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Jin L, Shan L, Yu K, Pan Y, Sun Y, Chen J, Han L, Li W, Li Z, Zhang Y. Postoperative acute kidney injury increases short- and long-term death risks in elderly patients (≥ 75 years old) undergoing coronary artery bypass graft surgery. Int Urol Nephrol 2024; 56:1497-1508. [PMID: 37878200 PMCID: PMC10923977 DOI: 10.1007/s11255-023-03845-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 10/08/2023] [Indexed: 10/26/2023]
Abstract
PURPOSE To explore the incidence of postoperative acute kidney injury (AKI) after coronary artery bypass grafting (CABG) in elderly Chinese patients (≥ 75 years old) and its impacts on the short- and long-term prognosis. METHODS A total of 493 patients aged 75-88 years old who underwent CABG from two medical centers between January 2006 and October 2021 were involved. Perioperative (preoperative and 7 days after operation) serum creatinine (Scr) levels were measured in all the enrolled patients. Univariate and multivariate logistic regression analyses were conducted to explore the independent risk factors of postoperative in-hospital mortality. Kaplan-Meier curves and COX model were used to test the risk factors of all-cause death during follow-up. Propensity score matching was used to balance differences between AKI and control groups. The primary outcome event was in-hospital death, and the secondary outcome was all-cause death during follow-up. RESULTS The 198 patients were diagnosed with postoperative AKI. Intra-aortic balloon pump (IABP), cardiopulmonary bypass, and postoperative AKI were independent risk factors of in-hospital death. Gender, New York Heart Association Classification, preoperative eGFR, last eGFR within 7 days after operation, postoperative AKI, and postoperative renal function all impacted long-term prognosis. After 1:1 matching, 190 patients were included in the AKI and control groups. Use of IABP, use of cardiopulmonary bypass, and occurrence of postoperative AKI were still independent risk factors of in-hospital death. Preoperative eGFR, last eGFR within 7 days after operation, postoperative AKI and postoperative renal function all impacted long-term prognosis. CONCLUSION The incidence of postoperative AKI in elderly patients undergoing CABG is high, and postoperative AKI is an independent risk factor of both short- and long-term postoperative prognosis.
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Affiliation(s)
- Lei Jin
- Department of Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lingtong Shan
- Department of Thoracic Surgery, Sheyang County People's Hospital, Yancheng, China
| | - Kaiyan Yu
- Department of Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yilin Pan
- The First Clinical Medical College of Nanjing Medical University, Nanjing, China
| | - Yangyang Sun
- The First Clinical Medical College of Nanjing Medical University, Nanjing, China
| | - Jiapeng Chen
- Xinglin College, Nantong University, Nantong, China
| | - Lixiang Han
- Department of Cardiovascular Surgery, Jiangsu Province Hospital, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Wei Li
- Department of Cardiovascular Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, 241 Huaihai Road, Shanghai, 200030, China.
| | - Zhi Li
- Department of Cardiovascular Surgery, Jiangsu Province Hospital, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
| | - Yangyang Zhang
- Department of Cardiovascular Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, 241 Huaihai Road, Shanghai, 200030, China.
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Cui X, Shen P, Jin L, Sun Y, Pan Y, Lv M, Shan L, Dai H, Sun L, Wang Z, Li W, Yu K, Zhang Y. Preoperative prognostic nutritional index is an independent indicator for perioperative prognosis in coronary artery bypass grafting patients. Nutrition 2023; 116:112215. [PMID: 37820569 DOI: 10.1016/j.nut.2023.112215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 08/13/2023] [Accepted: 09/01/2023] [Indexed: 10/13/2023]
Abstract
OBJECTIVES The prognostic nutritional index is widely used for surgery prognosis, but the association between preoperative prognostic nutritional index and short-term prognosis for coronary artery bypass grafting surgery and the profiles of perioperative prognostic nutritional index remain unclear. METHODS This study retrospectively enrolled a total of 879 adult patients undergoing coronary artery bypass grafting surgery in the Shanghai Chest Hospital from 2006 to 2022. The prognostic nutritional index was calculated based on serum albumin and peripheral lymphocyte count. In-hospital mortality, demographic characteristics, blood biochemistry parameters, cardiovascular medical history, and physical examination results were collected from the hospital information system. The propensity score matching method and multivariate logistic regression were used to detect the association between preoperative prognostic nutritional index and in-hospital mortality. RESULTS Patients were divided into a high-prognostic nutritional index group (n = 500) and a low-prognostic nutritional index group (n = 379), using a cutoff value of 48.1 according to receiver operating characteristic curve analysis. The propensity score matching-adjusted mean prognostic nutritional index levels decreased from 48.35 before the operation to 34.04 an in ≤24 h after the operation and rebounded to 43.36 before discharge. High preoperative prognostic nutritional index was inversely associated with in-hospital mortality for coronary artery bypass grafting surgery (odds ratio = 0.86; 95% CI, 0.77-0.97) in propensity score matching-adjusted multivariate logistic regression. CONCLUSIONS Preoperative prognostic nutritional index is an independent indicator for in-hospital mortality of for coronary artery bypass grafting surgery, and the variation trend of prognostic nutritional index during perioperation tends to be U-shaped.
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Affiliation(s)
- Xueying Cui
- Department of Nutrition, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Peiming Shen
- Department of Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lei Jin
- Department of Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yangyang Sun
- First School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Yilin Pan
- First School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Mengwei Lv
- Department of Cardiothoracic Surgery, The Affiliated BenQ Hospital of Nanjing Medical University, Suzhou, China
| | - Lingtong Shan
- Department of Thoracic Surgery, Sheyang County People's Hospital, Yancheng, China
| | - Huangdong Dai
- Department of Cardiovascular Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lin Sun
- Department of Cardiovascular Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zikun Wang
- Department of Cardiovascular Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Li
- Department of Cardiovascular Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Kaiyan Yu
- Department of Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yangyang Zhang
- Department of Cardiovascular Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Jia T, Xu K, Bai Y, Lv M, Shan L, Li W, Zhang X, Li Z, Wang Z, Zhao X, Li M, Zhang Y. Machine-learning predictions for acute kidney injuries after coronary artery bypass grafting: a real-life muticenter retrospective cohort study. BMC Med Inform Decis Mak 2023; 23:270. [PMID: 37996844 PMCID: PMC10668365 DOI: 10.1186/s12911-023-02376-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 11/16/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND Acute kidney injury (AKI) after coronary artery bypass grafting (CABG) surgery is associated with poor outcomes. The objective of this study was to apply a new machine learning (ML) method to establish prediction models of AKI after CABG. METHODS A total of 2,780 patients from two medical centers in East China who underwent primary isolated CABG were enrolled. The dataset was randomly divided for model training (80%) and model testing (20%). Four ML models based on LightGBM, Support vector machine (SVM), Softmax and random forest (RF) algorithms respectively were established in Python. A total of 2,051 patients from two other medical centers were assigned to an external validation group to verify the performances of the ML prediction models. The models were evaluated using the area under the receiver operating characteristics curve (AUC), Hosmer-Lemeshow goodness-of-fit statistic, Bland-Altman plots, and decision curve analysis. The outcome of the LightGBM model was interpreted using SHapley Additive exPlanations (SHAP). RESULTS The incidence of postoperative AKI in the modeling group was 13.4%. Similarly, the incidence of postoperative AKI of the two medical centers in the external validation group was 8.2% and 13.6% respectively. LightGBM performed the best in predicting, with an AUC of 0.8027 in internal validation group and 0.8798 and 0.7801 in the external validation group. The SHAP revealed the top 20 predictors of postoperative AKI ranked according to the importance, and the top three features on prediction were the serum creatinine in the first 24 h after operation, the last preoperative Scr level, and body surface area. CONCLUSION This study provides a LightGBM predictive model that can make accurate predictions for AKI after CABG surgery. The LightGBM model shows good predictive ability in both internal and external validation. It can help cardiac surgeons identify high-risk patients who may experience AKI after CABG surgery.
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Affiliation(s)
- Tianchen Jia
- College of Information Science, Shanghai Ocean University, Shanghai, P.R. China
| | - Kai Xu
- Department of Cardiovascular Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, P.R. China
| | - Yun Bai
- College of Information Science, Shanghai Ocean University, Shanghai, P.R. China
| | - Mengwei Lv
- Department of Thoracic Surgery, Xuzhou Cancer Hospital, Xuzhou, P.R. China
| | - Lingtong Shan
- Department of Thoracic Surgery, Sheyang County People's Hospital, Yancheng, P.R. China
| | - Wei Li
- Department of Cardiovascular Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, 241 Huaihai West Road, Shanghai, 200120, China
| | - Xiaobin Zhang
- Department of Cardiovascular Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, 241 Huaihai West Road, Shanghai, 200120, China
| | - Zhi Li
- Department of Cardiovascular Surgery, Jiangsu Province Hospital, the First Affiliated Hospital of Nanjing Medical University, Nanjing, P.R. China
| | - Zhenhua Wang
- College of Information Science, Shanghai Ocean University, Shanghai, P.R. China
| | - Xin Zhao
- Department of Cardiovascular Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, P.R. China.
| | - Mingliang Li
- Department of Cardiovascular Surgery, The General Hospital of Ningxia Medical University, Yinchuan, Ningxia, P.R. China.
| | - Yangyang Zhang
- Department of Cardiovascular Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, 241 Huaihai West Road, Shanghai, 200120, China.
