Reaction (qRT-PCR) and Western blot, followed by flow cytometry on the detection of cell apoptosis as well as proliferation assay. RESULTS A targeted regulatory relationship existed between miR-29a and PTEN. Comparing to CCD841 CoN cells, high level of miR-29a and decreasing expression of PTEN were found in SW480 cells. Moreover, further higher miR-29a and lower PTEN expressions were observed in SW480/Paclitaxel cells. Paclitaxel remarkably inhibited proliferation and facilitated apoptosis of SW480 cells but not SW480/Paclitaxel cells. Transfection of miR-29a inhibitor or pcDNA3.1-PTEN remarkably elevated PTEN expression, suppressed p-AKT expression, weakened proliferation, and enhanced apoptosis of SW480/Paclitaxel cells. CONCLUSIONS Our data demonstrated that suppression of miR-29a enhanced PTEN expression, inhibited cancer cell proliferation, facilitated apoptosis, and weakened drug resistance, which provides academic basis for the treatment of colorectal cancer.
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Ma N, Mei J, Lu RX, Jiang ZL, Tang M, Ding FB. [Clinical results of Mei mini maze procedure for atrial fibrillation patients with previously failed catheter ablation]. ZHONGHUA XIN XUE GUAN BING ZA ZHI 2018; 46:601-605. [PMID: 30139009 DOI: 10.3760/cma.j.issn.0253-3758.2018.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To evaluate the efficacy of Mei mini maze procedure for treating atrial fibrillation (AF) patients with previously failed catheter ablation. Methods: Between August 2010 and May 2016, 48 AF (8 proximal AF, 15 persistent AF and 25 long-standing persistent AF) patients (29 males, 19 females, mean age: (62.5±7.3) years old) with previously 1-3 failed catheter ablation results were treated with Mei mini maze procedure in our department. Under thoracoscopic assistance, the procedure was performed through three ports on left chest wall, pulmonary vein isolation and ablations of the roof and posterior wall of left atrium was made by bipolar radiofrequency ablation. Ganglionic plexus ablation was made by the ablation pen. Left atrial appendage was excluded. Patients were followed at outpatient clinic and per telephone. Electrocardiogram, CT and echocardiography examinations were performed at 1, 3, 6 and 12 months post operation. The success rate of the procedure was analyzed by Kaplan-Meier curves and evaluated by the log-rank test. Results: Mean AF history was (8.1±6.3) years and left atria dimension was (44.1±6.2) mm in this patient cohort. All procedures were performed successfully in these 48 patients. Pericardial adhesions were dissected in 21 patients. Durations of the procedures were (142.3±35.6) minutes.There were no serious complications. The hospital stay was (9.3±1.8) days. Sinus rhythm was documented in 44 patients (91.7%) at discharge. The mean follow-up duration was (28.0±17.2) months. Thirty-eight patients (82.6%) were in sinus rhythm. There was no stroke, thrombus in the left atrium and stenosis of pulmonary vein during the follow-up. Sinus rhythm was achieved in 7 out of 8 paroxysmal AF patients, in 31 out of 38 non-paroxysmal AF patients, and in 13 out of 15 persistent AF patients. Kaplan-Meier curve showed that the success rate in the long-standing persistent AF group was lower than in the other two groups, but there was no statistical difference. Conclusions: Mei mini maze procedure has a high success rate for AF patients with previously failed catheter ablation history, which could completely isolate the bilateral pulmonary vein and left atrial posterior wall with good quality and integrity of ablation line, and left atrial appendage is also resected during the procedure.
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Xia E, Mei J, Xie G, Li X, Li Z, Xu M. Learning Doctors' Medicine Prescription Pattern for Chronic Disease Treatment by Mining Electronic Health Records: A Multi-Task Learning Approach. AMIA ... ANNUAL SYMPOSIUM PROCEEDINGS. AMIA SYMPOSIUM 2018; 2017:1828-1837. [PMID: 29854254 PMCID: PMC5977645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Increasing learning ability from massive medical data and building learning methods robust to data quality issues are key factors toward building data-driven clinical decision support systems for medicine prescription decision support. Here, we attempted accordingly to address the factors using a multi-task neural network approach, benefiting from multi-task learning's advantage in modeling commonalities to increase learning performance and neural network's robustness to imprecise data. By mining electronic health record data, we learned medicine prescription patterns of multiple correlated antidiabetic agents in blood glucose control and antihypertensive drugs in blood pressure control scenarios. We achieved AUC increases of 0.02 to 0.06 in single drug prescription and an accuracy increase of 0.05 in prescription pattern prediction compared to logistic regression, demonstrating the efficacy of multi-task neural network approach in learning medicine prescription patterns.
