1
|
Feng Zong J, Lin PJ, Tsou HH, Guo Q, Liu YC, Xu H, Twu CW, Zheng W, Jiang RS, Liang KL, Lin TY, Ji Pan J, Jun Lin S, Lin JC. Comparison the Acute Toxicity of Two Different Induction Chemotherapy Schedules with Cisplatin and Fluorouracil in Nasopharyngeal Carcinoma Patients. Radiother Oncol 2023; 184:109699. [PMID: 37169301 DOI: 10.1016/j.radonc.2023.109699] [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: 11/22/2022] [Revised: 04/26/2023] [Accepted: 05/03/2023] [Indexed: 05/13/2023]
Abstract
PURPOSE To compare the acute toxicity of two different induction chemotherapy (IndCT) regimen followed by the same IMRT in patients with advanced nasopharyngeal carcinoma (NPC). MATERIALS AND METHODS From July 2015 to December 2016, 110 NPC patients with stage III-IV diseases were prospectively randomized to receive either a conventional triweekly cisplatin + 5-fluorouracil (PF) for 3 cycles or weekly P-F for 10 doses, followed by the same IMRT to both arms. The primary endpoints of this study were grade 3/4 and any grade acute toxicities during IndCT period. The secondary endpoints included tumor response and various survivals. RESULTS Baseline patient characteristics were comparable in both groups. Patients who received weekly P-F experienced significant reduction of grade 3/4 acute toxicities, including neutropenia (12.7% vs. 40.0%, P=0.0012), anorexia (0% vs. 14.6%, P=0.0059), mucositis (0% vs. 14.6%, P=0.0059), and hyponatremia (0% vs. 16.4%, P=0.0027), compared with the triweekly PF group, resulting in fewer IndCT interruptions (1.8% vs. 16.4%, P=0.0203), emergency room visits (0% vs. 12.7%, P=0.0128), and additional hospitalizations (0% vs. 9.1%, P=0.0568). The acute toxicities during IMRT period were similar. Weekly P-F arm had higher complete response rates (83.6% vs. 61.8%, P=0.0152) and lower relapse rates (16.4% vs. 33.3%, P=0.0402) after a median follow-up of 67 months. Kaplan-Meier survival analyses revealed a better trend of locoregional failure-free (P=0.0892), distant metastasis failure-free (P=0.0775), and progression-free (P=0.0709) survivals, favoring the weekly P-F arm. CONCLUSION IndCT of weekly schedule does reduce acute toxicities without compromised tumor response and survivals.
Collapse
Affiliation(s)
- Jing Feng Zong
- Departmentof Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China; FujianProvincial Key Laboratory of Translational Cancer Medicine, Fuzhou, China
| | - Po-Ju Lin
- Departmentof Radiation Oncology, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
| | - Hsiao-Hui Tsou
- Instituteof Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan; GraduateInstitute of Biostatistics, College of Public Health, China Medical University, Taichung, Taiwan
| | - Qiaojuan Guo
- Departmentof Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China; FujianProvincial Key Laboratory of Translational Cancer Medicine, Fuzhou, China
| | - Yi-Chun Liu
- Departmentof Radiation Oncology, Taichung Veterans General Hospital, Taichung, Taiwan; Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Hanchuan Xu
- Departmentof Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China; FujianProvincial Key Laboratory of Translational Cancer Medicine, Fuzhou, China
| | - Chih-Wen Twu
- Department of Otorhinolaryngology-Head and Neck Surgery, Changhua Christian Hospital, Changhua, Taiwan; Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Wei Zheng
- Departmentof Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China; FujianProvincial Key Laboratory of Translational Cancer Medicine, Fuzhou, China
| | - Rong-San Jiang
- Department of Otorhinolaryngology-Head and Neck Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Kai-Li Liang
- Department of Otorhinolaryngology-Head and Neck Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Tian-Yun Lin
- Department of Otorhinolaryngology-Head and Neck Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Jian Ji Pan
- Departmentof Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China; FujianProvincial Key Laboratory of Translational Cancer Medicine, Fuzhou, China
| | - Shao Jun Lin
- Departmentof Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China; FujianProvincial Key Laboratory of Translational Cancer Medicine, Fuzhou, China.
| | - Jin-Ching Lin
- Departmentof Radiation Oncology, Taichung Veterans General Hospital, Taichung, Taiwan; Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan; Departmentof Radiation Oncology, Changhua Christian Hospital, Changhua, Taiwan.
| |
Collapse
|
2
|
Shen MY, Zhang L, Zhu SZ, Pan JJ, Tang YM, Li Q, Zhou MG, He TJ. [Associations between different levels of blood pressure and risk of prediabetes]. Zhonghua Liu Xing Bing Xue Za Zhi 2022; 43:1939-1944. [PMID: 36572467 DOI: 10.3760/cma.j.cn112338-20220505-00379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Objective: To explore sex and rural-urban differences in the associations of different blood pressure levels with the risk of prediabetes. Methods: We used a multi-stage stratified cluster random sampling method to investigate 21 637 residents aged ≥18 years from 10 survey areas in Hubei province in 2020. The data on questionnaire, physical measurements, and laboratory indicators of the participants were collected. The associations of different blood pressure levels with risk of prediabetes by sex and regions were analyzed using multivariate logistic regressions after complex weighting. Results: A total of 16 111 subjects were included. The prevalence (95%CI) of prediabetes, impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and IFG complicated with IGT were 25.1% (14.4%-35.9%), 12.7% (3.2%-22.1%), 8.1% (6.3%-9.8%), and 4.4% (2.3%-6.5%), respectively. After multivariate adjustment, the risk of prediabetes, IFG, IGT, and IFG complicated with IGT increased with the increment of blood pressure (both P for trend <0.05). The positive dose-response relationships between blood pressure levels and risk of prediabetes were also significant among male, urban, and rural residents (both P for trend <0.05), and the interactions between sex and blood pressure showed significant associations for risk of prediabetes and IGT (both P for interaction <0.05). Conclusions: Higher blood pressure levels were associated with an increased risk of prediabetes. The association with prediabetes was stronger in males, but no significant difference was found between urban and rural residents. More distinctive and effective prevention and control strategies should be developed for different populations.
Collapse
Affiliation(s)
- M Y Shen
- Department of Disease Surveillance, Institute of Chronic Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, China
| | - L Zhang
- Department of Disease Surveillance, Institute of Chronic Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, China
| | - S Z Zhu
- Department of Disease Surveillance, Institute of Chronic Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, China
| | - J J Pan
- Department of Disease Surveillance, Institute of Chronic Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, China
| | - Y M Tang
- Department of Disease Surveillance, Institute of Chronic Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, China
| | - Q Li
- Department of Disease Surveillance, Institute of Chronic Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, China
| | - M G Zhou
- Department of Disease Surveillance, Institute of Chronic Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, China
| | - T J He
- Department of Disease Surveillance, Institute of Chronic Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, China
| |
Collapse
|
3
|
Song Y, Lu SD, Hu X, Wu BC, Fan W, Ma HX, Ye Y, Li DX, Li Y, Zhang BF, Zhao S, Wei HY, Pan JJ, Guo DC, Zhao DY, Guo WS, Huang XY. [Analysis of the whole genome traceability and transmission path simulation experiment of the local cluster COVID-19 epidemic]. Zhonghua Yu Fang Yi Xue Za Zhi 2022; 56:1795-1802. [PMID: 36536568 DOI: 10.3760/cma.j.cn112150-20220127-00095] [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 trace and characterize the whole genome of SARS-CoV-2 of confirmed cases in the outbreak of COVID-19 on July 31, 2021 in Henan Province. Method: Genome-wide sequencing and comparative analysis were performed on positive nucleic acid samples of SARS-CoV-2 from 167 local cases related to the epidemic on July 31, 2021, to analyze the consistency and evolution of the whole genome sequence of virus. Results: Through high-throughput sequencing, a total of 106 cases of SARS-CoV-2 whole genome sequences were obtained. The results of genome analysis showed that the whole genome sequences of 106 cases belonged to the VOC/Delta variant strain (B.1.617.2 clade), and the whole genome sequences of 106 cases were shared with the genomes of 3 imported cases from Myanmar admitted to a hospital in Zhengzhou. On the basis of 45 nucleotide sites, 1-5 nucleotide variation sites were added, and the genome sequence was highly homologous. Conclusion: Combined with the comprehensive analysis of viral genomics, transmission path simulation experiments and epidemiology, it is determined that the local new epidemic in Henan Province is caused by imported cases in the nosocomial area, and the spillover has caused localized infection in the community. At the same time, it spills over to some provincial cities and results in localized clustered epidemics.