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Hu L, Fenghu L, Li J, Du Y, Mei F, Tian X, Qin Y, Lu B, Shan L. Efficacy and Safety of Local Radiotherapy Combined with Chemotherapy ± Bevacizumab in the Treatment of Patients with Advanced and Recurrent Metastatic Cervical Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e512-e513. [PMID: 37785603 DOI: 10.1016/j.ijrobp.2023.06.1771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To observe the efficacy and safety of local radiotherapy combined with chemotherapy ± bevacizumab in the treatment of patients with advanced or recurrent metastatic cervical cancer. MATERIALS/METHODS A total of 53 patients with advanced and recurrent metastatic cervical cancer who had received local radiotherapy combined with chemotherapy ± bevacizumab in Affiliated Cancer Hospital of Guizhou Medical University from July 2018 to October 2021 were collected. The recurrence types included 21 patients of pelvic recurrence, 7 patients of distant metastasis, 14 patients of complex pelvic recurrence and distant metastasis, and 11 patients of advanced stage (initial diagnosis stage IVB). The primary endpoints were objective response rate (ORR) and disease control rate (DCR). The secondary endpoints were progression-free survival (PFS), overall survival (OS) and incidence of adverse reactions. RESULTS (1) Complete response (CR) was achieved in 4 patients (7.5%), partial response (PR) in 34 patients (64.2%), stable disease (SD) in 12 patients (22.6%), and disease progression (PD) in 3 patients (5.7%), ORR was 71.7%, DCR was 94.3%. (2) The follow-up time was 5.3 to 45.7 months, the median OS was 29.3 months, the median PFS was 15.7 months, the one-year and two-year OS were 83.0% and 59.2%, and the 1-year and two-year PFS were 62.2% and 34.4%. (3) Recurrence type, tumor size at the time of recurrence, and efficacy after radiotherapy were significant factors for PFS and OS rates in multivariate analysis. (4) The main adverse reactions were myelosuppression, gastrointestinal reaction and urinary reaction. Grade IV leukopenia occurred at 13.2%, grade IV neutropenia at 11.3%, grade IV thrombocytopenia at 15.1%, and grade IV anemia at 5.7%, all of which were tolerable. The gastrointestinal and urinary reactions were mainly grade I-II, and the incidence of vesical or rectovaginal fistulas was about 7.5% (2 patients had rectovaginal fistulas and 2 patients had vesto-vaginal fistulas). CONCLUSION Local radiotherapy combined with chemotherapy ± bevacizumab can improve the efficacy and survival of patients with advanced and recurrent metastatic cervical cancer. Adverse reactions are tolerable and may provide survival benefits in these patients.
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Affiliation(s)
- L Hu
- Department of Oncology, the Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - L Fenghu
- Department of Oncology, the Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - J Li
- Department of Oncology, the Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Y Du
- Department of Oncology, the Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - F Mei
- Department of Gynecologic Oncology, the Affiliated Cancer Hospital of Guizhou Medical University, Guiyang, Guizhou Province, China
| | - X Tian
- Department of Oncology, the Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Y Qin
- Department of Oncology, the Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - B Lu
- Department of Oncology, the Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - L Shan
- Department of Gynecologic Oncology, the Affiliated Cancer Hospital of Guizhou Medical University, Guiyang, Guizhou, China
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Minassian D, Dong C, Shan L, He C. Low socioeconomic status is linked to increased risk of invasive pneumococcal disease. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00612-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Shan L, Chen J, Sun Y, Pan Y, Wang C, Wang Y, Zhang Y. Advances of Liquid Biopsy for Diagnosis of Atrial Fibrillation and Its Recurrence After Ablation in Clinical Application. Methods Mol Biol 2023; 2695:351-365. [PMID: 37450131 DOI: 10.1007/978-1-0716-3346-5_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
Atrial fibrillation (AF) is a common arrhythmia disease with high morbidity in clinical practice and leads to stroke, heart failure, peripheral embolism, and other severe complications. With aging of the society, AF has become one of the biggest public health challenges. Effective treatments including antiarrhythmic drugs, electrical cardioversion, and ablation (with or without catheters) can alleviate the symptoms of AF. Ablation is the most effective method for the treatment of persistent AF, but cannot cure all patients. Recurrence of AF is a realistic and unavoidable problem. For early predicting and warning of AF and its recurrence, liquid biopsy for accurate molecular analysis of biofluids is a new strategy with potential value and easy sampling and can detect genetic and epigenetic polymorphisms, especially microRNAs. In this review, liquid biopsy is constructed as a new powerful way for diagnosing AF and predicting its recurrence, contributing to the treatment of AF.
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Affiliation(s)
- Lingtong Shan
- Department of Thoracic Surgery, Sheyang County People's Hospital, Yancheng, Jiangsu, People's Republic of China
| | - Jiapeng Chen
- Xinglin College, Nantong University, Nantong, Jiangsu, People's Republic of China
| | - Yangyang Sun
- The First Clinical Medical College of Nanjing Medical University, Nanjing, China
| | - Yilin Pan
- The First Clinical Medical College of Nanjing Medical University, Nanjing, China
| | - Chong Wang
- Department of Cardiovascular Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuliang Wang
- Department of Immunology, Nanjing Medical University, Nanjing, China.
| | - Yangyang Zhang
- Department of Cardiovascular Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Shan L, Tan CY, Shen X, Ramesh S, Kolahchi R, Hajmohammad MH, Rajak DK. Creep Behavior of A356 Aluminum Alloy Reinforced with Multi-Walled Carbon Nanotubes by Stir Casting. Materials (Basel) 2022; 15:ma15248959. [PMID: 36556764 PMCID: PMC9786553 DOI: 10.3390/ma15248959] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/06/2022] [Accepted: 12/08/2022] [Indexed: 06/12/2023]
Abstract
Lightweight aluminum alloy components are often used to manufacture a variety of engineering components in many industries. In recent years, researchers have studied the effect of improving the mechanical properties of metal alloys by incorporating nano-carbon into its structure. In this study, the effect of the addition of 0.2, 0.5, and 1 wt% of multi-walled carbon nanotubes (MWCNTs) on the stress-strain behavior and creep phenomenon of an A356 aluminum alloy were studied. The effect of nickel coating on 0.2 wt% MWCNTs was also investigated. Samples were prepared using the stir-casting method. The results revealed that the grain size became finer when MWCNT nano-particulates were introduced. Although the MWCNTs were distributed homogeneously in the A356 matrix, as confirmed by FESEM analysis, there were some agglomerations observed in a specific area with dimensions smaller than 100 nm. Nevertheless, the addition of MWCNTs was found to be beneficial in enhancing the hardness of alloys containing 0.2 wt%, 0.2 wt% nickel-coated, 0.5 wt%, and 1 wt% MWCNTs by 9%, 24%, 32%, and 15%, respectively, as compared with the unreinforced A345 matrix. It was also found that the 0.5 wt% MWCNT-A356 matrix exhibited an improvement in the creep lifetime by more than two orders of magnitude.
