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Liu LP, Zha Y, Wang JY, Xu LY, Qin X. [Role of innate lymphoid cells in oral squamous cell carcinoma microenvironment]. Zhonghua Kou Qiang Yi Xue Za Zhi 2024; 59:394-399. [PMID: 38548598 DOI: 10.3760/cma.j.cn112144-20240129-00041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Oral squamous cell carcinoma (OSCC) is the most common oral malignancy. It has a high incidence, strong invasion ability, easy metastasis, poor curative effect, and poor prognosis. Innate lymphoid cells (ILCs) are an important part of immune cells located in the mucosal barrier, which play an important role in the occurrence, development and outcome of tumors. ILCs are the key cells for decoding the regulatory mechanism of tumor microenvironment and the signatures for tumor progression. This paper reviewed the latest progress on ILCs, summarized the possible characteristics and functions of ILCs in the microenvironment of OSCC, and explored the relationship between ILCs and the occurrence, development and immunotherapy of OSCC.
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Affiliation(s)
- L P Liu
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Y Zha
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - J Y Wang
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - L Y Xu
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology & School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology & Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan 430030, China
| | - X Qin
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology & School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology & Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan 430030, China
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Chen RH, Liang FY, Han P, Lin PL, Lin XJ, Wang JY, Kong XW, Huang XM. [Preliminary outcomes of neoadjuvant chemoimmunotherapy combined with transoral robotic surgery for locally advanced oropharyngeal squamous cell carcinoma]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2024; 59:329-334. [PMID: 38599642 DOI: 10.3760/cma.j.cn115330-20231205-00273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
Objective: To evaluate the efficacy of neoadjuvant chemoimmunotherapy (NACI) combined with transoral robotic surgery (TORS) in the treatment of locally advanced oropharyngeal squamous cell carcinoma (OPSCC). Methods: This was a retrospective study of 15 patients with locally advanced OPSCC who underwent TORS after neoadjuvant therapy (NAT) at the Department of Otolaryngology-Head and Neck Surgery of Sun Yat-sen Memorial Hospital of Sun Yat-sen University from April 2019 to February 2023. There were 12 males and 3 females, aged 31 to 74 years. Twelve cases were tonsil cancer, and 3 cases were tongue base cancer. There were 11 cases in stage Ⅲ and 4 cases in stage Ⅳ. Two patients received neoadjuvant chemotherapy and 13 patients received NACI, with 2 to 3 cycles, and all patients underwent TORS after multidisciplinary team consultation. The clinicopathological characteristics, surgical outcomes, and oncological results were summarized. Results: All surgeries were successfully completed with negative surgical margins, and no case was required conversion surgery. All patients were fed via nasogastric tubes postoperatively, with a median gastric tube stay of 7 days (range: 2-60 days). No tracheotomy was applied. There were no major complications such as postoperative bleeding. Pathological complete response (pCR) was found in 10 cases (76.9%) among the 13 patients with NACI. The follow-up time was 21 months (range: 10-47 months), and there was no death or distant metastasis. One patient with rT0N3M0 tonsil cancer had local recurrence 5 months after surgery. The 2-year overall survival and 2-year disease-free survival were respectively 100.0% and 93.3% in the 15 patients. Conclusion: NACI combined with TORS provides a safe, effective and minimally invasive treatment for patients with locally advanced oropharyngeal squamous cell carcinoma.
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Affiliation(s)
- R H Chen
- Department of Otolaryngology, Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University,Guangzhou 510280, China Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangzhou 510280, China
| | - F Y Liang
- Department of Otolaryngology, Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University,Guangzhou 510280, China Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangzhou 510280, China
| | - P Han
- Department of Otolaryngology, Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University,Guangzhou 510280, China Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangzhou 510280, China
| | - P L Lin
- Department of Otolaryngology, Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University,Guangzhou 510280, China Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangzhou 510280, China
| | - X J Lin
- Department of Otolaryngology, Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University,Guangzhou 510280, China Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangzhou 510280, China
| | - J Y Wang
- Department of Otolaryngology, Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University,Guangzhou 510280, China Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangzhou 510280, China
| | - X W Kong
- Department of Otolaryngology, Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University,Guangzhou 510280, China Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangzhou 510280, China
| | - X M Huang
- Department of Otolaryngology, Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University,Guangzhou 510280, China Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangzhou 510280, China
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3
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Chen HW, Kuo YW, Chen CY, Chang CH, Wang SM, Chien YC, Lu WC, Chen JP, Chang CY, Wei YF, Chang SC, Shu CC, Wang JY, Liao WY, Wang HC, Yu CJ. Increased Tuberculosis Reactivation Risk in Patients Receiving Immune Checkpoint Inhibitor-Based Therapy. Oncologist 2024; 29:e498-e506. [PMID: 38227604 PMCID: PMC10994249 DOI: 10.1093/oncolo/oyad340] [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: 07/04/2023] [Accepted: 12/15/2023] [Indexed: 01/18/2024] Open
Abstract
OBJECTIVE Reports of tuberculosis (TB) during anticancer treatment with immune checkpoint inhibitors (ICIs) are increasing. However, it is not clear whether the use of ICIs is a significant risk factor for TB, including reactivation or latent TB infection (LTBI). METHODS To determine the risk of TB reactivation in patients with lung cancer who use ICIs or tyrosine kinase inhibitors (TKIs), we conducted a retrospective study using a hospital-based cancer registry. In addition, we monitored patients with cancer using ICI or TKI in a multicenter prospective study to check the incidence of LTBI. RESULTS In the retrospective study, several demographic factors were imbalanced between the ICI and TKI groups: the ICI group was younger, had more males, exhibited more squamous cell carcinoma in histology rather than adenocarcinoma, had fewer EGFR mutations, and received more chemotherapy. Propensity score matching was used to control for confounding factors, and we found that the incidence of TB was higher among patients with lung cancer who received ICIs than among those who received TKIs (2298 vs 412 per 100 000 person-years, P = .0165). Through multivariable analysis, group (ICI vs TKI) was the independent risk factor for TB development (adjusted hazard ratio (aHR): 6.29, 95% CI, 1.23-32.09, P = .0269). In the prospective cohort, which included 72 patients receiving ICIs and 50 receiving TKIs, we found that the incidence of positive seroconversion of LTBI by interferon gamma release assay (IGRA) was significantly higher in patients receiving ICIs (18% vs 0%, aHR: 9.88, P = 0.035) under multivariable Cox regression. CONCLUSION The use of ICIs may be linked to a higher likelihood of TB reactivation and LTBI than individuals solely receiving TKIs as anticancer therapy. Consequently, the implementation of a screening program for TB reactivation and LTBI among patients undergoing ICI treatment could prove advantageous by enabling early detection and prompt treatment of the infection.
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Affiliation(s)
- Hsing-Wu Chen
- Department of Oncology, National Taiwan University Hospital, Yunlin Branch, Yunlin County, Taiwan, Republic of China
- College of Medicine, National Taiwan University, Taipei, Taiwan, Republic of China
| | - Yao-Wen Kuo
- College of Medicine, National Taiwan University, Taipei, Taiwan, Republic of China
- Department of Integrated Diagnostics and Therapeutics, Medical Research, National Taiwan University Hospital, Taipei, Taiwan, Republic of China
| | - Chung-Yu Chen
- Department of Internal Medicine, National Taiwan University Hospital, Yunlin Branch, Yunlin County, Taiwan, Republic of China
| | - Chin-Hao Chang
- Department of Medical Research, National Taiwan University Hospital, Taipei, Taiwan, Republic of China
| | - Su-Mei Wang
- Department of Medical Research, National Taiwan University Hospital, Taipei, Taiwan, Republic of China
| | - Ying-Chun Chien
- College of Medicine, National Taiwan University, Taipei, Taiwan, Republic of China
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, Republic of China
| | - Wei-Chen Lu
- Department of Oncology, National Taiwan University Hospital, Yunlin Branch, Yunlin County, Taiwan, Republic of China
| | - Jo-Pai Chen
- Department of Oncology, National Taiwan University Hospital, Yunlin Branch, Yunlin County, Taiwan, Republic of China
| | - Cheng-Yu Chang
- Division of Chest Medicine, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei, Taiwan, Republic of China
- Department of Nursing, Cardinal Tien Junior College of Healthcare and Management, New Taipei, Taiwan, Republic of China
| | - Yu-Feng Wei
- Department of Internal Medicine, E-Da Cancer Hospital, I-Shou University, Kaohsiung, Taiwan, Republic of China
- School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, Taiwan, Republic of China
| | - Shih-Chieh Chang
- Department of Internal Medicine, National Yang Ming Chiao Tung University Hospital, Yilan county, Taiwan, Republic of China
| | - Chin-Chung Shu
- College of Medicine, National Taiwan University, Taipei, Taiwan, Republic of China
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, Republic of China
| | - Jann-Yuan Wang
- College of Medicine, National Taiwan University, Taipei, Taiwan, Republic of China
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, Republic of China
| | - Wei-Yu Liao
- College of Medicine, National Taiwan University, Taipei, Taiwan, Republic of China
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, Republic of China
| | - Hao-Chien Wang
- College of Medicine, National Taiwan University, Taipei, Taiwan, Republic of China
- Department of Medicine, National Taiwan University Cancer Center, Taipei, Taiwan, Republic of China
| | - Chong-Jen Yu
- College of Medicine, National Taiwan University, Taipei, Taiwan, Republic of China
- Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsin-Chu, Taiwan, Republic of China
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Chien YC, Chang CH, Huang CK, Chen YH, Liu CJ, Chen CY, Wang PH, Shu CC, Kuo LC, Wang JY, Ku SC, Wang HC, Yu CJ. The impact of nontuberculous mycobacterial lung disease in critically ill patients: Significance for survival and ventilator use. J Microbiol Immunol Infect 2024; 57:328-336. [PMID: 38220536 DOI: 10.1016/j.jmii.2023.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 12/16/2023] [Accepted: 12/28/2023] [Indexed: 01/16/2024]
Abstract
BACKGROUND This study investigates the impact of nontuberculous mycobacterial lung disease (NTM-LD) on mortality and mechanical ventilation use in critically ill patients. METHODS We enrolled patients with NTM-LD or tuberculosis (TB) in intensive care units (ICU) and analysed their association with 30-day mortality and with mechanical ventilator-free survival (VFS) at 30 days after ICU admission. RESULTS A total of 5996 ICU-admitted patients were included, of which 541 (9.0 %) had TB and 173 (2.9 %) had NTM-LD. The overall 30-day mortality was 22.2 %. The patients with NTM-LD had an adjusted hazard ratio (aHR) of 1.49 (95 % CI, 1.06-2.05), and TB patients had an aHR of 2.33 (95 % CI, 1.68-3.24), compared to ICU patients with negative sputum mycobacterial culture by multivariable Cox proportional hazard (PH) regression. The aHR of age<65 years, obesity, idiopathic pulmonary fibrosis, end-stage kidney disease, active cancer and autoimmune disease and diagnosis of respiratory failure were also significantly positively associated with ICU 30-day mortality. In multivariable Cox PH regression for VFS at 30 days in patients requiring invasive mechanical ventilation, NTM-LD was negatively associated with VFS (aHR 0.71, 95 % CI: 0.56-0.92, p = 0.009), while TB showed no significant association. The diagnosis of respiratory failure itself predicted unfavourable outcome for 30-day mortality and a negative impact on VFS at 30 days. CONCLUSIONS NTM-LD and TB were not uncommon in ICU and both were correlated with increasing 30-day mortality in ICU patients. NTM-LD was associated with a poorer outcome in terms of VFS at 30 days.
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Affiliation(s)
- Ying-Chun Chien
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chin-Hao Chang
- Department of Medical Research, National Taiwan University Hospital, Taipei, Taiwan
| | - Chun-Kai Huang
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yung-Hsuan Chen
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chia-Jung Liu
- Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
| | - Chung-Yu Chen
- Department of Internal Medicine, National Taiwan University, Hospital Yun-Lin Branch, Douliu City, Taiwan
| | - Ping-Huai Wang
- Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Chin-Chung Shu
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
| | - Lu-Cheng Kuo
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Jann-Yuan Wang
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Shih-Chi Ku
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Hao-Chien Wang
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Medicine, National Taiwan University Cancer Center, Taipei, Taiwan
| | - Chong-Jen Yu
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
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Wang SZ, Wang MD, Wang JY, Yuan M, Li YD, Luo PT, Xiao F, Li H. Genome-wide association study of growth curve parameters reveals novel genomic regions and candidate genes associated with metatarsal bone traits in chickens. Animal 2024; 18:101129. [PMID: 38574453 DOI: 10.1016/j.animal.2024.101129] [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: 10/26/2023] [Revised: 03/02/2024] [Accepted: 03/05/2024] [Indexed: 04/06/2024] Open
Abstract
The growth and development of chicken bones have an enormous impact on the health and production performance of chickens. However, the development pattern and genetic regulation of the chicken skeleton are poorly understood. This study aimed to evaluate metatarsal bone growth and development patterns in chickens via non-linear models, and to identify the genetic determinants of metatarsal bone traits using a genome-wide association study (GWAS) based on growth curve parameters. Data on metatarsal length (MeL) and metatarsal circumference (MeC) were obtained from 471 F2 chickens (generated by crossing broiler sires, derived from a line selected for high abdominal fat, with Baier layer dams) at 4, 6, 8, 10, and 12 weeks of age. Four non-linear models (Gompertz, Logistic, von Bertalanffy, and Brody) were used to fit the MeL and MeC growth curves. Subsequently, the estimated growth curve parameters of the mature MeL or MeC (A), time-scale parameter (b), and maturity rate (K) from the non-linear models were utilized as substitutes for the original bone data in GWAS. The Logistic and Brody models displayed the best goodness-of-fit for MeL and MeC, respectively. Single-trait and multi-trait GWASs based on the growth curve parameters of the Logistic and Brody models revealed 4 618 significant single nucleotide polymorphisms (SNPs), annotated to 332 genes, associated with metatarsal bone traits. The majority of these significant SNPs were located on Gallus gallus chromosome (GGA) 1 (167.433-176.318 Mb), GGA2 (96.791-103.543 Mb), GGA4 (65.003-83.104 Mb) and GGA6 (64.685-95.285 Mb). Notably, we identified 12 novel GWAS loci associated with chicken metatarsal bone traits, encompassing 35 candidate genes. In summary, the combination of single-trait and multi-trait GWASs based on growth curve parameters uncovered numerous genomic regions and candidate genes associated with chicken bone traits. The findings benefit an in-depth understanding of the genetic architecture underlying metatarsal growth and development in chickens.
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Affiliation(s)
- S Z Wang
- Key Laboratory of Chicken Genetics and Breeding, Ministry of Agriculture and Rural Affairs, Harbin 150030, PR China; Key Laboratory of Animal Genetics, Breeding and Reproduction, Education Department of Heilongjiang Province, Harbin 150030, PR China; College of Animal Science and Technology, Northeast Agricultural University, Harbin 150030, PR China
| | - M D Wang
- Key Laboratory of Chicken Genetics and Breeding, Ministry of Agriculture and Rural Affairs, Harbin 150030, PR China; Key Laboratory of Animal Genetics, Breeding and Reproduction, Education Department of Heilongjiang Province, Harbin 150030, PR China; College of Animal Science and Technology, Northeast Agricultural University, Harbin 150030, PR China
| | - J Y Wang
- Key Laboratory of Chicken Genetics and Breeding, Ministry of Agriculture and Rural Affairs, Harbin 150030, PR China; Key Laboratory of Animal Genetics, Breeding and Reproduction, Education Department of Heilongjiang Province, Harbin 150030, PR China; College of Animal Science and Technology, Northeast Agricultural University, Harbin 150030, PR China
| | - M Yuan
- Key Laboratory of Chicken Genetics and Breeding, Ministry of Agriculture and Rural Affairs, Harbin 150030, PR China; Key Laboratory of Animal Genetics, Breeding and Reproduction, Education Department of Heilongjiang Province, Harbin 150030, PR China; College of Animal Science and Technology, Northeast Agricultural University, Harbin 150030, PR China
| | - Y D Li
- Key Laboratory of Chicken Genetics and Breeding, Ministry of Agriculture and Rural Affairs, Harbin 150030, PR China; Key Laboratory of Animal Genetics, Breeding and Reproduction, Education Department of Heilongjiang Province, Harbin 150030, PR China; College of Animal Science and Technology, Northeast Agricultural University, Harbin 150030, PR China
| | - P T Luo
- Fujian Sunnzer Biotechnology Development Co. Ltd, Guangze, Fujian Province 354100, PR China
| | - F Xiao
- Fujian Sunnzer Biotechnology Development Co. Ltd, Guangze, Fujian Province 354100, PR China
| | - H Li
- Key Laboratory of Chicken Genetics and Breeding, Ministry of Agriculture and Rural Affairs, Harbin 150030, PR China; Key Laboratory of Animal Genetics, Breeding and Reproduction, Education Department of Heilongjiang Province, Harbin 150030, PR China; College of Animal Science and Technology, Northeast Agricultural University, Harbin 150030, PR China.
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Yang HB, Gan ZG, Li YJ, Liu ML, Xu SY, Liu C, Zhang MM, Zhang ZY, Huang MH, Yuan CX, Wang SY, Ma L, Wang JG, Han XC, Rohilla A, Zuo SQ, Xiao X, Zhang XB, Zhu L, Yue ZF, Tian YL, Wang YS, Yang CL, Zhao Z, Huang XY, Li ZC, Sun LC, Wang JY, Yang HR, Lu ZW, Yang WQ, Zhou XH, Huang WX, Wang N, Zhou SG, Ren ZZ, Xu HS. Discovery of New Isotopes ^{160}Os and ^{156}W: Revealing Enhanced Stability of the N=82 Shell Closure on the Neutron-Deficient Side. Phys Rev Lett 2024; 132:072502. [PMID: 38427897 DOI: 10.1103/physrevlett.132.072502] [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: 07/05/2023] [Revised: 09/12/2023] [Accepted: 01/19/2024] [Indexed: 03/03/2024]
Abstract
Using the fusion-evaporation reaction ^{106}Cd(^{58}Ni,4n)^{160}Os and the gas-filled recoil separator SHANS, two new isotopes _{76}^{160}Os and _{74}^{156}W have been identified. The α decay of ^{160}Os, measured with an α-particle energy of 7080(26) keV and a half-life of 201_{-37}^{+58} μs, is assigned to originate from the ground state. The daughter nucleus ^{156}W is a β^{+} emitter with a half-life of 291_{-61}^{+86} ms. The newly measured α-decay data allow us to derive α-decay reduced widths (δ^{2}) for the N=84 isotones up to osmium (Z=76), which are found to decrease with increasing atomic number above Z=68. The reduction of δ^{2} is interpreted as evidence for the strengthening of the N=82 shell closure toward the proton drip line, supported by the increase of the neutron-shell gaps predicted in theoretical models.
