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Zhou JY, Wang S, Yuan HL, Xu YJ, Huang XB, Gao SJ, Zhang YC, Zhou F, Liu Y, Song XM, Cai Y, Liu XL, Luo Y, Yang LX, Yang JM, Wang LB, Li YH, Huang R, Wang SQ, Zhou M, Dong YJ, Wang Q, Zhang X, Feng YM, Du X, Ling W, Zhu H, Zhu ZM, Chen XL, Wang SY, Meng FK, Bi KH, Huang N, Jiang M, Niu T, Ji J, Wan DM, Bian ZL, Chen Y, Liu L, Yan XQ, Yang X, Yi H, Wei XD, Li X, Cheng Q, Yuan CL, Wang W, Zhou YH, Ye BD, Ding J, Wu YJ, Huang QS, Zhu XL, Chen YH, He Y, Wang FR, Zhang YY, Mo XD, Han W, Wang JZ, Wang Y, Chen H, Zhao XY, Chang YJ, Liu KY, Huang XJ, Zhang XH. Impact of a novel prognostic model on allogeneic hematopoietic stem cell transplantation outcomes in patients with CMML. Am J Hematol 2023; 98:1394-1406. [PMID: 37366294 DOI: 10.1002/ajh.26999] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/30/2023] [Accepted: 06/07/2023] [Indexed: 06/28/2023]
Abstract
Chronic myelomonocytic leukemia (CMML) is a clonal hematopoietic stem cell malignancy, and allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the only curable treatment. The outcomes after transplant are influenced by both disease characteristics and patient comorbidities. To develop a novel prognostic model to predict the post-transplant survival of CMML patients, we identified risk factors by applying univariable and multivariable Cox proportional hazards regression to a derivation cohort. In multivariable analysis, advanced age (hazard ratio [HR] 3.583), leukocyte count (HR 3.499), anemia (HR 3.439), bone marrow blast cell count (HR 2.095), and no chronic graft versus host disease (cGVHD; HR 4.799) were independently associated with worse survival. A novel prognostic model termed ABLAG (Age, Blast, Leukocyte, Anemia, cGVHD) was developed and the points were assigned according to the regression equation. The patients were categorized into low risk (0-1), intermediate risk (2, 3), and high risk (4-6) three groups and the 3-year overall survival (OS) were 93.3% (95%CI, 61%-99%), 78.9% (95%CI, 60%-90%), and 51.6% (95%CI, 32%-68%; p < .001), respectively. In internal and external validation cohort, the area under the receiver operating characteristic (ROC) curves of the ABLAG model were 0.829 (95% CI, 0.776-0.902) and 0.749 (95% CI, 0.684-0.854). Compared with existing models designed for the nontransplant setting, calibration plots, and decision curve analysis showed that the ABLAG model revealed a high consistency between predicted and observed outcomes and patients could benefit from this model. In conclusion, combining disease and patient characteristic, the ABLAG model provides better survival stratification for CMML patients receiving allo-HSCT.
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Affiliation(s)
- Jian-Ying Zhou
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Song Wang
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Hai-Long Yuan
- Department of Hematology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Ya-Jing Xu
- Department of Hematology, Xiangya Hospital of Central South University, Changsha, China
| | - Xiao-Bing Huang
- Department of Hematology, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Su-Jun Gao
- Hematology Section, Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Yi-Cheng Zhang
- Department of Hematology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Fang Zhou
- Hematology Department, The 960th Hospital of The People's Liberation Army (PLA) Joint Logistics Support Force, Jinan, China
| | - Yue Liu
- Hematology Department, The 960th Hospital of The People's Liberation Army (PLA) Joint Logistics Support Force, Jinan, China
| | - Xian-Min Song
- Department of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu Cai
- Department of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiao-Liang Liu
- Hematology Section, Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Yi Luo
- Department of Hematology, Bone Marrow Transplant Center, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Lu-Xin Yang
- Department of Hematology, Bone Marrow Transplant Center, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Jian-Min Yang
- Department of Hematology, Changhai Hospital, The Naval Medical University, Shanghai, China
| | - Li-Bing Wang
- Department of Hematology, Changhai Hospital, The Naval Medical University, Shanghai, China
| | - Yu-Hua Li
- Department of Hematology, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Rui Huang
- Department of Hematology, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Shun-Qing Wang
- Department of Hematology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Ming Zhou
- Department of Hematology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Yu-Jun Dong
- Department of Hematology, Peking University First Hospital, Beijing, China
| | - Qian Wang
- Department of Hematology, Peking University First Hospital, Beijing, China
| | - Xi Zhang
- Xinqiao Hospital, The Third Military Medical University, Chongqing, China
| | - Yi-Mei Feng
- Xinqiao Hospital, The Third Military Medical University, Chongqing, China
| | - Xin Du
- Department of Hematology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Wei Ling
- Department of Hematology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Han Zhu
- Department of Hematology, Jiangsu Province Hospital, The First Affiliated Hospital With Nanjing Medical University, Nanjing, China
| | - Zun-Min Zhu
- Department of Hematology, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Xiang-Li Chen
- Department of Hematology, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Shi-Yu Wang
- Department of Hematology, Xiangya Hospital of Central South University, Changsha, China
| | - Fan-Kai Meng
- Department of Hematology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Ke-Hong Bi
- Department of Hematology, School of First Affiliated Hospital of Shandong First Medical University, Shandong Province Qianfoshan Hospital, Jinan, China
| | - Ning Huang
- Department of Hematology, School of First Affiliated Hospital of Shandong First Medical University, Shandong Province Qianfoshan Hospital, Jinan, China
| | - Ming Jiang
- Department of Hematology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Ting Niu
- Department of Hematology, West China Hospital, Sichuan University, Chengdu, China
| | - Jie Ji
- Department of Hematology, West China Hospital, Sichuan University, Chengdu, China
| | - Ding-Ming Wan
- Department of Hematology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhi-Lei Bian
- Department of Hematology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yi Chen
- Department of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Li Liu
- Department of Hematology, The Second Affiliated Hospital (Tangdu Hospital) of Air Force Medical University, Xi'an, China
| | - Xue-Qian Yan
- Department of Hematology, The Second Affiliated Hospital (Tangdu Hospital) of Air Force Medical University, Xi'an, China