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Affiliation(s)
- L. Shan
- Department of Mechanical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - C. Y. Tan
- Department of Mechanical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur 50603, Malaysia
- Centre of Advanced Manufacturing and Materials Processing (AMMP), Faculty of Engineering, University Malaya, Kuala Lumpur 50603, Malaysia
| | - X. Shen
- State Key Laboratory of Mechanics and Control of Mechanical Structures, Nanjing University of Aeronautics and Astronautics, Nanjing 210016, China
| | - S. Ramesh
- Department of Mechanical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur 50603, Malaysia
- Centre of Advanced Manufacturing and Materials Processing (AMMP), Faculty of Engineering, University Malaya, Kuala Lumpur 50603, Malaysia
- Huanghe Jiaotong University, Zhengzhou 454950, China
| | - R. Kolahchi
- School of Materials Science and Engineering, State Key Laboratory of Silicon Materials, Zhejiang University, Hangzhou 310027, China
| | - M. H. Hajmohammad
- Department of Mechanical Engineering, Imam Hossein University, Tehran 1698715461, Iran
| | - D. K. Rajak
- Indian Institute of Technology (ISM), Dhanbad 826004, JH, India
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Shan L, Wang Q. PP 1.21 – 00118 Regulation of HIV-1 persistence by the CARD8 inflammasome. J Virus Erad 2022. [DOI: 10.1016/j.jve.2022.100125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Jie W, Wu YL, Lu S, Wang Q, Li S, Zhong W, Wang Q, Li W, Wang B, Chen J, Cheng Y, Duan H, Li G, Shan L, Liu Y, Huang X, Atasoy A, He J. 85P Adjuvant osimertinib in patients (pts) with stage IB–IIIA EGFR mutation-positive (EGFRm) NSCLC after complete tumour resection: ADAURA China subgroup analysis. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.02.095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Gao F, Shan L, Wang C, Meng X, Chen J, Han L, Zhang Y, Li Z. Predictive Ability of European Heart Surgery Risk Assessment System II (EuroSCORE II) and the Society of Thoracic Surgeons (STS) Score for in-Hospital and Medium-Term Mortality of Patients Undergoing Coronary Artery Bypass Grafting. Int J Gen Med 2021; 14:8509-8519. [PMID: 34824547 PMCID: PMC8610380 DOI: 10.2147/ijgm.s338819] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 11/08/2021] [Indexed: 12/13/2022] Open
Abstract
Objective To evaluate the powers of European Heart Surgery Risk Assessment System II (EuroSCORE II) and the Society of Thoracic Surgeons (STS) score in predicting in-hospital and medium-term mortality of patients undergoing coronary artery bypass grafting (CABG). Methods Totally 1628 Chinese patients were included between January 2000 and January 2018. Their perioperative clinical data were collected and the patients were closely followed up. According to the length of follow-up time, the total cohort was divided into 1-year, 2-year, 3-year, 4-year and 5-year groups. The in-hospital and medium-term risk prediction of EuroSCORE II and STS score were comparatively assessed by calibration, discrimination, decision curve analysis (DCA), net reclassification index (NRI), integrated discrimination improvement (IDI) and Bland-Altman analysis. Results About 36 (2.21%) patients died during hospitalization. Both EuroSCORE II and STS score performed extremely well in predicting in-hospital mortality (area under curve = 0.900 and 0.879, respectively). However, calibration and discrimination analyses showed gradual decrease when these two risk evaluation systems were used to predict mortality during the follow-up period. At the same time, the predictive ability of EuroSCORE II was better than STS score. DCA curves showed that the performances of the two evaluation systems were roughly equal between the threshold probability of 0% to 20%. The percentage of correct reclassification of EuroSCORE II was 21.64% higher than that of STS score in predicting 2-year postoperative mortality. The IDI index showed that the predictive capabilities of these two systems were roughly equivalent. Bland-Altman analysis showed no significant difference between the values of the two systems. Conclusion EuroSCORE II and STS score have excellent predictive powers in predicting in-hospital mortality of patients undergoing CABG. In particular, EuroSCORE II is superior in calibration and discrimination. The prediction efficiency of the two risk evaluation systems is still acceptable for two-year postoperative mortality, but decreases year by year.
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Affiliation(s)
- Fei Gao
- Cardiovascular Department, Huaiyin Hospital of Huai'an City, Huai'an, Jiangsu, People's Republic of China
| | - Lingtong Shan
- Department of Thoracic Surgery, Sheyang County People's Hospital, Yancheng, Jiangsu, People's Republic of China
| | - Chong Wang
- Department of Cardiovascular Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Xiaoqi Meng
- The Second Clinical Medical College of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China
| | - Jiapeng Chen
- Xinglin College, Nantong University, Nantong, Jiangsu, People's Republic of China
| | - Lixiang Han
- Department of Cardiovascular Surgery, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China
| | - Yangyang Zhang
- Department of Cardiovascular Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Zhi Li
- Department of Cardiovascular Surgery, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China
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Gao F, Yang Y, Zhu H, Wang J, Xiao D, Zhou Z, Dai T, Zhang Y, Feng G, Li J, Lin B, Xie G, Ke Q, Zhou K, Li P, Sheng X, Wang H, Yan L, Lao C, Shan L, Li M, Lu Y, Chen M, Feng S, Zhao J, Wu D, Du X. First Demonstration of the FLASH Effect With Ultrahigh Dose-Rate High-Energy X-Rays. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Li J, Mao W, Li F, Ran L, Chang J, Mei F, Hu L, Du Y, Tian X, Liu M, Chen Y, Shan L, Mu J, Yin S, Qin Y, Liang N. A Phase II, Single-Arm, Prospective Clinical Trial for the Efficacy and Safety of Apatinib Combined With Capecitabine in Therapy for Recurrent/Metastatic and Persistent Cervical Cancer After Radiochemotherapy. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Li F, Li J, Yin S, Mei F, Du Y, Hu L, Tian X, Hong W, Shan L, Liu M, Chen Y, Mao W, Mu J, Lu B. A Phase III Prospective Randomized Controlled Clinical Trial for the Efficacy and Safety of Neoadjuvant Chemotherapy Combined With Concurrent Chemoradiotherapy and Concurrent Chemoradiotherapy for Locally Advanced Cervical Cancer (Lump ≥4 cm). Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Zou Z, Xing P, Hao X, Zhang C, Ma K, Shan L, Song X, Li J. P45.15 Clinical Outcomes, Long-Term Survival and Toleration With Sequential Therapy of First-Line Crizotinib Followed by Alectinib in ALK+ NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Li J, Mao W, Li F, Ran L, Chang J, Mei F, Hu L, Du Y, Tian X, Shan L, Liu M, Chen Y, Mu J, Qin Y, Yin S, Liang N. PO-1306 apatinib plus capecitabine in patients of recurrent/metastatic and persistent cervical cancer. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07757-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Gu Y, Shan L, Liu B, Lv M, Chen X, Yan T, Shi Y, Chen J, Li Z, Zhang Y. Release Profile of Cardiac Troponin T and Risk Factors of Postoperative Myocardial Injury in Patients Undergoing CABG. Int J Gen Med 2021; 14:2541-2551. [PMID: 34163222 PMCID: PMC8214547 DOI: 10.2147/ijgm.s315691] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 05/27/2021] [Indexed: 11/23/2022] Open
Abstract
Background Cardiac troponin T (cTnT) is currently one of the important indicators for clinical diagnosis of myocardial injury, which is inevitable in cardiac surgery, especially coronary artery bypass grafting (CABG). Describing the release profile of cTnT and finding out the risk factors of postoperative myocardial injury (PMI) are of great significance. The purposes of this study are to explore the release profile of cTnT in patients undergoing CABG and to search for independent risk factors of PMI. Methods In this retrospective study, clinical data of CABG patients were collected. The cTnT was measured at 24 hours before and 6, 12, 24, 48, 72, 96 and 120 hours after operation separately. The release profiles and peak time of cTnT in total cohort and sub-cohorts were observed. Independent risk factors of PMI were explored via univariate and multivariate logistic regression analyses. Results In total, 2084 patients were enrolled, including 998 patients in a cTnT group and 1086 patients in a high-sensitive cTnT (hs-cTnT) group. PMI was recognized in 797 patients. In both groups, cTnT showed a trend of rising first and then falling within 120 hours after operation. The peak cTnT appeared within 12–24 hours after operation, while the peak hs-cTnT occurred mostly within 24–48 hours after operation. Univariate logistic analysis showed that body mass index (BMI), New York Heart Association (NYHA) classification, coronary artery disease (CAD) classification, cerebrovascular disease, left ventricular ejection fraction, number of diseased vessels, valvular disease, intra-aortic balloon pump (IABP) implantation, chronic obstructive pulmonary disease, pulmonary hypertension, previous percutaneous coronary intervention (PCI), BMI, bypass graft number, cardiopulmonary bypass, and preoperative cTnT were related risk factors. Multivariate logistic regression analysis showed that NYHA classification, CAD classification, valvular disease, IABP implantation, pulmonary hypertension, previous PCI, bypass graft number, cardiopulmonary bypass, and preoperative cTnT were independent risk factors of PMI. Conclusion NYHA classification, CAD classification, valvular disease, IABP implantation, pulmonary hypertension, previous PCI, bypass graft number, cardiopulmonary bypass, and preoperative cTnT are independent risk factors of PMI in patients undergoing CABG.
