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Zhuang Z, Zhou J, Qiu M, Li J, Lin Z, Yi H, Liu X, Huang C, Tang B, Liu B, Li X. The Combination of Anti-CD47 Antibody with CTLA4 Blockade Enhances Anti-Tumor Immunity in Non-Small Cell Lung Cancer via Normalization of Tumor Vasculature and Reprogramming of the Immune Microenvironment. Cancers (Basel) 2024; 16:832. [PMID: 38398223 PMCID: PMC10887353 DOI: 10.3390/cancers16040832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/15/2024] [Accepted: 01/16/2024] [Indexed: 02/25/2024] Open
Abstract
In solid tumors, the formidable anti-tumor impact resulting from blocking the "don't eat me" signal, arising from CD47-SIRPα interaction, is constrained, especially compared to its efficacy in hematopoietic malignancies. Activating macrophage anti-tumor activity not only necessitates the inhibition of the "don't eat me" signal, but also the activation of the "eat me" (pre-phagocyte) signal. Intriguingly, the cytotoxic T-lymphocyte-associated antigen 4 (CTLA4) antibody (Ab) has been identified to stimulate Fc receptor-mediated active phagocytes in the tumor microenvironment, thereby generating "eat me" signals. This study postulates that concurrently targeting CD47 and CTLA4 could intensify the anti-tumor effects by simultaneously blocking the "don't eat me" signal while triggering the "eat me" signal. The experimental data from this investigation confirm that the combined targeting of CD47 and CTLA4 enhances immunity against solid tumors in LLC cell-transplanted tumor-bearing mice. This effect is achieved by reducing myeloid-derived suppressor cell infiltration while increasing the presence of effector memory CD8+ T cells, NK1.1+ CD8+ T cells, and activated natural killer T cells. Meanwhile, combination therapy also alleviated anemia. Mechanistically, the anti-CD47 Ab is shown to upregulate CTLA4 levels in NSCLC cells by regulating Foxp1. Furthermore, targeting CD47 is demonstrated to promote tumor vascular normalization through the heightened infiltration of CD4+ T cells. These findings suggest that the dual targeting of CD47 and CTLA4 exerts anti-tumor effects by orchestrating the "eat me" and "don't eat me" signals, reshaping the immune microenvironment, and fostering tumor vascular normalization. This combined therapeutic approach emerges as a potent strategy for effectively treating solid tumors.
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Affiliation(s)
- Zhan Zhuang
- Key Laboratory of College of First Clinical Medicine, College of First Clinical Medicine, Fujian Medical University, Taijiang Campus, Fuzhou 350001, China; (Z.Z.); (M.Q.); (J.L.); (Z.L.); (H.Y.); (X.L.); (C.H.); (B.T.)
| | - Jinglin Zhou
- Fujian Key Laboratory of Innate Immune Biology, Biomedical Research Center of South China, College of Life Science, Fujian Normal University Qishan Campus, Fuzhou 350117, China;
| | - Minglian Qiu
- Key Laboratory of College of First Clinical Medicine, College of First Clinical Medicine, Fujian Medical University, Taijiang Campus, Fuzhou 350001, China; (Z.Z.); (M.Q.); (J.L.); (Z.L.); (H.Y.); (X.L.); (C.H.); (B.T.)
| | - Jiamian Li
- Key Laboratory of College of First Clinical Medicine, College of First Clinical Medicine, Fujian Medical University, Taijiang Campus, Fuzhou 350001, China; (Z.Z.); (M.Q.); (J.L.); (Z.L.); (H.Y.); (X.L.); (C.H.); (B.T.)
| | - Zhuangheng Lin
- Key Laboratory of College of First Clinical Medicine, College of First Clinical Medicine, Fujian Medical University, Taijiang Campus, Fuzhou 350001, China; (Z.Z.); (M.Q.); (J.L.); (Z.L.); (H.Y.); (X.L.); (C.H.); (B.T.)
| | - Huihan Yi
- Key Laboratory of College of First Clinical Medicine, College of First Clinical Medicine, Fujian Medical University, Taijiang Campus, Fuzhou 350001, China; (Z.Z.); (M.Q.); (J.L.); (Z.L.); (H.Y.); (X.L.); (C.H.); (B.T.)
| | - Xuerong Liu
- Key Laboratory of College of First Clinical Medicine, College of First Clinical Medicine, Fujian Medical University, Taijiang Campus, Fuzhou 350001, China; (Z.Z.); (M.Q.); (J.L.); (Z.L.); (H.Y.); (X.L.); (C.H.); (B.T.)
| | - Changyu Huang
- Key Laboratory of College of First Clinical Medicine, College of First Clinical Medicine, Fujian Medical University, Taijiang Campus, Fuzhou 350001, China; (Z.Z.); (M.Q.); (J.L.); (Z.L.); (H.Y.); (X.L.); (C.H.); (B.T.)
| | - Binghua Tang
- Key Laboratory of College of First Clinical Medicine, College of First Clinical Medicine, Fujian Medical University, Taijiang Campus, Fuzhou 350001, China; (Z.Z.); (M.Q.); (J.L.); (Z.L.); (H.Y.); (X.L.); (C.H.); (B.T.)
| | - Bo Liu
- Key Laboratory of College of First Clinical Medicine, College of First Clinical Medicine, Fujian Medical University, Taijiang Campus, Fuzhou 350001, China; (Z.Z.); (M.Q.); (J.L.); (Z.L.); (H.Y.); (X.L.); (C.H.); (B.T.)
| | - Xu Li
- Key Laboratory of College of First Clinical Medicine, College of First Clinical Medicine, Fujian Medical University, Taijiang Campus, Fuzhou 350001, China; (Z.Z.); (M.Q.); (J.L.); (Z.L.); (H.Y.); (X.L.); (C.H.); (B.T.)
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Liu J, Zhang H, Qiao X, Wu M, Wang H, Ran K, Luo H, Chen Y, Sun J, Tang B. The feasibility and safety of laparoscopic inguinal hernia repair as a 24-h day surgery for patients aged 80 years and older: a retrospective cohort study. Hernia 2023; 27:1533-1541. [PMID: 37898974 DOI: 10.1007/s10029-023-02912-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 10/08/2023] [Indexed: 10/31/2023]
Abstract
INTRODUCTION As the proportion of aging adults increases and inguinal hernia repair becomes increasingly popular as a day surgery, the demand for laparoscopic inguinal hernia repair as a day surgery is increasing among patients aged 80 years and older. Relevant research needs to be completed, so we aimed to evaluate laparoscopic inguinal hernia repair as a 24-h day surgery for this group of patients. METHODS In this retrospective cohort study, we utilized propensity score matching to analyze the data of patients who underwent laparoscopic inguinal hernia repair at a day surgery center between January 1, 2019, and March 1, 2022. Patients were divided into ≥ 80 years old and < 80 years old groups. We compared the perioperative laboratory results, perioperative outcomes, and 1-year complications between the two groups. RESULT A total of 554 patients were included in the study. After propensity score matching, 292 patients were included in the matched cohort (98 patients in the ≥ 80 years old group and 194 patients in the < 80 years old group). During hospitalization, there were significant differences in ASA classification, Caprini score, length of hospital stays, risk of thrombosis, and delayed discharge rate. No significant difference was found in the incidence of total postoperative complications between the two groups at the 1-year follow-up (HR: 0.96, 95% CI 0.36-2.54, P = 0.96). CONCLUSION In our study, LIHR as a 24-h day surgery was safe and effective for patients over 80 years old. However, to reduce the rate of delayed discharge, cautious perioperative evaluation is necessary.
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Affiliation(s)
- J Liu
- Vascular, Hernia and Abdominal Wall Surgery, The Second Affiliated Hospital of Chongqing Medical University, 76 Linjiang Road, Yuzhong District, Chongqing, China
| | - H Zhang
- Vascular, Hernia and Abdominal Wall Surgery, The Second Affiliated Hospital of Chongqing Medical University, 76 Linjiang Road, Yuzhong District, Chongqing, China
| | - X Qiao
- The Second Clinical Medical College of Chongqing Medical University, 76 Linjiang Road, Yuzhong District, Chongqing, China
| | - M Wu
- Vascular, Hernia and Abdominal Wall Surgery, The Second Affiliated Hospital of Chongqing Medical University, 76 Linjiang Road, Yuzhong District, Chongqing, China
| | - H Wang
- Vascular, Hernia and Abdominal Wall Surgery, The Second Affiliated Hospital of Chongqing Medical University, 76 Linjiang Road, Yuzhong District, Chongqing, China
| | - K Ran
- Vascular, Hernia and Abdominal Wall Surgery, The Second Affiliated Hospital of Chongqing Medical University, 76 Linjiang Road, Yuzhong District, Chongqing, China
| | - H Luo
- Vascular, Hernia and Abdominal Wall Surgery, The Second Affiliated Hospital of Chongqing Medical University, 76 Linjiang Road, Yuzhong District, Chongqing, China
| | - Y Chen
- Vascular, Hernia and Abdominal Wall Surgery, The Second Affiliated Hospital of Chongqing Medical University, 76 Linjiang Road, Yuzhong District, Chongqing, China
| | - J Sun
- Vascular, Hernia and Abdominal Wall Surgery, The Second Affiliated Hospital of Chongqing Medical University, 76 Linjiang Road, Yuzhong District, Chongqing, China
| | - B Tang
- The Fourth Clinical College of Chongqing Medical University, 55 University-Town Middle Road, Shapingba District, Chongqing, China.
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You G, Zheng Z, Huang Y, Liu G, Luo W, Huang J, Zhuo L, Tang B, Liu S, Lin C. scRNA-seq and proteomics reveal the distinction of M2-like macrophages between primary and recurrent malignant glioma and its critical role in the recurrence. CNS Neurosci Ther 2023; 29:3391-3405. [PMID: 37194413 PMCID: PMC10580349 DOI: 10.1111/cns.14269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 05/02/2023] [Accepted: 05/03/2023] [Indexed: 05/18/2023] Open
Abstract
AIMS Tumor-associated macrophages (TAMs) in the immune microenvironment play an important role in the increased drug resistance and recurrence of malignant glioma, but the mechanism remains incompletely inventoried. The focus of this study was to investigate the distinctions of M2-like TAMs in the immune microenvironment between primary and recurrent malignant glioma and its influence in the recurrence. METHODS We employed single-cell RNA sequencing to construct a single-cell atlas for a total of 23,010 individual cells from 6 patients with primary or recurrent malignant glioma and identified 5 cell types, including TAMs and malignant cells. Immunohistochemical techniques and proteomics analysis were performed to investigate the role of intercellular interaction between malignant cells and TAMs in the recurrence of malignant glioma. RESULTS Six subgroups of TAMs were annotated and M2-like TAMs were found to increase in recurrent malignant glioma significantly. A pseudotime trajectory and a dynamic gene expression profiling during the recurrence of malignant glioma were reconstructed. Up-regulation of several cancer pathways and intercellular interaction-related genes are associated with the recurrence of malignant glioma. Moreover, the M2-like TAMs can activate the PI3K/Akt/HIF-1α/CA9 pathway in the malignant glioma cells via SPP1-CD44-mediated intercellular interaction. Interestingly, high expression of CA9 can trigger the immunosuppressive response in the malignant glioma, thus promoting the degree of malignancy and drug resistance. CONCLUSION Our study uncovers the distinction of M2-like TAMs between primary and recurrent glioma, which offers unparalleled insights into the immune microenvironment of primary and recurrent malignant glioma.
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Affiliation(s)
- Guiting You
- Department of Neurosurgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - Zhenyu Zheng
- Department of Neurosurgery, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Medical University, Fuzhou, China
| | - Yulong Huang
- Department of Neurosurgery, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Medical University, Fuzhou, China
| | - Guifen Liu
- Department of Gynaecology, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Wei Luo
- Department of Neurosurgery, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Medical University, Fuzhou, China
| | - Jianhuang Huang
- Department of Neurosurgery, Affiliated Hospital of Putian University, Putian, China
| | - Longjin Zhuo
- Pingtan Comprehensive Experimental Area Hospital, Fuzhou, China
| | - Binghua Tang
- Department of Neurosurgery, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Medical University, Fuzhou, China
| | - Shunyi Liu
- Department of Neurosurgery, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Medical University, Fuzhou, China
| | - Caihou Lin
- Department of Neurosurgery, Fujian Medical University Union Hospital, Fuzhou, China
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Wang XR, Li S, Liu JY, Gu B, Jia ZJ, Tang B. [Establishment of a rapid method for detection of influenza A/B virus' antigens]. Zhonghua Yu Fang Yi Xue Za Zhi 2023; 57:1608-1612. [PMID: 37859378 DOI: 10.3760/cma.j.cn112150-20230411-00280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
This study aims to develop a rapid and convenient test card for simultaneous detection of influenza A and influenza B viruses using quantum dot-based immunochromatographic assay. The test card consists of a test strip and a plastic casing. The test strip is composed of absorbent paper, a buffer pad, nitrocellulose membrane (NC membrane), sample pad, quantum dot-labeled antibody pad, and polyvinyl chloride (PVC) board. The NC membrane is coated with mouse monoclonal antibodies against influenza A and influenza B viruses for the T lines (test lines), and reference proteins A and B for the C line (control line). The quantum dot-labeled antibody pad contains mouse monoclonal antibody-quantum dot conjugates against influenza A and influenza B viruses. The results showed that the detection limit of the test card for both viruses ranged from 1.51 ×102 to 2.71×103 TCID50/ml, indicating its sensitivity for accurate detection of influenza A and influenza B viruses without being affected by various variants. The test card exhibited specific reactions with different subtypes of influenza A and influenza B virus culture fluids and showed no cross-reactivity with adenovirus, novel coronavirus, Mycoplasma pneumoniae, respiratory syncytial virus, Staphylococcus aureus, and other pathogens. Overall, the sensitivity and specificity of the test card for simultaneous detection of influenza A and influenza B viruses meet the requirements for clinical use. It offers the advantages of simplicity, rapidity, and no requirement for special equipment, enabling quick auxiliary diagnosis to prevent disease transmission.