Collapse
Affiliation(s)
- Y Song
- Henan Provincial Center for Disease Control and Prevention,Infectious Disease Control and Prevention Institute,Henan Provincial Key Laboratory of Infectious Disease Pathogens,Zhengzhou 450016, China
| | - S D Lu
- Henan Provincial Center for Disease Control and Prevention,Infectious Disease Control and Prevention Institute,Henan Provincial Key Laboratory of Infectious Disease Pathogens,Zhengzhou 450016, China
| | - X Hu
- Henan Provincial Center for Disease Control and Prevention,Infectious Disease Control and Prevention Institute,Henan Provincial Key Laboratory of Infectious Disease Pathogens,Zhengzhou 450016, China
| | - B C Wu
- Henan Provincial Center for Disease Control and Prevention,Infectious Disease Control and Prevention Institute,Henan Provincial Key Laboratory of Infectious Disease Pathogens,Zhengzhou 450016, China
| | - W Fan
- Henan Provincial Center for Disease Control and Prevention,Infectious Disease Control and Prevention Institute,Henan Provincial Key Laboratory of Infectious Disease Pathogens,Zhengzhou 450016, China
| | - H X Ma
- Henan Provincial Center for Disease Control and Prevention,Infectious Disease Control and Prevention Institute,Henan Provincial Key Laboratory of Infectious Disease Pathogens,Zhengzhou 450016, China
| | - Y Ye
- Henan Provincial Center for Disease Control and Prevention,Infectious Disease Control and Prevention Institute,Henan Provincial Key Laboratory of Infectious Disease Pathogens,Zhengzhou 450016, China
| | - D X Li
- Henan Provincial Center for Disease Control and Prevention,Infectious Disease Control and Prevention Institute,Henan Provincial Key Laboratory of Infectious Disease Pathogens,Zhengzhou 450016, China
| | - Y Li
- Henan Provincial Center for Disease Control and Prevention,Infectious Disease Control and Prevention Institute,Henan Provincial Key Laboratory of Infectious Disease Pathogens,Zhengzhou 450016, China
| | - B F Zhang
- Henan Provincial Center for Disease Control and Prevention,Infectious Disease Control and Prevention Institute,Henan Provincial Key Laboratory of Infectious Disease Pathogens,Zhengzhou 450016, China
| | - S Zhao
- Henan Provincial Center for Disease Control and Prevention, Institute of Immunization Prevention and Planning, Zhengzhou 450016, China
| | - H Y Wei
- Henan Provincial Center for Disease Control and Prevention,Infectious Disease Control and Prevention Institute,Henan Provincial Key Laboratory of Infectious Disease Pathogens,Zhengzhou 450016, China
| | - J J Pan
- Henan Provincial Center for Disease Control and Prevention,Infectious Disease Control and Prevention Institute,Henan Provincial Key Laboratory of Infectious Disease Pathogens,Zhengzhou 450016, China
| | - D C Guo
- Henan Provincial Center for Disease Control and Prevention,Infectious Disease Control and Prevention Institute,Henan Provincial Key Laboratory of Infectious Disease Pathogens,Zhengzhou 450016, China
| | - D Y Zhao
- Henan Provincial Center for Disease Control and Prevention,Infectious Disease Control and Prevention Institute,Henan Provincial Key Laboratory of Infectious Disease Pathogens,Zhengzhou 450016, China
| | - W S Guo
- Henan Provincial Center for Disease Control and Prevention,Infectious Disease Control and Prevention Institute,Henan Provincial Key Laboratory of Infectious Disease Pathogens,Zhengzhou 450016, China
| | - X Y Huang
- Henan Provincial Center for Disease Control and Prevention,Infectious Disease Control and Prevention Institute,Henan Provincial Key Laboratory of Infectious Disease Pathogens,Zhengzhou 450016, China
| |
Collapse
|
4
|
Chan SK, Lin C, Huang SH, Chau TC, Guo QJ, O'Sullivan B, Lam KO, Chau SC, Chan SY, Tong CC, Vardhanabhuti V, Kwong DLW, So TH, Ng CY, Leung TW, Luk MY, Lee AWM, Choi HCW, Pan JJ, Lee VHF. Refining TNM-8 M1 categories with anatomic subgroups for previously untreated de novo metastatic nasopharyngeal carcinoma. Oral Oncol 2022; 126:105736. [PMID: 35121396 DOI: 10.1016/j.oraloncology.2022.105736] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 01/15/2022] [Accepted: 01/20/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE To propose a refined M1 classification in de novo metastatic nasopharyngeal carcinoma (NPC) based on pooled data from two academic institutions. METHODS Previously untreated de novo M1 NPC patients prospectively treated at The University of Hong Kong (N = 69) and Fujian Cancer Hospital (N = 114) between 2007 and 2016 were recruited and randomized in a 2:1 ratio to generate training (N = 120) and validation (N = 63) cohorts, respectively. Multivariable analysis (MVA) was performed for the training and validation cohorts to identify anatomic prognostic factors for overall survival (OS). Recursive partitioning analysis (RPA) was performed which incorporated the anatomic prognostic factors identified in the MVA to derive Anatomic-RPA groups which stratified OS in the training cohort, and were then validated in the validation cohort. RESULTS Median follow-up for the training and validation cohorts was 27.2 and 30.2 months with 3-year OS of 51.6% and 51.1%, respectively. MVA revealed that co-existing liver-bone metastases was the only factor prognostic for OS in both the training and validation cohorts. Anatomic-RPA separated M1 disease into M1a (no co-existing liver-bone metastases) and M1b (co-existing liver-bone metastases) with median OS 39.5 and 23.7 months, respectively (p = 0.004) in the training cohort. RPA for the validation cohort also confirmed good segregation with co-existing liver-bone metastases with median OS 47.7 and 16.0 months, respectively (p = 0.008). CONCLUSION Our proposal to subdivide de novo M1 NPC into M1a (no co-existing liver-bone metastases) vs. M1b (co-existing liver-bone metastases) provides better OS segregation.
Collapse
Affiliation(s)
- Sik Kwan Chan
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Cheng Lin
- Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China; Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, China
| | - Shao Hui Huang
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada; Clinical Oncology Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Tin Ching Chau
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Qiao Juan Guo
- Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China; Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, China
| | - Brian O'Sullivan
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada; Clinical Oncology Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Ka On Lam
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong; Clinical Oncology Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Sze Chun Chau
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Sum Yin Chan
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Chi Chung Tong
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Varut Vardhanabhuti
- Department of Diagnostic Radiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Dora Lai Wan Kwong
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong; Clinical Oncology Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Tsz Him So
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Chor Yi Ng
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - To Wai Leung
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong; Clinical Oncology Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Mai Yee Luk
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Anne Wing Mui Lee
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong; Clinical Oncology Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Horace Cheuk Wai Choi
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Jian Ji Pan
- Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China; Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, China.
| | - Victor Ho Fun Lee
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong; Clinical Oncology Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.
| |
Collapse
|
5
|
Ng WT, Soong YL, Ahn YC, AlHussain H, Choi HCW, Corry J, Grégoire V, Harrington KJ, Hu CS, Jensen K, Kwong DL, Langendijk JA, Le QT, Lee NY, Lin JC, Lu TX, Mendenhall WM, O'Sullivan B, Ozyar E, Pan JJ, Peters LJ, Poh SS, Rosenthal DI, Sanguineti G, Tao Y, Wee JT, Yom SS, Chua MLK, Lee AWM. International Recommendations on Reirradiation by Intensity Modulated Radiation Therapy for Locally Recurrent Nasopharyngeal Carcinoma. Int J Radiat Oncol Biol Phys 2021; 110:682-695. [PMID: 33571626 DOI: 10.1016/j.ijrobp.2021.01.041] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 01/11/2021] [Accepted: 01/23/2021] [Indexed: 12/20/2022]
Abstract
PURPOSE Reirradiation for locally recurrent nasopharyngeal carcinoma (NPC) is challenging because prior radiation dose delivered in the first course is often close to the tolerance limit of surrounding normal structures. A delicate balance between achieving local salvage and minimizing treatment toxicities is needed. However, high-level evidence is lacking because available reports are mostly retrospective studies on small series of patients. Pragmatic consensus guidelines, based on an extensive literature search and the pooling of opinions by leading specialists, will provide a useful reference to assist decision-making for these difficult decisions. METHODS AND MATERIALS A thorough review of available literature on recurrent NPC was conducted. A set of questions and preliminary draft guideline was circulated to a panel of international specialists with extensive experience in this field for voting on controversial areas and comments. A refined second proposal, based on a summary of the initial voting and different opinions expressed, was recirculated to the whole panel for review and reconsideration. The current guideline was based on majority voting after repeated iteration for final agreement. RESULTS The initial round of questions showed variations in clinical practice even among the specialists, reflecting the lack of high-quality supporting data and the difficulties in formulating clinical decisions. Through exchange of comments and iterative revisions, recommendations with high-to-moderate agreement were formulated on general treatment strategies and details of reirradiation (including patient selection, targets contouring, dose prescription, and constraints). CONCLUSION This paper provides useful reference on radical salvage treatment strategies for recurrent NPC and optimization of reirradiation through review of published evidence and consensus building. However, the final decision by the attending clinician must include full consideration of an individual patient's condition, understanding of the delicate balance between risk and benefits, and acceptance of risk of complications.