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Li X, Li Z, Liu C, Zhang J, Sun Z, Feng Y, Mei J, Gu C, Li X, Yang S. Evaluation of the three-in-one team-based care model on hierarchical diagnosis and treatment patterns among patients with diabetes: a retrospective cohort study using Xiamen's regional electronic health records. BMC Health Serv Res 2017; 17:779. [PMID: 29179749 PMCID: PMC5704596 DOI: 10.1186/s12913-017-2705-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 11/07/2017] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Xiamen is a pilot city in China for hierarchical diagnosis and treatment reform of non-communicable diseases, especially diabetes. Since 2012, Xiamen has implemented a program called the "three-in-one", a team-based care model for the treatment of diabetes, which involves collaboration between diabetes specialists, general practitioners, and health managers. In addition, the program provides financial incentives to improve care, as greater accessibility to medications through community health care centers (CHCs). The aim of this study was to evaluate the effectiveness of these policies in shifting visits from general hospitals to CHCs for the treatment of type 2 diabetes mellitus (T2DM). METHOD AND MATERIALS A retrospective observational cohort study was conducted using Xiamen's regional electronic health record (EHR) database, which included 90% of all patients registered since 2012. Logistic regression was used to derive the adjusted odds ratio (OR) for patients shifting from general hospitals to CHCs. Among patients treated at hospitals, Kaplan-Meier(KM) curves were constructed to evaluate the time from each policy introduction until the switch to CHCs. A k-means clustering analysis was conducted to identify patterns of patient care-seeking behavior. RESULTS In total, 89,558 patients and 2,373,524 visits were included. In contrast to increased outpatient visits to general hospitals in China overall, the percentage of visits to CHCs in Xiamen increased from 29.7% in 2012 to 66.5% in 2016. The most significant and rapid shift occurred in later periods after full policy implementation. Three clusters of patients were identified with different levels of complications and health care-seeking frequency. All had similar responses to the policies. CONCLUSIONS The "three-in-one" team-based care model showed promising results for building a hierarchical health care system in China. These policy reforms effectively increased CHCs utilization among diabetic patients.
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He Y, Ma N, Tang M, Jiang ZL, Liu H, Mei J. The differentiation of beige adipocyte in pericardial and epicardial adipose tissues induces atrial fibrillation development. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2017; 21:4398-4405. [PMID: 29077154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Growing evidence has identified that excessive accumulation of pericardial adipose tissues (PAT) and epicardial adipose tissues (EAT) is associated with atrial fibrillation (AF) development. Moreover, beige adipocytes, present in PAT and EAT, have been proved beneficial in consumption of fatty acid and promotion of weight lose by nonshivering thermogenesis. The objective of this prospective, observational study was to reveal the potential association between beige adipocytes and AF development. PATIENTS AND METHODS Fat tissues from subcutaneous adipose tissue (SAT), PAT and EAT were obtained from 70 AF and 30 sinus rhythm patients. Hematoxylin and eosin (H&E) staining were performed to analyze morphological changes in fat tissues. Real-time PCR was performed to identify mRNA expression of unique uncoupling protein-1 (UCP-1). Western blotting and immunohistochemistry (IHC) were performed to determine protein expression of UCP-1. RESULTS Our results indicated that pericardial and epicardial adipocytes in AF patients demonstrated white-like change tendency and had lower expression of UCP-1 when compared to sinus rhythm patients. Additionally, the decrease of UCP-1 mRNA expression in PAT and EAT, together with LA enlargement, were independent risk factors of AF. Further, UCP-1 mRNA expression in EAT, but not in PAT, have a significant correlation with LA diameter. The function of nonshivering thermogenesis in PAT and EAT was impaired in AF patients, and this dysfunction in EAT had a great correlation with LA dilation. CONCLUSIONS Our data provide a new therapeutic target for LA remodeling and AF treatment.