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Affiliation(s)
- X R Wang
- Medical Technology School of Xuzhou Medical University, Xuzhou 221004, China
| | - S Li
- Nanjing Vazyme Medical Technology Co., Ltd, Nanjing 210000, China
| | - J Y Liu
- Nanjing Vazyme Medical Technology Co., Ltd, Nanjing 210000, China
| | - B Gu
- Department of Laboratory Medicine, Guangdong Provincial people's Hospital, Guangzhou 510080, China
| | - Z J Jia
- Department of Nuclear Medicine, the Drum Tower Hospital Affiliated to the Medical School of Nanjing University, Nanjing 210000, China
| | - B Tang
- Medical Technology School of Xuzhou Medical University, Xuzhou 221004, China Nanjing Vazyme Medical Technology Co., Ltd, Nanjing 210000, China
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Yang F, Liu M, Wang X, Wu J, Tang B, Li J, Kang S. Influence of Contrast Materials on Dose Accuracy of MR-Linac in Patients with SBRT Liver Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e352-e353. [PMID: 37785220 DOI: 10.1016/j.ijrobp.2023.06.2429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Objective: Intravenous injection of contrast agent during CT scanning can improve the accuracy of target area contouring, however the contrast agent will cause dose bias due to the high relative electron density. This study aims to explore the influence of contrast agent on the accuracy of dose calculation of the planning system during SBRT based on MRI-Linac for liver cancer treatment. MATERIALS/METHODS Methods: In this study, 20 patients undergoing stereotactic body radiation therapy (SBRT) for liver cancer were selected, and their complete unenhanced CT, contrast-enhanced CT, and corresponding structures were imported into Monaco V.5.4. The target and organs at risk (OARs) in the unenhanced CT and contrast-enhanced CT were additionally contoured according to the target contouring guidelines and OARs were ranked. The average relative electron densities of OARs (lung, spinal cord, heart, rib, etc.) were calculated with Monaco TPS. The reference plan is based on unenhanced CT for plan calculation (plan1). To compare the dosimetry errors caused by the synthetic CT, the average relative electron density of all structures in unenhanced CT was forced and the plans were recalculated (plan2). To investigate dosimetric differences caused by the changes of relative electron density due to the contrast agent, the average relative electron density of all structures in contrast-enhanced CT was forced and the plans were recalculated(plan3). The dosimetric differences in groups A (plan 1 and plan2), B (plan 1 and plan3), and C (plan2 and plan3) were compared, respectively. RESULTS There were not significant difference between three groups in the affected lung, heart, liver, blood, all within 3%. However, differences were significantly different in the group B. The maximum deviation of spinal cord Dmax reached 4.78%. In addition, the deviation of the dose parameters in the target area was small, except that the maximum deviation of the CI value in group B was 3.23%. CONCLUSION For SBRT planning of liver cancer based on magnetic resonance accelerator, synthetic CT has little influence on the calculation of planned dose. The dose difference caused by contrast materials is also relatively small, although the deviation of the CI value of the target area exceeds 3%, which is also within the clinical acceptance range. However, the deviation of the maximum value of the spinal cord is relatively large, exceeding the clinically acceptable range. Therefore, when optimizing the SBRT plan for liver cancer, attention should be paid to important organs such as the spinal cord, and should be avoided as far as possible when setting the fields.
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Affiliation(s)
- F Yang
- Sichuan Cancer Hospital & Institute, University of Electronic Science and Technology of China, Chengdu, China
| | - M Liu
- Sichuan Cancer Hospital & Institute, University of Electronic Science and Technology of China, Chengdu, China
| | - X Wang
- Sichuan Cancer Hospital & Institute, University of Electronic Science and Technology of China, Chengdu, China
| | - J Wu
- Sichuan Cancer Hospital & Institute, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - B Tang
- Sichuan Cancer Hospital & Institute, University of Electronic Science and Technology of China, Chengdu, China
| | - J Li
- Sichuan Cancer Hospital & Institute, University of Electronic Science and Technology of China, Chengdu, China
| | - S Kang
- Sichuan Cancer Hospital & Institute, University of Electronic Science and Technology of China, Chengdu, China
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Liu M, Li J, Zhang D, Yuan K, Wu F, Yang F, Peng G, Tang B, Orlandini LC. Challenges of Treating Lung Cancer Patients at MR-Linac Using MR-Based Synthetic CT Calculation in the Adaptive Workflow. Int J Radiat Oncol Biol Phys 2023; 117:e684. [PMID: 37786013 DOI: 10.1016/j.ijrobp.2023.06.2149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Magnetic Resonance guided adaptive radiotherapy (MRgART) allows plan adaptation according to the new patient anatomy; the contours of the structures are adjusted based on the patient's daily MRI, and in the adapt to shape (ATS) workflow, the adapted plan is recalculated on the MRI-based synthetic CT (sCT) generated by bulk density assignment. For sites where there is a high electronic density (ED) gradient between the target and surrounding tissues, such as in lung cancer treatments, the assignment of an average ED may not be able to reproduce an accurate dose calculation. This study evaluates the accuracy of the sCT adapted plan calculation for lung cancer patients and assesses whether the assignment of an optimized ED can reduce dosimetric differences should they arise MATERIALS/METHODS: Nine lung cancer patients treated at Unity 1.5 MR-Linac were selected for this retrospective study. The patient's target and organs at risk (OARs) were contoured, and a CT reference plan containing the ED bulk assignment information i.e., the contours to use in the ATS workflow, and their corresponding average ED was generated. To assess the accuracy of the dosimetry of the adapted plan calculated on the sCT, the plan was recalculated on an ideal sCT (sCTref) obtained from the reference CT by forcing the drawn contours to the average ED as defined on the CT reference plan. Targets and OARs dose-volume histogram (DVH) of the CT and sCTref plans and the dose distributions using gamma (γ) analysis with 2%-2mm criteria were compared. In the case of a discrepancy between the DVHs, the average Eds used for the recalculation on the sCTref were adjusted by several attempts to obtain a sCT optimized (sCTopt) for which a superposition of DVHs on CT and sCTopt was achieved. RESULTS For 7 of the 9 patients CT and sCTref target DVHs were not comparable, with a mean dosimetric difference of 5.55% (range 2.35%-7.46%) in the target volume receiving the prescription dose (VDpre), while OARs DVH dose differences remained below 1% for the nine patients. The adjustment of the ED of the homolateral lung in the sCTopt, reduced the mean target VDpre dosimetric difference between CT and sCTopt to 0.66% (range 0.17%-1.64%). In addition, the results of the gamma analysis increased from values ranging between 39.5%-70.3% to 88.5%-93.2%, as shown in the Table. CONCLUSION Dosimetric errors in the use of the sCT calculation for targets in high ED gradient areas may arise; the use of optimized ED for sCT calculation may be a promising strand to investigate in order to proceed with MR-based sCT plan adaptation for lung cancer treatment.
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Affiliation(s)
- M Liu
- Sichuan Cancer Hospital & Institute, University of Electronic Science and Technology of China, Chengdu, China
| | - J Li
- Sichuan Cancer Hospital & Institute, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - D Zhang
- Sichuan Cancer Hospital & Institute, University of Electronic Science and Technology of China, Chengdu, China
| | - K Yuan
- Sichuan Cancer Hospital & Institute, University of Electronic Science and Technology of China, Chengdu, China
| | - F Wu
- Sichuan Cancer Hospital & Institute, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - F Yang
- Sichuan Cancer Hospital & Institute, University of Electronic Science and Technology of China, Chengdu, China
| | - G Peng
- Sichuan Cancer Hospital & Institute, University of Electronic Science and Technology of China, Chengdu, China
| | - B Tang
- Sichuan Cancer Hospital & Institute, University of Electronic Science and Technology of China, Chengdu, China
| | - L C Orlandini
- Sichuan Cancer Hospital & Institute, University of Electronic Science and Technology of China, Chengdu, China
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Feng X, Tang B, Wang P, Kang S, Liao X, Yao X, Wang X, Orlandini LC. Effectiveness of Bladder Filling Control during Online MR-Guided Adaptive Radiotherapy for Rectum Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e725-e726. [PMID: 37786113 DOI: 10.1016/j.ijrobp.2023.06.2238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) MR-guided adaptive radiotherapy (MRgART) treatment sessions at MR-Linac are time-consuming and changes in bladder filling during the session can impact the treatment dosimetry. In this work, we present the procedure implemented in the clinical workflow to stabilize bladder filling during the MR based adaptive radiotherapy sessions and evaluate its effectiveness and the resulting dosimetric impact on the adaptive plan. MATERIALS/METHODS Twenty-five rectum cancer patients treated at 1.5T MR-Linac with a short course radiotherapy (25 Gy in 5 fractions of 5 Gy each) were included in this retrospective study. Patients were treated with the adapt-to-shape workflow consisting of a plan adaptation based on the MRI acquired in each session and optimized on the corresponding MR-based synthetic CT. Considering the significant interval time between the acquisition of the first daily MRI used for plan adaptation, and the beam delivery, a bladder catheter was used to stabilize the bladder filling; the procedure consists of emptying the bladder and refilling it with a well-known amount of physiological solution before each MRI acquisition. Two MRIs were acquired at each session: the first was used for plan adaptation and the second was acquired while approving the adapted plan, to be rigidly registered with the first to ensure the appropriateness of the isodoses on the ongoing delivery treatment. A total of 125 sessions and 250 MRI images and bladder contours were analyzed; for each fraction, the time interval between the first and second MRI and the corresponding bladder volumes were recorded; the consistency of bladder volumes and shapes along each online session was assessed with the dice similarity index (DSC) and Hausdorff distance (HD); the impact on plan dosimetry was evaluated by comparing target and bladder DVH cut off points of the plan on the two different MRI datasets. RESULTS The time interval between the first and second MRI, averaged over the 125 sessions is 39.0 min, range (18.6-75.8) min. The changes in bladder volumes, DSC index, HD, and the differences between the bladder and target DVH cut-off points are shown in the table below. The DSC and HD are comparable to inter-observer variability in manual contour segmentation, with an average DSC of 0.91 and average HD of 2.13 mm; the average differences in bladder and target dosimetry remain under 0.63% and 0.10%, respectively. CONCLUSION The use of a procedure in the clinical workflow of MRgART to stabilize the bladder filling throughout the online session may be helpful to guarantee the accuracy of the ongoing delivered treatment.
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Affiliation(s)
- X Feng
- Sichuan Cancer Hospital & Institute, University of Electronic Science and Technology of China, Chengdu, China
| | - B Tang
- Sichuan Cancer Hospital & Institute, University of Electronic Science and Technology of China, Chengdu, China
| | - P Wang
- Sichuan Cancer Hospital & Institute, University of Electronic Science and Technology of China, Chengdu, China
| | - S Kang
- Sichuan Cancer Hospital & Institute, University of Electronic Science and Technology of China, Chengdu, China
| | - X Liao
- Sichuan Cancer Hospital & Institute, University of Electronic Science and Technology of China, Chengdu, China
| | - X Yao
- Sichuan Cancer Hospital & Institute, University of Electronic Science and Technology of China, Chengdu, China
| | - X Wang
- Sichuan Cancer Hospital & Institute, University of Electronic Science and Technology of China, Chengdu, China
| | - L C Orlandini
- Sichuan Cancer Hospital & Institute, University of Electronic Science and Technology of China, Chengdu, China
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Wu J, Tang B, Orlandini LC, Li J, Wu F. Evaluation of Flattening-Filter-Free and Flattening Filter Dosimetric and Radiobiological Criteria for Lung SBRT: A Volume-Based Analysis. Int J Radiat Oncol Biol Phys 2023; 117:e738. [PMID: 37786143 DOI: 10.1016/j.ijrobp.2023.06.2267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The use of volumetric modulated arc therapy (VMAT) with flattening-filter-free (FFF) beams is becoming more prevalent in lung cancer stereotactic body radiotherapy (SBRT). The aim in this study was to assess the impact of dosimetric and radiobiological differences between FFF and flattening filter (FF) beams for lung SBRT based on the target volume. MATERIALS/METHODS A total of 198 lung stereotactic body radiation therapy treatment plans with FFF beams and FF beams were retrospectively selected for this study. For all plans, the prescribed dose was 50 Gy/5 fractions, and the dose volume histogram (DVH) for the target and organs at risk (OAR) and the normal tissue complication probability (NTCP) of the lung were recorded and compared. Moreover, monitor units (MUs), the beam on-time and the treatment time were evaluated. The study was performed following the Radiation Therapy Oncology Group (RTOG) 0813 and 0915 protocols. RESULTS No significant differences in D90, coverage rate (CR) or conformity index (CI) of the target were observed between FFF beams and FF beams (p>0.05). The D2, R50% and gradient index (GI) for the target improved with FFF beams compared with FF beams (p<0.05). FFF beams also significantly reduced the dose for the lung, heart, spinal cord, esophagus and NTCP of the lung (p<0.05), compared with FF beams. However, there was no significant difference in sparing of the trachea (p>0.05). The mean MUs, beam on-time and treatment time were 1871±278 MUs, 3.2 ±0.2 min and 3.9 ±0.3 min for FFF beams, and 1890±260 MUs, 4.2±0.3 min and 4.8 ±0.4 min for FF beams, respectively. CONCLUSION The FFF beam technique for lung SBRT with VMAT results in a better dose fall-off, better dose-sparing of OAR, lower NTCP of the lung and a shorter beam on-time compared with the FF beam technique. Additionally, the improvement in target and OAR-sparing for FFF beams was increased with increasing target volume.