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Affiliation(s)
- H B Yang
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - Z G Gan
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing 100049, China
- Advanced Energy Science and Technology Guangdong Laboratory, Huizhou 516007, China
| | - Y J Li
- School of Space Science and Physics, Shandong University, Weihai 264209, China
| | - M L Liu
- Sino-French Institute of Nuclear Engineering and Technology, Sun Yat-sen University, Zhuhai 519082, China
| | - S Y Xu
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - C Liu
- School of Space Science and Physics, Shandong University, Weihai 264209, China
| | - M M Zhang
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - Z Y Zhang
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - M H Huang
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing 100049, China
- Advanced Energy Science and Technology Guangdong Laboratory, Huizhou 516007, China
| | - C X Yuan
- Sino-French Institute of Nuclear Engineering and Technology, Sun Yat-sen University, Zhuhai 519082, China
| | - S Y Wang
- School of Space Science and Physics, Shandong University, Weihai 264209, China
| | - L Ma
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - J G Wang
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - X C Han
- School of Space Science and Physics, Shandong University, Weihai 264209, China
| | - A Rohilla
- School of Space Science and Physics, Shandong University, Weihai 264209, China
| | - S Q Zuo
- School of Space Science and Physics, Shandong University, Weihai 264209, China
| | - X Xiao
- School of Space Science and Physics, Shandong University, Weihai 264209, China
| | - X B Zhang
- School of Space Science and Physics, Shandong University, Weihai 264209, China
| | - L Zhu
- School of Space Science and Physics, Shandong University, Weihai 264209, China
| | - Z F Yue
- School of Space Science and Physics, Shandong University, Weihai 264209, China
| | - Y L Tian
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing 100049, China
- Advanced Energy Science and Technology Guangdong Laboratory, Huizhou 516007, China
| | - Y S Wang
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- Advanced Energy Science and Technology Guangdong Laboratory, Huizhou 516007, China
| | - C L Yang
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Z Zhao
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - X Y Huang
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Z C Li
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - L C Sun
- Guangxi Key Laboratory of Nuclear Physics and Technology, Guangxi Normal University, Guilin 541004, China
| | - J Y Wang
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- Advanced Energy Science and Technology Guangdong Laboratory, Huizhou 516007, China
| | - H R Yang
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Z W Lu
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - W Q Yang
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
| | - X H Zhou
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - W X Huang
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing 100049, China
- Advanced Energy Science and Technology Guangdong Laboratory, Huizhou 516007, China
| | - N Wang
- Guangxi Key Laboratory of Nuclear Physics and Technology, Guangxi Normal University, Guilin 541004, China
| | - S G Zhou
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing 100049, China
- Institute of Theoretical Physics, Chinese Academy of Sciences, Beijing 100190, China
| | - Z Z Ren
- School of Physics Science and Engineering, Tongji University, Shanghai 200092, China
| | - H S Xu
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000, China
- School of Nuclear Science and Technology, University of Chinese Academy of Sciences, Beijing 100049, China
- Advanced Energy Science and Technology Guangdong Laboratory, Huizhou 516007, China
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Yang YJ, Pan SC, Lee MR, Chung CL, Ku CP, Liao CY, Tsai TY, Wang JY, Fang CT, Chen YC. Quantifying the contribution of smear-negative, culture-positive pulmonary tuberculosis to nosocomial transmission. Am J Infect Control 2024:S0196-6553(24)00076-2. [PMID: 38365178 DOI: 10.1016/j.ajic.2024.02.005] [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: 12/30/2023] [Revised: 02/09/2024] [Accepted: 02/09/2024] [Indexed: 02/18/2024]
Abstract
BACKGROUND Despite current guidelines for tuberculosis (TB) control in health care settings, which focused on smear-positive cases, prevention of nosocomial TB transmission continues to be a challenge. Here, we report the results of the first hospital-wide prospective study applying interferon-gamma release assay to investigate the role of smear-negative, culture-positive index cases in nosocomial TB transmission. METHODS We prospectively identified cases of culture-confirmed smear-negative pulmonary TB receiving aerosol-generating procedures (AGPs) and cases of culture-confirmed smear-positive pulmonary TB admitted at a medical center. Nosocomial transmission was evaluated by screening their close contacts for latent TB infection (LTBI) using an interferon-gamma release assay. RESULTS A total of 93 smear-negative index receiving AGP and 122 smear-positive index were enrolled. Among them, 13 (14.0%) and 43 (35.2%) index cases, respectively, had secondary cases of LTBI (P < .001). Sputum smear negativity (adjusted odds ratio: 0.20 [0.08-0.48]) and AGP (sputum suction; adjusted odds ratio: 3.48 [1.34-9.05]) are independent factors of transmission. A similar proportion in the close contacts of the 2 index groups had LTBI (17 [15.3%] and 63 [16.0%], respectively), and the former index group contributed to 21.3% of the nosocomial transmission. CONCLUSIONS Smear-negative, culture-positive index cases receiving AGPs could be as infectious as smear-positive index cases. Hospital TB control policy should also focus on the former group.
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Affiliation(s)
- Ya-Jen Yang
- Center for Infection Control, National Taiwan University Hospital, Taipei, Taiwan
| | - Sung-Ching Pan
- Center for Infection Control, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Meng-Rui Lee
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Che-Liang Chung
- Department of Internal Medicine, Yuanlin Christian Hospital, Changhua, Taiwan
| | - Chia-Ping Ku
- Center for Infection Control, National Taiwan University Hospital, Taipei, Taiwan
| | - Chi-Yu Liao
- Center for Infection Control, National Taiwan University Hospital, Taipei, Taiwan
| | - Tien-Yu Tsai
- Center for Infection Control, National Taiwan University Hospital, Taipei, Taiwan
| | - Jann-Yuan Wang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
| | - Chi-Tai Fang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Population Health Research Center, National Taiwan University, Taipei, Taiwan; Ministry of Health and Welfare and National Taiwan University Infectious Disease Research and Education Center, Taipei, Taiwan.
| | - Yee-Chun Chen
- Center for Infection Control, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
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8
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Zhang LS, Wang JY, Xu JF. [Annual review of bronchiectasis research in 2023]. Zhonghua Jie He He Hu Xi Za Zhi 2024; 47:152-156. [PMID: 38309966 DOI: 10.3760/cma.j.cn112147-20231122-00328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/05/2024]
Abstract
This review focuses on the latest advances in bronchiectasis from October 1st, 2022 to September 30th, 2023, including the etiology, diagnosis, treatment, comorbidities, and management of bronchiectasis in order to provide a reference in clinical diagnosis and treatment, and future research of bronchiectasis for domestic peers.
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Affiliation(s)
- L S Zhang
- Department of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital, Institute of Respiratory Medicine, School of Medicine, Tongji University, Shanghai 200433, China
| | - J Y Wang
- Department of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital, Institute of Respiratory Medicine, School of Medicine, Tongji University, Shanghai 200433, China
| | - J F Xu
- Department of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital, Institute of Respiratory Medicine, School of Medicine, Tongji University, Shanghai 200433, China
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Hao YR, Li SY, Bao JY, Wang JY, Li A, Tian L, Jie Y. [Efficacy of 0.05% cyclosporine A combined with vitamin A palmitate in the treatment of meibomian gland dysfunction-related dry eye]. Zhonghua Yan Ke Za Zhi 2024; 60:127-136. [PMID: 38296318 DOI: 10.3760/cma.j.cn112142-20231109-00221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
Objective: To evaluate the efficacy of 0.05% cyclosporine A eye drops combined with vitamin A palmitate eye gel in the treatment of dry eye associated with meibomian gland dysfunction (MGD). Methods: A single-center, prospective, randomized, parallel controlled trial design was used to include patients diagnosed with MGD-associated dry eye. The patients were randomly divided into three groups and administered with medications binocularly for 12 weeks. The CsA+VA group was given 0.05% cyclosporine A eye drops twice a day and vitamin A palmitate eye gel three times a day. The CsA+HA group was given 0.05% cyclosporine A eye drops twice a day and 0.1% sodium hyaluronate eye drops three times a day. The HA group was given 0.1% sodium hyaluronate eye drops 3 times a day. The OSDI score, tear meniscus height, fluorescein tear break-up time, Schirmer Ⅰ test (without anesthesia), tear film lipid layer thickness, meibomian gland morphology and function examination, and corneal fluorescein sodium staining score were evaluated at baseline, 4, 8, and 12 weeks after the initiation of the treatment, respectively. Results: A total of 120 patients with MGD-related dry eye met the enrollment criteria, but 10 patients were lost to follow-up; 110 patients were finally included for observation, including 36 patients in the CsA+VA group, 38 in the CsA+HA group and 36 in the HA group. The OSDI score, tear meniscus height, fluorescein tear break-up time and meibomian gland secretion of the 3 groups were significantly improved. At the 12th week of the treatment, the differences of the CsA+VA group [25.45±15.11, (0.30±0.13) mm, (3.72±1.40) s, (5.03±2.52) points] and the CsA+HA group [26.98±16.89, (0.27±0.10) mm, (4.34±1.76) s, (5.11±2.39) points] from the HA group [24.57±11.26, (0.24±0.06) mm, (3.18±1.11) s, (9.11±3.34) points] were statistically significant (P<0.05). Compared with the CsA+HA group [(68.39±26.66) nm], the tear film lipid layer thickness in the CsA+VA group [(72.61±23.65) nm] was significantly increased (P<0.05). In the CsA+VA group, the meibomian gland secretion characters and discharge capacity among patients with severe abnormalities [(6.28±2.59) and (5.89±2.77) points at the 12th week of treatment], moderate abnormalities [(4.27±2.02) and (4.64±2.02) points at the 12th week of treatment] and mild abnormalities [(2.80±0.84) and (2.60±0.55) points at the 12th week of treatment] were significantly different (P<0.05). Conclusion: 0.05% cyclosporine A combined with vitamin A palmitate can significantly improve the symptoms and signs of patients with MGD-related dry eye, especially the tear film lipid layer thickness and the meibomian gland secretion characters and discharge capacity in severe cases.
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Affiliation(s)
- Y R Hao
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Ophthalmology, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing 100730, China
| | - S Y Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Ophthalmology, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing 100730, China
| | - J Y Bao
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Ophthalmology, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing 100730, China
| | - J Y Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Ophthalmology, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing 100730, China
| | - A Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Ophthalmology, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing 100730, China
| | - L Tian
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Ophthalmology, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing 100730, China
| | - Y Jie
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Ophthalmology, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing 100730, China
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Zhou HK, Gao XP, Shi FY, Wang JY, Yang QC, Li SS, Liu JQ, Ji PP, Wang WD, Yu PF, Gao RQ, Guo X, Ji G, Wei JP. [Comparison of short-term safety of two anastomotic techniques when resecting Siewert type II adenocarcinoma of the esophagogastric junction: a multicenter retrospective cohort study]. Zhonghua Wei Chang Wai Ke Za Zhi 2024; 27:47-53. [PMID: 38262900 DOI: 10.3760/cma.j.cn441530-20230913-00088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
Objective: In this study, we aimed to compare the short-term safety of two digestive tract reconstruction techniques, laparoscopic total abdominal overlap anastomosis and laparoscopic-assisted end-to-side anastomosis, following radical resection of Siewert Type II adenocarcinoma of the esophagogastric junction. Methods: In this retrospective cohort study, we analyzed relevant clinical data of 139 patients who had undergone radical surgery for Siewert Type II esophagogastric junction adenocarcinoma. These included 89 patients treated at the First Affiliated Hospital of Air Force Medical University from November 2021 to July 2023, 36 patients treated at the First Affiliated Hospital of Xi'an Jiaotong University from December 2020 to June 2021, and 14 patients treated at the Yuncheng Central Hospital in Shanxi Province from September 2021 to November 2022. The group consisted of 107 men (77.0%) and 32 women (23.0%) of mean age 62.5±9.3 years. Forty-eight patients underwent laparoscopic total abdominal overlap anastomosis (overlap group), and 91 laparoscopic-assisted end-to-side anastomosis (end-to-side group). Clinical data, surgical information, pathological findings, postoperative recovery, and related complications were compared between the two groups. Results: There were no significant differences in general clinical data between the overlap and end-to-side anastomosis groups (all P>0.05), indicating comparability. There was no significant difference in operation time (267.2±60.1 minutes vs. 262.8±70.6 minutes, t=0.370, P=0.712). However, the intraoperative blood loss in the overlap group (100 [50, 100] mL) was significantly lower compared to the end-to-side group (100[50, 175] mL, Z=2.776, P=0.005). Compared to the end-to-side group, longer distances between the tumor and distal resection margin proximal(1.7±1.0 cm vs. 1.3±0.9 cm, t=2.487, P=0.014) and the tumor and distal resection margin (9.5±2.9 cm vs. 7.9±3.5 cm, t=2.667, P=0.009) were achieved in the overlap group. Compared with the end-to-side group, the overlap group achieved significantly earlier postoperative ambulation (1.0 [1.0, 2.0] days vs. 2.0 [1.0, 3.0] days, Z=3.117, P=0.002), earlier time to first drink (4.7±2.6 days vs. 6.2±3.0 days, t=2.851, P=0.005), and earlier time to first meal (6.0±2.7 days vs. 7.1±3.0 days, t=2.170, P=0.032). However, the hospitalization costs were higher in the overlap group (113, 105.5±37, 766.3) yuan vs. (97, 250.2±27, 746.9) yuan; this difference is significant (t=2.818, P=0.006). There were no significant differences between the two groups in postoperative hospital stay, total number of lymph nodes cleared, or time to first postoperative flatus (all P>0.05). The incidence of surgery-related complications was 22.9%(11/48) in the overlap group and 19.8% (18/91) in the end-to-side group; this difference is not significant (χ²=0.187, P=0.831). Further comparison of complications using the Clavien-Dindo classification also showed no significant differences (Z=0.406, P=0.685). Conclusions: Both laparoscopic total abdominal overlap anastomosis and laparoscopic-assisted end-to-side anastomosis are feasible for radical surgery for Siewert Type II esophagogastric junction adenocarcinoma. Laparoscopic total abdominal overlap anastomosis achieves longer proximal and distal resection margins and better postoperative recovery; however, end-to-side anastomosis is more cost-effective.
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Affiliation(s)
- H K Zhou
- Gastrointestinal Surgery Department, the First Affiliated Hospital of Air Force Military Medical University, Xi'an 710032, China
| | - X P Gao
- Gastrointestinal Surgery Department, Yuncheng Central Hospital, Yuncheng 044000, China
| | - F Y Shi
- Department of General Surgery, High Talent Laboratory, the First Affiliated Hospital of Xi'an Jiaotong University, Center for Gut Microbiome Research, Med-X Institute, Xi'an Jiaotong University, Xi'an 710061, China
| | - J Y Wang
- Gastrointestinal Surgery Department, the First Affiliated Hospital of Air Force Military Medical University, Xi'an 710032, China
| | - Q C Yang
- Gastrointestinal Surgery Department, the First Affiliated Hospital of Air Force Military Medical University, Xi'an 710032, China
| | - S S Li
- Gastrointestinal Surgery Department, the First Affiliated Hospital of Air Force Military Medical University, Xi'an 710032, China
| | - J Q Liu
- Gastrointestinal Surgery Department, the First Affiliated Hospital of Air Force Military Medical University, Xi'an 710032, China
| | - P P Ji
- Gastrointestinal Surgery Department, the First Affiliated Hospital of Air Force Military Medical University, Xi'an 710032, China
| | - W D Wang
- Gastrointestinal Surgery Department, the First Affiliated Hospital of Air Force Military Medical University, Xi'an 710032, China
| | - P F Yu
- Gastrointestinal Surgery Department, the First Affiliated Hospital of Air Force Military Medical University, Xi'an 710032, China
| | - R Q Gao
- Gastrointestinal Surgery Department, the First Affiliated Hospital of Air Force Military Medical University, Xi'an 710032, China
| | - X Guo
- Gastrointestinal Surgery Department, the First Affiliated Hospital of Air Force Military Medical University, Xi'an 710032, China
| | - G Ji
- Gastrointestinal Surgery Department, the First Affiliated Hospital of Air Force Military Medical University, Xi'an 710032, China
| | - J P Wei
- Gastrointestinal Surgery Department, the First Affiliated Hospital of Air Force Military Medical University, Xi'an 710032, China
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Wang JY, Xiao WH, Zhang LY, Zhang C, Wei J, Yang JJ, Zhou B, Zhao L, Zhang XL, Xu LY, Hong SD, Dong XS, Liu GL. [Application value of questionnaires in the screening obstructive sleep apnea syndrome in pregnancy across trimesters]. Zhonghua Yi Xue Za Zhi 2023; 103:3932-3937. [PMID: 38129170 DOI: 10.3760/cma.j.cn112137-20230726-00096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Objective: To evaluate the clinical utility value of questionnaires of Berlin, STOP, STOP-Bang (SBQ), Epworth Sleepiness Scale (ESS) in screening obstructive sleep apnea syndrome (OSAS) in pregnant women of different trimesters. Methods: Consecutive pregnant women at high risk for OSAS were enrolled from January, 2021 to April, 2022 at the obstetric clinic of Peking University People's Hospital. They completed questionnaires of Berlin, STOP, SBQ, ESS and also underwent an overnight polysomnography (PSG). To evaluate the accuracy of questionnaires of Berlin, STOP, SBQ, ESS, sensitivity, specificity, positive predictive values, negative predictive values and the area under the receiver operating characteristics (ROC) curve of these questionnaires in pregnancy across trimesters (Pregnancy 1-15 weeks was the first stage, pregnancy 16-27 weeks was the second stage, and pregnancy 28-40 weeks was the third stage) were calculated. Results: A total of 100 pregnant women [(34.5±4.3) years old (26-46 years old)] were included in this study, including 20, 35 and 45 pregnant women in the first, second and third trimester of pregnancy, respectively. Based on PSG results, 45 (45%) of 100 pregnant women were diagnosed with OSAS. The overall predictive values of the four questionnaires were not good, area under[AUC(95%CI)] the ROC curve ESS, Berlin questionnaire STOP and SBQ were 0.54(0.43, 0.66), 0.59 (0.47, 0.70), 0.62(0.51, 0.73) and 0.61 (0.49, 0.72), respectively, sensitivity was 35.6%, 65.9%, 48.9%, 28.9%, specificity was 71.7%, 52.5%, 73.6%, 92.5%. When categorized according to trimesters, the predicted values of the four questionnaires increased in the first trimester, the AUC (95%CI) of STOP questionnaire was 0.81 (0.61, 1.00), sensitivity was 75.0%, specificity was 87.5%. Conclusion: The overall predictive power of the four screening questionnaires is limited in pregnant women. But predictive value of STOP questionnaire is acceptable in the first trimester.
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Affiliation(s)
- J Y Wang
- Division of Sleep Medicine, Peking University People's Hospital, Beijing 100044, China
| | - W H Xiao
- Department of Respiratory Medicine and Intensive Care Unit, Binzhou Medical University Hospital, Binzhou 256603, China
| | - L Y Zhang
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China
| | - C Zhang
- Division of Sleep Medicine, Peking University People's Hospital, Beijing 100044, China
| | - J Wei
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China
| | - J J Yang
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China
| | - B Zhou
- Division of Sleep Medicine, Peking University People's Hospital, Beijing 100044, China
| | - L Zhao
- Division of Sleep Medicine, Peking University People's Hospital, Beijing 100044, China
| | - X L Zhang
- Division of Sleep Medicine, Peking University People's Hospital, Beijing 100044, China
| | - L Y Xu
- Division of Sleep Medicine, Peking University People's Hospital, Beijing 100044, China
| | - S D Hong
- National Institute of Health Data Science at Peking University, Beijing 100191, China
| | - X S Dong
- Division of Sleep Medicine, Peking University People's Hospital, Beijing 100044, China
| | - G L Liu
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China
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Wang JY, Pao JB, Lee CH, Wang JY, Lee MC, Wu TT. Corticosteroids for COVID-19-induced olfactory dysfunction: A comprehensive systematic review and meta-analysis of randomized controlled trials. PLoS One 2023; 18:e0289172. [PMID: 38127940 PMCID: PMC10734960 DOI: 10.1371/journal.pone.0289172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 07/13/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Olfactory dysfunction is a common manifestation in COVID-19 patients and can significantly impact their quality of life. Corticosteroids have been proposed as a potential treatment, but their efficacy remains controversial. This systematic review and meta-analysis aims to comprehensively analyze the efficacy of corticosteroid therapy for treating COVID-19-related olfactory dysfunction. METHODS A literature search was conducted in PubMed, Cochrane Library, and Embase databases up to March 1, 2023. Randomized controlled trials investigating the effects of corticosteroids on olfactory dysfunction in patients with COVID-19 were included. The primary outcome was the olfactory score at the end of follow-up, and the secondary outcomes were the duration and the rate of recovery from olfactory dysfunction. RESULTS Seven randomized controlled trials with 999 participants were included in the meta-analysis. Compared with the control group, corticosteroid treatment resulted in a statistically significant improvement in olfactory score with a standardized mean difference of 0.55 (95% CI: 0.15 to 0.95). Topical corticosteroids were found to be effective, but systemic corticosteroids were not. In addition, longer durations and higher dosages of corticosteroids treatment may also be associated with significant improvements in olfactory scores. No significant effect was observed on the duration or recovery rate of olfactory dysfunction. CONCLUSIONS Our findings suggest that topical corticosteroid treatment is a viable option for improving COVID-19-related olfactory dysfunction, but further research is needed to investigate optimal treatment protocols and safety profiles.
