1
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Zhang ZW, Wang CY, He B. [Reperfusion strategies for STEMI patients: recent advances in comparative study of pharmaco-invasive strategy and primary PCI]. Zhonghua Xin Xue Guan Bing Za Zhi 2024; 52:295-299. [PMID: 38514333 DOI: 10.3760/cma.j.cn112148-20231130-00471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Affiliation(s)
- Z W Zhang
- Cardiovascular Department of Shanghai Chest Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200030, China
| | - C Y Wang
- Cardiovascular Department of Shanghai Chest Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200030, China
| | - B He
- Cardiovascular Department of Shanghai Chest Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200030, China
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2
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Huang CY, Chen LJ, Chen CS, Wang CY, Hong SY. MCL1 inhibition: a promising approach to augment the efficacy of sorafenib in NSCLC through ferroptosis induction. Cell Death Discov 2024; 10:137. [PMID: 38485916 PMCID: PMC10940654 DOI: 10.1038/s41420-024-01908-5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 03/04/2024] [Accepted: 03/05/2024] [Indexed: 03/18/2024] Open
Abstract
Ferroptosis, an iron-dependent form of regulated cell death, plays a crucial role in modulating the therapeutic response in non-small cell lung cancer (NSCLC) patients. Studies have identified the signal transducer and activator of transcription 3 (STAT3) and myeloid cell leukemia-1 (MCL1) as potential targets for sorafenib, which exhibits activities in inducing ferroptosis. However, the role of STAT3-MCL1 axis in sorafenib-induced ferroptosis in NSCLC is still unclear. This study provided evidence that ferroptosis is a critical driver of sorafenib-induced cell death in NSCLC, supported by the accumulation of lipid peroxidation products, indicative of oxidative stress-induced cell death. Additionally, both in vitro and in vivo experiments showed that ferroptosis contributed to a significant portion of the anti-cancer effects elicited by sorafenib in NSCLC. The noticeable accumulation of lipid peroxidation products in sorafenib-treated mice underscored the significance of ferroptosis as a contributing factor to the therapeutic response of sorafenib in NSCLC. Furthermore, we identified the involvement of the STAT3/MCL1 axis in sorafenib-induced antitumor activity in NSCLC. Mechanistically, sorafenib inhibited endogenous STAT3 activation and downregulated MCL1 protein expression, consequently unleashing the ferroptosis driver BECN1 from the BECN1-MCL1 complex. Conversely, there is an augmented association of BECN1 with the catalytic subunit of system Xc-, SLC7A11, whose activity to import cystine and alleviate lipid peroxidation is hindered upon its binding with BECN1. Notably, we found that MCL1 upregulation correlated with ferroptosis resistance in NSCLC upon sorafenib treatment. Our findings highlight the importance of sorafenib-triggered ferroptosis in NSCLC and offer a novel strategy to treat advanced NSCLC patients: by downregulating MCL1 and, in turn, predispose NSCLC cells to ferroptosis.
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Affiliation(s)
- Chao-Yuan Huang
- Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, 100229, Taiwan
| | - Li-Ju Chen
- Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, 100229, Taiwan
| | - Chi-Shuo Chen
- Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu, 300044, Taiwan
| | - Cheng-Yi Wang
- Department of Internal Medicine, Cardinal Tien Hospital and School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei, 231009, Taiwan.
| | - Shiao-Ya Hong
- Department of Biotechnology and Laboratory Science in Medicine, National Yang Ming Chiao Tung University, Taipei, 112304, Taiwan.
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3
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Zhang WJ, Zhang LP, Lin SJ, Wang CY, Le YG. Correction to: P2 purinergic receptors regulate the progression of colorectal cancer. Purinergic Signal 2024:10.1007/s11302-024-09995-w. [PMID: 38427183 DOI: 10.1007/s11302-024-09995-w] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024] Open
Affiliation(s)
- Wen-Jun Zhang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang City, 343000, Jiangxi Province, China
| | - Li-Peng Zhang
- Gastrointestinal Surgery, The Second Affiliated Hospital, Nanchang University, Nanchang City, 343000, Jiangxi Province, China
| | - Si-Jian Lin
- Department of Rehabilitation Medicine, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang City, 343000, Jiangxi Province, China
| | - Cheng-Yi Wang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang City, 343000, Jiangxi Province, China
| | - Yi-Guan Le
- Gastrointestinal Surgery, The Second Affiliated Hospital, Nanchang University, Nanchang City, 343000, Jiangxi Province, China.
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4
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Lin M, Griffin SO, Li CH, Wei L, Espinoza L, Wang CY, Thornton-Evans G. Exploring Recent Decreases in First Molar Sealants among US Children. J Dent Res 2024:220345241231774. [PMID: 38410889 DOI: 10.1177/00220345241231774] [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] [Indexed: 02/28/2024] Open
Abstract
Analyses of National Health and Nutrition Examination Survey (NHANES) data suggested a significant decrease in sealant prevalence among children between 2011 to 2014 and 2015 to 2018. We explore whether this decrease could be associated with possible changes in 1) clinical sealant delivery, 2) dental materials (i.e., increased use of glass ionomer [GI] sealants resulting in an inability to detect sealant fragments that still provide preventive benefits or increased use of composite restorations leading to misclassifying sealants as restorations), and 3) examination sensitivity and specificity. We used NHANES data to estimate the prevalences of sealants, untreated caries, and restorations in ≥1 first permanent molar among children aged 7 to 10 y and used Medical Expenditure Panel Survey data to estimate the annual clinical delivery of sealants and fluoride treatments. We examined changes in outcomes between 2 periods (P < 0.05) controlling for selected sociodemographic characteristics. NHANES sealant examination quality was based on the reference examiner's replicate examinations. The adjusted prevalence of sealants decreased relatively by 27.5% (46.6% vs. 33.8%). Overall, untreated caries decreased. Untreated caries and restoration decreased among children without sealants. Annual clinical sealant delivery did not change, whereas fluoride treatment delivery increased. The decrease in sealant prevalence held when assessed for various age ranges and NHANES cycle combinations. While sealant examination specificity remained similar between the periods, sensitivity (weighted by the proportion of exams by each examiner) decreased relatively by 17.4% (0.92 vs. 0.76). These findings suggest that decreased sealant prevalence was not supported by decreased clinical sealant delivery nor increased use of composite restorations. Decreased examination sensitivity, which could be due to an increased use of GI sealants, could contribute to the decrease in sealant prevalence. The decrease in caries among children without sealants could suggest the increased use of GI sealants. However, we could not rule out that the decrease in caries could be attributable to increased fluoride treatment delivery.
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Affiliation(s)
- M Lin
- Division of Oral Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - S O Griffin
- Division of Oral Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - C H Li
- CyberData Technologies, Inc., Herndon, VA, USA
| | - L Wei
- DB Consulting Group, Inc., Atlanta, GA, USA
| | - L Espinoza
- Division of Oral Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - C Y Wang
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, CDC, Hyattsville, MD, USA
| | - G Thornton-Evans
- Division of Oral Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
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5
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Lee PL, Wu YW, Cheng HM, Wang CY, Chuang LP, Lin CH, Hang LW, Yu CC, Hung CL, Liu CL, Chou KT, Su MC, Cheng KH, Huang CY, Hou CJY, Chiu KL. Recommended assessment and management of sleep disordered breathing in patients with atrial fibrillation, hypertension and heart failure: Taiwan Society of Cardiology/Taiwan Society of sleep Medicine/Taiwan Society of pulmonary and Critical Care Medicine joint consensus statement. J Formos Med Assoc 2024; 123:159-178. [PMID: 37714768 DOI: 10.1016/j.jfma.2023.08.024] [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: 04/16/2023] [Revised: 07/23/2023] [Accepted: 08/23/2023] [Indexed: 09/17/2023] Open
Abstract
Sleep disordered breathing (SDB) is highly prevalent and may be linked to cardiovascular disease in a bidirectional manner. The Taiwan Society of Cardiology, Taiwan Society of Sleep Medicine and Taiwan Society of Pulmonary and Critical Care Medicine established a task force of experts to evaluate the evidence regarding the assessment and management of SDB in patients with atrial fibrillation (AF), hypertension and heart failure with reduced ejection fraction (HFrEF). The GRADE process was used to assess the evidence associated with 15 formulated questions. The task force developed recommendations and determined strength (Strong, Weak) and direction (For, Against) based on the quality of evidence, balance of benefits and harms, patient values and preferences, and resource use. The resulting 11 recommendations are intended to guide clinicians in determining which the specific patient-care strategy should be utilized by clinicians based on the needs of individual patients.
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Affiliation(s)
- Pei-Lin Lee
- Center of Sleep Disorder, National Taiwan University Hospital, Taipei, Taiwan; School of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yen-Wen Wu
- Division of Cardiology, Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Hao-Min Cheng
- Division of Faculty Development, Taipei Veterans General Hospital, Taipei, Taiwan; PhD Program of Interdisciplinary Medicine (PIM), National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan
| | - Cheng-Yi Wang
- Department of Internal Medicine, Cardinal Tien Hospital and School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Li-Pang Chuang
- Sleep Center, Department of Thoracic Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan; School of Medicine, Chang Gung University, Tauyan, Taiwan
| | - Chou-Han Lin
- Division of Respirology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Liang-Wen Hang
- School of Nursing & Graduate Institute of Nursing, China Medical University, Taichung, Taiwan; Sleep Medicine Center, China Medical University Hospital, Taichung, Taiwan
| | - Chih-Chieh Yu
- School of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan; Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chung-Lieh Hung
- Cardiovascular Center, MacKay Memorial Hospital, Taipei, Taiwan; Institute of Biomedical Sciences, Mackay Medical College, Taipei, Taiwan
| | - Ching-Lung Liu
- Division of Chest, Departments of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan; MacKay Medical College, New Taipei City, Taiwan
| | - Kun-Ta Chou
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Division of Clinical Respiratory Physiology, Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Mao-Chang Su
- Sleep Center, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; Department of Respiratory Care, Chang Gung University of Science and Technology, Chiayi, Taiwan
| | - Kai-Hung Cheng
- Kao-Ho Hospital, Kaohsiung, Taiwan; Division of Cardiology, Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan
| | - Chun-Yao Huang
- Division of Cardiology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan; Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Charles Jia-Yin Hou
- Cardiovascular Center, MacKay Memorial Hospital, Taipei, Taiwan; MacKay Medical College, New Taipei City, Taiwan.
| | - Kuo-Liang Chiu
- Division of Chest Medicine, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan; School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan.
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Lan SH, Lai CC, Chang SP, Hsu CC, Chen CH, Wang YH, Huang YL, Wang CY, Lin YS. Corrigendum to <'Efficacy and safety of anti-interleukin-5 therapy in patients with chronic obstructive pulmonary disease: A meta-analysis of randomized, controlled trials'>[J Microbiol Immunol Infect 55 (1) (2022) 26-35]. J Microbiol Immunol Infect 2024; 57:207-208. [PMID: 37858516 DOI: 10.1016/j.jmii.2023.10.003] [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: 10/21/2023]
Affiliation(s)
| | - Chih-Cheng Lai
- Department of Internal Medicine, Kaohsiung Veterans General Hospital, Tainan Branch, Tainan, Taiwan
| | | | - Chun-Chun Hsu
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan; Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Cheng-Hsin Chen
- Department of Internal Medicine, Cardinal Tien Hospital and School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Ya-Hui Wang
- Medical Research Center, Cardinal Tien Hospital and School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Yueh Lan Huang
- Department of Internal Medicine, Cardinal Tien Hospital and School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
| | - Cheng-Yi Wang
- Department of Internal Medicine, Cardinal Tien Hospital and School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
| | - You-Shuei Lin
- Department of Physiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
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7
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Chen CH, Wang CY, Chen CY, Wang YH, Chen KH, Lai CC, Wei YF, Fu PK. The influence of prior use of inhaled corticosteroids on COVID-19 outcomes: A systematic review and meta-analysis. PLoS One 2024; 19:e0295366. [PMID: 38241229 PMCID: PMC10798539 DOI: 10.1371/journal.pone.0295366] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 11/21/2023] [Indexed: 01/21/2024] Open
Abstract
The influence of inhaled corticosteroids (ICS) on COVID-19 outcomes remains uncertain. To address this, we conducted a systematic review and meta-analysis, analyzing 30 studies, to investigate the impact of ICS on patients with COVID-19. Our study focused on various outcomes, including mortality risk, hospitalization, admission to the intensive care unit (ICU), mechanical ventilation (MV) utilization, and length of hospital stay. Additionally, we conducted a subgroup analysis to assess the effect of ICS on patients with chronic obstructive pulmonary disease (COPD) and asthma. Our findings suggest that the prior use of ICS did not lead to significant differences in mortality risk, ICU admission, hospitalization, or MV utilization between individuals who had used ICS previously and those who had not. However, in the subgroup analysis of patients with COPD, prior ICS use was associated with a lower risk of mortality compared to non-users (OR, 0.95; 95% CI, 0.90-1.00). Overall, while the use of ICS did not significantly affect COVID-19 outcomes in general, it may have beneficial effects specifically for patients with COPD. Nevertheless, more research is needed to establish a definitive conclusion on the role of ICS in COVID-19 treatment. PROSPERO registration number: CRD42021279429.
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Affiliation(s)
- Chao-Hsien Chen
- Division of Pulmonary Medicine, Department of Internal Medicine, Taitung MacKay Memorial Hospital, Taitung, Taiwan
- Department of Medicine, MacKey Medical College, New Taipei City, Taiwan
| | - Cheng-Yi Wang
- Department of Internal Medicine, Cardinal Tien Hospital and School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Ching-Yi Chen
- Division of Pulmonary Medicine, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Ya-Hui Wang
- Medical Research Center, Cardinal Tien Hospital and School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Kuang-Hung Chen
- Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chih-Cheng Lai
- Division of Hospital Medicine, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Yu-Feng Wei
- Department of Internal Medicine, E-Da Cancer Hospital, I-Shou University, Kaohsiung, Taiwan
- School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Pin-Kuei Fu
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
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8
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Wu L, Zhang J, Zhang HM, Wang CY. Study on red blood cell distribution width in children with severe Mycoplasma pneumoniae pneumonia. Biomark Med 2024; 18:69-77. [PMID: 38440878 DOI: 10.2217/bmm-2023-0671] [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] [Indexed: 03/06/2024] Open
Abstract
Background: This study aimed to investigate the clinical value of the red blood cell distribution width (RDW) in severe Mycoplasma pneumoniae pneumonia (MPP). Methods: A total of 185 children with diagnosed severe MPP were included. The patients' case records and laboratory examination data were analyzed retrospectively. The children were grouped into quartiles based on RDW. Results: Univariate analysis revealed that RDW was significantly correlated with the Pediatric Risk of Mortality (PRISM) III score, Sepsis-Related Organ Failure Assessment score, incidence of invasive intubation and 30-day in-hospital mortality. After adjustment for the severity of illness, multivariate analysis revealed that the PRISM III score and RDW were factors independently associated with 30-day in-hospital mortality. Conclusion: This study revealed that RDW could be correlated with the long-term prognosis and severity of severe MPP.