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Affiliation(s)
- J Wu
- Sichuan Cancer Hospital & Institute, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - B Tang
- Sichuan Cancer Hospital & Institute, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - L C Orlandini
- Sichuan Cancer Hospital & Institute, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - J Li
- Sichuan Cancer Hospital & Institute, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - F Wu
- Sichuan Cancer Hospital & Institute, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
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Tang B, Chen WJ, Jiang LD, Zhu SH, Song B, Chao YG, Song TJ, He W, Liu Y, Zhang HM, Chai WZ, Yin MG, Zhu R, Liu LX, Wu J, Ding X, Shang XL, Duan J, Xu QH, Zhang H, Wang XM, Huang QB, Gong RC, Li ZZ, Lu MS, Wang XT. [Expert consensus on late stage of critical care management]. Zhonghua Nei Ke Za Zhi 2023; 62:480-493. [PMID: 37096274 DOI: 10.3760/cma.j.cn112138-20221005-00731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Abstract
We wished to establish an expert consensus on late stage of critical care (CC) management. The panel comprised 13 experts in CC medicine. Each statement was assessed based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) principle. Then, the Delphi method was adopted by 17 experts to reassess the following 28 statements. (1) ESCAPE has evolved from a strategy of delirium management to a strategy of late stage of CC management. (2) The new version of ESCAPE is a strategy for optimizing treatment and comprehensive care of critically ill patients (CIPs) after the rescue period, including early mobilization, early rehabilitation, nutritional support, sleep management, mental assessment, cognitive-function training, emotional support, and optimizing sedation and analgesia. (3) Disease assessment to determine the starting point of early mobilization, early rehabilitation, and early enteral nutrition. (4) Early mobilization has synergistic effects upon the recovery of organ function. (5) Early functional exercise and rehabilitation are important means to promote CIP recovery, and gives them a sense of future prospects. (6) Timely start of enteral nutrition is conducive to early mobilization and early rehabilitation. (7) The spontaneous breathing test should be started as soon as possible, and a weaning plan should be selected step-by-step. (8) The waking process of CIPs should be realized in a planned and purposeful way. (9) Establishment of a sleep-wake rhythm is the key to sleep management in post-CC management. (10) The spontaneous awakening trial, spontaneous breathing trial, and sleep management should be carried out together. (11) The depth of sedation should be adjusted dynamically in the late stage of CC period. (12) Standardized sedation assessment is the premise of rational sedation. (13) Appropriate sedative drugs should be selected according to the objectives of sedation and drug characteristics. (14) A goal-directed minimization strategy for sedation should be implemented. (15) The principle of analgesia must be mastered first. (16) Subjective assessment is preferred for analgesia assessment. (17) Opioid-based analgesic strategies should be selected step-by-step according to the characteristics of different drugs. (18) There must be rational use of non-opioid analgesics and non-drug-based analgesic measures. (19) Pay attention to evaluation of the psychological status of CIPs. (20) Cognitive function in CIPs cannot be ignored. (21) Delirium management should be based on non-drug-based measures and rational use of drugs. (22) Reset treatment can be considered for severe delirium. (23) Psychological assessment should be conducted as early as possible to screen-out high-risk groups with post-traumatic stress disorder. (24) Emotional support, flexible visiting, and environment management are important components of humanistic management in the intensive care unit (ICU). (25) Emotional support from medical teams and families should be promoted through"ICU diaries"and other forms. (26) Environmental management should be carried out by enriching environmental content, limiting environmental interference, and optimizing the environmental atmosphere. (27) Reasonable promotion of flexible visitation should be done on the basis of prevention of nosocomial infection. (28) ESCAPE is an excellent project for late stage of CC management.
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Affiliation(s)
- B Tang
- Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - W J Chen
- Department of Neurosurgery ICU, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - L D Jiang
- Department of Neurosurgery ICU, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - S H Zhu
- Department of Critical Care Medicine, the Seventh Medical Center of PLA General Hospital, Beijing 100700, China
| | - B Song
- Department of Critical Care Medicine, the Seventh Medical Center of PLA General Hospital, Beijing 100700, China
| | - Y G Chao
- Department of Critical Care Medicine, the First Affiliated Hospital of Tsinghua University, Beijing 100016, China
| | - T J Song
- Department of Critical Care Medicine, the First Affiliated Hospital of Tsinghua University, Beijing 100016, China
| | - W He
- Department of Critical Care Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Y Liu
- Department of Critical Care Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - H M Zhang
- Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - W Z Chai
- Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - M G Yin
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - R Zhu
- Department of Critical Care Medicine, the First Hospital of China Medical Uinversity, Shenyang 110001, China
| | - L X Liu
- Department of Critical Care Medicine, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - J Wu
- Department of Critical Care Medicine, Ruijin Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200025, China
| | - X Ding
- Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - X L Shang
- Department of Critical Care Medicine, Fujian Provincial Hospital, Fuzhou 350001, China
| | - J Duan
- Department of Critical Care Medicine, China-Japan Friendship Hospital, Beijing 100029, China
| | - Q H Xu
- Department of Critical Care Medicine, Zhejiang Hospital, Hangzhou 310013, China
| | - H Zhang
- Department of Neurosurgery, the First Hospital of China Medical University, Shenyang 110001, China
| | - X M Wang
- Department of Critical Care Medicine, Xuzhou Central Hospital, Xuzhou 221009, China
| | - Q B Huang
- Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan 250012, China
| | - R C Gong
- Department of Critical Care Medicine, Affiliated Hospital of Taiwan Kaohsiung University, China
| | - Z Z Li
- Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - M S Lu
- Department of Health Care and Medical, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences,Beijing 100730, China
| | - X T Wang
- Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
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Haddadi S, Jordan-Sciutto KL, Akay-Espinoza C, Grelotti D, Letendre SL, Tang B, Ellis RJ. PKR-like ER kinase (PERK) Haplotypes Are Associated with Depressive Symptoms in People with HIV. J Neurol Psychol 2023; 10:07. [PMID: 37206541 PMCID: PMC10194542 DOI: 10.13188/2332-3469.1000049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Background Depression is a debilitating and difficult-to-treat condition in people with HIV (PWH) despite viral suppression on antiretroviral therapy (ART). Depression is associated with activation of the PKR-like ER kinase (PERK) pathway, which regulates protein synthesis in response to metabolic stress. We evaluated common PERK haplotypes that influence PERK expression in relation to depressed mood in PWH. Methods PWH from 6 research centers were enrolled in the study. Genotyping was conducted using targeted sequencing with TaqMan. The major PERK haplotypes A, B, and D were identified. Depressive symptom severity was assessed using the Beck Depression Inventory-II (BDI-II). Covariates including genetically-defined ancestry, demographics, HIV disease/treatment parameters and antidepressant treatments were assessed. Data were analyzed using multivariable regression models. Results A total of 287 PWH with a mean (SD) age of 57.1±7.8 years were enrolled. Although the largest ethnic group was non-Hispanic white (n=129, 45.3%), African-American (n=124, 43.5%) and Hispanic (n=30, 10.5%) made up over half the sample. 20.3% were female and 96.5% were virally suppressed. Mean BDI-II was 9.6±9.5, and 28.9% scored above the cutoff for mild depression (BDI-II>13). PERK haplotype frequencies were AA57.8%, AB25.8%, AD 10.1%, and BB4.88%. PERK haplotypes were differentially represented according to genetic ancestry (p=6.84e-6). BDI-II scores were significantly higher in participants with the AB haplotype (F=4.45, p=0.0007).This finding was robust to consideration of potential confounds. Conclusion PERK haplotypes were associated with depressed mood in PWH.Consequently, pharmacological targeting of PERK-related pathways might amelioratedepression in PWH.
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Affiliation(s)
- S Haddadi
- Warren College, University of California, San Diego, La Jolla, CA 92093, USA
| | - K L Jordan-Sciutto
- Department of Pathology, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - C Akay-Espinoza
- Department of Pathology, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - D Grelotti
- Department of Psychiatry, University of California, San Diego, La Jolla, CA 92093, USA
| | - S L Letendre
- Department of Medicine, University of California, San Diego, La Jolla, CA 92093, USA
| | - B Tang
- Department of Psychiatry, University of California, San Diego, La Jolla, CA 92093, USA
| | - R J Ellis
- Department of Neurosciences, University of California, San Diego, La Jolla, CA 92093, USA
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Tam C, Zhao FL, Gauba R, Kouhkamari M, Li S, Tang B. 204MO Patterns of treatment and outcomes in CLL patients in Australia: An analysis of the population-wide pharmaceutical benefits scheme dataset. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
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12
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Peng D, Liu M, Tang B, Feng X, Liu Y, Li J, Wu F, Orlandini L. MR-Guided Boost Irradiation for Patients with Pelvic Recurrence of Gynecological Cancer. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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13
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Tam C, Zhao FL, Gauba R, Azam S, Li S, Tang B. 205MO Patterns of treatment and outcomes in MCL patients in Australia: An analysis of the population-wide pharmaceutical benefits scheme dataset. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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Sun FF, Huang R, Meng JL, Yan J, Tang B, Wu GF. [Preliminary clinical effect evaluation of digital head and neck radiotherapy oral positioning stents]. Zhonghua Kou Qiang Yi Xue Za Zhi 2022; 57:1022-1028. [PMID: 36266075 DOI: 10.3760/cma.j.cn112144-20220701-00360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Objective: To develop a designing software of digital oral positioning stent for radiotherapy of head and neck, and to compare its clinical effect with traditional oral positioning stents made by lost wax process. Methods: Thirty patients with nasopharyngeal cancer who received oral examination before radiotherapy in the prosthodontics department from July to December, 2021, were selected and divided into three groups according to the patients' wishes, 10 per group: one group without radiotherapy oral positioning stents, one group with traditional oral positioning stents (traditional stents group), and the third group with digital oral positioning stents (digital stents group). Patients' ages range from 20 years old to 71 years old. There were 15 males and 15 females involved in this study. The manufacturing time and comfort of the two positioning stents were evaluated, and the radiation doses of the radiotherapy target areas and surrounding healthy tissues were statistically analyzed at the end of radiotherapy. Results: The manufacturing time of digital stents group [(209±7) min] was much less than that of traditional stents group [(490±10) min] (t=69.85, P<0.001). The comfort of patients' wearing of digital stents [first wearing: 5 (3, 6) score; at the end of radiotherapy: 4 (3, 5) score] was better than that of traditional ones [first wearing: 7 (3, 7) score; at the end of radiotherapy: 7 (3, 7) score] (U=22.00, P=0.033; U=20.50, P=0.023). There was no significant differences in the target radiation doses among the three groups, and the radiation doses of tongue [traditional stents group: (36.74±5.45) Gy; digital stents group: (35.96±4.98) Gy] and mandible [traditional stents group: (35.46±4.19) Gy; digital stents group: (35.34±3.98) Gy] were significantly lower in the patients wearing oral positioning stents than in the patients without oral positioning stents [tongue: (41.49±4.46) Gy; madible: (39.32±3.52) Gy] (P<0.05). Conclusions: Oral positioning stents for nasopharyngeal carcinoma radiotherapy could greatly reduce the exposure doses of tongue and madible of patients. Digital oral positioning stents designed and manufactured by independently developed software had higher production efficiency than the traditional method, and patients' evaluation of comfort was better.