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Gao B, Mei J, Ma Y, Yuan G, Ren L. Environmental-Friendly Assembly of Functional Graphene Hydrogels with Excellent Antibacterial Properties. ChemistrySelect 2017. [DOI: 10.1002/slct.201701419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Li Q, Heyman GD, Mei J, Lee K. Judging a Book by Its Cover: Children's Facial Trustworthiness as Judged by Strangers Predicts Their Real‐World Trustworthiness and Peer Relationships. Child Dev 2017; 90:562-575. [DOI: 10.1111/cdev.12907] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Androic D, Armstrong D, Asaturyan A, Averett T, Balewski J, Bartlett K, Beaufait J, Beminiwattha R, Benesch J, Benmokhtar F, Birchall J, Carlini R, Cates G, Cornejo J, Covrig S, Dalton M, Davis C, Deconinck W, Diefenbach J, Dowd J, Dunne J, Dutta D, Duvall W, Elaasar M, Falk W, Finn J, Forest T, Gal C, Gaskell D, Gericke M, Grames J, Gray V, Grimm K, Guo F, Hoskins J, Johnston K, Jones D, Jones M, Jones R, Kargiantoulakis M, King P, Korkmaz E, Kowalski S, Leacock J, Leckey J, Lee A, Lee J, Lee L, MacEwan S, Mack D, Magee J, Mahurin R, Mammei J, Martin J, McHugh M, Meekins D, Mei J, Michaels R, Micherdzinska A, Mkrtchyan A, Mkrtchyan H, Morgan N, Myers K, Narayan A, Ndukum L, Nelyubin V, Nuhait H, Nuruzzaman, van Oers W, Opper A, Page S, Pan J, Paschke K, Phillips S, Pitt M, Poelker M, Rajotte J, Ramsay W, Roche J, Sawatzky B, Seva T, Shabestari M, Silwal R, Simicevic N, Smith G, Solvignon P, Spayde D, Subedi A, Subedi R, Suleiman R, Tadevosyan V, Tobias W, Tvaskis V, Waidyawansa B, Wang P, Wells S, Wood S, Yang S, Young R, Zang P, Zhamkochyan S. Qweak: First Direct Measurement of the Proton’s Weak Charge. EPJ WEB OF CONFERENCES 2017. [DOI: 10.1051/epjconf/201713708005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Pan Y, Zhao J, Mei J, Shao M, Zhang J, Wu H. Retrievable Inferior Vena Cava Filters in Trauma Patients: Prevalence and Management of Thrombus Within the Filter. J Vasc Surg Venous Lymphat Disord 2017. [DOI: 10.1016/j.jvsv.2017.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Deng WY, Yuan MH, Mei J, Liu YJ, Su YX. Effect of calcium oxide (CaO) and sawdust on adhesion and cohesion characteristics of sewage sludge under agitated and non-agitated drying conditions. WATER RESEARCH 2017; 110:150-160. [PMID: 28006705 DOI: 10.1016/j.watres.2016.12.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 09/28/2016] [Accepted: 12/01/2016] [Indexed: 06/06/2023]
Abstract
Stickiness phenomenon is widely observed in sewage sludge drying practices. This paper is aimed at demonstrating and comparing the sticky properties of sewage sludge through non-agitated and agitated drying tests specially designed for sewage sludge. Special attentions were paid to the effects of additives, i.e. CaO, fine sawdust (FSD) and coarse sawdust (CSD), on the adhesive and cohesive characteristics of sewage sludge. The results indicated that the sticky properties of the sludge were markedly different under the different testing methods, and was also greatly influenced by CaO or sawdust addition. For instance, in the non-agitated drying tests, CaO can significantly enhance the maximum adhesive and cohesive stresses of the sludge, whereas in the agitated drying tests, the torque of agitation, which strongly correlated with the cohesive stress of the sludge, was lowered by CaO addition. During agitated drying process, sludge lump with CaO addition started to break up at higher moisture content than that of original sludge. On the other hand, sawdust also affected the sticky properties of sludge in a way that was totally different with CaO. After sawdust addition (at 5-10%WS (wet sludge basis)), the cohesive stress of the sludge was markedly increased due to strengthening of mechanical interlocking inside the sludge, whereas the adhesiveness of the sludge was lowered by sawdust addition. The influencing mechanisms of CaO and sawdust under the different testing methods were detailedly discussed in the paper.