| | - Xi Yang
- Department of Hematology, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Hai Yi
- Department of Hematology, Western Theater General Hospital of the People's Liberation Army of China, Chengdu, China
| | - Xu-Dong Wei
- Department of Hematology, The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, China
| | - Xin Li
- Department of Hematology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Qian Cheng
- Department of Hematology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Cheng-Lu Yuan
- Department of Hematology, Qilu Hospital, Shandong University, Jinan, China
| | - Wen Wang
- Department of Hematology, Qilu Hospital, Shandong University, Jinan, China
| | - Yu-Hong Zhou
- Department of Hematology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
| | - Bao-Dong Ye
- Department of Hematology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
| | - Jing Ding
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Ye-Jun Wu
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Qiu-Sha Huang
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Xiao-Lu Zhu
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Yu-Hong Chen
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Yun He
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Feng-Rong Wang
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Yuan-Yuan Zhang
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Xiao-Dong Mo
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Wei Han
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Jing-Zhi Wang
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Yu Wang
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Huan Chen
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Xiang-Yu Zhao
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Ying-Jun Chang
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Kai-Yan Liu
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Xiao-Jun Huang
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
| | - Xiao-Hui Zhang
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China
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Wu HY, Zhou X, Chu XX, Deng XZ, Yuan CL, Ran XH, Liu GQ, Fan CB, Hao HY, Zhong YP. [Bendamustine combined with pomalidomide and dexamethasone in relapsed multiple myeloma with extramedullary disease: a multicenter study]. Zhonghua Xue Ye Xue Za Zhi 2023; 44:667-671. [PMID: 37803841 PMCID: PMC10520229 DOI: 10.3760/cma.j.issn.0253-2727.2023.08.009] [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] [Received: 02/16/2023] [Indexed: 10/08/2023]
Abstract
Objective: To evaluate the efficacy and safety of bendamustine combined with pomalidomide and dexamethasone (BPD regimen) in the treatment of relapsed multiple myeloma (MM) with extramedullary disease. Methods: This open, single-arm, multicenter prospective cohort study included 30 relapsed MM patients with extramedullary disease diagnosed in seven hospitals including Qingdao Municipal Hospital. The patients were treated with BPD regimen from February 2021 to November 2022. This study analyzed the efficacy and adverse reactions of the BPD regimen. Results: The median age of the 30 patients was 62 (47-72) years, of which 18 (60% ) had first-time recurrence. The overall response rate (ORR) of the 18 patients with first-time recurrence was 100%, of which three (16.7% ) achieved complete remission, 10 (55.5% ) achieved very good partial remission (VGPR), and five (27.8% ) achieved partial remission (PR). The ORR of 12 patients with recurrence after second-line or above treatment was 50%, including zero patients with ≥VGPR and six patients (50% ) with PR. Three cases (25% ) had stable disease, and three cases (25% ) had disease progression. The one-year progression free survival rate of all patients was 65.2% (95% CI 37.2% -83.1% ), and the 1-year overall survival rate was 90.0% (95% CI 76.2% -95.4% ). The common grade 3-4 hematology adverse reactions included two cases (6.7% ) of neutropenia and one case (3.3% ) of thrombocytopenia. The overall adverse reactions are controllable. Conclusions: The BPD regimen has good efficacy and tolerance in relapsed MM patients with extramedullary disease.
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Affiliation(s)
- H Y Wu
- Qingdao Hospital, University of Health and Rehabilitation Sciences, Qingdao Municipal Hospital, Qingdao 266071, China
| | - X Zhou
- Qingdao Hospital, University of Health and Rehabilitation Sciences, Qingdao Municipal Hospital, Qingdao 266071, China
| | - X X Chu
- Yantai Yuhuangding Hospital, Yantai 264099, China
| | - X Z Deng
- Weihai Municipal Hospital, Weihai 264299, China
| | - C L Yuan
- Qilu Hospital of Shandong University, Qingdao 266035, China
| | - X H Ran
- Weifang People's Hospital, Weifang 261044, China
| | - G Q Liu
- Shengli Oilfield Center Hospital, Dongying 257099, China
| | - C B Fan
- Qingdao Haici Medical Group, Qingdao 266033, China
| | - H Y Hao
- Qilu Hospital of Shandong University, Qingdao 266035, China
| | - Y P Zhong
- Qingdao Hospital, University of Health and Rehabilitation Sciences, Qingdao Municipal Hospital, Qingdao 266071, China
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Jian J, Wang X, Hao H, Ji C, Yuan C, Lu F. A Prognostic Model of Pseudogenes in Acute Myeloid Leukemia. Clin Lab 2023; 69. [PMID: 37145087 DOI: 10.7754/clin.lab.2022.220825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
BACKGROUND Acute myeloid leukemia (AML) is a hematologic malignancy characterized by the abnormal proliferation of myeloid hematopoietic cells and it is urgently needed to develop new molecular biomarkers to predict clinical outcomes and improve therapeutic effects. METHODS The differentially expressed genes were identified by comparing TCGA with GETx data. Univariate LASSO and multivariate cox regression analysis were performed to identify prognosis-associated pseudogenes. Based on the overall survival of related pseudogenes, we used them to construct a prognostic model for AML patients. Moreover, we built the pseudogenes-miRNA-mRNA ceRNA networks and explored their involved biological functions and pathways via GO and KEGG enrichment analysis. RESULTS Seven prognosis-associated pseudogenes were identified, including CCDC150P1, DPY19L1P1, FTH1P8, GTF2IP4, HLA-K, NAPSB, and PDCD6IPP2. The risk model based on these 7 pseudogenes could accurately predict the 1-year, 3-year, and 5-year survival rates. The GO and KEGG enrichment analyses demonstrated that these prognosis-associated pseudogenes were significantly enriched in cell cycle, myeloid leukocyte differentiation, regulation of hemopoiesis, and other critical cancer-related biological functions and pathways. We systematically and comprehensively analyzed the prognostic role of pseudogenes in AML. CONCLUSIONS The prognostic model of pseudogenes we identified is an independent predictor of overall survival in AML and could be used as biomarker for AML treatment.