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Affiliation(s)
- F F Sun
- Department of Prosthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, China
| | - R Huang
- Department of Prosthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, China
| | - J L Meng
- Department of Prosthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, China
| | - J Yan
- Department of Oncology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - B Tang
- Nanjing Profeta Intelligent Technology Corperation, Nanjing 211112, China
| | - G F Wu
- Department of Prosthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, China
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Guan W, Tang B, Wang QF. A practical study regarding the effect of adaptive roller-skating on emotion regulation ability of autistic children. Eur Rev Med Pharmacol Sci 2022; 26:6487-6496. [PMID: 36196698 DOI: 10.26355/eurrev_202209_29747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Our aim is to analyze the effect of adaptive roller-skating on emotional regulation of autistic children. MATERIALS AND METHODS Adaptive roller-skating course was designed for autistic children based on adaptive sports and A-B-A experiments. RESULTS The adaptive roller-skating intervention focuses on improving emotional regulation ability, and directs the children to reasonably vent, recognize and stabilize their emotions. Adaptive roller-skating has a significant effect in intervening sadness, anger, anxiety and fear in autistic children; the intervention content setting and difficulty setting of the course have a certain impact on the intervention effect. Highly difficult and risky content can stimulate children. CONCLUSIONS Adaptive roller-skating intervention course should obey the concept of adaptive movement in view of the differences between autistic children and the fun of roller-skating and guide the autistic children in emotion regulation with positive emotions.
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Affiliation(s)
- W Guan
- Hunan International Business Vocational College, Hunan Modern Logistics College, Changsha Normal University, Changsha, Hunan, China.
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Van Tol AL, Tang B, Mackie ID. A case of Streptococcus canis bacteremia, osteomyelitis, sacroiliitis, myositis, and abscess. BMC Infect Dis 2022; 22:621. [PMID: 35840925 PMCID: PMC9287961 DOI: 10.1186/s12879-022-07580-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 06/30/2022] [Indexed: 12/03/2022] Open
Abstract
Background Streptococcus canis is a group G beta-hemolytic Streptococcus species which normally resides on the skin and mucosal surfaces of dogs. Although it rarely causes infection in humans, our case and review of relevant literature demonstrate that this multi-host pathogen may be responsible for metastatic infection. We present an appropriate management strategy in such cases.
Case presentation A previously healthy 26-year-old male presented to the emergency department with a 2-day history of erythema, pain, and swelling of the left ankle and foot, consistent with acute cellulitis. The patient was initially discharged home with a plan to complete a course of IV cefazolin as an outpatient, but later recalled after two sets of blood cultures grew gram positive cocci. Blood cultures speciated as Streptococcus canis. This was performed by identifying beta hemolytic strep on blood agar, then typed as Lancefield group G, followed by MALDI-TOF which distinguished S. canis. History was unremarkable except for a 2-week history of lower back pain precipitated by a wrestling injury. There was no canine bite or scratch wound, although the patient lives with a dog. CT spine was obtained which demonstrated right piriformis myositis and S1 osteomyelitis. MRI additionally demonstrated right erector spinae myositis, right sacroiliitis, and multiple collections in the right posterior paraspinal soft tissues. Transthoracic echocardiogram did not demonstrate valvular vegetations. The S. canis isolate was pan-susceptible and the patient was ultimately discharged home and completed a 8-week course of IV penicillin G. After completion of therapy, his symptoms, repeat imaging, and biochemical markers suggested resolution of infection on follow-up. Conclusions We suggest that management of S. canis bacteremia should involve consideration of screening for metastatic infection and infectious diseases consultation. However, despite its potential for systemic involvement, S. canis is often susceptible to narrow spectrum antibiotics, and may be treated with penicillins. S. canis does not require a clear portal of entry to cause infection When S. canis infection is identified, screening for sites of metastatic infection should be considered S. canis infection is typically susceptible to narrow-spectrum antibiotics
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Affiliation(s)
- A L Van Tol
- Department of Family Medicine, Queen's University, Kingston, ON, Canada.
| | - B Tang
- Division of General Internal Medicine, University of Toronto, Toronto, ON, Canada
| | - I D Mackie
- Division of General Internal Medicine, Vancouver General Hospital and University of British Columbia, Vancouver, BC, Canada
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Shah B, Yang K, Klink A, Liu T, Zimmerman T, Gajra A, Tang B. P1157: REAL-WORLD TREATMENT PATTERNS AND COMPARATIVE EFFECTIVENESS OF BRUTON TYROSINE KINASE INHIBITORS IN PATIENTS WITH MANTLE CELL LYMPHOMA. Hemasphere 2022. [PMCID: PMC9431325 DOI: 10.1097/01.hs9.0000847496.16686.fc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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18
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Li J, Tang B, Liu M, Guo S, Yao X, Liao X, Feng X, Clara Orlandini L. PO-1554 Catching errors by synthetic CT in the clinical workflow of an MR-Linac. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03518-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Xin L, Liu K, He B, Chen M, Tang B, Tang C, Zhang L. Morphological classification and clinical significance of medial malleolus based on computed tomography three-dimensional reconstruction. Folia Morphol (Warsz) 2021; 82:176-182. [PMID: 34966997 DOI: 10.5603/fm.a2021.0135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 12/08/2021] [Accepted: 12/10/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Internal malleolus fractures and postoperative functional limitations are serious complications of deltoid ligament repair, reconstruction, while studies on conducting beak. Anatomical structure classification of medial malleolus at home and abroad is reported rarely. Hence, this morphological study is mainly designed to investigate the anatomical morphological classification and clinical significance of medial malleolus based on computed tomography (CT) three-dimensional reconstruction. MATERIALS AND METHODS From October 2018 to January 2021, 373 patients who underwent CT examination of malleolus medialis joint in the Jiang'an Hospital of Traditional Chinese Medicine were observed. The medial malleolus was observed and classified; then, geometric parameters were measured according to different medial malleolus types. RESULTS According to the results of 373 cases, medial malleolus can be divided into four types: omega type (66%), radical sign type (16%), inverted triangle type (14%), and wave type (4%). CONCLUSIONS There are four main shapes: omega, inverted triangle, radical sign, and wave in the medial malleolus of all normal ankles. The measurement of medial malleolus parameters according to medial malleolus in different shapes was of importance to guide smooth operation of medial malleolus fixation and deltoid ligament reconstruction and epidemiological.
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Affiliation(s)
- L Xin
- Department of Orthopaedics, Jiang'an Hospital of Traditional Chinese Medicine, Yibin Sichuan, China.
| | - K Liu
- Department of Radiology, Yibin Third People's Hospital, Yibin Sichuan, China
| | - B He
- Department of Orthopaedics, Jiang'an Hospital of Traditional Chinese Medicine, Yibin Sichuan, China
| | - M Chen
- Department of Internal Medicine, Jiang'an Hospital of Traditional Chinese Medicine, Yibin Sichuan, China
| | - B Tang
- Department of Orthopaedics, Jiang'an Hospital of Traditional Chinese Medicine, Yibin Sichuan, China
| | - C Tang
- Department of Orthopaedics, Jiang'an Hospital of Traditional Chinese Medicine, Yibin Sichuan, China
| | - L Zhang
- Department of Orthopaedics, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou Sichuan, China.,Centre for Orthopaedic Diseases Research, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou Sichuan, China.,Expert Workstation in Luzhou, Luzhou Sichuan, China.,Clinical Base of Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Guangdong Province Medical 3D Printing Application Transformation Engineering Technology Research Centre, Luzhou Sichuan, China
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Gao LF, Chen DL, Chen BY, Li C, Wang XS, Yu PW, Tang B. [Effect of peritoneum reconstruction on postoperative complications after laparoscopic low anterior resection for rectal cancer]. Zhonghua Wei Chang Wai Ke Za Zhi 2021; 24:1079-1085. [PMID: 34923791 DOI: 10.3760/cma.j.cn441530-20210209-00061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To determine the effect of peritoneum reconstruction on postoperative complications after laparoscopic low anterior resection (LAR) for rectal cancer. Methods: Retrospective cohort study and propensity score matching were conducted. Case inclusion criteria: (1) pathologically confirmed rectal adenocarcinoma; (2) 18 to 80 years; (3) patients with middle to low rectal cancer undergoing laparoscopic LAR; (4) patients staging cT1-4aN0-2M0 or ycT1-4aN0-2M0 after neoadjuvant therapy; (5) the distance of 4-10 cm from tumor low margin to anal verge. Exclusion criteria: (1) abdominal surgery history (except appendicitis, cholecystitis, ectopic pregnancy); (2) anastomosis above the peritoneal reflection; (3) tumor distant metastasis or clinical staging of T4b during surgery; (4) conversion to open surgery; (5) severe incapacitating disease (American Society of Anesthesiologists classification IV or V, ASA). A total of 666 patients with middle to low rectal cancer undergoing laparoscopic LAR in The First Affiliated Hospital of Army Medical University from January 2017 to June 2020 were enrolled. There were 473 males and 193 females with the median age of 59 (18-80) years. Laparoscopic LAR with peritoneum reconstruction was performed in 188 cases (PR group), and laparoscopic LAR without peritoneum reconstruction was performed in 478 cases (NPR group). After 1:1 propensity score matching according to 1:1 based on age, gender, body mass index, TNM staging, ASA classification, intraoperative blood loss, distance from tumor low margin to anal edge, 153 cases were included in each group. Postoperative complications were classified according to Clavien-Dindo classification. Anastomotic leakage was defined and graded according to the International Study Group of Rectal Cancer (ISGRC) criteria. Results: After propensity score matching, there were no significant differences in baseline demographic characteristics between the 2 groups (all P>0.05), indicating that these two groups were comparable. (1) Operative conditions: All the patients in both groups completed operation successfully. Compared with the NPR group, the PR group had longer operation time [(181.3±60.3) minutes vs. (168.9±51.5) minutes, t=2.185, P=0.029], shorter postoperative median hospital stay [8 (7, 10) days vs. 9 (7, 11) days, Z=-2.282, P=0.022], and the differences were statistically significant (P<0.05). (2) Postoperative complications: The overall morbidity of postoperative complication in PR group and NPR group was 20.3% (31/153) and 24.2% (37/153) respectively, and the incidence of anastomotic leakage was 9.8% (15/153) and 11.1%(17/153) respectively, whose differences were not statistically significant (both P>0.05). Compared with NPR group, PR group had lower morbidity of grade III to IV complications [3.9% (6/153) vs. 11.1% (17/153), χ(2)=5.688, P=0.017] and lower secondary operation rate [1.3% (2/153) vs. 5.9% (9/153), χ(2)=4.621, P=0.032], the differences were statistically significant (both P<0.05). Though PR group had lower incidence of grade C anastomoic leakage [1.3% (2/153) vs. 3.9% (6/153), χ(2)=2.054, P=0.152], but the differences were not statistically significant. (3) Postoperative inflammation: The difference of the procalcitonin level of both PR and NPR groups at postoperative 1-d, 3-d, and 5-d was statistically significant (F=5.222, P=0.010) in time-dependent manner, while the difference was not significant in the interaction effect (P>0.05). No statistically significant differences in the C-reactive protein level between two groups at postoperative 1-d, 3-d, and 5-d were found (all P>0.05). Conclusion: Peritoneum reconstruction in laparoscopic LAR can decrease the morbidity of postoperative complication of grade III to IV and the reoperation rate, and plays an important role in controlling the inflammatory reaction, which has great clinical value.
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Affiliation(s)
- L F Gao
- Department of General Surgery, The First Affiliated Hospital, Army Medical University, Chongqing 400038, China
| | - D L Chen
- Department of General Surgery, The First Affiliated Hospital, Army Medical University, Chongqing 400038, China
| | - B Y Chen
- Department of General Surgery, The First Affiliated Hospital, Army Medical University, Chongqing 400038, China
| | - C Li
- Department of General Surgery, The First Affiliated Hospital, Army Medical University, Chongqing 400038, China
| | - X S Wang
- Department of General Surgery, The First Affiliated Hospital, Army Medical University, Chongqing 400038, China
| | - P W Yu
- Department of General Surgery, The First Affiliated Hospital, Army Medical University, Chongqing 400038, China
| | - B Tang
- Department of General Surgery, The First Affiliated Hospital, Army Medical University, Chongqing 400038, China
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Wang J, Yu X, Barnes G, Leaw S, Bao Y, Tang B. The effects of tislelizumab plus chemotherapy as first-line treatment on health-related quality of life of patients with advanced squamous non-small cell lung cancer: Results from a phase 3 randomized clinical trial. Cancer Treat Res Commun 2021; 30:100501. [PMID: 34952253 DOI: 10.1016/j.ctarc.2021.100501] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/10/2021] [Accepted: 12/13/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND This study assessed the effects of adding tislelizumab to first-line standard-of- care chemotherapy on the health-related quality of life (HRQoL) of patients with advanced squamous non-small cell lung cancer (sq-NSCLC). PATIENTS AND METHODS Patients in this open-label, multicenter, phase 3 RATIONALE 307 trial were randomized to one of the three arms: tislelizumab plus carboplatin and paclitaxel (Arm A), tislelizumab plus carboplatin and nab-paclitaxel (Arm B), or paclitaxel plus carboplatin (Arm C). HRQoL was measured using the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30) and the EORTC Quality of Life Questionnaire Lung Cancer 13-item module (QLQ-LC13). Mean score change from baseline at Weeks 6 and 12 in the QLQ-C30's global health status/quality of life (GHS/QoL), fatigue, and physical functioning scores and QLQ-LC13 lung cancer specific subscales were examined. Time to deterioration was estimated for the GHS/QoL score. RESULTS A total of 355 sq-NSCLC patients received at least one dose of study drug and completed at least one HRQoL assessment. The GHS/QoL scores improved in Arms A and B relative to Arm C at Weeks 6 and 12. Arms A and B also experienced a reduction in most lung cancer-specific symptoms relative to Arm C. Time to deterioration of GHS/QoL was not reached by any of the three arms. CONCLUSIONS The addition of tislelizumab to platinum-based chemotherapy is associated with improvements in sq-NSCLC patients' HRQoL, especially in GHS/QoL and most importantly in lung cancer-specific symptoms including coughing, dyspnea, and hemoptysis.