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Chanan-Khan A, Egyed M, Robak T, Martinelli de Oliveira FA, Echeveste MA, Dolan S, Desjardins P, Blonski JZ, Mei J, Golany N, Zhang J, Gribben JG. Randomized phase 3 study of lenalidomide versus chlorambucil as first-line therapy for older patients with chronic lymphocytic leukemia (the ORIGIN trial). Leukemia 2017; 31:1240-1243. [PMID: 28140392 PMCID: PMC5420789 DOI: 10.1038/leu.2017.47] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mei J, Zhao S, Jin F, Zhang L, Liu H, Li X, Xie G, Li X, Xu M. Deep Diabetologist: Learning to Prescribe Hypoglycemic Medications with Recurrent Neural Networks. Stud Health Technol Inform 2017; 245:1277. [PMID: 29295362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
In healthcare, applying deep learning models to electronic health records (EHRs) has drawn considerable attention. This sequential nature of EHR data make them wellmatched for the power of Recurrent Neural Network (RNN). In this poster, we propose "Deep Diabetologist" - using RNNs for EHR sequential data modeling to provide personalized hypoglycemic medication prediction for diabetic patients. Our results demonstrate improved performance compared with a baseline classifier using logistic regression.
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Xia E, Liu H, Li J, Mei J, Li X, Xu E, Li X, Hu G, Xie G, Xu M. Gathering Real World Evidence with Cluster Analysis for Clinical Decision Support. Stud Health Technol Inform 2017; 245:1185-1189. [PMID: 29295290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Clinical decision support systems are information technology systems that assist clinical decision-making tasks, which have been shown to enhance clinical performance. Cluster analysis, which groups similar patients together, aims to separate patient cases into phenotypically heterogenous groups and defining therapeutically homogeneous patient subclasses. Useful as it is, the application of cluster analysis in clinical decision support systems is less reported. Here, we describe the usage of cluster analysis in clinical decision support systems, by first dividing patient cases into similar groups and then providing diagnosis or treatment suggestions based on the group profiles. This integration provides data for clinical decisions and compiles a wide range of clinical practices to inform the performance of individual clinicians. We also include an example usage of the system under the scenario of blood lipid management in type 2 diabetes. These efforts represent a step toward promoting patient-centered care and enabling precision medicine.
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Yu Y, Li X, Hu G, Liu H, Mei J, Ni Y, Tang G, Xie G, Xu W. Personal Health Self-Management in a Data Perspective. Stud Health Technol Inform 2017; 245:1244. [PMID: 29295331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Along with the growth of numbers of patients with chronic diseases, personal health self-management becomes critical. The heterogeneity of self-management requirements makes the detail design and implementation of self-management program a non-trivial work. In this paper we address the problem with the Personal Health Advisor (PHA) application by introducing a personal health data flow mechanism, as well as modules including personal health risk assessment, similar patients profiling, and health question answering.
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Xu E, Li X, Mei J, Zhao S, Hu G, Xia E, Liu H, Xie G, Xu M, Li X. Applying Risk Models on Patients with Unknown Predictor Values: An Incremental Learning Approach. Stud Health Technol Inform 2017; 245:639-643. [PMID: 29295174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
In clinical practice, many patients may have unknown or missing values for some predictors, causing that the developed risk models cannot be directly applied on these patients. In this paper, we propose an incremental learning approach to apply a developed risk model on new patients with unknown predictor values, which imputes a patient's unknown values based on his/her k-nearest neighbors (k-NN) from the incremental population. We perform a real world case study by developing a risk prediction model of stroke for patients with Type 2 diabetes mellitus from EHR data, and incrementally applying the risk model on a sequence of new patients. The experimental results show that our risk prediction model of stroke has good prediction performance. And the k-nearest neighbors based incremental learning approach for data imputation can gradually increase the prediction performance when the model is applied on new patients.