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Affiliation(s)
- Jian-Ying Wang
- Department of Pharmacy, New Taipei City Hospital, New Taipei City, Taiwan
| | - Jiunn-Bey Pao
- Section of Clinical Pharmacy, Department of Pharmacy, Taipei City Hospital, Taipei, Taiwan
| | - Chih-Hsin Lee
- Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Pulmonary Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Jann-Yuan Wang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming-Chia Lee
- Department of Pharmacy, New Taipei City Hospital, New Taipei City, Taiwan
- School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
- Department of Nursing, Cardinal Tien College of Healthcare and Management, Taipei, Taiwan
| | - Tzu-Tuan Wu
- Department of Internal Medicine, New Taipei City Hospital, New Taipei City, Taiwan
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Ju KS, Lee RG, Lin HC, Chen JH, Hsu BF, Wang JY, Van Dong N, Yu MC, Lee CH. Serial electrocardiogram recordings revealed a high prevalence of QT interval prolongation in patients with tuberculosis receiving fluoroquinolones. J Formos Med Assoc 2023; 122:1255-1264. [PMID: 37268474 DOI: 10.1016/j.jfma.2023.05.020] [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: 03/14/2023] [Revised: 04/26/2023] [Accepted: 05/15/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND Fluoroquinolones, crucial components of treatment regimens for drug-resistant tuberculosis (TB), are associated with QT interval prolongation and risks of fatal cardiac arrhythmias. However, few studies have explored dynamic changes in the QT interval in patients receiving QT-prolonging agents. METHODS This prospective cohort study recruited hospitalized patients with TB who received fluoroquinolones. The study investigated the variability of the QT interval by using serial electrocardiograms (ECGs) recorded four times daily. This study analyzed the accuracy of intermittent and single-lead ECG monitoring in detecting QT interval prolongation. RESULTS This study included 32 patients. The mean age was 68.6 ± 13.2 years. The results revealed mild-to-moderate and severe QT interval prolongation in 13 (41%) and 5 (16%) patients, respectively. The incremental yields in sensitivity of one to four daily ECG recordings were 61.0%, 26.1%, 5.6%, and 7.3% in detecting mild-to-moderate QT interval prolongation, and 66.7%, 20.0%, 6.7%, and 6.7% in detecting severe QT interval prolongation. The sensitivity levels of lead II and V5 ECGs in detecting mild-to-moderate and severe QT interval prolongation exceeded 80%, and their specificity levels exceeded 95%. CONCLUSION This study revealed a high prevalence of QT interval prolongation in older patients with TB who receive fluoroquinolones, particularly those with multiple cardiovascular risk factors. Sparsely intermittent ECG monitoring, the prevailing strategy in active drug safety monitoring programs, is inadequate owing to multifactorial and circadian QT interval variability. Additional studies performing serial ECG monitoring are warranted to enhance the understanding of dynamic QT interval changes in patients receiving QT-prolonging anti-TB agents.
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Affiliation(s)
- Ke-Shiuan Ju
- Division of Cardiology, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Ren-Guey Lee
- Department of Electronic Engineering, National Taipei University of Technology, Taipei, Taiwan; Pulmonary Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Hsien-Chun Lin
- Pulmonary Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Jin-Hua Chen
- Pulmonary Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Biostatistics Center, Department of Medical Research, Wang Fang Hospital, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Data Science, College of Management, Taipei Medical University, Taipei, Taiwan; Institutional Research Center, Office of Data Science, Taipei Medical University, Taipei, Taiwan
| | - Bi-Fang Hsu
- Pulmonary Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Jann-Yuan Wang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Nguyen Van Dong
- International Master/Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Intensive Care Unit, Danang Hospital, Danang, Viet Nam
| | - Ming-Chih Yu
- Pulmonary Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chih-Hsin Lee
- Pulmonary Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
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Ho CM, Yeh CC, Wang JY, Hu RH, Lee PH. Linking the choice of the class format and preclass learning experiences sheds light on a step further in blended medical education. Med Educ Online 2023; 28:2186207. [PMID: 36866636 PMCID: PMC9987758 DOI: 10.1080/10872981.2023.2186207] [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] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 02/26/2023] [Accepted: 02/26/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The core principle of HyFlex ('hybrid' and 'flexible') learning is to maintain learning equity under most circumstances. Within a blended framework in precision medical education, how different preferences of synchronous learning environment influence learning process and outcome is limited. We investigated students' preclass online video learning experiences and their choices toward synchronous class formats. METHODS This was a mixed-methods study. During the 2021 academic year, all 5th-year medical students who had viewed online video clips presenting core concepts were asked to complete a survey on their preference for future synchronous class format (face-to-face, online, or HyFlex) and asked to provide reflective comments on their self-learning. Anonymous survey data, online records, and summative assessment scores (short-term learning outcomes) were collected. Kruskal - Wallis or Chi-square tests were used to compare differences between groups, and multiple linear regression was managed to select the factors associated with various choices. The students' comments were coded in a descriptive thematic analysis. RESULTS Among 152 medical students, 150 responded to the questionnaires, and 109 provided comments. Medical students spent a median of 32 min online, significantly shorter in the face-to-face group than in the online and HyFlex groups. The online group had a lower preclass video completion rate for certain concepts. The choice was not associated with short-term learning outcomes. Student feedback revealed a higher frequency of multiple themes for each student in the face-to-face and HyFlex groups, and these themes fell into the categories of learning efficiency, focus concentration, and course attractiveness. CONCLUSIONS Linking the choice of the class format and learning experiences of preclass online videos sheds light on a step further within a blended framework of precision medical education. Supplement of online interactive elements may help secure learning engagement among students choosing 'online only' class format of HyFlex learning.
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Affiliation(s)
- Cheng-Maw Ho
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
- School of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chi-Chuan Yeh
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
- School of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Jann-Yuan Wang
- School of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Center of Faculty Development and Curriculum Integration, College of Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Rey-Heng Hu
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
- School of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Po-Huang Lee
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
- School of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Surgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
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15
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Zhang LQ, Wang C, Baumjohann W, Wang RS, Wang JY, Burch JL, Khotyaintsev YV. First observation of fluid-like eddy-dominant bursty bulk flow turbulence in the Earth's tail plasma sheet. Sci Rep 2023; 13:19201. [PMID: 37932297 PMCID: PMC10628178 DOI: 10.1038/s41598-023-45867-w] [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: 04/19/2023] [Accepted: 10/25/2023] [Indexed: 11/08/2023] Open
Abstract
Turbulence is a ubiquitous phenomenon in neutral and conductive fluids. According to classical theory, turbulence is a rotating flow containing vortices of different scales. Eddies play a fundamental role in the nonlinear cascade of kinetic energy at different scales in turbulent flow. In conductive fluids, the Alfvénic/kinetic Alfvénic wave (AW/KAW) is the new "cell" of magnetohydrodynamic (MHD) turbulence (frozen-in condition). Wave energy, which has equal kinetic and magnetic energy, is redistributed among multiple-scale Fourier modes and transferred from the large MHD scale to the small kinetic scale through the collision of counter-propagating Alfvénic wave packages propagating along the magnetic field line. Fluid-like eddy-dominant plasma flow turbulence has never been found in space since the launch of the first satellite in 1957. In this paper, we report the first observation of eddy-dominant turbulence within magnetic reconnection-generated fast flow in the Earth's tail plasma sheet by the Magnetospheric Multiscale Spacecraft (MMS). In eddy-dominant turbulent reconnection jet, ions dominate the flow field while electrons dominate current and magnetic fluctuations. Our findings shed new light on the nonlinear kinetic and magnetic energy cascade in MHD turbulence.
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Affiliation(s)
- L Q Zhang
- State Key Laboratory of Space Weather, National Space Science Center, Chinese Academy of Sciences, Beijing, 100080, China
| | - Chi Wang
- State Key Laboratory of Space Weather, National Space Science Center, Chinese Academy of Sciences, Beijing, 100080, China.
| | - W Baumjohann
- Space Research Institute, Austrian Academy of Sciences, 8042, Graz, Austria
| | - R S Wang
- CAS KCAS Key Laboratory of Geospace Environment, Department of Geophysics and Planetary Science, University of Science and Technology of China, Hefei, 230026, China
| | - J Y Wang
- Information Engineering College, Central University for Nationalities, Beijing, 100081, China
| | - James L Burch
- Southwest Research Institute San Antonio, San Antonio, TX, 78238, USA
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16
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Su YW, Li YH, Wang JY, Zhang Y, Zhou LL, Wang Z. [Effects of electric welding on hearing loss and respiratory damage]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2023; 41:832-837. [PMID: 37935549 DOI: 10.3760/cma.j.cn121094-20221009-00477] [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: 11/09/2023]
Abstract
Objective: To investigate the occupational health status of electric welding workers and explore the effects of electric welding on hearing loss and respiratory damage. Methods: From August to December 2021, the cluster sampling method was used to select workers from an automobile manufacturer in Guangzhou City as research subjects: 636 welding workers in the welding workshop as the welding group, 757 assembly workers in the engine workshop and the final assembly workshop exposed to pure noise as the assembly group. Occupational disease hazard factors were detected for welding positions and assembly positions, and occupational health examination was carried out for research subjects. The occupational health status, the trends of hearing loss and respiratory abnormalities with working age were compared and analyzed between the two groups. Binary logistic regression was used to analyze the association between hearing loss and respiratory abnormalities in welding workers. Results: The excess rates of welding fumes, manganese and its compounds in the welding position were both 9.68% (3/31). Its noise exposure intensity [ (85.36±2.68) dB (A) ] and excess rate [48.39% (15/31) ] were not significantly different from those in the assembly position [ (84.86±3.28) dB (A) and 43.24% (16/37) ] (P>0.05). The results of the occupational health examination showed that the detection rates of hearing loss, digital radiography (DR) chest X-ray abnormality, alanine aminotransferase abnormality, deazelaic aminotransferase abnormality and white blood cell count abnormality of workers in the welding group were higher than those in the assembly group (P<0.05). The detection rates of hearing loss, DR chest X-ray abnormality, pulmonary ventilation abnormality in the welding group and the detection rate of hearing loss in the assembly group increased with the working age of the workers (P<0.05). The hearing loss detection rate and DR chest X-ray abnormality detection rate of the workers with ≥9 years working age in the welding group were both higher than those in the assembly group workers with same working age (P<0.05). The binary logistic regression analysis showed that abnormal pulmonary ventilation and abnormal DR chest X-ray were the risk factors for hearing loss in welding workers (OR=10.83, 95%CI: 7.31-16.06; OR=16.59, 95%CI: 5.72-48.10; P<0.05) . Conclusion: Hearing loss and respiratory damage are prominent problems among welding workers, and the detection rates of abnormality increase with the working age of the workers. Hearing loss in welding workers is associated with abnormal pulmonary ventilation and abnormal DR chest X-ray.
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Affiliation(s)
- Y W Su
- Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou 510620, China
| | - Y H Li
- Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou 510620, China
| | - J Y Wang
- Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou 510620, China
| | - Y Zhang
- Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou 510620, China
| | - L L Zhou
- Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou 510620, China
| | - Z Wang
- Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou 510620, China
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17
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Wang XQ, Chen SY, Wang JY, Lin GW. [Achieving the thorough understanding of clinical epidemiology]. Zhonghua Nei Ke Za Zhi 2023; 62:1155-1157. [PMID: 37766432 DOI: 10.3760/cma.j.cn112138-20221007-00736] [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: 09/29/2023]
Affiliation(s)
- X Q Wang
- Department of Hematology, Huashan Hospital, Fudan University, Shanghai 200040, China Evidence-based Medicine Center,Fudan University, Shanghai 200040, China
| | - S Y Chen
- Evidence-based Medicine Center,Fudan University, Shanghai 200040, China Department of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - J Y Wang
- Evidence-based Medicine Center,Fudan University, Shanghai 200040, China Department of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - G W Lin
- Department of Hematology, Huashan Hospital, Fudan University, Shanghai 200040, China Evidence-based Medicine Center,Fudan University, Shanghai 200040, China
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18
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Pham D, Wang JY, Kidd EA, Wen Z, Smith LM, Lyu Q, Boudet J, Bessieres I, Hristov DH. Fixed-Field IMRT for Cervix Carcinoma Patients on an MR-LINAC Platform: Dosimetric Feasibility and Challenges. Int J Radiat Oncol Biol Phys 2023; 117:e538. [PMID: 37785663 DOI: 10.1016/j.ijrobp.2023.06.1828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To investigate the impact of MR-LINAC performance characteristics and inverse planning implementation on the feasibility of fixed-field IMRT for cervix carcinoma patients by benchmarking MR-LINAC plans against clinically used VMAT plans in a single institution study and multi-institutional treatment planning challenge. MATERIALS/METHODS For 10 cervix cancer patients who had previously received Linac-based VMAT, new treatment plans were optimized for MR-LINAC IMRT using 6X FFF fixed fields with maximum available field size of 27.4 x 24.1 cm2. Dose optimization was performed on the clinically used planning CT and structure set. Prescribed dose was 48.6 Gy in 27 fractions for all patients with 6 patients receiving an additional integrated boost for a total of 58.05 Gy to involved nodes. Constraints were based on our institutional protocol as per Table 1. IMRT delivery time was limited to 20 min. Original clinically used VMAT plans were generated on Eclipse (Varian Medical System) using 3 to 4 arcs. For the multi-institutional planning challenge, the data set from a single patient was anonymized and shared to participants. Participants used a single MR-based Linac planning platform to generate a plan based on our institutional constraints, with maximum treatment time limited to 20 min. For all analyses, a paired samples t-test was used to compare the significance defined at p < 0.05. RESULTS For MR-LINAC plans, the mean number of fields used was 23, mean number of segments 229, and the average estimated treatment delivery time was 17.3 minutes. MR-LINAC plans showed a significantly higher heterogeneity and dose to organs at risk compared to VMAT plans (Table 1). For the planning challenge, a total of 30 participants registered interest. Of this, seven plans were submitted to the challenge. On average, participants generated a plan that would be acceptable based on our institutional constraints (Table 1). However, the volumetric dose to bowel and pelvic bones were higher on MR-LINAC plans compared to the reference VMAT plan. CONCLUSION MR-LINAC fixed-field IMRT for cervix cancer patients is feasible but system constraints and optimization implementation result in greater dose heterogeneity and worse organ-at-risk sparing compared to Linac based VMAT. Further research is needed to determine if potential reduction of treatment margins, allowed by better MRI soft-tissue visualization, will result in MR-LINAC IMRT superior to Linac VMAT.
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Affiliation(s)
- D Pham
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - J Y Wang
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - E A Kidd
- Department of Radiation Oncology, Stanford University School of Medicine, Palo Alto, CA
| | - Z Wen
- Hoag Memorial Hospital Presbyterian, Newport Beach, CA
| | - L M Smith
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA
| | - Q Lyu
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA
| | - J Boudet
- Centre Georges-François Leclerc, Dijon, France
| | - I Bessieres
- Centre Georges-François Leclerc, Dijon, France
| | - D H Hristov
- Department of Radiation Oncology, Stanford University School of Medicine, Palo Alto, CA
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19
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Yang Y, Wang JY, Dong P, Kovalchuk N, Gensheimer MF, Beadle BM, Bagshaw HP, Buyyounouski MK, Le QT, Xing L. Clinical Implementation of an Automated IMRT/VMAT Treatment Planning Tool. Int J Radiat Oncol Biol Phys 2023; 117:e739-e740. [PMID: 37786147 DOI: 10.1016/j.ijrobp.2023.06.2272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To create an in-house automated treatment planning tool for IMRT/VMAT treatments and evaluate the dosimetric plan quality against manually generated plans. MATERIALS/METHODS A scripting application programming interface is employed to interact with a commercial treatment planning system (TPS) to implement automatic plan evaluation and update optimization parameters by mimicking the human planning process. The automated planning performs in an iterative fashion until reaching an acceptable tradeoff among target coverage/dose homogeneity and sparing of critical organs at risk. In each iteration, the dose constraints, priorities, and optimization structures for are automatically updated based on the results of the current iteration. Twenty previously treated plans (10 prostate and 10 head and neck), were preliminarily used to evaluate the performance of the automated planning tool. The differences in target and organ-at-risk metrics from the manually generated clinical plans were analyzed using paired t-test to evaluate clinical acceptability of tour automated planning tool. The current in-house-developed automated planning solution is able to create plans for different disease sites, including head & neck, prostate, pelvis, and lung. So far, the VMAT plans for more than 150 different cases have been generated with the tool. The results for these were also evaluated. RESULTS Compared to the manually generated clinical head and neck plans, all auto plans achieved PTV D95% coverage and critical organs at risk sparing without statistically significant change in average global Dmax (107.4% for manual vs 107.3% for automated plans). The auto-planning solution provided reduced maximum doses to brainstem and spinal cord (average reductions with standard deviations of 5.1 ± 2.6 Gy and 2.9 ± 1.4 Gy, respectively, all p <0.03), reduced average mean doses to contralateral parotid, ipsilateral parotid, contralateral submandibular gland, pharynx, esophagus, cochleae (reductions of 2.2 ± 2.9 Gy, 4.8 ± 4.7 Gy, 3.6 ± 5.2 Gy, 2.0 ± 7.1 Gy, 3.9 ± 2.6 Gy, 3.8 ± 5.0 Gy, respectively, all p < 0.045). Similar results were observed for the prostate plans. With the same PTV coverage and without statistically significant change in average global Dmax (106.5% for manual vs 106.8% for automated plans), the automated solution provided superior sparing for both bladder and rectum. Bladder V75, V70, V65 were reduced by 0.6% ± 2.1%, 0.8% ± 2.5%, and 0.9% ± 2.9% (all p <0.04), respectively. Rectum V75, V70, V65, V60 were reduced by 1.0% ± 2.3%, 1.2% ± 2.8%, 1.3% ± 3.2%, 1.6% ± 3.6% (all p < 0.01), respectively. CONCLUSION Our automated treatment planning solution is capable of efficiently generating VMAT plans for different disease sites with superior dosimetric indices compared to manually generated plans. Our tool is integrated within a commercial TPS platform, so it has the advantage of seamless adoption into the standard workflow to improve plan quality and treatment planning efficiency in our clinic.