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Affiliation(s)
- Yuying Gu
- Department of Cardiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Lingtong Shan
- Department of Thoracic Surgery, Sheyang County People's Hospital, Yancheng, Jiangsu, People's Republic of China
| | - Ban Liu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Mengwei Lv
- Department of Cardiovascular Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Xi Chen
- Department of Cardiovascular Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Tao Yan
- Department of Cardiovascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Yu Shi
- Department of Cardiovascular Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Jiapeng Chen
- Xinglin College, Nantong University, Nantong, Jiangsu, People's Republic of China
| | - Zhi Li
- Department of Cardiovascular Surgery, Jiangsu Province Hospital, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China
| | - Yangyang Zhang
- Department of Cardiovascular Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
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Zou Z, Xing P, Hao X, Wang Y, Shan L, Zhang C, Song X, Ma K, Liu Z, Dong G, Li J. 154P Intracranial efficacy of alectinib in ALK-positive NSCLC patients with CNS metastases: A multicenter retrospective study. J Thorac Oncol 2021. [DOI: 10.1016/s1556-0864(21)01996-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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18
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Tharangani R, Yakun C, Zhao L, Ma L, Liu H, Su S, Shan L, Yang Z, Kononoff P, Weiss WP, Bu D. Corn silage quality index: An index combining milk yield, silage nutritional and fermentation parameters. Anim Feed Sci Technol 2021. [DOI: 10.1016/j.anifeedsci.2021.114817] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Li X, Shan L, Lv M, Li Z, Han C, Liu B, Ge W, Zhang Y. Predictive ability of EuroSCORE II integrating cardiactroponin T in patients undergoing OPCABG. BMC Cardiovasc Disord 2020; 20:463. [PMID: 33115418 PMCID: PMC7594339 DOI: 10.1186/s12872-020-01745-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 10/18/2020] [Indexed: 12/14/2022] Open
Abstract
Background Preoperative risk evaluation systems are significant and important to the allocation of medical resources and the communication between doctors and patients. The European System for Cardiac Operative Risk Evaluation II (EuroSCORE II) is widely used in clinical practice. Cardiac troponin T (cTnT) can specifically and accurately reflect myocardial injury. Whether EuroSCORE II can improve the predictive power after integrating with cTnT is still unclear. This study was a retrospective single center study designed to assess the predictive ability of EuroSCORE II integrated with cTnT for patients undergoing isolated off-pump coronary artery bypass grafting (OPCABG). Methods This retrospective and observational cohort study included 1887 patients who underwent first isolated OPCABG. cTnT was detected within 48 h before operation in each patient. According to myocardial injury, patients were divided by cTnT into 4 stages. A new risk evaluation system was created through logistic regression with EuroSCORE II and myocardial injury classification as covariates. Then the two risk evaluation systems were comparatively assessed by regression analysis, receiver operator characteristic curves, net reclassification index, Bland–Altman plots and decision curve analysis. Results There were 43 in-hospital deaths, with a mortality of 2.30% (43/1887). The logistic regression analysis showed that preoperative myocardial injury classification was a significant risk factor for in-hospital mortality in both total cohort (OR 1.491, 95%CI 1.049–2.119) and subsets (OR 1.761, 95%CI 1.102–2.814). The new risk evaluation system has higher calibration and discrimination power than EuroSCORE II, both for overall cohort and subsets. Especially, the new system has obvious advantages in discrimination power in the subset of acute myocardial infarction (AUC 0.813 vs. 0.772, 0.906 vs. 0.841, and 0.715 vs. 0.646, respectively). Conclusions Both myocardial injury classification and EuroSCORE II are independent risk factors of in-hospital mortality in OPCABG patients. The new risk evaluation system has higher predictive ability than EuroSCORE II, especially in patients with a recent history of AMI.
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Affiliation(s)
- Xiang Li
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, People's Republic of China
| | - Lingtong Shan
- Department of Thoracic Surgery, Sheyang County People's Hospital, Yancheng, Jiangsu, People's Republic of China.,Department of Thoracic Surgery, Yancheng Third People's Hospital, The Affiliated Yancheng Hospital of Southeast University Medical College, Yancheng, Jiangsu, People's Republic of China
| | - Mengwei Lv
- Shanghai East Hospital of Clinical Medical College, Nanjing Medical University, Shanghai, People's Republic of China.,Department of Cardiovascular Surgery, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Shanghai, 200120, People's Republic of China
| | - Zhi Li
- Department of Cardiovascular Surgery, Jiangsu Province Hospital, The First Affiliated Hospital With Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China
| | - Chunyan Han
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No.301 Central Yanchang Road, Shanghai, 200072, People's Republic of China
| | - Ban Liu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No.301 Central Yanchang Road, Shanghai, 200072, People's Republic of China.
| | - Wen Ge
- Department of Cardiothoracic Surgery, Shuguang Hospital, Affiliated to Shanghai University of TCM, Shanghai, People's Republic of China.
| | - Yangyang Zhang
- Department of Cardiovascular Surgery, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Shanghai, 200120, People's Republic of China.
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Xiao YX, Zhu XL, Bi R, Tu XY, Cheng YF, Chang B, Yu L, Huang D, Lu YM, Shan L, Yang WT. [Ovarian Sertoli-Leydig cell tumors: DICER1 hotspot mutations and associated clinicopathological features]. Zhonghua Bing Li Xue Za Zhi 2020; 49:441-447. [PMID: 32392927 DOI: 10.3760/cma.j.cn112151-20190826-00466] [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 DICER1 hotspot mutations in ovarian Sertoli-Leydig cell tumor (SLCT) and its associated clinicopathological features. Methods: Forty-three SLCTs and 40 other sex cord-stromal tumors (SCSTs) diagnosed between 2010 and 2017 at Fudan University Shanghai Cancer Center were examined for somatic DICER1 hotspot mutations by Sanger sequencing. The associations between mutation status and clinicopathological features, including patient age, tumor differentiation and recurrence, were analyzed. Results: Somatic DICER1 mutations were found in 51% (22/43) of SLCTs, while none in the other 40 SCSTs. The most common mutation of DICER1 was p.D1709N in exon 24 (41%, 9/22) and the second most common mutation of DICER1 was p.E1813K in exon 25 (14%, 3/22). A novel frameshift mutation (c.5464delG, p.M1837fs*16) was identified in one SLCT with microcystic pattern. Mutations were more likely to occur in patients under forty years of age (P=0.046), whereas no significant associations were found between DICER1 mutations and clinical symptoms, morphology or tumor recurrence. Conclusions: Somatic DCIER1 hotspot mutations are specifically found in SLCT and may serve as an ancillary marker in differential diagnosis of SLCT from other SCST. The mutations occur more often in young patients (<40 years old). Additional studies are warranted to examine the associations between DICER1 mutations and clinicopathological features and prognosis of SLCT.
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Affiliation(s)
- Y X Xiao
- Pathology Residency Training Program, Fudan University Shanghai Cancer Center, Shanghai 200032, China(Xiao Yaoxing is working on the Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai 200011, China)
| | - X L Zhu
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - R Bi
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - X Y Tu
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Y F Cheng
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - B Chang
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - L Yu
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - D Huang
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Y M Lu
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - L Shan
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - W T Yang
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
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Cruijsen H, Poitevin E, Brunelle SL, Almeida S, Braun U, Connelly M, Giuliani L, Huertas R, Hui S, Ikeuchi Y, Jaudzems G, Kimura S, Kittleson J, Larkin G, Li F, McMahon A, Nagatoshi M, Piccon I, Postma M, Rizzo A, Sadipiralla B, Shan L, Shinichi T, Silva F, Torres M, van Goethem S, vander Moolen H, Xindong G. Determination of Minerals and Trace Elements in Milk, Milk Products, Infant Formula, and Adult Nutrition: Collaborative Study 2011.14 Method Modification. J AOAC Int 2019. [DOI: 10.1093/jaoac/102.6.1845] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Official Method SM 2011.14/ISO 15151:2018/IDF 229:2018 uses microwave digestion of samples and inductively coupled plasma–atomic emission spectrometry for determination of nine elements, including Ca, Cu, Fe, K, Mg, Mn, Na, P, and Zn. The method was evaluated in a collaborative study of 25 products, including 13 fortified nutritional products (powders, ready-to-feed liquids, and liquid concentrates), five product placebos, six dairy products (liquids, powders, butter, and processed cheese), and the National Institute for Standards and Technology (NIST) Standard Reference Material (SRM) 1849a, in compliance with AOAC INTERNATIONAL Standard Method Performance Requirement (SMPR®) 2014.004. This study significantly expanded the applicability of Official Method 2011.14 beyond the original scope of chocolate milk powder, dietetic milk powder, infant cereal, peanut butter, and wheat gluten. The study included 14 collaborators from 11 countries, and results were compared to SMPR 2014.004. Accuracy of the method was demonstrated using NIST SRM 1849a, yielding recoveries across all laboratories of 98–101% for the nine elements. Precision for the 13 fortified nutritional product samples was 2.2–3.9% for repeatability (relative SD of repeatability) and 6.0–12.2% for reproducibility (RSDR). Excluding Mn, which was present at a wide range of concentrations, the reproducibility was 6.0–9.5%, meeting the performance requirements of SMPR 2014.004. Placebo samples (not fortified with Cu, Fe, Mn, or Zn) yielded acceptable repeatability of 1.8–2.9% for Ca, K, Mg, Na, and P (minerals) but 5.4–29.4% for the low levels of Cu, Fe, Mn, and Zn (trace elements). Reproducibility for the placebos showed the same pattern, with acceptable reproducibility (5.4–10.3%) for minerals but not for the low levels of the trace elements (13.2–82.8%). In the six dairy product samples, repeatability ranged from 1.6 to 3.6% for the minerals, Zn, and the low range of Mn but from 9.4 to 24.6% for Cu, Fe, and the high range of Mn, where concentrations were low as for the nutritional placebos. Reproducibility in the dairy samples was 5.3–8.8% for the minerals but 11.4–55.0% for the trace elements. The mean concentrations of Cu, Fe, and Zn in the dairy products were similar with those in the placebo products, while Zn was present at levels more similar with the fortified nutritional products. Thus, the method met the SMPR criteria except where the trace minerals were present at very low levels. Based on these results, the AOAC Stakeholder Panel for Infant Formula and Adult Nutritionals recommended Final Action status of the expanded applicability of the method. The method was adopted as Final Action by the AOAC Official Methods Board.
