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Jiao G, Ye S, Zhang J, Wu B, Wei D, Liu D, Liu F, Hu C, Chen J. Association of cardiac disease with the risk of post-lung transplantation mortality in Chinese recipients aged over 65 years. Front Med 2022; 17:58-67. [PMID: 36536194 PMCID: PMC9762646 DOI: 10.1007/s11684-022-0937-y] [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: 11/20/2021] [Accepted: 05/10/2022] [Indexed: 12/23/2022]
Abstract
The current organ allocation rules prioritize elderly and urgent patients on the lung transplantation (LT) waiting list. A steady increase in the threshold at which age is taken into consideration for LT has been observed. This retrospective cohort study recruited 166 lung transplant recipients aged ≽ 65 years between January 2016 and October 2020 in the largest LT center in China. In the cohort, subgroups of patients aged 65-70 years (111 recipients, group 65-70) and ≽ 70 years (55 recipients, group ≽ 70) were included. Group D restrictive lung disease was the main indication of a lung transplant in recipients over 65 years. A significantly higher percentage of coronary artery stenosis was observed in the group ≽ 70 (30.9% vs. 14.4% in group 65-70, P = 0.014). ECMO bridging to LT was performed in 5.4% (group 65-70) and 7.3% (group ≽ 70) of patients. Kaplan-Meier estimates showed that recipients with cardiac abnormalities had a significantly increased risk of mortality. After adjusting for potential confounders, cardiac abnormality was shown to be independently associated with the increased risk of post-LT mortality (HR 6.37, P = 0.0060). Our result showed that LT can be performed in candidates with an advanced age and can provide life-extending benefits.
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Affiliation(s)
- Guohui Jiao
- Wuxi Lung Transplant Center, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, 214023, China
| | - Shugao Ye
- Wuxi Lung Transplant Center, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, 214023, China
| | - Ji Zhang
- Wuxi Lung Transplant Center, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, 214023, China
| | - Bo Wu
- Wuxi Lung Transplant Center, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, 214023, China
| | - Dong Wei
- Wuxi Lung Transplant Center, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, 214023, China
| | - Dong Liu
- Wuxi Lung Transplant Center, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, 214023, China
| | - Feng Liu
- Wuxi Lung Transplant Center, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, 214023, China
| | - Chunxiao Hu
- Wuxi Lung Transplant Center, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, 214023, China
| | - Jingyu Chen
- Wuxi Lung Transplant Center, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, 214023, China.
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Jiao G, Huang J, Wu B, Hu C, Gao C, Chen W, Huang M, Chen J. Association of Pulmonary Artery Pressure Change With Post-Lung Transplantation Survival: Retrospective Analysis of China Registry. JACC Asia 2022; 2:819-828. [PMID: 36713754 PMCID: PMC9877213 DOI: 10.1016/j.jacasi.2022.09.017] [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] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 08/16/2022] [Accepted: 09/12/2022] [Indexed: 12/23/2022]
Abstract
Background Extracorporeal membrane oxygenation (ECMO) has been used as intraoperative hemodynamic support in patients with end-stage lung diseases and pulmonary hypertension undergoing lung transplantation (LT). Objectives The aim of this study was to identify the association of pulmonary artery pressure change during ECMO and post-LT survival. Methods The study investigators collected and analyzed the data from Chinese Lung Transplantation Registry. Patients who have severe pulmonary hypertension with intraoperative ECMO support were enrolled. Post-LT mortality and morbidity were further collected and compared. Results A total of 208 recipients were included in the study, during which 53 deaths occurred post-LT. All the patients had severe pulmonary hypertension and were supported by intraoperative ECMO. Using eXtreme Gradient Boosting, or XGboost, model method, 20 variables were selected and ranked. Changes of mean pulmonary artery pressure at the time of ECMO support and ECMO wean-off (ΔmPAP) were related to post-LT survival, after adjusting for potential confounders (recipient age, New York Heart Association functional class status before LT, body mass index, pre-LT hypertension, pre-LT steroids, and pre-LT ECMO bridging). A nonlinear relationship was detected between ΔmPAP and post-LT survival, which had an inflection point of 35 mm Hg. Recipients with ΔmPAP ≦35 mm Hg had higher mortality rate calculated through the Kaplan-Meier estimator (P = 0.041). Interaction analysis showed that recipients admitted in LT center with high case volume (≥50 cases/year) and ΔmPAP >35 mm Hg had better long-term survival. The trend was reversed in recipients who were admitted in LT center with low case volume (<50 cases/year). Conclusions The relationship between ΔmPAP and post-LT survival was nonlinear. Optimal perioperative ECMO management strategy with experienced team is further warranted.