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Affiliation(s)
- Y Yang
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - J Y Wang
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - P Dong
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - N Kovalchuk
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - M F Gensheimer
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - B M Beadle
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - H P Bagshaw
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - M K Buyyounouski
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - Q T Le
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - L Xing
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
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Wang J, He Q, Li ZR, Huang N, Huang R, Wang JY, Zhou Q, Wang XH, Han F. The Lyman Normal Tissue Complication Probability Model and Risk Prediction for Temporal Lobe Injury after Re-Irradiation in Patients with Recurrent Nasopharyngeal Carcinoma. Int J Radiat Oncol Biol Phys 2023; 117:e587. [PMID: 37785777 DOI: 10.1016/j.ijrobp.2023.06.1932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The risk of temporal lobe injury (TLI) in recurrent nasopharyngeal carcinoma (rNPC) patients with intensity-modulated radiation therapy (IMRT) is high. We aimed to construct the normal tissue complication probability (NTCP) model for TLI of rNPC and establish a risk predictive model. MATERIALS/METHODS We retrospectively analyzed 103 patients with rNPC who had received two courses of IMRT in our institution. The 206 temporal lobes (TLs) of these patients were randomly divided into a training (n = 144) and validation group (n = 62). We determined the mean value of the following parameters to construct the Lyman NTCP model: TD50(1) (the dose with a 50% probability of complications to an organ when all volumes are irradiated), m [steepness of the dose-response at TD50(1)], and n (the parameter related to volume effect). The most predictive dosimetric parameter and clinical variables were integrated in Cox proportional hazards models. A nomogram was developed for predicting risk of TLs. RESULTS The parameters of the fitted NTCP model were TD50(1) = 107.84 Gy (95% confidence interval (CI), [97.15, 118.54]), m = 0.16 (95% CI, [0.14, 0.19]), and n = 0.04 (95% CI, [0.01, 0.06]). The cumulative dose delivered to 0.1 cm3 of temporal lobe volume (D0.1cc-c) was the most predictive dosimetric parameter for TLI. The Kaplan-Meier curves showed a significant difference in 2-year TLI-free survival among different risk groups according to the total score of nomograms. CONCLUSION The TD50(1) of TLI in patients with rNPC is 107.84 Gy in Lyman NTCP model. The nomogram model can accurately predict the risk of TLI for individual.
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Affiliation(s)
- J Wang
- Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
| | - Q He
- Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
| | - Z R Li
- Manteia Technologies Co., Ltd, Xiamen, Fujian, China
| | - N Huang
- Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
| | - R Huang
- Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
| | - J Y Wang
- Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
| | - Q Zhou
- Manteia Technologies Co., Ltd, Xiamen, Fujian, China
| | - X H Wang
- Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
| | - F Han
- Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
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21
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Chiang CY, Chen CH, Feng JY, Chiang YJ, Huang WC, Lin YJ, Huang YW, Wu HH, Lee PH, Lee MC, Shu CC, Wang HH, Wang JY, Wu MY, Lee CY, Wu MS. Prevention and management of tuberculosis in solid organ transplantation: A consensus statement of the transplantation society of Taiwan. J Formos Med Assoc 2023; 122:976-985. [PMID: 37183074 DOI: 10.1016/j.jfma.2023.04.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/08/2023] [Accepted: 04/26/2023] [Indexed: 05/16/2023] Open
Abstract
Solid organ transplant recipients have an increased risk of tuberculosis (TB). Due to the use of immunosuppressants, the incidence of TB among solid organ transplant recipients has been consistently reported to be higher than that among the general population. TB frequently develops within the first year after transplantation when a high level of immunosuppression is maintained. Extrapulmonary TB and disseminated TB account for a substantial proportion of TB among solid organ transplant recipients. Treatment of TB among recipients is complicated by the drug-drug interactions between anti-TB drugs and immunosuppressants. TB is associated with an increased risk of graft rejection, graft failure and mortality. Detection and management of latent TB infection among solid organ transplant candidates and recipients have been recommended. However, strategy to mitigate the risk of TB among solid organ transplant recipients has not yet been established in Taiwan. To address the challenges of TB among solid organ transplant recipients, a working group of the Transplantation Society of Taiwan was established. The working group searched literatures on TB among solid organ transplant recipients as well as guidelines and recommendations, and proposed interventions to strengthen TB prevention and care among solid organ transplant recipients.
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Affiliation(s)
- Chen-Yuan Chiang
- Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Cheng-Hsu Chen
- Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan; Department of Life Science, Tunghai University, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan
| | - Jia-Yih Feng
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Institute of Emergency and Critical Care Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yang-Jen Chiang
- Department of Urology, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Organ Transplantation Institute, Chang Gung Memorial Hospital, Taoyuan, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wei-Chang Huang
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan; Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Mycobacteria Center of Excellence, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan; Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan; Department of Medical Technology, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli, Taiwan
| | - Yih-Jyh Lin
- Division of General and Transplant Surgery, Department of Surgery, National Cheng Kung University Hospital, Tainan, Taiwan; College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Wen Huang
- Pulmonary and Critical Care Unit, Changhua Hospital, Ministry of Health and Welfare, Changhua, Taiwan
| | - Hsin-Hsu Wu
- Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Pin-Hui Lee
- Taiwan Centers for Disease Control, Taipei, Taiwan
| | - Ming-Che Lee
- Division of General Surgery, Department of Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; TMU Research Center for Organ Transplantation, Taipei Medical University, Taipei, Taiwan
| | - Chin-Chung Shu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; School of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Hsu-Han Wang
- Department of Urology, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Organ Transplantation Institute, Chang Gung Memorial Hospital, Taoyuan, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Jann-Yuan Wang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; School of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Mei-Yi Wu
- Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Division of Nephrology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; TMU Research Center of Urology and Kidney, Taipei Medical University, Taipei, Taiwan
| | - Chih-Yuan Lee
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Mai-Szu Wu
- Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Division of Nephrology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; TMU Research Center of Urology and Kidney, Taipei Medical University, Taipei, Taiwan.
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Wang JY, Chen Y, Pham D, Lewis J, Beadle BM, Gensheimer MF, Le QT, Gu X, Xing L. Prospective Clinical Adoption of Artificial Intelligence for Organ Contouring in Head and Neck Radiation Treatment Planning. Int J Radiat Oncol Biol Phys 2023; 117:e490-e491. [PMID: 37785549 DOI: 10.1016/j.ijrobp.2023.06.1721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Patients that undergo head and neck (H&N) radiation therapy (RT) require laborious delineation of organs-at-risk (OARs) on computed tomography (CT) scans in a treatment planning system (TPS) to minimize radiation to normal tissue. This task can be completed rapidly and accurately with recently developed artificial intelligence-based semantic segmentation models. The current study aims to deploy and evaluate a strategy for improving clinical practice with this technology. MATERIALS/METHODS Deep learning models were trained and tested with CT scans and OAR contours from previous H&N RT cases at our clinic. Two medical physicists vetted the models and selected a 2.5D U-Net for further implementation. The model was embedded in a dedicated server at the hospital, programmed to read H&N CT scans staged for import into the TPS, generate auto-contours, and write them into a TPS-compatible format made available alongside the scan. In the pilot implementation, the auto-contouring service was utilized for more than 60 cases, prospectively. The auto-contours were quantitatively evaluated against the treatment-approved contours to determine how much modification was performed by the clinical team. RESULTS The 2.5D U-Net selected for clinical integration segments 21 OARs in less than 3 minutes per scan. Across all the prospective cases, the mean Dice score and mean 95th percentile Hausdorff distance (mm) between the auto-contour and treatment-approved contour for each of the 21 OARs were as follows, respectively: brainstem (0.93, 1.94), optic chiasm (0.70, 2.96), left cochlea (0.69, 2.37), right cochlea (0.68, 2.44), esophagus (0.88, 2.46), left globe (0.93, 1.50), right globe (0.93, 1.63), glottis (0.91, 2.13), larynx (0.93, 2.76), mandible (0.90, 4.86), left optic nerve (0.78, 1.64), right optic nerve (0.82, 1.65), oral cavity (0.86, 8.46), left parotid gland (0.91, 2.78), right parotid gland (0.91, 2.39), pharynx (0.85, 2.39), spinal cord (0.87, 2.27), left submandibular gland (0.85, 3.46), right submandibular gland (0.83, 3.69), left temporal lobe (0.94, 2.20), and right temporal lobe (0.95, 2.09). The auto-contours for the optic chiasm, optic nerves, cochleas, and submandibular glands differed substantially from the final contours, a finding corroborated by the clinical team; the rest were clinically acceptable with minor or no edits necessary. CONCLUSION The proposed strategy provides a sophisticated starting point for treatment planning that has garnered overall favorable feedback from the participating radiation oncologists and dosimetrists. Consequently, the technique is being extended to other treatment sites.
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Affiliation(s)
- J Y Wang
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - Y Chen
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - D Pham
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - J Lewis
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - B M Beadle
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - M F Gensheimer
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - Q T Le
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - X Gu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - L Xing
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
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23
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Capaldi DPI, Wang JY, Liu L, Sheth V, Kidd EA, Hristov DH. Parametric Response Mapping of Co-Registered Ivim MRI and PET to Identify Radioresistant Sub-Volumes in Locally Advanced Cervical Carcinoma Undergoing CCRT. Int J Radiat Oncol Biol Phys 2023; 117:e648. [PMID: 37785926 DOI: 10.1016/j.ijrobp.2023.06.2067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To investigate parametric response mapping (PRM) of co-registered positron emission tomography (PET) and intravoxel incoherent motion (IVIM) MRI in locally advanced cervical carcinoma patients to identify sub-volumes that may predict treatment response to adjuvant concurrent chemoradiation therapy (CCRT). MATERIALS/METHODS Pre- and on-treatment (∼after four weeks of CCRT) diffusion weighted images (DWIs) MRI and pre-treatment PET were performed on 20 cervical cancer patients (median [range] age: 63 [41 to 85]; FIGO staging: 3 IIB, 1 IIIB, 10 IIIC1, 4 IIIC2, 2 IVA; histology: 11 squamous cell carcinoma, 4 endocervical adenocarcinoma; LN status: 4 negative, 16 positive). IVIM MRI maps were generated by Bayesian fitting of a two-compartment IVIM model to the DWIs to produce three-dimensional diffusion coefficient (D) and perfusion fraction (f). Three-dimensional IVIM D and f maps were co-registered to PET standardized uptake value (SUV) maps. Population means of PET SUV, IVIM D and f from pre-treatment scans were calculated to generate thresholds to identify low versus high metabolic (μSUV) regions, low versus high diffused (μD) regions as well as low versus high perfused (μf) regions, respectively. PRM maps were generated using voxel-wise joint histogram analysis to classify voxels within the tumor as highly metabolic and with low cellular density (SUV↑D↑), highly metabolic and with high cellular density (SUV↑D↓), metabolically inactive and with high cellular density (SUV↓D↓), or metabolically inactive and with low cellular density (SUV↓D↑) tissue based on the population mean thresholds. Similar PRM maps were generated using the joint histogram analysis with SUV and f. Summary statistics for these and other imaging parameters were calculated pre- and on-treatment. Univariate analysis was performed to determine relationships between relative change in gross tumor volume (ΔGTV) and pre-treatment imaging measurements. RESULTS In tumors, on- versus pre-treatment tumor volume (p<.001) significantly decreased, while IVIM f (p = .002) and D (p = .03) significantly increased. Pre-treatment tumor volume (r = .45, p = .04) and PRM SUV↑D↓ (r = .65, p = .002) regions were positively related with ΔGTV, while pre-treatment IVIM D (r = -.64, p = .002), PRM SUV↓f↑ (r = -.52, p = .02) and PRM SUV↓D↑ (r = -.74, p<.001) regions were negatively related with ΔGTV. The latter PRM result suggests that larger regions of low cellular density (as represented by elevated D) + low metabolism result in a reduced change in tumor volume on-treatment, potentially representing a radioresistant sub-volume. CONCLUSION PRM, generated from PET and IVIM MRI, was applied to patients with locally advanced cervical carcinoma and radioresistant sub-volumes were identified which may predict treatment response. The complementary information provided from PET and IVIM, combined using PRM, may assist in decision-making to individualize therapies, such as with image guided brachytherapy, to improve patient outcomes.
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Affiliation(s)
- D P I Capaldi
- Department of Radiation Oncology, University of California San Francisco, San Francisco, CA
| | - J Y Wang
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - L Liu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - V Sheth
- Department of Radiology, Stanford University School of Medicine, Palo Alto, CA
| | - E A Kidd
- Department of Radiation Oncology, Stanford University School of Medicine, Palo Alto, CA
| | - D H Hristov
- Department of Radiation Oncology, Stanford University School of Medicine, Palo Alto, CA
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Provenzano D, Wang JY, Haji-Momenian S, Shin B, Riess J, Khati N, Bauman J, Goyal S, Loew M, Chappell N, Rao YJ. Prediction of Progression After Cervix Cancer Radiotherapy Using a Machine-Learning Model on Pre-Treatment MRI. Int J Radiat Oncol Biol Phys 2023; 117:S132. [PMID: 37784341 DOI: 10.1016/j.ijrobp.2023.06.482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) MRI may be useful to identify women with cervical cancer at high risk of disease progression to test strategies of treatment intensification. The purpose of this study was to determine the value of a machine-learning model built on pre-treatment MRI for prediction of risk of progression after radiation therapy. MATERIALS/METHODS MagneticResonance Imaging (MRI) data for women with cervical cancer was collected from The Cancer Genome Atlas Cervical Squamous Cell Carcinoma and Endocervical Adenocarcinoma Collection (TCGA-CESC) on the Cancer Imaging Archive (TCIA), which reported clinical, treatment, and imaging data from a single institution. 27 patients who had received radiation for cervical cancer were selected for input into a custom 3-D Residual Neural Network (ResNet) model with added custom layers specific to DICOM data in tensorflow python package. One T2 MRI per patient was used to predict recurrence free survival after radiation treatment, where patients were predicted to be "high risk" or "low risk" for disease recurrence as the output of the model. All slices of the T2 MRI were used. The model was validated using five-fold cross validation; 80% of the data was used to train each fold and 20% was used for testing. Final model statistical significance was confirmed through shuffle test at the p < 0.01 level. The clinical outcomes of patients and the model's "low-risk" and "high-risk" prediction were compared. RESULTS There were 27 patients in the study with mean age of 51 years (range 29-79). 20 patients had squamous cell carcinoma and 7 patients had adenocarcinoma. The stage breakdown consisted of 9 women IB, 2 IIA, 9 IIB, 2 IIIA, 2 IIIB, and 3 stage IV. 10 women were treated with radiation alone and 17 with chemo-radiation. 5 women received surgery in addition to radiation or chemoradiation. 21 patients received brachytherapy. Median follow-up of patients was 29 months (range 3-64). The model predicted 7 patients as "high risk" for recurrence; all 7 developed a recurrence during follow up. None of the 20 patients predicted to be "low risk" developed disease recurrence. Among all patients in the study, the two-year progression free survival (PFS) was 82.0%. Patients identified as "low risk" and "high risk" by model had two-year PFS of 100% and 43%, respectively. Among patients with recurrence, 3 developed local recurrence and 4 developed distant metastases. The ResNet model achieved cross-validated accuracy of 92% for prediction of progression-free survival (p<0.01). CONCLUSION A 3-D ResNet machine-learning model using pretreatment MRI image data can accurately predict clinical outcomes for cervical cancer following radiation therapy. Future work to confirm generalizability should focus on validation with a larger clinical dataset.
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Affiliation(s)
- D Provenzano
- Biomedical Engineering, George Washington University School of Engineering and Applied Science, Washington, DC
| | - J Y Wang
- Radiation Oncology, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - S Haji-Momenian
- Radiology, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - B Shin
- Radiology, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - J Riess
- Radiology, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - N Khati
- Radiology, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - J Bauman
- Medical Oncology, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - S Goyal
- Radiation Oncology, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - M Loew
- Medical Oncology, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - N Chappell
- Gynecological Oncology, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Y J Rao
- Radiation Oncology, George Washington University School of Medicine and Health Sciences, Washington, DC
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Bai R, Wang JY, Zhang C, Hong SD, Zhang LY, Wei J, Wang Y, Yang JJ, Dong XS, Han F, Liu GL. [Relationships between hypertensive disorders in pregnancy and obstructive sleep apnea syndrome]. Zhonghua Fu Chan Ke Za Zhi 2023; 58:658-663. [PMID: 37724382 DOI: 10.3760/cma.j.cn112141-20230219-00074] [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: 09/20/2023]
Abstract
Objective: To investigate the impact of obstructive sleep apnea syndrome (OSAS) on pregnancy outcomes, especially the relationship between OSAS and hypertensive disorders in pregnancy (HDP). Methods: A total of 228 pregnant women with high risk of OSAS who underwent sleep monitoring during pregnancy in Peking University People's Hospital from January 2021 to April 2022 were collected by reviewing their medical records for retrospective analysis. According to the diagnosis of OSAS, the pregnant women were divided into OSAS group (105 cases) and non-OSAS group (123 cases). The non-parametric Mann-Whitney U test, χ2 test or Fisher's exact test were used to compare the general data and maternal and fetal outcomes between the two groups, and the occurrence of each type of HDP was further compared. Results: (1) Compared with the non-OSAS group, the median pre-pregnancy body mass index (23.6 vs 27.6 kg/m2) and the proportion of snoring [28.9% (33/114) vs 59.2% (61/103)] in the OSAS group were higher, and the differences were both statistically significant (both P<0.001). (2) The incidence of HDP [67.6% (71/105) vs 39.0% (48/123)] and gestational diabetes mellitus [GDM; 40.0% (42/105) vs 26.8% (33/123)] of pregnant women in the OSAS group were higher than those in the non-OSAS group, and the median delivery week was shorter than that in the non-OSAS group (38.4 vs 39.0 weeks). The differences were all statistically significant (all P<0.05). Between-group differences for the delivery way, postpartum hemorrhage, the rate of intensive care unit admission, preterm birth, small for gestational age infants, neonatal asphyxia, the rate of neonatal intensive care unit admission, newborn birth weight and the proportion of umbilical artery blood pH<7.00 were not statistically significant (all P>0.05). (3) Compared with the non-OSAS group, the incidence of chronic hypertension [11.4% (14/123) vs 22.9% (24/105)] and chronic hypertension with superimposed pre-eclampsia [11.4% (14/123) vs 30.5% (32/105)] were higher in the OSAS group, and the differences were both statistically significant (both P<0.01). Conclusion: OSAS is related to HDP (especially chronic hypertension and chronic hypertension with superimposed pre-eclampsia) and GDM, which could provide a practical basis for the screening, diagnosis and treatment of OSAS in pregnant women at high risk.
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Affiliation(s)
- R Bai
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China
| | - J Y Wang
- Division of Sleep Medicine, Peking University People's Hospital, Beijing 100044, China
| | - C Zhang
- Division of Sleep Medicine, Peking University People's Hospital, Beijing 100044, China
| | - S D Hong
- National Institute of Health Data Science, Peking University, Beijing 100191, China
| | - L Y Zhang
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China
| | - J Wei
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China
| | - Y Wang
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China
| | - J J Yang
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China
| | - X S Dong
- Division of Sleep Medicine, Peking University People's Hospital, Beijing 100044, China
| | - F Han
- Division of Sleep Medicine, Peking University People's Hospital, Beijing 100044, China
| | - G L Liu
- Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China
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Winters N, Belknap R, Benedetti A, Borisov A, Campbell JR, Chaisson RE, Chan PC, Martinson N, Nahid P, Scott NA, Sizemore E, Sterling TR, Villarino ME, Wang JY, Menzies D. Completion, safety, and efficacy of tuberculosis preventive treatment regimens containing rifampicin or rifapentine: an individual patient data network meta-analysis. Lancet Respir Med 2023; 11:782-790. [PMID: 36966788 DOI: 10.1016/s2213-2600(23)00096-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 04/04/2023]
Abstract
BACKGROUND 3 months of weekly rifapentine plus isoniazid (3HP) and 4 months of daily rifampicin (4R) are recommended for tuberculosis preventive treatment. As these regimens have not been compared directly, we used individual patient data and network meta-analysis methods to compare completion, safety, and efficacy between 3HP and 4R. METHODS We conducted a network meta-analysis of individual patient data by searching PubMed for randomised controlled trials (RCTs) published between Jan 1, 2000, and Mar 1, 2019. Eligible studies compared 3HP or 4R to 6 months or 9 months of isoniazid and reported treatment completion, adverse events, or incidence of tuberculosis disease. Deidentified individual patient data from eligible studies were provided by study investigators and outcomes were harmonised. Methods for network meta-analysis were used to generate indirect adjusted risk ratios (aRRs) and risk differences (aRDs) with their 95% CIs. FINDINGS We included 17 572 participants from 14 countries in six trials. In the network meta-analysis, treatment completion was higher for people on 3HP than for those on 4R (aRR 1·06 [95% CI 1·02-1·10]; aRD 0·05 [95% CI 0·02-0·07]). For treatment-related adverse events leading to drug discontinuation, risks were higher for 3HP than for 4R for adverse events of any severity (aRR 2·86 [2·12-4·21]; aRD 0·03 [0·02-0·05]) and for grade 3-4 adverse events (aRR 3·46 [2·09-6·17]; aRD 0·02 [0·01-0·03]). Similar increased risks with 3HP were observed with other definitions of adverse events and were consistent across age groups. No difference in the incidence of tuberculosis disease between 3HP and 4R was found. INTERPRETATION In the absence of RCTs, our individual patient data network meta-analysis indicates that 3HP provided an increase in treatment completion over 4R, but was associated with a higher risk of adverse events. Although findings should be confirmed, the trade-off between completion and safety must be considered when selecting a regimen for tuberculosis preventive treatment. FUNDING None. TRANSLATIONS For the French and Spanish translations of the abstract see Supplementary Materials section.