Collapse
Affiliation(s)
- Wai Tong Ng
- Department of Clinical Oncology, University of Hong Kong, Hong Kong, China
| | - Yoke Lim Soong
- Division of Radiation Oncology, National Cancer Centre Singapore, Duke-NUS Medical School, Singapore
| | - Yong Chan Ahn
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hussain AlHussain
- Department of Radiation Oncology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Horace C W Choi
- Department of Clinical Oncology, University of Hong Kong, Hong Kong, China
| | - June Corry
- Radiation Oncology, GenesisCare, St. Vincent's Hospital, Melbourne, Victoria, Australia
| | - Vincent Grégoire
- Center for Molecular Imaging, Oncology, and Radiotherapy, Université Catholique de Louvain, Brussels, Belgium, and Department of Radiation Oncology, Centre Léon Bérard, Lyon, France
| | - Kevin J Harrington
- Royal Marsden/Institute of Cancer Research National Institute for Health Research Biomedical Research Centre, London, United Kingdom
| | - Chao Su Hu
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Kenneth Jensen
- Danish Center for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - Dora L Kwong
- Department of Clinical Oncology, University of Hong Kong and Queen Mary Hospital, Hong Kong
| | - Johannes A Langendijk
- Department of Radiotherapy, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Quynh Thu Le
- Department of Radiation Oncology, Stanford University, NRG Oncology and HNCIG, Stanford, California
| | - Nancy Y Lee
- Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York City, New York
| | - Jin Ching Lin
- Department of Radiation Oncology, Taichung Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan
| | - Tai Xiang Lu
- Department of Radiation Oncology, Cancer Center of Sun Yat-Sen University, Guangzhou, China
| | - William M Mendenhall
- Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida
| | - Brian O'Sullivan
- Department of Radiation Oncology, University of Toronto, Princess Margaret Cancer Centre, Toronto, Canada
| | - Enis Ozyar
- Department of Radiation Oncology, Acibadem University School of Medicine, Istanbul, Turkey
| | - Jian Ji Pan
- Department of Radiation Oncology, Fujian Cancer Hospital and Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Lester J Peters
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Sharon S Poh
- Division of Radiation Oncology, National Cancer Centre Singapore, Duke-NUS Medical School, Singapore
| | - David I Rosenthal
- Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, Texas
| | - Giuseppe Sanguineti
- Department of Radiation Oncology, Regina Elena National Cancer Institute, Rome, Italy
| | - Yungan Tao
- Department of Radiation Oncology, Institut Gustave Roussy, Paris-Saclay University, Villejuif, France
| | - Joseph T Wee
- Division of Radiation Oncology, National Cancer Centre Singapore, Duke-NUS Medical School, Singapore
| | - Sue S Yom
- Department of Radiation Oncology, University of California San Francisco, San Francisco, California
| | - Melvin L K Chua
- Division of Radiation Oncology, National Cancer Centre Singapore, Duke-NUS Medical School, Singapore
| | - Anne W M Lee
- Department of Clinical Oncology, University of Hong Kong Shenzhen Hospital and University of Hong Kong, Hong Kong, China.
| |
Collapse
|
6
|
Zhang H, Pan JJ, Jiang XF, Lin JJ, Lu LJ, Chu JG. [Study of portal venous pressure gradient to predict high-hepatic encephalopathy-risk population post TIPS]. Zhonghua Gan Zang Bing Za Zhi 2021; 29:72-74. [PMID: 33548970 DOI: 10.3760/cma.j.cn501113-20190716-00248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Transjugular intrahepatic portosystemic shunt (TIPS) can effectively reduce the portal venous pressure and relieve the clinical complications related to portal hypertension. However, hepatic encephalopathy (HE) is still the main complication post TIPS. Studies have shown that patients over 65 years old with liver function reserve in Child-Pugh grade C are the high-HE-risk group post TIPS, and early TIPS treatment can benefit the survival of these high-risk patients. In this study, TIPS was used to treat 60 cases aged > 65 years old and liver function reserve in Child-Pugh grade C (decompensated liver cirrhosis) with esophagogastric variceal bleeding. The clinical results of 1-year was observed and the porto systemic gradient (PSG) was evaluated. The relationship between the incidence of HE and the PSG of patients with and without HE were compared to evaluate the effect of PSG on the incidence of HE.
Collapse
Affiliation(s)
- H Zhang
- Department of Gastroenterology, Wenzhou Central Hospital, Wenzhou 325000, China
| | - J J Pan
- Department of Radiology, Wenzhou People's Hospital, Wenzhou 325000, China
| | - X F Jiang
- Department of Gastroenterology, Wenzhou Central Hospital, Wenzhou 325000, China
| | - J J Lin
- Department of Gastroenterology, Wenzhou Central Hospital, Wenzhou 325000, China
| | - L J Lu
- Department of Gastroenterology, Wenzhou Central Hospital, Wenzhou 325000, China
| | - J G Chu
- Department of Radiology, Air Force General Hospital, Beijing 100142, China
| |
Collapse
|
7
|
Tang YM, Zhang L, Zhu SZ, Pan JJ, Zhou SH, He TJ, Li Q. Gout in China, 1990-2017: the Global Burden of Disease Study 2017. Public Health 2021; 191:33-38. [PMID: 33482625 DOI: 10.1016/j.puhe.2020.06.029] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [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: 04/27/2020] [Revised: 06/08/2020] [Accepted: 06/10/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The aim of the study was to estimate the gout burden and risk factors in China from 1990 to 2017. STUDY DESIGN The Global Burden of Disease (GBD) Study uses various analytical tools and a diverse set of data sources to generate comparable estimates of deaths and mortality rates broken down by age, sex, cause, year, and geography. METHODS We used the results from the GBD Study 2017 to compare disability-adjusted life years (DALYs), prevalence, incidence, and risk factors of gout in China. The median of the percentage change and 95% uncertainty intervals were determined for the period between 1990 and 2017. RESULTS The age-standardized DALY rate, prevalence, and incidence increased 6.92%, 6.88%, and 6.16%, respectively, in China from 1990 to 2017. Although the rates of gout both globally and in China were increasing, the range of change for males in China was larger than that of the global level. All risk factors combined accounted for 30.04% of gout DALYs in 2017. The leading risk factors for gout DALYs were high body mass index and impaired kidney function, and the proportion of high body mass index increased significantly from 10.67% to 24.31%, whereas the proportion of impaired kidney function remained basically unchanged. CONCLUSIONS The age-standardized DALY rate, prevalence, and incidence in China have increased progressively since 1990. Increasing attention on body weight management should be prioritized for controlling the rising prevalence of gout in the young and middle-aged population.
Collapse
Affiliation(s)
- Y M Tang
- Institute of Chronic and Non-communicable Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, Hubei, China
| | - L Zhang
- Institute of Chronic and Non-communicable Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, Hubei, China
| | - S Z Zhu
- Institute of Chronic and Non-communicable Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, Hubei, China
| | - J J Pan
- Institute of Chronic and Non-communicable Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, Hubei, China
| | - S H Zhou
- Institute of Chronic and Non-communicable Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, Hubei, China
| | - T J He
- Institute of Chronic and Non-communicable Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, Hubei, China
| | - Q Li
- Institute of Chronic and Non-communicable Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, Hubei, China.
| |
Collapse
|
8
|
Lee AW, Ng WT, Pan JJ, Chiang CL, Poh SS, Choi HC, Ahn YC, AlHussain H, Corry J, Grau C, Grégoire V, Harrington KJ, Hu CS, Kwong DL, Langendijk JA, Le QT, Lee NY, Lin JC, Lu TX, Mendenhall WM, O'Sullivan B, Ozyar E, Peters LJ, Rosenthal DI, Sanguineti G, Soong YL, Tao Y, Yom SS, Wee JT. International Guideline on Dose Prioritization and Acceptance Criteria in Radiation Therapy Planning for Nasopharyngeal Carcinoma. Int J Radiat Oncol Biol Phys 2019; 105:567-580. [PMID: 31276776 DOI: 10.1016/j.ijrobp.2019.06.2540] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 06/12/2019] [Accepted: 06/25/2019] [Indexed: 12/09/2022]
Abstract
PURPOSE The treatment of nasopharyngeal carcinoma requires high radiation doses. The balance of the risks of local recurrence owing to inadequate tumor coverage versus the potential damage to the adjacent organs at risk (OARs) is of critical importance. With advancements in technology, high target conformality is possible. Nonetheless, to achieve the best possible dose distribution, optimal setting of dose targets and dose prioritization for tumor volumes and various OARs is fundamental. Radiation doses should always be guided by the As Low As Reasonably Practicable principle. There are marked variations in practice. This study aimed to develop a guideline to serve as a global practical reference. METHODS AND MATERIALS A literature search on dose tolerances and normal-tissue complications after treatment for nasopharyngeal carcinoma was conducted. In addition, published guidelines and protocols on dose prioritization and constraints were reviewed. A text document and preliminary set of variants was circulated to a panel of international experts with publications or extensive experience in the field. An anonymized voting process was conducted to rank the proposed variants. A summary of the initial voting and different opinions expressed by members were then recirculated to the whole panel for review and reconsideration. Based on the comments of the panel, a refined second proposal was recirculated to the same panel. The current guideline was based on majority voting after repeated iteration for final agreement. RESULTS Variation in opinion among international experts was repeatedly iterated to develop a guideline describing appropriate dose prioritization and constraints. The percentage of final agreement on the recommended parameters and alternative views is shown. The rationale for the recommendations and the limitations of current evidence are discussed. CONCLUSIONS Through this comprehensive review of available evidence and interactive exchange of vast experience by international experts, a guideline was developed to provide a practical reference for setting dose prioritization and acceptance criteria for tumor volumes and OARs. The final decision on the treatment prescription should be based on the individual clinical situation and the patient's acceptance of optimal balance of risk.