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Affiliation(s)
- Guohui Jiao
- Wuxi Lung Transplant Center, Wuxi People’s Hospital affiliated to Nanjing Medical University, Wuxi, China
| | - Jian Huang
- The Second Affiliated Hospital of Hainan Medical University, Hainan, China
| | - Bo Wu
- Wuxi Lung Transplant Center, Wuxi People’s Hospital affiliated to Nanjing Medical University, Wuxi, China
| | - Chunxiao Hu
- Wuxi Lung Transplant Center, Wuxi People’s Hospital affiliated to Nanjing Medical University, Wuxi, China
| | - Chenyang Gao
- General Intensive Care Unit, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wenhui Chen
- Center for Lung Transplantation, China-Japan Friendship Hospital, Beijing, China
| | - Man Huang
- General Intensive Care Unit, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China,Address for correspondence: Dr Man Huang, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310052, China.
| | - Jingyu Chen
- Wuxi Lung Transplant Center, Wuxi People’s Hospital affiliated to Nanjing Medical University, Wuxi, China,Center for Lung Transplantation, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China,Dr Jingyu Chen, QingYang Road, No 299#, Wuxi Lung Transplant Center, Wuxi People’s Hospital affiliated to Nanjing Medical University, Wuxi 214023, China.
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Jiao G, Zhang J, Liu D, Chen J. Cardiac Disease Increased Risk of Death and Early Comorbidities Impacting Prognosis of Lung Transplant Recipients with Extreme Ages. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Jiao G, Li X, Wu B, Yang H, Zhang G, Ding Z, Zhao G, Chen J. Case Report: Delayed Lung Transplantation With Intraoperative ECMO Support for Herbicide Intoxication-Related Irreversible Pulmonary Fibrosis: Strategy and Outcome. Front Surg 2021; 8:754816. [PMID: 34901140 PMCID: PMC8660696 DOI: 10.3389/fsurg.2021.754816] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 11/01/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Lung transplantation is recognized as the only therapeutic option for patients who develop irreversible pulmonary fibrosis after herbicide intoxication. Methods: We have collected and presented clinical course and outcome of four patients who received lung transplantation due to paraquat and diquat intoxication from 2018 to 2021. Another patient who received initial lung transplantation due to paraquat intoxication and re-transplantation due to chronic lung allograft dysfunction in 2019, was further reported. Patients were admitted in lung transplantation centers, including the 1st affiliated hospital of Zhengzhou University and Wuxi Lung transplantation center. Previous reported cases from Europe, Canada and China were also summarized as benchmark. Results: During the period from the year of 2018 to 2021, there have been four patients in China, who received lung transplantation due to herbicide intoxication. Median age of the four patients was 37 (IQR 34.5, 39.75) years old. Median time from intoxication to lung transplantation was 27.5 (IQR 27, 30.5) days. Bilateral lung transplantation was performed in three patients, while one single lung transplantation was performed in an urgent listed patient. Extracorporeal Membrane Oxygenation (ECMO) and hemopurification support were used in all patients (100%). Details of the cases with follow-ups were further presented and analyzed. Conclusions: Late timing of bilateral lung transplantation can be performed successfully for pulmonary fibrosis after paraquat or diquat intoxication. The survival of patients with complex perioperative conditions can be achieved with a multidisciplinary team to manage the irreversible effects of intoxication.