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Affiliation(s)
- Nicholas Winters
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Robert Belknap
- Denver Health and Hospital Authority and Division of Infectious Diseases, Department of Medicine, University of Colorado, Denver, CO, USA
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Andrey Borisov
- US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jonathon R Campbell
- Department of Medicine, McGill University, Montreal, QC, Canada; Department of Global and Public Health, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada; McGill International TB Centre, Montreal, QC, Canada; Respiratory Epidemiology and Clinical Research Unit, Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Richard E Chaisson
- Johns Hopkins University School of Medicine, Center for Tuberculosis Research, Baltimore, MD, USA
| | - Pei-Chun Chan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Division of Chronic Infectious Disease, Taiwan Centers for Disease Control, Taipei City, Taiwan
| | - Neil Martinson
- Johns Hopkins University School of Medicine, Center for Tuberculosis Research, Baltimore, MD, USA
| | - Payam Nahid
- UCSF Center for Tuberculosis, University of California, San Francisco, CA, USA
| | - Nigel A Scott
- US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Erin Sizemore
- US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Timothy R Sterling
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Jann-Yuan Wang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Dick Menzies
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.
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Lee MR, Huang HL, Huang WC, Wu SY, Liu PC, Wu JC, Cheng MH, Sheu CC, Tang KT, Wang JY, Ho CC, Shih JY, Chong IW. Electronic nose in differentiating and ascertaining clinical status among patients with pulmonary nontuberculous mycobacteria: A prospective multicenter study. J Infect 2023; 87:255-258. [PMID: 37348565 DOI: 10.1016/j.jinf.2023.06.012] [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] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 06/12/2023] [Indexed: 06/24/2023]
Affiliation(s)
- Meng-Rui Lee
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Hung-Ling Huang
- Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wei-Chang Huang
- Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan; Mycobacteria Center of Excellence, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan; Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung 402, Taiwan; Department of Medical Technology, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli, Taiwan
| | - Shang-Yu Wu
- Department. of Electrical Engineering, National Tsing Hua University, Hsinchu, Taiwan
| | - Pang-Chun Liu
- Department. of Electrical Engineering, National Tsing Hua University, Hsinchu, Taiwan
| | - Jui-Ching Wu
- Department. of Electrical Engineering, National Tsing Hua University, Hsinchu, Taiwan
| | - Meng-Hsuan Cheng
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chau-Chyun Sheu
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Kea-Tiong Tang
- Department. of Electrical Engineering, National Tsing Hua University, Hsinchu, Taiwan.
| | - Jann-Yuan Wang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
| | - Chao-Chi Ho
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Jin-Yuan Shih
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Inn-Wen Chong
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Respiratory Therapy, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Biological Science & Technology, National Chiao Tung University, Hsin-Chu, Taiwan
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28
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Xiu M, Lu Y, Wang X, Fan Y, Li Q, Li Q, Wang JY, Luo Y, Cai RG, Chen SS, Yuan P, Ma F, Xu BH, Zhang P. [Dose-dense paclitaxel plus carboplatin in combination with trastuzumab neoadjuvant versus standard adjuvant therapy in human epidermal growth factor receptor-2 positive and hormone receptor negative breast cancer: a prospective cohort study]. Zhonghua Zhong Liu Za Zhi 2023; 45:709-716. [PMID: 37580278 DOI: 10.3760/cma.j.cn112152-20221006-00678] [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: 08/16/2023]
Abstract
Objective: To provide survival evidence of anthracycline-free neoadjuvant chemotherapy for patients with stages Ⅱ-Ⅲ human epidermal growth factor receptor-2 (HER-2) positive and hormone receptor (HR) negative breast cancer. Methods: The prospective cohort study was conducted at the Department of Medical Oncology of Cancer Hospital, Chinese Academy of Medical Sciences. Patients with HER-2 positive and HR negative breast cancer in stages Ⅱ-Ⅲ were enrolled to receive neoadjuvant therapy (NAT) of dose-dense paclitaxel (175 mg/m(2)) plus carboplatin (AUC=4.0) biweekly for 6 cycles in combination with trastuzumab (PCbH), and matched patients who received standard adjuvant therapy of physicians' choice were recruited for survival and safety comparison. Results: From July 2013 to November 2019, 166 patients were included (neoadjuvant 51, adjuvant 115). Compared with those who received adjuvant therapy, patients receiving NAT were younger (<35 years: 19.6% vs 5.2%, P=0.014), had larger tumors (T3: 62.7% vs 7.8%, P<0.001) and more advanced diseases (stage ⅡA: 2.0% vs 41.7%, P<0.001). Patients in the neoadjuvant group all received surgery, and 96 (83.5%) in the adjuvant group received anthracycline-and-taxane-containing regimens. A total of 98 patients (49 pairs) were matched, and the covariates between the two groups were acceptably balanced. Within a median follow-up of 46.5 (range, 14-87) months, the 4-year recurrence-free survival (RFS) rate among patients who received NAT was 73.3% (95% CI: 59.0%-87.6%), versus 80.6% (95% CI: 67.9%-93.3%) among those in the adjuvant group without statistical difference (P=0.418). A similar result was observed for the 4-year overall survival (OS) [neoadjuvant versus adjuvant: 91.5% (95% CI: 81.7%-100.0%) vs 97.8% (95% CI: 93.5%-100.0%), P=0.314]. Compared with standard adjuvant therapy, PCbH was related to less neutropenia and better cardiac safety. Conclusions: These results support the consideration of anthracycline-free neoadjuvant chemotherapy combined with anti-HER-2 therapy for patients with stages Ⅱ-Ⅲ HER-2-positive and HR-negative breast cancer. Optimized regimens with both efficacy and safety are needed and to be further investigated.
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Affiliation(s)
- M Xiu
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Y Lu
- Department of Medical Oncology, the First People's Hospital of Nanning, Nanning 530016, China
| | - X Wang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Y Fan
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Q Li
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Q Li
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - J Y Wang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Y Luo
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - R G Cai
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - S S Chen
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - P Yuan
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - F Ma
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - B H Xu
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - P Zhang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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29
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Yu KL, Tseng YS, Yang HC, Liu CJ, Kuo PC, Lee MR, Huang CT, Kuo LC, Wang JY, Ho CC, Shih JY, Yu CJ. Deep learning with test-time augmentation for radial endobronchial ultrasound image differentiation: a multicentre verification study. BMJ Open Respir Res 2023; 10:e001602. [PMID: 37532473 PMCID: PMC10401203 DOI: 10.1136/bmjresp-2022-001602] [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: 12/28/2022] [Accepted: 06/23/2023] [Indexed: 08/04/2023] Open
Abstract
PURPOSE Despite the importance of radial endobronchial ultrasound (rEBUS) in transbronchial biopsy, researchers have yet to apply artificial intelligence to the analysis of rEBUS images. MATERIALS AND METHODS This study developed a convolutional neural network (CNN) to differentiate between malignant and benign tumours in rEBUS images. This study retrospectively collected rEBUS images from medical centres in Taiwan, including 769 from National Taiwan University Hospital Hsin-Chu Branch, Hsinchu Hospital for model training (615 images) and internal validation (154 images) as well as 300 from National Taiwan University Hospital (NTUH-TPE) and 92 images were obtained from National Taiwan University Hospital Hsin-Chu Branch, Biomedical Park Hospital (NTUH-BIO) for external validation. Further assessments of the model were performed using image augmentation in the training phase and test-time augmentation (TTA). RESULTS Using the internal validation dataset, the results were as follows: area under the curve (AUC) (0.88 (95% CI 0.83 to 0.92)), sensitivity (0.80 (95% CI 0.73 to 0.88)), specificity (0.75 (95% CI 0.66 to 0.83)). Using the NTUH-TPE external validation dataset, the results were as follows: AUC (0.76 (95% CI 0.71 to 0.80)), sensitivity (0.58 (95% CI 0.50 to 0.65)), specificity (0.92 (95% CI 0.88 to 0.97)). Using the NTUH-BIO external validation dataset, the results were as follows: AUC (0.72 (95% CI 0.64 to 0.82)), sensitivity (0.71 (95% CI 0.55 to 0.86)), specificity (0.76 (95% CI 0.64 to 0.87)). After fine-tuning, the AUC values for the external validation cohorts were as follows: NTUH-TPE (0.78) and NTUH-BIO (0.82). Our findings also demonstrated the feasibility of the model in differentiating between lung cancer subtypes, as indicated by the following AUC values: adenocarcinoma (0.70; 95% CI 0.64 to 0.76), squamous cell carcinoma (0.64; 95% CI 0.54 to 0.74) and small cell lung cancer (0.52; 95% CI 0.32 to 0.72). CONCLUSIONS Our results demonstrate the feasibility of the proposed CNN-based algorithm in differentiating between malignant and benign lesions in rEBUS images.
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Affiliation(s)
- Kai-Lun Yu
- Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yi-Shiuan Tseng
- Department of Computer Science, National Tsing Hua University, Hsinchu, Taiwan
| | - Han-Ching Yang
- Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
| | - Chia-Jung Liu
- Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
| | - Po-Chih Kuo
- Department of Computer Science, National Tsing Hua University, Hsinchu, Taiwan
| | - Meng-Rui Lee
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chun-Ta Huang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Lu-Cheng Kuo
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Jann-Yuan Wang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chao-Chi Ho
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Jin-Yuan Shih
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chong-Jen Yu
- Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
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Zhao JJ, Bi N, Zhang T, Wang JY, Deng L, Wang X, Chen DF, Dai JR, Wang LH. [Analysis of risk factors of radiation-induced toxicity in limited-stage small cell lung cancer treated with hypofractionated intensity-modulated radiotherapy]. Zhonghua Zhong Liu Za Zhi 2023; 45:627-633. [PMID: 37462020 DOI: 10.3760/cma.j.cn112152-20221031-00733] [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: 07/20/2023]
Abstract
Objective: To compare the incidence of radiation-related toxicities between conventional and hypofractionated intensity-modulated radiation therapy (IMRT) for limited-stage small cell lung cancer (SCLC), and to explore the risk factors of hypofractionated radiotherapy-induced toxicities. Methods: Data were retrospectively collected from consecutive limited-stage SCLC patients treated with definitive concurrent chemoradiotherapy in Cancer Hospital of Chinese Academy of Medical Sciences from March 2016 to April 2022. The enrolled patients were divided into two groups according to radiation fractionated regimens. Common Terminology Criteria for Adverse Events (CTCAE, version 5.0) was used to evaluate the grade of radiation esophagus injuries and lung injuries. Logistic regression analyses were used to identify factors associated with radiation-related toxicities in the hypofractionated radiotherapy group. Results: Among 211 enrolled patients, 108 cases underwent conventional IMRT and 103 patients received hypofractionated IMRT. The cumulative incidences of acute esophagitis grade ≥2 [38.9% (42/108) vs 35.0% (36/103), P=0.895] and grade ≥ 3 [1.9% (2/108) vs 5.8% (6/103), P=0.132] were similar between conventional and hypofractionated IMRT group. Late esophagus injuries grade ≥2 occurred in one patient in either group. No differences in the cumulative incidence of acute pneumonitis grade ≥2[12.0% (13/108) vs 5.8% (6/103), P=0.172] and late lung injuries grade ≥2[5.6% (6/108) vs 10.7% (11/103), P=0.277] were observed. There was no grade ≥3 lung injuries occurred in either group. Using multiple regression analysis, mean esophageal dose ≥13 Gy (OR=3.33, 95% CI: 1.23-9.01, P=0.018) and the overlapping volume between planning target volume (PTV) and esophageal ≥8 cm(3)(OR=3.99, 95% CI: 1.24-12.79, P=0.020) were identified as the independent risk factors associated with acute esophagitis grade ≥2 in the hypofractionated radiotherapy group. Acute pneumonitis grade ≥2 was correlated with presence of chronic obstructive pulmonary disease (COPD, P=0.025). Late lung injuries grade ≥2 was correlated with tumor location(P=0.036). Conclusions: Hypofractionated IMRT are tolerated with manageable toxicities for limited-stage SCLC patients treated with IMRT. Mean esophageal dose and the overlapping volume between PTV and esophageal are independently predictive factors of acute esophagitis grade ≥2, and COPD and tumor location are valuable factors of lung injuries for limited-stage SCLC patients receiving hyofractionated radiotherapy. Prospective studies are needed to confirm these results.
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Affiliation(s)
- J J Zhao
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China
| | - N Bi
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China
| | - T Zhang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China
| | - J Y Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China
| | - L Deng
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China
| | - X Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China
| | - D F Chen
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China
| | - J R Dai
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China
| | - L H Wang
- Department of Radiation Oncology, National Cancer Center/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen 518116, China
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Ma LF, Zeng BJ, Wang XZ, Zhang X, Wang JY. [The prospect and challenge of liquid biopsy in the diagnosis and treatment of chest malignancy]. Zhonghua Yu Fang Yi Xue Za Zhi 2023; 57:968-975. [PMID: 37482733 DOI: 10.3760/cma.j.cn112150-20221108-01082] [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: 07/25/2023]
Abstract
In recent years, the incidence of chest malignant tumors in China has increased year by year, which has seriously threatened the health problems of people. Among them, early screening and intervention of patients with chest malignancies is the key to cancer prevention. Early detection, early diagnosis, and early treatment as the "three early prevention" of clinical practice are conducive to improve the survival rate of tumor patients. As a non-invasive and real-time reflection of tumor status, liquid biopsy has gradually received attention in clinical diagnosis and treatment. Circulating tumor cells (CTCs), circulating tumor DNA (ctDNA) and exosomes as liquid biopsy "Three carriages" are not only widely used in the diagnosis, monitoring and prognostic evaluation of chest malignancies, but also face many unknown challenges. In this article, the application of liquid biopsy in chest malignancies in recent years is elaborated in detail, which provides a reference for the formulation of clinical tumor prevention and diagnosis and treatment strategies.
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Affiliation(s)
- L F Ma
- Department of Clinical Laboratory, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China Institute of Thoracic Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - B J Zeng
- Department of Clinical Laboratory, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - X Z Wang
- Department of Clinical Laboratory, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - X Zhang
- Institute of Thoracic Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - J Y Wang
- Department of Clinical Laboratory, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China Institute of Thoracic Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
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Wang JY, Cheng JZ, Yang N, Zhang JH, Tu CL. [Spatial correlation between the prevalence of dental fluorosis and the chemical elemental composition of drinking water sources in a typical coal-fired pollution fluorosis area]. Zhonghua Liu Xing Bing Xue Za Zhi 2023; 44:891-898. [PMID: 37380409 DOI: 10.3760/cma.j.cn112338-20221206-01042] [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: 06/30/2023]
Abstract
Objective: To investigate the spatial distribution characteristics and correlation between the prevalence of dental fluorosis and the chemical elemental composition of drinking water sources in coal-fired fluorosis areas. Methods: Based on the survey data on the prevalence of dental fluorosis at CDC in Guizhou Province in 2022, 274 original surface drinking water sources were collected in typical coal-fired fluorosis areas, and fluoride (F), calcium (Ca), magnesium (Mg), aluminum (Al), titanium (Ti), chromium (Cr), manganese (Mn), iron (Fe), nickel (Ni), copper (Cu), zinc (Zn), arsenic (As), selenium (Se), molybdenum (Mo), cadmium (Cd), barium (Ba), lead (Pb) 17 elements; apply Moran's I index, Getis-Ord Gi* hotspot analysis of the global spatial autocorrelation of chemical elements in drinking water and the degree of aggregation of each element on the local area, and correlation analysis with the prevalence of dental fluorosis in the region. Results: Except for Cu, Zn, and Cd, global spatial autocorrelation Moran's I was negative, and all other elements were positive. F, Ca, Al, Ti, As, Mo, Cd, and Cu elements showed high values of aggregation in the southeastern low-altitude area; Mg, Ba, Pb, Cr, Mn, and Fe elements were mainly aggregated in the central altitude terrain transition area, Zn and Se elements in water sources are significantly positively correlated with the prevalence of dental fluorosis (P<0.05). In contrast, F, Mg, Al, Ti, As, Mo, Cd, Ba, and Pb elements negatively correlate (P<0.05). Elements in the central region were high-high aggregation, as a hot spot aggregation area with high disease incidence, while F, Al, Mn, Mo, Cd, and Ba elements in the western region were low-low aggregation, as a cold spot aggregation area with a low incidence of fluorosis. Conclusions: The risk of population fluoride exposure in surface drinking water sources is shallow. However, the chemical element content of drinking water sources in coal-fired polluted endemic fluorosis areas has prominent spatial geographical distribution characteristics. There is a significant spatial aggregation effect with the prevalence of dental fluorosis, which may play a synergistic or antagonistic effect on the occurrence and prevalence of dental fluorosis.
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Affiliation(s)
- J Y Wang
- Key Laboratory of Environmental Pollution and Disease Surveillance/Ministry of Education, School of Public Health and Health, Guizhou Medical University, Guiyang 550025, China
| | - J Z Cheng
- State Key Laboratory of Environmental Geochemistry/Institute of Geochemistry, Chinese Academy of Sciences, Guiyang 550081, China
| | - N Yang
- Key Laboratory of Environmental Pollution and Disease Surveillance/Ministry of Education, School of Public Health and Health, Guizhou Medical University, Guiyang 550025, China
| | - J H Zhang
- Key Laboratory of Environmental Pollution and Disease Surveillance/Ministry of Education, School of Public Health and Health, Guizhou Medical University, Guiyang 550025, China
| | - C L Tu
- Key Laboratory of Environmental Pollution and Disease Surveillance/Ministry of Education, School of Public Health and Health, Guizhou Medical University, Guiyang 550025, China Toxicity Testing Center, Guizhou Medical University, Guiyang 550025, China
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Liang FY, Lin PL, Lin XJ, Han P, Chen RH, Wang JY, Zou X, Huang XM. [Preliminary experience of gasless transoral vestibular robotic thyroidectomy]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2023; 58:596-601. [PMID: 37339900 DOI: 10.3760/cma.j.cn115330-20221108-00672] [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: 06/22/2023]
Abstract
Objective: To explore the feasibility and safety of the gasless transoral vestibular robotic thyroidectomy using skin suspension. Methods: The clinical data of 20 patients underwent gasless transoral vestibular robotic thyroidectomy in the Department of Otorhinolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University from February 2022 to May 2022 were retrospectively analyzed. Among them, 18 were females and 2 were males, aged (38.7±8.0) years old. The intraoperative blood loss, operation time, postoperative hospital stay, postoperative drainage volume, postoperative pain visual analogue scale (VAS) score, postoperative swallowing function swallowing impairment score-6 (SIS-6), postoperative aesthetic VAS score, postoperative voice handicap index-10 (VHI-10) voice quality, postoperative pathology and complications were recorded. SPSS 25.0 was used for statistical analysis of the data. Results: The operations were successfully completed without conversion to open surgery in all patients. Pathological examination showed papillary thyroid carcinoma in 18 cases, retrosternal nodular goiter in 1 case, and cystic change in goiter in 1 case. The operative time for thyroid cancer was 161.50 (152.75, 182.50) min [M (P25, P75), the same below] and the average operative time for benign thyroid diseases was 166.50 minutes. The intraoperative blood loss 25.00 (21.25, 30.00) ml. In 18 cases of thyroid cancer, the mean diameter of the tumors was (7.22±2.02) mm, and lymph nodes (6.56±2.14) were dissected in the central region, with a lymph node metastasis rate of 61.11%. The postoperative pain VAS score was 3.00 (2.25, 4.00) points at 24 hours, the mean postoperative drainage volume was (118.35±24.32) ml, the postoperative hospital stay was 3.00 (3.00, 3.75) days, the postoperative SIS-6 score was (4.90±1.58) points at 3 months, and the postoperative VHI-10 score was 7.50 (2.00, 11.00) points at 3 months. Seven patients had mild mandibular numbness, 10 patients had mild cervical numbness, and 3 patients had temporary hypothyroidism three months after surgery and 1 patient had skin flap burn, but recovered one month after surgery. All patients were satisfied with the postoperative aesthetic effects, and the postoperative aesthetic VAS score was 10.00 (10.00, 10.00). Conclusion: Gasless transoral vestibular robotic thyroidectomy using skin suspension is a safe and feasible option with good postoperative aesthetic effect, which can provide a new treatment option for some selected patients with thyroid tumors.