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Affiliation(s)
- Lin Wu
- Department of Pediatrics, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology & Pediatrics, Fujian Medical University, Fuzhou, Fujian Province, 350001, China
- Department of Pediatrics, Fujian Maternity and Children Hospital, College of Clinical Medicine for Obstetrics & Gynecology & Pediatrics, Fujian Medical University, Fuzhou, Fujian Province, 350001, China
| | - Jinyan Zhang
- College of Clinical Medicine for Obstetrics & Gynecology & Pediatrics, Fujian Medical University, Fuzhou, Fujian Province, 350001, China
| | - Hui-Min Zhang
- Department of Pediatrics, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology & Pediatrics, Fujian Medical University, Fuzhou, Fujian Province, 350001, China
| | - Cheng-Yi Wang
- Department of Pediatrics, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology & Pediatrics, Fujian Medical University, Fuzhou, Fujian Province, 350001, China
- Department of Pediatrics, Fujian Maternity and Children Hospital, College of Clinical Medicine for Obstetrics & Gynecology & Pediatrics, Fujian Medical University, Fuzhou, Fujian Province, 350001, China
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9
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Roshanov PS, Chan MTV, Borges FK, Conen D, Wang CY, Xavier D, Berwanger O, Marcucci M, Sessler DI, Szczeklik W, Spence J, Alonso-Coello P, Fernández C, Pearse RM, Malaga G, Garg AX, Srinathan SK, Jacka MJ, Tandon V, McGillion M, Popova E, Sigamani A, Abraham V, Biccard BM, Villar JC, Chow CK, Polanczyk CA, Tiboni M, Whitlock R, Ackland GL, Panju M, Lamy A, Sapsford R, Williams C, Wu WKK, Cortés OL, MacNeil SD, Patel A, Belley-Côté EP, Ofori S, McIntyre WF, Leong DP, Heels-Ansdell D, Gregus K, Devereaux PJ. One-year Outcomes after Discharge from Noncardiac Surgery and Association between Predischarge Complications and Death after Discharge: Analysis of the VISION Prospective Cohort Study. Anesthesiology 2024; 140:8-24. [PMID: 37713506 DOI: 10.1097/aln.0000000000004763] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 09/17/2023]
Abstract
BACKGROUND In previous analyses, myocardial injury after noncardiac surgery, major bleeding, and sepsis were independently associated with most deaths in the 30 days after noncardiac surgery, but most of these deaths occurred during the index hospitalization for surgery. The authors set out to describe outcomes after discharge from hospital up to 1 yr after inpatient noncardiac surgery and associations between predischarge complications and postdischarge death up to 1 yr after surgery. METHODS This study was an analysis of patients discharged after inpatient noncardiac surgery in a large international prospective cohort study across 28 centers from 2007 to 2013 of patients aged 45 yr or older followed to 1 yr after surgery. The study estimated (1) the cumulative postdischarge incidence of death and other outcomes up to a year after surgery and (2) the adjusted time-varying associations between postdischarge death and predischarge complications including myocardial injury after noncardiac surgery, major bleeding, sepsis, infection without sepsis, stroke, congestive heart failure, clinically important atrial fibrillation or flutter, amputation, venous thromboembolism, and acute kidney injury managed with dialysis. RESULTS Among 38,898 patients discharged after surgery, the cumulative 1-yr incidence was 5.8% (95% CI, 5.5 to 6.0%) for all-cause death and 24.7% (95% CI, 24.2 to 25.1%) for all-cause hospital readmission. Predischarge complications were associated with 33.7% (95% CI, 27.2 to 40.2%) of deaths up to 30 days after discharge and 15.0% (95% CI, 12.0 to 17.9%) up to 1 yr. Most of the association with death was due to myocardial injury after noncardiac surgery (15.6% [95% CI, 9.3 to 21.9%] of deaths within 30 days, 6.4% [95% CI, 4.1 to 8.7%] within 1 yr), major bleeding (15.0% [95% CI, 8.3 to 21.7%] within 30 days, 4.7% [95% CI, 2.2 to 7.2%] within 1 yr), and sepsis (5.4% [95% CI, 2.2 to 8.6%] within 30 days, 2.1% [95% CI, 1.0 to 3.1%] within 1 yr). CONCLUSIONS One in 18 patients 45 yr old or older discharged after inpatient noncardiac surgery died within 1 yr, and one quarter were readmitted to the hospital. The risk of death associated with predischarge perioperative complications persists for weeks to months after discharge. EDITOR’S PERSPECTIVE
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Affiliation(s)
- Pavel S Roshanov
- Department of Medicine, Western University, London, Canada; Population Health Research Institute, Hamilton, Canada
| | - Matthew T V Chan
- Department of Anaesthesia and Intensive Care, Chinese University of Hong Kong and Prince of Wales Hospital, Hong Kong, Hong Kong
| | - Flavia K Borges
- Department of Medicine, McMaster University, Hamilton, Canada; Population Health Research Institute, Hamilton, Canada
| | - David Conen
- Department of Medicine, McMaster University, Hamilton, Canada; Population Health Research Institute, Hamilton, Canada
| | - C Y Wang
- Honorary Professor; Department of Anesthesiology, University of Malaya, Kuala Lumpur, Malaysia
| | - Denis Xavier
- St. John's Medical College Hospital, Bangalore, India
| | - Otavio Berwanger
- George Institute for Global Health, London, United Kingdom; Imperial College London, London, United Kingdom
| | - Maura Marcucci
- Clinical Epidemiology and Research Centre (CERC), Department of Biomedical Sciences, Humanitas University and IRCCS Humanitas Research Hospital, Milan, Italy; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Daniel I Sessler
- Department of Outcomes Research, Cleveland Clinic, Cleveland, Ohio
| | - Wojciech Szczeklik
- Center for Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Jessica Spence
- Anesthesia and Critical Care, McMaster University, Hamilton, Canada; Population Health Research Institute, Hamilton, Canada
| | - Pablo Alonso-Coello
- Iberoamerican Cochrane Center, Hospital Sant Pau, Barcelona, Spain; Centro de Investigación Biomédica en Red (CIBER) de Epidemiología y Salud Pública, Madrid, Spain
| | - Carmen Fernández
- Department of Anesthesiology and Intensive Care Medicine, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Rupert M Pearse
- Barts and the London School of Medicine & Dentistry, Queen Mary University of London, London, United Kingdom
| | - German Malaga
- Department of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Amit X Garg
- Department of Medicine, University of Western Ontario, London, Canada
| | | | - Michael J Jacka
- Department of Critical Care and Anesthesia, University of Alberta, Edmonton, Canada
| | - Vikas Tandon
- Department of Medicine, McMaster University, Hamilton, Canada
| | - Michael McGillion
- School of Nursing, McMaster University, Hamilton, Canada; Population Health Research Institute, Hamilton, Canada
| | - Ekaterine Popova
- IIB Sant Pau, Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain; Centro Cochrane Iberoamericano, Barcelona, Spain
| | - Alben Sigamani
- Numen Health, Bangalore, India; Narayana Hrudayalaya Health City Bangalore, Bangalore, India
| | - Valsa Abraham
- Christian Medical College and Hospital Ludhiana, Ludhiana, India
| | - Bruce M Biccard
- Department of Anaesthesia and Perioperative Medicine, Groote Schuur Hospital, University of Cape Town, Observatory, South Africa
| | | | - Clara K Chow
- Westmead Applied Research Centre, University of Sydney, Sydney, Australia; Department of Cardiology, Westmead Hospital, Sydney, Australia
| | - Carísi A Polanczyk
- Graduate Program in Epidemiology and Cardiovascular Science, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; Institute for Health Technology Assessment, Porto Alegre, Rio Grande do Sul, Brazil
| | - Maria Tiboni
- Department of Medicine, McMaster University, Hamilton, Canada
| | - Richard Whitlock
- Department of Surgery, McMaster University, Hamilton, Canada; Population Health Research Institute, Hamilton, Canada
| | - Gareth L Ackland
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Mohamed Panju
- Department of Medicine, McMaster University, Hamilton, Canada
| | - André Lamy
- Department of Surgery, McMaster University, Hamilton, Canada; Population Health Research Institute, Hamilton, Canada
| | - Robert Sapsford
- Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Colin Williams
- Royal Liverpool University Hospital, Liverpool, United Kingdom
| | - William Ka Kei Wu
- Department of Anaesthesia and Intensive Care, Chinese University of Hong Kong, New Territories, Hong Kong
| | - Olga L Cortés
- Research Department and Nursing Department, Fundación Cardioinfantil-Instituto de Cardiología, Bogotá DC, Colombia
| | - S Danielle MacNeil
- Schulich School of Medicine and Dentistry, Western University, London, Canada; Otolaryngology-Head & Neck Surgery, London Health Sciences Centre, London, Canada
| | - Ameen Patel
- Department of Medicine, McMaster University, Hamilton, Canada
| | - Emilie P Belley-Côté
- Department of Medicine, McMaster University, Hamilton, Canada; Population Health Research Institute, Hamilton, Canada
| | - Sandra Ofori
- Population Health Research Institute, Hamilton, Canada; Department of Medicine, McMaster University, Hamilton, Canada
| | - William F McIntyre
- Department of Medicine, McMaster University, Hamilton, Canada; Population Health Research Institute, Hamilton, Canada
| | - Darryl P Leong
- Department of Medicine, McMaster University, Hamilton, Canada; Population Health Research Institute, Hamilton, Canada
| | - Diane Heels-Ansdell
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Canada
| | | | - P J Devereaux
- Department of Medicine, McMaster University, Hamilton, Canada; Population Health Research Institute, Hamilton, Canada
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10
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Zhang WJ, Zhang LP, Lin SJ, Wang CY, Le YG. P2 purinergic receptors regulate the progression of colorectal cancer. Purinergic Signal 2023:10.1007/s11302-023-09983-6. [PMID: 38153612 DOI: 10.1007/s11302-023-09983-6] [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: 10/05/2023] [Accepted: 12/12/2023] [Indexed: 12/29/2023] Open
Abstract
More and more studies have revealed that P2 purinergic receptors play a key role in the progression of colorectal cancer (CRC). P2X and P2Y purinergic receptors can be used as promoters and regulators of CRC and play a dual role in the progression of CRC. CRC microenvironment is rich in ATP and its cleavage products (ADP, AMP, Ado), which act as activators of P2X and P2Y purinergic receptors. The activation of P2X and P2Y purinergic receptors regulates the progression of CRC mainly by regulating the function of immune cells and mediating different signal pathways. In this paper, we focus on the specific mechanisms and functional roles of P2X7, P2Y12, and P2Y2 receptors in the growth and progression of CRC. The antagonistic effects of these selective antagonists of P2X purinergic receptors on the growth, invasion, and metastasis of CRC were further discussed. Moreover, different studies have reported that P2X7 receptor can be used as an effective predictor of patients with CRC. All these indicate that P2 purinergic receptors are a key regulator of CRC. Therefore, antagonizing P2 purinergic receptors may be an innovative treatment for CRC.
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Affiliation(s)
- Wen-Jun Zhang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang City, 343000, Jiangxi Province, China
| | - Li-Peng Zhang
- Gastrointestinal Surgery, The Second Affiliated Hospital, Nanchang University, Nanchang City, 343000, Jiangxi Province, China
| | - Si-Jian Lin
- Department of Rehabilitation Medicine, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang City, 343000, Jiangxi Province, China
| | - Cheng-Yi Wang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang City, 343000, Jiangxi Province, China
| | - Yi-Guan Le
- Gastrointestinal Surgery, The Second Affiliated Hospital, Nanchang University, Nanchang City, 343000, Jiangxi Province, China.
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11
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Zhou QH, Song ZH, Jin XD, Liu YH, Qian ZY, Wang CY. [Study on reproductive toxicity of nano-cadmium sulfide with different particle sizes on male mice]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2023; 41:887-892. [PMID: 38195222 DOI: 10.3760/cma.j.cn121094-20220615-00317] [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] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
Objective: To investigate the reproductive toxicity of cadmium sulfide nanoparticles (Nano-CdS) with different particle sizes on male mice. Methods: In January 2019, 30 SPF grade male mice were randomly divided into a control group, an experimental group[CdS Ⅰ group (particle size approximately 5 nm), and a CdS Ⅱ group (particle size approximately 50 nm) ], with 10 mice in each group. The experimental group was orally gavaged with 100 mg/kg, once a day, while the control group was gavaged with an equal volume of physiological saline for 45 consecutive days. After 45 days, levels of cadmium accumulation in testis were determined directly by AAS, deformity and testicular histopathological changes were also observed. Serum testosterone levels were measured by enzyme-linked immunosorbentassay (ELISA), expression levels of P450scc, 17β-HSD and P450c17 mRNA were determined by real-time PCR. P450c17 protein was determinated by Western Blot. Results: The histopathological results showed that the testes of the experimental group mice showed varying degrees of damage; Ultrastructural observation showed that the ultrastructure of mouse testicular cells in each experimental group showed varying degrees of mitochondrial expansion and disappearance of cristae, as well as irregular nuclear membranes. The degree of damage in CdS Ⅰ group was milder than that in CdS Ⅱ group. Compared with the control group, the cadmium content in the testes of the CdS Ⅰ and CdS Ⅱ groups significantly increased (P=0.001, 0.001), and the CdS Ⅱ group was higher than the CdS Ⅰ group (P=0.001). Compared with the control group, the levels of testosterone in the CdS Ⅰ and CdS Ⅱ groups decreased with statistical significance (P=0.001, 0.001). Real time fluorescence quantitative PCR results showed that compared with the control group, the experimental group's P450scc, 17β-HSD. The expression levels of 17β-HSD and P450c17 mRNA were significantly reduced, with statistically significant differences (P=0.001, 0.001, 0.001), and CdS Ⅱ group 17β-HSD. The expression levels of 17β-HSD and P450c17 mRNA were significantly lower than those of CdS Ⅰ group (P=0.001, 0.036). The Western Blot assay results showed that the expression levels of P450c17 protein in the testes of CdS Ⅰ and CdS Ⅱ groups of mice were significantly reduced, with statistical significance (P=0.001, 0.001) ; And the CdS Ⅱ group was significantly lower than the CdS Ⅰ group (P=0.001). According to Spearman correlation analysis, testosterone levels are correlated with P450scc, P450c17, 17β-HSD mRNA. There is a highly positive correlation between 17β-HSD mRNA levels, with statistically significant differences (r(s)=0.88, 0.80, 0.70, P=0.001, 0.001, 0.004) . Conclusion: Nano cadmium sulfide may induce reproductive toxicity by reducing the expression levels of key enzyme genes and enzyme protein activity in testosterone and its synthesis in mice, and the CdS Ⅱ group has a stronger toxic effect.
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Affiliation(s)
- Q H Zhou
- Department of Toxicology, Tianjin Centers for Disease Control and Prevention, Tianjin 300011, China
| | - Z H Song
- Department of Amesthsiology Tianjin Medical University General Hospital, Tianjin 300052, China
| | - X D Jin
- Department of Amesthsiology Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Y H Liu
- Department of Toxicology, Tianjin Centers for Disease Control and Prevention, Tianjin 300011, China
| | - Z Y Qian
- Department of Toxicology, Tianjin Centers for Disease Control and Prevention, Tianjin 300011, China
| | - C Y Wang
- Department of Amesthsiology Tianjin Medical University General Hospital, Tianjin 300052, China
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12
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Wu VC, Chen JY, Lin YH, Wang CY, Lai CC. Assessing the cardiovascular events and clinical outcomes of COVID-19 on patients with primary aldosteronism. J Microbiol Immunol Infect 2023; 56:1158-1168. [PMID: 37827953 DOI: 10.1016/j.jmii.2023.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 07/23/2023] [Revised: 09/12/2023] [Accepted: 09/20/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND Primary Aldosteronism (PA) is a common subtype of hypertension that increases the risk of adverse cardiovascular and kidney events. The impact of COVID-19 on patients with PA is not well understood. This study aimed to investigate the impact of COVID-19 on patients with PA and compare their outcomes with hypertensive patients with essential hypertension. METHODS A cohort study was conducted using data from the Trinetx platform, including 9,817,307 participants enrolled between January 1, 2020, and July 31, 2022. The study group consisted of participants who tested positive for PCR SARS-CoV-2. The primary outcome was critical care and all-cause mortality, while the secondary outcomes were major adverse cardiac events (MACE) or major adverse kidney events (MAKE). The study included 4814 patients with PA and 4814 hypertensive controls. RESULTS Patients with PA had a higher risk of critical outcomes than the hypertensive control group (adjusted hazard ratio [aHR] 1.14, p = 0.001). Moreover, they had higher risks of MACE (aHR 1.32, p < 0.001) and MAKE (aHR 1.36, p < 0.001) for up to 180 days after COVID-19. The analysis of the aHR as a horizon plot after discharge showed that patients with pre-existing PA and COVID-19 had the highest risk of critical outcomes at 7 months (aHR = 1.21), MACE (aHR = 1.35) at 9 months, and MAKE (aHR = 1.47) at 10 months compared to those with EH. CONCLUSIONS This study provides a comprehensive analysis of the cardiovascular impact of the COVID-19 pandemic on individuals with PA. The findings underscore the increased risk of mortality, critical care, MACE, and MAKE among patients with PA and COVID-19. The study highlights the need for continued optimization of strategies for follow-up care for patients with PA after SARS-CoV-2 infections.
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Affiliation(s)
- Vin-Cent Wu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Jui-Yi Chen
- Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Yen-Hung Lin
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Cheng-Yi Wang
- Department of Internal Medicine, Cardinal Tien Hospital and School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
| | - Chih-Cheng Lai
- Division of Hospital Medicine, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan; School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan.
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13
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Wang CY, Liao KM, Wang YH, Chen KH, Chuang S, Liu CJ, Shu CC, Wang HC. Dipeptidyl peptidase IV inhibitors and the risk of mycobacterial pulmonary infections in type 2 diabetes mellitus. J Infect Public Health 2023; 16:1709-1715. [PMID: 37729686 DOI: 10.1016/j.jiph.2023.08.018] [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: 12/25/2022] [Revised: 07/10/2023] [Accepted: 08/22/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (DM) is a risk factor for mycobacterial pulmonary infections (MPI), including tuberculosis (TB) and nontuberculous mycobacterial lung disease (NTM-LD). Dipeptidyl peptidase IV inhibitor (DPP4i), a common DM medication, has an immune-modulation effect that raises concerns about developing MPI. However, there is scarce research on the topic. METHODS This retrospective study was conducted in a tertiary-referral center in Taiwan from 2009 to 2016. Patients with type 2 DM who were receiving any DM medication were enrolled. TB and NTM-LD were defined by microbiological criteria. We analyzed the risk of MPI in DPP4i users using Cox proportional hazard regression with adjusted inverse probability of treatment weighting. RESULTS A total of 9963 patients were included. Among them, 3931 were classified as DPP4i users, and 6032 patients were DPP4i nonusers. DPP4i users had no increase in incidences of MPI (604 vs. 768 per 100,000 person-years, p = 0.776), NTM-LD (174 vs. 255 per 100,000 person-years, p = 0.228), and TB (542 vs. 449 per 100,000 person-years, p = 0.663) relative to those of DPP4i nonusers. After adjustment, the adjusted hazard ratios for MPI (aHR: 1.07, 95% CI: 0.79-1.45), TB (aHR: 1.15, 95% CI: 0.81-1.64) and NTM-LD (aHR: 0.85, 95% CI: 0.49-1.47) were not significantly increased relative to those of nonusers. The subgroup analysis also showed that DPP4i use did not increase the risk of MPI in different DM severities and comorbidities. CONCLUSIONS According to our large cohort study, DPP4i use is safe for patients with type 2 DM and might not increase the risk of MPI.