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Affiliation(s)
- Hans Cruijsen
- Friesland Campina, Laboratory and Quality Services, P. Stuyvesantweg 1, 8937 AC Leeuwarden, The Netherlands
| | - Eric Poitevin
- Nestlé Research Center, Vers-chez-les-Blanc, 1000 Lausanne 26, Switzerland
| | - Sharon L Brunelle
- Brunelle Biotech Consulting, 6620 NW Burgundy Dr, Corvallis, OR 97330
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Dirajlal-Fargo S, Shan L, Sattar A, Bowman E, Gabriel J, Kulkarni M, Funderburg N, Nazzinda R, Musiime V, McComsey GA. Insulin resistance and intestinal integrity in children with and without HIV infection in Uganda. HIV Med 2019; 21:119-127. [PMID: 31642582 DOI: 10.1111/hiv.12808] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 08/22/2019] [Accepted: 09/03/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVES The risk of cardiometabolic complications in children with perinatally acquired HIV infection (PHIVs) and in perinatally HIV-exposed but uninfected children (HEUs) and its relationship to systemic inflammation and markers of gut integrity are not well established. In this current study, we assed insulin resitance in PHIV compared to HEUs and HIV unexposed uninfected children and explored potential association with intestinal damage biomarkers. METHODS This was a cross-sectional study in PHIVs, HEUs and HIV-unexposed, uninfected children (HUUs) aged 2-10 years enrolled in Uganda. PHIVs were on stable antiretroviral therapy (ART) with HIV viral load < 400 HIV-1 RNA copies/mL. Insulin resistance was estimated using the homeostasis model assessment of insulin resistance (HOMA-IR). We measured markers of systemic inflammation, monocyte activation and gut integrity. Kruskal-Wallis tests were used to compare markers by HIV status; Pearson correlation and multiple linear regressions were used to assess associations of the HOMA-IR index with biomarkers of intestinal damage and translocation. RESULTS Overall, 172 participants were enrolled in the study (57 PHIVs, 59 HEUs and 56 HUUs). The median age was 7.8 [interquartile range (IQR) 6.39, 8.84] years, 55% were female and the median body mass index (BMI) was 15 (IQR 14.3, 15.8) kg/m2 . Among PHIVs, the median CD4% was 37%, and 93% had viral load ≤ 20 copies/mL. PHIVs had higher waist:hip ratio, high-density lipoprotein (HDL) cholesterol, triglycerides and HOMA-IR index than the other groups (P ≤ 0.02). Factors correlated with insulin resistance included higher BMI and HDL cholesterol and lower soluble tumour necrosis factor receptor I (sTNFRI) (P ≤ 0.02). There was no correlation between any of the other inflammatory or gut biomarkers and HOMA-IR index (P ≥ 0.05). After adjusting for age and sTNFRI, BMI remained independently associated with the HOMA-IR index (β = 0.16; P < 0.01). CONCLUSIONS Despite viral suppression, Ugandan PHIVs have disturbances in glucose metabolism. Higher BMI, and not immune activation or alteration of gut integrity, was associated with insulin resistance in this population.
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Affiliation(s)
- S Dirajlal-Fargo
- University Hospitals Cleveland Medical Center, Cleveland, OH, USA.,Rainbow Babies and Children's Hospital, Cleveland, OH, USA.,Case Western Reserve University, Cleveland, OH, USA
| | - L Shan
- Case Western Reserve University, Cleveland, OH, USA
| | - A Sattar
- Case Western Reserve University, Cleveland, OH, USA
| | - E Bowman
- Ohio State University School of Health and Rehabilitation Sciences, Columbus, OH, USA
| | - J Gabriel
- Ohio State University School of Health and Rehabilitation Sciences, Columbus, OH, USA
| | - M Kulkarni
- Ohio State University School of Health and Rehabilitation Sciences, Columbus, OH, USA
| | - N Funderburg
- Ohio State University School of Health and Rehabilitation Sciences, Columbus, OH, USA
| | - R Nazzinda
- Joint Clinical Research Centre, Makerere University, Kampala, Uganda
| | - V Musiime
- Joint Clinical Research Centre, Makerere University, Kampala, Uganda
| | - G A McComsey
- University Hospitals Cleveland Medical Center, Cleveland, OH, USA.,Rainbow Babies and Children's Hospital, Cleveland, OH, USA.,Case Western Reserve University, Cleveland, OH, USA
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Lu S, Chen G, Sun Y, Sun S, Chang J, Yao Y, Chen Z, Ye F, Lu J, Shi J, He J, Liu X, Zhang Y, Liu Z, Fang J, Cheng Y, Hu C, Mao W, Hu Y, Gong Y, Shan L, Yang Z, Song Y, Li W, Bai C, Wang B, Ma R, Zheng Z, Liu M, Jie Z, Cao L, Liao W, Pan H, Huang D, Chen Y, Yang J, Qin S, Ma S, Liang L, Liu Z, Zhou J, Tao M, Huang Y, Qiu F, Huang Y, Hua Y, Chen Y, Su W. MA14.05 A Randomized Phase III Trial of Fruquintinib Versus Placebo in Patients with Advanced Non-Small Cell Lung Cancer (FALUCA). J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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24
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Zheng S, Zhou S, Wang G, Shan L, Huang Z, Liu S, Chen C, Tao Y, Chang H, Ding S, Liao R, Chen C, Xia Y. Is Hepatitis B Viral Infection A Risk Factor for Epstein-Barr Virus-Associated Nasopharyngeal Carcinoma in the Intensity-Modulated Radiotherapy Era? Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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25
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Huang Z, Shan L, Zheng S, Wang G, Ding S, Tao Y, Chen C, Yang X, Liu S, Xia Y. The Prognostic Significance of PD-L1 and PD-1 Expression in Patients with Nasopharyngeal Carcinoma: A Systematic Review and Meta-Analysis. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Xing P, Wang Q, Ma D, Hao X, Wang M, Wang Y, Shan L, Xin T, Liang L, Liang H, Du Y, Zhang Z, Li J. P2.13-04 Outcomes of ALK-Positive Non-Small-Cell Lung Cancer (NSCLC) Patients Treated with Crizotinib: A Multicenter Cohort Retrospective Study. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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27
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Wang S, Xing P, Ma D, Wang Q, Hao X, Wang M, Wang Y, Shan L, Xin T, Liang L, Liang H, Du Y, Zhang Z, Li J. P3.01-103 Efficacy of Crizotinib in Chinese Non-Small Cell Lung Cancer Patients with Brain Metastasis: A Multicenter Retrospective Study. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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28
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Xing L, Wang J, Li L, Ma Z, Hu C, Zhang H, Shan L, Chen Z, Zhang J, Zhou Q, Gao S, Ma X, Sun P, Ren Q, Wu M, Wu J, Li J, Yao J, Ma H, Wang W, Yao W, Wang D, Kang J, Li G, Wang X, Zhu W, Wang J, Yu J. MA02.06 A Randomized, Double-Blind, Placebo-Controlled Trial of Chemotherapy Combined with Yangzheng Xiaoji in Advanced NSCLC. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Wang L, de Ángel Solá D, Mao Y, Bielecki P, Zhu Y, Sun Z, Shan L, Flavell RA, Bazzy-Asaad A, DeWan A. Family-based study reveals decreased abundance of sputum Granulicatella in asthmatics. Allergy 2018; 73:1918-1921. [PMID: 29862523 DOI: 10.1111/all.13493] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- L. Wang
- Division of Pulmonary and Critical Care Medicine; Department of Medicine; Washington University School of Medicine; St. Louis MO USA
- Department of Chronic Disease Epidemiology; Yale University School of Public Health; New Haven CT USA