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Chang Y, Yao T, Shi J, Wu YT, Yang F, Yuan CL, Nie XY, Wang FZ, Feng YL, Wang S. [Non/hypo-response to hepatitis B vaccination and influencing factors in HIV-infected patients in the context of different immunization schedules]. Zhonghua Liu Xing Bing Xue Za Zhi 2022; 43:696-701. [PMID: 35589575 DOI: 10.3760/cma.j.cn112338-20211214-00982] [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: 06/15/2023]
Abstract
Objective: To study the non/hypo-response to hepatitis B vaccination in HIV-infected patients, identify the influencing factors and provide evidence for the development of hepatitis B prevention and control strategies and measures for special population. Methods: On the basis of the randomized controlled trial of 20 µg hepatitis B vaccine immunization at 0-1-6 month, 0-1-2-6 month and 60 µg hepatitis B vaccine immunization at 0-1-2-6 month, the HIV-infected patients who completed one-month follow-up after the full course vaccination were selected as study subjects. Quantification of antibody to hepatitis B surface antigen (anti-HBs) in serum samples was performed by using chemiluminescent microparticle immunoassay (CMIA) and demographic characteristics, disease history, HIV infection and treatment status of the study subjects were collected. Statistical analysis was conducted by χ2 test, t test, unconditional logistic regression and interaction analyses. Results: The non/hypo-response rates to hepatitis B vaccination were 34.65% (35/101), 24.49% (24/98) and 10.99% (10/91) in 20 µg group at 0-1-6 month or 0-1-2-6 month and 60 µg group at 0-1-2-6 month (P<0.001), respectively. Logistic regression analysis showed that after controlling for confounding factors, the risk for non/hypo-response was 0.22 times higher in HIV-infected patients receiving 60 µg hepatitis B vaccine at 0-1-2-6 month than in patients receiving 20 µg hepatitis B vaccine at 0-1-6 month (95%CI: 0.10-0.50), the risk for non/hypo-response was higher in men than in women (OR=3.65, 95%CI: 1.88-7.07), and the risk for non/hypo-response was 2.64 times higher in those without hepatitis B vaccination history than in those with hepatitis B vaccination history (95%CI: 1.10-6.32). Moreover, there were multiplicative interactions between immunization schedule and gender (OR=2.49, 95%CI: 1.24-5.00). Conclusion: The non/hypo-response rate to hepatitis B vaccination was significantly lower in HIV-infected patients receiving 60 µg hepatitis B vaccine at 0-1-2-6 month than in those receiving 20 µg hepatitis B vaccine at 0-1-6 month and 0-1-2-6 month. Gender, vaccination schedule and history of hepatitis B vaccination were the influencing factors of the non/hypo-response to hepatitis B vaccination. There was a multiplicative interaction between vaccination schedule and gender, and men receiving 20 µg hepatitis B vaccines had a higher risk for non/hypo-response to hepatitis B vaccination.
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Affiliation(s)
- Y Chang
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China
| | - T Yao
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China
| | - J Shi
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China
| | - Y T Wu
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China
| | - F Yang
- Department of Infectious Diseases, The Second Hospital of Yuncheng, Yuncheng 044000, China
| | - C L Yuan
- Department of STD/AIDS Prevention and Control, Shanxi Provincial Center for Disease Control and Prevention, Taiyuan 030012, China
| | - X Y Nie
- Department of STD/AIDS Prevention and Control, Shanxi Provincial Center for Disease Control and Prevention, Taiyuan 030012, China
| | - F Z Wang
- Department of National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Y L Feng
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China
| | - Suping Wang
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China
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Yao Y, Sui WW, Liao AJ, Wang W, Chen LJ, Chu XX, Bao L, Cen XN, Fu R, Liu H, Sun CY, Jin FY, Yan H, Wang LQ, Yuan CL, Gao GX, Gao D, Zhang JQ, He JX, Hu JD, Ma LM, Zhang L, Zhou DB, Zou DH, Li J. Comprehensive geriatric assessment in newly diagnosed older myeloma patients: a multicentre, prospective, non-interventional study. Age Ageing 2022; 51:6399896. [PMID: 34673897 DOI: 10.1093/ageing/afab211] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 04/17/2021] [Revised: 08/23/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Multiple myeloma is a disease of the older people, whose prognoses are highly heterogeneous. The International Myeloma Working Group (IMWG) proposed a geriatric assessment (GA) based on age, functional status and comorbidities to discriminate between fit and frail patients. Given the multidimensional nature of frailty and the relatively recent exploration of frailty in the field of MM, reaching a consensus on the measurement of frailty in MM patients remains challenging. OBJECTIVE We sought to assess the feasibility of performing a comprehensive GA (CGA) in older MM patients in a real-world and multicentre setting and to evaluate their baseline CGA profiles. RESULTS We studied 349 older patients with newly diagnosed MM (age range, 65-86 years). Our results showed that a CGA is feasible for older MM patients. Using the IMWG-GA criteria, we identified significantly more frail patients in our cohort comparing to in the IMWG cohort (43% vs 30%, P = 0.002). In the IMWG-GA 'fit' group, risk of malnutrition, depression and cognitive impairment remains. The median follow-up time was 26 months (range 1-38). The median overall survival (OS) was 34.7 months, and the estimated 3-year OS rate was 50%. A high MNA-SF score (MNA-SF ≥ 12), low GDS score (GDS ≤ 5) and high CCI score (CCI ≥ 2) can be used to predict the OS of older patients with newly diagnosed MM. This study is registered at www.clinicaltrials.gov (NCT03122327). CONCLUSIONS Our study justifies the need for a CGA in older patients with newly diagnosed MM.