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Wang J, Fan N, Deng Y, Zhu J, Mei J, Chen Y, Yang H. Association between genetic polymorphisms of interleukins and cerebral infarction risk: a meta-analysis. Biosci Rep 2016; 36:e00404. [PMID: 27679860 PMCID: PMC5293575 DOI: 10.1042/bsr20160226] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 09/05/2016] [Accepted: 09/27/2016] [Indexed: 12/19/2022] Open
Abstract
Interleukins (ILs) are the most typical inflammatory and immunoregulatory cytokines. Evidences have shown that polymorphisms in ILs are associated with cerebral infarction risk. However, the results remain inconclusive. The present study was to evaluate the role of ILs polymorphisms in cerebral infarction susceptibility. Relevant case-control studies published between January 2000 and December 2015 were searched and retrieved from the electronic databases of Web of Science, PubMed, Embase and the Chinese Biomedical Database. The odds ratio (OR) with its 95% confidence interval (CI) were employed to calculate the strength of association. A total of 55 articles including 12619 cerebral infarction patients and 14436 controls were screened out. Four ILs (IL-1, IL-6, IL-10 and IL-18) contained nine single nucleotide polymorphisms (SNPs; IL-1α -899C/T, IL-1β -511C/T and IL-1β +3953C/T; IL-6 -174G/C and -572C/G; IL-10 -819C/T and -1082A/G; IL-18 -607C/A and -137G/C). Our result showed that IL-1α -899C/T and IL-18 -607C/A (under all the genetic models), and IL-6 -572C/G (under the allelic model, heterogeneity model and dominant model) were associated with increased the risk of cerebral infarction (P<0.05). Subgroup analysis by ethnicity showed that IL-6 -174G/C polymorphism (under all the five models) and IL-10 -1082A/G polymorphism (under the allelic model and heterologous model) were significantly associated with increased the cerebral infarction risk in Asians. Other genetic polymorphisms were not related with cerebral infarction susceptibility under any genetic models. In conclusion, IL-1α -899C/T, IL-6 -572C/G and IL-18 -607C/A might be risk factors for cerebral infarction development. Further studies with well-designed and large sample size are still required.
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Bi J, Yang J, Wang Y, Yao C, Mei J, Liu Y, Cao J, Lu Y. Efficacy and Safety of Adjunctive Corticosteroids Therapy for Severe Community-Acquired Pneumonia in Adults: An Updated Systematic Review and Meta-Analysis. PLoS One 2016; 11:e0165942. [PMID: 27846240 PMCID: PMC5113003 DOI: 10.1371/journal.pone.0165942] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 10/20/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Adjunctive corticosteroids therapy is an attractive option for community-acquired pneumonia (CAP) treatment. However, the effectiveness of adjunctive corticosteroids on mortality of CAP remains inconsistent, especially in severe CAP. We performed a meta-analysis to evaluate the efficacy and safety of adjunctive corticosteroids in severe CAP patients. METHODS Three databases of PubMed, EMBASE and Cochrane Library were searched for related studies published in English up to December, 2015. Randomized controlled trials (RCTs) of corticosteroids in hospitalized adults with severe CAP were included. Meta-analysis was performed by a random-effect model with STATA 11.0 software. We estimated the summary risk ratios (RRs) or effect size (ES) with its corresponding 95% confidence interval (95%CI) to assess the outcomes. RESULTS We included 8 RCTs enrolling 528 severe CAP patients. Adjunctive corticosteroids significantly reduced all-cause mortality (RR = 0.46, 95%CI: 0.28 to 0.77, p = 0.003), risk of adult respiratory distress syndrome (ARDS) (RR = 0.23, 95%CI: 0.07 to 0.80, p = 0.02) and need for mechanical ventilation (RR = 0.50, 95%CI: 0.27 to 0.92, p = 0.026). Adjunctive corticosteroids did not increase frequency of hyperglycemia requiring treatment (RR = 1.03, 95%CI: 0.61 to 1.72, p = 0.91) or gastrointestinal hemorrhage (RR = 0.66, 95%CI: 0.19 to 2.31, p = 0.52). In subgroup analysis by duration of corticosteroids, we found that prolonged corticosteroids therapy significantly reduced all-cause mortality (RR = 0.41, 95%CI: 0.20 to 0.83, p = 0.01) and length of hospital stay (-4.76 days, 95% CI:-8.13 to -1.40, p = 0.006). CONCLUSIONS Results from this meta-analysis suggested that adjunctive corticosteroids therapy was safe and beneficial for severe CAP. In addition, prolonged corticosteroids therapy was more effective. These results should be confirmed by adequately powered studies in the future.