| | - D. de Ángel Solá
- Department of Pediatrics; Section of Pulmonology, Allergy, Immunology and Sleep Medicine; Yale University School of Medicine; New Haven CT USA
| | - Y. Mao
- National Institute of Environmental Health; Chinese Center for Disease Control and Prevention; Beijing China
- Department of Environmental Health Sciences; Yale University School of Public Health; New Haven CT USA
| | - P. Bielecki
- Department of Immunobiology; Yale University School of Medicine; New Haven CT USA
| | - Y. Zhu
- Department of Environmental Health Sciences; Yale University School of Public Health; New Haven CT USA
| | - Z. Sun
- National Institute of Environmental Health; Chinese Center for Disease Control and Prevention; Beijing China
| | - L. Shan
- Division of Infectious Diseases; Department of Medicine; Washington University School of Medicine; St. Louis MO USA
| | - R. A. Flavell
- Department of Immunobiology; Yale University School of Medicine; New Haven CT USA
- Howard Hughes Medical Institute; Yale University; New Haven CT USA
| | - A. Bazzy-Asaad
- Department of Pediatrics; Section of Pulmonology, Allergy, Immunology and Sleep Medicine; Yale University School of Medicine; New Haven CT USA
| | - A. DeWan
- Department of Chronic Disease Epidemiology; Yale University School of Public Health; New Haven CT USA
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Dong HY, Wang B, Li HH, Shan L, Jia FY. [Correlation between serum 25-hydroxyvitamin D level and core symptoms of autism spectrum disorder in children]. Zhonghua Er Ke Za Zhi 2018; 55:916-919. [PMID: 29262471 DOI: 10.3760/cma.j.issn.0578-1310.2017.12.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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 explore the relationship between serum 25-hydroxyvitamin D levels and core symptoms of autism spectrum disorder (ASD) in children. Method: In this cross-sectional study, ASD children 4 to 6 years of age who were diagnosed in Department of Developmental and Behavioral Pediatrics, First Hospital of Jilin university from January to May 2017 were assigned to ASD group, and children for routine growth and development assessment in Jilin province were assigned to control group. The two groups were well matched for age and sex, and none of them had received vitamin D supplementation. Serum 25-hydroxyvitamin D levels were measured by HPLC-MS/MS method. The patients of the ASD group were assessed with autism behavior checklist (ABC), childhood autism rating scale (CARS), social response scale (SRS), and autism treatment evaluation checklist (ATEC). The levels of vitamin D were divided into normal(>0.03 ng/L), insufficient (0.01-0.03 ng/L) and deficient (<0.01 ng/L). Levels of serum vitamin D between the two groups were compared by two independent sample t-test, and the difference in the percentages of normal, insufficient and deficient levels of vitamin D was tested by chi-square test, and correlations between vitamin D levels and the total scores or subscales of ABC, CARS, SRS and ATEC were analyzed by Pearson correlation analysis. Result: The 87 subjects in the ASD group included 75 males and 12 females, with a mean (±SD) age of (4.7±0.7) years. The 301 subjects in the control group included 249 males and 52 females, with a mean (±SD) age of (4.8±0.8) years. Serum vitamin D level in ASD children was significantly lower than that of the control group ( (0.021±0.008) vs. (0.036±0.016) ng/L, t=-8.17, P<0.01), and the between-group percentage difference of normal, insufficient and deficient levels of vitamin D was statistically significant (12 (14%) vs. 186 (62%) , 67 (77%) vs. 113 (37%) , 8 (9%) vs. 2 (1%) , χ(2)=72.1, P<0.01). There were negative correlations between serum vitamin D level in ASD children and total ABC score or ABC subscale scores (body behavior, self-care, language and social interaction)(r=-0.531,-0.397,-0.283,-0.248,-0.262, P=0.000, 0.000, 0.007, 0.020, 0.014). There were negative correlations between serum vitamin D level in ASD children and total CARS score and CARS subscale scores (imitation, nonverbal communication and general impression) (r=-0.352, -0.216, -0.248, -0.216, P=0.001, 0.046, 0.021, 0.046). There were negative correlations between serum vitamin D level in ASD children and SRS behavior subscale or ATEC social interaction subscale (r=-0.536, P=0.005, r=-0.400, P=0.014). Conclusion: Serum 25-hydroxyvitamin D level in children with ASD is obviously lower than that in the healthy control group, and there are negative correlations between vitamin D levels and core symptoms of ASD. Trial registration Chinese Clinical Trial Registry, ChiCTR-CCC-13004498.
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Affiliation(s)
- H Y Dong
- Department of Developmental and Behavioral Pediatrics, First Hospital of Jilin University, Changchun 130021, China
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Shan L, Ge W, Pu Y, Cheng H, Cang Z, Zhang X, Li Q, Xu A, Wang Q, Gu C, Zhang Y. Assessment of three risk evaluation systems for patients aged ≥70 in East China: performance of SinoSCORE, EuroSCORE II and the STS risk evaluation system. PeerJ 2018; 6:e4413. [PMID: 29492345 PMCID: PMC5827670 DOI: 10.7717/peerj.4413] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 02/05/2018] [Indexed: 01/12/2023] Open
Abstract
Objectives To assess and compare the predictive ability of three risk evaluation systems (SinoSCORE, EuroSCORE II and the STS risk evaluation system) in patients aged ≥70, and who underwent coronary artery bypass grafting (CABG) in East China. Methods Three risk evaluation systems were applied to 1,946 consecutive patients who underwent isolated CABG from January 2004 to September 2016 in two hospitals. Patients were divided into two subsets according to their age: elderly group (age ≥70) with a younger group (age <70) used for comparison. The outcome of interest in this study was in-hospital mortality. The entire cohort and subsets of patients were analyzed. The calibration and discrimination in total and in subsets were assessed by the Hosmer-Lemeshow and the C statistics respectively. Results Institutional overall mortality was 2.52%. The expected mortality rates of SinoSCORE, EuroSCORE II and the STS risk evaluation system were 0.78(0.64)%, 1.43(1.14)% and 0.78(0.77)%, respectively. SinoSCORE achieved the best discrimination (the area under the receiver operating characteristic curve (AUC) = 0.829), followed by the STS risk evaluation system (AUC = 0.790) and EuroSCORE II (AUC = 0.769) in the entire cohort. In the elderly group, the observed mortality rate was 4.82% while it was 1.38% in the younger group. SinoSCORE (AUC = .829) also achieved the best discrimination in the elderly group, followed by the STS risk evaluation system (AUC = .730) and EuroSCORE II (AUC = 0.640) while all three risk evaluation systems all had good performances in the younger group. SinoSCORE, EuroSCORE II and the STS risk evaluation system all achieved positive calibrations in the entire cohort and subsets. Conclusion The performance of the three risk evaluation systems was not ideal in the entire cohort. In the elderly group, SinoSCORE appeared to achieve better predictive efficiency than EuroSCORE II and the STS risk evaluation system.
