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Du J, Zhai Y, Dong W, Che B, Miao M, Peng Y, Ju Z, Xu T, He J, Zhang Y, Zhong C. One-Year Disability Trajectories and Long-Term Cardiovascular Events, Recurrent Stroke, and Mortality After Ischemic Stroke. J Am Heart Assoc 2024; 13:e030702. [PMID: 38240201 PMCID: PMC11056157 DOI: 10.1161/jaha.123.030702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 12/19/2023] [Indexed: 02/07/2024]
Abstract
BACKGROUND Patients with stroke are often affected by varying degrees of functional disability and have different evolution patterns in functional disability. However, little is known about the predictive usefulness of disability changes after stroke. We aimed to describe 1-year disability trajectories and to assess the associations of longitudinal disability trajectories with 24-month clinical outcomes after ischemic stroke. METHODS AND RESULTS A total of 3533 patients with ischemic stroke from CATIS (China Antihypertensive Trial in Acute Ischemic Stroke) were studied. Distinct trajectories of disability were identified by the group-based trajectory model, as measured by modified Rankin Scale score within 12 months. Cox proportional hazards regression models were used to examine the associations of disability trajectories with 24-month cardiovascular events and all-cause mortality. We identified 4 distinct disability trajectories: no significant disability (562 participants [15.9%]), slight disability to recovery (1575 participants [44.6%]), severe to moderate disability (1087 participants [30.8%]), and persistent severe disability (309 participants [8.7%]). Compared with no significant disability trajectory, the multivariable adjusted hazard ratios (95% CIs) of patients within the persistent heavy-severe trajectory were 2.63 (1.20-5.76) for cardiovascular events, 2.55 (1.12-5.79) for recurrent stroke, and 6.10 (2.22-16.72) for all-cause mortality; notably, the hazard ratios (95% CIs) for patients within the severe to moderate disability trajectory were 1.99 (1.01-3.94) for cardiovascular events and 1.85 (1.03-3.33) for the composite outcome of cardiovascular events and all-cause mortality. CONCLUSIONS Functional disability trajectories within 12 months after stroke onset were associated with the risk of 24-month adverse outcomes. Patients with persistent severe disability or severe to moderate disability had higher risk of cardiovascular events and all-cause mortality. REGISTRATION URL: https://www.clinicaltrials.gov; Unique identifier: NCT01840072.
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Affiliation(s)
- Jigang Du
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and ImmunologySuzhou Medical College of Soochow UniversitySuzhouChina
- Department of Medical ManagementGansu Provincial HospitalLanzhouChina
| | - Yujia Zhai
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and ImmunologySuzhou Medical College of Soochow UniversitySuzhouChina
| | - Wenjing Dong
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and ImmunologySuzhou Medical College of Soochow UniversitySuzhouChina
| | - Bizhong Che
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and ImmunologySuzhou Medical College of Soochow UniversitySuzhouChina
| | - Mengyuan Miao
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and ImmunologySuzhou Medical College of Soochow UniversitySuzhouChina
| | - Yanbo Peng
- Department of NeurologyAffiliated Hospital of North China University of Science and TechnologyTangshanHebeiChina
| | - Zhong Ju
- Department of NeurologyKerqin District First People’s Hospital of Tongliao CityTongliaoChina
| | - Tan Xu
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and ImmunologySuzhou Medical College of Soochow UniversitySuzhouChina
| | - Jiang He
- Department of EpidemiologyTulane University School of Public Health and Tropical MedicineNew OrleansLAUSA
| | - Yonghong Zhang
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and ImmunologySuzhou Medical College of Soochow UniversitySuzhouChina
| | - Chongke Zhong
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and ImmunologySuzhou Medical College of Soochow UniversitySuzhouChina
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Xia J, Zhao Y, Wu XJ, Qiu HY, Tang XW, Wang Y, Jin ZM, Miao M, Ma X, Wu DP, Chen SN, Chen F. [Clinical observation on 16 cases of DEK-NUP214 fusion gene positive acute myeloid leukemia treated with allogeneic hematopoietic stem cell transplantation]. Zhonghua Xue Ye Xue Za Zhi 2023; 44:1041-1044. [PMID: 38503531 PMCID: PMC10834877 DOI: 10.3760/cma.j.issn.0253-2727.2023.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Indexed: 03/21/2024]
Affiliation(s)
- J Xia
- Department of Hematology, the First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215000, China Department of Hematology, Soochow Hopes Hematology Hospital, Suzhou 215000, China
| | - Y Zhao
- Department of Hematology, the First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215000, China Department of Hematology, Soochow Hopes Hematology Hospital, Suzhou 215000, China
| | - X J Wu
- Department of Hematology, the First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215000, China Department of Hematology, Soochow Hopes Hematology Hospital, Suzhou 215000, China
| | - H Y Qiu
- Department of Hematology, the First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215000, China
| | - X W Tang
- Department of Hematology, the First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215000, China
| | - Y Wang
- Department of Hematology, the First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215000, China
| | - Z M Jin
- Department of Hematology, the First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215000, China
| | - M Miao
- Department of Hematology, the First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215000, China
| | - X Ma
- Department of Hematology, the First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215000, China Department of Hematology, Soochow Hopes Hematology Hospital, Suzhou 215000, China
| | - D P Wu
- Department of Hematology, the First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215000, China
| | - S N Chen
- Department of Hematology, the First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215000, China
| | - F Chen
- Department of Hematology, the First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215000, China Department of Hematology, Soochow Hopes Hematology Hospital, Suzhou 215000, China
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Dong W, Zhong X, Yuan K, Miao M, Zhai Y, Che B, Xu T, Xu X, Zhong C. Lipoprotein(a) and functional outcome of acute ischemic stroke when discordant with low-density lipoprotein cholesterol. Postgrad Med J 2023; 99:1160-1166. [PMID: 37624118 DOI: 10.1093/postmj/qgad070] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/23/2023] [Accepted: 07/28/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND Several studies have indicated that residual cardiovascular risk might be associated with elevated lipoprotein(a) [Lp(a)] even in the setting of controlled low-density lipoprotein cholesterol (LDL-C). We aimed to prospectively examine the association between Lp(a) and unfavorable functional outcome among patients with acute ischemic stroke when Lp(a) and LDL-C were discordant. METHODS Based on samples from the Infectious Factors, Inflammatory Markers and Prognosis of Acute Ischemic Stroke study, 973 patients with baseline plasma Lp(a) levels were included. The primary outcome was the composite outcome of death or major disability (modified Rankin Scale score of 3-6) at 6 months. Logistic regression models were used to estimate the risk for the primary outcome. Discordance analyses were performed, using difference in percentile units (>10 units), to detect the relative risk when Lp(a) and LDL-C were discordant. RESULTS In total, 201 (20.7%) participants experienced major disability or death at 6 months. The multivariable-adjusted odds ratio (OR) for the highest quartile was 1.88 [95% confidence interval (CI): 1.16-3.04] compared with the lowest quartile. Each 1-SD higher log-Lp(a) was associated with a 23% increased risk (95% CI: 2%-47%) for the primary outcome. Compared with the concordant group, the high Lp(a)/low LDL-C discordant group was associated with increased risk for the primary outcome (adjusted OR: 1.59, 95% CI: 1.01-2.52). CONCLUSIONS Elevated plasma Lp(a) levels were associated with increased risk of major disability and death at 6 months. Discordantly high Lp(a)/low LDL-C was associated with an unfavorable functional outcome, supporting the predictive potential of plasma Lp(a) after ischemic stroke, especially when discordant with LDL-C. Key messages What is already known on this topic Previous studies have indicated that a positive association between increased lipoprotein(a) [Lp(a)] and cardiovascular disease risk remained even in patients who achieved controlled low-density lipoprotein cholesterol (LDL-C) levels. The findings of studies exploring the association between Lp(a) and unfavorable clinical outcomes of stroke were inconsistent, and whether Lp(a) can predict the risk of unfavorable functional outcome in stroke patients when Lp(a) and LDL-C levels are discordant remains unknown. What this study adds Elevated plasma Lp(a) levels were associated with increased risk of major disability and death at 6 months beyond LDL-C levels in acute ischemic stroke patients. How this study might affect research, practice, or policy The combination of LDL-C-lowering therapies and Lp(a)-lowering therapies may have better clinical efficacy for patients with ischemic stroke, and it is of great clinical interest to further explore this possibility in dedicated randomized trials.