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Fan J, Jiang B, Yuan F, Li SZ, Zhou JQ, Mei J, Cheng LM, Yu GR. [Clinical effect of compound internal fixations in treating extreme distal radial fractures]. ZHONGHUA WAI KE ZA ZHI [CHINESE JOURNAL OF SURGERY] 2016; 54:766-771. [PMID: 27686641 DOI: 10.3760/cma.j.issn.0529-5815.2016.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the clinical character and treating strategy of extreme distal radial fractures. Methods: From June 2012 to May 2014, 12 patients who suffered from extreme distal radial fractures were treated in Department of Orthopedics, Tongji Hospital, Tongji University. According to AO/OTA classification, there were 4 cases of type 23B1, 3 cases of 23B2, 3 cases of 23C1 and 2 cases of 23C3.When classified by morphological features, there were 4 of simple styloid process fracture, 3 of simple extreme distal radial fracture without articular surface involved, 3 of styloid process fracture combined with distal radial articular fracture, and 2 of articular surface splintered or collapse fracture. According to the fracture features that radiographic exams showed, different surgical paths and fixation methods were chosen in order to protect soft tissues to the best advantage. To those patients with simple styloid process fracture, screw alone, Kirschner-wire or styloid plate were used for fixation. To the other types of fracture, open reduction and compound internal fixation with low-notch volar plate, dorsal or volar mini-plate, screw or Kirschner-wire was applied to ensure the stability of fixation, and maximally protect soft tissues like tendons, ligaments and neurovascular bundles, counting on the "stuffing-squeezing" effects after reduction or reconstruction of the articular surface. Situation of the wound and soft tissue were mainly checked in the first 2 weeks, and in the 3rd month post-operatively, fracture reduction and internal fixation were evaluated by radiographic methods like X-ray and CT scan. When 12 months post-operatively, not only radiographic follow-up such as fracture reduction, internal fixation and osteoarthritis were taken, but also some other evaluation, such as pain of wrist, rotation range of forearm, grip strength, and function of wrist according to DASH scores. Results: All of the 12 cases were followed up for at least 1 year. The wound healed well in all cases 2 weeks post-operatively, and no soft tissue infections, necrosis or neurovascular complications occurred. All fractures healed and no loss of reduction occurred 3 months post-operatively. Internal fixations were at good condition except in 2 cases, whose Kirschner-wire had been removed 2.5 and 2.8 months after the operation due to loosening and partly backing out on dorsal side. When followed up at 12 months post-operatively, one from these 2 patients suffered from a mild pain of wrist, and grip strength together with the function of the affected wrist dramatic declined when compared to the unaffected side. With the help of radiograph, local collapse on the articular surface was found, which meant to be traumatic arthritis. There were no pain in the rest 11 cases, and flexion-extension range of the wrist, rotation range of forearm and grip strength of the affected side recovered to over 80% of the unaffected side, with a DASH score was from 7 to 15 points(average 11.9 points)below 15 points. Conclusions: Traditional volar plates can not be used for extreme distal radial fractures. It may be an effective way to treat extreme distal radial fractures with compound internal fixation on the basis of morphological feature of fractures and the situation of soft tissue because of vivid of the fixation, reducing damage of soft tissue and early functional training.