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Affiliation(s)
- Cheng-Yi Wang
- Department of Internal Medicine, Cardinal Tien Hospital and School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Kuang-Ming Liao
- Department of Internal Medicine, Chi Mei Medical Center, Chiali, Taiwan
| | - Ya-Hui Wang
- Medical Research Center, Cardinal Tien Hospital and School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Kuang-Hung Chen
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Shulin Chuang
- Department of Medical Research, National Taiwan University Hospital, Taipei, Taiwan
| | - Chia-Jung Liu
- National Taiwan University College of Medicine, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsin-Chu country, Taiwan
| | - Chin-Chung Shu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; National Taiwan University College of Medicine, Taipei, Taiwan.
| | - Hao-Chien Wang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; National Taiwan University College of Medicine, Taipei, Taiwan; National Taiwan University Cancer Center, Taipei, Taiwan
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14
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Wei H, Wang CY, Yin YY, Wang Y. [Analysis on morbidity characteristics of occupational diseases in Taian City from 2006 to 2021]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2023; 41:841-845. [PMID: 37935551 DOI: 10.3760/cma.j.cn121094-20220506-00237] [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: 11/09/2023]
Abstract
Objective: To analyze the morbidity characteristics of new occupational diseases in Taian City from 2006 to 2021 and provide scientific evidence for local prevention and treatment of occupational diseases. Methods: In March 2022, the data of newly diagnosed occupational diseases in Taian City from 2006 to 2021 were obtained from Information Monitoring System for Occupational Diseases and Health Hazards. A descriptive analysis was performed for the distribution of onset age, working years, types of occupational diseases, region, industries, enterprise scale, enterprise economic type and the epidemic trend of occupational diseases. Results: 1362 cases of occupational diseases in 29 species of 9 categories were reported in Taian City from 2006 to 2021, including 1311 males and 51 females. The M (P(25), P(75)) of onset age and working age were 53 (47, 64) and 24.08 (16.56, 29.25) respectively. The top three categories of occupational diseases were occupational pneumoconiosis and other respiratory diseases (1128 cases, 82.82%), occupational otolaryngology and oral diseases (107 cases, 7.86%), and occupational chemical poisoning (70 cases, 5.14%) in sequence. Coal worker's pneumoconiosis, noise deafness, silicosis, poisoning of manganese and its compounds and cataract were the top five species of occupational diseases, which accounted for 69.60% (948/1362), 7.64% (104/1362), 5.58% (76/1362), 3.38% (46/1362) and 2.94% (40/1362) of the total cases of occupational diseases.There were significant differences among the composition of occupational diseases categories reported annually (P<0.001), but the number of occupational pneumoconiosis and other respiratory diseases was the highest on each year. The number of occupational diseases showed a decreasing trend with the year, and the optimal fitting curve was an growth curve. The number of newly diagnosed occupational diseases was predicted to be 172 cases from 2022 to 2026. Occupational pneumoconiosis and other respiratory diseases was the main disease in 6 counties. The occupational diseases cases were mainly distributed in Feicheng County and Xintai County, with 520 cases and 504 cases respectively, accounting for 75.18% of occupational diseases cases. The coal mining and washing industry had the largest number of occupational diseases cases, accounting for 73.05% of all occupational diseases cases. 91.85% of occupational diseases cases came from large and medium-sized enterprises. The economic type of enterprises with the most occupational diseases was state-owned enterprises, accounting for 74.52% of occupational diseases cases. Conclusion: The predominant occupational diseases in Taian City are occupational pneumoconiosis and other respiratory diseases, occupational otolaryngology and oral diseases, occupational chemical poisoning. And the prevention and control of occupational diseases should be strengthened in key industries such as coal mining and washing industry, key enterprises such as state-owned large and medium-sized enterprises.
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Affiliation(s)
- H Wei
- Occupational Health Department, Taian Municipal Center for Diseases Control and Prevention, Taian 271000, China
| | - C Y Wang
- Occupational Health Department, Taian Municipal Center for Diseases Control and Prevention, Taian 271000, China
| | - Y Y Yin
- Occupational Health Department, Taian Municipal Center for Diseases Control and Prevention, Taian 271000, China
| | - Y Wang
- Occupational Health Department, Taian Municipal Center for Diseases Control and Prevention, Taian 271000, China
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15
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Rao J, Wang CY, Yao B, Chen ZJ, Zhao KX, Lu W. Meterscale Strong Coupling between Magnons and Photons. Phys Rev Lett 2023; 131:106702. [PMID: 37739385 DOI: 10.1103/physrevlett.131.106702] [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] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/13/2023] [Accepted: 08/09/2023] [Indexed: 09/24/2023]
Abstract
We experimentally realize a meterscale strong coupling effect between magnons and photons at room temperature, with a coherent coupling of ∼20 m and a dissipative coupling of ∼7.6 m. To this end, we integrate a saturable gain into a microwave cavity and then couple this active cavity to a magnon mode via a long coaxial cable. The gain compensates for the cavity dissipation, but preserves the cavity radiation that mediates the indirect photon-magnon coupling. It thus enables the long-range strong photon-magnon coupling. With full access to traveling waves, we demonstrate a remote control of photon-magnon coupling by modulating the phase and amplitude of traveling waves, rather than reconfiguring subsystems themselves. Our method for realizing long-range strong coupling in cavity magnonics provides a general idea for other physical systems. Our experimental achievements may promote the construction of information networks based on cavity magnonics.
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Affiliation(s)
- Jinwei Rao
- School of Physical Science and Technology, ShanghaiTech University, Shanghai 201210, China
| | - C Y Wang
- School of Physical Science and Technology, ShanghaiTech University, Shanghai 201210, China
| | - Bimu Yao
- School of Physical Science and Technology, ShanghaiTech University, Shanghai 201210, China
- State Key Laboratory of Infrared Physics, Shanghai Institute of Technical Physics, Chinese Academy of Sciences, Shanghai 200083, China
| | - Z J Chen
- School of Physical Science and Technology, ShanghaiTech University, Shanghai 201210, China
| | - K X Zhao
- School of Physical Science and Technology, ShanghaiTech University, Shanghai 201210, China
| | - Wei Lu
- School of Physical Science and Technology, ShanghaiTech University, Shanghai 201210, China
- State Key Laboratory of Infrared Physics, Shanghai Institute of Technical Physics, Chinese Academy of Sciences, Shanghai 200083, China
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16
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Liu S, Wang CY, Huang ML, Yang YX, Zhang M. [Mechanisms of trained immunity and impacts on atherosclerosis]. Zhonghua Xin Xue Guan Bing Za Zhi 2023; 51:879-886. [PMID: 37583340 DOI: 10.3760/cma.j.cn112148-20230701-00386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
Affiliation(s)
- S Liu
- Center for Coronary Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - C Y Wang
- Center for Coronary Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - M L Huang
- Center for Coronary Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Y X Yang
- Surgical Center of Structural Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - M Zhang
- Center for Coronary Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
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17
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Yang LQ, Zhu L, Shi X, Miao CH, Yuan HB, Liu ZQ, Gu WD, Liu F, Hu XX, Shi DP, Duan HW, Wang CY, Weng H, Huang ZL, Li LZ, He ZZ, Li J, Hu YP, Lin L, Pan ST, Xu SH, Tang D, Sessler DI, Liu J, Irwin MG, Yu WF. Postoperative pulmonary complications in older patients undergoing elective surgery with a supraglottic airway device or tracheal intubation. Anaesthesia 2023; 78:953-962. [PMID: 37270923 DOI: 10.1111/anae.16030] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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] [Accepted: 03/20/2023] [Indexed: 06/06/2023]
Abstract
The two most commonly used airway management techniques during general anaesthesia are supraglottic airway devices and tracheal tubes. In older patients undergoing elective non-cardiothoracic surgery under general anaesthesia with positive pressure ventilation, we hypothesised that a composite measure of in-hospital postoperative pulmonary complications would be less frequent when a supraglottic airway device was used compared with a tracheal tube. We studied patients aged ≥ 70 years in 17 clinical centres. Patients were allocated randomly to airway management with a supraglottic airway device or a tracheal tube. Between August 2016 and April 2020, 2900 patients were studied, of whom 2751 were included in the primary analysis (1387 with supraglottic airway device and 1364 with a tracheal tube). Pre-operatively, 2431 (88.4%) patients were estimated to have a postoperative pulmonary complication risk index of 1-2. Postoperative pulmonary complications, mostly coughing, occurred in 270 of 1387 patients (19.5%) allocated to a supraglottic airway device and 342 of 1364 patients (25.1%) assigned to a tracheal tube (absolute difference -5.6% (95%CI -8.7 to -2.5), risk ratio 0.78 (95%CI 0.67-0.89); p < 0.001). Among otherwise healthy older patients undergoing elective surgery under general anaesthesia with intra-operative positive pressure ventilation of their lungs, there were fewer postoperative pulmonary complications when the airway was managed with a supraglottic airway device compared with a tracheal tube.
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Affiliation(s)
- L Q Yang
- Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Key Laboratory of Anesthesiology (Shanghai Jiao Tong University), Ministry of Education, Shanghai, China
| | - L Zhu
- Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Key Laboratory of Anesthesiology (Shanghai Jiao Tong University), Ministry of Education, Shanghai, China
| | - X Shi
- Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - C H Miao
- Fudan University Shanghai Cancer Center, Shanghai, China
| | - H B Yuan
- Shanghai Changzheng Hospital, Shanghai, China
| | - Z Q Liu
- Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - W D Gu
- Huadong Hospital, Fudan University, Shanghai, China
| | - F Liu
- West China Hospital, Sichuan University, Chengdu, China
| | - X X Hu
- Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - D P Shi
- Jiading District Central Hospital Affiliated Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - H W Duan
- Shanghai Pudong Hospital Fudan University Pudong Medical Center, Shanghai, China
| | - C Y Wang
- Huangpu Branch of Ninth People's Hospital Affiliated to Medical College of Shanghai Jiao Tong University, Shanghai, China
| | - H Weng
- Shanghai Fengxian District Central Hospital, Shanghai, China
| | - Z L Huang
- Ren Ji Hospital (West) affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - L Z Li
- Shanghai Pudong New Area People's Hospital, Shanghai, China
| | - Z Z He
- Ren Ji Hospital (South) affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - J Li
- First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Y P Hu
- The Second Hospital of Wuxi affiliated to Nanjing Medical University, Wuxi, China
| | - L Lin
- The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - S T Pan
- Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - S H Xu
- Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - D Tang
- Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | | | - J Liu
- West China Hospital, Sichuan University, Chengdu, China
| | - M G Irwin
- Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - W F Yu
- Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Key Laboratory of Anesthesiology (Shanghai Jiao Tong University), Ministry of Education, Shanghai, China
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18
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Zhao XK, Zhu MM, Wang SN, Zhang TT, Wei XN, Wang CY, Zheng J, Zhu WY, Jiang MX, Xu SW, Yang XX, Duan YJ, Zhang BC, Han JH, Miao QR, Hu H, Chen YL. Transcription factor 21 accelerates vascular calcification in mice by activating the IL-6/STAT3 signaling pathway and the interplay between VSMCs and ECs. Acta Pharmacol Sin 2023; 44:1625-1636. [PMID: 36997664 PMCID: PMC10374894 DOI: 10.1038/s41401-023-01077-8] [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: 12/05/2022] [Accepted: 03/13/2023] [Indexed: 03/31/2023] Open
Abstract
Vascular calcification is caused by the deposition of calcium salts in the intimal or tunica media layer of the aorta, which increases the risk of cardiovascular events and all-cause mortality. However, the mechanisms underlying vascular calcification are not fully clarified. Recently it has been shown that transcription factor 21 (TCF21) is highly expressed in human and mouse atherosclerotic plaques. In this study we investigated the role of TCF21 in vascular calcification and the underlying mechanisms. In carotid artery atherosclerotic plaques collected from 6 patients, we found that TCF21 expression was upregulated in calcific areas. We further demonstrated TCF21 expression was increased in an in vitro vascular smooth muscle cell (VSMC) osteogenesis model. TCF21 overexpression promoted osteogenic differentiation of VSMC, whereas TCF21 knockdown in VSMC attenuated the calcification. Similar results were observed in ex vivo mouse thoracic aorta rings. Previous reports showed that TCF21 bound to myocardin (MYOCD) to inhibit the transcriptional activity of serum response factor (SRF)-MYOCD complex. We found that SRF overexpression significantly attenuated TCF21-induced VSMC and aortic ring calcification. Overexpression of SRF, but not MYOCD, reversed TCF21-inhibited expression of contractile genes SMA and SM22. More importantly, under high inorganic phosphate (3 mM) condition, SRF overexpression reduced TCF21-induced expression of calcification-related genes (BMP2 and RUNX2) as well as vascular calcification. Moreover, TCF21 overexpression enhanced IL-6 expression and downstream STAT3 activation to facilitate vascular calcification. Both LPS and STAT3 could induce TCF21 expression, suggesting that the inflammation and TCF21 might form a positive feedback loop to amplify the activation of IL-6/STAT3 signaling pathway. On the other hand, TCF21 induced production of inflammatory cytokines IL-1β and IL-6 in endothelial cells (ECs) to promote VSMC osteogenesis. In EC-specific TCF21 knockout (TCF21ECKO) mice, VD3 and nicotine-induced vascular calcification was significantly reduced. Our results suggest that TCF21 aggravates vascular calcification by activating IL-6/STAT3 signaling and interplay between VSMC and EC, which provides new insights into the pathogenesis of vascular calcification. TCF21 enhances vascular calcification by activating the IL-6-STAT3 signaling pathway. TCF21 inhibition may be a new potential therapeutic strategy for the prevention and treatment of vascular calcification.
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Affiliation(s)
- Xiao-Kang Zhao
- Key Laboratory of Metabolism and Regulation for Major Diseases of Anhui Higher Education Institutes, School of Food and Biological Engineering, Hefei University of Technology, Hefei, 230009, China
| | - Meng-Meng Zhu
- Key Laboratory of Metabolism and Regulation for Major Diseases of Anhui Higher Education Institutes, School of Food and Biological Engineering, Hefei University of Technology, Hefei, 230009, China
| | - Sheng-Nan Wang
- Key Laboratory of Metabolism and Regulation for Major Diseases of Anhui Higher Education Institutes, School of Food and Biological Engineering, Hefei University of Technology, Hefei, 230009, China
| | - Ting-Ting Zhang
- Key Laboratory of Metabolism and Regulation for Major Diseases of Anhui Higher Education Institutes, School of Food and Biological Engineering, Hefei University of Technology, Hefei, 230009, China
| | - Xiao-Ning Wei
- Key Laboratory of Metabolism and Regulation for Major Diseases of Anhui Higher Education Institutes, School of Food and Biological Engineering, Hefei University of Technology, Hefei, 230009, China
| | - Cheng-Yi Wang
- Key Laboratory of Metabolism and Regulation for Major Diseases of Anhui Higher Education Institutes, School of Food and Biological Engineering, Hefei University of Technology, Hefei, 230009, China
| | - Juan Zheng
- Key Laboratory of Metabolism and Regulation for Major Diseases of Anhui Higher Education Institutes, School of Food and Biological Engineering, Hefei University of Technology, Hefei, 230009, China
| | - Wen-Ya Zhu
- Key Laboratory of Metabolism and Regulation for Major Diseases of Anhui Higher Education Institutes, School of Food and Biological Engineering, Hefei University of Technology, Hefei, 230009, China
| | - Mei-Xiu Jiang
- The Institute of Translational Medicine, the National Engineering Research Center for Bioengineering Drugs and the Technologies, Nanchang University, Nanchang, 330031, China
| | - Suo-Wen Xu
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230036, China
- School of Pharmacy, Bengbu Medical College, Bengbu, 233000, China
| | - Xiao-Xiao Yang
- Key Laboratory of Metabolism and Regulation for Major Diseases of Anhui Higher Education Institutes, School of Food and Biological Engineering, Hefei University of Technology, Hefei, 230009, China
| | - Ya-Jun Duan
- Department of Cardiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230036, China
| | - Bu-Chun Zhang
- Department of Cardiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230036, China
| | - Ji-Hong Han
- Key Laboratory of Metabolism and Regulation for Major Diseases of Anhui Higher Education Institutes, School of Food and Biological Engineering, Hefei University of Technology, Hefei, 230009, China
- College of Life Sciences, Key Laboratory of Bioactive Materials of Ministry of Education, Nankai University, Tianjin, 300071, China
| | - Qing R Miao
- Diabetes and Obesity Research Center, New York University Long Island School of Medicine, New York, NY, USA
| | - Hao Hu
- Department of Cardiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230036, China.
| | - Yuan-Li Chen
- Key Laboratory of Metabolism and Regulation for Major Diseases of Anhui Higher Education Institutes, School of Food and Biological Engineering, Hefei University of Technology, Hefei, 230009, China.
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19
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Liu LJ, Li X, Wang CY, Wang AJ, Huang RR, Zhang GW. [Computed tomography manifestations in a case of a giant solid pseudopapillary tumor of the pancreas combined with multi-step metastasis]. Zhonghua Gan Zang Bing Za Zhi 2023; 31:750-751. [PMID: 37580259 DOI: 10.3760/cma.j.cn501113-20230329-00132] [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: 08/16/2023]
Affiliation(s)
- L J Liu
- Department of Radiology, Yantaishan Hospital, Yantai 264001, China
| | - X Li
- Dechengqu Chinese Medical Hospital, Special Inspection Section, Dezhou 253000, China
| | - C Y Wang
- Department of Radiology, Yantaishan Hospital, Yantai 264001, China
| | - A J Wang
- Department of Radiology, Yantaishan Hospital, Yantai 264001, China
| | - R R Huang
- Department of Radiology, Yantaishan Hospital, Yantai 264001, China
| | - G W Zhang
- Department of Radiology, Yantaishan Hospital, Yantai 264001, China
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20
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Tsan SEH, Viknaswaran NL, Cheong CC, Cheah S, Ng KT, Mong SXY, Wang CY. Prophylactic intravenous tranexamic acid and thromboembolism in non-cardiac surgery: a systematic review, meta-analysis and trial sequential analysis. Anaesthesia 2023. [PMID: 37314744 DOI: 10.1111/anae.16058] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2023] [Indexed: 06/15/2023]
Abstract
Tranexamic acid is an antifibrinolytic drug that is widely used during surgery, but there are concerns about its thromboembolic effects. We aimed to investigate the effect of prophylactic intravenous tranexamic acid on thromboembolic outcomes in patients undergoing non-cardiac surgery. The MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials were searched. Randomised controlled trials comparing intravenous tranexamic acid with placebo or no treatment in patients undergoing non-cardiac surgery were included. The primary outcome was a composite of peri-operative cardiovascular thromboembolic events, defined as any deep vein thrombosis, pulmonary embolism, myocardial ischaemia/infarction or cerebral ischaemia/infarction. A total of 191 randomised controlled trials (40,621 patients) were included in the review. The primary outcome occurred in 4.5% of patients receiving intravenous tranexamic acid compared with 4.9% of patients in the control group. Our analysis showed that there was no difference between groups for composite cardiovascular thromboembolic events (risk ratio 1.02, 95%CI 0.94-1.11, p = 0.65, I2 0%, n = 37,512). This finding remained robust when sensitivity analysis was performed with continuity correction and in studies with a low risk of bias. However, in trial sequential analysis, our meta-analysis only achieved 64.6% of the required information size. There was no association between intravenous tranexamic acid and seizure rate or mortality rate within 30 days. Intravenous tranexamic acid was associated with a reduced blood transfusion rate compared with control (9.9% vs. 19.4%, risk ratio 0.46, 95%CI 0.41-0.51, p < 0.0001). It was encouraging to see the evidence that the administration of intravenous tranexamic in patients undergoing non-cardiac surgery was not associated with an increased risk of thromboembolic outcomes. However, our trial sequential analysis demonstrated that currently available evidence is not yet sufficient to reach a firm conclusion.