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Affiliation(s)
- Wenjing Dong
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, Suzhou, 215123, China
| | - Xiaoyan Zhong
- School of Public Health, Suzhou Medical College of Soochow University, Suzhou, 215123, China
| | - Ke Yuan
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, Suzhou, 215123, China
| | - Mengyuan Miao
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, Suzhou, 215123, China
| | - Yujia Zhai
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, Suzhou, 215123, China
| | - Bizhong Che
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, Suzhou, 215123, China
| | - Tan Xu
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, Suzhou, 215123, China
| | - Xiang Xu
- Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Chongke Zhong
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, Suzhou, 215123, China
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You S, Chen H, Miao M, Du J, Che B, Xu T, Liu CF, Zhang Y, He J, Zhong X, Cao Y, Zhong C. Prognostic significance of plasma SDF-1 in acute ischemic stroke patients with diabetes mellitus: the CATIS trial. Cardiovasc Diabetol 2023; 22:274. [PMID: 37817149 PMCID: PMC10566135 DOI: 10.1186/s12933-023-01996-0] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 09/18/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Evidence on the associations between baseline stromal cell-derived factor (SDF)-1 and clinical outcomes in acute ischemic stroke patients is lacking. The present study aimed to examine the relationship between plasma SDF-1 levels and clinical outcomes based on a large multicenter study of the China Antihypertensive Trial in Acute Ischemic Stroke (CATIS). METHODS Secondary analysis was conducted among 3,255 participants from the CATIS trial with a baseline measurement of plasma SDF-1 levels. We evaluated the associations between plasma SDF-1 levels and one-year recurrent stroke, cardiovascular events, and all-cause mortality using Cox regression models. We further investigated the prognostic effect of SDF-1 on clinical outcomes in patients with different characteristics. RESULTS Higher plasma SDF-1 levels were not associated with recurrent stroke, cardiovascular events, and all-cause mortality at one-year after ischemic stroke (all P trend ≥ 0.05). There were significant interactions between plasma SDF-1 levels and history of diabetes mellitus on recurrent stroke (P = 0.005), cardiovascular events (P = 0.007) and all-cause mortality (P = 0.04) at one year. In patients with diabetes mellitus, plasma SDF-1 was significantly associated with an increased risk of recurrent stroke and cardiovascular events after adjustment for confounders. For example, 1-SD higher log-SDF-1 was associated with a hazard ratio (95% confidence interval) of 1.65 (1.18-2.32) for recurrent stroke and 1.47 (1.08-1.99) for the cardiovascular events, but not all-cause mortality 1.36 (0.96-1.93) at one year. However, there were no associations between plasma SDF-1 and clinical outcomes in patients without diabetes mellitus (all P > 0.05). The addition of plasma SDF-1 to the conventional risk factors model significantly improved the risk prediction of all outcomes. Similarly, findings between elevated SDF-1 levels and two-year outcomes were found only in patients with diabetes mellitus. CONCLUSIONS Elevated plasma SDF-1 was significantly associated with an increased risk of recurrent stroke and cardiovascular events only in ischemic patients with diabetes mellitus.
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Affiliation(s)
- Shoujiang You
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, No.1055, Sanxiang Road, Suzhou, 215004, China
| | - Hongyu Chen
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, 215123, China
| | - Mengyuan Miao
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, 215123, China
| | - Jigang Du
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, 215123, China
| | - Bizhong Che
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, 215123, China
| | - Tan Xu
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, 215123, China
| | - Chun-Feng Liu
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, No.1055, Sanxiang Road, Suzhou, 215004, China
- Institutes of Neuroscience, Soochow University, Suzhou, 215123, China
| | - Yonghong Zhang
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, 215123, China
| | - Jiang He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Xiaoyan Zhong
- School of Public Health, Suzhou Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, Jiangsu, 215123, China.
| | - Yongjun Cao
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, No.1055, Sanxiang Road, Suzhou, 215004, China.
- Institutes of Neuroscience, Soochow University, Suzhou, 215123, China.
| | - Chongke Zhong
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, 215123, China.
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Du J, Wang Y, Che B, Miao M, Bao A, Peng Y, Ju Z, Xu T, He J, Zhang Y, Zhong C. The relationship between neurological function trajectory, assessed by repeated NIHSS measurement, and long-term cardiovascular events, recurrent stroke, and mortality after ischemic stroke. Int J Stroke 2023; 18:1005-1014. [PMID: 37226318 DOI: 10.1177/17474930231180446] [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: 05/26/2023]
Abstract
BACKGROUND Clinically significant changes in neurological deficits frequently occur after stroke onset, reflecting further neurological injury or neurological improvement. However, the National Institutes of Health Stroke Scale (NIHSS) score is only evaluated once in most studies, usually at stroke onset. Utilizing repeated measures of NIHSS scores to identify different trajectories of neurological function may be more informative and provide more useful predictive information. We determined the association of neurological function trajectories with long-term clinical outcomes after ischemic stroke. METHODS A total of 4025 participants with ischemic stroke from the China Antihypertensive Trial in Acute Ischemic Stroke were included. Patients were recruited from 26 hospitals across China between August 2009 and May 2013. A group-based trajectory model was used to identify distinct neurological function trajectories, as measured by NIHSS at admission, 14 days or hospital discharge, and 3 months. Study outcomes were cardiovascular events, recurrent stroke, and all-cause mortality during 3-24 months after ischemic stroke onset. Cox proportional hazards models were used to examine the associations of neurological function trajectories with outcomes. RESULTS We identified three distinct subgroups of NIHSS trajectories: persistent severe (persistent high NIHSS scores during the 3-month follow-up), moderate (NIHSS scores started at around 5 and gradually reduced), and mild (NIHSS scores always below 2). The three trajectory groups had different clinical profiles and different risk of stroke outcomes at 24-month follow-up. Compared to the mild trajectory group, patients in the persistent severe trajectory group had a higher risk of cardiovascular events (multivariable-adjusted hazard ratios (95% confidence intervals) = 1.77 (1.10-2.86)), recurrent stroke (1.82 (1.10-3.00)), and all-cause mortality (5.64 (3.37-9.43)). Those with moderate trajectory had an intermediate risk: 1.45 (1.03-2.04) for cardiovascular events and 1.52 (1.06-2.19) for recurrent stroke. CONCLUSION Longitudinal neurological function trajectories derived from repeated NIHSS measurements during the first 3 months after stroke provide additional predictive information and are associated with long-term clinical outcomes. The trajectories characterized by persistent severe and moderate neurological impairment were associated with increased risk of subsequent cardiovascular events.
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Affiliation(s)
- Jigang Du
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Yan Wang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Bizhong Che
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Mengyuan Miao
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Anran Bao
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Yanbo Peng
- Department of Neurology, Affiliated Hospital of North China University of Science and Technology, Tangshan, China
| | - Zhong Ju
- Department of Neurology, Kerqin District First People's Hospital of Tongliao City, Tongliao, China
| | - Tan Xu
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Jiang He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Yonghong Zhang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Chongke Zhong
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
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Che B, Zhong C, Du J, Miao M, Shi M, Peng Y, Yang P, Guo D, Chen J, Wang A, Xu T, Zhang Y, He J. Plasma homeostatic chemokines CCL19 and CCL21 and the prognosis of ischemic stroke in two Chinese prospective cohorts. Eur J Neurol 2023; 30:3149-3160. [PMID: 37399099 DOI: 10.1111/ene.15959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 06/20/2023] [Accepted: 06/28/2023] [Indexed: 07/05/2023]
Abstract
BACKGROUND The homeostatic chemokines CCL19 and CCL21 are involved in carotid plaque vulnerability and post-ischemic neuroinflammatory responses. This study aimed to examine the prognostic values of CCL19 and CCL21 in ischemic stroke. METHODS Plasma CCL19 and CCL21 were measured in 4483 ischemic stroke patients from two independent cohorts of CATIS (China Antihypertensive Trial in Acute Ischemic Stroke) and IIPAIS (Infectious Factors, Inflammatory Markers, and Prognosis of Acute Ischemic Stroke), and participants were followed up at 3 months after stroke. The primary outcome was the composite outcome of death or major disability. The associations of CCL19 and CCL21 levels with the primary outcome were examined. RESULTS In CATIS, multivariable-adjusted odds ratios of the primary outcome in the highest quartiles of CCL19 and CCL21 compared with the lowest quartiles were 2.06 and 2.62, respectively. In IIPAIS, odds ratios of the primary outcome in the highest quartiles of CCL19 and CCL21 were 2.81 and 2.78 compared with the lowest quartiles, respectively. In the pooled analysis of the two cohorts, odds ratios of the primary outcome associated with the highest quartiles of CCL19 and CCL21 were 2.24 and 2.66, respectively. Similar findings were observed in the analysis with major disability, death, and the composite outcome of death or cardiovascular events as the secondary study outcomes. Adding CCL19 and CCL21 to conventional risk factors significantly improved risk reclassification and discrimination for adverse outcomes. CONCLUSIONS Both CCL19 and CCL21 levels were independently associated with adverse outcomes within 3 months after ischemic stroke and should be further investigated for risk stratification and potential therapeutic targets of ischemic stroke.