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Affiliation(s)
- Guohui Jiao
- Wuxi Lung Transplant Center, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, China
| | - Xiangnan Li
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Bo Wu
- Wuxi Lung Transplant Center, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, China
| | - Hang Yang
- Wuxi Lung Transplant Center, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, China
| | - Guoqing Zhang
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zheng Ding
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Gaofeng Zhao
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingyu Chen
- Wuxi Lung Transplant Center, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, China
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Wu B, Huang M, Jiao G, Hu C, Yang Y, Jingyu C. Lung transplantation during the outbreak of Coronavirus Disease 2019 in China. J Thorac Cardiovasc Surg 2020; 163:326-335.e6. [PMID: 33461803 PMCID: PMC7704333 DOI: 10.1016/j.jtcvs.2020.10.154] [Citation(s) in RCA: 2] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 10/30/2020] [Accepted: 10/30/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVES The study objectives were to illustrate our workflow for lung donation and transplantation during the Coronavirus Disease 2019 crisis and to report our preliminary experience with perioperative care. METHODS We retrospectively analyzed data in the China Lung Transplantation Registration from January 23, 2020, to March 23, 2020 (2020 cohort), compared with the same period in 2019 (2019 cohort). Pre- and post-lung transplantation management strategies, including measures aiming to prevent severe acute respiratory syndrome coronavirus 2 infection, were applied to all recipients, including 5 post-Coronavirus Disease 2019 transplants during the Coronavirus Disease 2019 pandemic period in China. RESULTS Twenty-eight lung transplant procedures were performed, including lung transplant for 5 patients with acute respiratory distress syndrome due to Coronavirus Disease 2019-related pulmonary fibrosis. Compared with the 2019 cohort, more patients with urgent conditions received transplantation in 2020, with a shorter pre-lung transplant admission time and early mobilization post-lung transplant. A large proportion (60%) of lung donations were transported on high-speed trains and commercial flights or highways and commercial flights. Grafts in the preservation containers were handed over to the receiving staff at the airport for 40% (10/25) of donations, which reduced the unnecessary quarantine of transporting staff entering the city. Listed candidates were urgently transferred to other qualified centers in 17.9% of cases (5/28), which reduced the risk of severe acute respiratory syndrome coronavirus 2 exposure in Coronavirus Disease 2019-designated hospitals. The 90-day survival of the transplant recipients in 2020 was 85.7%, including 3 of 5 recipients (60%) who had critically severe Coronavirus Disease 2019. CONCLUSIONS Lung transplant and donation amid Coronavirus Disease 2019 can be performed safely with coordinated efforts on medical resource sharing and medical staff protection based on stratification of the infection risk. Outcomes were not compromised during the Coronavirus Disease 2019 outbreak. Lung transplantion can be regarded as salvage therapy for critical patients with Coronavirus Disease 2019 with a confirmed positive turned negative virology status.
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Affiliation(s)
- Bo Wu
- Wuxi Lung Transplant Center, Wuxi People's Hospital affiliated to Nanjing Medical University, Wuxi, China
| | - Man Huang
- General ICU, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Guohui Jiao
- Wuxi Lung Transplant Center, Wuxi People's Hospital affiliated to Nanjing Medical University, Wuxi, China
| | - Chunxiao Hu
- Wuxi Lung Transplant Center, Wuxi People's Hospital affiliated to Nanjing Medical University, Wuxi, China
| | - Yi Yang
- Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
| | - Chen Jingyu
- Wuxi Lung Transplant Center, Wuxi People's Hospital affiliated to Nanjing Medical University, Wuxi, China; Center for Lung Transplantation, China-Japan Friendship Hospital, Beijing, China.
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Chen J, Li X, Hu C, Liu F, Jiao G. GREEN CHANNEL OF HUMAN ORGAN TRANSPORT IMPROVING DONATED LUNGS UTILIZATION WITH PROMOTION IMPACT. Chest 2020. [DOI: 10.1016/j.chest.2020.05.514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Wu B, Hu C, Chen W, He J, Jiang G, Zhang J, Liu D, Li X, Wei D, Jiao G, Wang C, Chen J. China lung transplantation developing: past, present and future. Ann Transl Med 2020; 8:41. [PMID: 32154286 PMCID: PMC7036632 DOI: 10.21037/atm.2019.10.26] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 09/25/2019] [Indexed: 12/23/2022]
Abstract
Lung transplantation in China has been developing for almost 40 years (1979-2019). The pioneers of this procedure experienced struggles and obstacles upon accomplishment of the initial 20 cases of lung transplantation. Like the expanding process of transplant programs elsewhere in western countries and other regions in Asia, transplant teams in China have found their own way to step forward, with the establishment of the two largest centers in Beijing and Wuxi. Since 2015, which was a novel start and milestone for transplant affairs in China, the pace of transplant volume and comparable quality of care for lung transplant recipients have increased noticeably. We reviewed the advancement of lung transplantation programs and registry setup in China and indicated that more socioeconomic factors and human care aspects needed to be considered to benefit Chinese recipients, which may further inspire the modification of criteria of listing and organ utilization based on East Asian cultural and traditional origins.