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Affiliation(s)
- S E H Tsan
- Department of Anaesthesiology and Intensive Care, Faculty of Medicine and Health Sciences, University of Malaysia Sarawak, Malaysia
| | | | - C C Cheong
- Department of Anaesthesia, Faculty of Medicine, University of Malaya, Malaysia
| | - S Cheah
- Department of Anaesthesiology and Intensive Care, Hospital Sultanah Nora Ismail, Batu Pahat, Malaysia
| | - K T Ng
- Department of Anaesthesia, Faculty of Medicine, University of Malaya, Malaysia
| | - S X Y Mong
- Department of Anaesthesiology and Intensive Care, Hospital Raja Permaisuri Bainun, Ipoh, Malaysia
| | - C Y Wang
- Department of Anaesthesiology and Intensive Care, Hospital Sultanah Nora Ismail, Batu Pahat, Malaysia
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21
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Hong SY, Lu YT, Chen SY, Hsu CF, Lu YC, Wang CY, Huang KL. Targeting pathogenic macrophages by the application of SHP-1 agonists reduces inflammation and alleviates pulmonary fibrosis. Cell Death Dis 2023; 14:352. [PMID: 37291088 PMCID: PMC10249559 DOI: 10.1038/s41419-023-05876-z] [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: 10/19/2022] [Revised: 05/07/2023] [Accepted: 05/31/2023] [Indexed: 06/10/2023]
Abstract
Idiopathic pulmonary fibrosis is a progressive fibrotic disorder with no cure that is characterized by deterioration of lung function. Current FDA-approved drugs for IPF delay the decline in lung function, but neither reverse fibrosis nor significantly improve overall survival. SHP-1 deficiency results in hyperactive alveolar macrophages accumulating in the lung, which contribute to the induction of pulmonary fibrosis. Herein, we investigated whether employing a SHP-1 agonist ameliorates pulmonary fibrosis in a bleomycin-induced pulmonary fibrosis murine model. Histological examination and micro-computed tomography images showed that SHP-1 agonist treatment alleviates bleomycin-induced pulmonary fibrosis. Reduced alveolar hemorrhage, lung inflammation, and collagen deposition, as well as enhanced alveolar space, lung capacity, and improved overall survival were observed in mice administered the SHP-1 agonist. The percentage of macrophages collected from bronchoalveolar lavage fluid and circulating monocytes in bleomycin-instilled mice were also significantly reduced by SHP-1 agonist treatment, suggesting that the SHP-1 agonist may alleviate pulmonary fibrosis by targeting macrophages and reshaping the immunofibrotic niche. In human monocyte-derived macrophages, SHP-1 agonist treatment downregulated CSF1R expression and inactivated STAT3/NFκB signaling, culminating in inhibited macrophage survival and perturbed macrophage polarization. The expression of pro-fibrotic markers (e.g., MRC1, CD200R1, and FN1) by IL4/IL13-induced M2 macrophages that rely on CSF1R signaling for their fate-determination was restricted by SHP-1 agonist treatment. While M2-derived medium promoted the expression of fibroblast-to-myofibroblast transition markers (e.g., ACTA2 and COL3A1), the application of SHP-1 agonist reversed the transition in a dose-dependent manner. Our report indicates that pharmacological activation of SHP-1 ameliorates pulmonary fibrosis via suppression of CSF1R signaling in macrophages, reduction of pathogenic macrophages, and the inhibition of fibroblast-to-myofibroblast transition. Our study thus identifies SHP-1 as a druggable target for the treatment of IPF, and suggests that the SHP-1 agonist may be developed as an anti-pulmonary fibrosis medication that both suppresses inflammation and restrains fibroblast-to-myofibroblast transition.
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Affiliation(s)
- Shiao-Ya Hong
- Department of Biotechnology and Laboratory Science in Medicine, National Yang Ming Chiao Tung University, Taipei, 11221, Taiwan
- Medical Research Center, Cardinal Tien Hospital, New Taipei, 23148, Taiwan
| | - Ya-Ting Lu
- Institute of Biomedical Sciences, Academia Sinica, Taipei, 11529, Taiwan
| | - Shih-Yu Chen
- Institute of Biomedical Sciences, Academia Sinica, Taipei, 11529, Taiwan
| | - Chiung-Fang Hsu
- Department of Biotechnology and Laboratory Science in Medicine, National Yang Ming Chiao Tung University, Taipei, 11221, Taiwan
- Medical Research Center, Cardinal Tien Hospital, New Taipei, 23148, Taiwan
| | - Yi-Chun Lu
- Medical Research Center, Cardinal Tien Hospital, New Taipei, 23148, Taiwan
| | - Cheng-Yi Wang
- Department of Internal Medicine, Cardinal Tien Hospital and School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei, 23148, Taiwan.
| | - Kun-Lun Huang
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, 11490, Taiwan.
- Division of Pulmonary and Critical Care Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, 11490, Taiwan.
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22
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Zhang WJ, Li MY, Wang CY, Feng X, Hu DX, Wu LD, Hu JL. P2Y12 receptor involved in the development of chronic nociceptive pain as a sensory information mediator. Biomed Pharmacother 2023; 164:114975. [PMID: 37267639 DOI: 10.1016/j.biopha.2023.114975] [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: 04/16/2023] [Revised: 05/24/2023] [Accepted: 05/30/2023] [Indexed: 06/04/2023] Open
Abstract
Direct or indirect damage to the nervous system (such as inflammation or tumor invasion) can lead to dysfunction and pain. The generation of pain is mainly reflected in the activation of glial cells and the abnormal discharge of sensory neurons, which transmit stronger sensory information to the center. P2Y12 receptor plays important roles in physiological and pathophysiological processes including inflammation and pain. P2Y12 receptor involved in the occurrence of pain as a sensory information mediator, which enhances the activation of microglia and the synaptic plasticity of primary sensory neurons, and reaches the higher center through the ascending conduction pathway (mainly spinothalamic tract) to produce pain. While the application of P2Y12 receptor antagonists (PBS-0739, AR-C69931MX and MRS2359) have better antagonistic activity and produce analgesic pharmacological properties. Therefore, in this article, we discussed the role of the P2Y12 receptor in different chronic pains and its use as a pharmacological target for pain relief.
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Affiliation(s)
- Wen-Jun Zhang
- Department of Rehabilitation Medicine, the Second Affiliated Hospital, Nanchang University, Nanchang City, Jiangxi Province 343000, China
| | - Mei-Yong Li
- Department of Laboratory medicine, the Second Affiliated Hospital, Nanchang University, Nanchang City, Jiangxi Province 343000, China
| | - Cheng-Yi Wang
- Department of Rehabilitation Medicine, the Second Affiliated Hospital, Nanchang University, Nanchang City, Jiangxi Province 343000, China
| | - Xiao Feng
- Department of Rehabilitation Medicine, the Second Affiliated Hospital, Nanchang University, Nanchang City, Jiangxi Province 343000, China
| | - Dong-Xia Hu
- Department of Rehabilitation Medicine, the Second Affiliated Hospital, Nanchang University, Nanchang City, Jiangxi Province 343000, China.
| | - Li-Dong Wu
- Department of Emergency Medicine, the Second Affiliated Hospital, Nanchang University, Nanchang City, Jiangxi Province 343000, China.
| | - Jia-Ling Hu
- Department of Emergency Medicine, the Second Affiliated Hospital, Nanchang University, Nanchang City, Jiangxi Province 343000, China.
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23
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Yang L, Wang CY, Zhang YD, Geng Q, Qin WH. [Determination of cobalt and tungsten in human urine by inductively coupled plasma mass spectrometry]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2023; 41:371-374. [PMID: 37248085 DOI: 10.3760/cma.j.cn121094-20211214-00614] [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: 05/31/2023]
Abstract
Objective: To establish a inductively coupled plasma mass spectrometry method for the determination of trace cobalt and tungsten in human urine. Methods: The authors used 1% nitric acid solution as diluent in October-December 2021, the sample dilution factor and internal standard element were optimized by single factor rotation experiment, and the difference between the working curve and the standard curve was compared. Results: The method uses working curve to determine cobalt and tungsten in urine, the linear range of this method was 0.0~10.0 μg/L, the correlation coefficient was 0.999 9, the detection limits respectively were 0.005 μg/L (cobalt) and 0.09 μg/L (tungsten), the recoveries of samples respectively were 87.0%~100.2% (cobalt) and 89.4%~104.8% (tungsten), the relative standard deviations respectively were 0.4%~4.4% (cobalt) and 0.6%~3.8% (tungsten) . Conclusion: A simple and rapid method for determination of cobalt and tungsten in urine has been established. This method has the advantages of simple operation, high sensitivity, low detection limit and good stability. It is suitable for determination of cobalt and tungsten in urine of all kinds of people.
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Affiliation(s)
- L Yang
- The Third People's Hospital of Henan Province (Henan Hospital for Occupational Diseases) Occupational and Environmental Testing and Inspection Center, Henan Provincial Key Laboratory of Chemical Toxicology Detection, Zhengzhou 450052, China
| | - C Y Wang
- The Third People's Hospital of Henan Province (Henan Hospital for Occupational Diseases) Occupational and Environmental Testing and Inspection Center, Henan Provincial Key Laboratory of Chemical Toxicology Detection, Zhengzhou 450052, China
| | - Y D Zhang
- The Third People's Hospital of Henan Province (Henan Hospital for Occupational Diseases) Occupational and Environmental Testing and Inspection Center, Henan Provincial Key Laboratory of Chemical Toxicology Detection, Zhengzhou 450052, China
| | - Q Geng
- The Third People's Hospital of Henan Province (Henan Hospital for Occupational Diseases) Occupational and Environmental Testing and Inspection Center, Henan Provincial Key Laboratory of Chemical Toxicology Detection, Zhengzhou 450052, China
| | - W H Qin
- The Third People's Hospital of Henan Province (Henan Hospital for Occupational Diseases) Occupational and Environmental Testing and Inspection Center, Henan Provincial Key Laboratory of Chemical Toxicology Detection, Zhengzhou 450052, China
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24
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Guan J, Wang LL, Wang CY, Zhu XM, Shuai HZ, Yi X, Zou L, Yu D, Cheng H. [A new form of familial platelet disorder caused by germline mutations in RUNX1 in a pedigree]. Zhonghua Nei Ke Za Zhi 2023; 62:393-400. [PMID: 37032134 DOI: 10.3760/cma.j.cn112138-20220414-00273] [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: 04/11/2023]
Abstract
Objective: To investigate the clinical and biological characteristics of familial platelet disorder (FPD) with germline Runt-related transcription factor (RUNX) 1 mutations. Methods: Patients diagnosed with myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML) with RUNX1 mutations from February 2016 to December 2021 in Wuhan No.1 Hospital underwent pedigree analysis and were screened for gene mutations (somatic and germline). Patients diagnosed with FPD with germline RUNX1 mutations were enrolled and evaluated in terms of clinical characteristics and biological evolution. Bioinformatics analysis was used to assess the pathogenicity of mutations and to analyze the effect of mutated genes on the function of the corresponding protein. Results: Germline RUNX1 mutations were detected in three out of 34 patients suffering from MDS/AML who had RUNX1 mutations. A pedigree of FPD with RUNX1 (RUNX1-FPD) c.562A>C and RUNX1 c.1415T>C mutations was diagnosed, and the mutations were of patrilineal origin. Bioinformatics analysis indicated that the locus at positions 188 and 472 in the AML-1G type of RUNX1 was highly conserved across different species, and that variations might influence functions of the proteins. The mutations were evaluated to be highly pathogenic. Of the nine cases with germline RUNX1 mutations: two patients died due AML progression; one case with AML survived without leukemia after transplantation of hemopoietic stem cells; four patients showed mild-to-moderate thrombocytopenia; two cases had no thrombocytopenia. During the disease course of the proband and her son, mutations in RUNX1, NRAS and/or CEBPA and KIT appeared in succession, and expression of cluster of differentiation-7 on tumor cells was enhanced gradually. None of the gene mutations correlated with the tumor were detected in the four cases not suffering from MDS/AML, and they survived until the end of follow-up. Conclusions: RUNX1-FPD was rare. The mutations c.562A>C and c.1415T>C of RUNX1 could be the disease-causing genes for the family with RUNX1-FPD, and these mutations could promote malignant transformation. Biological monitoring should be carried out regularly to aid early intervention for family members with RUNX1-FPD.
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Affiliation(s)
- J Guan
- The Department of Hematology, Wuhan No.1 Hospital, Wuhan 430022, China
| | - L L Wang
- The Department of Hematology, Wuhan No.1 Hospital, Wuhan 430022, China
| | - C Y Wang
- The Department of Hematology, Tongji Hospital of Huazhong University of Science and Technology, Wuhan 430074, China
| | - X M Zhu
- Department of Lymphoma, Hubei Cancer Hospital, Wuhan 430079, China
| | - H Z Shuai
- The Department of Hematology, Wuhan No.1 Hospital, Wuhan 430022, China
| | - X Yi
- The Department of Hematology, Wuhan No.1 Hospital, Wuhan 430022, China
| | - L Zou
- The Department of Hematology, Wuhan No.1 Hospital, Wuhan 430022, China
| | - D Yu
- The Department of Hematology, Wuhan No.1 Hospital, Wuhan 430022, China
| | - H Cheng
- The Department of Hematology, Wuhan No.1 Hospital, Wuhan 430022, China
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25
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Wang CY, Tian R, Li JX, Zhu YM. Nickel/Copper Cooperative Catalysis Decarbonylative Heteroarylation of Aryl Anhydrides with Benzoxazoles via C-O/C-H Coupling. J Org Chem 2023; 88:3378-3385. [PMID: 36579720 DOI: 10.1021/acs.joc.2c01449] [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: 12/30/2022]
Abstract
A new strategy for the synthesis of 2-arylbenzoxazole derivatives via nickel-/copper-catalyzed decarbonylative heteroarylation of aryl anhydrides via C-O/C-H coupling has been developed. The reaction is promoted by a user-friendly, inexpensive, and air- and moisture-stable Ni precatalyst. A variety of 2-arylbenzoxazole derivatives have been successfully synthesized and have good functional group tolerance in this process, which afforded products in moderate-to-excellent yields.
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Affiliation(s)
- Cheng-Yi Wang
- College of Pharmaceutical Sciences, Soochow University, Suzhou215123, China
| | - Rui Tian
- College of Pharmaceutical Sciences, Soochow University, Suzhou215123, China
| | - Jia-Xin Li
- College of Pharmaceutical Sciences, Soochow University, Suzhou215123, China
| | - Yong-Ming Zhu
- College of Pharmaceutical Sciences, Soochow University, Suzhou215123, China
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26
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He XY, Zhu MM, Zheng J, Wang CY, Zhao XK, Zhang BT, Zhou DC, Zhang S, Yang XX, Duan YJ, Han JH, Chen YL. Liver X receptor agonists exert antitumor effects against hepatocellular carcinoma via inducing REPS2 expression. Acta Pharmacol Sin 2023; 44:635-646. [PMID: 35995867 PMCID: PMC9958117 DOI: 10.1038/s41401-022-00961-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 03/02/2022] [Accepted: 07/13/2022] [Indexed: 11/08/2022] Open
Abstract
Recent studies show that liver X receptor (LXR) agonists exert significant antitumor effects in a variety of tumor cell lines including hepatocellular carcinoma (HCC). But the molecular mechanisms underlying LXR antitumor activity are not fully understood. In this study we investigated the effect of LXR agonist T0901317 (T317) on HCC development and its relationship with RalA binding protein 1 (RALBP1)-associated EPS domain containing 2 (REPS2)/epidermal growth factor receptor (EGFR) signaling axis. We showed that T317 (0.1-0.5 μM) dose-dependently increased REPS2 expression in normal hepatocytes (BNLCL.2 and LO2) and HCC cells (HepG2 and Huh-7). Using promoter activity assay and chromatin immunoprecipitation (CHIP) assay we demonstrated that T317 enhanced REPS2 expression at the transcriptional level via promoting the binding of LXR protein to the LXR-response element (LXRE) in the REPS2 promoter region. We showed that the inhibitory effect of T317 on the proliferation and migration of HCC cells was closely related to REPS2. Moreover, we revealed that T317 (400 nM) increased expression of REPS2 in HepG2 cells, thus inhibiting epidermal growth factor (EGF)-mediated endocytosis of EGFR as well as the downstream activation of AKT/NF-κB, p38MAPK, and ERK1/2 signaling pathways. Clinical data analysis revealed that REPS2 expression levels were inversely correlated with the development of HCC and reduced REPS2 expression associated with poor prognosis, suggesting that REPS2 might be involved in the development of HCC. In conclusion, this study provides new insights into the potential mechanisms of LXR agonist-inhibited HCC.