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Affiliation(s)
- Bizhong Che
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, Suzhou, China
| | - Chongke Zhong
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, Suzhou, China
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
| | - Jigang Du
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, Suzhou, China
| | - Mengyuan Miao
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, Suzhou, China
| | - Mengyao Shi
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, Suzhou, China
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
| | - Yanbo Peng
- Department of Neurology, Affiliated Hospital of North China University of Science and Technology, Hebei, China
| | - Pinni Yang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, Suzhou, China
| | - Daoxia Guo
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, Suzhou, China
| | - Jing Chen
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
- Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Aili Wang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, Suzhou, China
| | - Tan Xu
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, Suzhou, China
| | - Yonghong Zhang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, Suzhou, China
| | - Jiang He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
- Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA
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Zhou M, Kang HZ, Gu CY, Liu YJ, Wang Y, Miao M, Fu JH, Tang XW, Qiu HY, Fu CC, Jin ZM, Li CX, Chen SN, Sun AN, Wu DP, Han Y. [Efficacy and safefy of Polymyxin B treatment for neutropenic patients suffering from refractory Gram-negative bacterial bloodstream infection]. Zhonghua Xue Ye Xue Za Zhi 2023; 44:484-489. [PMID: 37550204 PMCID: PMC10450549 DOI: 10.3760/cma.j.issn.0253-2727.2023.06.007] [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] [Received: 10/08/2022] [Indexed: 08/09/2023]
Abstract
Objective: To assess the efficacy and safety of polymyxin B in neutropenic patients with hematologic disorders who had refractory gram-negative bacterial bloodstream infection. Methods: From August 2021 to July 2022, we retrospectively analyzed neutropenic patients with refractory gram-negative bacterial bloodstream infection who were treated with polymyxin B in the Department of Hematology of the First Affiliated Hospital of the Soochow University between August 2021 to July 2022. The cumulative response rate was then computed. Results: The study included 27 neutropenic patients with refractory gram-negative bacterial bloodstream infections. Polymyxin B therapy was effective in 22 of 27 patients. The median time between the onset of fever and the delivery of polymyxin B was 3 days [interquartile range (IQR) : 2-5]. The median duration of polymyxin B treatment was 7 days (IQR: 5-11). Polymyxin B therapy had a median antipyretic time of 37 h (IQR: 32-70). The incidence of acute renal dysfunction was 14.8% (four out of 27 cases), all classified as "injury" according to RIFLE criteria. The incidence of hyperpigmentation was 59.3%. Conclusion: Polymyxin B is a viable treatment option for granulocytopenia patients with refractory gram-negative bacterial bloodstream infections.
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Affiliation(s)
- M Zhou
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - H Z Kang
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - C Y Gu
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - Y J Liu
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - Y Wang
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - M Miao
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - J H Fu
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - X W Tang
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - H Y Qiu
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - C C Fu
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - Z M Jin
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - C X Li
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - S N Chen
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - A N Sun
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - D P Wu
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
| | - Y Han
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, National Clinical Research Center for Hematologic Diseases, Suzhou 215006, China
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Xia J, Zhao Y, Chen F, Miao M, Qiu HY, Ma X, Tang XW, Wang Y, Wu XJ, Fu ZZ, Wu DP, Chen SN. [Allogeneic hematopoietic stem cell transplantation in acute leukemia patients with the SET-NUP214 fusion gene: Efficacy and survival analysis]. Zhonghua Nei Ke Za Zhi 2023; 62:410-415. [PMID: 37032136 DOI: 10.3760/cma.j.cn112138-20220411-00264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
Objective: To investigate the clinical efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for patients with acute leukemia who are positive for the SET-NUP214 fusion gene (SET-NUP214+AL). Methods: This was a retrospective case series study. Clinical data of 18 patients with SET-NUP214+AL who received allo-HSCT in the First Affiliated Hospital of Soochow University and Soochow Hongci Hematology Hospital from December 2014 to October 2021 were retrospectively analyzed to investigate treatment efficacy and prognosis. The Kaplan-Meier method was used for survival analysis. Results: Of the 18 patients, 12 were male and 6 were female, and the median age was 29 years (range, 13-55 years). There were six cases of mixed phenotype acute leukemia (three cases of myeloid/T, two cases of B/T, one case of myeloid/B/T), nine cases of acute lymphoblastic leukemia (ALL) (one case of B-ALL and eight cases of T-ALL), and three cases of acute myeloid leukemia. All patients received induction chemotherapy after diagnosis, and 17 patients achieved complete remission (CR) after chemotherapy. All patients subsequently received allo-HSCT. Pre-transplantation status: 15 patients were in the first CR, 1 patient was in the second CR, 1 was in partial remission, and 1 patient did not reach CR. All patients were successfully implanted with stem cells. The median time of granulocyte and platelet reconstitution was +12 and +13 days, respectively. With a median follow-up of 23 (4-80) months, 15 patients survived, while 3 patients died. The cause of death was recurrence of SET-NUP214+AL after transplantation. After allo-HSCT, 5 patients relapsed. The estimated 3-year overall survival (OS) and relapse-free survival (RFS) rates were 83.3%±15.2% and 55.4%±20.7%, respectively. Among the 15 patients who achieved CR before transplantation, there was no significant difference in OS and RFS between haploidentical HSCT and matched sibling donor HSCT (all P>0.05). Conclusions: Allo-HSCT can improve the prognosis and long-term survival rate of patients with SET-NUP214+AL. Disease recurrence is the most important factor affecting long-term survival.
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Affiliation(s)
- J Xia
- Department of Hematology, the First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Suzhou 215006, China the First Affiliated Hospital of Soochow University, Soochow Hongci Hematology Hospital, Suzhou 215100, China
| | - Y Zhao
- Department of Hematology, the First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Suzhou 215006, China the First Affiliated Hospital of Soochow University, Soochow Hongci Hematology Hospital, Suzhou 215100, China
| | - F Chen
- Department of Hematology, the First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Suzhou 215006, China the First Affiliated Hospital of Soochow University, Soochow Hongci Hematology Hospital, Suzhou 215100, China
| | - M Miao
- Department of Hematology, the First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Suzhou 215006, China
| | - H Y Qiu
- Department of Hematology, the First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Suzhou 215006, China
| | - X Ma
- Department of Hematology, the First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Suzhou 215006, China the First Affiliated Hospital of Soochow University, Soochow Hongci Hematology Hospital, Suzhou 215100, China
| | - X W Tang
- Department of Hematology, the First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Suzhou 215006, China
| | - Y Wang
- Department of Hematology, the First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Suzhou 215006, China
| | - X J Wu
- Department of Hematology, the First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Suzhou 215006, China the First Affiliated Hospital of Soochow University, Soochow Hongci Hematology Hospital, Suzhou 215100, China
| | - Z Z Fu
- Department of Hematology, the First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Suzhou 215006, China
| | - D P Wu
- Department of Hematology, the First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Suzhou 215006, China
| | - S N Chen
- Department of Hematology, the First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Suzhou 215006, China
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Miao M, Bi Y, Hao L, Bao A, Sun Y, Du H, Song L, You S, Zhong C. Triglyceride-glucose index and short-term functional outcome and in-hospital mortality in patients with ischemic stroke. Nutr Metab Cardiovasc Dis 2023; 33:399-407. [PMID: 36586773 DOI: 10.1016/j.numecd.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/12/2022] [Accepted: 11/01/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND AND AIMS The triglyceride-glucose (TyG) index has been demonstrated as an independent marker of ischemic stroke. Whether TyG index predicts short-term outcomes in patients with ischemic stroke remains uncertain. The aim of the study was to investigate the early prognosis value of TyG index in ischemic stroke patients. METHODS AND RESULTS A total of 3216 acute ischemic stroke patients from 22 hospitals were included in this analysis. The TyG index was calculated as ln (fasting triglyceride [mg/dL] × fasting glucose [mg/dL]/2). Logistic regression model was performed to estimate the relationship between TyG index and unfavorable functional outcome of death or disability (modified Rankin Scale score of 4-6) at discharge. Risk reclassification with TyG index to predict unfavorable functional outcome was analyzed. During hospitalization, 748 patients (23.3%) experienced poor functional outcome and 105 patients (3.3%) died from all causes. The multivariable adjusted odds ratios for the highest versus lowest quartile of TyG index was 1.62 (95% CI 1.15-2.29) for unfavorable functional outcome at discharge. The addition of TyG index to the conventional model improved the risk reclassification (net reclassification improvement 10.37%; integrated discrimination improvement 0.27%; both p < 0.05) for poor functional outcome. Moreover, TyG index was associated with an odds ratio (95% CI) of 1.26 (1.02-1.55) for an ordinal shift in mRS score and 2.49 (1.21-5.12) for in-hospital mortality. CONCLUSIONS Higher TyG index was associated with higher risk of unfavorable functional outcome at discharge and in-hospital mortality, implicating the significant short-term prognostic effect of TyG index in patients with ischemic stroke.