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Affiliation(s)
- F Y Liang
- Department of Otorhinolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Key Laboratory of Epigenetics and Gene Regulation of Malignant Tumor in Guangdong Province, Guangzhou 510280, China
| | - P L Lin
- Department of Otorhinolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Key Laboratory of Epigenetics and Gene Regulation of Malignant Tumor in Guangdong Province, Guangzhou 510280, China
| | - X J Lin
- Department of Otorhinolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Key Laboratory of Epigenetics and Gene Regulation of Malignant Tumor in Guangdong Province, Guangzhou 510280, China
| | - P Han
- Department of Otorhinolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Key Laboratory of Epigenetics and Gene Regulation of Malignant Tumor in Guangdong Province, Guangzhou 510280, China
| | - R H Chen
- Department of Otorhinolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Key Laboratory of Epigenetics and Gene Regulation of Malignant Tumor in Guangdong Province, Guangzhou 510280, China
| | - J Y Wang
- Department of Otorhinolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Key Laboratory of Epigenetics and Gene Regulation of Malignant Tumor in Guangdong Province, Guangzhou 510280, China
| | - X Zou
- Department of Otorhinolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Key Laboratory of Epigenetics and Gene Regulation of Malignant Tumor in Guangdong Province, Guangzhou 510280, China
| | - X M Huang
- Department of Otorhinolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Key Laboratory of Epigenetics and Gene Regulation of Malignant Tumor in Guangdong Province, Guangzhou 510280, China
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Fan F, Cao S, Zhang LM, Chen N, You P, Su L, Wang JY, Zhao XL, Chen GD. [Endoscopic ultrasonographic features of submucosal lesions of upper digestive tract suspected gastrointestinal stromal tumors and their correlation with progression and pathological risk grade of the lesions]. Zhonghua Yi Xue Za Zhi 2023; 103:1643-1648. [PMID: 37248065 DOI: 10.3760/cma.j.cn112137-20230207-00177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Objective: To investigate the endoscopic ultrasonographic (EUS) characteristics of submucosal lesions of upper digestive tract suspected gastrointestinal stromal tumors (GIST) and their correlation with biological behaviors and pathological risk grade of the tumors. Methods: Retrospective cohort study. The EUS findings, follow-up review, surgical treatment and pathological data of patients with suspected GIST at the Gastrointestinal Endoscopy Center of Peking University People's Hospital from January 2013 to April 2021 were collected. All samples were divided into follow-up group and treatment group based on the pathological condition and the patient's treatment intention. According to whether or not the tumor was enlarged in EUS, the follow-up group was divided into non-enlarged group and enlarged group. Paired T-test was used to compare the lesion size before and after follow-up, and logistic regression was used to analyze the risk factors of tumor enlargement. According to the treatment methods, the treatment group was further divided into endoscopic treatment group and surgical treatment group. According to the pathological results and risk grade, the treatment group was further divided into the low-risk group and the medium-risk group. The risk factors of pathological malignant risk were analyzed by logistic regression, and the tumor diameter of patients with moderate or above pathological risk was predicted by receiver operation characteristic (ROC) curve. The relationship between the findings of EUS and the progression and pathological risk of GIST were also explored. Results: Seventy-three cases including 23 males and 50 females, with an age of 58 (30-88) years, were included in the follow-up group, with a mean lesion diameter of (1.21±0.49) cm before follow-up, median follow-up interval of 33.8 months, and a lesion diameter of (1.18±0.49) cm after follow-up. There was no significant difference (all P>0.05) in lesion diameter between before and after follow-up. There was no significant difference (all P>0.05) between tumor enlargement group (18 cases, 24.7%) and non-enlargement group (55 cases, 75.3%). One hundred and thirty-eight cases, including 52 males and 86 females, with an age of 60 (19-84) years, were enrolled in the treatment group, with a mean EUS estimated diameter of (2.55±1.35) cm and pathological diameters of (3.43±2.42) cm. Ninety-five (68.8%) of these cases were pathologically confirmed as GIST while 43 cases were diagnosed as other tumor types, including 37 benign tumors and 6 malignant tumors. In multifactorial logistic regression analysis, only the increase of tumor diameter [OR (95%CI): 1.800 (1.172-2.766), P=0.007] was a risk factor for pathological intermediate or higher risk. The optimal tumor diameter for predicting pathological intermediate or higher risk using ROC curve analysis was 2.75 cm, with a sensitivity 71.4%, specificity 79.0%, Youden index 0.5 and area under ROC curve 0.807 (95%CI: 0.703-0.909). Conclusions: EUS is essential for assessing the risk of progression and malignancy of submucosal lesions of upper digestive tract suspected GIST. For lesions of small diameter, the interval of follow-up shall be relatively extended while the indication of treatment could be partially waived.
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Affiliation(s)
- F Fan
- Department of Gastroenterology, Peking University People's Hospital, Beijing 100044, China
| | - S Cao
- Department of Gastroenterology, Peking University People's Hospital, Beijing 100044, China
| | - L M Zhang
- Department of Gastroenterology, Peking University People's Hospital, Beijing 100044, China
| | - N Chen
- Department of Gastroenterology, Peking University People's Hospital, Beijing 100044, China
| | - P You
- Department of Gastroenterology, Peking University People's Hospital, Beijing 100044, China
| | - L Su
- Department of Gastroenterology, Peking University People's Hospital, Beijing 100044, China
| | - J Y Wang
- Department of Gastroenterology, Peking University People's Hospital, Beijing 100044, China
| | - X L Zhao
- Department of Gastroenterology, Peking University People's Hospital, Beijing 100044, China
| | - G D Chen
- Department of Gastroenterology, Peking University People's Hospital, Beijing 100044, China
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Zhao WP, Wang LM, Wang JY, Xie S, Jin JH, Huang Y. [Transient elastography technology role assessment during the diagnosis and treatment of patients with chronic hepatitis B virus infection]. Zhonghua Gan Zang Bing Za Zhi 2023; 31:489-494. [PMID: 37365025 DOI: 10.3760/cma.j.cn501113-20221129-00585] [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: 06/28/2023]
Abstract
Objective: To explore the role of transient elastography technology in the assessment of disease staging and treatment in patients with chronic hepatitis B virus (HBV) infection. Methods: Patients who were clinically diagnosed with chronic HBV infection at Beijing Tsinghua Changgung Hospital from January 2018 to December 2021 was collected. Liver stiffness measurement (LSM) examination was performed more than once by transient elastography. The count data were expressed as cases (%) and the χ (2) test was made. Fisher's exact test was used with theoretical frequency less than 5. The measurement data between two groups was compared by t-test. Multiple groups were compared with an analysis of variance. Results: 1 055 patients were included in this study, including 669 (63.4%) males and 386 (36.6%) females. 757 (71.8%) patients were untreated. Among the untreated patients, the LSM value in the immune clearance (10.2 ± 3.8) kPa (187 cases, 40.4%), and the reactivation stages (9.1 ± 3.4) kPa (114 cases, 24.6%) was significantly higher than that in the immune tolerance (8.7 ± 3.6) kPa (78 cases, 16.8%) and immune control stages (8.4 ± 3.5) KPa (84 cases, 18.1%), and the difference between the four groups was statistically significant (F = 5.31 and P = 0.03). With ALT (male: 30 U/L, female: 19 U/L) as defined the normal value, the LSM value in the immune tolerance and the immune control stages were (5.8 ± 0.9) kPa and (7.1 ± 2.5) kPa, respectively, which were significantly lower than those of patients in the immune tolerance and immune control stages, and the difference was statistically significant (P < 0.01). There were 294 (38.8%) patients with uncertain period, excluding patients with fatty liver. Patients with uncertain periods were divided into four gray zone (GZ) groups: immune tolerance stage: LSM (5.1 ± 1.3) kPa was significantly lower than GZ-A (6.5 ± 2.4) kPa, t = 2.06, P = 0.03, and the difference was statistically significant; immune control stage: LSM was (5.6 ± 1.5) kPa, which was also lower than GZ-C (6.8 ± 1.3) kPa, t = 3.08, P = 0.02, and the difference was statistically significant; immune clearance stage: LSM > 8.0 kPa. LSM values showed a year-by-year reduction in patients with expanded indications who started antiviral treatment and were followed up for three years. Conclusion: The LSM value is significantly lower after the decrease of the defined high-normal ALT value in patients with the immune tolerance and immune control stages of chronic HBV infection. The LSM values of GZ-A and GZ-C in the uncertain periods of chronic HBV infection are higher than those of patients in the immune tolerance and immune control stages.
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Affiliation(s)
- W P Zhao
- Department of Hepatobiliary Medicine, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing 102218, China
| | - L M Wang
- Department of Hepatobiliary Medicine, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing 102218, China
| | - J Y Wang
- Department of Hepatobiliary Medicine, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing 102218, China
| | - S Xie
- Department of Hepatobiliary Medicine, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing 102218, China
| | - J H Jin
- Department of Hepatobiliary Medicine, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing 102218, China
| | - Y Huang
- Department of Hepatobiliary Medicine, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing 102218, China
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Ding QY, Zhao LR, Gu QH, Wang JY, Bai H. [Exploring the etiology of a case of intractable ascites after cholecystectomy]. Zhonghua Gan Zang Bing Za Zhi 2023; 31:542-544. [PMID: 37365033 DOI: 10.3760/cma.j.cn501113-20210618-00289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Affiliation(s)
- Q Y Ding
- Department of Infectious Disease, Shengjing Hospital Affiliated to China Medical University, Shenyang 110022, China
| | - L R Zhao
- Department of Infectious Disease, Shengjing Hospital Affiliated to China Medical University, Shenyang 110022, China
| | - Q H Gu
- Department of Infectious Disease, Shengjing Hospital Affiliated to China Medical University, Shenyang 110022, China
| | - J Y Wang
- Department of Infectious Disease, Shengjing Hospital Affiliated to China Medical University, Shenyang 110022, China
| | - H Bai
- Department of Infectious Disease, Shengjing Hospital Affiliated to China Medical University, Shenyang 110022, China
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Singh S, Wang JY, Heysell SK, McShane PJ, Wadle C, Shankar P, Huang HL, Pasipanodya J, Boorgula GD, Philley JV, Gumbo T, Srivastava S. Omadacycline pharmacokinetics/pharmacodynamics in the hollow fiber model and clinical validation of efficacy to treat pulmonary Mycobacterium abscessus Disease. Int J Antimicrob Agents 2023:106847. [PMID: 37187338 DOI: 10.1016/j.ijantimicag.2023.106847] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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: 01/20/2023] [Revised: 05/03/2023] [Accepted: 05/09/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND Guideline-based therapy for pulmonary Mycobacterium abscessus (Mab) disease achieves sustained sputum culture conversion (SSCC) rates of 30%, a fact reflected by poor efficacy of GBT in the hollow fiber system model of Mab (HFS-Mab) which killed ∼1.22 log10 CFU/mL. This study was performed to determine what clinical dose of omadacycline, a tetracycline antibiotic, should be used in combination therapy to treat pulmonary Mab disease for relapse free cure. METHODS First, we mimicked omadacycline intrapulmonary concentration-time profiles of seven daily doses in the HFS-Mab model and identified exposures associated with optimal efficacy. Second, we determined if oral omadacycline 300mg/day would achieve these optimal exposures in 10,000 subject Monte-Carlo simulations. Third, we performed a retrospective clinical study for rates of SSCC and toxicity, on omadacycline versus primarily tigecycline-based salvage therapy. Fourth, a single patient was recruited to validate the findings. RESULTS Omadacycline efficacy in the HFS-Mab was 2.09 log10 CFU/mL at exposures achieved in >99% of patients on 300mg/day omadacycline. In the retrospective study, SSCC with omadacycline 300mg/day-based combinations was achieved in 8/10 versus 1/9 (p=0.006), symptom improvement in 8/8 versus 5/9 (p=0.033), toxicity in 0 versus 9/9 (p<0.001), and therapy discontinuation due to toxicity in 0 versus 3/9 (p<0.001) of cases versus comparators, respectively. In one prospectively recruited patient, omadacycline 300mg/day salvage therapy achieved SSCC and symptom-resolution in 3-months. CONCLUSION Based on the preclinical and clinical data, omadacycline dose of 300mg/day in combination regimens could be appropriate for testing in phase III trials in patients with Mab pulmonary disease.
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Affiliation(s)
- Sanjay Singh
- Department of Medicine, University of Texas School of Medicine, Tyler, Texas, USA
| | - Jann-Yuan Wang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Scott K Heysell
- Division of Infectious Diseases and International Health, University of Virginia, USA
| | - Pamela J McShane
- Section of Pulmonary and Critical Care, University of Texas at Tyler, Tyler, Texas, USA
| | - Carly Wadle
- Section of Pulmonary and Critical Care, University of Texas at Tyler, Tyler, Texas, USA
| | - Prem Shankar
- Department of Medicine, University of Texas School of Medicine, Tyler, Texas, USA
| | - Hung-Ling Huang
- Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jotam Pasipanodya
- Quantitative Preclinical & Clinical Sciences Department, Praedicare Inc, Dallas, Texas
| | | | - Julie V Philley
- Section of Pulmonary and Critical Care, University of Texas at Tyler, Tyler, Texas, USA
| | - Tawanda Gumbo
- Quantitative Preclinical & Clinical Sciences Department, Praedicare Inc, Dallas, Texas; Hollow Fiber System & Experimental Therapeutics Laboratories, Praedicare Inc, Dallas, TX
| | - Shashikant Srivastava
- Department of Medicine, University of Texas School of Medicine, Tyler, Texas, USA; Department of Cellular and Molecular Biology, University of Texas Health Science Center at Tyler, Tyler, Texas, USA; Center for Biomedical Research, University of Texas Health Science Centre at Tyler, Tyler, Texas, USA.
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Liu CJ, Tsai CC, Kuo LC, Kuo PC, Lee MR, Wang JY, Ko JC, Shih JY, Wang HC, Yu CJ. A deep learning model using chest X-ray for identifying TB and NTM-LD patients: a cross-sectional study. Insights Imaging 2023; 14:67. [PMID: 37060419 PMCID: PMC10105818 DOI: 10.1186/s13244-023-01395-9] [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: 11/27/2022] [Accepted: 02/19/2023] [Indexed: 04/16/2023] Open
Abstract
BACKGROUND Timely differentiating between pulmonary tuberculosis (TB) and nontuberculous mycobacterial lung disease (NTM-LD), which are radiographically similar, is important because infectiousness and treatment differ. This study aimed to evaluate whether artificial intelligence could distinguish between TB or NTM-LD patients by chest X-rays (CXRs) from suspects of mycobacterial lung disease. METHODS A total of 1500 CXRs, including 500 each from patients with pulmonary TB, NTM-LD, and patients with clinical suspicion but negative mycobacterial culture (Imitator) from two hospitals, were retrospectively collected and evaluated in this study. We developed a deep neural network (DNN) and evaluated model performance using the area under the receiver operating characteristic curves (AUC) in both internal and external test sets. Furthermore, we conducted a reader study and tested our model under three scenarios of different mycobacteria prevalence. RESULTS Among the internal and external test sets, the AUCs of our DNN model were 0.83 ± 0.005 and 0.76 ± 0.006 for pulmonary TB, 0.86 ± 0.006 and 0.64 ± 0.017 for NTM-LD, and 0.77 ± 0.007 and 0.74 ± 0.005 for Imitator. The DNN model showed higher performance on the internal test set in classification accuracy (66.5 ± 2.5%) than senior (50.8 ± 3.0%, p < 0.001) and junior pulmonologists (47.5 ± 2.8%, p < 0.001). Among different prevalence scenarios, the DNN model has stable performance in terms of AUC to detect TB and mycobacterial lung disease. CONCLUSION DNN model had satisfactory performance and a higher accuracy than pulmonologists on classifying patients with presumptive mycobacterial lung diseases. DNN model could be a complementary first-line screening tool.
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Affiliation(s)
- Chia-Jung Liu
- Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Cheng Che Tsai
- Department of Computer Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lu-Cheng Kuo
- Department of Internal Medicine, National Taiwan University Hospital, #7, Zhongshan South Rd., Zhongzheng Dist., Taipei, 100226, Taiwan
| | - Po-Chih Kuo
- Department of Computer Science, National Tsing Hua University, No. 101, Kuang Fu Rd, Sec.2, Hsinchu, 300044, Taiwan.
| | - Meng-Rui Lee
- Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu, Taiwan.
- Department of Internal Medicine, National Taiwan University Hospital, #7, Zhongshan South Rd., Zhongzheng Dist., Taipei, 100226, Taiwan.
| | - Jann-Yuan Wang
- Department of Internal Medicine, National Taiwan University Hospital, #7, Zhongshan South Rd., Zhongzheng Dist., Taipei, 100226, Taiwan
| | - Jen-Chung Ko
- Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu, Taiwan
| | - Jin-Yuan Shih
- Department of Internal Medicine, National Taiwan University Hospital, #7, Zhongshan South Rd., Zhongzheng Dist., Taipei, 100226, Taiwan
| | - Hao-Chien Wang
- Department of Internal Medicine, National Taiwan University Hospital, #7, Zhongshan South Rd., Zhongzheng Dist., Taipei, 100226, Taiwan
- Department of Medicine, National Taiwan University Cancer Center, Taipei, Taiwan
| | - Chong-Jen Yu
- Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital, #7, Zhongshan South Rd., Zhongzheng Dist., Taipei, 100226, Taiwan
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Liao TY, Wang JY, Shih JY. Association of pulmonary nontuberculous mycobacteria with the outcomes of patients with lung cancer: A retrospective matched cohort study with a special emphasis on the impact of chemotherapy. J Microbiol Immunol Infect 2023; 56:392-399. [PMID: 36456443 DOI: 10.1016/j.jmii.2022.11.003] [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] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 10/11/2022] [Accepted: 11/12/2022] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Nontuberculous mycobacteria (NTM) may be present in the respiratory tract of patients with lung cancer. We investigated the association of pulmonary NTM with the clinical features and outcomes of patients with lung cancer. METHODS Between 2015 and 2019, the data of patients diagnosed with lung cancer at a medical center in northern Taiwan were analyzed. Patients whose respiratory specimens were culture-positive for NTM were identified (NTM group). For each patient in the NTM group, a matched control was selected (control group). The survival of the two groups was compared using the Kaplan-Meier method and Cox proportional hazards regression analysis. RESULTS Among 8718 patients with lung cancer, 5418 (62.1%) underwent a sputum mycobacterial culture. At least one NTM species was isolated from 138 (2.5%) patients. The median age was 72 years (range: 64-80). In the NTM group, 19.8% fulfilled both the microbiological and radiographic criteria for the diagnosis of NTM lung disease. Compared with the control group, the NTM group exhibited a lower body mass index (22.4 vs. 23.6, p = 0.025) and a higher prevalence of structural lung disease (38.9% vs. 22.2%, p = 0.004). The two-year survival was not significantly different between the two groups (hazard ratio [HR]: 1.110; 95% confidence interval [CI]: 0.702-1.754, p = 0.656). In patients receiving chemotherapy, pulmonary NTM was associated with worse survival (HR: 2.497, 95% CI: 1.262-4.943, p = 0.009). CONCLUSIONS Except in patients receiving chemotherapy, pulmonary NTM may not be clinically relevant in patients with lung cancer.