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Affiliation(s)
- Xiao-Yu He
- Key Laboratory of Metabolism and Regulation for Major Diseases of Anhui Higher Education Institutes, College of Food and Biological Engineering, Hefei University of Technology, Hefei, 230009, China
| | - Meng-Meng Zhu
- Key Laboratory of Metabolism and Regulation for Major Diseases of Anhui Higher Education Institutes, College of Food and Biological Engineering, Hefei University of Technology, Hefei, 230009, China
| | - Juan Zheng
- Key Laboratory of Metabolism and Regulation for Major Diseases of Anhui Higher Education Institutes, College of Food and Biological Engineering, Hefei University of Technology, Hefei, 230009, China
| | - Cheng-Yi Wang
- Key Laboratory of Metabolism and Regulation for Major Diseases of Anhui Higher Education Institutes, College of Food and Biological Engineering, Hefei University of Technology, Hefei, 230009, China
| | - Xiao-Kang Zhao
- Key Laboratory of Metabolism and Regulation for Major Diseases of Anhui Higher Education Institutes, College of Food and Biological Engineering, Hefei University of Technology, Hefei, 230009, China
| | - Bao-Tong Zhang
- Department of Human Cell Biology and Genetics, Southern University of Science and Technology, School of Medicine, Shenzhen, 518055, China
| | - Da-Chen Zhou
- Department of General Surgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, China
| | - Shuang Zhang
- Key Laboratory of Metabolism and Regulation for Major Diseases of Anhui Higher Education Institutes, College of Food and Biological Engineering, Hefei University of Technology, Hefei, 230009, China
| | - Xiao-Xiao Yang
- Key Laboratory of Metabolism and Regulation for Major Diseases of Anhui Higher Education Institutes, College of Food and Biological Engineering, Hefei University of Technology, Hefei, 230009, China
| | - Ya-Jun Duan
- Key Laboratory of Metabolism and Regulation for Major Diseases of Anhui Higher Education Institutes, College of Food and Biological Engineering, Hefei University of Technology, Hefei, 230009, China
| | - Ji-Hong Han
- College of Life Sciences, Key Laboratory of Bioactive Materials of Ministry of Education, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin, 300071, China.
| | - Yuan-Li Chen
- Key Laboratory of Metabolism and Regulation for Major Diseases of Anhui Higher Education Institutes, College of Food and Biological Engineering, Hefei University of Technology, Hefei, 230009, China.
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27
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Rao JW, Yao B, Wang CY, Zhang C, Yu T, Lu W. Unveiling a Pump-Induced Magnon Mode via Its Strong Interaction with Walker Modes. Phys Rev Lett 2023; 130:046705. [PMID: 36763434 DOI: 10.1103/physrevlett.130.046705] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 11/16/2022] [Accepted: 01/05/2023] [Indexed: 06/18/2023]
Abstract
We observe a power-dependent anticrossing of Walker spin-wave modes under microwave pumping when a ferrimagnet is placed in a microwave waveguide that does not support any discrete photon mode. We interpret this unexpected anticrossing as the generation of a pump-induced magnon mode that couples strongly to the Walker modes of the ferrimagnet. This anticrossing inherits an excellent tunability from the pump, which allows us to control the anticrossing via the pump power, frequency, and waveform. Further, we realize a remarkable functionality of this anticrossing, namely, a microwave frequency comb, in terms of the nonlinear interaction that mixes the pump and probe frequencies. Such a frequency comb originates from the magnetic dynamics and thereby does not suffer from the charge noise. The unveiled hybrid magnonics driven away from its equilibrium enriches the utilization of anticrossing for coherent information processing.
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Affiliation(s)
- J W Rao
- School of Physical Science and Technology, ShanghaiTech University, Shanghai 201210, China
| | - Bimu Yao
- School of Physical Science and Technology, ShanghaiTech University, Shanghai 201210, China
- State Key Laboratory of Infrared Physics, Shanghai Institute of Technical Physics, Chinese Academy of Sciences, Shanghai 200083, China
| | - C Y Wang
- School of Physical Science and Technology, ShanghaiTech University, Shanghai 201210, China
| | - C Zhang
- School of Physical Science and Technology, ShanghaiTech University, Shanghai 201210, China
| | - Tao Yu
- School of Physics, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Wei Lu
- School of Physical Science and Technology, ShanghaiTech University, Shanghai 201210, China
- State Key Laboratory of Infrared Physics, Shanghai Institute of Technical Physics, Chinese Academy of Sciences, Shanghai 200083, China
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28
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Chang L, Wang CY, Li ZH, Zhou DB, Cao XX. [Low-oxygen-affinity hemoglobinopathy Hemoglobin Sunshine Seth: a case report and literature review]. Zhonghua Xue Ye Xue Za Zhi 2023; 44:72-74. [PMID: 36987728 PMCID: PMC10067374 DOI: 10.3760/cma.j.issn.0253-2727.2023.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Affiliation(s)
- L Chang
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730 China
| | - C Y Wang
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730 China
| | - Z H Li
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730 China
| | - D B Zhou
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730 China
| | - X X Cao
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730 China
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29
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Hong SY, Lai CC, Teng NC, Chen CH, Hsu CC, Chan NJ, Wang CY, Wang YH, Lin YS, Chen L. Premorbid use of selective beta-blockers improves sepsis incidence and course: Human cohort and animal model studies. Front Med (Lausanne) 2023; 10:1105894. [PMID: 37144032 PMCID: PMC10151496 DOI: 10.3389/fmed.2023.1105894] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 03/22/2023] [Indexed: 05/06/2023] Open
Abstract
Introduction Beta-blockers are widely prescribed to manage hypertension and cardiovascular diseases and have been suggested as an attractive therapy to improve the prognosis of sepsis. Herein, we investigated the potential benefits of premorbid selective beta-blocker use in sepsis with a real-world database and explored the underlying mechanism by in vivo and in vitro experiments. Methods A total of 64,070 sepsis patients and 64,070 matched controls who were prescribed at least one anti-hypertensive drug for more than 300 days within 1 year were selected for the nested case-control study. Female C57BL/6 J mice and THP-1 cells stimulated with lipopolysaccharide (LPS) were used for studying systemic responses during sepsis to validate our clinical findings. Results The risk of sepsis was lower in current selective beta-blocker users than in non-users (adjusted OR (aOR), 0.842; 95% CI, 0.755-0.939), and in recent users than in non-users (aOR, 0.773; 95% CI, 0.737-0.810). A mean daily dose of ≥0.5 DDD was associated with a lower risk of sepsis (aOR, 0.7; 95% CI, 0.676-0.725). Metoprolol, atenolol, and bisoprolol users had lower risk of sepsis than non-users. In a LPS-induced sepsis mouse model, mice pre-fed with atenolol had significantly reduced mortality. While atenolol had some mild effects on LPS-induced release of inflammatory cytokines in septic mice, it significantly reduced serum soluble PD-L1 levels. Notably, atenolol treatment reversed the negative correlation of sPD-L1 with inflammatory cytokines in septic mice. Moreover, atenolol markedly downregulated the PD-L1 expression on LPS-stimulated THP-1 monocytes/macrophages via targeting ROS-induced NF-κB and STAT3 activation. Conclusion Atenolol pretreatment can reduce sepsis mortality in mice, and in vivo and in vitro studies of PD-L1 expression suggest a role for atenolol in the modulation of immune homeostasis. These findings may contribute to the reduced incidence of sepsis in hypertensive patients with premorbid treatment with selective beta-blockers, especially atenolol.
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Affiliation(s)
- Shiao-Ya Hong
- Department of Biotechnology and Laboratory Science in Medicine, National Yang Ming Chiao Tung University, Taipei City, Taiwan
- Medical Research Center, Cardinal Tien Hospital, New Taipei City, Taiwan
| | - Chih-Cheng Lai
- Division of Hospital Medicine, Department of Internal Medicine, Chi Mei Medical Center, Tainan City, Taiwan
| | - Nai-Chi Teng
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
| | - Chao-Hsien Chen
- Division of Pulmonary Medicine, Department of Internal Medicine, MacKay Memorial Hospital, Taipei City, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
| | - Chun-Chun Hsu
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei City, Taiwan
| | - Nai-Ju Chan
- Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei City, Taiwan
| | - Cheng-Yi Wang
- Department of Internal Medicine, Cardinal Tien Hospital and School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
- *Correspondence: Cheng-Yi Wang,
| | - Ya-Hui Wang
- Medical Research Center, Cardinal Tien Hospital, New Taipei City, Taiwan
- Ya-Hui Wang,
| | - You Shuei Lin
- Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei City, Taiwan
- Department of Physiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan
- You Shuei Lin,
| | - Likwang Chen
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
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Huang YW, Chen Y, Wang CY, Wu L. [Impact of late sodium current inhibition on cardiac electrophysiology parameters and ventricular arrhythmias in isolated Langendorff perfused rabbit hearts with short QT interval]. Zhonghua Xin Xue Guan Bing Za Zhi 2022; 50:1087-1093. [PMID: 36418277 DOI: 10.3760/cma.j.cn112148-20220705-00518] [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 determine the electrophysiological effects and related mechanisms of late sodium current inhibitors on hearts with short QT intervals. Methods: The electrophysiological study was performed on isolated Langendorff perfused rabbit hearts. A total of 80 New Zealand White rabbits were used and 34 hearts without drug treatment were defined as control group A, these hearts were then treated with IKATP opener pinacidil, defined as pinacidil group A. Then, 27 hearts from pinacidil group A were selected to receive combined perfusion with sodium channel inhibitors or quinidine, a traditional drug used to treat short QT syndrome, including ranolazine combined group (n=9), mexiletine combined group (n=9), and quinidine combined group (n=9). Nineteen out of the remaining 46 New Zealand rabbits were selected as control group B (no drug treatments, n=19), and then treated with pinacidil, defined as pinacidil group B (n=19). The remaining 27 rabbits were treated with sodium inhibitors or quinidine alone, including ranolazine alone group (n=9), mexiletine alone group (n=9), and quinidine alone group (n=9). Electrocardiogram (ECG) physiological parameters of control group A and pinacidil group A were collected. In control group B and pinacidil group B, programmed electrical stimulation was used to induce ventricular arrhythmias and ECG was collected. ECG physiological parameters and ventricular arrhythmia status of various groups were analyzed. The concentrations of pinacidil, ranolazine, mexiletine and quinidine used in this study were 30, 10, 30 and 1 μmol/L, respectively. Results: Compared with control group A, the QT interval, 90% of the repolarization in epicardial and endocardial monophasic action potential duration (MAPD90-Epi, MAPD90-Endo) was shortened, the transmural dispersion of repolarization (TDR) was increased, and the effective refractor period (ERP) and post-repolarization refractoriness (PRR) were reduced in pinacidil group A (all P<0.05). Compared with the pinacidil group A, MAPD90-Epi, MAPD90-Endo, QT interval changes were reversed in quinidine combined group and mexiletine combined group (all P<0.05), but not in ranolazine combined group. All these three drugs reversed the pinacidil-induced increases of TDR and the decreases of ERP and PRR. The induced ventricular arrhythmia rate was 0 in control group B, and increased to 10/19 (χ2=13.6, P<0.05) in pinacidil group B during programmed electrical stimulation. Compared with the pinacidil group B, incidences of ventricular arrhythmia decreased to 11% (1/9), 11% (1/9) and 0 (0/9) (χ2=4.5, 4.5, 7.4, P<0.05) respectively in ranolazine group, mexiletine group and quinidine group. Conclusions: Inhibition of late sodium current does not increase but even decreases the risk of malignant arrhythmia in hearts with a shortened QT interval. The antiarrhythmic mechanism might be associated with the reversal of the increase of TDR and the decrease of refractoriness (including both ERP and PRR) of hearts with shortened QT interval.
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Affiliation(s)
- Y W Huang
- Department of Cardiology, Peking University First Hospital, Beijing 100034, China
| | - Y Chen
- Department of Cardiology, Peking University First Hospital, Beijing 100034, China
| | - C Y Wang
- Department of Cardiology, Peking University First Hospital, Beijing 100034, China
| | - L Wu
- Department of Cardiology, Peking University First Hospital, Beijing 100034, China
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Wang QW, Zhang W, Zhu ZM, Jia CY, Wang CY, Zhang RL, Zhang Y, Wang QF, Dou JG, Wen J. [Evaluation of bladder function and sleep patterns in children with primary mono-symptomatic nocturnal enuresis by polysomnography combined with ambulatory urodynamic monitoring]. Zhonghua Yi Xue Za Zhi 2022; 102:2994-3000. [PMID: 36229199 DOI: 10.3760/cma.j.cn112137-20220122-00169] [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 evaluate the bladder function and sleep pattern in the children with primary mono-symptomatic nocturnal enuresis (PMNE) by the polysomnography (PSG) and ambulatory urodynamic monitoring (AUM). Methods: From October 2019 to October 2021, forty-three patients with PMNE were selected as PMNE group from the First Affiliated Hospital of Zhengzhou University and further subdivided into the severe PMNE group (enuresis>4 times/week) and the non-severe PMNE group (enuresis times 4 times/week) according to the severity. The conventional urodynamics (CUD), AUM, and PSG examinations and bladder diary were completed in the PMNE group. The control group consisted of 23 children with normal PSG findings and without the lower urinary tract symptoms. Results: The severe PMNE group included 9 males and 14 females, aged(12.1±3.2)years, and nocturnal enuresis number per week is 6.7±1.7. The non-severe PMNE group included 9 males and 11 females, aged(12.0±3.4)years, and nocturnal enuresis number per week is 2.3±1.0. The incidences of nocturnal polyuria and the reduction in maximum bladder capacity in the PMNE group was 34.9% and 11.6%, respectively. The incidence and frequency of detrusor overactivity (DO) in the severe PMNE group were significantly higher than those in the non-severe PMNE group [78.3% vs 45.0%, (5.5±1.8) times/h vs (3.4±1.0) times/h, respectively, all P<0.05]. It was found by the PSG that the severe PMNE group had significantly higher cortical arousal index, apnea hypopnea index (AHI), and percentage of N1+N2 phase in total sleep time, compared with the control group[(58.6±9.8)% vs (49.3±9.5)%, (9.4±4.4) times/h vs (3.1±1.5) times/h, (2.7±0.9) times/h vs (0.9±0.7) times/h] (all P<0.05). While the sleep efficiency of the severe PMNE group was substantially lower than that of the non-severe PMNE group [(86.4±4.3)% vs (91.0±3.9)%], the cortical arousal index and AHI were significantly greater than those of the non-severe PMNE group[(9.4±4.4) times/h vs (5.7±3.2) times/h, (2.7±0.9) times/h vs (1.9±0.7) times/h] (all P<0.05). In the PMNE group, there were positive correlations between cortical arousal index and nocturnal DO frequency or AHI (r=0.705, 0.765, P=0.001). Conclusions: Children with PMNE have nocturnal bladder dysfunction and abnormal sleep pattern, and there is a certain correlation between them. PSG and AUM are necessary for the evaluation and treatment of children with PMNE.
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Affiliation(s)
- Q W Wang
- Department of Urology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - W Zhang
- Department of Urology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Z M Zhu
- Department of Urology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - C Y Jia
- Department of Urology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - C Y Wang
- Department of Urology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - R L Zhang
- Department of Urology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Y Zhang
- Department of Urodynamic Center, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Q F Wang
- Department of Urology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - J G Dou
- Department of Urology, the First Affiliated Hospital of Xinxiang Medical University, Xinxiang 453100, China
| | - Jianguo Wen
- Henan Joint International Pediatric Urodynamic Laboratory, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
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Wang CY, Xu HM, Tian J, Hong SQ, Liu G, Wang SX, Gao F, Liu J, Liu FR, Yu H, Wu X, Chen BQ, Shen FF, Zheng G, Yu J, Shu M, Liu L, Du LJ, Li P, Xu ZW, Zhu MQ, Huang LS, Huang HY, Li HB, Huang YY, Wang D, Wu F, Bai ST, Tang JJ, Shan QW, Lan LC, Zhu CH, Xiong Y, Tian JM, Wu JH, Hao JH, Zhao HY, Lin AW, Song SS, Lin DJ, Zhou QH, Guo YP, Wu JZ, Yang XQ, Zhang XH, Guo Y, Cao Q, Luo LJ, Tao ZB, Yang WK, Zhou YK, Chen Y, Feng LJ, Zhu GL, Zhang YH, Xue P, Li XQ, Tang ZZ, Zhang DH, Su XW, Qu ZH, Zhang Y, Zhao SY, Qi ZZ, Pang L, Wang CY, Deng HL, Liu XL, Chen YH, Shu S. [A multicenter epidemiological study of acute bacterial meningitis in children]. Zhonghua Er Ke Za Zhi 2022; 60:1045-1053. [PMID: 36207852 DOI: 10.3760/cma.j.cn112140-20220608-00522] [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 analyze the clinical epidemiological characteristics including composition of pathogens , clinical characteristics, and disease prognosis acute bacterial meningitis (ABM) in Chinese children. Methods: A retrospective analysis was performed on the clinical and laboratory data of 1 610 children <15 years of age with ABM in 33 tertiary hospitals in China from January 2019 to December 2020. Patients were divided into different groups according to age,<28 days group, 28 days to <3 months group, 3 months to <1 year group, 1-<5 years of age group, 5-<15 years of age group; etiology confirmed group and clinically diagnosed group according to etiology diagnosis. Non-numeric variables were analyzed with the Chi-square test or Fisher's exact test, while non-normal distrituction numeric variables were compared with nonparametric test. Results: Among 1 610 children with ABM, 955 were male and 650 were female (5 cases were not provided with gender information), and the age of onset was 1.5 (0.5, 5.5) months. There were 588 cases age from <28 days, 462 cases age from 28 days to <3 months, 302 cases age from 3 months to <1 year of age group, 156 cases in the 1-<5 years of age and 101 cases in the 5-<15 years of age. The detection rates were 38.8% (95/245) and 31.5% (70/222) of Escherichia coli and 27.8% (68/245) and 35.1% (78/222) of Streptococcus agalactiae in infants younger than 28 days of age and 28 days to 3 months of age; the detection rates of Streptococcus pneumonia, Escherichia coli, and Streptococcus agalactiae were 34.3% (61/178), 14.0% (25/178) and 13.5% (24/178) in the 3 months of age to <1 year of age group; the dominant pathogens were Streptococcus pneumoniae and the detection rate were 67.9% (74/109) and 44.4% (16/36) in the 1-<5 years of age and 5-<15 years of age . There were 9.7% (19/195) strains of Escherichia coli producing ultra-broad-spectrum β-lactamases. The positive rates of cerebrospinal fluid (CSF) culture and blood culture were 32.2% (515/1 598) and 25.0% (400/1 598), while 38.2% (126/330)and 25.3% (21/83) in CSF metagenomics next generation sequencing and Streptococcus pneumoniae antigen detection. There were 4.3% (32/790) cases of which CSF white blood cell counts were normal in etiology confirmed group. Among 1 610 children with ABM, main intracranial imaging complications were subdural effusion and (or) empyema in 349 cases (21.7%), hydrocephalus in 233 cases (14.5%), brain abscess in 178 cases (11.1%), and other cerebrovascular diseases, including encephalomalacia, cerebral infarction, and encephalatrophy, in 174 cases (10.8%). Among the 166 cases (10.3%) with unfavorable outcome, 32 cases (2.0%) died among whom 24 cases died before 1 year of age, and 37 cases (2.3%) had recurrence among whom 25 cases had recurrence within 3 weeks. The incidences of subdural effusion and (or) empyema, brain abscess and ependymitis in the etiology confirmed group were significantly higher than those in the clinically diagnosed group (26.2% (207/790) vs. 17.3% (142/820), 13.0% (103/790) vs. 9.1% (75/820), 4.6% (36/790) vs. 2.7% (22/820), χ2=18.71, 6.20, 4.07, all P<0.05), but there was no significant difference in the unfavorable outcomes, mortility, and recurrence between these 2 groups (all P>0.05). Conclusions: The onset age of ABM in children is usually within 1 year of age, especially <3 months. The common pathogens in infants <3 months of age are Escherichia coli and Streptococcus agalactiae, and the dominant pathogen in infant ≥3 months is Streptococcus pneumoniae. Subdural effusion and (or) empyema and hydrocephalus are common complications. ABM should not be excluded even if CSF white blood cell counts is within normal range. Standardized bacteriological examination should be paid more attention to increase the pathogenic detection rate. Non-culture CSF detection methods may facilitate the pathogenic diagnosis.