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Affiliation(s)
- Mengyuan Miao
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China; Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yucong Bi
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Lijun Hao
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Anran Bao
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Yaming Sun
- Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou 215600, China
| | - Huaping Du
- Department of Neurology, The Affiliated Wujiang Hospital of Nantong University, Suzhou 215200, China
| | - Liyan Song
- Department of Neurology, The First People's Hospital of Taicang, Suzhou 215400, China
| | - Shoujiang You
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China.
| | - Chongke Zhong
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China; Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China.
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10
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You S, Bi Y, Miao M, Bao A, Du J, Xu T, Liu CF, Zhang Y, He J, Cao Y, Zhong C. Plasma sDPP4 (Soluble Dipeptidyl Peptidase-4) and Cognitive Impairment After Noncardioembolic Acute Ischemic Stroke. Stroke 2023; 54:113-121. [PMID: 36475470 DOI: 10.1161/strokeaha.122.040798] [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] [Indexed: 12/12/2022]
Abstract
BACKGROUND DPP4 (dipeptidyl peptidase-4) inhibitors have been proven to promote neuronal regeneration, reverse the development of cognitive deficits. However, the association of circulating soluble form (sDPP4 [soluble DPP4]) with poststroke cognitive impairment (PSCI) is unclear. We aimed to investigate the association between plasma sDPP4 levels and PSCI in patients with ischemic stroke. METHODS A total of 600 noncardioembolic stroke patients were included based on a preplanned ancillary study from the CATIS (China Antihypertensive Trial in Acute Ischemic Stroke). We used the Montreal Cognitive Assessment to evaluate cognitive function at 3 months follow-up after ischemic stroke. Binary logistic regression analyses were performed to investigate the association of plasma sDPP4 levels with subsequent PSCI. We further calculated integrated discrimination improvement and category-free net reclassification improvement to investigate the incremental prognostic effect of plasma sDPP4 beyond the basic model with conventional risk factors. RESULTS Plasma sDPP4 was inversely associated with PSCI after ischemic stroke, and the adjusted odds ratio (95% CI) for the highest versus lowest quartile of sDPP4 was 0.49 (0.29-0.81; P for trend=0.011). Each 1-SD increase of logarithm-transformed plasma sDPP4 concentration was associated with 17% (odds ratio, 0.83 [95% CI, 0.70-0.99]) lower risk of PSCI. Adding plasma sDPP4 to the basic model notably improved risk reclassification for PSCI, as shown by a category-free net reclassification improvement of 19.10% (95% CI, 2.52%-35.68%; P=0.03) and integrated discrimination improvement of 0.79% (95% CI, 0.13%-1.46%; P=0.02). CONCLUSIONS Higher plasma sDPP4 levels were associated with decreased risk of cognitive impairment after noncardioembolic ischemic stroke.
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Affiliation(s)
- Shoujiang You
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, China (S.Y., C.-F.L., Y.C.).,Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, China (Y.B., M.M., A.B., J.D., T.X., Y.Z., C.Z.)
| | - Yucong Bi
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, China (Y.B., M.M., A.B., J.D., T.X., Y.Z., C.Z.)
| | - Mengyuan Miao
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, China (Y.B., M.M., A.B., J.D., T.X., Y.Z., C.Z.)
| | - Anran Bao
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, China (Y.B., M.M., A.B., J.D., T.X., Y.Z., C.Z.)
| | - Jigang Du
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, China (Y.B., M.M., A.B., J.D., T.X., Y.Z., C.Z.)
| | - Tan Xu
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, China (Y.B., M.M., A.B., J.D., T.X., Y.Z., C.Z.)
| | - Chun-Feng Liu
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, China (S.Y., C.-F.L., Y.C.).,Institutes of Neuroscience, Soochow University, Suzhou, China (C.-F.L., Y.C.)
| | - Yonghong Zhang
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, China (Y.B., M.M., A.B., J.D., T.X., Y.Z., C.Z.)
| | - Jiang He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (J.H.)
| | - Yongjun Cao
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, China (S.Y., C.-F.L., Y.C.).,Institutes of Neuroscience, Soochow University, Suzhou, China (C.-F.L., Y.C.)
| | - Chongke Zhong
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, China (Y.B., M.M., A.B., J.D., T.X., Y.Z., C.Z.)
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Guo W, Zhao X, Cheng D, Liang X, Miao M, Li X, Lu J, Xu N, Hu S, Zhang Q. Muscle Fat Content Is Associated with Nonalcoholic Fatty Liver Disease and Liver Fibrosis in Chinese Adults. J Nutr Health Aging 2023; 27:960-965. [PMID: 37997716 DOI: 10.1007/s12603-023-2015-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 10/09/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVES Several studies have linked myosteatosis with nonalcoholic fatty liver disease (NAFLD) in individuals with obesity. The clinical significance of myosteatosis in individuals with NAFLD in the general population has not been well investigated. Here, we wanted to explore and compare the associations of NAFLD and liver fibrosis with muscle fat content and skeletal muscle mass (SMM) in a relatively large general population in China. METHODS We retrospectively included all participants who underwent abdominal CT scans in our health promotion center between April 2021 and October 2021. Muscle fat content was assessed by abdomen quantitative computed tomography (QCT) scans, and SMM was evaluated by bioelectrical impedance. NAFLD was assessed by ultrasonography. The NAFLD fibrosis score (NFS) and Fibrosis-4 Index (FIB-4) score were calculated to assess liver fibrosis. RESULTS Compared with participants without NAFLD, patients with NAFLD showed significantly increased intermuscular adipose tissue (IMAT%) (7.40±3.37% vs. 6.76±2.66%, P <0.01). According to a multiple logistic regression model, IMAT% (OR=1.091, 95% CI 1.030-1.155, P=0.003) was only independently correlated with NAFLD in obese participants. Mediation analysis showed that BMI mediated the association between IMAT% and NAFLD. In participants with NAFLD, increased IMAT% was independently associated with an increased intermediate to high risk of advanced fibrosis assessed by the NFS or FIB-4 score after adjusting for multiple potential confounders. However, SMM was only independently correlated with an intermediate to high risk for advanced fibrosis evaluated by the NFS and not by the FIB-4 score. CONCLUSION Increased muscle fat content is positively correlated with NAFLD and intermediate to high risk for advanced fibrosis in the general Chinese population.
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Affiliation(s)
- W Guo
- Qun Zhang, M.D., Department of Health Promotion Center, the First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, China, 210029. E-mail: , ORCID: 0000-0003-2208-7998; Shuang Hu, M.D., Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, China, 210008, E-mail:
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12
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Du J, Miao M, Lu Z, Chen H, Bao A, Che B, Zhang J, Ju Z, Xu T, He J, Zhang Y, Zhong C. Plasma l-carnitine and risks of cardiovascular events and recurrent stroke after ischemic stroke: A nested case-control study. Nutr Metab Cardiovasc Dis 2022; 32:2579-2587. [PMID: 36155150 DOI: 10.1016/j.numecd.2022.08.016] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 08/11/2022] [Accepted: 08/16/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND AIMS l-Carnitine was suggested to prevent the progression of atherosclerosis, myocardial and neurologic injury, and exhibited cardioprotective effects. However, epidemiological data on circulating l-carnitine and risks of cardiovascular events in the setting of stroke is rare. We aimed to explore the relationships between plasma l-carnitine and cardiovascular events and stroke recurrence after ischemic stroke in a nested case-control study. METHODS AND RESULTS A total of 323 cardiovascular events (including 264 recurrent strokes) and 323 matched controls (free of recurrent cardiovascular events) were included. Study outcomes included cardiovascular events and recurrent stroke after ischemic stroke. Plasma l-carnitine concentrations were measured by ultra-high-performance LC-MS/MS. Conditional logistic regression models were used to estimate odds ratios (ORs) of stroke outcomes. Plasma l-carnitine was inversely associated with cardiovascular events (OR = 0.69, 95% CI: 0.57-0.84 per SD) and recurrent stroke (OR = 0.72, 95% CI: 0.58-0.88 per SD) after adjusting for established risk confounders. Compared with the lowest tertile of l-carnitine, adjusted ORs of cardiovascular events and recurrent stroke for participants in the highest tertiles were 0.35 (95% CI: 0.21-0.57) and 0.36 (95% CI: 0.21-0.62), respectively. In addition, l-carnitine provided incremental predictive ability beyond established risk factors, shown by increase in C statistics, net reclassification improvement and integrated discrimination improvement. CONCLUSIONS Higher l-carnitine levels were associated with lower risks of cardiovascular events and recurrent stroke after ischemic stroke. Our findings provided evidence supporting plasma l-carnitine as a potential prognostic marker in risk discrimination and stratification in patients with ischemic stroke. TRIAL REGISTRATION Clinicaltrials.gov as NCT01840072. URL: https://www. CLINICALTRIALS gov.