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Affiliation(s)
- Bo Wu
- Wuxi Lung Transplant Center, Wuxi People’s Hospital Affiliated to Nanjing Medical University, Wuxi 214000, China
| | - Chunxiao Hu
- Wuxi Lung Transplant Center, Wuxi People’s Hospital Affiliated to Nanjing Medical University, Wuxi 214000, China
| | - Wenhui Chen
- Center for Lung Transplantation, China-Japan Friendship Hospital, Beijing 100000, China
| | - Jianxing He
- Department of Thoracic Surgery/Oncology State Key Laboratory and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510000, China
| | - Gening Jiang
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200000, China
| | - Ji Zhang
- Wuxi Lung Transplant Center, Wuxi People’s Hospital Affiliated to Nanjing Medical University, Wuxi 214000, China
| | - Dong Liu
- Wuxi Lung Transplant Center, Wuxi People’s Hospital Affiliated to Nanjing Medical University, Wuxi 214000, China
| | - Xiaoshan Li
- Wuxi Lung Transplant Center, Wuxi People’s Hospital Affiliated to Nanjing Medical University, Wuxi 214000, China
| | - Dong Wei
- Wuxi Lung Transplant Center, Wuxi People’s Hospital Affiliated to Nanjing Medical University, Wuxi 214000, China
| | - Guohui Jiao
- Wuxi Lung Transplant Center, Wuxi People’s Hospital Affiliated to Nanjing Medical University, Wuxi 214000, China
| | - Chen Wang
- Center for Lung Transplantation, China-Japan Friendship Hospital, Beijing 100000, China
| | - Jingyu Chen
- Wuxi Lung Transplant Center, Wuxi People’s Hospital Affiliated to Nanjing Medical University, Wuxi 214000, China
- Center for Lung Transplantation, China-Japan Friendship Hospital, Beijing 100000, China
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Wang X, Jin H, Han F, Cui Y, Chen J, Yang C, Zhu P, Wang W, Jiao G, Wang W, Hao C, Gao Z. Homozygous DNAH1 frameshift mutation causes multiple morphological anomalies of the sperm flagella in Chinese. Clin Genet 2016; 91:313-321. [PMID: 27573432 DOI: 10.1111/cge.12857] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 08/22/2016] [Accepted: 08/22/2016] [Indexed: 01/19/2023]
Abstract
This study aimed to investigate the genetic pathogeny of multiple morphological anomalies of the flagella (MMAF), which is a genetically heterogeneous disorder leading to male infertility. Nine patients with severe asthenozoospermia caused by MMAF were recruited. Whole genome sequencing and Sanger sequencing were performed, and we found that four of the nine patients were affected by the same homozygous frameshift mutation c.11726_11727delCT (p.[Pro3909ArgfsTer33]) in exon 73 of dynein axonemal heavy chain 1 ( DNAH1 ) gene. The parents and the sibling of proband 1 were all identified as heterozygous carriers. This mutation was distinct from previously reported DNAH1 mutations associated with MMAF and only affected the East Asian group. Furthermore, the variant DNAH1 protein could not be detected in spermatozoa by Western blot or immunofluorescence staining although DNAH1 mRNA was expressed in the spermatozoa. Scanning electron microscopy and transmission electron microscopy analysis showed the anomalies in sperm flagella morphology and ultrastructure in patients carrying this genetic variant. In conclusion, our results add to knowledge of the genetic pathogeny of MMAF and further confirmed the effectiveness of genetic screening in the diagnosis of MMAF.