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Affiliation(s)
- C Y Wang
- Department of Infectious Diseases, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310052, China
| | - H M Xu
- Department of Infectious Diseases, Children's Hospital of Chongqing Medical University, Chongqing 400014, China
| | - J Tian
- Department of Infectious Diseases, Children's Hospital of Chongqing Medical University, Chongqing 400014, China
| | - S Q Hong
- Department of Infectious Diseases, Children's Hospital of Chongqing Medical University, Chongqing 400014, China
| | - G Liu
- Department of Infectious Diseases, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
| | - S X Wang
- Department of Infectious Diseases, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
| | - F Gao
- Department of Infectious Diseases, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310052, China
| | - J Liu
- Department of Infectious Diseases, Hunan Children's Hospital, Changsha 410007, China
| | - F R Liu
- Department of Infectious Diseases, Hunan Children's Hospital, Changsha 410007, China
| | - H Yu
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai 201102, China
| | - X Wu
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai 201102, China
| | - B Q Chen
- Department of Infectious Diseases, Anhui Provincial Children's Hospital, Hefei 230022, China
| | - F F Shen
- Department of Infectious Diseases, Anhui Provincial Children's Hospital, Hefei 230022, China
| | - G Zheng
- Department of Neurology, Children's Hospital of Nanjing Medical University,Nanjing 210008, China
| | - J Yu
- Department of Neurology, Children's Hospital of Nanjing Medical University,Nanjing 210008, China
| | - M Shu
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu 610044, China
| | - L Liu
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu 610044, China
| | - L J Du
- Department of Neurology, Children's Hospital of Shanxi, Taiyuan 030006, China
| | - P Li
- Department of Neurology, Children's Hospital of Shanxi, Taiyuan 030006, China
| | - Z W Xu
- Department of Infectious Diseases, the Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China
| | - M Q Zhu
- Department of Infectious Diseases, the Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China
| | - L S Huang
- Department of Infectious Diseases, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - H Y Huang
- Department of Infectious Diseases, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - H B Li
- Department of Pediatrics, the First Hospital of Jilin University, Changchu 130061, China
| | - Y Y Huang
- Department of Pediatrics, the First Hospital of Jilin University, Changchu 130061, China
| | - D Wang
- Department of Neurology, the Affiliated Children's Hospital of Xi'an Jiao Tong University, Xi'an 710002, China
| | - F Wu
- Department of Neurology, the Affiliated Children's Hospital of Xi'an Jiao Tong University, Xi'an 710002, China
| | - S T Bai
- Department of Pediatrics, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - J J Tang
- Department of Pediatrics, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Q W Shan
- Department of Pediatrics, the First Affiliated Hospital of Guangxi Medical University,Nanning 530021, China
| | - L C Lan
- Department of Pediatrics, the First Affiliated Hospital of Guangxi Medical University,Nanning 530021, China
| | - C H Zhu
- Department of Infectious Diseases, Jiangxi Provincial Children's Hospital, Nanchang 330006, China
| | - Y Xiong
- Department of Infectious Diseases, Jiangxi Provincial Children's Hospital, Nanchang 330006, China
| | - J M Tian
- Department of Infectious Diseases, Children's Hospital of Soochow University,Suzhou 215002, China
| | - J H Wu
- Department of Infectious Diseases, Children's Hospital of Soochow University,Suzhou 215002, China
| | - J H Hao
- Department of Infectious Diseases, Kaifeng Children's Hospital, Kaifeng 475000, China
| | - H Y Zhao
- Department of Infectious Diseases, Kaifeng Children's Hospital, Kaifeng 475000, China
| | - A W Lin
- Department of Infectious Diseases, Children's Hospital Affiliated Shandong University, Jinan 250022, China
| | - S S Song
- Department of Infectious Diseases, Children's Hospital Affiliated Shandong University, Jinan 250022, China
| | - D J Lin
- Department of Infectious Diseases, Hainan Women and Children's Medical Center, Haikou 571103, China
| | - Q H Zhou
- Department of Infectious Diseases, Hainan Women and Children's Medical Center, Haikou 571103, China
| | - Y P Guo
- Department of Infectious Diseases, Hainan Women and Children's Medical Center, Haikou 571103, China
| | - J Z Wu
- Department of Pediatrics, Women's and Children's Hospital Affiliated to Xiamen University, Xiamen 361003, China
| | - X Q Yang
- Department of Pediatrics, Women's and Children's Hospital Affiliated to Xiamen University, Xiamen 361003, China
| | - X H Zhang
- Department of Neonatology, Children's Hospital of Shanxi, Taiyuan 030006, China
| | - Y Guo
- Department of Neonatology, Children's Hospital of Shanxi, Taiyuan 030006, China
| | - Q Cao
- Department of Infectious Diseases, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - L J Luo
- Department of Infectious Diseases, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - Z B Tao
- Department of Pediatrics, the First Hospital of Lanzhou University, Lanzhou 730013, China
| | - W K Yang
- Department of Pediatrics, the First Hospital of Lanzhou University, Lanzhou 730013, China
| | - Y K Zhou
- Department of Pediatrics, the First Hospital of Lanzhou University, Lanzhou 730013, China
| | - Y Chen
- Department of Pediatrics, the Second Hospital of Hebei Medical University, Shijiazhuang 050004, China
| | - L J Feng
- Department of Pediatrics, the Second Hospital of Hebei Medical University, Shijiazhuang 050004, China
| | - G L Zhu
- Department of Infection and Digestive, Qinghai Province Women and Children's Hospital, Xining 810007, China
| | - Y H Zhang
- Department of Infection and Digestive, Qinghai Province Women and Children's Hospital, Xining 810007, China
| | - P Xue
- Department of Pediatrics, Taiyuan Maternal and Child Health Care Hospital, Taiyuan 030012, China
| | - X Q Li
- Department of Pediatrics, Taiyuan Maternal and Child Health Care Hospital, Taiyuan 030012, China
| | - Z Z Tang
- Department of Pediatrics, the First People's Hospital of Zunyi, Zunyi 563099, China
| | - D H Zhang
- Department of Pediatrics, the First People's Hospital of Zunyi, Zunyi 563099, China
| | - X W Su
- Department of Pediatrics, Inner Mongolia People's Hospital, Inner Mongolia 750306, China
| | - Z H Qu
- Department of Pediatrics, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - Y Zhang
- Department of Pediatrics, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - S Y Zhao
- Department of Infectious Diseases, Hangzhou Children's Hospital, Hangzhou 310005, China
| | - Z Z Qi
- Department of Infectious Diseases, Hangzhou Children's Hospital, Hangzhou 310005, China
| | - L Pang
- Department of Pediatrics, Beijing Ditan Hospital, Capital Medical University, Beijing 100102, China
| | - C Y Wang
- Department of Pediatrics, Beijing Ditan Hospital, Capital Medical University, Beijing 100102, China
| | - H L Deng
- Department of Pediatrics, Xi'an Central Hospital, Xi'an 710004, China
| | - X L Liu
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Y H Chen
- Department of Infectious Diseases, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310052, China
| | - Sainan Shu
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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Ho CT, Wang CY. A Robust Design-Based Expert System for Feature Selection and COVID-19 Pandemic Prediction in Japan. Healthcare (Basel) 2022; 10:healthcare10091759. [PMID: 36141369 PMCID: PMC9498613 DOI: 10.3390/healthcare10091759] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 09/03/2022] [Accepted: 09/08/2022] [Indexed: 11/16/2022] Open
Abstract
Expert systems are frequently used to make predictions in various areas. However, the practical robustness of expert systems is not as good as expected, mainly due to the fact that finding an ideal system configuration from a specific dataset is a challenging task. Therefore, how to optimize an expert system has become an important issue of research. In this paper, a new method called the robust design-based expert system is proposed to bridge this gap. The technical process of this system consists of data initialization, configuration generation, a genetic algorithm (GA) framework for feature selection, and a robust mechanism that helps the system find a configuration with the highest robustness. The system will finally obtain a set of features, which can be used to predict a pandemic based on given data. The robust mechanism can increase the efficiency of the system. The configuration for training is optimized by means of a genetic algorithm (GA) and the Taguchi method. The effectiveness of the proposed system in predicting epidemic trends is examined using a real COVID-19 dataset from Japan. For this dataset, the average prediction accuracy was 60%. Additionally, 10 representative features were also selected, resulting in a selection rate of 67% with a reduction rate of 33%. The critical features for predicting the epidemic trend of COVID-19 were also obtained, including new confirmed cases, ICU patients, people vaccinated, population, population density, hospital beds per thousand, middle age, aged 70 or older, and GDP per capital. The main contribution of this paper is two-fold: Firstly, this paper has bridged the gap between the pandemic research and expert systems with robust predictive performance. Secondly, this paper proposes a feature selection method for extracting representative variables and predicting the epidemic trend of a pandemic disease. The prediction results indicate that the system is valuable to healthcare authorities and can help governments get hold of the epidemic trend and strategize their use of healthcare resources.
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Wang CY, Chen CH, Tu CY, Chen WC, Kuo LK, Wang YT, Fu PK, Ku SC, Fang WF, Chen CM, Lai CC. Clinical effectiveness of branded versus generic piperacillin-tazobactam for treating severe community-acquired pneumonia. J Infect Public Health 2022; 15:961-965. [DOI: 10.1016/j.jiph.2022.07.008] [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] [Received: 04/30/2022] [Revised: 06/16/2022] [Accepted: 07/19/2022] [Indexed: 10/17/2022] Open
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Ni J, Jiang JJ, Wang CY, Wen W, Tang JK, Chen C, You Y, Hu SQ, Zhang XW, Wang MW. [Association between non-alcoholic fatty liver disease and coronary heart disease]. Zhonghua Xin Xue Guan Bing Za Zhi 2022; 50:835-839. [PMID: 35982021 DOI: 10.3760/cma.j.cn112148-20220412-00264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- J Ni
- Department of Cardiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou Institute of Cardiovascular Diseases, Hangzhou 310015, China
| | - J J Jiang
- Department of Cardiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou Institute of Cardiovascular Diseases, Hangzhou 310015, China
| | - C Y Wang
- Department of Cardiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou Institute of Cardiovascular Diseases, Hangzhou 310015, China
| | - W Wen
- Department of Cardiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou Institute of Cardiovascular Diseases, Hangzhou 310015, China
| | - J K Tang
- Department of Cardiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou Institute of Cardiovascular Diseases, Hangzhou 310015, China
| | - C Chen
- Department of Cardiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou Institute of Cardiovascular Diseases, Hangzhou 310015, China
| | - Y You
- Department of Cardiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou Institute of Cardiovascular Diseases, Hangzhou 310015, China
| | - S Q Hu
- Department of Cardiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou Institute of Cardiovascular Diseases, Hangzhou 310015, China
| | - X W Zhang
- Department of Cardiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou Institute of Cardiovascular Diseases, Hangzhou 310015, China
| | - M W Wang
- Department of Cardiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou Institute of Cardiovascular Diseases, Hangzhou 310015, China
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Chen M, Wang ST, Liu Y, Xiong P, Tao ZX, Zhang L, Jia JL, Wang CY, Xu S. [Genetic characteristics of varicella zoster virus in Shandong province from 2020 to 2021]. Zhonghua Yu Fang Yi Xue Za Zhi 2022; 56:1080-1086. [PMID: 35922235 DOI: 10.3760/cma.j.cn112150-20220105-00017] [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 investigate the genetic characteristics of varicella zoster virus (VZV) in Shandong province from 2020 to 2021. Methods: From April 2020 to December 2021, 85 herpes fluid samples from suspected varicella patients in Shandong province were collected. The qPCR was used to detect viral DNA and screen suspected samples. Six single nucleotide polymorphisms (SNPs) of ORF22 fragment and ORF38 fragment in positive samples were examined via PCR and Sanger sequencing to identify the viral genotypes. Four SNPs of ORF38 and ORF62 were examined to identify the vaccine and wild-type strains. The sequences were analyzed with Sequencher and MEGA7 software, using the VZV reference strain sequences from GenBank. Results: In the 85 samples suspected of varicella, 80 were VZV positive and wild-type strains belonging to Clade 2. Compared with clade 2 representative strains, the nucleotide and amino acid similarities of ORF22 fragment were 99.5%-100% and 98.5%-100%, respectively. SD20-1, SD20-5, SD20-6, SD20-8, SD20-9, SD20-10, SD20-11, SD20-12, SD20-13, SD20-30 and SD20-31 had a A➝G nucleotide mutation at 37990, causing amino acid change from glutamine to arginine. SD21-1 had a C➝A nucleotide mutation at 38059, causing threonine to asparagine during coding. Conclusions: From 2020 to 2021, all VZV strains in Shandong province are the wild-type strains belonging to Clade 2.
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Affiliation(s)
- M Chen
- Division of EPI, Shandong Center for Disease Control and Prevention, Jinan 250014, China Shandong Qidu Pharmaceutical Co. Ltd./Shandong Provincial Key Laboratory of Neuroprotective Drugs, Zibo 255400, China
| | - S T Wang
- Division of EPI, Shandong Center for Disease Control and Prevention, Jinan 250014, China
| | - Y Liu
- Division of EPI, Shandong Center for Disease Control and Prevention, Jinan 250014, China
| | - P Xiong
- Division of EPI, Shandong Center for Disease Control and Prevention, Jinan 250014, China
| | - Z X Tao
- Division of EPI, Shandong Center for Disease Control and Prevention, Jinan 250014, China
| | - L Zhang
- Division of EPI, Shandong Center for Disease Control and Prevention, Jinan 250014, China
| | - J L Jia
- Liaocheng Center for Disease Control and Prevention, Liaocheng 252000, China
| | - C Y Wang
- Division of EPI, Shandong Center for Disease Control and Prevention, Jinan 250014, China
| | - Songtao Xu
- National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing 102206, China
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Lai CC, Wang YH, Chen KH, Chen CH, Wang CY. The Clinical Efficacy and Safety of Anti-Viral Agents for Non-Hospitalized Patients with COVID-19: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials. Viruses 2022; 14:v14081706. [PMID: 36016328 PMCID: PMC9415971 DOI: 10.3390/v14081706] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 07/29/2022] [Accepted: 07/30/2022] [Indexed: 12/23/2022] Open
Abstract
This network meta-analysis compared the clinical efficacy and safety of anti-viral agents for the prevention of disease progression among non-hospitalized patients with COVID-19. PubMed, Embase, Web of Science, Cochrane Library, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform were searched from their inception to 28 May 2022. Only randomized controlled trials (RCTs) that investigated the clinical efficacy of anti-viral agents for non-hospitalized patients with COVID-19 were included. Three RCTs involving 4241 patients were included. Overall, anti-viral agents were associated with a significantly lower risk of COVID-19 related hospitalization or death compared with the placebo (OR, 0.23; 95% CI: 0.06-0.96; p = 0.04). Compared with the placebo, patients receiving nirmatrelvir plus ritonavir had the lowest risk of hospitalization or death (OR, 0.12; 95% CI: 0.06-0.24), followed by remdesivir (OR, 0.13; 95% CI: 0.03-0.57) and then molnupiravir (OR, 0.67; 95% CI: 0.46-0.99). The rank probability for each treatment calculated using the P-score revealed that nirmatrelvir plus ritonavir was the best anti-viral treatment, followed by remdesivir and then molnupiravir. Finally, anti-viral agents were not associated with an increased risk of adverse events compared with the placebo. For non-hospitalized patients with COVID-19 who are at risk of disease progression, the currently recommended three anti-viral agents, nirmatrelvir plus ritonavir, molnupiravir and remdesivir, should continue to be recommended for the prevention of disease progression. Among them, oral nirmatrelvir plus ritonavir and intravenous remdesivir seem to be the better choice, followed by molnupiravir, as determined by this network meta-analysis. Additionally, these three anti-viral agents were shown to be as tolerable as the placebo in this clinical setting.