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Affiliation(s)
- Yuan Yao
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College
| | - Wei-Wei Sui
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Blood Diseases Hospital & Institute of Hematology, Chinese Academy of Medical Sciences & Peking Union Medical College
| | - Ai-Jun Liao
- Department of Hematology, Shengjing Hospital of China Medical University
| | - Wei Wang
- Department of Hematology, The Affiliated Hospital of Qingdao University
| | - Li-Juan Chen
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital
| | - Xiao-Xia Chu
- Department of Hematology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University
| | - Li Bao
- Department of Hematology, Beijing Jishuitan Hospital
| | - Xi-Nan Cen
- Department of Hematology, Peking University First Hospital
| | - Rong Fu
- Department of Hematology, Tianjin Medical University General Hospital
| | - Hui Liu
- Department of Hematology, Beijing Hospital, National Center of Gerontology
| | - Chun-Yan Sun
- Department of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
| | - Feng-Yan Jin
- Department of Hematology, Cancer Center, the First Hospital of Jilin University
| | - Hua Yan
- Department of Hematology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine
| | - Lu-Qun Wang
- Department of Hematology, Qilu Hospital, Cheeloo College of Medicine, Shangdong University
| | - Cheng-Lu Yuan
- Department of Hematology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University
| | - Guang-Xun Gao
- Department of Hematology, Xijing Hospital, Air Force Medical University
| | - Da Gao
- Department of Hematology, Inner Mongolia Medical College Affiliated Hospital
| | - Jin-Qiao Zhang
- Department of Hematology, Third Hospital of Hebei Medical University
| | - Jian-Xia He
- Department of Hematology, Shanxi Provincial People’s Hospital Affiliated to Shanxi Medical University
| | - Jian-Da Hu
- Department of Hematology, Fujian Medical University Union Hospital, Fujian Institute of Hematology, Fujian Provincial Key Laboratory on Hematology
| | | | - Lu Zhang
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College
| | - Dao-Bin Zhou
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College
| | - De-Hui Zou
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Blood Diseases Hospital & Institute of Hematology, Chinese Academy of Medical Sciences & Peking Union Medical College
| | - Jian Li
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College
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Wang H, Liu JL, Wu XX, Zhang SQ, Zhang ZK, Pan WW, Yuan G, Yuan CL, Ren YL, Lei W. Ultra-long high quality catalyst-free WO 3 nanowires for fabricating high-performance visible photodetectors. Nanotechnology 2020; 31:274003. [PMID: 32209740 DOI: 10.1088/1361-6528/ab8327] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This work presents a study on the controlled growth of WO3 nanowires via chemical vapor deposition without catalyst, and their potential applications in visible photodetectors. The influence of growth conditions on the morphology of WO3 nanowires is studied in order to understand the growth mechanism of WO3 nanowires, and ultra-long (60 [Formula: see text], the longest one ever reported) WO3 nanowires with a spindle shape are achieved by optimizing the growth conditions. It was found that the length of WO3 nanowires increases from 15 [Formula: see text] to 60 [Formula: see text] with increasing the argon carrier gas flow rate from 30 sccm to 90 sccm, and then saturates with further increasing the argon carrier gas flow rate. However, the length of WO3 nanowires reduces from 60 [Formula: see text] to 19 [Formula: see text] with increasing the tube inner pressure from 2.5 Torr to 3.5 Torr. The photoconductor detectors based on WO3 single nanowires present excellent device performance with a responsivity as high as 19 A W-1 at a bias of 0.1 V, a detectivity as high as 1.06 × 1011 Jones, and a response (rising and decay) time as short as 8 ms under the illumination of a 404 nm laser. These results indicate the great potential of WO3 nanowires for applications in fabricating high performance visible photodetectors.
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Affiliation(s)
- H Wang
- Department of Electrical, Electronic and Computer Engineering, The University of Western Australia, 35 Stirling Highway, Crawley 6009, Australia. These authors contributed to the work equally
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Yuan CL, Li H, Zhu L, Liu Z, Zhou J, Shu Y. Aberrant expression of long noncoding RNA PVT1 and its diagnostic and prognostic significance in patients with gastric cancer. Neoplasma 2019; 63:442-9. [PMID: 26925791 DOI: 10.4149/314_150825n45] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Emerging evidences indicate that dysregulated long noncoding RNAs (lncRNAs) are implicated in cancer tumorigenesis and progression and might be used as diagnosis and prognosis biomarker, or potential therapeutic targets. LncRNA PVT1 has been reported to be upregulated in diverse human cancers; however, its clinical significance in gastric cancer (GC) remains elusive. This study was to evaluate the expression of PVT1 in GC and further explore its clinical significance.Previous microarray datasets were analyzed to conduct a preliminary screening for candidate lncRNAs of gastric cancer biomarkers in human gastric cancer tissues. Expression levels of PVT1 in 111pairs of gastric cancer and adjacent normal tissues, gastric cancer cell lines and gastric cancer juices compared to their corresponding controls were detected by real-time quantitative RT-PCR assay. A receiver operating characteristic (ROC) curve and Kaplan-Meier analysis were constructed to evaluate the diagnostic and prognostic values. Univariate and multivariate analysis were performed using the Cox proportional hazard analysis.PVT1 expression was remarkably increased in gastric cancer tissues and cell lines compared with that in the normal control, and its up-regulation was significantly correlated to invasion depth (P < 0.001), advanced TNM stage (P = 0.002) and regional lymph nodes metastasis (P < 0.001) in gastric cancer. PVT1 levels were robust in differentiating gastric cancer tissues from controls [area under the curve (AUC) = 0.728; 95 % confidence interval (CI) = 0.665-0.786, p<0.01]. Kaplan-Meier analysis demonstrated that increased PVT1 expression contributed to poor overall survival (P < 0.01) and disease-free survival (P < 0.01) of patients. A multivariate survival analysis also indicated that PVT1 could be an independent prognostic marker. The levels of PVT1 in gastric juice from gastric patients were significantly higher than those from normal subjects (P = 0.03). PVT1 might serve as a promising biomarker for early detection and prognosis prediction of gastric cancer.