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Affiliation(s)
- J Wang
- Department of Parenteral and Enteral Nutrition, State Key Laboratory of Molecular Oncology, Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - X Yu
- Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, China
| | - G Barnes
- Health Economics and Outcomes Research, BeiGene, Ltd., Emeryville, CA, USA
| | - S Leaw
- Clinical Development, BeiGene (Shanghai) Co., Ltd., Shanghai, China
| | - Y Bao
- Clinical Development, BeiGene (Shanghai) Co., Ltd., Shanghai, China
| | - B Tang
- Health Economics and Outcomes Research, BeiGene, Ltd., Emeryville, CA, USA
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Lu JF, Gao JH, Tang B, Sun M, Ge HG. A Novel 3D Na(I) Coordination Polymer Constructed by 3,5-Bis(4'-Carboxy-Phenyl)-1,2,4-Triazole: Synthesis, Crystal Structure, and Photocatalytic Property. CRYSTALLOGR REP+ 2021. [DOI: 10.1134/s1063774521070269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Huang SB, Hu ZC, Zhang Y, Tang B, Wang P, Xu HL, Wang ZY, Dong YX, Cheng P, Rong YC, Wu J, Zhu JY. [Effects and mechanisms of allogeneic epidermal stem cells on the survival of allogeneic full-thickness skin grafts in nude mice with full-thickness skin defect wounds]. Zhonghua Shao Shang Za Zhi 2021; 37:1061-1069. [PMID: 34794258 DOI: 10.3760/cma.j.cn501120-20200704-00339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the effects and mechanisms of allogeneic epidermal stem cells (ESCs) on the survival of allogeneic full-thickness skin grafts in nude mice with full-thickness skin defect wounds. Methods: Experimental research methods were applied. Primary ESCs that appeared paving stone-like after being cultured for 7 d were obtained by enzymatic digestion method from one 4-week-old male BALB/c-NU nude mouse (the same strain, age, and sex below). The cells of third passage were identified by flow cytometry to positively express ESC marker CD44 and negatively express CD45, meanwhile, the positive expression of ESC markers of p63 and integrin 6α, and negative expression of CD71 were identified by immunofluorescence method. The ESCs of third passage in the logarithmic growth phase were used for the following experiments. Twenty-six nude mice were equally divided into phosphate buffered saline (PBS) group and ESCs group according to the random number table. A full-thickness skin defect wound was made on the back of each nude mouse, and then the wounds of the two groups were sprayed with equal volumes of PBS and ESCs, respectively. The wounds were transplanted with full-thickness skin grafts cut from the backs of 4 other nude mice. Each ten nude mice from the two groups were selected, the wound healing and skin survival on post surgery day (PSD) 0 (immediately), 3, 7, 14, and 21 were observed, and the survival ratio and shrinkage rate of skin grafts on PSD 3, 7, 14, and 21 were calculated (the number of sample was the number of surviving skin grafts at each time point); the blood perfusion in the skin grafts on PSD 3, 7, and 14 was detected by the laser speckle blood flow imager, and the blood flow ratio of nude mice skin grafts in ESCs group to PBS group at each time point was calculated (the number of sample was the pair number of surviving skin grafts in group pairing at each time point). The skin graft tissue of each 3 nude mice remained in the two groups were collected on PSD 7, and the mRNA expressions and protein expressions of tumor necrosis factor α (TNF-α), interleukin 8 (IL-8), IL-10, type Ⅰ collagen, type Ⅲ collagen, and matrix metalloproteinase 9 (MMP-9) in the tissue were detected by real-time fluorescent quantitative reverse transcription polymerase chain reaction and Western blotting, respectively. Data were statistically analyzed with Log-rank test, analysis of variance for repeated measurement, one-way analysis of variance, independent sample t test, and Bonferroni correction. Results: Taking the condition on PSD 0 as a reference, the wounds of nude mice in the two groups healed gradually on PSD 3, 7, 14, and 21, and the shrinkage of skin grafts was gradually obvious. Among them, the shrinkage healing of wound of nude mice in PBS group was more significant than that in ESCs group. On PSD 3, the skin graft of 1 nude mouse failed in ESCs group, while the skin graft of 3 nude mice failed in PBS group. On PSD 7, the skin graft of another nude mouse failed in PBS group. The survival ratio of skin grafts of nude mice in the two groups was similar on PSD 3, 7, 14, and 21 (P>0.05). On PSD 3, 7, 14, and 21, the shrinkage rates of skin grafts of nude mice in ESCs group were (9.2±0.4)%, (19.7±1.2)%, (53.6±3.5)%, and (62.2±5.1)%, respectively, which was significantly lower than (11.0±0.9)%, (47.8±2.8)%, (86.1±7.1)%, and (89.7±9.0)% in PBS group (t=5.719, 26.650, 11.940, 7.617, P<0.01). On PSD 3, 7, and 14, blood perfusion signals were observed in the skin grafts of nude mice in the two groups. The average blood perfusion ratios of the skin grafts of nude mice in ESCs group to PBS group were greater than 1, and there was no statistically significant difference in the overall comparison of 3 time points (P>0.05). On PSD 7, compared with those of PBS group, the mRNA and protein expressions of TNF-α, IL-8, type Ⅰ collagen, and type Ⅲ collagen in the skin graft tissue of nude mice in ESCs group were significantly reduced, while the mRNA and protein expressions of IL-10 and MMP-9 in the skin graft tissue of nude mice in ESCs group were significantly increased (in mRNA comparison, t=2.823, 2.934, 2.845, 2.860, 3.877, 2.916, P<0.05). Conclusions: Allogeneic ESCs can reduce the shrinkage of allogeneic full-thickness skin grafts transplanted on full-thickness skin defect wounds in nude mice, promote the formation of new blood vessels between the skin graft and the wound, reduce inflammation and collagen protein expression, and promote the expression of MMP-9, thus improving the survival quality of skin grafts.
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Affiliation(s)
- S B Huang
- Department of Burns, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Z C Hu
- Department of Burns, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Y Zhang
- Department of Burns and Plastic Surgery, Affiliated Hospital of Nantong University, Nantong 226001, China
| | - B Tang
- Department of Burns, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - P Wang
- Department of Burns, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - H L Xu
- Department of Burns, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Z Y Wang
- Department of Burns, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Y X Dong
- Department of Burns, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - P Cheng
- Department of Burns, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Y C Rong
- Department of Burns, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - J Wu
- Department of Burns and Plastic Surgery, the First Affiliated Hospital of Shenzhen University, Shenzhen 518037, China
| | - J Y Zhu
- Department of Burns, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
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Xu H, Tang B, Huang W, Luo S, Zhang T, Yuan J, Zheng Q, Zan X. Deliver protein across bio-barriers via hexa-histidine metal assemblies for therapy: a case in corneal neovascularization model. Mater Today Bio 2021; 12:100143. [PMID: 34765961 PMCID: PMC8569714 DOI: 10.1016/j.mtbio.2021.100143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 09/02/2021] [Accepted: 09/18/2021] [Indexed: 01/26/2023] Open
Abstract
Because of their high specificity and low side effects, protein drugs possess a substantial global market. However, the low bioavailability of protein is still a major obstacle to their expanded applications, which is expected to be answered with proper protein formulations. Taking corneal neovascularization (CNV) as an example, we demonstrated a co-assembled system of hexa-histidine and Ava (Avastin) with metal ions (HmA@Ava) could cross the cornea, the most important bio-barrier during the treatment of most diseases of the anterior segment in clinics. We found that the nanosized HmA@Ava efficiently encapsulated Ava with impressive loading capacity without destroying the bioactivity of Ava and assisted Ava penetration through the corneal barriers to effectively inhibit CNV development in an alkali burn rat model with sustained and pH-dependent Ava release. Our results suggested that the co-assembled strategy of protein and HmA is a proper formulation to protein drugs, with promising penetration ability to deliver protein across bio-barriers, which could open a path for topical administration of protein drugs for treatment of various ocular diseases and hold enormous potential for delivery of therapeutic proteins not only for ocular diseases but also for other diseases that require protein treatment. HmA@Ava can bring protein drug, Ava, across over the primary bio-barrier of the anterior segment and efficiently treat CNV. HmA@Ava was nanoparticles, with impressive loading capacity without destroying bioactivity of Ava and strong pH-dependent release. HmA can open a path for the treatment of eye diseases and hold huge potential to protein drugs to other diseases.
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Affiliation(s)
- H Xu
- The Affiliated Ningbo Eye Hospital of Wenzhou Medical University, Ningbo, China.,School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical Engineering, Wenzhou Medical University, Wenzhou, Zhejiang Province, 325035, PR China
| | - B Tang
- School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical Engineering, Wenzhou Medical University, Wenzhou, Zhejiang Province, 325035, PR China
| | - W Huang
- School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical Engineering, Wenzhou Medical University, Wenzhou, Zhejiang Province, 325035, PR China.,Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang Province, 317000, PR China
| | - S Luo
- School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical Engineering, Wenzhou Medical University, Wenzhou, Zhejiang Province, 325035, PR China
| | - T Zhang
- Oujiang Laboratory, Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, 325001, China
| | - J Yuan
- The Affiliated Ningbo Eye Hospital of Wenzhou Medical University, Ningbo, China
| | - Q Zheng
- The Affiliated Ningbo Eye Hospital of Wenzhou Medical University, Ningbo, China.,School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical Engineering, Wenzhou Medical University, Wenzhou, Zhejiang Province, 325035, PR China
| | - X Zan
- The Affiliated Ningbo Eye Hospital of Wenzhou Medical University, Ningbo, China.,School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical Engineering, Wenzhou Medical University, Wenzhou, Zhejiang Province, 325035, PR China.,Oujiang Laboratory, Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, 325001, China
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25
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Tang B, Cui N. [Several key points that need to be concerned in the clinical application of ceftazidime/avibactam]. Zhonghua Yi Xue Za Zhi 2021; 101:3365-3370. [PMID: 34758539 DOI: 10.3760/cma.j.cn112137-20210531-01240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Ceftazidime/avibactam is a new enzyme inhibitor combination medication composed of ceftazidime and avibactam. It forms an enzyme-inhibitor complex by covalently binding β-lactamase, which can effectively restore the antibacterial activity of ceftazidime against a variety of carbapenemase-producing enterobacteriaceae strains, covering Klebsiella pneumoniae carbapenemase (KPC)-producing carbapenem-resistant Klebsiella pneumonia (CRKP) and other common drug-resistant gram-negative bacteria infections. The related issues of anti-infective effects of ceftazidime/avibactam on lung infections, abdominal infections, bloodstream infections, urinary tract infections and other different infections were discussed in this article. The clinical safety and indications of ceftazidine/avibatan were referred in the article.
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Affiliation(s)
- B Tang
- Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - N Cui
- Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
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Liu M, Wu J, Yao X, Yuan K, Zhang D, Tang B, Yin J. Feasibility of Single Non-Coplanar Models for Stereotactic Radiosurgery of Brain Metastases. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Tang B, Peng Q, Lenkowicz J, Boldrini L, Hou Q, Dinapoli N, Valentini V, Orlandini L. Local Tuning of an Existing Externally Developed Radiomic-Based Model for Predicting Patient Outcome in Locally Advanced Rectal Cancer. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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28
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Lian B, Cui C, Si L, Chi Z, Sheng X, Mao L, Wang X, Tang B, Bai X, Yan X, Li S, Zhou L, Zhou H, Wang Y, Hou QS, Guo J. 1086P IBI310 alone or in combination with sintilimab for advanced melanoma: Updated results of a phase Ia/Ib study. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Ren Z, Assenat E, Rimassa L, Fang W, Tang B, Chica Duque S, Li V, Wu J, Wang Y, Barnes G. 936P Effects of tislelizumab (TIS) monotherapy on health-related quality of life in patients with previously treated unresectable hepatocellular carcinoma (HCC). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Zhao Y, Tang B, Li J, Wang P, Liao X, Yao X, Xin X, Orlandini L. PO-1902 Treating left-sided breast patients in breath hold using a real time surface tracking system. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08353-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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31
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Tang B, Peng Q, Lenkowicz J, Boldrini L, Qing H, Dinapoli N, Valentini V, Orlandini L. PO-1814 Enhancing a radiomic-based model prediction of patient outcome in locally advanced rectal cancer. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08265-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lin C, Liu G, Huang Y, Liu S, Tang B. Rare-earth nanoparticles induce depression, anxiety-like behavior, and memory impairment in mice. Food Chem Toxicol 2021; 156:112442. [PMID: 34332012 DOI: 10.1016/j.fct.2021.112442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 07/18/2021] [Accepted: 07/23/2021] [Indexed: 10/20/2022]
Abstract
Rare-earth nanoparticles have been widely studied for disease diagnosis, in vivo optical imaging, biosensing, and drug delivery. However, the effects of rare-earth nanoparticles on a central nervous system remain unclear. Here, we report that the continuous exposure to rare-earth nanoparticles in mice can cause behavioral alterations including cognitive deficits, anxiety, and depression-like behavior. Using an open-field test and a morris water maze, we showed that long-term exposure to rare-earth nanoparticles may lead to significant depression, anxiety-like behavior, and memory impairment. The histopathological investigation on the neurotoxicological effects of nanoparticles indicated a significant decrease in cell viability after seven days' nanoparticle exposure. Western blotting analysis suggested that the changes of ATP-citrate lyase (ACLY) and O-linked N-acetylglucosamine transferase (OGT, a unique glycosyltransferase enzyme) played important roles in neurobehavioral disorders in mice. These findings provide a pathway to understand the cytotoxicity of rare-earth nanoparticles for medial applications and offer insights into the risk of these nanoparticles in biological systems.