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Liu L, Mei J. P-198PULMONARY VENOPLASTY IN LUNG CANCER SURGERY: A CASE SERIES. Interact Cardiovasc Thorac Surg 2016. [DOI: 10.1093/icvts/ivw260.196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Fan J, Jiang B, Wang B, Chen K, Yuang F, Mei J, Yu GR. Analysis of soft-tissue complications of volar plate fixation for managing distal radius fractures and clinical effect while preserving pronator quadratus. Acta Orthop Belg 2016; 82:305-312. [PMID: 27682293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The aim of the study was to analysis soft-tissue complications of volar plate fixation and it's prevention strategies along with exploring clinical effects of preserving pronator quadratus (PQ) muscle. From February 2011 to February 2013, sixty-five patients with distal radius fracture underwent open reduction and internal fixation with the volar locking palmar plates. The group with preserving PQ involved 30 patients and group with PQ repair involved 35 patients. Surgeons must took great care of not -letting drill pierce dorsal cortical bone rapidly and dorsal carpal tangential fluoroscopy was also taken in addition to lateral fluoroscopy to get accurate screw length. Volar plate must be placed not go beyond the watershed region of distal radius. The wrist pain, forearm range of motion, grip strength, wrist functional recovery score, X-ray and CT imaging were followed-up after surgery. Two groups were compared for Clinical efficacy. The minimum follow-up for the whole cohort was one year. The relevant post operative data were collected after 2 weeks, 6 weeks, 3 and 12 month respectively. Fractures healing after postoperative 3 months are significant in X -ray and CT imaging. Fixation position and stability were good, but each group had one case with a screw piercing the dorsal cortical. The -differences between the two groups were significant regarding the wrist pain, forearm range of motion, grip and strength at 2 and 6 weeks after operation, but not significant at 3 and 12 month after operation. The differences between the two groups were also significant regarding wrist functional scores at 6 weeks, but not significant at 3 and 12 month after operation. Drilling the dorsal cortical bone gently and accurate screws length can avoid extensor tendon injury. -Dorsal carpal tangential fluoroscopy is a useful supplement for accurate screws length besides lateral fluoroscopy. Volar plate's position not go beyond the watershed region of distal radius is the key factor in reducing the flexor tendon injury and preservation of the PQ muscle can also prevent the flexor tendon -injury, yield better early wrist function and shorten rehabilitation time.
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Bühler A, Wendtner CM, Kipps TJ, Rassenti L, Fraser GAM, Michallet AS, Hillmen P, Dürig J, Gregory SA, Kalaycio M, Aurran-Schleinitz T, Trentin L, Gribben JG, Chanan-Khan A, Purse B, Zhang J, De Bedout S, Mei J, Hallek M, Stilgenbauer S. Lenalidomide treatment and prognostic markers in relapsed or refractory chronic lymphocytic leukemia: data from the prospective, multicenter phase-II CLL-009 trial. Blood Cancer J 2016; 6:e404. [PMID: 26967821 PMCID: PMC4817104 DOI: 10.1038/bcj.2016.9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Accepted: 02/02/2016] [Indexed: 11/09/2022] Open
Abstract
Efficacy of lenalidomide was investigated in 103 patients with relapsed/refractory chronic lymphocytic leukemia (CLL) treated on the prospective, multicenter randomized phase-II CLL-009 trial. Interphase cytogenetic and mutational analyses identified TP53 mutations, unmutated IGHV, or del(17p) in 36/96 (37.5%), 68/88 (77.3%) or 22/92 (23.9%) patients. The overall response rate (ORR) was 40.4% (42/104). ORRs were similar irrespective of TP53 mutation (36.1% (13/36) vs 43.3% (26/60) for patients with vs without mutation) or IGHV mutation status (45.0% (9/20) vs 39.1% (27/68)); however, patients with del(17p) had lower ORRs than those without del(17p) (21.7% (5/22) vs 47.1% (33/70); P=0.049). No significant differences in progression-free survival and overall survival (OS) were observed when comparing subgroups defined by the presence or absence of high-risk genetic characteristics. In multivariate analyses, only multiple prior therapies (⩾3 lines) significantly impacted outcomes (median OS: 21.2 months vs not reached; P=0.019). This analysis indicates that lenalidomide is active in patients with relapsed/refractory CLL with unfavorable genetic profiles, including TP53 inactivation or unmutated IGHV. (ClinicalTrials.gov identifier: NCT00963105).