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Affiliation(s)
- X Wang
- Department of Surgery, Medical College of Shandong University, Jinan, People's Republic of China.,Reproductive Medicine Center, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, People's Republic of China
| | - H Jin
- Department of Urological Surgery, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, People's Republic of China
| | - F Han
- Medicine and Pharmacy Research Center, Binzhou Medical University, Yantai, People's Republic of China
| | - Y Cui
- Reproductive Medicine Center, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, People's Republic of China
| | - J Chen
- Reproductive Medicine Center, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, People's Republic of China
| | - C Yang
- Medicine and Pharmacy Research Center, Binzhou Medical University, Yantai, People's Republic of China
| | - P Zhu
- Central laboratory, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, People's Republic of China
| | - W Wang
- Central laboratory, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, People's Republic of China
| | - G Jiao
- Reproductive Medicine Center, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, People's Republic of China
| | - W Wang
- Reproductive Medicine Center, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, People's Republic of China
| | - C Hao
- Reproductive Medicine Center, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, People's Republic of China
| | - Z Gao
- Department of Urological Surgery, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, People's Republic of China
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Zheng Z, Jiao G, Wang T, Chen X, Wang B. Ligation-Assisted Endoscopic Enucleation for the Resection of Gastrointestinal Tumors Originating from the Muscularis Propria: Analysis of Efficacy and Facility. Dig Surg 2016; 33:488-94. [PMID: 27250727 DOI: 10.1159/000445957] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [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] [Received: 10/18/2015] [Accepted: 04/03/2016] [Indexed: 01/18/2023]
Abstract
BACKGROUND Gastrointestinal tumors originating from the muscularis propria are believed to have the potential to progress to malignant tumors. The efficacy of 'pre-management' with elastic band or endoloop assistant ligation after initial submucosal dissection in endoscopic enucleation procedure of these tumors was investigated and evaluated. METHODS The study included 21 patients with small gastric stromal tumors arising in the gastric muscularis propria as determined by endoscopy (endoscopic ultrasonography). A standard endoscope with a transparent cap attached to the tip was used. The cap was placed over the lesion, after incision of the surrounding tissue, maximum sustained suction was applied. Then the elastic band or endoloop was released around the base. Circumference resection was performed with clips strengthening the defect closure. RESULTS The 22 gastrointestinal stromal tumors sloughed completely. The mean time required for the full-thickness resection was 48 min. Minor perforation occurred with metal clips closing the defect of the gastric wall. Follow-up ranged from 13 to 42 months, during which time no recurrence was observed postoperatively. CONCLUSIONS The band or endoloop assistant endoscopic ligation technique is effective for the enucleation of deep gastric tumors. It may help avoiding disturbance the abdominal cavity hemostasis in traditional full-thickness enucleation procedure.
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Affiliation(s)
- Zhongqing Zheng
- Department of Gastroenterology, Tianjin Medical University General Hospital, Tianjin, China
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Jiao G, Zheng Z, Jiang K, Zhang J, Wang B. Enteropathy-associated T-cell lymphoma presenting with gastrointestinal tract symptoms: A report of two cases and review of diagnostic challenges and clinicopathological correlation. Oncol Lett 2014; 8:91-94. [PMID: 24959225 PMCID: PMC4063612 DOI: 10.3892/ol.2014.2105] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Accepted: 03/14/2014] [Indexed: 12/22/2022] Open
Abstract
The gastrointestinal tract is the most common location for primary extranodal non-Hodgkin lymphoma (NHL) with cases less commonly found in the intestine. The majority of primary intestinal B-cell lymphomas are exophytic, whereas enteropathy-associated T-cell lymphomas present predominantly as thickened plaques, ulcers or strictures. Crohn's disease (CD) is a chronic inflammatory disease of the intestines with fissures and ulcers, which is difficult for clinicians to diagnose based on endoscopic observations alone. Malignant lymphoma must be considered when clinically diagnosed CD is refractory to medication or when its clinical course becomes aggressive. The current study presents a rare case of primary colon T-cell lymphoma in a 16-year-old male with poor prognosis, as well as a case of gastrointestinal lymphoma occurring in the duodenum and colon in a 62-year-old male with a 10-year history of NHL. It was difficult to determine the diagnosis by a single endoscopic biopsy as the majority of biopsy specimens revealed mixed inflammation within which the lymphoma cells were difficult to identify. The present study indicated that it is important to recognize ulcerative or stenotic lymphoma and to differentiate it from CD as it exhibits a much more aggressive clinical behavior. The correct diagnosis may be confirmed by careful histopathological study and ancillary examination.
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Affiliation(s)
- Guohui Jiao
- Department of Gastroenterology, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Zhongqing Zheng
- Department of Gastroenterology, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Kui Jiang
- Department of Gastroenterology, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Jie Zhang
- Department of Gastroenterology, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Bangmao Wang
- Department of Gastroenterology, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
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Zhang Z, Liu Q, Che Y, Yuan X, Dai L, Zeng B, Jiao G, Zhang Y, Wu X, Yu Y, Zhang Y, Yang R. Antigen presentation by dendritic cells in tumors is disrupted by altered metabolism that involves pyruvate kinase M2 and its interaction with SOCS3. Cancer Res 2009; 70:89-98. [PMID: 19996282 DOI: 10.1158/0008-5472.can-09-2970] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Dendritic cell (DC) function is negatively affected by tumors and tumor-derived factors, but little is known about the underlying mechanisms. Here, we show that intracellular SOCS3 in DCs binds to pyruvate kinase type M2 (M2-PK), which plays a critical role in ATP production through glycolysis. The interaction of SOCS3 with M2-PK reduced ATP production and impaired DC-based immunotherapy against tumors. Thus, SOCS3, which has been shown to be upregulated by tumor-derived factors, interacts with M2-PK to decrease ATP production, causing DC dysfunction. These dysfunctional DCs have a reduced ability to present antigens. Alteration of DC metabolism mediated by SOCS3 represents a novel mechanism for DC dysfunction in the tumor microenvironment.