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Affiliation(s)
- Caihou Lin
- Department of Neurosurgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, 350001, China.
| | - Guifen Liu
- Department of Gynaecology, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, 350001, China
| | - Yulong Huang
- Department of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian, 350100, China
| | - Shunyi Liu
- Department of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian, 350100, China
| | - Binghua Tang
- Department of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian, 350100, China
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Zhang F, Wang XS, Tang B, Li PA, Wen Y, Yu PW. Long non-coding RNA FTX promotes gastric cancer progression by targeting miR-215. Eur Rev Med Pharmacol Sci 2021; 24:3037-3048. [PMID: 32271421 DOI: 10.26355/eurrev_202003_20668] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Gastric cancer (GC) is one of the most common malignant tumors in the world, which is seriously harmful to people's health. The increasing number of studies have shown that long non-coding RNA (lncRNA) is related to the occurrence of gastric cancer. In this study, we aimed at investigating the role of lnc FTX in the occurrence of gastric cancer. MATERIALS AND METHODS The expression of FTX in gastric cancer patients and gastric cancer cell lines was detected by RT-qPCR. Univariate Kaplan-Meier method was used to analyze the relationship between FTX expression level, clinicopathological parameters and overall survival rate (OS). After transferring si-FTX and overexpression FTX plasmids into MGC-803 and SGC-7901, the expression of miR-215-3p was detected by RT-qPCR, and the changes of cell proliferation and cell cycle were detected by CCK-8 and flow cytometry. In addition, luciferase activity was used to detect whether miR-215-3p combined with FTX and SIVA1. Finally, Western blot (WB) was used to detect the change of SIVA1 protein expression by miR-215 mimic. RESULTS We found that the expression of FTX in tumor tissues of 71 GC patients was higher than that in paracancerous tissues, and the prognosis of patients with high FTX was poor. The expression of FTX in gastric cancer cells was higher than that in normal human gastric epithelial cells (GES-1). Transferring overexpression plasmid of FTX into gastric cancer cells (MGC-803 and SGC-7901) promoted cell proliferation and the ratio of cells in G0-G1 phase was decreased. Transferring si-FTX to MGC-803 and SGC-7901 led to opposite results. There was a negative correlation between the expression of mi215-3p and FTX in MGC-803 and SGC-7901 gastric cancer cells, and luciferase results showed that mi215-3p could directly bind to FTX and regulate cell growth and cell cycle changes. In addition, luciferase results showed that mi215-3p could bind directly to SIVA1. What's more, RT-qPCR and WB results showed that mi215 mimic could promote the expression of MGC-803, SGC-7901 SIVA1mRNA and protein. CONCLUSIONS According to these results, this study revealed that the previously neglected FTX-miR2153p-SIVA1 regulatory axis for the regulation of gastric cancer progression, which may be a potential target for the treatment of gastric cancer.
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Affiliation(s)
- F Zhang
- Department of General Surgery, The First Hospital Affiliated to Army Medical University, Chongqing, China.
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Ma C, Hui Q, Gao X, Xu D, Tang B, Pen M, Lui S, Chen X. The feasibility of dual-energy CT to predict the probability of symptomatic intracerebral haemorrhage after successful mechanical thrombectomy. Clin Radiol 2021; 76:316.e9-316.e18. [PMID: 33509606 DOI: 10.1016/j.crad.2020.12.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 12/22/2020] [Indexed: 02/05/2023]
Abstract
AIM To study the ability of dual-energy computed tomography (DECT) after successful mechanical thrombectomy (MT) to predict symptomatic intracerebral haemorrhage (sICH) in anterior circulation acute ischaemic stroke (AIS). MATERIALS AND METHODS From June 2018 to February 2020, 102 AIS patients with DECT performed immediately after successful MT were enrolled prospectively. According to the presence of iodine contrast media extravasation (ICME) on DECT and subsequent sICH development, patients were classified into four groups. The neurological outcome was compared among groups. Imaging parameters, together with clinical factors, were investigated for sICH prediction based on a linear logistic regression model after class-imbalance resolved by Synthetic Minority Sampling Technique (SMOTE) method. RESULTS Among 102 patients, patients (14.7%, 15/102) with the presence of sICH experienced worse outcomes than others without sICH (p<0.001). No case without ICME was observed with sICH development (0/102). The parameters derived from DECT have excellent performance for sICH prediction after successful MT, which is better than clinical predictive model boosted data (area under the curve [AUC]: DECT 0.87 versus clinical prediction 0.65), cross-validation results (AUC: DECT 0.87 versus clinical prediction 0.65), and original data (AUC: DECT 0.85 versus clinical prediction 0.68). By combining clinical and radiological parameters, the predictive performance for sICH could be further improved with an AUC of 0.90 (95% CI: 0.85-0.96). CONCLUSIONS Based on DECT parameters acquired immediately after successful MT, the present model was more efficient than the clinical model for accurate prediction of sICH. Rho and ICME volume appeared to be the best parameters for predicting sICH using DECT.
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Affiliation(s)
- C Ma
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China; Department of Radiology, People's Hospital of Deyang City, Deyang, Sichuan, China
| | - Q Hui
- Department of Radiology, People's Hospital of Deyang City, Deyang, Sichuan, China
| | - X Gao
- Department of Radiology, People's Hospital of Deyang City, Deyang, Sichuan, China
| | - D Xu
- Department of Laboratory, People's Hospital of Deyang City, Deyang, Sichuan, China
| | - B Tang
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - M Pen
- Department of Neurology, People's Hospital of Deyang City, Deyang, Sichuan, China
| | - S Lui
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
| | - X Chen
- CT Collaboration, Siemens Healthineers, Beijing, China
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Lu S, Yu Y, Barnes G, Qiu X, Bao Y, Li J, Tang B. MO01.43 Examining the Impact of Tislelizumab Added to Platinum Doublet Chemotherapy on Health-Related Quality of Life in Patients with Non-Squamous NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2020.10.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Wang J, Yu X, Barnes G, Li J, Leaw S, Lin X, Tang B. MO01.50 Tislelizumab Plus Standard Chemotherapy for Treatment of Advanced Squamous Non-Small Cell Lung Cancer: Patients’ Health Related Quality of Life. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2020.10.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Tang B, Cheng Y, Li Y, Li W, Ma Y, Zhou Q, Lu K. Adipokinetic hormone enhances CarE-mediated chlorpyrifos resistance in the brown planthopper, Nilaparvata lugens. Insect Mol Biol 2020; 29:511-522. [PMID: 32686884 DOI: 10.1111/imb.12659] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 07/07/2020] [Accepted: 07/09/2020] [Indexed: 06/11/2023]
Abstract
Adipokinetic hormone (AKH), the principal stress-responsive neurohormone in insects, has been implicated in insect responses to insecticides. However, the functionality of AKH and its mode of signalling in insecticide resistance are unknown. Herein, we demonstrated that the enhanced activity of carboxylesterases (CarEs) is involved in the chlorpyrifos resistance in Nilaparvata lugens [brown planthopper (BPH)]. Chlorpyrifos exposure significantly induced the expression of AKH and its receptor AKHR in the susceptible BPH (Sus), and these two AKH signalling genes were over-expressed in the chlorpyrifos-resistant strain (Res) compared to Sus. RNA interference (RNAi) against AKH or AKHR decreased the CarE activity and suppressed the BPH's resistance to chlorpyrifos in Res. Conversely, AKH peptide injection elevated the CarE activity and enhanced the BPH's survival against chlorpyrifos in Sus. Furthermore, five CarE genes were identified to be positively affected by the AKH pathway using RNAi and AKH injection. Among these CarE genes, CarE and Esterase E4-1 were found to be over-expressed in Res compared to Sus, and knockdown of either gene decreased the BPH's resistance to chlorpyrifos. In conclusion, AKH plays a role in enhancing chlorpyrifos resistance in the BPH through positive influence on the expression of CarE genes and CarE enzyme activity.
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Affiliation(s)
- B Tang
- State Key Laboratory of Biocontrol, School of Life Sciences, Sun Yat-sen University, Guangzhou, China
| | - Y Cheng
- College of Life Sciences, Fujian Agriculture and Forestry University, Fuzhou, China
| | - Y Li
- College of Life Sciences, Fujian Agriculture and Forestry University, Fuzhou, China
| | - W Li
- College of Life Sciences, Fujian Agriculture and Forestry University, Fuzhou, China
| | - Y Ma
- School of Agriculture, Sun Yat-sen University, Guangzhou, China
| | - Q Zhou
- State Key Laboratory of Biocontrol, School of Life Sciences, Sun Yat-sen University, Guangzhou, China
| | - K Lu
- State Key Laboratory of Biocontrol, School of Life Sciences, Sun Yat-sen University, Guangzhou, China
- College of Life Sciences, Fujian Agriculture and Forestry University, Fuzhou, China
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Tang B, Fan W, Wang X, Li J, Wang P, Kang S, Xiao M, Orlandini L. Evaluation of Synthetic CT Image Generated Using a Neural Network for MR-Only Radiotherapy. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Tan X, Tan J, Ming F, Lv L, Zhang H, Tang B, Yan W, Peng X, Bai R, Xiao Q, Wang C. Up-regulation of miR-409-3p in cerebrospinal fluid of Parkinson's disease reduce the apoptosis of dopamine neurons. Parkinsonism Relat Disord 2020. [DOI: 10.1016/j.parkreldis.2020.06.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Lin LJ, Ge YM, Tian Y, Liu N, Luo XH, Xue YT, Xue YZB, Wen CY, Tang B. Multi-scale mechanical investigation of articular cartilage suffered progressive pseudorheumatoid dysplasia. Clin Biomech (Bristol, Avon) 2020; 79:104947. [PMID: 31959394 DOI: 10.1016/j.clinbiomech.2019.12.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 11/16/2019] [Accepted: 12/30/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Progressive pseudorheumatoid dysplasia is a rare skeletal dysplasia mainly caused by abnormal autosomal recessive inheritance. Although the main function of cartilage is mechanical support and the characteristics of this disease is the degradation of AC, previous studies on it had been mainly focused on clinical and genetic aspects and the mechanical behavior of the cartilage affected by PPRD is still ambiguous. In this study, we investigate the mechanics and structure of the cartilage suffered disease at multi-scale, from individual chondrocytes to the bulk-scale tissue. METHODS Depth-sensing indenter were employed to investigate the mechanics of cartilage; we performed atomic force microscope nanoindentation to investigate the cell mechanics and scanning electron microscopy were used to explore the structure feature and chemical composition. FINDINGS The elastic modulus of chondrocytes harvested from cartilage suffered from progressive pseudorheumatoid dysplasia is significantly higher than from normal cartilage, same trend were also found in tissue level. Moreover, denser collagen meshwork and matrix calcification were also observed. INTERPRETATION The elastic modulus of cartilage should closely related to its denser structure and the calcification, and may potentially be an indicator for clinical diagnosis. The stiffening of chondrocytes during PPRD progression should play a rather important role in its pathogenesis.
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Affiliation(s)
- L J Lin
- Department of Orthopedics, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Y M Ge
- Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Y Tian
- Department of Materials Science and Engineering, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - N Liu
- Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - X H Luo
- Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Y T Xue
- Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Y Z B Xue
- Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - C Y Wen
- Interdisciplinary Division of Biomedical Engineering, Hong Kong Polytechnic University, HKUSAR, China
| | - B Tang
- Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, Guangdong, China; Department of Materials Science and Engineering, Southern University of Science and Technology, Shenzhen, Guangdong, China.