Collapse
Affiliation(s)
- Anne W Lee
- Department of Clinical Oncology, University of Hong Kong Shenzhen Hospital and University of Hong Kong, China
| | - Wai Tong Ng
- Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong
| | - Jian Ji Pan
- Department of Radiation Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Chi-Leung Chiang
- Department of Clinical Oncology, University of Hong Kong Shenzhen Hospital and University of Hong Kong, China
| | - Sharon S Poh
- Division of Radiation Oncology, National Cancer Centre Singapore, Oncology ACP, Duke-NUS Medical School, Singapore
| | - Horace C Choi
- Department of Clinical Oncology, University of Hong Kong, Hong Kong
| | - Yong Chan Ahn
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hussain AlHussain
- Department of Radiation Oncology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia
| | - June Corry
- Radiation Oncology, GenesisCare, St. Vincent's Hospital, Melbourne, Victoria, Australia
| | - Cai Grau
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Vincent Grégoire
- Center for Molecular Imaging, Oncology and Radiotherapy, Université Catholique de Louvain, Brussels, Belgium and Department of Radiation Oncology, Centre Léon Bérard, Lyon, France
| | - Kevin J Harrington
- The Royal Marsden/The Institute of Cancer Research National Institute for Health Research Biomedical Research Centre, London, UK
| | - Chao Su Hu
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Dora L Kwong
- Department of Clinical Oncology, University of Hong Kong and Queen Mary Hospital, Hong Kong
| | - Johannes A Langendijk
- Department of Radiotherapy, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Quynh Thu Le
- Department of Radiation Oncology, Stanford University, NRG Oncology and Head and Neck Cancer International Group, California
| | - Nancy Y Lee
- Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York
| | - Jin Ching Lin
- Department of Radiation Oncology, Taichung Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan
| | - Tai Xiang Lu
- Department of Radiation Oncology, Cancer Center of Sun Yat-Sen University, Guangzhou, China
| | - William M Mendenhall
- Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida
| | - Brian O'Sullivan
- Department of Radiation Oncology, University of Toronto, Princess Margaret Cancer Centre, Toronto, Canada
| | - Enis Ozyar
- Department of Radiation Oncology, Acibadem University School of Medicine, Istanbul, Turkey
| | - Lester J Peters
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - David I Rosenthal
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Giuseppe Sanguineti
- Department of Radiation Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Yoke Lim Soong
- Division of Radiation Oncology, National Cancer Centre Singapore, Oncology ACP, Duke-NUS Medical School, Singapore
| | - Yungan Tao
- Department of Radiation Oncology, Institut Gustave Roussy, Paris-Saclay University, Villejuif, France
| | - Sue S Yom
- Department of Radiation Oncology, University of California-San Francisco, San Francisco, California
| | - Joseph T Wee
- Division of Radiation Oncology, National Cancer Centre Singapore, Oncology ACP, Duke-NUS Medical School, Singapore.
| |
Collapse
|
9
|
Zhang Z, Zheng YM, Jiang LL, Ji H, Chen GP, Luo P, Pan JJ, Tian XL, Wei LL, Huo D, Miao ZP, Zou XN, Chen JH, Liao QH, Chang ZR. [Review on the etiology and complications of hand, foot and mouth disease, using data from the national sentinel surveillance program, in China, 2015-2016]. Zhonghua Liu Xing Bing Xue Za Zhi 2019; 40:627-632. [PMID: 31238609 DOI: 10.3760/cma.j.issn.0254-6450.2019.06.005] [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] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Objective: To understand the characteristics relating to the etiology and complications of hand, foot and mouth disease (HFMD) based on data from the pilot National Sentinel Surveillance (NSS) program so as to explore the feasibility, advantages and disadvantages of the NSS. Methods: Data were extracted from the NSS system, conducted in 11 provinces of China from November 2015 to October 2016. Characteristics regarding the etiology, complications of HFMD and factors related to the positive rates of HFMD specimens were analyzed under the logistic regression method by SPSS 20.0 software. Results: A total of 4 783 specimens were collected, including 3 390 from mild, 1 390 from severe and 3 from death cases. The overall positive rate was 81.43% (3 895/4 783). Other enteroviruses (non EV71/Cox A16 enteroviruses) appeared the major serotype (52.68%, 1 482/2 813) for mild infection of the disease while EV71 was for the severe cases (65.31%, 706/1 081). The serotype spectrum revealed by the pilot NSS was almost identical with the existing surveillance system. Other enteroviruses tended to infect younger children (χ(2)=130.17, P<0.001) than EV71 and Cox A16, in China. The multivariate logistic regression results showed that higher positive rate was associated with specimens which were collected from males, at children' hospitals, in peak seasons, timely and in stools. The positive rates presented downwarding trends with the extension of the onset-sampling interval (χ(2)=14.47, P<0.001 in stool specimen; χ(2)=31.99, P<0.001 in throat swab; χ(2)=24.26, P<0.001 in anal swab). Aseptic meningitis, non-brainstem encephalitis and brainstem encephalitis appeared the top three complications of both EV71-associated and other enteroviruses-associated severe HFMD cases. Conclusions: Factors as gender, season/place/timeliness of specimen collection, and types of hospital all appeared independently influenced the positive rates. NSS seemed feasible to be used as an alternative or supplement tool to the existing surveillance program in China.
Collapse
Affiliation(s)
- Z Zhang
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China; Chinese Field Epidemiology Training Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Y M Zheng
- Division of Infectious Disease, Key Laboratory of Surveillance and Early Warning on InfectiousDisease, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - L L Jiang
- Yunnan Provincial Center for Disease Control and Prevention, Kunming 650011, China
| | - H Ji
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - G P Chen
- Anhui Provincial Center for Disease Control and Prevention, Hefei 230601, China
| | - P Luo
- Shaoyang Municipal Center for Disease Control and Prevention, Shaoyang 422000, China
| | - J J Pan
- Henan Provincial Center for Disease Control and Prevention, Zhengzhou 450016, China
| | - X L Tian
- Inner Mongolia Autonomous Region General Center for Disease Control and Prevention, Hohhot 010031, China
| | - L L Wei
- Jilin Provincial Center for Disease Control and Prevention, Changchun 130062, China
| | - D Huo
- Beijing Center for Disease Control and Prevention, Beijing 100013, China
| | - Z P Miao
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
| | - X N Zou
- Guangdong Women and Children Hospital, Guangzhou 511440, China
| | - J H Chen
- Gansu Provincial Center for Disease Control and Prevention, Lanzhou 730000, China
| | - Q H Liao
- Division of Infectious Disease, Key Laboratory of Surveillance and Early Warning on InfectiousDisease, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Z R Chang
- Division of Infectious Disease, Key Laboratory of Surveillance and Early Warning on InfectiousDisease, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| |
Collapse
|
10
|
Watt GP, Lee M, Pan JJ, Fallon MB, McCormick JP, Fisher-Hoch SP. Prevalence and Characteristics of Liver Fibrosis Detected by Elastography: Results from the Cameron County Hispanic Cohort. Cancer Epidemiol Biomarkers Prev 2018. [DOI: 10.1158/1055-9965.epi-18-0050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
Mexican Americans in south Texas have among highest rates of hepatocellular carcinoma (HCC) in the US. Non-invasive measures of liver fibrosis are needed to identify those at high risk of HCC. The purpose of the study was to determine the prevalence of and factors associated with liver fibrosis using acoustic radiation force impulse (ARFI) elastography, an accurate and non-invasive modality, in the Cameron County Hispanic Cohort (CCHC). Methods. The CCHC is a well characterized population-based cohort in south Texas. Liver stiffness was measured by ARFI in 404 participants in the CCHC by two separate operators. Median liver stiffness > 1.34 m/s was considered significant (F2-F4) fibrosis. Ultrasound was used to determine presence of steatosis. Absence of HCV and HBsAg antigen, and absence of heavy drinking, was considered non-alcoholic fatty liver disease (NAFLD). We calculated design-based prevalence of fibrosis and determined clinical associations with (1) significant fibrosis and (2) simple steatosis using multinomial logistic regression. Results. Mean age was 51.1 years, 44.6% were male, and 29.1% had diabetes. The prevalence of significant fibrosis was 16.5%. In the fibrosis group, most (47/57, 84%) had NAFLD. We excluded participants with etiologies other than NAFLD for further analyses. After adjustment for age and sex, hypertension [Odds Ratio (OR) 3.0, 95% confidence interval (CI) 1.1–8.1), platelet count (OR 0.6, 95% CI, 0.5–1.0), and potassium level (OR 1.5, 95% CI, 1.1–2.0) were significantly associated with fibrosis, but not steatosis. HDL cholesterol (OR 0.5, 95% CI, 0.4–0.7), obesity (OR 2.2, 95% CI, 1.2–4.0) and insulin level (OR 2.1, 95% CI, 1.2–3.7) were significantly associated with steatosis, but not fibrosis. Elevated fasting glucose, diabetes, and elevated ALT levels were significantly associated with both steatosis and fibrosis. Conclusion. This is the first population-based application of liver elastography in the US. We find a high prevalence of fibrosis in Mexican Americans, dominated by NAFLD. Our results indicate a higher burden of fibrosis than population-based studies of liver fibrosis conducted elsewhere. We urge community intervention for the early detection of liver disease and prevention of NAFLD-related HCC.
Collapse
|
11
|
Lee AW, Ng WT, Pan JJ, Poh SS, Ahn YC, AlHussain H, Corry J, Grau C, Grégoire V, Harrington KJ, Hu CS, Kwong DL, Langendijk JA, Le QT, Lee NY, Lin JC, Lu TX, Mendenhall WM, O'Sullivan B, Ozyar E, Peters LJ, Rosenthal DI, Soong YL, Tao Y, Yom SS, Wee JT. International guideline for the delineation of the clinical target volumes (CTV) for nasopharyngeal carcinoma. Radiother Oncol 2018; 126:25-36. [DOI: 10.1016/j.radonc.2017.10.032] [Citation(s) in RCA: 105] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Revised: 10/25/2017] [Accepted: 10/25/2017] [Indexed: 12/09/2022]
|
12
|
Fang XQ, Zhang JF, Song HY, Chen ZL, Dong J, Chen X, Pan JJ, Liu B, Chen CX. [Effect of umbilical cord mesenchymal stem cell transplantation on immune function and prognosis of patients with decompensated hepatitis B cirrhosis]. Zhonghua Gan Zang Bing Za Zhi 2017; 24:907-910. [PMID: 28073411 DOI: 10.3760/cma.j.issn.1007-3418.2016.12.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the effect of human umbilical cord mesenchymal stem cells (hUCMSCs) on the immune function and prognosis of patients with decompensated hepatitis B cirrhosis. Methods: A total of 65 patients with decompensated hepatitis B cirrhosis were divided into observation group and control group. The patients in the observation group were given intervention (via the proper hepatic artery or the portal vein) and intravenous infusion of 4×108 hUCMSCs in two doses, as well as the same basic treatment as in the control group. The patients in the control group were given conventional medical treatment. ELISA as used to measure the serum levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNFα), interleukin-10 (IL-10), and transforming growth factor-β (TGFβ) in the observation group before surgery and at 1 week after surgery, as well as the serum levels of IL-6, TNFα, IL-10, and TGFβ in the control group on admission and at 1 week after admission. Flow cytometry was used to measure the percentage of lymphocyte subsets in the observation group before surgery and at 1 week after surgery, as well as that in the control group on admission and at 1 week after admission. In addition, the patients' prognosis and major complications during hospitalization were observed in both groups, and the patients were followed up for 24 weeks to record the number of deaths. The t-test was used for comparison of continuous data, and the chi-square test was used for comparison of categorical data which were expressed as percentages. Results: At 1 week after the transplantation of hUCMSCs, compared with the control group, the observation group had significant reductions in the serum levels of IL-6 and TNFα and significant increases in the serum levels of IL-10 and TGFβ (all P < 0.001), as well as significant increases in the percentages of T4 cells and Treg cells and significant reductions in the percentages of T8 cells and B cells (all P < 0.05). There were no significant differences in the changes in T3 cells and natural killer cells between the two groups (P > 0.05). Compared with the control group, the observation group had a significantly lower probability of progression to liver failure (6.45% vs 14.71%, P = 0.017). Conclusion: In the treatment of patients with decompensated hepatitis B cirrhosis, transplantation of UCMSCs can inhibit the proliferation of T cells and B cells and the differentiation of T8 cells, upregulate Treg cells, promote the secretion of immunosuppressive cytokines, and reduce the production of inflammatory cytokines. Therefore, it can alleviate liver inflammatory response and liver cell damage and reduce the probability of hepatic failure.