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Liu L, Dong WH, Du YH, Song XF, Yuan CL, Li Z. [Immunoglobulin D multiple myeloma with elevated creatine kinase and numb chin syndrome: a case report]. Zhonghua Zhong Liu Za Zhi 2017; 39:879-880. [PMID: 29151296 DOI: 10.3760/cma.j.issn.0253-3766.2017.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- L Liu
- Department of Hematology, Qilu Hospital of Shandong University(Qingdao), Qingdao 266035, China
| | - W H Dong
- Department of Hematology, Qilu Hospital of Shandong University(Qingdao), Qingdao 266035, China
| | - Y H Du
- Department of Hematology, Qilu Hospital of Shandong University(Qingdao), Qingdao 266035, China
| | - X F Song
- Department of Orthopedics, Qilu Hospital of Shandong University(Qingdao), Qingdao 266035, China
| | - C L Yuan
- Department of Hematology, Qilu Hospital of Shandong University(Qingdao), Qingdao 266035, China
| | - Z Li
- Department of Hematology, Qilu Hospital of Shandong University(Qingdao), Qingdao 266035, China
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Liang R, Yan XX, Lin Y, Li Q, Yuan CL, Liu ZH, Li YQ. Functional polymorphisms of the cyclooxygenase-2 gene and prognosis of hepatocellular carcinoma - a cohort study in Chinese people. Genet Mol Res 2016; 15:gmr8093. [PMID: 27173352 DOI: 10.4238/gmr.15028093] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Cyclooxygenase-2 (COX-2) influences carcinogenesis through regulation of angiogenesis, apoptosis, cytokine expression, and immune response suppression. It has been well established that COX-2 is overexpressed in a variety of human cancers, such as hepatocellular carcinoma (HCC). In this study, we aimed to evaluate the association between COX-2 polymorphisms and prognosis of HCC. We genotyped 200 HCC patients of Chinese Han descent for COX-2 gene polymorphisms (-765G>C and -1195G>A) using PCR-RFLP. Data were statistically analyzed using the Kaplan-Meier method and the Cox's proportional hazard regression model. We found that patients with the COX-2 -1195AG and -1195AG + AA genotypes demonstrated significantly decreased disease-free survival (DFS) as compared with those carrying the -1195GG genotype (P < 0.05). However, the COX-2 -765G>C polymorphism was not associated with DFS (P > 0.05). Moreover, by Cox regression analysis, blood alpha fetoprotein ≤400 ng/mL before the operation and the -1195G>A polymorphism were found to be of prognostic significance (P < 0.05), while the -765G>C polymorphism was not (P > 0.05). In summary, post-operation progression of HCC is more likely to occur in patients with the -1195AG genotype and the A allele. On the other hand, the -765G>C polymorphism is not an independent influence factor of HCC prognosis.
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Affiliation(s)
- R Liang
- First Department of Chemotherapy, Affiliated Tumour Hospital of Guangxi Medical University, Nanning, China
| | - X X Yan
- First Department of Chemotherapy, Affiliated Tumour Hospital of Guangxi Medical University, Nanning, China
| | - Y Lin
- First Department of Chemotherapy, Affiliated Tumour Hospital of Guangxi Medical University, Nanning, China
| | - Q Li
- First Department of Chemotherapy, Affiliated Tumour Hospital of Guangxi Medical University, Nanning, China
| | - C L Yuan
- First Department of Chemotherapy, Affiliated Tumour Hospital of Guangxi Medical University, Nanning, China
| | - Z H Liu
- First Department of Chemotherapy, Affiliated Tumour Hospital of Guangxi Medical University, Nanning, China
| | - Y Q Li
- First Department of Chemotherapy, Affiliated Tumour Hospital of Guangxi Medical University, Nanning, China
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Liang R, Lin Y, Liu ZH, Liao XL, Yuan CL, Liao SN, Li YQ. Correlation between ERCC1 expression and concurrent chemotherapy and radiotherapy in patients with locally advanced nasopharyngeal cancer. Genet Mol Res 2015; 14:5804-11. [PMID: 26125779 DOI: 10.4238/2015.may.29.12] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
In this study, the expression of DNA excision repair cross-complementing gene 1 (ERCC1) in local advanced nasopharyngeal carcinoma has been correlated with the efficacy of concurrent chemoradiotherapy. A total of 76 patients diagnosed with undifferentiated nasopharyngeal carcinoma diagnosed by nasopharyngeal biopsy and undergoing single-agent cisplatin chemotherapy (80 mg/m(2)) with concurrent radiotherapy (on the first, twenty-second, and forty-third day, 5 times per week, mean dose 74 Gy, range 70-78 Gy) at the Affiliated Cancer Hospital of Guangxi Medical University between January and December 2010 were included. After chemoradiotherapy, outcomes and long-term survival were evaluated. Immunohistochemistry was used to detect expression of ERCC1 protein in nasopharyngeal carcinoma. The relationship between the expression of ERCC1 and efficacy of concurrent chemoradiotherapy and long-term survival were analyzed. ERCC1 was expressed in 42.1% of cases. The expression of ERCC1 was correlated with T stage and clinical staging (P < 0.05), but not with gender, age, or N stage. The response rate in the ERCC1-positive and ERCC1-negative groups was 75.0% and 97.7%, respectively (P < 0.05). In the 72 cases with follow-up available, 1-, 2-, and 3-year survival rates were 91.0, 83.3, and 79.0%; they were 92.4, 87.8, 80.5%, respectively, in the ERCC1-positive group, and 87.9, 77.4, 77.4%, respectively, in the ERCC1-negative group. The expression of ERCC1 may be a sensitive prognostic indicator of concurrent chemoradiotherapy in locally advanced nasopharyngeal carcinoma.