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Affiliation(s)
- Lingtong Shan
- The First Clinical Medical College, Nanjing Medical University, Nanjing, China
| | - Wen Ge
- Department of Cardiothoracic Surgery, Shuguang Hospital affiliated to Shanghai University of TCM, Shanghai, China
| | - Yiwei Pu
- The First Clinical Medical College, Nanjing Medical University, Nanjing, China
| | - Hong Cheng
- Department of Neurology, Jiangsu Province People's Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Zhengqiang Cang
- The First Clinical Medical College, Nanjing Medical University, Nanjing, China
| | - Xing Zhang
- The First Clinical Medical College, Nanjing Medical University, Nanjing, China
| | - Qifan Li
- The First Clinical Medical College, Nanjing Medical University, Nanjing, China
| | - Anyang Xu
- Department of Chronic and Noncommunicable Disease, Shanghai Changning District Center for Disease Control and Prevention, Shanghai, China
| | - Qi Wang
- The First Clinical Medical College, Nanjing Medical University, Nanjing, China
| | - Chang Gu
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai JiaoTong University, Shanghai, China
| | - Yangyang Zhang
- Key Laboratory of Arrhythmias of the Ministry of Education of China, East Hospital, Tongji University School of Medicine, Shanghai, China.,Department of Cardiovascular Surgery, East Hospital, Tongji University School of Medicine, Shanghai, China.,Department of Thoracic and Cardiovascular Surgery, Jiangsu Province People's Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Deng M, Shan L, Tang M, Wang C, Xia L, Zhou B. P861Cardiodynamicsgram, a new spatiotemporal electrocardiographic method for detecting abnormal dynamics of cardiac repolarization during stable coronary artery disease. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Liu B, Gu C, Wang Y, Wang X, Ge W, Shan L, Wei Y, Xu X, Zhang Y. Feasibility and efficacy of simultaneous off-pump coronary artery bypass grafting and esophagectomy in elderly patients. Oncotarget 2017; 8:46498-46505. [PMID: 28148891 PMCID: PMC5542285 DOI: 10.18632/oncotarget.14824] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 01/17/2017] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION To analyze the outcomes of off-pump coronary artery bypass grafting (OPCABG) and esophagectomy simultaneously for patients with coronary artery disease (CAD) and coexisting esophageal cancer. METHODS Twenty-two patients with CAD and coexisting esophageal cancer underwent combined surgical interventions were subjected to the study. OPCABG was performed first, followed by esophagectomy. All the corresponding data including clinicopathological characteristics and postoperative outcomes were all investigated. RESULTS All the combined procedures were performed successfully. The average number of grafts was 2.36. Tumors were located at the middle third of the esophagus in 5 patients, at the lower third of the esophagus in 8 patients, at the esophageal gastric junction (EGJ) in 9 patients, respectively. The operations were carried out through a left lateral thoracotomy approach in 21 patients while a median sternotomy and left lateral thoracotomy approach was used in 1 patient for his condition rapidly worsened. Postoperatively, pneumonia occurred in 4 patients (18.2%). During the follow-up, three patients died of cancer metastasis /recurrence (6, 18, 37 months) and one died of pneumonia (1 month). The cumulative 5 years survival rate is 52.9%. CONCLUSIONS The combined procedure of OPCABG and esophagectomy is a safe and effective treatment option for patients with severe CAD and esophageal cancer.
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Affiliation(s)
- Ban Liu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Chang Gu
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yuliang Wang
- School of Public Health, Nanjing Medical University, Nanjing, China
| | - Xiaowei Wang
- Department of Cardiovascular Surgery, The First Affiliated Hospital with Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Wen Ge
- Department of Cardiovascular Surgery, Shuguang Hospital, Affiliated to Shanghai University of TCM, Shanghai, China
| | - Lingtong Shan
- The First Clinical Medical College of Nanjing Medical University, Nanjing, China
| | - Yujian Wei
- The First Clinical Medical College of Nanjing Medical University, Nanjing, China
| | - Xiaohan Xu
- Department of Cardiovascular Surgery, The First Affiliated Hospital with Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Yangyang Zhang
- Department of Cardiovascular Surgery, East Hospital, Tongji University School of Medicine, Shanghai, China
- Key Laboratory of Arrhythmias of the Ministry of Education of China, East Hospital, Tongji University School of Medicine, Shanghai, China
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Deng M, Shan L, Tang M, Wang C, Zhou B. P1048Detecting abnormal dynamics of cardiac repolarization during ischemia from surface electrocardiogram by cardiodynamicsgram-based method. Europace 2017. [DOI: 10.1093/ehjci/eux151.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Zhu Y, Xing P, Shan L, Chen S, Hao X, Li J. A retrospective study in Chinese patients: Is there a role of nanoparticle albumin bound paclitaxel in advanced NSCLC? Ann Oncol 2017. [DOI: 10.1093/annonc/mdx091.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Le AW, Wang ZH, Shan L, Dai XY, Xiao TH, Li XR. Clinical analysis of 95 cases with ovarian pregnancy. CLIN EXP OBSTET GYN 2016. [DOI: 10.12891/ceog3110.2016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Le A, Wang Z, Shan L, Xiao T, Luo G, Shen Y. Analysis of rectal injuries resulting from laparoscopic peritoneal vaginoplasty (Luohu operation). CLIN EXP OBSTET GYN 2016. [DOI: 10.12891/ceog2117.2016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Le A, Wang Z, Shan L, Xiao T, Luo G, Shen Y. Analysis of rectal injuries resulting from laparoscopic peritoneal vaginoplasty (Luohu operation). CLIN EXP OBSTET GYN 2016; 43:250-253. [PMID: 27132421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To explore the causes of rectal injuries during laparoscopic peritoneal vaginoplasty (Luohu operation) and assess measures that can be taken to increase safety of the operation. MATERIALS AND METHODS Data of patients with rectal injuries that occurred during Luohu vaginoplasty were analyzed retrospectively. RESULTS Three hundred and six patients received Luohu vaginoplasty. Rectal injuries occurred in 13 patients (4.2%). All patients recovered after intraoperative repair or postoperative rectovaginal fistula repair, performed within three to six months. Full display of the anatomical structures at the bottom of the pelvic cavity and successful construction of the vaginal tunnel are the two most important requirements for reducing the risk of rectal injury in laparoscopic vaginoplasty. In repair of fistulae postoperatively, it is important that resection of tissues or scars around the fistulae be avoided in order to reduce the chance of a injuries caused by diverting colostomy or colostomy closure. CONCLUSION Laparoscopic vaginoplasty is a generally safe procedure, but rectal injury can occur. Retaining the tissues or scars around the rectovaginal fistula can be successfully repaired, either when they are recognized during the operation or within a few months postoperatively.
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Le AW, Wang ZH, Shan L, Dai XY, Xiao TH, Li XR. Clinical analysis of 95 cases with ovarian pregnancy. CLIN EXP OBSTET GYN 2016; 43:871-874. [PMID: 29944241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Ovarian pregnancy (OP) is a rare ectopic pregnancy, in which it is very difficult to achieve preoperative diagnosis. Ovarian blood supply in OP increases which will lead to intra-abdominal bleeding, hazarding women's lives. Surgical exploration should be conducted once cases of OP are suspected. OBJECTIVE To investigate clinical characteristics, diagnosis, and therapy of OP. MATERIALS AND METHODS A retrospective study was conducted in 95 patients with OP admitted to the present hospital from January 2005 to June 2014. RESULTS OP accounted for 1.79% of ectopic pregnancy over the same period, of which 68.4% had a history of artificial abortion, 6.3% was treated with intrauterine contraceptive device (IUD), 87.4% had abdominal pain, 84.2% had a history of menopause, and 51.6% had vaginal bleeding. All patients had no preoperative diagnosis and underwent laparoscopic wedge resection of ovary or lesionectomy and were all were cured. CONCLUSION Since the cause of OP is still unknown and it has no typical clinical manifestations, the present authors adopt blood P-hCG combined with B-ultrasound to improve the preoperative diagnosis. They prefer laparoscopic wedge resection of ovary or lesionectomy, which induce higher rate of intrauterine pregnancy and lower rates of ectopic pregnancy and infertility in re-pregnancy after surgery.
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Fan H, Tang HB, Kang J, Shan L, Song H, Zhu K, Wang J, Ju G, Wang YZ. Involvement of endoplasmic reticulum stress in the necroptosis of microglia/macrophages after spinal cord injury. Neuroscience 2015; 311:362-73. [PMID: 26523978 DOI: 10.1016/j.neuroscience.2015.10.049] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [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: 05/28/2015] [Revised: 10/22/2015] [Accepted: 10/24/2015] [Indexed: 12/11/2022]
Abstract
Microglia/macrophages play a crucial role in inflammation after spinal cord injury (SCI). Although extensive studies have been performed on the mechanisms of microglia/macrophage activation and recruitment, how microglia/macrophages are eliminated remains unclear. In the present study, we observed a high-level expression of mixed lineage kinase domain-like protein (MLKL), a key molecule in the execution of necroptosis, in microglia/macrophages after SCI in mice. In vivo PI-labeling and Necrostatin-1 treatment confirmed the necroptosis of microglia/macrophages. Interestingly, our electronic microscopic (EM) study revealed that MLKL localized not only at the membrane but also on the endoplasmic reticulum (ER) of necroptotic microglia/macrophages. Furthermore, receptor-interacting protein 3 (RIP3), another necrosome component, was also found on the ER of necroptotic microglia/macrophages. And Glucose-regulated protein 78 (GRP78), an ER stress sensor, was up-regulated in MLKL-positive microglia/macrophages after SCI, suggesting a possible link between necroptosis and ER stress. In vitro, oxygen-glucose deprivation (OGD) stress induced ER stress and necroptosis in microglia. Inhibiting ER stress by 4-phenylbutyrate (4-PBA) significantly blocked the OGD-induced necroptosis of microglia. In the end, our data showed that, GRP78 and phosphorylated MLKL were co-expressed by the microglia/macrophages in the injured human spinal cord. Taken together, these results suggested that microglia/macrophages undergo an ER-stress involved necroptosis after SCI, implying that ER stress and necroptosis could be manipulated for modulating inflammation post-SCI.