Collapse
Affiliation(s)
- X Q Fang
- Clinical College of PLA of Anhui Medical University, Hefei 230001, China
| | - J F Zhang
- The Infectious Department in the NO.105 Hospital of PLA, Hefei 230001, China
| | - H Y Song
- The Infectious Department in the NO.105 Hospital of PLA, Hefei 230001, China
| | - Z L Chen
- The Infectious Department in the NO.105 Hospital of PLA, Hefei 230001, China
| | - J Dong
- The Infectious Department in the NO.105 Hospital of PLA, Hefei 230001, China
| | - X Chen
- The Infectious Department in the NO.105 Hospital of PLA, Hefei 230001, China
| | - J J Pan
- The Infectious Department in the NO.105 Hospital of PLA, Hefei 230001, China
| | - B Liu
- The Infectious Department in the NO.105 Hospital of PLA, Hefei 230001, China
| | - C X Chen
- The Infectious Department in the NO.105 Hospital of PLA, Hefei 230001, China
| |
Collapse
|
13
|
Zheng YM, Chang ZR, Jiang LL, Ji H, Chen GP, Luo P, Pan JJ, Tian XL, Wei LL, Huo D, Miao ZP, Zou XN, Chen JH, Liao QH. [Severe cases with hand, foot and mouth disease: data based on national pilot hand, foot and mouth disease surveillance system]. Zhonghua Liu Xing Bing Xue Za Zhi 2017. [PMID: 28647978 DOI: 10.3760/cma.j.issn.0254-6450.2017.06.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the clinical severity, etiological classification and risk factors of severe cases with hand, foot and mouth disease (HFMD). Methods: A total of 1 489 records on severe and fatal HFMD cases reported to the national pilot surveillance system of HFMD were used to analyze the demographic, medical treatment, etiological classification of the cases. Treatment outcome related risk factors were also studied with multi-variable stepwise logistic regression method. Results: Seven out of the 1 489 severe HFMD cases died of this disease. A total of 960 (72.9%) were under three years old and 62.9% were male and most of the cases (937, 62.9%) resided in rural areas. Among all the cases, 494 (33.2%) went to seek the first medical assistance at the institutions of village or township level. Durations between disease onset and first medical attendance, being diagnosed as the disease or diagnosed as severe cases were 0(0-1) d, 1 (0-2) d and 2 (1-4) d, respectively. In total, 773 (51.9%) of the severe HFMD cases were diagnosed as with aseptic meningitis, 260 (17.5%) with brainstem encephalitis, 377 (25.3%) with non-brainstem encephalitis, 6 (0.4%) with encephalomyelitis, 1 (0.1%) with acute flaccid paralysis, 4 (0.3%) with pulmonary hemorrhage/pulmonary edema and 68 (4.6%) with cardiopulmonary failure. Of the etiologically diagnosed 1 217 severe and fatal HFMD cases, 642 (52.8%) were with EV71, other enterovirus 261 (21.5%), Cox A16 36 (3.0%), 1 (0.1%) with both EV71 and Cox A16. However, 277 (22.8%) showed negative on any pathogenic virus. Complication (Z=3.15, P=0.002) and duration between onset and diagnosed as severe cases (Z=3.95, P<0.001) were shown as key factors related to treatment outcomes. Conclusions: Most severe HFMD cases appeared in boys, especially living in the rural areas. Frequently seen complications would include aseptic meningitis, non-brainstem encephalitis and brainstem encephalitis. EV71 was the dominant etiology for severe and fatal cases. Early diagnosis and complication control were crucial, related to the treatment outcome of HFMD.
Collapse
Affiliation(s)
- Y M Zheng
- Division of Infectious Disease, Key Laboratory of Surveillance and Early Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Z R Chang
- Division of Infectious Disease, Key Laboratory of Surveillance and Early Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - L L Jiang
- Yunnan Provincial Center for Disease Control and Prevention, Kunming 650011, China
| | - H Ji
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - G P Chen
- Anhui Provincial Center for Disease Control and Prevention, Hefei 230601, China
| | - P Luo
- Shaoyang Center for Disease Control and Prevention, Shaoyang 422000, China
| | - J J Pan
- Henan Provincial Center for Disease Control and Prevention, Zhengzhou 450016, China
| | - X L Tian
- Inner Mongolia General Autonomous Region Center for Disease Control and Prevention, Hohhot 010031, China
| | - L L Wei
- Jilin Provincial Center for Disease Control and Prevention, Changchun 130062, China
| | - D Huo
- Beijing Center for Disease Control and Prevention, Beijing 100013, China
| | - Z P Miao
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
| | - X N Zou
- Guangdong Maternal and Child Health Hospital, Guangzhou 517017, China
| | - J H Chen
- Gansu Provincial Center for Disease Control and Prevention, Lanzhou 730000, China
| | - Q H Liao
- Division of Infectious Disease, Key Laboratory of Surveillance and Early Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| |
Collapse
|
14
|
Ma HX, Pan JJ, Li Y, Kang K, Huang XY, You AG, Xu BL. [Human enterovirus infection status and clinical characteristics of 274 patients with viral encephalitis in Henan Province, 2011-2012]. Zhonghua Yu Fang Yi Xue Za Zhi 2017; 51:150-153. [PMID: 28219154 DOI: 10.3760/cma.j.issn.0253-9624.2017.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate human enterovirus (HEV) infection and clinical characteristics of viral encephalitis patients in Pingdingshan, Henan Province. Methods: Cerebrospinal fluid specimens and epidemiological information were collected from 274 viral encephalitis patients in the departments of pediatrics and neurology in hospitals in Pingdingshan, Henan Province, from April 2011 to August 2012. Patients with bacterial infections were excluded from the study. Demographic information was collected by questionnaires and clinical information was mainly obtained from hospital examinations. Viral RNA was extracted using magnetic bead extraction. Real-time RT-PCR was then performed for HEV, CV-A16, and EV-A71 testing. SPSS statistical software was statistical analyses. Significant differences were determined using the chi-squared test (P<0.05). Results: Among 274 cases of viral encephalitis, 180 cases (65.7%) were male and 94 cases were female (34.3%). The median age was 2.17 years. Approximately 61.3% (168) of patients were younger than 3 years of age. A total of 107 (39.1%), 2 (0.7%), and 42 (15.3%) cases were positive for HEV, CV-A16, and EV-A71, respectively. Eleven patients were younger than 6 months of age and one patient was co-infected with HEV and EV-A71. In the<3, 3-5, 6-15, and>15 years old age groups, HEV infections comprised 31.5% (53/168), 52.9% (18/34), 53.0% (35/66), and 16.7% (1/6) (χ(2)=13.10, P=0.003), respectively. The EV-A71 infection rates were 17.9% (30/168), 23.5% (8/34), 6.1% (4/66), and 0 (χ(2)=8.04, P=0.045), respectively. The other enterovirus (OEV) infection rates were 12.5% (21/168), 29.4% (10/34), 48.5% (32/66), and 16.7% (1/6) (χ(2)=35.19, P<0.001), respectively. The rate of vomiting in OEV and EV-A71 infected patients was 73% (44/60) and 26% (11/42), respectively, while the frequency of skin rash in OEV and EV-A71 infected patients was 32% (19/60) and 79% (33/42), respectively. Approximately 95% (99/104) of patients infected with HEV had a fever, and the breathing rhythm change rate was 19% (20/104), which was lower than that of patients without HEV infection (36.8% (60/163)) (χ(2)=9.35, P=0.002). Conclusion: In Pingdingshan, HEV was a major causative agent of viral encephalitis and the rate of OEV infection was high, especially in children aged 3-15 years old. Fever was a common clinical symptom of patients infected with HEV. Patients infected with OEV primarily exhibited vomiting symptoms and EV-A71 infected patients showed skin rash.