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Affiliation(s)
- Zhuohan Zhang
- Department of Immunology, Nankai University School of Medicine and Key Laboratory of Bioactive Materials, Ministry of Education, Nankai University, Tianjin, People's Republic of China
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Zhang Z, Zeng B, Jiao G, Li Y, Liu Y, Zhang Y, Yang R. AA28–67 domain within MyD88 suppresses c-myc activity and expression to regulate differentiation and function of dendritic cells. Clin Immunol 2009; 133:324-32. [DOI: 10.1016/j.clim.2009.08.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2009] [Revised: 07/19/2009] [Accepted: 08/06/2009] [Indexed: 02/02/2023]
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Liu Y, Yu Y, Yang S, Zeng B, Zhang Z, Jiao G, Zhang Y, Cai L, Yang R. Regulation of arginase I activity and expression by both PD-1 and CTLA-4 on the myeloid-derived suppressor cells. Cancer Immunol Immunother 2009; 58:687-97. [PMID: 18828017 PMCID: PMC11030939 DOI: 10.1007/s00262-008-0591-5] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.5] [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: 05/27/2008] [Accepted: 09/03/2008] [Indexed: 12/20/2022]
Abstract
An elevated number of Gr-1(+)CD11b(+) myeloid-derived suppression cells (MDSCs) has been described in mice and human bearing tumor and associated with immune suppression. Arginase I production by MDSCs in the tumor environment may be a central mechanism for immunosuppression and tumor evasion. In this study and before, we found that Gr-1(+)CD11b(+) MDSCs from ascites and spleen of mice bearing ovarian 18D carcinoma express a high level of PD-1, CTLA-4, B7-H1 and CD80 while other co-stimulatory molecules, namely CD40, B7-DC and CD86 are not detected. Further studies showed that PD-1 and CTLA-4 on the Gr-1(+)CD11b(+) MDSCs regulated the activity and expression of arginase I. The blockage and silencing of PD-1, CTLA-4 or both PD-1 and CTLA4 molecules could significantly reduce arginase I activity and expression induced with tumor-associated factor. Similar results were also observed while their ligands B7-H1 and/or CD80 were blocked or silenced. Furthermore, CD80 deficiency also decreased the arginase I expression and activity. Antibody blockade or silencing of PD-1, CTLA-4 or both reduced the suppressive potential of PD-1+CTLA-4+MDSCs. Blockade of PD-1, CTLA-4 or both also slowed tumor growth and improved the survival rate of tumor-bearing mice. Thus, there may exist a coinhibitory and costimulatory molecules-based immuno-regulating net among MDSCs.