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Affiliation(s)
- R Liang
- Affiliated Cancer Hospital of Guangxi Medical University, Nanning, China
| | - Y Lin
- Affiliated Cancer Hospital of Guangxi Medical University, Nanning, China
| | - Z H Liu
- Affiliated Cancer Hospital of Guangxi Medical University, Nanning, China
| | - X L Liao
- Affiliated Cancer Hospital of Guangxi Medical University, Nanning, China
| | - C L Yuan
- Affiliated Cancer Hospital of Guangxi Medical University, Nanning, China
| | - S N Liao
- Affiliated Cancer Hospital of Guangxi Medical University, Nanning, China
| | - Y Q Li
- Affiliated Cancer Hospital of Guangxi Medical University, Nanning, China
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Zhu CX, Yuan CL, Cui L, Yu Y, Liu RA, Zhao W, Hua XG. Molecular detection of Torque teno sus virus from tissues samples of sick pigs in China. Virus Res 2012; 165:225-30. [PMID: 22361032 DOI: 10.1016/j.virusres.2012.02.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2011] [Revised: 02/06/2012] [Accepted: 02/07/2012] [Indexed: 10/28/2022]
Abstract
In the present study, Torque teno sus virus (TTSuV) was detected from different tissues, stool and serum samples of 25 sick pigs. The total prevalence of TTSuV1 and TTSuV2 were 64% (16/25) and 28% (7/25), 24% (6/25) were co-infected with both TTSuV1 and TTSuV2. The prevalence of TTSuV infection in spleen is a slightly higher, with positive rates of 52% (13/25) for TTSuV1 and 24% (6/25) for TTSuV2. Phylogenetic analysis of TTSuV1 showed that 21 isolates were distributed into two clusters (genotype TTSuV1a and TTSuV1b), with genotype TTSuV1b was the dominant genotype. Phylogenetic analysis of TTSuV2 showed that the nine isolates shared 80.9-99.2% nucleotide homology with each other, and were distributed in different genotypes (TTSuV2a-TTSuV2f). TTSuV2d was the most prevalent genotype in this study, which contained five Spanish strains and nine Chinese strains, and shared 94.2-96.8% homology.
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Affiliation(s)
- C X Zhu
- Shanghai Key Laboratory of Veterinary Biotechnology, School of Agriculture and Biology, Shanghai JiaoTong University, Shanghai 200240, China
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Zhao W, Zhu AL, Yuan CL, Yu Y, Zhu CX, Lan DL, Yang ZB, Cui L, Hua XG. Detection of astrovirus infection in pigeons (Columbia livia) during an outbreak of diarrhoea. Avian Pathol 2011; 40:361-5. [PMID: 21812714 DOI: 10.1080/03079457.2011.587792] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Avian astrovirus infections are widespread in many countries, and infections have been linked to enteritis and increased mortality in young poultry. Although pigeons are treated as an important poultry product in some countries, their diseases are often poorly understood and astrovirus infection in pigeons has not been reported. In the present study, faecal samples were collected during an outbreak of gastrointestinal illness in a population of Shanghai pigeons. The samples were examined for astroviruses by reverse transcription-polymerase chain reaction. Eighty-nine per cent (40/45) and 4% (2/45) were found to be positive for avian nephritis virus (ANV) and chicken astrovirus, respectively. One positive sample indicated a co-infection with both ANV and chicken astrovirus. Phylogenetic analysis based on the partial polymerase gene sequence and full-length capsid protein from published avian astrovirus sequences in GenBank revealed that the pigeon viruses detected in this study were evolutionarily closely related to chicken ANV. The present study provided evidence for the presence of astrovirus in pigeons and suggests that cross-infection between pigeons and commercial chickens was likely. Whether the astroviruses in pigeons were responsible for the diarrhoea remains to be determined.
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Affiliation(s)
- W Zhao
- Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai, 200240, PR China
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Dai XQ, Yuan CL, Yu Y, Zhao W, Yang ZB, Cui L, Hua XG. Molecular detection of Saffold Virus in children in Shanghai, China. J Clin Virol 2010; 50:186-7. [PMID: 21159549 DOI: 10.1016/j.jcv.2010.11.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2010] [Revised: 11/02/2010] [Accepted: 11/02/2010] [Indexed: 11/15/2022]
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Shan TL, Wang CM, Cui L, Delwart E, Yuan CL, Zhao W, Guo W, Dai XQ, Yu Y, Hua XG. Human parechovirus infections in monkeys with diarrhea, China. Emerg Infect Dis 2010; 16:1168-9. [PMID: 20587198 DOI: 10.3201/eid1607.091103] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Information about human parechovirus (HPeV) infection in animals is scant. Using 5' untranslated region reverse transcription-PCR, we detected HPeV in feces of monkeys with diarrhea and sequenced the complete genome of 1 isolate (SH6). Monkeys may serve as reservoirs for zoonotic HPeV transmissions and as models for studies of HPeV pathogenesis.