Collapse
Affiliation(s)
- H X Ma
- Henan Center for Disease Control and Prevention, Zhengzhou 450016, China
| | | | | | | | | | | | | |
Collapse
|
15
|
Pan JJ, Ng WT, Zong JF, Lee SWM, Choi HCW, Chan LLK, Lin SJ, Guo QJ, Sze HCK, Chen YB, Xiao YP, Kan WK, O'Sullivan B, Xu W, Le QT, Glastonbury CM, Colevas AD, Weber RS, Lydiatt W, Shah JP, Lee AWM. Prognostic nomogram for refining the prognostication of the proposed 8th edition of the AJCC/UICC staging system for nasopharyngeal cancer in the era of intensity-modulated radiotherapy. Cancer 2016; 122:3307-3315. [PMID: 27434142 DOI: 10.1002/cncr.30198] [Citation(s) in RCA: 109] [Impact Index Per Article: 13.6] [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: 05/19/2016] [Revised: 06/12/2016] [Accepted: 06/20/2016] [Indexed: 12/26/2022]
Abstract
BACKGROUND The objective of this study was to develop a nomogram for refining prognostication for patients with nondisseminated nasopharyngeal cancer (NPC) staged with the proposed 8th edition of the American Joint Committee on Cancer (AJCC)/Union for International Cancer Control (UICC) staging system. METHODS Consecutive patients who had been investigated with magnetic resonance imaging, staged with the proposed 8th edition of the AJCC/UICC staging system, and irradiated with intensity-modulated radiotherapy from June 2005 to December 2010 were analyzed. A cohort of 1197 patients treated at Fujian Provincial Cancer Hospital was used as the training set, and the results were validated with 412 patients from Pamela Youde Nethersole Eastern Hospital. Cox regression analyses were performed to identify significant prognostic factors for developing a nomogram to predict overall survival (OS). The discriminative ability was assessed with the concordance index (c-index). A recursive partitioning algorithm was applied to the survival scores of the combined set to categorize the patients into 3 risk groups. RESULTS A multivariate analysis showed that age, gross primary tumor volume, and lactate dehydrogenase were independent prognostic factors for OS in addition to the stage group. The OS nomogram based on all these factors had a statistically higher bias-corrected c-index than prognostication based on the stage group alone (0.712 vs 0.622, P <.01). These results were consistent for both the training cohort and the validation cohort. Patients with <135 points were categorized as low-risk, patients with 135 to <160 points were categorized as intermediate-risk, and patients with ≥160 points were categorized as high-risk. Their 5-year OS rates were 92%, 84%, and 58%, respectively. CONCLUSIONS The proposed nomogram could improve prognostication in comparison with the TNM stage group. This could aid in risk stratification for individual NPC patients. Cancer 2016;122:3307-3315. © 2016 American Cancer Society.
Collapse
Affiliation(s)
- Jian Ji Pan
- Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Provincial Clinical College of Fujian Medical University, Fujian, China.,Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fujian, China
| | - Wai Tong Ng
- Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China
| | - Jing Feng Zong
- Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Provincial Clinical College of Fujian Medical University, Fujian, China.,Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fujian, China
| | - Sarah W M Lee
- Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China
| | - Horace C W Choi
- Department of Systems Engineering and Engineering Management, City University of Hong Kong, Hong Kong, China
| | - Lucy L K Chan
- Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China
| | - Shao Jun Lin
- Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Provincial Clinical College of Fujian Medical University, Fujian, China.,Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fujian, China
| | - Qiao Juan Guo
- Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Provincial Clinical College of Fujian Medical University, Fujian, China.,Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fujian, China
| | - Henry C K Sze
- Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China
| | - Yun Bin Chen
- Department of Radiology, Fujian Provincial Cancer Hospital, Provincial Clinical College of Fujian Medical University, Fujian, China
| | - You Ping Xiao
- Department of Radiology, Fujian Provincial Cancer Hospital, Provincial Clinical College of Fujian Medical University, Fujian, China
| | - Wai Kuen Kan
- Department of Diagnostic Radiology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China
| | - Brian O'Sullivan
- Department of Radiation Oncology, Princess Margaret Cancer Centre/University of Toronto, Toronto, Ontario, Canada
| | - Wei Xu
- Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Quynh Thu Le
- Department of Radiation Oncology, Stanford University, Stanford, California
| | - Christine M Glastonbury
- Department of Clinical Radiology, University of California San Francisco, San Francisco, California
| | - A Dimitrios Colevas
- Department of Medicine (Oncology), Stanford Cancer Institute, Stanford University, Stanford, California
| | - Randal S Weber
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - William Lydiatt
- Department of Otolaryngology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Jatin P Shah
- Department of Head and Neck Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Anne W M Lee
- Department of Clinical Oncology, University of Hong Kong/University of Hong Kong-Shenzhen Hospital, Hong Kong, China.
| |
Collapse
|
16
|
Pan JJ, Ng WT, Zong JF, Chan LLK, O'Sullivan B, Lin SJ, Sze HCK, Chen YB, Choi HCW, Guo QJ, Kan WK, Xiao YP, Wei X, Le QT, Glastonbury CM, Colevas AD, Weber RS, Shah JP, Lee AWM. Proposal for the 8th edition of the AJCC/UICC staging system for nasopharyngeal cancer in the era of intensity-modulated radiotherapy. Cancer 2015; 122:546-58. [PMID: 26588425 DOI: 10.1002/cncr.29795] [Citation(s) in RCA: 219] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 10/11/2015] [Accepted: 10/26/2015] [Indexed: 01/31/2023]
Abstract
BACKGROUND An accurate staging system is crucial for cancer management. Evaluations for continual suitability and improvement are needed as staging and treatment methods evolve. METHODS This was a retrospective study of 1609 patients with nasopharyngeal carcinoma investigated by magnetic resonance imaging, staged with the 7th edition of the American Joint Committee on Cancer (AJCC)/International Union Against Cancer (UICC) staging system, and irradiated by intensity-modulated radiotherapy at 2 centers in Hong Kong and mainland China. RESULTS Among the patients without other T3/T4 involvement, there were no significant differences in overall survival (OS) between medial pterygoid muscle (MP) ± lateral pterygoid muscle (LP), prevertebral muscle, and parapharyngeal space involvement. Patients with extensive soft tissue involvement beyond the aforementioned structures had poor OS similar to that of patients with intracranial extension and/or cranial nerve palsy. Only 2% of the patients had lymph nodes > 6 cm above the supraclavicular fossa (SCF), and their outcomes resembled the outcomes of those with low extension. Replacing SCF with the lower neck (extension below the caudal border of the cricoid cartilage) did not affect the hazard distinction between different N categories. With the proposed T and N categories, there were no significant differences in outcome between T4N0-2 and T1-4N3 disease. CONCLUSIONS After a review by AJCC/UICC preparatory committees, the changes recommended for the 8th edition include changing MP/LP involvement from T4 to T2, adding prevertebral muscle involvement as T2, replacing SCF with the lower neck and merging this with a maximum nodal diameter > 6 cm as N3, and merging T4 and N3 as stage IVA criteria. These changes will lead not only to a better distinction of hazards between adjacent stages/categories but also to optimal balance in clinical practicability and global applicability.
Collapse
Affiliation(s)
- Jian Ji Pan
- Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Provincial Clinical College of Fujian Medical University, Fuzhou, China.,Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, China
| | - Wai Tong Ng
- Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China
| | - Jing Feng Zong
- Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Provincial Clinical College of Fujian Medical University, Fuzhou, China.,Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, China
| | - Lucy L K Chan
- Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China
| | - Brian O'Sullivan
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada
| | - Shao Jun Lin
- Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Provincial Clinical College of Fujian Medical University, Fuzhou, China.,Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, China
| | - Henry C K Sze
- Department of Clinical Oncology, Queen Mary Hospital, Hong Kong, China
| | - Yun Bin Chen
- Department of Radiology, Fujian Provincial Cancer Hospital, Provincial Clinical College of Fujian Medical University, Fuzhou, China
| | - Horace C W Choi
- Department of Systems Engineering and Engineering Management, City University of Hong Kong, Hong Kong, China
| | - Qiao Juan Guo
- Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Provincial Clinical College of Fujian Medical University, Fuzhou, China.,Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, China
| | - Wai Kuen Kan
- Department of Diagnostic Radiology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China
| | - You Ping Xiao
- Department of Radiology, Fujian Provincial Cancer Hospital, Provincial Clinical College of Fujian Medical University, Fuzhou, China
| | - Xu Wei
- Department of Biostatistics, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada
| | - Quynh Thu Le
- Department of Radiation Oncology, Stanford University, Stanford, California
| | | | - A Dimitrios Colevas
- Department of Medicine (Oncology), Stanford Cancer Institute, Stanford University, Stanford, California
| | - Randal S Weber
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jatin P Shah
- Department of Head and Neck Surgery, Memorial Sloan Kettering Cancer Center, New York
| | - Anne W M Lee
- Clinical Oncology Center, University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| |
Collapse
|
17
|
Xue C, Huang Y, Huang PY, Yu QT, Pan JJ, Liu LZ, Song XQ, Lin SJ, Wu JX, Zhang JW, Zhao HY, Xu F, Liu JL, Hu ZH, Zhao LP, Zhao YY, Wu X, Zhang J, Ma YX, Zhang L. Phase II study of sorafenib in combination with cisplatin and 5-fluorouracil to treat recurrent or metastatic nasopharyngeal carcinoma. Ann Oncol 2012; 24:1055-61. [PMID: 23172635 DOI: 10.1093/annonc/mds581] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND We aimed to investigate the efficacy and tolerability of sorafenib combined with cisplatin and 5-fluorouracil (5-FU) in patients with recurrent or metastatic nasopharyngeal carcinoma (NPC). PATIENTS AND METHODS It was a Simon two-stage designed trial. Chemotherapy-naive patients with recurrent or metastatic disease were enrolled. The regimen was sorafenib 400 mg orally b.i.d., cisplatin 80 mg/m(2) i.v. day 1, and 5-FU 1000 mg/m(2)/day CIV for 4 days, repeated every 21 days. After a maximum of six cycles of chemotherapy, patients received maintenance of sorafenib. RESULTS In total, 54 patients were enrolled. The objective response rate reached 77.8%, including 1 complete response and 41 partial responses. The median progression-free survival was 7.2 months (95% CI 6.8-8.4 months), and the median overall survival was 11.8 months (95% CI 10.6-18.7 months). Major toxic effects included hand-foot skin reaction, myelosuppression, and gastrointestinal (GI) reaction. The incidence of hemorrhage was 22.2%, and one patient with liver metastases died of GI bleeding. Contrast-enhanced ultrasonography was carried out in a subset of patients with liver metastases. CONCLUSION Combination of sorafenib, cisplatin (80 mg/m(2)) and 5-FU (3000 mg/m(2)) was tolerable and feasible in recurrent or metastatic NPC. Further randomized trials to compare sorafenib plus cisplatin and 5-FU with standard dose of cisplatin plus 5-FU in NPC are warranted.