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MESH Headings
- Animals
- Antibodies, Monoclonal/pharmacology
- Antigens, CD/genetics
- Antigens, CD/physiology
- Antigens, Surface/analysis
- Antigens, Surface/genetics
- Antigens, Surface/physiology
- Apoptosis Regulatory Proteins/analysis
- Apoptosis Regulatory Proteins/genetics
- Apoptosis Regulatory Proteins/physiology
- Arginase/biosynthesis
- Arginase/genetics
- B7-1 Antigen/immunology
- B7-H1 Antigen
- CD11b Antigen/analysis
- CD8-Positive T-Lymphocytes/immunology
- CTLA-4 Antigen
- Carcinoma/enzymology
- Carcinoma/immunology
- Carcinoma/pathology
- Cell Line, Tumor/immunology
- Cell Line, Tumor/transplantation
- Enzyme Induction
- Female
- Male
- Membrane Glycoproteins/immunology
- Mice
- Mice, Inbred C57BL
- Neoplasm Proteins/biosynthesis
- Neoplasm Proteins/genetics
- Neoplasm Proteins/physiology
- Ovarian Neoplasms/enzymology
- Ovarian Neoplasms/immunology
- Ovarian Neoplasms/pathology
- Peptides/immunology
- Programmed Cell Death 1 Receptor
- RNA Interference
- RNA, Small Interfering/genetics
- RNA, Small Interfering/physiology
- Receptors, Chemokine/analysis
- Specific Pathogen-Free Organisms
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Affiliation(s)
- Yu Liu
- Department of Immunology, Nankai University School of Medicine, Nankai University, 300071 Tianjin, China
- Key Laboratory of Bioactive Materials, Ministry of Education, Nankai University, 300071 Tianjin, China
| | - Yinyan Yu
- Department of Immunology, Nankai University School of Medicine, Nankai University, 300071 Tianjin, China
- Key Laboratory of Bioactive Materials, Ministry of Education, Nankai University, 300071 Tianjin, China
| | - Suguang Yang
- Department of Immunology, Nankai University School of Medicine, Nankai University, 300071 Tianjin, China
- Key Laboratory of Bioactive Materials, Ministry of Education, Nankai University, 300071 Tianjin, China
| | - Bin Zeng
- Department of Immunology, Nankai University School of Medicine, Nankai University, 300071 Tianjin, China
- Key Laboratory of Bioactive Materials, Ministry of Education, Nankai University, 300071 Tianjin, China
| | - Zhuohan Zhang
- Department of Immunology, Nankai University School of Medicine, Nankai University, 300071 Tianjin, China
- Key Laboratory of Bioactive Materials, Ministry of Education, Nankai University, 300071 Tianjin, China
| | - Guohui Jiao
- Department of Immunology, Nankai University School of Medicine, Nankai University, 300071 Tianjin, China
- Key Laboratory of Bioactive Materials, Ministry of Education, Nankai University, 300071 Tianjin, China
| | - Yuan Zhang
- Department of Immunology, Nankai University School of Medicine, Nankai University, 300071 Tianjin, China
- Key Laboratory of Bioactive Materials, Ministry of Education, Nankai University, 300071 Tianjin, China
| | - Limin Cai
- Department of Immunology, Nankai University School of Medicine, Nankai University, 300071 Tianjin, China
- Key Laboratory of Bioactive Materials, Ministry of Education, Nankai University, 300071 Tianjin, China
| | - Rongcun Yang
- Department of Immunology, Nankai University School of Medicine, Nankai University, 300071 Tianjin, China
- Key Laboratory of Bioactive Materials, Ministry of Education, Nankai University, 300071 Tianjin, China
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14
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Zhang Z, Zeng B, Zhang Z, Jiao G, Li H, Jing Z, Ouyang J, Yuan X, Chai L, Che Y, Zhang Y, Yang R. Suppressor of Cytokine Signaling 3 Promotes Bone Marrow Cells to Differentiate into CD8+ T Lymphocytes in Lung Tissue via Up-Regulating Notch1 Expression. Cancer Res 2009; 69:1578-86. [DOI: 10.1158/0008-5472.can-08-2744] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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15
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Jiao G, Wang Y. [Effects of muscular position splint on maxillomandibular realignment]. Hua Xi Kou Qiang Yi Xue Za Zhi 1999; 17:254-6. [PMID: 12539299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
OBJECTIVE To study the effects of muscular position splint on maxillomandibular realignment. METHODS The changes of occlusal impression on splint in 102 craniomandibular disorder (CMD) patients were recorded after wearing the splint 1 week, 2 weeks, 1 month, two to three or six months. If there appeared instability of occlusal impression when biting, the original impression was cleared and new soft resin was placed on its surface in order to get a new impression. The splint was always adjusted to fit well. When the signs and symptoms of CMD disappeared, the splint was worn off. Finally, whether the muscular contact position harmonized with the intercuspal position (ICP) or not was recorded. RESULTS There appeared two different conditions: 1. The original occlusal impression remained unchanged in 66 patients; 2. Being unfitted in 36 patients, occlusal analysis revealed that 12/102 patients had abnormal occlusion including premature anterior teeth contact (2 cases), natural defective vertical dimension (1 case) and deflected ICP (9 cases). These abnormal occlusion could not be determined before treatment. CONCLUSION The muscular position splint can correct the abnormal muscular position. On the premise that the muscular position is normal, the muscular position splint can be used to judge whether the ICP is normal.
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Affiliation(s)
- G Jiao
- Department of Dental Sciences, Bethune International Peace Hospital
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