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Affiliation(s)
- Jigang Du
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Mengyuan Miao
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Zian Lu
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Haichang Chen
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Anran Bao
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Bizhong Che
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Jintao Zhang
- Department of Neurology, The 88th Hospital of PLA, Shandong, China
| | - Zhong Ju
- Department of Neurology, Kerqin District First People's Hospital of Tongliao City, Tongliao, China
| | - Tan Xu
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Jiang He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Yonghong Zhang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China.
| | - Chongke Zhong
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China.
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You S, Miao M, Lu Z, Bao A, Du J, Che B, Xu T, Zhong C, Cao Y, Liu CF, Zhang Y, He J. Plasma-Soluble Dipeptidyl Peptidase 4 and Risk of Major Cardiovascular Events After Ischemic Stroke: Secondary Analysis of China Antihypertensive Trial in Acute Ischemic Stroke (CATIS). Neurology 2022; 99:e925-e934. [PMID: 35654589 DOI: 10.1212/wnl.0000000000200784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 04/11/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Recent studies have suggested that plasma soluble dipeptidyl peptidase-4 (sDPP4) have important physiological effects, which may influence the prognosis of ischemic stroke. Our study aimed to examine the relationship between plasma sDDP4 levels and long-term clinical outcomes among acute ischemic stroke patients. METHODS Secondary analysis was conducted among 3,564 participants (2,270 men and 1,294 women) from the China Antihypertensive Trial in Acute Ischemic Stroke with baseline measurement of plasma sDPP4 levels. We evaluated the associations between plasma sDPP4 levels and 2-year clinical outcomes using logistic regression and Cox regression models. We further investigated the predictive utility of sDPP4 by calculating net reclassification index (NRI) and integrated discrimination improvement (IDI). RESULTS The highest plasma sDPP4 quartile was associated with lower risk of cardiovascular events (HR 0.62, 95% CI 0.45-0.87), recurrent stroke (HR 0.70, 95% CI 0.49-0.99), all-cause mortality (HR 0.62, 95% CI 0.44-0.87), stroke-specific mortality (HR 0.65, 95% CI 0.44-0.94) and poor functional outcomes (OR 0.66, 95% CI 0.53-0.82) at 2 years compared with the lowest sDPP4 category in multivariable models. The addition of plasma sDPP4 to conventional risk factors model significantly improved risk prediction of all outcomes. DISCUSSION In this study, we found that higher plasma sDPP4 levels in acute ischemic stroke patients were associated with decreased risks of cardiovascular events, recurrent stroke, all-cause mortality, and poor functional outcomes after ischemic stroke. These findings suggest that plasma sDPP4 may be a potential prognostic marker for initial risk stratification in patients with acute ischemic stroke.
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Affiliation(s)
- Shoujiang You
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - Mengyuan Miao
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou 215123, China
| | - Zian Lu
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou 215123, China
| | - Anran Bao
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou 215123, China
| | - Jigang Du
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou 215123, China
| | - Bizhong Che
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou 215123, China
| | - Tan Xu
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou 215123, China
| | - Chongke Zhong
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou 215123, China
| | - Yongjun Cao
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China.,Institutes of Neuroscience, Soochow University, Suzhou 215123, China
| | - Chun-Feng Liu
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China.,Institutes of Neuroscience, Soochow University, Suzhou 215123, China
| | - Yonghong Zhang
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou 215123, China
| | - Jiang He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
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Guo W, Zhao X, Miao M, Liang X, Li X, Qin P, Lu J, Zhu W, Wu J, Zhu C, Xu N, Zhang Q. Association Between Skeletal Muscle Mass and Severity of Steatosis and Fibrosis in Non-alcoholic Fatty Liver Disease. Front Nutr 2022; 9:883015. [PMID: 35558748 PMCID: PMC9087584 DOI: 10.3389/fnut.2022.883015] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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: 02/24/2022] [Accepted: 04/04/2022] [Indexed: 12/18/2022] Open
Abstract
Background Sarcopenia is known to be the risk factor of non-alcoholic fatty liver disease (NAFLD). However, studies evaluating the association of skeletal muscle mass (SMM) with liver fibrosis by transient elastography are limited. Here, we investigated the association of SMM with hepatic steatosis and fibrosis assessed in Chinese adults. Methods Patients who underwent liver ultrasonography at the Health Promotion Center of the First Affiliated Hospital of Nanjing Medical University between January 2020 to June 2021 were enrolled. We used transient elastography to evaluate the degree of hepatic fat and liver stiffness. Appendicular skeletal muscle mass was determined by bioelectrical impedance and was adjusted for body weight to derive the skeletal muscle mass index (SMI). Results Of 3,602 finally enrolled individuals, 1,830 had NAFLD and 1,772 did not have NAFLD. SMI gradually decreased as the severity of hepatic steatosis increased (40.47 ± 3.94% vs. 39.89 ± 3.57% vs. 39.22 ± 3.46% vs. 37.81 ± 2.84%, P < 0.001). Individuals with F3-F4 and F2 liver fibrosis groups had significantly lower SMI than individuals with F0-F1 stages (37.51 ± 3.19% vs. 38.06 ± 3.51% vs. 39.36 ± 3.38%, P < 0.001). As the SMI increased, the percentages of subjects with mild and severe NAFLD, and the percentages of subjects in F2 and F3-F4 stage were gradually decreased. SMI was independently associated with the severity of hepatic steatosis and fibrosis by logistic regression analysis. Moreover, decreased SMI was an independent risk factor for NAFLD and fibrosis. Conclusion SMI is closely associated with liver fat content and liver fibrosis in Chinese adults with NAFLD.
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Affiliation(s)
- Wen Guo
- Department of Health Promotion Center, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Xin Zhao
- Department of Health Promotion Center, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Mengyuan Miao
- Department of Health Promotion Center, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Xiuru Liang
- Department of Health Promotion Center, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Xiaona Li
- Department of Health Promotion Center, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Pei Qin
- Department of Health Promotion Center, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Jing Lu
- Department of Health Promotion Center, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Wenfang Zhu
- Department of Health Promotion Center, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Juan Wu
- Department of Health Promotion Center, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Chen Zhu
- Department of Health Promotion Center, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Nianzhen Xu
- Department of Health Promotion Center, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Qun Zhang
- Department of Health Promotion Center, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
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Miao M, Zhou G, Bao A, Sun Y, Du H, Song L, Cao Y, You S, Zhong C. Triglyceride-glucose index and common carotid artery intima-media thickness in patients with ischemic stroke. Cardiovasc Diabetol 2022; 21:43. [PMID: 35303881 PMCID: PMC8933990 DOI: 10.1186/s12933-022-01472-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 02/28/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Triglyceride glucose (TyG) index was recently reported to be associated with an increased risk of the development and recurrence of cardiovascular events, and atherosclerosis is a main speculative mechanism. However, data on the relationship between TyG index and atherosclerosis, especially in the setting of ischemic stroke, is rare. We aimed to explore the association between TyG index and carotid atherosclerosis in patients with ischemic stroke. METHODS A total of 1523 ischemic stroke patients with TyG index and carotid artery imaging data were enrolled in this analysis. The TyG index was calculated as ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. Carotid atherosclerosis was measured by common carotid artery intima-media thickness (cIMT), and abnormal cIMT was defined as a mean cIMT and maximum cIMT value ≥ 1 mm. Multivariable logistic regression models and restricted cubic spline models were used to assess the relationships between TyG index and abnormal cIMT. Risk reclassification and calibration of models with TyG index were analyzed. RESULTS The multivariable-adjusted odds ratios (95% CIs) in quartile 4 versus quartile 1 of TyG index were 1.56 (1.06-2.28) for abnormal mean cIMT and 1.46 (1.02-2.08) for abnormal maximum cIMT, respectively. There were linear relationships between TyG index and abnormal mean cIMT (P for linearity = 0.005) and abnormal maximum cIMT (P for linearity = 0.027). In addition, the TyG index provided incremental predictive capacity beyond established risk factors, shown by an increase in net reclassification improvement and integrated discrimination improvement (all P < 0.05). CONCLUSIONS A higher TyG index was associated with carotid atherosclerosis measured by cIMT in patients with ischemic stroke, suggesting that TyG could be a promising atherosclerotic marker.
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Affiliation(s)
- Mengyuan Miao
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, 215123, Jiangsu, China.,Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Guo Zhou
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China.,Department of Cardiology, Nantong Third People's Hospital, Nantong University, Nantong, 226006, China
| | - Anran Bao
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, 215123, Jiangsu, China
| | - Yaming Sun
- Department of Neurology, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, 215600, China
| | - Huaping Du
- Department of Neurology, The Affiliated Wujiang Hospital of Nantong University, Suzhou, 215200, China
| | - Liyan Song
- Department of Neurology, The First People's Hospital of Taicang, Suzhou, 215400, China
| | - Yongjun Cao
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China.
| | - Shoujiang You
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China.
| | - Chongke Zhong
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, 215123, Jiangsu, China.