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Affiliation(s)
- Ting-Yu Liao
- Department of Internal Medicine, National Taiwan University Hospital Hsin-chu Branch, National Taiwan University College of Medicine, Hsin-chu, Taiwan
| | - Jann-Yuan Wang
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
| | - Jin-Yuan Shih
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
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Wu LP, Xie BS, Wang JY, DeJi JCM, Zhao FY, Ding X, Liu XJ, Lin XY, Zhou XC, Zhao Y, Wu Q, Shi BY. [Study on protective effects and mechanisms of total glucosides of Paeony on Graves disease in BALB/c mice]. Zhonghua Yi Xue Za Zhi 2023; 103:689-695. [PMID: 36858370 DOI: 10.3760/cma.j.cn112137-20220720-01584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
Objective: To investigate the protective effect and its immunoregulatory mechanism of Total Glucosides of Paeony (TGP) against Graves' Disease (GD) model on BALB/c mice. Methods: Fifty female (6 weeks old, weighing 16-18 g) BALB/c mice of specific pathogen free were divided into control group according to random number table method, model group, early low-dose TGP intervention group (250 mg·kg-1·d-1), early high-dose TGP intervention group (500 mg·kg-1·d-1), and late TGP intervention group, with 10 mice in each group. Except the control group, the other 4 groups were immunized 3 times (0, 3rd, and 6th week) with recombinant adenovirus expressing the thyroid stimulating hormone receptor (TSHR) A subunit to establish the GD model. The early low-dose and high-dose intervention group were given diets containing different doses of TGP throughout the whole process, and the late intervention group was given diets containing low doses of TGP from the 1st week after the 2nd immunization (week 4). The levels of thyrotropin receptor antibody (TRAb) and total thyroxine (TT4) were detected in the tail venous blood of mice at the 4th week. At the 10th week, the serum TRAb and TT4 levels and the ratio of regulatory T cells (Treg) in each group were detected, and the pathological changes of thyroid tissue were observed. Serum helper T cell 1(Th1) and Th2 cell-related factors interleukin-2 (IL-2), IL-4, IL-5, IL-10, IL-12p70, granulocyte-macrophage colony-stimulating factor (GM-CSF), interferon-γ (IFN-γ) and tumor necrosis factors-α (TNF-α) were detected to investigate the protective effect of TGP on GD model in BALB/c mice and its mechanism. Results: At the 4th week, The level of TT4 [(55.07±12.89) μg/L] in early high-dose intervention group was lower than that in model group [(74.33±8.63) μg/L] (all P<0.05). The level of TT4 in early low-dose intervention group and late intervention group and model group had no statistical significance (all P>0.05). TRAb level of mice between early low-dose, early high-dose, late intervention groups and model group was no significant difference (all P>0.05). At the 10th week, TRAb [(90.00±26.89) U/L] and TT4[(32.66±8.11) μg/L] levels in the early high-dose intervention group were lower than those in the model group [(396.97±95.35) U/L, (73.70±16.33) μg/L] (all P<0.05). The TRAb and TT4 levels in the early low-dose intervention group and late intervention group were not significantly different from those in the model group (all P>0.05). The thyroid tissue of hyperthyroidism mice in the early high dose intervention group showed focal hypertrophic changes, while the thyroid tissue of other hyperthyroidism mice showed diffuse hypertrophic changes. The CD4+CD25+/CD4+Treg ratio in early high-dose intervention group was higher than that in model group at the 10th week (4 weeks after three recombinant adenovirus immunization) (P<0.05). Compared with the model group at the 10th week, the levels of IL-2, IL-12p70 and IFN-γ in the early high-dose intervention group were all decreased (all P<0.05), and the levels of IL-10 were increased (P<0.05). Conclusion: Early high-dose (500 mg·kg-1·d-1) TGP intervention group displays a protective effect against GD mice, the mechanism of which may be related to regulatory T cell function changes and Th1/Th2 cytokine balance restoration.
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Affiliation(s)
- L P Wu
- Department of Endocrinology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - B S Xie
- Department of Endocrinology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - J Y Wang
- Department of Endocrinology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - J C M DeJi
- Department of Endocrinology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - F Y Zhao
- Department of Endocrinology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - X Ding
- Department of Endocrinology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - X J Liu
- Department of Endocrinology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - X Y Lin
- Department of Endocrinology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - X C Zhou
- Department of Endocrinology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Y Zhao
- Department of Gerontology, Shanxi Provincial People's Hospital, Xi'an 710068, China
| | - Q Wu
- Department of Epidemiology, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China
| | - B Y Shi
- Department of Endocrinology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
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Chang CH, Chang LY, Ko JC, Wen YF, Chang CJ, Keng LT, Tsou PH, Yu KL, Wang JY, Yu CJ. Incidence of and Risk Factors for Acute Kidney Injury During Antituberculosis Treatment: A Prospective Cohort Study and Literature Review. Infect Dis Ther 2023; 12:919-931. [PMID: 36773200 PMCID: PMC10017892 DOI: 10.1007/s40121-023-00761-w] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 01/10/2023] [Indexed: 02/12/2023] Open
Abstract
INTRODUCTION Acute kidney injury (AKI) is occasionally detected in patients receiving anti-tuberculosis (TB) treatment. This prospective cohort study is the first to investigate the incidence, risk factors, and renal outcomes of AKI during anti-TB treatment. METHODS This study was conducted from January 1, 2016, to May 31, 2018. Patients with a new diagnosis of TB and on standard anti-TB treatment were enrolled, and the patients received regular laboratory monitoring. AKI was defined according to the Kidney Disease: Improving Global Outcome (KDIGO) criteria. Urinalysis, renal ultrasonography, blood erythrocyte morphology, and fractional excretion of sodium were performed at AKI onset. The TB treatment regimen was adjusted by the primary physician if necessary. Risk factors for AKI were identified through Cox regression. RESULTS In total, 106 patients were recruited (mean age 52.6 years, 71.7% men). Eleven (10.3%) patients experienced AKI. Increased serum uric acid and hemoglobin levels were noted at AKI onset. All patients with AKI achieved renal recovery and completed anti-TB treatment containing rifampin. Age [hazard ratio (HR) 1.06 (1.02-1.11)], a higher baseline estimated glomerular filtration rate [eGFR; HR 1.04 (1.02-1.06)], and a blood eosinophil count > 350 (109/L) [HR 10.99 (2.28-53.02)] were associated with a higher risk of AKI during TB treatment. CONCLUSION Regular pharmacovigilant monitoring revealed an incidence of renal impairment during anti-TB treatment that was higher than expected. AKI was more common in older patients with a higher eGFR and blood eosinophil count. However, the complications had no influence on TB treatment completion, and no permanent renal impairment occurred.
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Affiliation(s)
- Chia-Hao Chang
- Division of Pulmonary Medicine, Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu, Taiwan
| | - Lih-Yu Chang
- Division of Pulmonary Medicine, Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu, Taiwan
| | - Jen-Chung Ko
- Division of Pulmonary Medicine, Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu, Taiwan
| | - Yueh-Feng Wen
- Division of Pulmonary Medicine, Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu, Taiwan
| | - Chien-Jen Chang
- Division of Pulmonary Medicine, Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu, Taiwan
| | - Li-Ta Keng
- Division of Pulmonary Medicine, Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu, Taiwan
| | - Ping-Hsien Tsou
- Division of Pulmonary Medicine, Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu, Taiwan
| | - Kai-Lun Yu
- Division of Pulmonary Medicine, Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu, Taiwan
| | - Jann-Yuan Wang
- Department of Internal Medicine, National Taiwan University Hospital, #7, Chung-Shan South Road, Taipei, 100, Taiwan.
| | - Chong-Jen Yu
- Department of Internal Medicine, National Taiwan University Hospital, #7, Chung-Shan South Road, Taipei, 100, Taiwan
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Jiang LL, Jiao YN, Wang JY, Zhu MC, Lin Y. [Influence of hearing aid on speech recognition ability, psychology and cognitive function of presbycusis]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2023; 58:160-165. [PMID: 36748160 DOI: 10.3760/cma.j.cn115330-20221212-00747] [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: 02/08/2023]
Affiliation(s)
- L L Jiang
- Department of Otorhinolaryngology Head and Neck Surgery, Guangzhou 12th People's Hospital, Institute of Otorhinolaryngology Head and Neck Surgery, Guangzhou Medical University, Guangzhou 510620, China
| | - Y N Jiao
- Department of Otorhinolaryngology Head and Neck Surgery, Guangzhou 12th People's Hospital, Institute of Otorhinolaryngology Head and Neck Surgery, Guangzhou Medical University, Guangzhou 510620, China
| | - J Y Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Guangzhou 12th People's Hospital, Institute of Otorhinolaryngology Head and Neck Surgery, Guangzhou Medical University, Guangzhou 510620, China
| | - M C Zhu
- Department of Otorhinolaryngology Head and Neck Surgery, Guangzhou 12th People's Hospital, Institute of Otorhinolaryngology Head and Neck Surgery, Guangzhou Medical University, Guangzhou 510620, China
| | - Y Lin
- Department of Otorhinolaryngology Head and Neck Surgery, Guangzhou 12th People's Hospital, Institute of Otorhinolaryngology Head and Neck Surgery, Guangzhou Medical University, Guangzhou 510620, China
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Lee MC, Fujita Y, Muraki S, Huang HL, Lee CH, Wang JY, Ieiri I. Isoniazid level and flu-like symptoms during rifapentine-based tuberculosis preventive therapy: A population pharmacokinetic analysis. Br J Clin Pharmacol 2023; 89:714-726. [PMID: 36100960 DOI: 10.1111/bcp.15527] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 08/26/2022] [Accepted: 08/29/2022] [Indexed: 01/18/2023] Open
Abstract
AIM A population pharmacokinetic (PPK) study of the correlation of adverse drug reactions (ADRs) with the 3HP regimen (weekly high-dose rifapentine plus isoniazid for 12 doses) for latent tuberculosis infection (LTBI) remains lacking. The purpose of this study is to determine the association of rifapentine or isoniazid concentration and ADRs. METHODS This prospective, multicentre, observational study enrolled LTBI contacts receiving 3HP treatment between January 2017 and August 2020. The concentrations of rifapentine, isoniazid and their metabolites (25-desacetyl-rifapentine and acetyl-isoniazid) in plasma samples collected monthly after 3HP treatment were determined. A PPK model was constructed to predict the maximum concentration (Cmax ) and area under the concentration-time curve from 0 to 24 h (AUC). Their association with ADRs was evaluated by applying three multivariate logistic regression models with adjustment for various covariates. RESULTS A total of 415 LTBI cases were ultimately enrolled; 355 (85.5%) completed the 3HP treatment. Among them, 47 (11.3%) experienced systemic drug reactions and 291 (70.0%) experienced one or more flu-like symptom. The plasma concentration-time profiles of isoniazid, rifapentine and their metabolites were adequately described by the developed models. A higher Cmax of isoniazid was significantly correlated with a higher risk of any ADR (adjusted odds ratio and 95% confidence interval: 3.04 [1.07-8.65]) and any or at least two flu-like symptoms (all severity grades) (2.76 [1.06-7.17]). CONCLUSIONS Isoniazid may be responsible for ADRs, especially flu-like symptoms, during 3HP treatment.
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Affiliation(s)
- Ming-Chia Lee
- Department of Pharmacy, New Taipei City Hospital, New Taipei City, Taiwan.,School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Yuito Fujita
- Department of Clinical Pharmacokinetics, Graduate School of Kyushu University, Fukuoka, Japan
| | - Shota Muraki
- Department of Clinical Pharmacokinetics, Graduate School of Kyushu University, Fukuoka, Japan
| | - Hung-Ling Huang
- Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Division of Pulmonary and Critical Care Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chih-Hsin Lee
- Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Jann-Yuan Wang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ichiro Ieiri
- Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan
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Huang HL, Luo YC, Lu PL, Huang CH, Lin KD, Lee MR, Cheng MH, Yeh YT, Kao CY, Wang JY, Yang JM, Chong IW. Gut microbiota composition can reflect immune responses of latent tuberculosis infection in patients with poorly controlled diabetes. Respir Res 2023; 24:11. [PMID: 36631857 PMCID: PMC9835344 DOI: 10.1186/s12931-023-02312-w] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 01/02/2023] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Diabetes mellitus (DM) is a major risk factor for tuberculosis (TB). Evidence has linked the DM-related dysbiosis of gut microbiota to modifiable host immunity to Mycobacterium tuberculosis infection. However, the crosslinks between gut microbiota composition and immunological effects on the development of latent TB infection (LTBI) in DM patients remain uncertain. METHODS We prospectively obtained stool, blood samples, and medical records from 130 patients with poorly-controlled DM (pDM), defined as ever having an HbA1c > 9.0% within previous 1 year. Among them, 43 had LTBI, as determined by QuantiFERON-TB Gold in-Tube assay. The differences in the taxonomic diversity of gut microbiota between LTBI and non-LTBI groups were investigated using 16S ribosomal RNA sequencing, and a predictive algorithm was established using a random forest model. Serum cytokine levels were measured to determine their correlations with gut microbiota. RESULTS Compared with non-LTBI group, the microbiota in LTBI group displayed a similar alpha-diversity but different beta-diversity, featuring decrease of Prevotella_9, Streptococcus, and Actinomyces and increase of Bacteroides, Alistipes, and Blautia at the genus level. The accuracy was 0.872 for the LTBI prediction model using the aforementioned 6 microbiome-based biomarkers. Compared with the non-LTBI group, the LTBI group had a significantly lower serum levels of IL-17F (p = 0.025) and TNF-α (p = 0.038), which were correlated with the abundance of the aforementioned 6 taxa. CONCLUSIONS The study results suggest that gut microbiome composition maybe associated with host immunity relevant to TB status, and gut microbial signature might be helpful for the diagnosis of LTBI.
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Affiliation(s)
- Hung-Ling Huang
- grid.412027.20000 0004 0620 9374Division of Pulmonary and Critical Care Medicine, Kaohsiung Medical University Hospital, 100, Shih-Chuan 1st Road, Kaohsiung, 80708 Taiwan ,grid.412027.20000 0004 0620 9374Department of Internal Medicine, Kaohsiung Medical University Hospital, 100, Shih-Chuan 1st Road, Kaohsiung, 80708 Taiwan ,grid.415007.70000 0004 0477 6869Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, 68, Jhonghua 3rd Rd, Cianjin District, Kaohsiung, 80145 Taiwan ,grid.412019.f0000 0000 9476 5696Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, 100, Shih-Chuan 1st Road, Kaohsiung, 80708 Taiwan
| | - Yong-Chun Luo
- grid.260539.b0000 0001 2059 7017Institute of Bioinformatics and Systems Biology, National Yang Ming Chiao Tung University, 1001, University Road Hsinchu, 30010 Taiwan
| | - Po-Liang Lu
- grid.412027.20000 0004 0620 9374Department of Internal Medicine, Kaohsiung Medical University Hospital, 100, Shih-Chuan 1st Road, Kaohsiung, 80708 Taiwan ,grid.412019.f0000 0000 9476 5696Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, 100, Shih-Chuan 1st Road, Kaohsiung, 80708 Taiwan ,grid.412019.f0000 0000 9476 5696Center for Liquid Biopsy and Cohort, Kaohsiung Medical University, 100, Shih-Chuan 1st Road, Kaohsiung, 80708 Taiwan
| | - Cheng-Hsieh Huang
- grid.411396.80000 0000 9230 8977Aging and Disease Prevention Research Center, Fooyin University, 151, Jinxue Rd., Daliao Dist., Kaohsiung, 83102 Taiwan ,grid.412019.f0000 0000 9476 5696Ph. D. Program in Environmental and Occupational Medicine, Kaohsiung Medical University, 100, Shih-Chuan 1st Road, Kaohsiung, 80708 Taiwan ,grid.411396.80000 0000 9230 8977Department of Medical Laboratory Science and Biotechnology, Fooyin University, 151, Jinxue Rd., Daliao Dist., Kaohsiung, 83102 Taiwan
| | - Kun-Der Lin
- grid.412027.20000 0004 0620 9374Department of Internal Medicine, Kaohsiung Medical University Hospital, 100, Shih-Chuan 1st Road, Kaohsiung, 80708 Taiwan ,grid.412019.f0000 0000 9476 5696Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, 100, Shih-Chuan 1st Road, Kaohsiung, 80708 Taiwan ,grid.412027.20000 0004 0620 9374Division of Endocrinology and Metabolism, Kaohsiung Medical University Hospital, 100, Shih-Chuan 1st Road, Kaohsiung, 80708 Taiwan
| | - Meng-Rui Lee
- grid.412094.a0000 0004 0572 7815Department of Internal Medicine, National Taiwan University Hospital, 7, Chung-Shan South Rd., Zhongzheng Dist., Taipei, 100225 Taiwan
| | - Meng-Hsuan Cheng
- grid.412027.20000 0004 0620 9374Division of Pulmonary and Critical Care Medicine, Kaohsiung Medical University Hospital, 100, Shih-Chuan 1st Road, Kaohsiung, 80708 Taiwan ,grid.412027.20000 0004 0620 9374Department of Internal Medicine, Kaohsiung Medical University Hospital, 100, Shih-Chuan 1st Road, Kaohsiung, 80708 Taiwan ,grid.412019.f0000 0000 9476 5696Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, 100, Shih-Chuan 1st Road, Kaohsiung, 80708 Taiwan ,grid.412027.20000 0004 0620 9374Department of Respiratory Therapy, Kaohsiung Medical University Hospital, 100, Shih-Chuan 1st Road, Kaohsiung, 80708 Taiwan
| | - Yao-Tsung Yeh
- grid.411396.80000 0000 9230 8977Department of Medical Laboratory Science and Biotechnology, Fooyin University, 151, Jinxue Rd., Daliao Dist., Kaohsiung, 83102 Taiwan
| | - Cheng-Yuan Kao
- grid.59784.370000000406229172Immunology Research Center, National Health Research Institutes, 35, Keyan Road, Zhunan Town, Miaoli, 35053 Taiwan
| | - Jann-Yuan Wang
- Department of Internal Medicine, National Taiwan University Hospital, 7, Chung-Shan South Rd., Zhongzheng Dist., Taipei, 100225, Taiwan.
| | - Jinn-Moon Yang
- Institute of Bioinformatics and Systems Biology, National Yang Ming Chiao Tung University, 1001, University Road, Hsinchu, 30010, Taiwan. .,Department of Biological Science and Technology, National Yang Ming Chiao Tung University, 75, Boai Street, Hsinchu, 300193, Taiwan. .,Center for Intelligent Drug Systems and Smart Bio-Devices, National Yang Ming Chiao Tung University, 75 Boai Street, Hsinchu, 300193, Taiwan.
| | - Inn-Wen Chong
- Division of Pulmonary and Critical Care Medicine, Kaohsiung Medical University Hospital, 100, Shih-Chuan 1st Road, Kaohsiung, 80708, Taiwan. .,Department of Internal Medicine, Kaohsiung Medical University Hospital, 100, Shih-Chuan 1st Road, Kaohsiung, 80708, Taiwan. .,Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, 100, Shih-Chuan 1st Road, Kaohsiung, 80708, Taiwan. .,Department of Biological Science and Technology, National Yang Ming Chiao Tung University, 75, Boai Street, Hsinchu, 300193, Taiwan.