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Zhu XZ, Mei J. Effect and mechanism analysis of siRNA in inhibiting VEGF and its anti-angiogenesis effects in human osteosarcoma bearing rats. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2015; 19:4362-4370. [PMID: 26636524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To explore the effect of siRNA in inhibiting vascular endothelial growth factor (VEGF) expression in tumor cells from human osteosarcoma bearing rats and its anti-angiogenesis effect, to further study the reliability, effectiveness and safety of VEGF as a therapeutic target in treating osteosarcoma. MATERIALS AND METHODS After treatment, the long diameter and short diameter of tumor lesion were detected by Vernier caliper, and the tumor volume and tumor inhibition rate were calculated. The whole-body fluorescence imaging was used to detect the general morphology and volume change of tumor lesion before and after treatment. The rats were killed after treatment, RT-PCR and Western blot were used to detect VEGF expression. MTT was used to detect the proliferative ability of tumor cells in vitro. RESULTS Three chemotherapies could inhibit the growth of tumor lesion, the decrease of tumor volume was significant (p < 0.05), the therapeutic effect in Ad-VEGF-siRNA + neoadjuvant chemotherapy group was better than the other two groups, the differences were statistically significant (p < 0.05). Furthermore, the three chemotherapies could inhibit the invasiveness of tumor cells, which was most significant in Ad-VEGF-siRNA + neoadjuvant chemotherapy group (p < 0.05). CONCLUSIONS The growth of tumor tissue in osteosarcoma bearing rats is inhibited in Ad-VEGF-siRNA group, Ad-VEGF-siRNA + neoadjuvant chemotherapy group and Ad-VEGF-siRNA + anti-angiogenesis chemotherapy group. The effect in Ad-VEGF-siRNA + neoadjuvant chemotherapy is more significant than simple biological therapy or Ad-VEGF-siRNA + anti-angiogenesis chemotherapy.
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Zhao J, Du H, Belinson JL, Qu X, Zhang W, Mei J, Yang B, Wang C, Zhang L, Wu R. Evaluation of The Cervista HPV A9 group In Screening Patients for Cervical Cancer. J Med Screen 2015; 23:38-43. [PMID: 26466824 DOI: 10.1177/0969141315604863] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 08/18/2015] [Indexed: 11/15/2022]
Abstract
Objective To exploit the prevalence of HPV genotypes 52/58 in a Chinese population, we evaluated algorithms that the use the Cervista Assay A9 group for primary cervical cancer screening. Methods The SHENCCAST II trial database was re-analyzed, focussing on the A9 pool of the Cervista HR-HPV Assay. Results for the detection CIN2+ and CIN3+ were correlated with a genotyping assay (MALDI-TOF) and cervical cytology to explore various screening algorithms. Results This analysis included 8,556 women with a mean age of 38.9. CIN 2+ rates were 2.7% (233/8556); CIN 3+ rates were 1.7% (141/8556). Overall HPV infection rates were 11.1% (950/8556) for Cervista, in which A5/A6, A7 and A9 groups were 26.5% (227/950), 22.9% (218/950) and 67.8% (644/950), respectively. The HPV A9 group is highly predictive of high-grade cervical lesions (CIN2+ OR = 103.61, CIN3+ OR = 128.059). Sensitivity and specificity for Cervista A9 group for CIN 2+ was 85.4% and 94.7%, and for CIN 3+ 89.4% and 93.8% respectively. Cervista A9 Assay followed by triage cytology for non-A9 positives has sensitivity and specificity for CIN2+ of 91.5% of 93.5%, and for CIN 3+ 94.3% and 92.6%. Conclusion Using the Cervista A9 as the primary screen instead of the full Cervista assay, the percentage referred to colposcopy would decrease from 11.1% to 8.8% and percentage requiring cytology would decrease from 11.1% to 3.6%. Sensitivity of detecting CIN 2+(91.5%), CIN3+(94.3%) would remain similar to the complete Cervista HR-HPV assay for CIN 2+(93.1%), CIN3+(95.0%).
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Zhang L, Li K, Xu Y, Mei J, Zhang F, Li K. Maximizing reliability with energy conservation for parallel task scheduling in a heterogeneous cluster. Inf Sci (N Y) 2015. [DOI: 10.1016/j.ins.2015.02.023] [Citation(s) in RCA: 113] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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