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Affiliation(s)
- T L Shan
- Shanghai Jiao Tong University, Shanghai, 200240, People's Republic of China
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Shan TL, Wang CM, Cui L, Delwart E, Yuan CL, Zhao W, Guo W, Dai XQ, Yu Y, Hua XG. Human parechovirus infections in monkeys with diarrhea, China. Emerg Infect Dis 2010. [PMID: 20587198 PMCID: PMC3321892 DOI: 10.3201/1607.091103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Information about human parechovirus (HPeV) infection in animals is scant. Using 5′ untranslated region reverse transcription–PCR, we detected HPeV in feces of monkeys with diarrhea and sequenced the complete genome of 1 isolate (SH6). Monkeys may serve as reservoirs for zoonotic HPeV transmissions and as models for studies of HPeV pathogenesis.
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Affiliation(s)
- T L Shan
- Shanghai Jiao Tong University, Shanghai, 200240, People's Republic of China
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Zhu CX, Cui L, Shan TL, Luo XN, Liu ZJ, Yuan CL, Lan DL, Zhao W, Liu ZW, Hua XG. Porcine torque teno virus infections in China. J Clin Virol 2010; 48:296-8. [PMID: 20554244 DOI: 10.1016/j.jcv.2010.04.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2010] [Revised: 04/05/2010] [Accepted: 04/30/2010] [Indexed: 10/19/2022]
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Abstract
A Ge/GeO(2) core/shell nanostructure embedded in an Al(2)O(3) gate dielectrics matrix was produced. A larger memory window with good data retention was observed in the fabricated metal-insulator-semiconductor (MIS) capacitor for Ge/GeO(2) core/shell nanoparticles compared to Ge nanoparticles only, which is due to the high percentage of defects located on the surface and grain boundaries of the GeO(2) shell. We believe that the findings presented here provide physical insight and offer useful guidelines to controllably modify the charge storage properties of indirect semiconductors through defect engineering.
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Affiliation(s)
- C L Yuan
- Department of Physics, Jiangxi Normal University, Nanchang 330022, Jiangxi, People's Republic of China
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Wang WZ, Wu JZ, Ma GY, Dai XY, Yang B, Wang TP, Yuan CL, Hong Z, Bell GS, Prilipko L, de Boer HM, Sander JW. Efficacy assessment of phenobarbital in epilepsy: a large community-based intervention trial in rural China. Lancet Neurol 2006; 5:46-52. [PMID: 16361022 DOI: 10.1016/s1474-4422(05)70254-4] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Many people with epilepsy need not experience further seizures if the diagnosis and treatment are correct. Most epilepsy patients have convulsions, which are usually fairly easy to diagnose. This study tested a model for treatment of people with convulsive forms of epilepsy at primary health-care level in rural areas of China. METHODS Patients with convulsive epilepsy were identified at primary care level and provided with phenobarbital monotherapy. Local physicians, who were provided with special training, carried out screening, treatment, and follow-up. A local neurologist confirmed the diagnoses. Efficacy was assessed from the percentage reduction in seizure frequency from baseline and the retention of patients on treatment. FINDINGS The study enrolled 2455 patients. In 68% of patients who completed 12 months' treatment, seizure frequency was decreased by at least 50%, and a third of patients were seizure free. 72% of patients who completed 24 months' treatment had reduction of seizure frequency of at least 50% and a quarter of patients remained seizure free. Probability of retention was 0.84 at 1 year, and 0.76 at 2 years. Medication was well tolerated and reported adverse events were mild; only 32 patients (1%) discontinued medication because of side-effects. INTERPRETATION This pragmatic study confirmed that this simple protocol was suitable for the treatment of convulsive forms of epilepsy in rural areas of China. Physicians with basic training could treat epilepsy patients with phenobarbital, with beneficial effects for most patients with convulsive seizures. Few cognitive or behavioural adverse events were noted, but formal psychometric testing was not done.
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Affiliation(s)
- W Z Wang
- Beijing Neurosurgical Institute, Beijing, People's Republic of China.
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Wang WZ, Wu JZ, Wang DS, Dai XY, Yang B, Wang TP, Yuan CL, Scott RA, Prilipko LL, de Boer HM, Sander JW. The prevalence and treatment gap in epilepsy in China: an ILAE/IBE/WHO study. Neurology 2003; 60:1544-5. [PMID: 12743252 DOI: 10.1212/01.wnl.0000059867.35547.de] [Citation(s) in RCA: 127] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The authors carried out a door-to-door survey to determine the prevalence of epilepsy among 55,000 people in China. The lifetime prevalence was 7.0/1000, and 41% of all persons had never received appropriate treatment. The prevalence of active epilepsy was 4.6/1000, and 63% of people with active epilepsy had not received antiepileptic treatment in the week before the survey. Figures for the prevalence and the treatment gap were significantly higher than previous estimates.
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Affiliation(s)
- W Z Wang
- Department of Neuroepidemiology, Beijing Neurosurgical Institute, PRC.
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Abstract
Miller Fisher syndrome (MFS), characterized as ataxia, areflexia and ophthalmoplegia, is generally considered as a variant of Guillain-Barré syndrome (GBS). However, some investigators believed that the syndrome could be explained by a central origin. To obtain more information about MFS for comparison with GBS, we conducted a retrospective study by analyzing the clinical data of MFS patients admitted to our hospital over a period of 11 years. The calibrated male/female ratio was 1.65. A seasonal clustering in winter was noted. The percentage of MFS among GBS was especially high (18%, 11/60) in Taiwan when compared with other series. Involvement of limb muscle strength, autonomic function and cranial nerves, except ocular motor nerves, was rarely found in our patients. When MFS is accompanied by limb weakness, it might represent a transitional form between MFS and GBS. Bulbar palsy and dysautonomia might predict a relatively poor prognosis. To obtain more reliable information, lumbar puncture should be done 1 week after disease onset, and electrophysiological tests should be done serially in every MFS patient. Eighty percent (80%, 4/5) of our patients were positive for IgG anti-GQ(1b) antibody activity. In our study, there is more evidence indicating that MFS is a peripheral nervous system disorder; however, no definite conclusion could be made as to whether MFS is exclusively a peripheral or central nervous system disorder. We think MFS is an immune-mediated clinical entity which mainly involves the peripheral nervous system with rare involvement of other parts of the central nervous system.