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Chen YT, Chang YH, Pathak N, Tzou SC, Luo YC, Hsu YC, Li TN, Lee JY, Chen YC, Huang YW, Yang HJ, Hsu NY, Tsai HP, Chang TY, Hsu SC, Liu PC, Chin YF, Lin WC, Yang CM, Wu HL, Lee CY, Hsu HL, Liu YC, Chu JW, Wang LHC, Wang JY, Huang CH, Lin CH, Hsieh PS, Wu Lee YH, Hung YJ, Yang JM. Methotrexate inhibition of SARS-CoV-2 entry, infection and inflammation revealed by bioinformatics approach and a hamster model. Front Immunol 2022; 13:1080897. [PMID: 36618412 PMCID: PMC9811668 DOI: 10.3389/fimmu.2022.1080897] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 11/29/2022] [Indexed: 12/24/2022] Open
Abstract
Background Drug repurposing is a fast and effective way to develop drugs for an emerging disease such as COVID-19. The main challenges of effective drug repurposing are the discoveries of the right therapeutic targets and the right drugs for combating the disease. Methods Here, we present a systematic repurposing approach, combining Homopharma and hierarchal systems biology networks (HiSBiN), to predict 327 therapeutic targets and 21,233 drug-target interactions of 1,592 FDA drugs for COVID-19. Among these multi-target drugs, eight candidates (along with pimozide and valsartan) were tested and methotrexate was identified to affect 14 therapeutic targets suppressing SARS-CoV-2 entry, viral replication, and COVID-19 pathologies. Through the use of in vitro (EC50 = 0.4 μM) and in vivo models, we show that methotrexate is able to inhibit COVID-19 via multiple mechanisms. Results Our in vitro studies illustrate that methotrexate can suppress SARS-CoV-2 entry and replication by targeting furin and DHFR of the host, respectively. Additionally, methotrexate inhibits all four SARS-CoV-2 variants of concern. In a Syrian hamster model for COVID-19, methotrexate reduced virus replication, inflammation in the infected lungs. By analysis of transcriptomic analysis of collected samples from hamster lung, we uncovered that neutrophil infiltration and the pathways of innate immune response, adaptive immune response and thrombosis are modulated in the treated animals. Conclusions We demonstrate that this systematic repurposing approach is potentially useful to identify pharmaceutical targets, multi-target drugs and regulated pathways for a complex disease. Our findings indicate that methotrexate is established as a promising drug against SARS-CoV-2 variants and can be used to treat lung damage and inflammation in COVID-19, warranting future evaluation in clinical trials.
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Affiliation(s)
- Yun-Ti Chen
- Institute of Bioinformatics and Systems Biology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Yu-Hsiu Chang
- Institute of Preventive Medicine, National Defense Medical Center, Taipei, Taiwan,Department of Microbiology and Immunology, National Defense Medical Center, Taipei, Taiwan
| | - Nikhil Pathak
- Institute of Bioinformatics and Systems Biology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Shey-Cherng Tzou
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan,Institute of Molecular Medicine and Bioengineering, National Yang Ming Chiao Tung University, Hsinchu, Taiwan,Center for Intelligent Drug Systems and Smart Bio-Devices, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Yong-Chun Luo
- Institute of Bioinformatics and Systems Biology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Yen-Chao Hsu
- Institute of Bioinformatics and Systems Biology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Tian-Neng Li
- Institute of Molecular and Cellular Biology, National Tsing Hua University, Hsinchu, Taiwan
| | - Jung-Yu Lee
- Institute of Bioinformatics and Systems Biology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Yi-Cyun Chen
- Institute of Bioinformatics and Systems Biology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Yu-Wei Huang
- Institute of Bioinformatics and Systems Biology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Hsin-Ju Yang
- Institute of Bioinformatics and Systems Biology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Nung-Yu Hsu
- Institute of Bioinformatics and Systems Biology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Hui-Ping Tsai
- Institute of Preventive Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Tein-Yao Chang
- Institute of Preventive Medicine, National Defense Medical Center, Taipei, Taiwan,Department of Microbiology and Immunology, National Defense Medical Center, Taipei, Taiwan
| | - Shu-Chen Hsu
- Institute of Preventive Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Ping-Cheng Liu
- Institute of Preventive Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Yuan-Fan Chin
- Institute of Preventive Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Wen-Chin Lin
- Institute of Preventive Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Chuen-Mi Yang
- Institute of Preventive Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Hsueh-Ling Wu
- Institute of Preventive Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Chia-Ying Lee
- Institute of Preventive Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Hui-Ling Hsu
- Institute of Preventive Medicine, National Defense Medical Center, Taipei, Taiwan,Department of Microbiology and Immunology, National Defense Medical Center, Taipei, Taiwan
| | - Yi-Chun Liu
- Institute of Preventive Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Jhih-Wei Chu
- Institute of Bioinformatics and Systems Biology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan,Center for Intelligent Drug Systems and Smart Bio-Devices, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Lily Hui-Ching Wang
- Institute of Molecular and Cellular Biology, National Tsing Hua University, Hsinchu, Taiwan
| | - Jann-Yuan Wang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chih-Heng Huang
- Institute of Preventive Medicine, National Defense Medical Center, Taipei, Taiwan,Department of Microbiology and Immunology, National Defense Medical Center, Taipei, Taiwan,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Chi-Hung Lin
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan,Institute of Microbiology and Immunology, National Yang Ming Chiao Tung University, Taipei, Taiwan,Institute of Biophotonics, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Po-Shiuan Hsieh
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Yan-Hwa Wu Lee
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan,Center for Intelligent Drug Systems and Smart Bio-Devices, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Yi-Jen Hung
- Institute of Preventive Medicine, National Defense Medical Center, Taipei, Taiwan,Division of Endocrine and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan,*Correspondence: Yi-Jen Hung, ; Jinn-Moon Yang,
| | - Jinn-Moon Yang
- Institute of Bioinformatics and Systems Biology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan,Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan,Center for Intelligent Drug Systems and Smart Bio-Devices, National Yang Ming Chiao Tung University, Hsinchu, Taiwan,*Correspondence: Yi-Jen Hung, ; Jinn-Moon Yang,
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Qi ZY, Zhang JS, Xu XH, Gan ZC, Xiong RC, Zhang SY, Wang JY, Liu MH, Li Y, Wang Q, Li FY, Chen XL. [Implement of mixed reality navigation based on multimodal imaging in the resection of intracranial eloquent lesions]. Zhonghua Wai Ke Za Zhi 2022; 60:1100-1107. [PMID: 36480878 DOI: 10.3760/cma.j.cn112139-20220531-00248] [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: 06/17/2023]
Abstract
Objective: To examine the clinical feasibility of mixed reality navigation (MRN) technology based on multimodal imaging for the resection of intracranial eloquent lesions. Methods: Fifteen patients with intracranial eloquent lesions admitted to the Department of Neurosurgery, the First Medical Center, People's Liberation Army General Hospital from September 2020 to September 2021 were retrospectively enrolled. There were 7 males and 8 females, aged (50±16) years (range: 16 to 70 years). Postoperative pathological diagnosis included meningioma (n=7), metastatic carcinoma (n=3), cavernous hemangioma, glioma, ependymoma, aneurysmal changes and lymphoma (n=1, respectively). The open-source software was used to perform the three-dimensional visualization of preoperative images, and the self-developed MRN system was used to perform the fusion and interaction of multimodal images, so as to formulate the surgical plan and avoid damaging the eloquent white matter fiber tracts. Traditional navigation, intraoperative ultrasound and fluorescein sodium angiography were used to determine the extent of lesion resection. The intraoperative conditions of MRN-assisted surgery were analyzed, and the setup time and localization error of MRN system were measured. The changes of postoperative neurological function were recorded. Results: MRN based on multimodal imaging was achieved in all patients. The MRN system setup time (M(IQR)) was 36 (12) minutes (range: 20 to 44 minutes), and the localization error was 3.2 (2.0) mm (range: 2.6 to 6.7 mm). The reliability of eloquent white matter fiber tracts localization based on MRN was rated as "excellent" in 11 cases, "medium" in 3 cases, and "poor" in 1 case. There were no perioperative death and no new impairment in motor, language, or visual functions after operation. Transient limb numbness occurred in 1 patient after operation, and recovered to the preoperative state in 2 weeks after operation. Conclusion: The MRN system based on multimodal imaging can improve the surgical accuracy and safety, and reduce the incidence of iatrogenic neurological dysfunction.
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Affiliation(s)
- Z Y Qi
- Department of Neurosurgery, the First Medical Center, People's Liberation Army General Hospital, Beijing 100853, China
| | - J S Zhang
- Department of Neurosurgery, the First Medical Center, People's Liberation Army General Hospital, Beijing 100853, China
| | - X H Xu
- Department of Neurosurgery, the First Medical Center, People's Liberation Army General Hospital, Beijing 100853, China
| | - Z C Gan
- Department of Neurosurgery, the First Medical Center, People's Liberation Army General Hospital, Beijing 100853, China
| | - R C Xiong
- Department of Neurosurgery, the First Medical Center, People's Liberation Army General Hospital, Beijing 100853, China
| | - S Y Zhang
- Department of Neurosurgery, the First Medical Center, People's Liberation Army General Hospital, Beijing 100853, China
| | - J Y Wang
- Department of Neurosurgery, the First Medical Center, People's Liberation Army General Hospital, Beijing 100853, China
| | - M H Liu
- Department of Neurosurgery, the First Medical Center, People's Liberation Army General Hospital, Beijing 100853, China
| | - Y Li
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Q Wang
- Department of Neurosurgery, the First Medical Center, People's Liberation Army General Hospital, Beijing 100853, China
| | - F Y Li
- Department of Neurosurgery, the First Medical Center, People's Liberation Army General Hospital, Beijing 100853, China
| | - X L Chen
- Department of Neurosurgery, the First Medical Center, People's Liberation Army General Hospital, Beijing 100853, China
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Lee MR, Chen YL, Wu CW, Chen LC, Chang LY, Chen JY, Huang YT, Wang JY, Shih JY, Yu CJ. Toll-like receptor and matrix metalloproteinase single-nucleotide polymorphisms, haplotypes, and polygenic risk score differentiated between tuberculosis disease and infection. Int J Infect Dis 2022; 125:61-66. [PMID: 36272698 DOI: 10.1016/j.ijid.2022.10.020] [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: 06/16/2022] [Revised: 09/29/2022] [Accepted: 10/14/2022] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES The association of toll-like receptors (TLRs) and matrix metalloproteinases (MMPs) single-nucleotide polymorphisms (SNPs) among latent tuberculosis (TB) infection and active TB remained less studied. METHODS We recruited participants with TB disease (active TB) (n = 400) and TB infection (latent TB infection) (n = 203) in this study. We genotyped SNPs in TLR1, TLR2, TLR4, MMP1, MMP8, MMP9, MMP12, and tissue inhibitor of MMP2. Single-variant analysis and haplotype analysis were performed, and a polygenic risk score (PRS) was created. RESULTS We found that SNPs in TLR1 (rs5743580, rs5743551), TLR2 (rs3804100), and MMP8 (rs2508383) were associated with different TB disease status risks. TLR1 rs5743580 was associated with a higher risk of TB disease status in genotypic, recessive, and additive models. TLR2 rs3804100 polymorphisms demonstrated significant association with TB disease status in genotypic, dominant, and additive models. In the haplotype analysis, the TLR1 haplotype was associated with a higher risk of TB disease, and the MMP12 haplotype was associated with a lower risk of TB disease. A PRS using 3 SNPs was associated with a higher risk of TB disease. CONCLUSION This study revealed that SNP variants in TLR1, TLR2, and MMP8 differed among TB infection and disease. Haplotypes and PRS could potentially help predict TB disease status.
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Affiliation(s)
- Meng-Rui Lee
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan
| | - Yen-Lin Chen
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chang-Wei Wu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan
| | - Lun-Che Chen
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch Biomedical Park Hospital, Hsin-Chu, Taiwan
| | - Lih-Yu Chang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan
| | - Jung-Yueh Chen
- Department of Internal Medicine, E-DA Hospital, Kaohsiung, Taiwan; College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Yu-Tsung Huang
- Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Jann-Yuan Wang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
| | - Jin-Yuan Shih
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chong-Jen Yu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan; Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch Biomedical Park Hospital, Hsin-Chu, Taiwan
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Huang HL, Lee JY, Yang JM, Chong IW, Wang JY. Reply to Chang and Huang. Clin Infect Dis 2022; 75:1867. [PMID: 35833899 PMCID: PMC9662314 DOI: 10.1093/cid/ciac574] [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] [Received: 07/02/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Hung-Ling Huang
- Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University,Kaohsiung, Taiwan
| | - Jung-Yu Lee
- Institute of Bioinformatics and Systems Biology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Jinn-Moon Yang
- Institute of Bioinformatics and Systems Biology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
- Center for Intelligent Drug Systems and Smart Biodevices, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Inn-Wen Chong
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University,Kaohsiung, Taiwan
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Jann-Yuan Wang
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
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Lee LN, Chou WR, Wang JY, Kuo YL, Chang CY, Lee YC, Tung SH, Tsao WC, Chao KY, Liu WL. Characteristics and local risk factors of community-acquired and health-care-associated Staphylococcus aureus pneumonia. Sci Rep 2022; 12:18670. [PMID: 36333461 PMCID: PMC9636242 DOI: 10.1038/s41598-022-23246-1] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 10/27/2022] [Indexed: 11/06/2022] Open
Abstract
This study aims at identifying characteristics, risk factors and mortality of community-acquired (CAP) and health-care-associated pneumonia (HCAP) by Staphylococcus aureus (S. aureus). We retrieved adults with S. aureus CAP or HCAP diagnosed by blood or pleural effusion culture in 2.6 years, and compared with those of Streptococcus pneumoniae (S. pneumoniae) CAP or HCAP diagnosed by blood or respiratory culture, or urine antigen. We found 18 patients with CAP and 9 HCAP due to S. aureus (female 33%, 66.6 ± 12.4 years-old), and 48 patients with CAP and 15 HCAP due to S pneumoniae (female 41%, 69.5 ± 17.5 years). Diabetes mellitus (52% vs. 24%, p = 0.019), hemodialysis (11% vs. 0%, p = 0.046), skin lesions (44% vs. 0%, p < 0.001), cavitary nodules (37% vs. 1.6%, p < 0.001) and pleural effusions (48% vs. 18%, p = 0.007) were more common in staphylococcal than pneumococcal group. Three patients with staphylococcal pneumonia had acute myocardial infarction. Pneumonia severity index (139 ± 52 vs. 109 ± 43, p = 0.005) and 30-day mortality (41% vs. 9.5%, p = 0.001) were higher in staphylococcal group. Multivariate analysis showed underlying disease (especially cancer and cirrhosis), risk class 4/5, altered mentality, shock and bilateral pneumonia were risk factors for 30-day mortality.
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Affiliation(s)
- Li-Na Lee
- grid.256105.50000 0004 1937 1063Department of Laboratory Medicine, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan ,grid.256105.50000 0004 1937 1063Internal Medicine, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan ,grid.256105.50000 0004 1937 1063School of Medicine, College of Medicine, Fu Jen Catholic University, No. 510, Zhongzheng Rd., Xinzhuang Dist., New Taipei City, 24205 Taiwan ,grid.19188.390000 0004 0546 0241Department of Laboratory Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan
| | - Wen-Ru Chou
- grid.256105.50000 0004 1937 1063Internal Medicine, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Jann-Yuan Wang
- grid.19188.390000 0004 0546 0241Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan
| | - Yen-Liang Kuo
- grid.256105.50000 0004 1937 1063Internal Medicine, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan ,grid.256105.50000 0004 1937 1063School of Medicine, College of Medicine, Fu Jen Catholic University, No. 510, Zhongzheng Rd., Xinzhuang Dist., New Taipei City, 24205 Taiwan
| | - Chi-Yueh Chang
- grid.256105.50000 0004 1937 1063Internal Medicine, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Yi-Chien Lee
- grid.256105.50000 0004 1937 1063Internal Medicine, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan ,grid.256105.50000 0004 1937 1063School of Medicine, College of Medicine, Fu Jen Catholic University, No. 510, Zhongzheng Rd., Xinzhuang Dist., New Taipei City, 24205 Taiwan
| | - Shao-Hsien Tung
- grid.256105.50000 0004 1937 1063Internal Medicine, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Wen-Ching Tsao
- grid.256105.50000 0004 1937 1063Department of Laboratory Medicine, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Ke-Yun Chao
- grid.256105.50000 0004 1937 1063Department of Respiratory Therapy, Fu Jen Catholic University Hospital, New Taipei City, Taiwan
| | - Wei-Lun Liu
- grid.256105.50000 0004 1937 1063School of Medicine, College of Medicine, Fu Jen Catholic University, No. 510, Zhongzheng Rd., Xinzhuang Dist., New Taipei City, 24205 Taiwan ,grid.256105.50000 0004 1937 1063Department of Critical Care Medicine, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan ,grid.256105.50000 0004 1937 1063Data Science Center, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
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Liang FY, Han P, Lin PL, Chen RH, Wang JY, Huang XM. [Preliminary experience of robotic lateral neck dissection via combined axillary-retroauricular approach for N1b papillary thyroid carcinoma]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2022; 57:1072-1078. [PMID: 36177561 DOI: 10.3760/cma.j.cn115330-20211231-00837] [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 feasibility, safety, and short-term efficacy of robotic lateral neck dissection via combined axillary-retroauricular approach for N1b papillary thyroid carcinoma (PTC). Methods: Thirty patients with cT1-2N1bM0 PTC who received robotic lateral neck dissection via combined axillary-retroauricular approach were included in the Department of Otorhinolaryngology of Sun Yat-sen Memorial Hospital from December 2016 to December 2020. There were 10 males and 20 females, with a median age of 34.5 years and a median body mass index of 25.55 kg/m2. The clinical, surgical, complications, pathology and follow-up data were analysed with SPSS 25.0 software package. Results: The median operative time of 30 patients was 255.50 min, the median operative blood loss was 69.00 ml, and the median postoperative hospital stay was 6.00 days. The incidence of postoperative temporary recurrent laryngeal nerve paralysis was 3.33% (1/30), temporary hypoparathyroidism was 16.67%(5/30), temporary accessory nerve injury was 3.33% (1/30), hematoma was 3.33% (1/30) and chylous leakage was 3.33% (1/30). The median visual analogue scale (VAS) score was 8.00, and the follow-up time was 13-38 months, with a median of 25.5 months. One case showed cervical lymph node recurrence 14 months after surgery. The most recent dynamic recurrence risk stratification showed 21 patients (70.00%) had excellent responses. Conclusions: Robotic lateral neck dissection via combined axillary-retroauricular approach for unilateral cN1b PTC is safe, feasible and aesthetic. The short-term efficacy and dynamic recurrence risk stratification results of short-term follow-up are satisfactory. It can provide a surgical option for cN1b PTC patients.
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Affiliation(s)
- F Y Liang
- Department of Otolaryngology-Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510280, China Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangzhou 510280, China
| | - P Han
- Department of Otolaryngology-Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510280, China Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangzhou 510280, China
| | - P L Lin
- Department of Otolaryngology-Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510280, China Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangzhou 510280, China
| | - R H Chen
- Department of Otolaryngology-Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510280, China Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangzhou 510280, China
| | - J Y Wang
- Department of Otolaryngology-Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510280, China Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangzhou 510280, China
| | - X M Huang
- Department of Otolaryngology-Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510280, China Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangzhou 510280, China
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