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Miao M, Du J, Che B, Guo Y, Zhang J, Ju Z, Xu T, Zhong X, Zhang Y, Zhong C. Circulating choline pathway nutrients and depression after ischemic stroke. Eur J Neurol 2021; 29:459-468. [PMID: 34611955 DOI: 10.1111/ene.15133] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 09/30/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND PURPOSE Choline pathway nutrients, including choline and betaine, are reported to exert antidepressant effects. However, there is little population-based evidence on the relationships between circulating choline and betaine and poststroke depression (PSD). We aimed to prospectively explore the associations between plasma choline and betaine and depression after ischemic stroke. METHODS This study was based on the China Antihypertensive Trial in Acute Ischemic Stroke. A total of 612 participants with plasma choline and betaine concentrations were included in the analysis. The study outcome was depression 3 months after ischemic stroke. Logistic regression models were performed to estimate the relationships between plasma choline and betaine and the risk of PSD. Risk reclassification and calibration of models with choline or betaine were analyzed. RESULTS Patients with PSD had lower choline and betaine levels than those without PSD (p < 0.05). Compared with tertile 1, the multivariable-adjusted odds ratios (95% CIs) for tertile 3 of choline and betaine were 0.54 (0.35-0.83) and 0.59 (0.38-0.92), respectively. Per 1 SD increase in choline or betaine was associated with a 25% (95% CI 9%-37%) or an 19% (95% CI 3%-32%) decreased risk of PSD, respectively. Furthermore, the addition of choline or betaine to the established risk factors model improved the risk reclassification for PSD, as shown by an increase in the net reclassification index and integrated discrimination improvement (all p < 0.05). CONCLUSIONS Patients with elevated levels of choline and betaine had a lower risk of depression after acute ischemic stroke, suggesting the protective significance of choline pathway nutrients for PSD.
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Affiliation(s)
- Mengyuan Miao
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Jigang Du
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Bizhong Che
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Yufei Guo
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Jintao Zhang
- Department of Neurology, The 88th Hospital of PLA, Shandong, China
| | - Zhong Ju
- Department of Neurology, Kerqin District First People's Hospital of Tongliao City, Tongliao, China
| | - Tan Xu
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Xiaoyan Zhong
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Yonghong Zhang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Chongke Zhong
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
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Zhong C, Miao M, Che B, Du J, Wang A, Peng H, Bu X, Zhang J, Ju Z, Xu T, He J, Zhang Y. Plasma choline and betaine and risks of cardiovascular events and recurrent stroke after ischemic stroke. Am J Clin Nutr 2021; 114:1351-1359. [PMID: 34159355 DOI: 10.1093/ajcn/nqab199] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 02/19/2021] [Accepted: 05/25/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Choline and betaine have been suggested to play a pivotal role in neurotransmitter synthesis, cell membrane integrity, and methyl-group metabolism, exerting neuroprotective effects in patients with various neurological disorders. However, population-based evidence on choline and betaine with subsequent cardiovascular events after stroke is rare. OBJECTIVES We aimed to prospectively investigate the relationships of circulating choline and betaine with cardiovascular events and recurrent stroke in patients with ischemic stroke. METHODS We performed a nested case-control study within the China Antihypertensive Trial in Acute Ischemic Stroke. A total of 323 cardiovascular events (including 264 recurrent strokes) and 323 controls (free of recurrent cardiovascular events) matched for age (±1 y), sex, and treatment group were included. The primary endpoint was a composite of cardiovascular events after ischemic stroke. Plasma choline and betaine were measured at baseline by ultra-high-performance LC-MS/MS. Conditional logistic regression models were applied, and discrimination, reclassification, and calibration of models with choline pathway metabolites were evaluated. RESULTS Plasma choline and betaine were inversely associated with cardiovascular events and recurrent stroke after ischemic stroke. Specifically, in fully adjusted models, each additional SD of choline and betaine was associated with 35% (95% CI: 20%-48%) and 30% (95% CI: 14%-43%) decreased risks of subsequent cardiovascular events, respectively, and 34% (95% CI: 16%-48%) and 29% (95% CI: 12%-43%) decreased risks of recurrent stroke, respectively. In addition, both choline and betaine offered substantial risk discrimination and reclassification improvement for cardiovascular events and recurrent stroke beyond traditional risk factors, as evidenced by an increase in C statistics, the net reclassification index, and integrated discrimination improvement. CONCLUSIONS Plasma choline pathway metabolites, including choline and betaine, were associated with decreased risks of cardiovascular events and recurrent stroke and provided incremental value in risk discrimination and stratification in patients with ischemic stroke. This nested case-control study was based on the China Antihypertensive Trial in Acute Ischemic Stroke, which is registered at clinicaltrials.gov as NCT01840072.
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Affiliation(s)
- Chongke Zhong
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Mengyuan Miao
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Bizhong Che
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Jigang Du
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Aili Wang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Hao Peng
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Xiaoqing Bu
- Department of Epidemiology, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Jintao Zhang
- Department of Neurology, The 88th Hospital of PLA, Shandong, China
| | - Zhong Ju
- Department of Neurology, Kerqin District First People's Hospital of Tongliao City, Tongliao, China
| | - Tan Xu
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Jiang He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Yonghong Zhang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
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Xia J, Chen SN, Jin ZM, Tang XW, Chen F, Ma X, Miao M, Wu DP. [Outcome of haploidentical hematopoietic stem cell transplantation for aggressive natural killer cell leukemia]. Zhonghua Xue Ye Xue Za Zhi 2021; 42:591-593. [PMID: 34455747 PMCID: PMC8408496 DOI: 10.3760/cma.j.issn.0253-2727.2021.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Affiliation(s)
- J Xia
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - S N Chen
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - Z M Jin
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - X W Tang
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - F Chen
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - X Ma
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - M Miao
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
| | - D P Wu
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China
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Yan M, Wu YJ, Chen F, Tang XW, Han Y, Qiu HY, Sun AN, Xue SL, Jin ZM, Wang Y, Miao M, Wu DP. [CAR T-cell bridging to allo-HSCT for relapsed/refractory B-cell acute lymphoblastic leukemia: the follow-up outcomes]. Zhonghua Xue Ye Xue Za Zhi 2020; 41:710-715. [PMID: 33113601 PMCID: PMC7595870 DOI: 10.3760/cma.j.issn.0253-2727.2020.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Indexed: 12/12/2022]
Abstract
Objective: This study aims to investigate the efficacy and safety of chimeric antigen receptor (CAR) T-cell bridging allogeneic hematopoietic stem cell transplantation (allo-HSCT) in the treatment of recurrent and refractory acute B-lymphocytic leukemia (R/R B-ALL) . Methods: A total of 50 R/R B-ALL patients who underwent CAR T-scell therapy to bridge allo-HSCT in the First Affiliated Hospital of Soochow University from January 2017 to May 2019 were retrospectively analyzed. The overall survival (OS) rate, event-free survival (EFS) rate, cumulative recurrence rate (CIR) , and transplant-related mortality (TRM) of patients with different bone marrow minimal residual disease (MRD) levels were analyzed before and after CAR T-cell infusion and before allo-HSCT. Results: The response rate of CAR T-cell therapy and the incidence rate of severe cytokine release syndrome were 92% and 28% , respectively. During 55 infusions, no treatment-related deaths occurred in any of the patients. The median time of CAR T-cell infusion to allo-HSCT was 54 (26-232) days, the median follow-up time after CAR T-cell infusion was 637 (117-1097) days, and the 1-year OS and EFS rates were (80.0±5.7) % and (60.0±6.9) % . The 1-year CIR and TRM after allo-HSCT were (28.0±0.4) % and (8.0±0.2) % . After CAR T-cell infusion and before allo-HSCT, patients with bone marrow MRD<0.01% had a significantly longer EFS [ (70.0±7.2) % vs (20.0±12.6) % , P<0.001; (66.7±7.5) % vs (36.4±14.5) % , P=0.008]and lower CIR [ (25.0±0.5) % vs (70.0±2.6) % , P<0.001; (23.08±0.47) % vs (45.45±2.60) % , P=0.038]. Conclusion: CAR T-cell therapy bridging allo-HSCT is safe and effective for recurrent and refractory B-ALL.