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Affiliation(s)
- C L Yuan
- Neurology, The Neurological Institute, Veterans General Hospital, Taipei, Taiwan, ROC
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Yao JM, Wang J, Wang XQ, Yuan CL, Wang WS, Yu ZL. [Breeding of arachidonic acid producting strain by ion implantation]. Sheng Wu Gong Cheng Xue Bao 2000; 16:478-81. [PMID: 11051823] [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: 02/18/2023]
Abstract
With ion implantation, a high-yield arachidonic acid producting strain(Mortierella alpina) I49-N18 was selected, whose biomass was 30.80 g/L. The lipid component of biomass was 25.8%, in which AA content was 45.37%. The results showed that selected high-yield strain was steady on 250 L fermentor, whose AA yield was 4.0 g/L.
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Affiliation(s)
- J M Yao
- Centre of Ion Beam Bioengineering, Institute of Plasma Physics, Academia Sinica, Hefei
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Oliver DK, Swanson SJ, Yuan CL, Welch PG. The Walter Reed Army Medical Center outpatient infusion service: lessons for managing health care change at the local level. Mil Med 1999; 164:688-92. [PMID: 10544620] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
Abstract
The Military Health Services System is undergoing tremendous changes paralleling those seen in the civilian health care system. Many of the same problems and frustrations are being encountered in the military as it builds TRICARE, one of the largest managed care systems in the country. This paper describes how a team of multidisciplinary subspecialty providers established an Infusion Service for Walter Reed Army Medical Center to fulfill customer needs brought about by system changes in the medical center. Policy and operations were directed toward addressing patient and provider frustrations. Organ transplantation ward length of stay shortened significantly in association with the establishment of this Infusion Service. Peritoneal Dialysis Clinic staff productivity improved. Organizational factors and values affecting patient outcomes and health system reform are discussed. Lessons learned from this project are identified and presented as suggestions that can be used in planning and executing changes throughout the Military Health Services System.
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Affiliation(s)
- D K Oliver
- Department of Nursing, Walter Reed Army Medical Center, Washington, DC 20307-5001, USA
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Chang LB, Tsai CP, Liao KK, Kao KP, Yuan CL, Yen DJ, Lin KP. Use of botulinum toxin A in the treatment of hemifacial spasm and blepharospasm. Zhonghua Yi Xue Za Zhi (Taipei) 1999; 62:1-5. [PMID: 10063705] [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: 02/11/2023]
Abstract
BACKGROUND Hemifacial spasm and blepharospasm are both dystonic disorders. They may seriously affect individuals' lifestyle and social activities. In 1990, the Food and Drug Administration of the USA approved botulinum toxin A as a therapeutic agent in the treatment of hemifacial spasm and blepharospasm. We present a therapeutic review of botulinum toxin A in 80 patients in Taiwan. METHODS Fifty-eight patients with hemifacial spasm and 22 with blepharospasm. Botulinum toxin A was prepared and injected into the facial and eyelid muscles. Patients were monitored every two weeks and classified into four groups (excellent, moderate, mild and no improvement) according to the clinical improvement scale. Complications were also recorded. RESULTS A total of 86.2% of hemifacial spasm patients and 81.8% of blepharospasm patients had excellent improvement on the spasm intensity scale, while 6.8% of hemifacial spasm and 9.0% of blepharospasm patients had moderate improvement. The complication rate was low and included transient mild facial weakness (5%), ptosis (3.8%), eyelid swelling and/or ecchymosis (3.8%), nausea/vomiting (2.5%) and transient severe facial weakness (1.3%). CONCLUSION Botulinum toxin A is an excellent therapeutic agent to improve spasm intensity and has a low complication rate.
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Affiliation(s)
- L B Chang
- Section of Neurology, Cardinal Tien Hospital, Taipei, Taiwan, ROC
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Zhao YQ, Yuan CL. [Chemical constituents of the fruit of Panax ginseng C. A. Meyer]. Zhongguo Zhong Yao Za Zhi 1993; 18:296-7, 319. [PMID: 8216805] [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: 01/29/2023]
Abstract
Four compounds were isolated from the fruit of cultivated Panax ginseng and identified as beta-sitosterol,20(R)-protopanaxatriol, daucosterine and 20(R)-ginsenoside-Rg3 on the basis of physicochemical constants and spectral evidences.
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Affiliation(s)
- Y Q Zhao
- Liaoning College of Traditional Chinese Medicine, Shenyang
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25
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Yuan CL. [Preliminary therapeutic observation in 82 cases of pulmonary infarction]. Zhonghua Jie He He Hu Xi Za Zhi 1990; 13:88-90, 127. [PMID: 2397537] [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: 12/31/2022]
Abstract
The therapeutic effects on pulmonary infarction in 82 cases were reported. The cases were divided into 2 groups: trial group of 60 cases treated with heparin and Chinese herbal medicine Qing Fei decoction (QFD) and control group with antibiotics, cough-remedy, expectorant and treatment for symptomatic relief. The results showed that the resolution rate of pulmonary infarction in the trial group was higher than that of the other group (P less than 0.01). The fading phase of the infarction appeared earlier in the trial group than that in the control group (P less than 0.01). Thrombophlebitis and venous thrombosis were cured simultaneously and the recurrence rate was lower in the trial group than that in the control. Evidences showed that heparin combined with QFD has a excellent effects on the treatment of pulmonary infarction.
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Affiliation(s)
- C L Yuan
- Hospital of Zhangjiakou Medical College, Zhangjiakou
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Yuan CL, Wang ZB, Jiao Y, Cao AM, Huo YL, Cui CX. [Sedative and hypnotic constituents of flavonoids in the seeds of Ziziphus spinosae]. Zhong Yao Tong Bao 1987; 12:34-6, 62-3. [PMID: 3449249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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