Collapse
Affiliation(s)
- C Xue
- State Key Laboratory of Oncology in South China
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Johnson AT, Jones SC, Pan JJ, Vossoughi J. Variation of respiratory resistance suggests optimization of airway caliber. IEEE Trans Biomed Eng 2012; 59:2355-61. [PMID: 22711765 DOI: 10.1109/tbme.2012.2204055] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Physiologically optimized processes, such as respiration, walking, and cardiac function, usually show a range of variability about the optimized value. Airway resistance has, in the past, been noted as variable, and this variability has been connected to pulmonary disease (e.g., asthma). A hypothesis was presented many years ago that postulated airway resistance as an optimized parameter in healthy individuals, and we have noticed that respiratory measurements made with the airflow perturbation device (APD) tend to be variable in nature. It was posited that this variability indicates that respiratory resistance is optimized similarly to other physiological processes. Fifty subjects with a wide range of demographics volunteered to have 100 measurements made of their respiratory resistances. Resistances were separated into inhalation and exhalation phases. These were plotted and shown to have frequency distributions that were consistent with expectations for an optimized process. The frequency distributions were not quite symmetrical, being skewed slightly toward upper resistances. Comparison between subject data and data from a mechanical respiratory analog showed that subject resistance variation is overwhelmingly from the respiratory system and not from the APD.
Collapse
Affiliation(s)
- A T Johnson
- Fischell Department of Bioengineering, Universityof Maryland, College Park, MD 20742 , USA.
| | | | | | | |
Collapse
|
19
|
Pan JJ, Firpi RJ. The management of hepatitis C. MINERVA GASTROENTERO 2009; 55:23-35. [PMID: 19212305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Hepatitis C is a serious public health problem with more than 170 million chronic carriers worldwide. Although hepatitis C infection can be cured in up to 40% of patients, current treatment is not ideal and is associated with a wide spectrum of side effects and complications. Therefore, emerging evidence suggests that patients can receive tailored therapy based on their viral kinetic changes during treatment. With better knowledge of hepatitis C viral genome and life cycle, compounds so called ''Specifically Targeted Antiviral Therapy for HCV or STAT-C'' are under development. This review will discuss current therapies and recent advances in new therapies for hepatitis C.
Collapse
Affiliation(s)
- J J Pan
- Section of Hepatobiliary Diseases and Liver Transplantation, Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Florida Gainesville, FL, USA
| | | |
Collapse
|
20
|
Stephens PJ, Pan JJ, Devlin FJ, Cheeseman JR. Determination of the absolute configurations of natural products using TDDFT optical rotation calculations: the iridoid oruwacin. J Nat Prod 2008; 71:285-288. [PMID: 18211006 DOI: 10.1021/np070502r] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
We report the determination of the absolute configuration (AC) of the iridoid natural product oruwacin by comparison of the optical rotations, [alpha] D, of its two enantiomers, calculated using time-dependent density functional theory (TDDFT), to the experimental [alpha] D value, +193. Conformational analysis of oruwacin using density functional theory (DFT) identifies eight conformations which are significantly populated at room temperature. [alpha] D values of these eight conformations are calculated using TDDFT at the B3LYP/aug-cc-pVDZ//B3LYP/6-31G* level, leading to the conformationally averaged [alpha] D values of -193 for the (1 R,5 S,8 S,9 S,10 S)-enantiomer and +193 for the (1 S,5 R,8 R,9 R,10 R)-enantiomer. Comparison of the calculated [alpha] D values to the value of the natural product proves that naturally occurring oruwacin has the AC 1 S,5 R,8 R,9 R,10 R. This AC is opposite to that assigned by Adesogan by comparison of the [alpha] D of oruwacin to that of the iridoid plumericin. Our results show that the assignment of the AC of a natural product by comparison of its [alpha] D to that of a chemically related molecule can be unreliable and should not be assumed to be definitive.
Collapse
Affiliation(s)
- P J Stephens
- Department of Chemistry, University of Southern California, Los Angeles, California 90089-0482, USA.
| | | | | | | |
Collapse
|
21
|
Stephens PJ, Pan JJ, Devlin FJ, Krohn K, Kurtán T. Determination of the Absolute Configurations of Natural Products via Density Functional Theory Calculations of Vibrational Circular Dichroism, Electronic Circular Dichroism, and Optical Rotation: The Iridoids Plumericin and Isoplumericin. J Org Chem 2007; 72:3521-36. [PMID: 17388636 DOI: 10.1021/jo070155q] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The absolute configurations (ACs) of the iridoid natural products, plumericin (1) and isoplumericin (2), have been re-investigated using vibrational circular dichroism (VCD) spectroscopy, electronic circular dichroism (ECD) spectroscopy, and optical rotatory dispersion (ORD). Comparison of DFT calculations of the VCD spectra of 1 and 2 to the experimental VCD spectra of the natural products, (+)-1 and (+)-2, leads unambiguously to the AC (1R,5S,8S,9S,10S)-(+) for both 1 and 2. In contrast, comparison of time-dependent DFT (TDDFT) calculations of the ECD spectra of 1 and 2 to the experimental spectra of (+)-1 and (+)-2 does not permit definitive assignment of their ACs. On the other hand, TDDFT calculations of the ORD of (1R,5S,8S,9S,10S)-1 and -2 over the range of 365-589 nm are in excellent agreement with the experimental data of (+)-1 and (+)-2, confirming the ACs derived from the VCD spectra. Thus, the ACs initially proposed by Albers-Schönberg and Schmid are shown to be correct, and the opposite ACs recently derived from the ECD spectra of 1 and 2 by Elsässer et al. are shown to be incorrect. As a result, the ACs of other iridoid natural products obtained by chemical correlation with 1 and 2 are not in need of revision.
Collapse
Affiliation(s)
- P J Stephens
- Department of Chemistry, University of Southern California, Los Angeles, California 90089-0482, USA.
| | | | | | | | | |
Collapse
|
22
|
Munkacsi AB, Pan JJ, Villesen P, Mueller UG, Blackwell M, McLaughlin DJ. Convergent coevolution in the domestication of coral mushrooms by fungus-growing ants. Proc Biol Sci 2004; 271:1777-82. [PMID: 15315892 PMCID: PMC1691797 DOI: 10.1098/rspb.2004.2759] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Comparisons of phylogenetic patterns between coevolving symbionts can reveal rich details about the evolutionary history of symbioses. The ancient symbiosis between fungus-growing ants, their fungal cultivars, antibiotic-producing bacteria and cultivar-infecting parasites is dominated by a pattern of parallel coevolution, where the symbionts of each functional group are members of monophyletic groups. However, there is one outstanding exception in the fungus-growing ant system, the unidentified cultivar grown only by ants in the Apterostigma pilosum group. We classify this cultivar in the coral-mushroom family Pterulaceae using phylogenetic reconstructions based on broad taxon sampling, including the first mushroom collected from the garden of an ant species in the A. pilosum group. The domestication of the pterulaceous cultivar is independent from the domestication of the gilled mushrooms cultivated by all other fungus-growing ants. Yet it has the same overall assemblage of coevolved ant-cultivar-parasite-bacterium interactions as the other ant-grown fungal cultivars. This indicates a pattern of convergent coevolution in the fungus-growing ant system, where symbionts with both similar and very different evolutionary histories converge to functionally identical interactions.
Collapse
Affiliation(s)
- A B Munkacsi
- Department of Plant Biology, Evolution and Behavior, University of Minnesota, St. Paul, MN 55108, USA.
| | | | | | | | | | | |
Collapse
|
23
|
|
24
|
Abstract
Dispersion-compensating fiber Bragg gratings with approximately 99.9% reflectivity that are made by continuous apodization and phase control are demonstrated. These strong dispersion-compensating gratings provide precision second-order, third-order, or even more complex dispersion compensation, as well as sufficient transmission isolation to be used at add-drop stages without additional filtering. A 99.84% grating with a constant approximately 700-ps/nm dispersion and a 99.94% grating with dispersion varying linearly from 1000 to -1000 ps/nm are demonstrated.