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Affiliation(s)
- Chih-Cheng Lai
- Division of Hospital Medicine, Department of Internal Medicine, Chi Mei Medical Center, Tainan 710, Taiwan;
| | - Ya-Hui Wang
- Medical Research Center, Cardinal Tien Hospital and School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 231, Taiwan;
| | - Kuang-Hung Chen
- Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei 100, Taiwan;
| | - Chao-Hsien Chen
- Division of Pulmonary, Department of Internal Medicine, MacKay Memorial Hospital, Taipei 104, Taiwan
- Department of Medicine, MacKey Medical College, New Taipei City 252, Taiwan
- Correspondence: (C.-H.C.); (C.-Y.W.)
| | - Cheng-Yi Wang
- Department of Internal Medicine, Cardinal Tien Hospital and School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 231, Taiwan
- Correspondence: (C.-H.C.); (C.-Y.W.)
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Wang CY, Cao Y, Feng YM, Li J, Jiang B, Zhang Y, Wen J, Zhu YJ, Li J. [Analysis and significance of HBV DNA below the lower detection limit of HBV RNA levels after long-term NAs antiviral therapy in patients with hepatitis B virus cirrhosis]. Zhonghua Gan Zang Bing Za Zhi 2022; 30:758-762. [PMID: 36038347 DOI: 10.3760/cma.j.cn501113-20201126-00629] [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 analyze the significance of HBV DNA below the lower detection limit of HBV RNA levels after long-term nucleos(t)ide analogues (NAs) antiviral therapy in patients with hepatitis B virus cirrhosis. Methods: 97 cases with hepatitis B virus cirrhosis treated with NAs antiviral therapy for at least 3 years between May 2018 to July 2019 were selected. High-sensitivity HBV DNA (<20 IU/ml), alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyltransferase (GGT), HBsAg, HBeAg and HBV RNA at least twice every 6 months were detected. According to Child-Pugh classification, HBeAg, HBsAg level, and HBV RNA level intergroup comparison was performed. Rank sum test, χ2 test and linear regression analysis were performed on the data. Results: Compared with the HBV RNA level of child-Pugh class A patients, the HBV RNA level of Child-Pugh class B+C patients were significantly higher [4.1 (0,4.9) log10 copies/ml and 2.0 (0,3.5) log10 copies/ml], and the difference was statistically significant (Z=2.370, P<0.05). According to different HBeAg levels, they were divided into HBeAg positive and negative group, and the quantitative comparison of HBV RNA levels between the two groups were 2.0 (0, 4.5) log10 copies/ml and 1.0 (1.0, 2.0) log10 copies/ml, respectively, and the difference was statistically significant (Z=3.233, P<0.05). According to different HBsAg levels, they were divided into three groups: HBsAg≤100 IU/ml, 100<HBsAg<1 000 IU/ml, and HBsAg≥1 000 IU/ml, and the quantitative comparison of HBV RNA levels among the three groups were 0 (0, 2.0) log10, 2.0 (0,4.6) log10, and 2.2 (2.0, 4.7) log10 copies/ml, respectively, and the difference was statistically significant (H=11.265, P<0.05). Gender, age, ALT, AST, GGT, HBsAg, and HBeAg were included for linear regression analysis, and the HBsAg and AST levels were correlated with HBV RNA quantification (P<0.05). Adverse events occurrence during 1-year follow-up were recorded. 19 (31.7%) out of 60 cases had adverse events with detectable HBV RNA, and 3 (8.1%) out of 37 cases had adverse events with undetectable HBV RNA, and the difference was statistically significant (χ2=7.24, P<0.05). Conclusion: HBV RNA can still be detected after HBV DNA falls below the detection limit in patients with hepatitis B virus cirrhosis treated with long-term NAs antiviral therapy. HBV RNA quantification level is higher in patients with Child Pugh class B and C. Patients with detectable HBV RNA has higher proportion of adverse events, and AST and HBsAg levels may be correlated with serum HBV RNA.
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Affiliation(s)
- C Y Wang
- Department of Chronic Liver Disease,Tianjin Second People's Hospital, Tianjin 300192, China
| | - Y Cao
- Hepatopathy Research Institute, Tianjin Second People's Hospital, Tianjin 300192, China
| | - Y M Feng
- Department of Chronic Liver Disease,Tianjin Second People's Hospital, Tianjin 300192, China
| | - J Li
- Graduate School of Tianjin Medical University, Tianjin 300192, China
| | - B Jiang
- Hepatopathy Research Institute, Tianjin Second People's Hospital, Tianjin 300192, China
| | - Y Zhang
- Department of Chronic Liver Disease,Tianjin Second People's Hospital, Tianjin 300192, China
| | - J Wen
- Department of Chronic Liver Disease,Tianjin Second People's Hospital, Tianjin 300192, China
| | - Y J Zhu
- Graduate School of Tianjin Medical University, Tianjin 300192, China
| | - J Li
- Department of Chronic Liver Disease,Tianjin Second People's Hospital, Tianjin 300192, China
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Chen CH, Wang CY, Wang YH, Chen CY, Chen KH, Lai CC, Wei YF, Fu PK. The effect of inhaled corticosteroids on the outcomes of patients with COVID-19: A systematic review and meta-analysis of randomized controlled trials. Expert Rev Clin Pharmacol 2022; 15:593-600. [PMID: 35786288 DOI: 10.1080/17512433.2022.2094769] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 12/15/2022]
Abstract
BACKGROUND The effect of inhaled corticosteroids (ICS) on the clinical outcomes of patients with coronavirus disease 2019 (COVID-19) was not known. RESEARCH DESIGN AND METHODS Only phase 2 and 3 randomized clinical trials (RCTs) from electronic database that investigated ICS in the treatment of COVID-19 patients were included. The outcomes of interest were the resolution of symptoms, risk of hospitalization or urgent medical visit, mortality, and the incidence of adverse events (AEs). RESULTS Five RCTs involving 1243 patients who received ICS and 1526 patients with placebo or usual care were included. The ICS group had a higher rate of symptom resolution than the control group at day 14 (risk ratio [RR], 1.21; 95% confidence interval [CI], 1.12-1.30, p < 0.00001) and day 28 (RR, 1.12; 95% CI, 1.06-1.18, p < 0.0001). Subgroup analysis showed that only inhaled budesonide, but not ciclesonide, significantly improved symptom resolution at day 14 compared with usual care. Additionally, the ICS group had a significantly lower risk of needing urgent medical care or hospitalization than the control group (RR, 0.15; 95% CI, 0.05-0.50; I2 = 0, p = 0.002). However, no significant difference in 28-day mortality rate. The incidence of AEs between the ICS and control groups was also similar (RR, 1.04; 95% CI, 0.58-1.88, p = 0.90). CONCLUSIONS In patients with mild-to-moderate COVID-19, ICS therapy improved symptom resolution, decreased the risk of needing urgent medical care or hospitalization, and did not increase AEs.
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Affiliation(s)
- Chao-Hsien Chen
- Division of Pulmonary, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan.,Department of Medicine, MacKey Medical College, New Taipei, Taiwan
| | - Cheng-Yi Wang
- Department of Internal Medicine, Cardinal Tien Hospital and School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei, Taiwan
| | - Ya-Hui Wang
- Medical Research Center, Cardinal Tien Hospital and School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei, Taiwan
| | - Ching-Yi Chen
- Division of Pulmonary Medicine, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Kuang-Hung Chen
- Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chih-Cheng Lai
- Division of Hospital Medicine, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Yu-Feng Wei
- Department of Internal Medicine, E-Da Cancer Hospital, Kaohsiung, Taiwan.,School of Medicine for International Students, College of Medicine, and Institute of Biotechnology and Chemical Engineering, I-Shou University, Kaohsiung, Taiwan
| | - Pin-Kuei Fu
- Department of Critical Care Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.,College of Human Science and Social Innovation, Hungkuang University, Taichung, Taiwan.,Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan
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Chen CH, Wang CY, Lai CC. Inhaled Ciclesonide for Patients With Asthma or Chronic Obstructive Pulmonary Disease and COVID-19. JAMA Intern Med 2022; 182:571-572. [PMID: 35311912 DOI: 10.1001/jamainternmed.2022.0207] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Chao-Hsien Chen
- Division of Pulmonary, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan
| | - Cheng-Yi Wang
- Cardinal Tien Hospital and School of Medicine, College of Medicine, Department of Internal Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Chih-Cheng Lai
- Department of Internal Medicine, Kaohsiung Veterans General Hospital, Tainan Branch, Tainan, Taiwan
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Wang CY, Xiong B, Liu JC, Yang CT, Ju SG, Bai YW, Yao W, Wang YL. [Effect of underdilated stent on the occurrence of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt creation]. Zhonghua Nei Ke Za Zhi 2022; 61:537-542. [PMID: 35488604 DOI: 10.3760/cma.j.cn112138-20211010-00685] [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: 06/14/2023]
Abstract
Objective: To evaluate whether underdilated stent could reduce the occurrence of hepatic encephalopathy (HE) after transjugular intrahepatic portosystemic shunt (TIPS) creation. Methods: A total of 197 patients with decompensated liver cirrhosis, who had underwent TIPS creation at Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, were analyzed retrospectively, including 110 males and 87 females with age 25-79 (54±11) years old. Uncovered and covered stents with 8 mm diameter were implanted in all subjects, and then dilated by balloon catheters with 6 mm or 8 mm diameter. The patients were divided into two groups, including underdilated group (6 mm, n=105) and control group (8 mm, n=92).Kaplan-Meier curves were used to illustrate cumulative rate of HE, and the differences were assessed with the log-rank test. Multivariate analyses with a Cox regression model were conducted to explore the risk factors for HE. Results: During a median follow-up period of 29 (12-54) months, 16 (15.2%) patients developed HE in the underdilated group and 27 (29.3%) patients in the control group. There was a significant difference in the cumulative rate of HE (P=0.014), but no statistical differences were found in terms of variceal rebleeding, shunt dysfunction and survival between the two groups (P=0.608, P=0.659, P=0.968). In multivariated analysis, group assignment (underdilated vs. control, HR=0.291, 95%CI 0.125-0.674, P=0.004) was identified as an independent risk factor for HE after TIPS creation. Conclusion: Underdilated TIPS could reduced the risk of HE compared with completely dilated TIPS, with comparable risk of variceal rebleeding, shunt dysfunction and mortality. And it is worthy of applying this technique to a large sample of patients in clinical practice.
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Affiliation(s)
- C Y Wang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
| | - B Xiong
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
| | - J C Liu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
| | - C T Yang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
| | - S G Ju
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
| | - Y W Bai
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
| | - W Yao
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
| | - Y L Wang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
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Cheng KC, Lai CC, Wang CY, Wang CM, Ho CH, Sung MI, Hsing SC, Liao KM, Ko SC. The Impact of the Pay-for-Performance Program on the Outcome of COPD Patients in Taiwan After One Year. Int J Chron Obstruct Pulmon Dis 2022; 17:883-891. [PMID: 35480556 PMCID: PMC9037731 DOI: 10.2147/copd.s349468] [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: 11/20/2021] [Accepted: 04/11/2022] [Indexed: 11/29/2022] Open
Abstract
Objective To investigate the impact of a multidisciplinary intervention on the clinical outcomes of patients with COPD. Methods This study retrospectively extracted the data of patients enrolled in the national pay-for-performance (P4P) program for COPD in four hospitals. Only COPD patients who received regular follow-up for at least one year in the P4P program between September 2018 and December 2020 were included. Results A total of 1081 patients were included in this study. Among them, 424 (39.2%), 287 (26.5%), 179 (16.6%), and 191 (17.7%) patients were classified as COPD Groups A, B, C, and D, respectively. Dual therapy with long-acting β2-agonist (LABA)/long-acting muscarinic antagonist (LAMA) was the most used inhaled bronchodilator at baseline (n = 477, 44.1%) patients, followed by LAMA monotherapy (n = 195, 18.0%), triple therapy with inhaled corticosteroid (ICS)/LABA/LAMA (n = 184, 17.0%), and ICS/LABA combination (n = 165, 15.3%). After one year of intervention, 374 (34.6%) and 323 (29.9%) patients had their pre- and post-bronchodilator-forced expiratory volume in one second (FEV1) increase of more than 100 mL. Both the COPD Assessment Test (CAT) and modified British Medical Research Council (mMRC) scores had a mean change of −2.2 ± 5.5 and −0.3 ± 0.9, respectively. The improvement in pulmonary function and symptom score were observed across four groups. The decreased number of exacerbations was only observed in Groups C and D, and not in Groups A and B. Conclusion This real-world study demonstrated that the intervention in the P4P program could help improve the clinical outcome of COPD patients. It also showed us a different view on the use of dual therapy, which has a lower cost in Taiwan.
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Affiliation(s)
- Kuo-Chen Cheng
- Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Chih-Cheng Lai
- Department of Internal Medicine, Kaohsiung Veterans General Hospital Tainan Branch, Tainan, Taiwan
| | - Cheng-Yi Wang
- Department of Internal Medicine, Cardinal Tien Hospital, New Taipei City, Taiwan
| | - Ching-Min Wang
- Department of Internal Medicine, Chi Mei Medical Center, Liouying, Taiwan
| | - Chung-Han Ho
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan.,Cancer Center, Wan Fang Hospital, Taipei Medical University, Taipei, 11695, Taiwan.,Department of Information Management, Southern Taiwan University of Science and Technology, Tainan, Taiwan
| | - Mei-I Sung
- Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Shu-Chen Hsing
- Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Kuang-Ming Liao
- Department of Internal Medicine, Chi Mei Medical Center, Chiali, Taiwan
| | - Shian-Chin Ko
- Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
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Wang CY, Liu J, Liang XP, Guo BL, Hu RZ, Liu Y. [Clinical characteristics and prognostic features of 63 HIV-associated diffuse large B-cell lymphoma: a single-center real-world study in China]. Zhonghua Xue Ye Xue Za Zhi 2022; 43:203-208. [PMID: 35405777 PMCID: PMC9072062 DOI: 10.3760/cma.j.issn.0253-2727.2022.03.004] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Indexed: 11/09/2022]
Abstract
Objective: This study aimed to look into the clinical characteristics and prognosis of patients with human immunodeficiency virus (HIV) -associated diffuse large B-cell lymphoma (DLBCL) . Methods: Retrospective review of the clinical data of 63 HIV-infected patients with DLBCL diagnosed at Chongqing University Cancer Hospital between July 2008 and August 2021. The Kaplan-Meier method was used to calculate survival curves, and the log-rank test method was used to compare survival between groups. The Cox proportional hazards model was used for multivariate analysis. Results: In 63 patients with HIV-associated DLBCL, 57 (90.5% ) were men, and the median age was 49 (23-87) years. The most common pathological subtype was the germinal center B-cell-like lymphoma (74.6% ) ; 46.0% (29/63) were combined with extranodal lesions. Seventeen of 63 (27.0% ) patients had large masses (≥7.5 cm) . Twenty of 63 (31.7% ) patients had B symptoms. The median CD4(+) T cell count was 203 (4-1022) ×10(6)/L. A total of 49% (25/51) patients had CD4(+) cell count <200×10(6)/L, 56.9% (33/58) had high (3-5) International Prognostic Index (IPI) scores, and 43.1% (25/58) had low (0-2) IPI scores. Further, 78% (46/59) were diagnosed with Ann Arbor Stage Ⅲ/Ⅳ, and 25.4% (16/63) didn't receive chemotherapy. A total of 22.2% (14/63) of patients received less than four cycles of chemotherapy, and 52.4% (33/63) received four or more cycles of chemotherapy. Among patients undergoing chemotherapy, 61.7% (29/47) received R-CHOP-like regimens, and 38.3% (18/47) used CHOP-like regimens. The 1-, 2-, 3-, and 5-year overall survival (OS) rates were 65.0% , 53.8% , 47.1% , and 43.5% , respectively. Univariate analysis revealed that age ≥ 60 years (P=0.012) , Eastern Cooperative Oncology Gruop Performance Status (ECOG-PS) score 2-4 points (P=0.043) , IPI score 3-5 points (P=0.001) , β(2)-MG elevation (≥5.5 mg/L) (P=0.007) , and systemic chemotherapy cycles less than four times (P<0.001) were the negative prognostic factors affecting the OS of patients. The Cox multivariate analysis depicted that age ≥60 years (HR=2.272, 95% CI 1.110-4.651, P=0.025) , IPI score 3-5 points (HR=3.562, 95% CI 1.794-7.074, P<0.001) , ECOG-PS score 2-4 points (HR=2.675, 95% CI 1.162-6.153, P=0.021) , and number of cycles of chemotherapy<4 (HR=0.290, 95% CI 0.176-0.479, P<0.001) were independent risk factors for adverse prognosis of OS. Conclusion: HIV-associated DLBCL is the most common HIV-related tumor, is most commonly seen in men, and has a high 1-year mortality rate. Chemotherapy combined with antiretroviral therapy can improve patient prognosis.