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Affiliation(s)
- M Yan
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou 215123, China
| | - Y J Wu
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou 215123, China
| | - F Chen
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou 215123, China
| | - X W Tang
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou 215123, China
| | - Y Han
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou 215123, China
| | - H Y Qiu
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou 215123, China
| | - A N Sun
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou 215123, China
| | - S L Xue
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou 215123, China
| | - Z M Jin
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou 215123, China
| | - Y Wang
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou 215123, China
| | - M Miao
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou 215123, China
| | - D P Wu
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Collaborative Innovation Center of Hematology, State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou 215123, China
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Xia J, Chen SN, Chen J, Fan Y, Chen F, Ma X, Miao M, Wu DP. [Efficacy and safety of haploidentical hematopoietic stem cell transplantation for 17 patients with paroxysmal nocturnal hemamoglobinuria]. Zhonghua Xue Ye Xue Za Zhi 2019; 39:904-907. [PMID: 30486585 PMCID: PMC7342361 DOI: 10.3760/cma.j.issn.0253-2727.2018.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
目的 探讨单倍型造血干细胞移植治疗阵发性睡眠性血红蛋白尿症(PNH)的疗效和安全性。 方法 回顾性分析2013年1月至2017年9月采用亲缘单倍型移植治疗的17例PNH患者临床资料。 结果 17例患者中原发PNH 4例,再生障碍性贫血(AA)-PNH综合征13例。所有患者均以改良白消安+环磷酰胺联合抗胸腺细胞球蛋白(ATG)进行清髓性预处理。G-CSF动员的供者骨髓联合外周血干细胞作为移植物来源。环孢素A+吗替麦考酚酯+短程甲氨蝶呤预防移植物抗宿主病(GVHD)。移植后17例患者均获粒系及巨核系造血重建,粒细胞中位植入时间为移植后12(10~15)d,血小板中位植入时间为移植后14(11~45)d。所有患者在+30 d经植入鉴定证实为完全供者嵌合体。7例患者发生Ⅱ~Ⅳ度急性GVHD,4例发生慢性GVHD。中位随访时间为27.1(8.6~60.4)个月,17例患者中15例存活,2例死亡,死因分别为肺部重症感染和移植相关的血栓性微血管病。3年总生存率为(77.8±15.2)%。 结论 对于无完全相合供者的PNH患者,尝试进行单倍型造血干细胞移植有效、安全。
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Affiliation(s)
- J Xia
- Jiangsu Institute of Hematology, Department of Hematology, the First Affiliated Hospital of Soochow University, Key Lab of Thrombosis and Hemostasis of Ministry of Health, Suzhou 215006, China
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Liu LM, Zhang YM, Zhou HF, Wang QY, Qiu HY, Tang XW, Han Y, Fu CC, Jin ZM, Sun AN, Miao M, Wu DP. [Outcome of combination of HLA-haploidentical hematopoietic SCT with an unrelated cord blood unit for 127 patients with acquired severe aplastic anemia]. Zhonghua Xue Ye Xue Za Zhi 2019; 39:624-628. [PMID: 30180460 PMCID: PMC7342829 DOI: 10.3760/cma.j.issn.0253-2727.2018.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
目的 评价单倍型造血干细胞移植(haplo-HSCT)联合第三方脐血干细胞移植治疗重型再生障碍性贫血(SAA)的疗效及安全性。 方法 对2011年9月至2017年4月间接受haplo-HSCT联合第三方脐血干细胞移植的127例SAA患者进行回顾性研究。 结果 全部127例SAA患者中,男74例,女53例,中位年龄23.5(3~54)岁,其中极重型再生障碍性贫血65例。诊断至移植中位时间2(0.5~180)个月。单倍型造血干细胞来源为骨髓+外周血。脐血均选用单份,HLA配型≥4/6相合。127例患者均接受改良Bu/Cy+ATG/ALG预处理方案(白消安+环磷酰胺+抗胸腺细胞球蛋白/抗淋巴细胞球蛋白)。以环孢素A、霉酚酸酯联合短程甲氨蝶呤预防GVHD。回输单倍型供者单个核细胞10.87(3.61~24.00)×108/kg,CD34+细胞3.49(1.02~8.89)×106/kg;回输脐血单个核细胞2.22(1.10~7.30)×107/kg,CD34+细胞0.56(0.16~2.27)×105/kg。127例患者中5例发生早期死亡。在可评估的122例患者中,1例发生原发植入失败,其余121例患者成功植入(均为单倍型造血干细胞植入)。中性粒细胞、血小板植入时间分别为11(9~28)d、15(9~330)d,5例患者发生血小板植入不良。移植过程中74例(58.27%)发生感染。存活患者中位随访20.5(4.0~60.0)个月,Ⅱ~Ⅳ度急性GVHD发生率为24.79%(30/121),中/重度慢性GVHD发生率为14.15%(15/106),预期4年总生存率为(78.5±4.3)%,无失败生存率为(77.4±4.3)%。 结论 haplo-HSCT联合第三方脐血干细胞移植治疗SAA疗效确切且安全性较好,在无全相合供者情况下可作为有价值的治疗选择。
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Affiliation(s)
- L M Liu
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Collaborative Innovation Center of Hematology, Suzhou 215006, China
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- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Collaborative Innovation Center of Hematology, Suzhou 215006, China
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Chen GH, Huang HW, Wang Y, Liu HW, Xu LJ, Ma X, Xue SL, He XF, Wang Y, Gu B, Li CX, Qiu HY, Tang XW, Jin ZM, Miao M, Sun AN, Wu DP. [An experimental study of CD4 targeted chimeric antigen receptor modified T cell with anti-lymphoma activity]. Zhonghua Xue Ye Xue Za Zhi 2019; 39:148-152. [PMID: 29562451 PMCID: PMC7342564 DOI: 10.3760/cma.j.issn.0253-2727.2018.02.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
目的 探讨针对CD4膜蛋白的CAR-T细胞对CD4+T细胞淋巴瘤细胞的靶向特异性杀伤作用。 方法 采用重组DNA技术构建含4-1BB共刺激分子的第二代针对CD4的CAR慢病毒载体,应用293T细胞包装慢病毒,采用流式细胞术检测T细胞的转染效率及T细胞亚群动态变化,采用流式细胞术微球法检测培养上清中IFN-γ浓度。 结果 ①构建的慢病毒载体转染激活的T细胞后CAR膜蛋白阳性率达到50.0%~70.0%。T细胞激活后部分CD8+T细胞弱表达(dim)CD4膜蛋白。T细胞转染针对CD4的CAR慢病毒后CD4+ T细胞、CD8+ CD4dim T细胞逐渐被清除。②CAR-T细胞、对照组T细胞(空载体转染的T细胞)以8∶1效靶比分别与CD4+人T细胞淋巴瘤细胞株KARPAS 299细胞共培养24 h,杀伤效率分别为(96.9±2.1)%和(11.2±3.1)%,前者明显高于后者(t=7.137,P=0.028)。③CAR-T细胞单独培养,与转染慢病毒载体表达人CD4的K562细胞(K562-CD4细胞)、K562细胞共培养后上清中IFN-γ浓度分别为(1 785±268)、(15 648±2 168)、(1 978±354)pg/ml,CAR-T细胞与K562-CD4细胞共培养上清IFN-γ浓度明显高于其他两组,差异有统计学意义(P<0.01)。 结论 CD4特异性CAR-T细胞效应细胞免疫表型为CD8+ CD4+ T细胞,在体外具有杀伤正常CD4+ T细胞和CD4+ T细胞淋巴瘤细胞的活性,对于CD4dim T细胞也有较好的清除活性。
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Affiliation(s)
- G H Chen
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, Suzhou Institute of Blood and Marrow Transplantation, Suzhou 215006, China
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Wang QL, Huang HW, Jin ZM, Tang XW, Qiu HY, Fu CC, Han Y, Miao M, Chang HR, Sun AN, Wu DP. [Comparison of allogeneic or autologous hematopoietic stem cell transplant for high-risk peripheral T cell lymphomas]. Zhonghua Xue Ye Xue Za Zhi 2018; 37:952-956. [PMID: 27995879 PMCID: PMC7348511 DOI: 10.3760/cma.j.issn.0253-2727.2016.11.005] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
目的 比较自体造血干细胞移植(auto-HSCT)和异基因造血干细胞移植(allo-HSCT)治疗高危外周T细胞淋巴瘤(PTCL)疗效的差异。 方法 回顾性分析苏州大学附属第一医院60例接受HSCT治疗的高危PTCL患者临床资料。 结果 60例PTCL患者均为高危组患者(IPI评分≥3分),接受移植时中位年龄31 (12~58)岁。包括PTCL非特指型22例、ALK阴性的间变大细胞淋巴瘤22例、血管免疫母细胞淋巴瘤16例。其中接受auto-HSCT的有39例(63.5%),接受allo-HSCT的有21例(36.5%)。移植前40例完全缓解(CR),2例部分缓解(PR),18例未缓解(NR)。40例CR患者中10例接受allo-HSCT, 30例接受auto-HSCT。20例PR+NR患者中11例接受allo-HSCT, 9例接受auto-HSCT。移植后中位随访时间为39 (1~96)个月,auto-HSCT和allo-HSCT组的5年无进展生存率分别为61%和60%(P=0.724)。auto-HSCT和allo-HSCT组的5年总生存率分别为62%和61%(P=0.724)。auto-HSCT和allo-HSCT组的5年移植相关死亡率分别为22.7%和41.8%(P=0.250)。截至末次随访时间,auto-HSCT中7例患者复发,allo-HSCT组中2例复发,auto-HSCT和allo-HSCT组的5年累计复发率分别为37.2%和10.1%(P=0.298)。 结论 高危PTCL患者选择auto-HSCT或allo-HSCT治疗长期生存无明显差异,但allo-HSCT组患者移植前多为NR状态,表明对于NR患者,allo-HSCT效果可能较好。
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Affiliation(s)
- Q L Wang
- Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Key Laboratory of Thrombosis and Hemstasis of Ministry of Health, Collaborative Innovation Center of Hematology, Suzhou 215006, China
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Yan LZ, Chen SN, He XF, Zhao Y, Zhang XY, Wu LL, Ping NN, Xu XY, Sun AN, Qiu HY, Tang XW, Han Y, Fu CC, Jin ZM, Miao M, Wu DP. [Expression level and clinical significance of MEF2C gene in adult acute myeloid leukemia]. Zhonghua Xue Ye Xue Za Zhi 2018; 39:682-685. [PMID: 30180473 PMCID: PMC7342833 DOI: 10.3760/cma.j.issn.0253-2727.2018.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Indexed: 11/05/2022]