Collapse
Affiliation(s)
- Yisi Liu
- Department of Electrical Engineering, University of California at Santa Cruz, Santa Cruz, California 95064, USA.
| | | | | | | |
Collapse
|
25
|
Yuan YL, Zhang TZ, Jing SR, Pan JJ, Xing CZ, Guo LP, Tang CM. Studies of the inheritance of seed qualities and the exploitation of F2 heterosis in low gossypol strains in upland cotton. Yi Chuan Xue Bao 2001; 28:471-81. [PMID: 11441661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Twenty cross combinations were made with 4 recessive glandless lines (gl2gl2 gl3gl3) used as females and 5 dominant glandless lines (Gl2eGl2e Gl3Gl3) used as male parents to estimate the genetic variance components of kernel oil and protein content of seeds, oil and protein index, and kernel index using a genetic model for parents, F2 and F3. The results showed that all the analyzed traits were mainly controlled by additive effects. Oil content was controlled mainly by maternal additive effect, and other traits by direct additive effect. The average heterosis of F2 over mid-parent based on population mean was -1.99% to 1.11% for all these traits. It suggests that little inbreeding depression exists for F2 and F3 seeds. There were 75% and 60% of the F2 and the F3 combinations in which open-pollinated seeds contained gossypol levels lower than 0.4 gkg-1. This result indicated that it is possible to screen and select high yielding F2 hybrids with a gossypol content lower than the regulated criterion and without lowering seed quality.
Collapse
Affiliation(s)
- Y L Yuan
- Department of Genetics & Breeding, Nanjing Agricultural University, Key Laboratory of Crop Genetics & Germplasm Enhancement, Ministry of Education, Key Laboratory of Crop Gemplasm & Breeding, Ministry of Agriculture, Nanjing 210095, China
| | | | | | | | | | | | | |
Collapse
|
26
|
Pan JJ, Yang LW, Liang PH. Effect of site-directed mutagenesis of the conserved aspartate and glutamate on E. coli undecaprenyl pyrophosphate synthase catalysis. Biochemistry 2000; 39:13856-61. [PMID: 11076526 DOI: 10.1021/bi001226h] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Undecaprenyl pyrophosphate synthase (UPPs) catalyzes condensation of eight molecules of isopentenyl pyrophosphate with farnesyl pyrophosphate to yield C(55)-undecaprenyl pyrophosphate. We have mutated the aspartates and glutamates in the five conserved regions (I to V) of UPPs protein sequence to evaluate their effects on substrate binding and catalysis. The mutant enzymes including D26A, E73A, D150A, D190A, E198A, E213A, D218A, and D223A were expressed and purified to great homogeneity. Kinetic analyses of these mutant enzymes indicated that the substitution of D26 in region I with alanine resulted in a 10(3)-fold decrease of k(cat) value compared to wild-type UPPs. Its IPP K(m) value has only minor change. The mutagenesis of D150A has caused a much lower IPP affinity with IPP K(m) value 50-fold larger than that of wild-type UPPs but did not affect the FPP K(m) and the k(cat). The E213A mutant UPPs has a 70-fold increased IPP K(m) value and has a 100-fold decreased k(cat) value compared to wild-type. These results suggest that D26 of region I is critical for catalysis and D150 in region IV plays a significant role of IPP binding. The E213 residue in region V is also important in IPP binding as well as catalysis. Other mutant UPPs enzymes in this study have shown no significant change (<5-fold) of k(cat) with exception of E73A and D218A. Both enzymes have 10-fold lower k(cat) value relative to wild-type UPPs.
Collapse
Affiliation(s)
- J J Pan
- Institute of Biological Chemistry, Academia Sinica, Nankang, Taipei 11529, Taiwan
| | | | | |
Collapse
|
27
|
Pan JJ, Chiou ST, Liang PH. Product distribution and pre-steady-state kinetic analysis of Escherichia coli undecaprenyl pyrophosphate synthase reaction. Biochemistry 2000; 39:10936-42. [PMID: 10978182 DOI: 10.1021/bi000992l] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Undecaprenyl pyrophosphate synthase (UPPs) catalyzes the condensation of eight molecules of isopentenyl pyrophosphate (IPP) with farnesyl pyrophosphate (FPP) to generate C(55) undecaprenyl pyrophosphate. We investigated the kinetics and mechanism of this reaction pathway using Escherichia coli UPPs. With a variety of different ratios of enzyme to substrate and FPP to IPP in the presence or absence of Triton, different product distributions were found. In the presence of excess FPP, the intermediates (C(25)-C(50)) accumulated. Under a condition with enzyme and FPP in excess of IPP, instead of C(20)-geranylgeranyl pyrophosphate, C(20), C(25), and C(30) were the major products. The UPPs steady-state k(cat) value (2.5 s(-1)) in the presence of 0.1% Triton was 190-fold larger than in the absence of Triton (0.013 s(-1)). The k(cat) value matched the rate constant of each IPP condensation obtained from the enzyme single-turnover experiments. This suggested that the IPP condensation rather than product release was the rate-limiting step in the presence of Triton. In the absence of Triton, the intermediates formed and disappeared in a similar manner under enzyme single turnover in contrast to the slow steady-state rate, which indicated a step after product generation was rate limiting. This was further supported by a burst product formation. Judging from the accumulation level of C(55), C(60), and C(65), their dissociation from the enzyme cannot be too slow and an even slower enzyme conformational change with a rate of 0.001 s(-1) might govern the UPPs reaction rate under the steady-state condition in the absence of Triton.
Collapse
Affiliation(s)
- J J Pan
- Institute of Biological Chemistry, Academia Sinica, Nankang, Taipei 11529, Taiwan
| | | | | |
Collapse
|
28
|
Abstract
Novel multiplexers-demultiplexers for dense wavelength-division multiplexing systems that use interleaved sampled gratings are presented. It is shown that, with the appropriate design, configurations ranging from hybrid to add-drop as well as all-grating-based multiplexers can easily be realized.
Collapse
|
29
|
Pan JJ, Hwang JK. Mixed quantum mechanical/molecular mechanical simulations of chemical reactions in solution and in enzymes by the classical trajectory mapping approach. Pac Symp Biocomput 1997:539-49. [PMID: 9390257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We present a practical hybrid quantum mechanical/molecular mechanical approach to study chemical reactions in solution and in enzymes. In this method, referred to as the "Classical Trajectory Mapping" method, trajectories are calculated on the classical potential surfaces and, by using the classical surfaces as a reference state for the actual quantum mechanical ground state potential, the free energy profile of the chemical reaction is obtained by the free energy perturbation technique. This method was applied to proton-transfer reactions both in aqueous solution and in papain. The encouraging results indicate the applicability of our method to chemical reactions in the condensed phase and the biological systems.
Collapse
Affiliation(s)
- J J Pan
- Department of Life Sciences, National Tsing Hua University, Taiwan
| | | |
Collapse
|
30
|
Vyas AA, Pan JJ, Patel HV, Vyas KA, Chiang CM, Sheu YC, Hwang JK, Wu WG. Analysis of binding of cobra cardiotoxins to heparin reveals a new beta-sheet heparin-binding structural motif. J Biol Chem 1997; 272:9661-70. [PMID: 9092495 DOI: 10.1074/jbc.272.15.9661] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Heparin and heparan sulfate have recently been shown to bind to snake cardiotoxin (CTX) and to potentiate its penetration into phospholipid monolayer under physiological ionic conditions. Herein we analyze the heparin-binding domain of CTX using 10 CTXs from Taiwan and African cobra venom. We also performed computer modeling to obtain more information of the binding at molecular level. The results provide a molecular model for interaction of CTX-heparin complex where the cationic belt of the conserved residues on the concave surface of three finger beta-sheet polypeptides initiates ionic interaction with heparin-like molecules followed by specific binding of Lys residues near the tip of loop 2 of CTX. The dissociation constants of CTXs differ by as much as 4 orders of magnitude, ranging from approximately 140 microM for toxin gamma to approximately 20 nM for CTX M3, depending on the presence of Lys residues near the tip of loop 2. High affinity heparin binding becomes possible due to the presence of Arg-28, Lys-33, or the so-called consensus heparin binding sequence of XKKXXXKRX near the tip of the loop. The well defined three-finger loop structure of CTX provides an interesting template for the design of high affinity heparin-binding polypeptides with beta-sheet structure. The finding that several cobra CTXs and phospholipase A2 bind to heparin with different affinity may provide information on the synergistic action of the two venom proteins.
Collapse
Affiliation(s)
- A A Vyas
- Department of Life Sciences, National Tsing Hua University, Hsinchu 30043, Taiwan
| | | | | | | | | | | | | | | |
Collapse
|
31
|
Pan JJ, Liu SI. [Polydipsia and water intoxication in schizophrenia patients: report of two cases]. Kaohsiung J Med Sci 1996; 12:549-54. [PMID: 8819359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
This report describes two cases of schizophrenia inpatients with polydipsia, intermittent hyponatremia, and water intoxication. Case 1, a 38 year-old male, developed polydipsia after seven years duration of schizophrenia, with a daily intake of water of more than 10 liters as a result of auditory hallucination suggestion. Nocturnal hyponatremia, agitation and exacerbation of psychosis were noted during admission. After 12 treatments of electroconvulsive therapy, the symptoms of psychosis and polydipsia declined. Case 2, a 42 year-old male, had also been a case of schizophrenia for about twenty years, and developed polydipsia with more than 5 liters of daily water intake in a chronic psychiatric hospital for a period of 5 years schizophrenia. He claimed that he enjoyed the pleasure of drinking water. The symptom of water intoxication had been noted intermittently in the past year, leading to at least two seizures. Finally the patient was transferred to our ward due to agitated mood, self-destructive behavior, consciousness loss, and motor weakness. The clinical features, differential diagnosis and treatment concept of polydipsia and water intoxication were also discussed in context.
Collapse
Affiliation(s)
- J J Pan
- Department of Psychiatry, Makay Memorial Hospital, Taipei, Taiwan, Republic of China
| | | |
Collapse
|
32
|
Pan JJ, Senba M, Arseneau DJ, Kempton JR, Fleming DG, Baer S, Gonzalez AC, Snooks R. Muonium atom spin exchange with alkali-metal vapors: Mu+Cs. Phys Rev A 1993; 48:1218-1226. [PMID: 9909725 DOI: 10.1103/physreva.48.1218] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
|