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Yuan F, Guo X, Wei X, Xie F, Zheng J, Huang Y, Huang Z, Chang Z, Li H, Guo Y, Chen J, Guo J, Tang B, Deng B, Wang Q. Lee Silverman Voice Treatment for dysarthria in patients with Parkinson's disease: a systematic review and meta-analysis. Eur J Neurol 2020; 27:1957-1970. [PMID: 32539227 DOI: 10.1111/ene.14399] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 06/04/2020] [Indexed: 02/06/2023]
Abstract
Approximately 89% of patients with Parkinson's disease (PD) suffer from dysarthria. Lee Silverman Voice Treatment (LSVT), a behavioral therapy, aims to improve speech and voice functions. The objective was to assess the effectiveness of LSVT compared with other/no speech interventions for dysarthria in patients with PD. Electronic databases, including PubMed, Embase and the Cochrane Library, were searched. The publication date of all included studies was before 6 March 2020. Only randomized controlled trials (RCTs) that evaluated the LSVT intervention compared with other/no speech intervention were considered. The data obtained from the included studies were described and the mean differences were calculated. Eight RCTs were included in this meta-analysis comparing LSVT with other/no speech interventions. In the comparison of LSVT versus no intervention, vocal intensity for sustained 'Ah' phonation, reading the 'Rainbow passage', monologue and describing a picture increased by 8.87, 4.34, 3.25 and 3.31 dB, respectively, after 1 month of therapy. Compared with the respiratory therapy group, the LSVT group also showed significant improvement in vocal intensity for sustained 'Ah' phonation, reading the 'Rainbow passage' and monologue immediately after treatment (13.39, 6.66 and 3.19 dB). Positive improvement still existed after 24 months. There was no difference in the therapeutic effect between face-to-face and online LSVT. The effectiveness of LSVT for dysarthria in patients with PD was verified in these trials. However, future RCTs with sufficient participants are essential to evaluate the effectiveness of LSVT for dysarthria.
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Affiliation(s)
- F Yuan
- Department of Neurology, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | - X Guo
- Department of Neurology, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | - X Wei
- Department of Neurology, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | - F Xie
- Department of Neurology, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | - J Zheng
- Department of Neurology, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | - Y Huang
- Department of Neurology, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | - Z Huang
- Department of Neurology, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | - Z Chang
- Department of Neurology, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | - H Li
- Department of Neurology, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | - Y Guo
- Department of Neurology, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | - J Chen
- Department of Neurology, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | - J Guo
- Department of Neurology, Xiangya Hospital of Central South University, Changsha, China
| | - B Tang
- Department of Neurology, Xiangya Hospital of Central South University, Changsha, China
| | - B Deng
- Department of Neurology, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | - Q Wang
- Department of Neurology, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, China
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Zou RC, Guo ZT, Wei D, Shi ZT, Ye ZC, Zhai G, Zhong C, Tang B, Wang L, Ge JY. Downregulation of CDCA3 expression inhibits tumor formation in pancreatic cancer. Neoplasma 2020; 67:1223-1232. [PMID: 32701354 DOI: 10.4149/neo_2020_200411n388] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 04/29/2020] [Indexed: 11/08/2022]
Abstract
Downregulation of cell division cycle-associated 3 (CDCA3) markedly inhibited cell growth and induced apoptosis in tumors. However, the effect of CDCA3 in pancreatic cancer (PAC) was rarely investigated. Therefore, this study attempted to clarify the role of CDCA3 in PAC. The mRNA and protein expression of CDCA3 were examined in PAC cell lines and tumor tissues by using real-time quantitative PCR (RT-qPCR), western blotting (WB), and immunohistochemistry (IHC). The effects of CDCA3 downregulation on cell proliferation, apoptosis, and colony information were investigated through MTT assay, Annexin V-APC single staining cell apoptosis detection, and colony formation test. The microarray and ingenuity pathway analysis were employed to explore the potential regulatory relation. The tumor xenograft model was established for determining the effect of CDCA3 downregulation on the growth of PAC in vivo. The results showed that the expression of CDCA3 in tumor tissues was higher than that of normal tissues (p<0.05). In addition, the mRNA expression of CDCA3 was markedly increased in PANC-1 cells and SW 1990 cells when compared with human pancreatic duct epithelial (HPDE) cells (p<0.05). MTT assay showed that the cell proliferation of PANC-1 cells and SW 1990 cells was significantly inhibited after the lentivirus transfection of CDCA3 knockdown (p<0.05). Annexin V-APC apoptosis assays suggested that the apoptotic cell number was markedly increased in the shCDCA3 group compared to that in the shCtrl group in SW 1990 cells and PANC-1 cells (p<0.05). Meanwhile, the activity of caspase-3/7 was obviously elevated in the shCDCA3 group compared to the shCtrl group (p<0.05). The colony formation was notably inhibited in the shCDCA3 group relative to the shCtrl group in SW 1990 cells (p<0.05). Moreover, the tumor growth was evidently suppressed in the shCDCA3 group compared with the shCtrl group in vivo (p<0.05). These findings revealed that CDCA3 plays a crucial role in the progress of PCA by regulating cell apoptosis and proliferation, which may serve as a potential target for PAC treatment.
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Affiliation(s)
- R C Zou
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital, Kunming Medical University, Kunming, China
| | - Z T Guo
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital, Kunming Medical University, Kunming, China
| | - D Wei
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital, Kunming Medical University, Kunming, China
| | - Z T Shi
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital, Kunming Medical University, Kunming, China
| | - Z C Ye
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital, Kunming Medical University, Kunming, China
| | - G Zhai
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital, Kunming Medical University, Kunming, China
| | - C Zhong
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital, Kunming Medical University, Kunming, China
| | - B Tang
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital, Kunming Medical University, Kunming, China
| | - L Wang
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital, Kunming Medical University, Kunming, China
| | - J Y Ge
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital, Kunming Medical University, Kunming, China
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Lu M, Xiang Z, Gong T, Zhou X, Zhang Z, Tang B, Zeng J, Wang L, Cui T, Li Y. Intrinsic Fluoride Tolerance Regulated by a Transcription Factor. J Dent Res 2020; 99:1270-1278. [PMID: 32485128 DOI: 10.1177/0022034520927385] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Fluoride facilitates the remineralization of dental hard tissues and affects bacterial activities. Therefore, it is extensively used as an anti-caries agent in clinical practice and daily life. Although some studies focused on understanding Streptococcus mutans' response to fluoride, the mechanism regulating intrinsic fluoride tolerance is not yet clear. Since the TetR family of transcription factors is associated with multidrug resistance, our aim was to evaluate whether they are related to fluoride tolerance in S. mutans. A mutant library including each S. mutans TetR gene was constructed and the transcription factor fluoride related transcriptional regulator (FrtR) was identified. The in-frame deletion of the S. mutans frtR gene resulted in decreased cell viability under fluoride in both the planktonic state and single-/dual-species biofilms. This in-frame frtR mutant was used for RNA-sequencing and the fluoride related permease gene (frtP) was found as 1 of the downstream genes directly regulated by FrtR. The recombinant FrtR protein was purified, and conserved DNA binding motifs were determined using electrophoretic mobility shift and DNase I footprinting assays. Finally, a series of mutant and complement strains were constructed to perform the minimum inhibitory concentration (MIC) assays, which indicated that frtP upregulation led to the increase of fluoride sensitivity. Collectively, our results indicate that FrtR is an important transcription factor regulating the frtP expression in S. mutans, thus affecting the intrinsic fluoride tolerance. Therefore, this study provides novel insights into a potential target to increase the S. mutans sensitivity to fluoride for a better prevention of dental caries.
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Affiliation(s)
- M Lu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Z Xiang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - T Gong
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - X Zhou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Z Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - B Tang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - J Zeng
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - L Wang
- Division of Infectious Diseases, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - T Cui
- School of Life Sciences, Northwestern Polytechnical University, Xi'an, Shanxi, China
| | - Y Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
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Xie SH, Shi Y, Long D, Chen J, Zhao YL, Qian F, Hao YX, Tang B, Li PA, Yu PW. [Long-term efficacy of robotic radical total gastrectomy for gastric cancer and analysis of prognostic factors]. Zhonghua Wei Chang Wai Ke Za Zhi 2020; 23:357-363. [PMID: 32306603 DOI: 10.3760/cma.j.cn.441530-20200113-00021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To analyze long-term outcomes and prognostic factors of gastric cancer patients after robotic radical total gastrectomy. Methods: A retrospective case-control study was conducted. Inclusion criteria: (1) receiving robotic radical total gastrectomy; (2) gastric adenocarcinoma was confirmed by postoperative pathology; (3) no previous history of other malignant tumors; (4) no preoperative chemotherapy or radiation therapy performed. Exclusion criteria: (1) age <18 years old or age >80 years old;(2)distant metastasis before surgery, or palliative surgery; (3) conversion to laparotomy;(4) R1 or R2 resection; (5)emergency surgery; (6) remnant gastric cancer or recurrence; (7)died of severe complications during hospitalization or within 1 month after surgery. Overall survival rates (OS) and disease-free survival rates (DFS) were evaluated using the Kaplan-Meier method. Cox regression analysis was used to identify prognosis factors for overall survival. Results: According to the above criteria, 166 gastric cancer patients who underwent robotic radical total gastrectomy between March 2010 and November 2018 were included in this study. Roux-en-Y reconstruction was performed in all patients. Reconstruction were achieved using extracorporeal method through a minilaparotomy in 149 case and intracorporeal anastomosis in 17 cases. The number of harvested lymph nodes was (34.8±17.5), and the number of harvested lymph nodes at group 2 was (10.1±6.7). The number of patients with lymph node metastasis of group 2 was 73 (44.0%). The median follow-up time was 25 months (range 2-109). There were 55 (33.1%) cases of recurrence during follow-up. The 3- and 5-year overall survival rates were 55.8% and 46.2% respectively. The 3- and 5-year disease-free survival rates were 53.4% and 45.4% respectively. The 5-year overall survival rates grouped based on TNM stage were 78.9% for stage I, 58.5% for stage II, and 37.1% for stage III. The 5-year disease-free survival rates grouped based on TNM stage were 78.9% for stage I, 59.2% for stage II, and 34.6% for stage III. Univariate analysis suggested that TNM stage, the number of harvested lymph nodes and number of harvested lymph nodes at group 2 were associated with overall survival rates (all P<0.05). Multivariate analyses revealed that TNM stage (P<0.001; stage IIIB: HR=5.357, 95%CI:1.182 to 24.275; stage IIIC: HR=11.937, 95%CI: 2.677 to 53.226) and number of harvested lymph nodes at group 2 (P=0.034; 6-10: HR=0.562,95%CI:0.326 to 0.969; >10: HR=0.388, 95%CI: 0.176 to 0.857) were independent prognostic factors for overall survival. Conclusion: The long-term outcomes of robotic radical total gastrectomy were satisfactory. TNM stage and number of harvested lymph nodes at group 2 were independent prognostic factors for overall survival.
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Affiliation(s)
- S H Xie
- Department of General Surgery, The First Affiliated Hospital, The Army Medical University, Chongqing 400038, China
| | - Y Shi
- Department of General Surgery, The First Affiliated Hospital, The Army Medical University, Chongqing 400038, China
| | - D Long
- Department of General Surgery, The First Affiliated Hospital, The Army Medical University, Chongqing 400038, China
| | - J Chen
- Department of General Surgery, The First Affiliated Hospital, The Army Medical University, Chongqing 400038, China
| | - Y L Zhao
- Department of General Surgery, The First Affiliated Hospital, The Army Medical University, Chongqing 400038, China
| | - F Qian
- Department of General Surgery, The First Affiliated Hospital, The Army Medical University, Chongqing 400038, China
| | - Y X Hao
- Department of General Surgery, The First Affiliated Hospital, The Army Medical University, Chongqing 400038, China
| | - B Tang
- Department of General Surgery, The First Affiliated Hospital, The Army Medical University, Chongqing 400038, China
| | - P A Li
- Department of General Surgery, The First Affiliated Hospital, The Army Medical University, Chongqing 400038, China
| | - P W Yu
- Department of General Surgery, The First Affiliated Hospital, The Army Medical University, Chongqing 400038, China
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Ji X, Cui Z, Xiang Y, Zhang Q, Qin K, Tang B, Wei Y. Complete Genome Sequence Analysis of the Cold-active Siphoviridae Bacteriophage from Pseudomonas fluorescens. Microbiology (Reading) 2020. [DOI: 10.1134/s0026261720030066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Tang B, Gao GM, Zou Z, Liu DN, Tang C, Jiang QG, Lei X, Li TY. [Efficacy comparison between robot-assisted and laparoscopic surgery for mid-low rectal cancer: a prospective randomized controlled trial]. Zhonghua Wei Chang Wai Ke Za Zhi 2020; 23:377-383. [PMID: 32306606 DOI: 10.3760/cma.j.cn.441530-20190401-00135] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Objective: To compare the short- and long-term outcomes of robot-assisted and laparoscopic radical resection for mid-low rectal cancer. Methods: A prospective randomized controlled trial was conducted. A total of 130 patients with mid-low rectal cancer (inclusion criteria: age > 18 or ≤80 years old; pathological diagnosis of rectal adenocarcinoma by colonoscopy; distance from tumor to the anal verge ≤12 cm; no distant metastasis; cT1-3N0-1 or ycT1-3 after neoadjuvant radiotherapy and chemotherapy; suitable for laparoscopic and robotic surgery) at the Department of Colorectal Surgery of the First Affiliated Hospital of Nanchang University from October 2016 to September 2018 were prospectively enrolled. According to computer-generated random number method, patients were randomly divided into the robot group (n=66) and laparoscopy group (n=64), and underwent robot-assisted surgery or laparoscopic surgery respectively. Clinicopathological data of all the patients were collected and analyzed. The demographic parameters, short- and long-term outcomes were compared between two groups. Results: One patient in robot group whose postoperative sample was diagnosed as rectal adenoma by pathology was excluded. There were no statistically significant differences in age, sex, BMI, ASA classification, distance from tumor to the anal verge, serum CEA level, CA199 level between two groups (all P>0.05). Operations were successfully performed in all the patients without conversion to open operation. Robotic surgery was found to be associated with less intraoperative blood loss than laparoscopic surgery [(73.4±49.7) ml vs. (119.1±65.7) ml, t=-4.461, P<0.001], while there were no statistically significant differences in surgical procedures, operation time, time to first flatus, time to first liquid intake, time to removal of catheter or postoperative hospital stay between two groups (all P>0.05). Besides, there was no significant difference in the morbidity of postoperative complication between two groups [10.8% (7/65) vs. 12.5 (8/64), χ(2)=4.342, P=0.720]. The median number of harvested lymph node in the robot group and the laparoscopy group was 15.7±6.2 and 13.8±6.1 (t=1.724, P=0.087). There were no significant differences between two groups in tumor sample length, distance between proximal and distal resection margin, integrity grade of TME specimen, number of positive lymph nodes, postoperative pathological stage and tumor differentiation (all P>0.05). The distal resection margin of samples in two groups was all negative. One case in the robot group was found to have positive circumferential resection margin. The median follow up was 24 (9 to 31) months. In the robot group and the laparoscopy group, the 2-year overall survival rate was 95.4% and 90.6% respectively; the 2-year disease-free survival rate was 90.8% and 85.9% respectively, whose differences were not significant (both P>0.05). Conclusion: Robot-assisted radical resection for mid-low rectal cancer can achieve similar short-term and long-term outcomes of laparoscopic resection, while robot-assisted surgery can decrease blood loss during operation, leading to more precise practice in minimally invasive surgery.