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Affiliation(s)
- C Y Wang
- Department of Hematology-Oncology, Chongqing University Cancer Hospital, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing 400030, China
| | - J Liu
- Department of Hematology-Oncology, Chongqing University Cancer Hospital, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing 400030, China
| | - X P Liang
- Department of Hematology-Oncology, Chongqing University Cancer Hospital, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing 400030, China
| | - B L Guo
- Department of Hematology-Oncology, Chongqing University Cancer Hospital, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing 400030, China
| | - R Z Hu
- Department of Hematology-Oncology, Chongqing University Cancer Hospital, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing 400030, China
| | - Y Liu
- Department of Hematology-Oncology, Chongqing University Cancer Hospital, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing 400030, China
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Wang CY, Hsieh MK, Hu YJ, Bit A, Lai PL. Monocarboxylate transporter 1-mediated lactate accumulation promotes nucleus pulposus degeneration under hypoxia in a 3D multilayered nucleus pulposus degeneration model. Eur Cell Mater 2022; 43:53-65. [PMID: 35188217 DOI: 10.22203/ecm.v043a06] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
During intervertebral disc degeneration (IVDD), due to endplate calcification, diminished oxygen and nutrient concentrations and accumulated lactate are present in the microenvironment of the nucleus pulposus (NP). The disadvantages of 3D layered culture include uneven oxygen and nutrient gradients. In the present study, to mimic the in vivo microenvironment of the NP, a 5-layered 3D culture was constructed using clinical haemostatic gelatine sponges and developed as a NP degeneration (NPD) model. Subsequently, cell distribution as well as expression of NP chondrogenic markers (type II collagen and aggrecan), glycosaminoglycan (GAG) and degeneration markers [e.g. matrix metalloproteinase (MMP) 3] were measured from the top to the bottom layer. However, in a single NP-cell-loaded disc model, the chondrogenic potency in the middle or bottom layer was higher than that in the top layer. To further study the mechanism underlying the degeneration of NP cells in this NPD model, the contribution of secreted metabolites was examined. Lactate identified in the supernatant modulated GAG accumulation and MMP3 expression. Inhibition of lactate influx by the monocarboxylate transporter (MCT)-1 inhibitor, AZD3965, reversed the effect of lactate on GAG accumulation and MMP3 expression and further improved NP cell degeneration in the NPD model. Thanks to the homogenous expression of lactate in the model, it was possible to further identified that the combination of lactate and hypoxia enhanced MMP3 expression. Taken together, multilayered cell-loaded sponges, with oxygen and nutrient gradients as well as lactate accumulation, can represent a 3D multilayered NPD model for exploring potential agents for IVDD.
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Affiliation(s)
| | | | | | | | - P L Lai
- Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, No. 5, Fuxing Street, Guishan District, Taoyuan City, 33305,
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Hong SY, Lu YC, Hsiao SH, Kao YR, Lee MH, Lin YP, Wang CY, Wu CW. Stabilization of AURKA by the E3 ubiquitin ligase CBLC in lung adenocarcinoma. Oncogene 2022; 41:1907-1917. [PMID: 35149839 DOI: 10.1038/s41388-022-02180-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 12/22/2021] [Accepted: 01/05/2022] [Indexed: 11/10/2022]
Abstract
CBL family proteins (CBL, CBLB and CBLC in mammals) are E3 ubiquitin ligases of protein tyrosine kinases. CBL mediates the lysosomal degradation of activated EGFR through K63-linked ubiquitination, while CBLC has an oncogenic function by positively regulating EGFR activation through K6 and K11-linked ubiquitination in EGFR mutant lung adenocarcinoma (LAD). Here, we used immunoprecipitation and mass spectrometry to study the CBLC interactome, and found that CBLC is also involved in cell cycle regulation by stabilizing Aurora kinase A (AURKA). CBLC interacted with the kinase domain of AURKA and positively regulated the stability of AURKA by conjugating monoubiquitination and K11/K63-linked polyubiquitination, which are protective from degrading K11/K48 polyubiquitination. CBLC depletion markedly decreased the half-life of AURKA in cycloheximide-treated LAD cells. When LAD cells were synchronized with double thymidine block at the G1/S boundary and then released into mitotic arrest, CBLC depletion delayed the accumulation and activation of AURKA and prevented cancer cells from entering mitosis. CBLC deficiency significantly delayed cell cycle progression, reduced the mitotic population, and increased apoptosis of LAD cells. Targeting CBLC inhibited tumor growth of LAD cells and enhanced their sensitivity to paclitaxel in xenograft models. Immunohistochemical staining of the tissue microarray also revealed a positive correlation between the expression of CBLC and AURKA in normal and LAD tissues, further supporting the positive regulation of AURKA expression by CBLC. In summary, these findings indicate that the oncogenic E3 ligase CBLC plays a role in mitotic entry by stabilizing AURKA via ubiquitination in LAD. This work demonstrates that targeting CBLC combined with paclitaxel might be a potential option for the treatment of LAD patients who have no available targeted therapies.
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Affiliation(s)
- Shiao-Ya Hong
- Medical Research Center, Cardinal Tien Hospital, New Taipei, Taiwan.,Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
| | - Yi-Chun Lu
- Medical Research Center, Cardinal Tien Hospital, New Taipei, Taiwan
| | - Shih-Hsin Hsiao
- Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Yu-Rung Kao
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
| | - Meng-Hsuan Lee
- Institute of Microbiology and Immunology, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yi-Ping Lin
- Institute of Microbiology and Immunology, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Cheng-Yi Wang
- Department of Internal Medicine, Cardinal Tien Hospital, New Taipei, Taiwan. .,School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei, Taiwan.
| | - Cheng-Wen Wu
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan. .,Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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Weng MT, Shih IL, Tung CC, Leong YL, Shieh MJ, Wang CY, Wong JM, Ni YH, Wei SC. Association of young age and male sex with primary sclerosing cholangitis in Taiwanese patients with inflammatory bowel disease. Intest Res 2022; 20:224-230. [PMID: 35124955 PMCID: PMC9082000 DOI: 10.5217/ir.2021.00042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 04/10/2021] [Indexed: 12/04/2022] Open
Abstract
Background/Aims Primary sclerosing cholangitis (PSC) is associated with inflammatory bowel disease (IBD). We aimed to evaluate the prevalence, clinical manifestation, and outcomes of PSC in Taiwanese patients with IBD. Methods This retrospective study enrolled patients with IBD admitted from January 1, 1996, to December 31, 2018, to National Taiwan University Hospital. A case-matched analysis was performed comparing patients with IBD with and without PSC according to age, sex, and time of admission, with ratios of 1:4 and 1:2 in the adult and pediatric groups, respectively. Results In total, 763 patients with IBD were enrolled, 12 of whom were also diagnosed with PSC (1.57%). All these patients had ulcerative colitis (UC). A greater incidence of IBD with PSC was observed in younger patients than in older patients. Male sex was a risk factor for PSC in pediatric patients with IBD (P=0.015); 75% of these patients were diagnosed with PSC along with or after the diagnosis of UC. There was no significant difference in colitis extent and severity between the groups; however, a higher proportion of rectal sparing was observed in patients with PSC (P=0.001). There was no significant difference in cancer development between the groups (P=0.679). Conclusions A 1.57% prevalence of PSC was observed in Taiwanese patients with IBD. The majority of patients with IBD and PSC were men and were diagnosed at a younger age. Hence, routine evaluation of biliary enzymes and liver imaging is recommended in young male patients with IBD.
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Affiliation(s)
- Meng-Tzu Weng
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei City, Taiwan
| | - I-Lun Shih
- Department of Medical Imaging, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei City, Taiwan
| | - Chien-Chih Tung
- Department of Integrated Diagnostics and Therapeutics, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei City, Taiwan
| | - Yew-Loong Leong
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei City, Taiwan.,Good Liver Clinic, Taipei City, Taiwan
| | - Ming-Jium Shieh
- Department of Oncology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei City, Taiwan
| | - Cheng-Yi Wang
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei City, Taiwan
| | - Jau-Min Wong
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei City, Taiwan
| | - Yen-Hsuan Ni
- Department of Pediatrics, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei City, Taiwan
| | - Shu-Chen Wei
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei City, Taiwan
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Ma MS, Wang W, Zhou Y, Zhong LQ, Yu ZX, Gou LJ, Li J, Wang L, Wang CY, Tang XY, Quan MY, Song HM. [Analysis of clinical characteristics of 35 inflammasomopathies cases]. Zhonghua Er Ke Za Zhi 2022; 60:114-118. [PMID: 35090227 DOI: 10.3760/cma.j.cn112140-20210906-00756] [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: 06/14/2023]
Abstract
Objective: To summarize the clinical characteristics of inflammasomopathies, enhance the recognition of those diseases, and help to establish the early diagnosis. Methods: The clinical manifestations including fever, rash, systems involvement as well as laboratory results and genotypic characteristics of 35 children with inflammasomopathies diagnosed by the Department of Pediatrics, Peking Union Medical College Hospital, from January 1, 2008 to December 31, 2020 were analyzed retrospectively. Results: A total of 35 cases of inflammasomopathies were diagnosed, and 20 of them were boys while 15 were girls. Inflammasomopathies patients have early onset, the age of onset as well as diagnostic age were 1 (0,7) and 7 (3,12), respectively. Among those patients, 10 had familial mediterranean fever, 3 had mevalonate kinase deficiency, 15 cases had NLRP3 gene associated autoinflammatory disease, 4 cases had NLRP12-associated autoinflammatory disease, 2 cases had familial cold autoinflammatory syndrome 3, and 1 case had familial cold autoinflammatory syndrome 4. A total of 34 cases (97%) showed recurrent fever, 27 cases (77%) had skin rashes, while 11 cases (31%), 10 cases (29%), and 8 cases (23%) were presented with lymphadenopathy, hepatosplenomegaly and growth retardation, respectively. In terms of systemic involvement, there were 18 cases (51%), 12 cases (34%), 8 cases (23%), and 5 cases (14%) with skeletal, neurological, auditory, and renal involvement, respectively. Central nervous system involvement was seen only in NLRP3 gene associtated autoinflammatory diseases (12 cases), sensorineural deafness was seen in NLRP3 gene associtated autoinflammatory diseases (6 cases) and NLRP12 gene associated autoinflammatory diseases (2 cases), and abdominal pain was observed in familial Mediterranean fever (5 cases), mevalonate kinase deficiency (1 case) and NLRP12 gene related autoinflammatory diseases (1 case). In the acute inflammatory phase, the acute phase reactants (erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)) of 35 cases (100%) were significantly increased. There were 21 cases received ferritin examination, and only 4 cases (19%) showed an increase of it. In terms of autoantibodies, among all 35 patients, 4 cases (11%) were positive for antinuclear antibodies (ANA). Conclusions: Fever, skin rash, and skeletal manifestations are the most common clinical features, accompanied with increased CRP and ESR, and negative results of autoantibodies such as ANA. The clinical manifestations of those diseases are complex and diverse, and it is prone to delayed diagnosis and treatment.
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Affiliation(s)
- M S Ma
- Department of Pediatrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - W Wang
- Department of Pediatrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Y Zhou
- Department of Pediatrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - L Q Zhong
- Department of Pediatrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Z X Yu
- Department of Pediatrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - L J Gou
- Department of Pediatrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - J Li
- Department of Pediatrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - L Wang
- Department of Pediatrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - C Y Wang
- Department of Pediatrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - X Y Tang
- Department of Pediatrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - M Y Quan
- Department of Pediatrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - H M Song
- Department of Pediatrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
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Lan SH, Lai CC, Chang SP, Hsu CC, Chen CH, Wang YH, Huang YL, Wang CY, Lin YS. Efficacy and safety of anti-interleukin-5 therapy in patients with chronic obstructive pulmonary disease: A meta-analysis of randomized, controlled trials. J Microbiol Immunol Infect 2022; 55:26-35. [PMID: 33349601 DOI: 10.1016/j.jmii.2020.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 06/01/2020] [Revised: 09/18/2020] [Accepted: 11/06/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Anti-interleukin-5 (IL-5) therapy has been proposed as a novel treatment option for patients with chronic obstructive pulmonary disease (COPD). However, its efficacy for preventing COPD exacerbation remains unclear. METHODS A literature review was conducted to August 26th 2019. Only randomized controlled trials (RCTs) that investigated the clinical efficacy and adverse effects of anti-IL-5 therapy were included in the meta-analysis. The primary outcome was the risk of COPD exacerbation. RESULTS A total of 3 articles containing 5 RCTs were included in the study. Overall, 2837 and 1442 patients received anti-IL-5 therapy (mepolizumab, n = 865; benralizumab, n = 1972) and placebo, respectively. In the pooled analysis, anti-IL-5 therapy was associated with a lower risk of COPD exacerbation compared with the placebo (rate ratio, 0.92; 95% CI, 0.86-0.97, I2 = 0%). In addition, no significant differences in the changes in SGRQ scores and FEV1 from baseline were found between the anti-IL-5 therapy and placebo (SGRQ, mean difference, -0.86, 95% CI, -1.92 - 0.19, I2 = 0%; FEV1, mean difference, 0.01, 95% CI, -0.01 - 0.03, I2 = 0%). Anti-IL-5 therapy had a similar risk of any adverse event (risk ratio, 1.02; 95% CI, 0.99-1.05), an event leading to treatment discontinuation (risk ratio, 1.04; 95% CI, 0.72-1.48) and any serious adverse events (risk ratio, 0.93; 95% CI, 0.85-1.01) when compared with the placebo. CONCLUSION Anti-IL-5 therapy was associated with a lower rate of COPD exacerbation compared with placebo. In addition, anti-IL-5 therapy was well tolerated for COPD patients.
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Affiliation(s)
| | - Chih-Cheng Lai
- Department of Internal Medicine, Kaohsiung Veterans General Hospital, Tainan Branch, Tainan, Taiwan
| | | | - Chun-Chun Hsu
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan; Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Cheng-Hsin Chen
- Department of Internal Medicine, Cardinal Tien Hospital and School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Ya-Hui Wang
- Medical Research Center, Cardinal Tien Hospital and School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Yueh Lan Huang
- Department of Internal Medicine, Cardinal Tien Hospital and School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
| | - Cheng-Yi Wang
- Department of Internal Medicine, Cardinal Tien Hospital and School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
| | - You-Shuei Lin
- Department of Physiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
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Chen CH, Wang CY, Lai CC. Association of Tramadol vs Codeine Prescription Dispensation With Mortality and Other Adverse Outcomes. JAMA 2022; 327:488. [PMID: 35103771 DOI: 10.1001/jama.2021.23120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Chao-Hsien Chen
- Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan
| | - Cheng-Yi Wang
- Department of Internal Medicine, Cardinal Tien Hospital, New Taipei City, Taiwan
| | - Chih-Cheng Lai
- Department of Internal Medicine, Kaohsiung Veterans General Hospital, Tainan Branch, Tainan, Taiwan
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Lai CC, Chen CH, Chen KH, Wang CY, Huang TM, Wang YH, Wang HC. The Impact of 52-Week Single Inhaler Device Triple Therapy versus Dual Therapy on the Mortality of COPD Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Life (Basel) 2022; 12:life12020173. [PMID: 35207460 PMCID: PMC8877713 DOI: 10.3390/life12020173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 01/20/2022] [Accepted: 01/21/2022] [Indexed: 12/28/2022] Open
Abstract
There are more single inhaler device triple therapy available for COPD patients now. However, the effect of long-term triple therapy fixed dose combination (FDC) on mortality remains unclear. This study aimed to evaluate the impact of one-year single inhaler device triple therapy, including long-acting β2-agonists (LABAs), long-acting muscarinic receptor antagonists (LAMAs), and inhaled corticosteroids (ICSs), with dual therapies, comprised of either LABA/LAMA or ICS/LABA, on the mortality of patients with COPD. We searched the PubMed, Cochrane library, Web of Science, Embase databases, and clinical trial registry of clinicaltrials.gov and WHO ICTRP. Randomized controlled trials (RCTs) compared single inhaler device triple and dual therapies for 52 weeks were selected for the meta-analysis. The primary endpoint was all-cause mortality. A total of 6 RCTs were selected for the meta-analysis, including 10,274 patients who received single inhaler device triple therapy (ICS/LABA/LAMA FDC) and 12,395 patients who received ICS/LABA or LABA/LAMA dual therapy. Risk of death was significantly lower in the ICS/LABA/LAMA FDC group compared to the LABA/LAMA group (RR = 0.69, 95% CI = 0.53–0.90, p = 0.007). There was no significant difference in mortality between the ICS/LABA/LAMA FDC and ICS/LABA therapy groups (RR = 0.94, 95% CI = 0.72–1.24, p = 0.66). In addition, patients receiving ICS/LABA/LAMA FDC therapy had less moderate or severe exacerbations compared with the dual therapy groups (RR = 0.76, 95% CI = 0.73–0.80, p < 0.001 for LABA/LAMA; RR = 0.84, 95% CI = 0.78–0.90, p < 0.001 for ICS/LABA). By contrast, the risk of pneumonia in the ICS/LABA/LAMA FDC group was higher than in the LABA/LAMA group (RR = 1.43, 95% CI = 1.21–1.68, p < 0.001). In conclusion, ICS/LABA/LAMA FDC therapy could help improve the clinical outcomes of patients with COPD. However, triple therapy could increase the risk of pneumonia in comparison with LABA/LAMA dual therapy.
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Affiliation(s)
- Chih-Cheng Lai
- Department of Internal Medicine, Kaohsiung Veterans General Hospital, Tainan Branch, Tainan 710, Taiwan;
| | - Chao-Hsien Chen
- Division of Pulmonary, Department of Internal Medicine, MacKay Memorial Hospital, Taipei 104, Taiwan;
- Department of Medicine, MacKay Medical College, New Taipei City 252, Taiwan
| | - Kuang-Hung Chen
- Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei 100, Taiwan; (K.-H.C.); (H.-C.W.)
| | - Cheng-Yi Wang
- Department of Internal Medicine, Cardinal Tien Hospital and School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 231, Taiwan
- Correspondence: e-mail (C.-Y.W.); (T.-M.H.); (Y.-H.W.)
| | - Tsan-Ming Huang
- Department of Internal Medicine, Cardinal Tien Hospital and School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 231, Taiwan
- Correspondence: e-mail (C.-Y.W.); (T.-M.H.); (Y.-H.W.)
| | - Ya-Hui Wang
- Medical Research Center, Cardinal Tien Hospital and School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 231, Taiwan
- Correspondence: e-mail (C.-Y.W.); (T.-M.H.); (Y.-H.W.)
| | - Hao-Chien Wang
- Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei 100, Taiwan; (K.-H.C.); (H.-C.W.)
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