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Affiliation(s)
- H Fan
- Department of Neurobiology and Collaborative Innovation Center for Brain Science, Institute of Neurosciences, Fourth Military Medical University, 169 Chang Le Xi Road, Xi'an 710032, China
| | - H-B Tang
- Department of Clinical Laboratory Medicine, Xijing Hospital, Fourth Military Medical University, 127 Chang Le Xi Road, Xi'an 710003, China
| | - J Kang
- Department of Neurobiology and Collaborative Innovation Center for Brain Science, Institute of Neurosciences, Fourth Military Medical University, 169 Chang Le Xi Road, Xi'an 710032, China
| | - L Shan
- Department of Orthopedics, Tangdu Hospital, Fourth Military Medical University, Xin Si Road, Xi'an, Shaanxi 710038, China
| | - H Song
- Department of Occupational and Environmental Health, School of Public Health, Fourth Military Medical University, Xi'an 710032, China
| | - K Zhu
- Zhejiang University China Brain Bank, Department of Pathology and Pathophysiology, Department of Neuroscience, 866 Yu-Hang-Tang Road, Zhejiang University Zi-Jin-Gang Campus, Hangzhou, Zhejiang 310058, China
| | - J Wang
- Department of Neurobiology and Collaborative Innovation Center for Brain Science, Institute of Neurosciences, Fourth Military Medical University, 169 Chang Le Xi Road, Xi'an 710032, China
| | - G Ju
- Department of Neurobiology and Collaborative Innovation Center for Brain Science, Institute of Neurosciences, Fourth Military Medical University, 169 Chang Le Xi Road, Xi'an 710032, China.
| | - Y-Z Wang
- Department of Neurobiology and Collaborative Innovation Center for Brain Science, Institute of Neurosciences, Fourth Military Medical University, 169 Chang Le Xi Road, Xi'an 710032, China.
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Hua Y, Azeem W, Shan L, Marvyin K, Zhang S, Qu Y, Olsen J, Hellem M, øyan A, Zhang W, Ke X. 2553 Development of a small molecule for treatment of castration resistant prostate cancer via androgen receptor and IL6/STAT3 pathways. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31372-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Le A, Shan L, Xiao T, Zhuo R, Wang Z. Removal of an incarcerated intrauterine device in the sigmoid colon under the assistance of hysteroscope and laparoscope: a case report. CLIN EXP OBSTET GYN 2015. [DOI: 10.12891/ceog1887.2015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Le A, Shan L, Wang Z, Dai X, Xiao T, Zuo R. Effects of icariin on the expression of ER, VEGF, and KDR in the endometrial cells of thin endometrium. Genet Mol Res 2015; 14:11250-8. [DOI: 10.4238/2015.september.22.19] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Le A, Shan L, Xiao T, Zhuo R, Wang Z. Removal of an incarcerated intrauterine device in the sigmoid colon under the assistance of hysteroscope and laparoscope: a case report. CLIN EXP OBSTET GYN 2015; 42:531-534. [PMID: 26411227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND/AIMS To explore the value of hysteroscope and laparoscope in removing an incarcerated or ectopic intrauterine device (IUD). MATERIALS AND METHODS A 33-year-old woman was admitted to the present hospital on May 22nd, 2013. An incarcerated IUD was proven by ultrasonography. An IUD had been implanted in October 2011. Clinical case report of an incarcerated IUD in the sigmoid colon. RESULTS An IUD was successfully removed with the assistance of hysteroscope and laparoscope. CONCLUSION Ultrasonography should be performed in the follow-up of the patients after IUD implantation. Ectopic or incarcerated IUD can be successfully removed with the assistance of hysteroscope and laparoscope with minimal trauma.
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Le A, Shan L, Wang Z, Dai X, Xiao T, Shen Y. Transvaginal repair of rectovaginal fistula by filling with bulbocavernosus fat pad and retaining scar tissue. CLIN EXP OBSTET GYN 2014. [DOI: 10.12891/ceog17242014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Chen T, Xiong J, Yang C, Shan L, Tan G, Yu L, Tan Y. Silencing of FOXM1 transcription factor expression by adenovirus-mediated RNA interference inhibits human hepatocellular carcinoma growth. Cancer Gene Ther 2014; 21:133-8. [DOI: 10.1038/cgt.2014.8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Revised: 01/21/2014] [Accepted: 01/22/2014] [Indexed: 01/20/2023]
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Le A, Shan L, Wang Z, Dai X, Xiao T, Shen Y. Transvaginal repair of rectovaginal fistula by filling with bulbocavernosus fat pad and retaining scar tissue. CLIN EXP OBSTET GYN 2014; 41:587-589. [PMID: 25864267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The authors performed transvaginal repair of rectovaginal fistual (RVF) with bulbocavernosus fat pad by incising left side of the labia majora and retained scar tissues which were formed after three months for one patient. Repair of the RVF was successful and the patient had normal diet and defecation at a week after surgery. Previous gynecological surgery performed on the patient resulted in RVF accompanied by weak rectal tissues. Retaining the tissues and scars surrounding to the fistula and filling the fistula with bulbocavernosus fat pad tissue increased rectal wall thickness and facilitated healing. The efficacy of this surgical technique will need further studies with larger patient cohorts to establish a clear success rate.
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Wilson M, Belle C, Dang A, Hannan P, Kellogg L, Kenyon C, Low H, Mochizuki A, Nguyen A, Sheade N, Shan L, Shum A, Stayton T, Volz C, Vosburgh B, Wellman H, Woolley M. A preliminary phylogenetic analysis of <i>Pleurothallis sensu lato</i> based upon nuclear and plastid sequences. Lankesteriana 2013. [DOI: 10.15517/lank.v0i0.11568] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Ying J, Guo L, Qiu T, Shan L, Ling Y, Liu X, Lu N. Diagnostic value of a novel fully automated immunochemistry assay for detection of ALK rearrangement in primary lung adenocarcinoma. Ann Oncol 2013; 24:2589-2593. [PMID: 23904459 DOI: 10.1093/annonc/mdt295] [Citation(s) in RCA: 108] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND To evaluate the diagnostic value of a novel fully automated immunohistochemistry (IHC) assay for detection of anaplastic lymphoma kinase (ALK) fusion in a large number of ALK-positive lung adenocarcinoma (ADC) patients. PATIENTS AND METHODS We tested 196 lung ADCs for ALK rearrangement by two IHC assays (Ventana pre-diluted ALK D5F3 antibody with the Optiview DAB IHC detection kit and Optiview Amplification kit, D5F3 by Cell Signaling Technology (CST) with Ultraview DAB detection kit by Ventana), fluorescence in situ hybridization (FISH) and real-time reverse transcription-PCR (RT-PCR). CST ALK IHC was scored using the scoring scheme of 0, no staining; 1+, faint; 2+, moderate; and 3+, strong cytoplasmic reactivity in ≥ 10% of tumor cells. As for Ventana IHC, a binary scoring system (positive or negative for ALK status) was adopted for evaluating the staining results. RESULTS Among 196 cases tested, 63 (32%), 65 (33%), 70 (36%), and 69 (35%) cases were ALK positive by FISH, Ventana IHC, CST IHC, and RT-PCR, respectively. The sensitivity and specificity of Ventana IHC were 100% and 98%, respectively. Two Ventana IHC-positive cases, which were also CST IHC score of 3+, showed FISH negative, but their ALK rearrangement was confirmed by RT-PCR and direct sequencing. The sensitivity and specificity of CST IHC with staining intensity score of 1+ or more were 100% and 95%, respectively. Five (25%, of 20) patients with CST IHC score of 1+ were both FISH and RT-PCR negative. The sensitivity and specificity of RT-PCR for detection of ALK fusion were 98% and 95%, respectively. The total accordance rate between ALK RT-PCR and Ventana IHC was 97%. CONCLUSIONS The novel fully automated IHC assay is a reliable screening tool in routine pathologic laboratories for identification of patients with ALK rearrangement for targeted therapy in lung ADC.
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Affiliation(s)
- J Ying
- Department of Pathology, Cancer Institute and Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
| | - L Guo
- Department of Pathology, Cancer Institute and Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - T Qiu
- Department of Pathology, Cancer Institute and Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - L Shan
- Department of Pathology, Cancer Institute and Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Y Ling
- Department of Pathology, Cancer Institute and Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - X Liu
- Department of Pathology, Cancer Institute and Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - N Lu
- Department of Pathology, Cancer Institute and Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
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Shan L, Li X, Liu L, Ding X, Wang Q, Zheng Y, Duan Y, Xuan C, Wang Y, Yang F, Shang Y, Shi L. GATA3 cooperates with PARP1 to regulate CCND1 transcription through modulating histone H1 incorporation. Oncogene 2013; 33:3205-16. [DOI: 10.1038/onc.2013.270] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2012] [Revised: 04/14/2013] [Accepted: 05/09/2013] [Indexed: 12/18/2022]
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