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Affiliation(s)
- B Tang
- Department of General Surgery, the First Affiliated Hospital, Nanchang University, Nanchang 330006, China
| | - G M Gao
- Department of General Surgery, the First Affiliated Hospital, Nanchang University, Nanchang 330006, China
| | - Z Zou
- Department of General Surgery, the First Affiliated Hospital, Nanchang University, Nanchang 330006, China
| | - D N Liu
- Department of General Surgery, the First Affiliated Hospital, Nanchang University, Nanchang 330006, China
| | - C Tang
- Department of General Surgery, the First Affiliated Hospital, Nanchang University, Nanchang 330006, China
| | - Q G Jiang
- Department of General Surgery, the First Affiliated Hospital, Nanchang University, Nanchang 330006, China
| | - X Lei
- Department of General Surgery, the First Affiliated Hospital, Nanchang University, Nanchang 330006, China
| | - T Y Li
- Department of General Surgery, the First Affiliated Hospital, Nanchang University, Nanchang 330006, China
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Tang B, Xiao S. Logistic regression analysis of risk factors for upper gastrointestinal bleeding induced by PCI in combination with double antiplatelet therapy for STEMI patients. Acta Gastroenterol Belg 2020; 83:245-248. [PMID: 32603042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To analyze the risk factors for upper gastrointestinal bleeding (UGIB) in patients with ST-segment elevation myocardial infarction (STEMI) during double antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI). METHODS A total of 388 patients treated from January 2015 to September 2017 due to STEMI were selected. Thirty-two cases of UGIB occurring during DAPT after PCI were included as a UGIB group, and another 356 cases without UGIB were set as a control group. Age, gender, body mass index, smoking, drinking, history of previous diseases (hypertension, diabetes and digestive tract diseases), infection of Helicobacter pylori (Hp), combined use of other drugs (statins, NSAIDs, β receptor blockers, PPI, H2RA and dabigatran etexilate), as well as serum levels of creatinine (Cr), alanine transaminase (ALT) and C-reactive protein (CRP) were compared. The risk factors for UGIB were subjected to univariate and logistic regression analyses. RESULTS Compared with the control group, the UGIB group had significantly longer hospital stay, and higher proportion of discontinuation of antithrombotic drugs and mortality rate (P<0.05). Logistic regression analysis showed that age (P=0.002), smoking (P=0.000), Hp infection (P=0.020), history of digestive tract diseases (P=0.030) and renal insufficiency (P=0.041) were independent risk factors for UGIB, and use of PPI (P=0.028) was a protective factor for UGIB. CONCLUSIONS Old age, smoking, Hp infection, history of digestive tract diseases and renal insufficiency are risk factors for UGIB caused by PCI combined with DAPT in patients with STEMI. Proper use of PPI thereafter can reduce the incidence rate of UGIB.
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Affiliation(s)
- B Tang
- Department of Cardiology, Jingzhou Central Hospital, The Second Clinical Medical College, Yangtze University, Jingzhou, China
| | - S Xiao
- Department of Cardiology, Jingzhou Central Hospital, The Second Clinical Medical College, Yangtze University, Jingzhou, China
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Tang B, Li S, Han J, Cao W, Sun X. Associations between Blood Cell Profiles and Primary Open-Angle Glaucoma: A Retrospective Case-Control Study. Ophthalmic Res 2020; 63:413-422. [PMID: 32018245 DOI: 10.1159/000504450] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 10/26/2019] [Indexed: 11/19/2022]
Abstract
PURPOSE We aimed to evaluate whether the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and systemic immune inflammation index (SII) were associated with primary open-angle glaucoma (POAG). MATERIALS AND METHODS This retrospective case-control study included 240 patients with POAG and 300 age- and sex-matched control subjects. Complete ophthalmological examination and blood count measurements were performed for all subjects. RESULTS The values of NLR, PLR, and SII in the POAG group were significantly increased compared with the control group (p < 0.001; p = 0.012; p < 0.001). However, the LMR value was lower in the POAG patients than in the control group (p < 0.001). When we divided the subjects into different age and gender subgroups, the NLR and SII values in the POAG patients were always higher than those in the control group. In the comparison of laboratory parameters in POAG subjects stratified according to severity, we also found that NLR and SII increased with the severity. The receiver operating characteristic (ROC) analysis revealed that the areas under the ROC curve of NLR, PLR, LMR, and SII to predict patients with POAG were found to be 0.627, 0.569, 0.382, and 0.986, respectively. The best cutoff point of NLR was 1.998 with a sensitivity of 59.8% and a specificity of 63.0%, and the SII was 947.365 with a sensitivity of 95.4% and a specificity of 95.7%. Multivariable logistic regression analysis showed that NLR was positively associated with mean deviation; moreover, NLR and SII were independent indicators correlated with POAG (OR 1.502; 95% CI 1.227-1.839; p < 0.001; OR 1.02; 95% CI 1.009-1.021; p < 0.001). CONCLUSION We speculated that elevated NLR and SII might serve as readily available inflammatory predictors in POAG patients.
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Affiliation(s)
- Binghua Tang
- Department of Clinical Laboratory, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Shengjie Li
- Department of Clinical Laboratory, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jianping Han
- Department of Clinical Laboratory, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Wenjun Cao
- Department of Clinical Laboratory, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China, .,Department of Ophthalmology and Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China,
| | - Xinghuai Sun
- Department of Ophthalmology and Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China.,State Key Laboratory of Medical Neurobiology, Institutes of Brain Science and Collaborative Innovation Center for Brain Science, Fudan University, Shanghai, China.,Key Laboratory of Myopia, Ministry of Health (Fudan University), Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai, China
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Liu HC, Li C, Zhang F, Wang XS, Zhang C, Luo HX, Song J, Yu PW, Tang B. [Analysis on the technical characteristics and clinical efficacy of robotic-assisted intersphincteric resection for patients with low rectal cancer]. Zhonghua Wei Chang Wai Ke Za Zhi 2020; 22:1137-1143. [PMID: 31874529 DOI: 10.3760/cma.j.issn.1671-0274.2019.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the technical characteristics and short-term clinical efficacy of robotic-assisted intersphincteric resection (ISR) for patients with low rectal cancer. Methods: A retrospective cohort study was used. Inclusion criteria: (1) rigid colonoscopy showed lower margin of the tumor ≤5 cm from the anal verge; (2) preoperative rectal MRI or endorectal ultrasound revealed staging T1-2, or T3 patients receiving concurrent chemoradiotherapy; (3) patients less than 70 years old with good function of anal sphincter before surgery; (4) no synchronous multiple primary carcinoma, and no distant metastasis; (5) the method of operation was agreed by the patient. Exclusion criteria: (1) T4 stage tumors; (2) sphincter dysfunction before operation; (3) recurrent tumors; (4) lower edge of tumors beyond the dentate line; (5) death due to non-rectal cancer during follow-up and unsatisfactory follow-up data. The clinical data of 21 patients with low rectal cancer meeting inclusion criteria undergoing robotic-assisted ISR at our department from January 2015 to June 2018 were collected. Parameters during and after operation were observed. Anorectal manometry was performed at 3, 6, and 12 months after the operation, and anal function was evaluated at 3, 6, and 12 months after the closure of the stoma by Kirwan classification and Wexner fecal incontinence score. The key steps of the operation are as follows: according to the principle of total mesorectal excision, the robot continued to enter into the levator ani hiatusdistally, and dissectin the sphincter space; according to the scope of sphincter resection, ISRwas divided into partial ISR, subtotal ISR, and total ISR; subtotal and total ISR usually needed to be combined with transanal pathway. The reconstruction of digestive tract was performed by double stapler anastomosis under laparoscope orhand-sewnanastomosis under direct vision, and preventive ileostomy was completed in the right lower abdomen. Results: Of 21 patients, 13 were male and 8 were female with mean age of (57.5±16.3) years. All the patients successfully completed the operation without conversion to laparotomy. Fourteen cases (66.7%) adopted partial ISR through complete transabdominal approach, 6 cases (28.6%) adopted the subtotal ISR through combined transabdominal and transanal approachs, and 1 case (4.8%) adopted the total ISR through the combined transabdominal and transanal approachs. The total operation time was (213.1±56.3) minutes, including (27.3±5.4) minutes for mechanical arm installation and (175.7±51.6) minutes for robotic operation. The amount of intraoperative hemorrhage was (62.8±23.2) ml, and no blood transfusion was performed in any patient. All patients underwent prophylactic ileostomy, and the stoma was closed 3-6 months after the operation. Except one case of anastomotic leakage, all other stomas were closed successfully. The postoperative hospitalization time was (7.6±2.2) days, and time to fluid intake was (3.3±0.9) days. One case of anastomotic leakage, one case of anastomotic stenosis, one case of inflammatory external hemorrhoids and one case of urinary retention occurred after surgery,and all of them were cured by conservative treatment. The mean diameter of tumors was (2.9±1.2) cm, and the number of harvested lymph node was 12.8 ± 3.3. In the whole group, the circumcision margin was negative, the proximal margin was (12.2 ± 2.1) cm, the distal margin was (1.1 ± 0.4) with all negative, and the R0 resection rate was 100%. The results of anorectal manometry showed that the preoperative rest pressure, rectal maximum squeeze pressure, initial sensory volume and maximum tolerated volume were (45.19±8.46) mmHg, (128.18±18.80) mmHg, (44.33±10.11) ml and (119.00±19.28) ml, respectively;these parameters reduced significantly 3 months after operation and they were (23.44±5.54) mmHg, (93.72±12.15) mmHg, (17.72±5.32) ml and (70.44±10.9) ml, respectively. The differences were statistically significant (all P<0.001). The resting pressure and the rectal maximum squeeze pressure returned to preoperative levels 12 months after operation, which were (39.33±6.64) mmHg and (120.58±16.47) mmHg, respectively (both P>0.05), while the initial sensory volume and the maximum tolerated volume failed to reach the preoperative state, which were (30.67±7.45) ml and (92.25±10.32) ml, respectively (both P<0.05). The patients were followed up for (22.1±10.6) months without local recurrence and distant metastasis. Eighteen patients were evaluated for anal function: Kirwan classification was grade I for 6 cases, grade II for 7 cases, grade III for 4 cases, and grade IV for 1 case; Wexner incontinence score was 8.6±0.8; 14 cases had good defecation control. Conclusion: The clinical efficacy of ISR with Da Vinci robot in the treatment of low rectal cancer is satisfactory.
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Affiliation(s)
- H C Liu
- Department of General Surgery, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
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Tang B, Yang C, Hu S, Sun W, Pan Z, Li L, Wang J. Molecular Characterization of Goose Phosphoenolpyruvate Carboxylase Kinase 1 (Pepck) Gene and Its Potential Role in Hepatic Steatosis Induced by Overfeeding. Braz J Poult Sci 2020. [DOI: 10.1590/1806-9061-2019-1128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- B Tang
- Sichuan Agricultural University, China
| | - C Yang
- Sichuan Animal Science Academy, P.R. China
| | - S Hu
- Sichuan Agricultural University, China
| | - W Sun
- Sichuan Agricultural University, China
| | - Z Pan
- Sichuan Agricultural University, China
| | - L Li
- Sichuan Agricultural University, China
| | - J Wang
- Sichuan Agricultural University, China
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