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Tao T, Xue SL, Chen F, Xu Y, Ma X, Miao M, Tang XW, Wu DP. [Anti-CD(25) monoclonal antibody as a salvage therapy for steroid-refractory acute graft-versus-host disease in 80 patients receiving allogeneic hematopoietic stem cell transplantation]. Zhonghua Nei Ke Za Zhi 2018; 57:324-329. [PMID: 29747286 DOI: 10.3760/cma.j.issn.0578-1426.2018.05.004] [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 efficacy of anti-CD(25) monoclonal antibody for steroid-refractory acute graft-versus-host disease (SR-aGVHD) in allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients. Methods: A total of 80 patients with SR-aGVHD from January 1st 2012 to December 31st 20l6 were enrolled in this study. Acute GVHD were classified as classic aGVHD (n=72) and late-onset aGVHD (n=8). Anti-CD(25) monoclonal antibodys (mAb) were administrated on days 1, 4, 8, 15, and 22. The efficacy of anti-CD(25) mAb was evaluated at day 28 after the initial treatment. The associated factors of clinical outcome were analyzed. Results: The overall response (OR) rate of anti-CD(25) mAb was 75% (60/80), with complete response (CR) rate, partial response (PR) rate and no response(NR) rate 52.5% (42/80), 22.5% (18/80), and 25% (20/80), respectively. GVHD-relapse was not observed with a median follow-up time of 394.5 days (range, 12-1 761 days). The 6-month overall survival (OS) rate was 68.4%(95%CI 63.2%-73.6%). The 1-year OS rate was 63.1% (95%CI 57.6%-68.6%), and 2-years OS rate was 50.7% (95%CI 44.3%-57.1%). Non-relapse mortality (NRM) rate of 1 and 3 years was 32.6% (95%CI 27.2%-38%) and 41.7% (95%CI 35.3%-48.1%), respectively. The 1 and 2 years cumulative incidence of chronic graft versus host disease (cGVHD) was 32.9% (95%CI 26.4%-39.4%) and 38.9% (95%CI 31.8%-46.0%). By univariate and multivariate analysis, liver involvement was an independent poor risk factor of SR-aGVHD (OR=4.66, 95%CI 1.145-18.962, P=0.032). Conclusion: Anti-CD(25) mAb serves as an alternative and effective salvage therapy for SR-aGVHD at present. Liver involvement is a predictive factor of poor response in patients with SR-aGVHD.
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Affiliation(s)
- T Tao
- Department of Hematology, the First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Collaborative Innovation Center of Hematology, Suzhou 215006, China
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Hu XB, Yang YN, Zhang MY, Miao M, Bai YN, Zheng S, Wang MZ. [Present situation and influencing factors on classroom mobile phone dependence syndrome in college students]. Zhonghua Liu Xing Bing Xue Za Zhi 2017; 38:1352-1357. [PMID: 29060978 DOI: 10.3760/cma.j.issn.0254-6450.2017.10.011] [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 explore the current situation and influencing factors on Classroom Mobile Phone Dependence Syndrome (CMPDS) among college students, and to provide scientific basis for guiding college students to use mobile phones reasonably and healthily. Methods: Stratified cluster sampling method was used. Students from different majors and different grades in Lanzhou University were included as the research objects. Classes were recognized as a unit in receiving basic field investigation in this questionnaire related study. Informed consent principles were followed and process of survey was anonymously carried out. Results: The overall rate of CMPDS in college students was 8.7%, including 'mild rate' as 6.6% and 'seriously mild rate' as 2.1%. No significant differences were found on genders or grades. Factors as shopping in the classroom shopping (OR=3.720), being bored on courses (OR=1.740), WiFi coverage (OR=1.787), time of practice in the classrooms (OR=1.514), and the total time of daily mobile phone use (OR=1.513) etc, appeared as risk factors related to CMPDS among the college students. However. shooting courseware (OR=0.579) appeared as a protective factor. Conclusions: Rate of CMPDS was high in college students and we suggested to form a joint task force among the college authority, teachers and students to work on the related problems. Hopefully, the serious CMPDS condition will be minimized and both physical and mental health of the college students be improved.
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Affiliation(s)
- X B Hu
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - Y N Yang
- Pediatric Department of Second Hospital Affiliated to Lanzhou University, Lanzhou 730030, China
| | - M Y Zhang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - M Miao
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - Y N Bai
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - S Zheng
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - M Z Wang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
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Liu X, Xu CF, Xu L, Miao M, Cao QF, Yu CH, Li YM. [Association between serum apolipoprotein B level and nonalcoholic fatty liver disease]. Zhonghua Gan Zang Bing Za Zhi 2017; 25:44-46. [PMID: 28297779 DOI: 10.3760/cma.j.issn.1007-3418.2017.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- X Liu
- Gastroenterology Department, Ningbo Seventh Hospital, Ningbo 315202, China
| | - C F Xu
- Gastroenterology Department, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - L Xu
- Gastroenterology Department, Ningbo First Hospital, Ningbo 315010, China
| | - M Miao
- Gastroenterology Department, The Affiliated Hospital of School of Medicine of Ningbo University, Ningbo 315020, China
| | - Q F Cao
- Gastroenterology Department, Ningbo Seventh Hospital, Ningbo 315202, China
| | - C H Yu
- Gastroenterology Department, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Y M Li
- Gastroenterology Department, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
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Abstract
To evaluate the genotype-phenotype relationship of Gitelman syndrome in Chinese patients. We selected patients with Gitelman syndrome presenting hypokalemia. Medical history, clinical manifestations, laboratory test results, and imaging data of these patients were collected for analysis. Target gene sequencing was performed to evaluate the genotype-phenotype relationship. Gitelman syndrome was diagnosed based on medical history, clinical manifestations, laboratory test results, and imaging data. The causative gene for Gitelman syndrome, SLC12A3, and the causative gene for the classic Bartter syndrome, CLCNKB, were screened for disease-causing mutations by direct sequencing. Clinical diagnoses of ten patients were consistent with Gitelman syndrome. Disease-causing mutations in the SLC12A3 gene were found in six patients. Among the variants, T60M in exon 1 was the hot spot in Chinese patients. Additionally, we found a small deletion of ACGG in exon 3 and L671P in exon 16; these have not been reported in previous studies. No disease-causing mutations were observed in the other four patients. Since mutations in the SLC12A3 and CLCNKB genes are not present in all patients with clinical manifestations of Gitelman syndrome, genetic screening after clinical diagnosis is essential.
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Affiliation(s)
- M Miao
- Key Laboratory of Endocrine Diseases of Liaoning Province, Department of Endocrinology and Metabolism, Institute of Endocrinology, The First Affiliated Hospital, China Medical University, Shenyang, China
| | - C Q Zhao
- Key Laboratory of Endocrine Diseases of Liaoning Province, Department of Endocrinology and Metabolism, Institute of Endocrinology, The First Affiliated Hospital, China Medical University, Shenyang, China
| | - X L Wang
- Key Laboratory of Endocrine Diseases of Liaoning Province, Department of Endocrinology and Metabolism, Institute of Endocrinology, The First Affiliated Hospital, China Medical University, Shenyang, China
| | - Z Y Shan
- Key Laboratory of Endocrine Diseases of Liaoning Province, Department of Endocrinology and Metabolism, Institute of Endocrinology, The First Affiliated Hospital, China Medical University, Shenyang, China
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Gu B, Chen GH, Shen HJ, Ma X, Fu CC, Han Y, Tang XW, Miao M, Qiu HY, Sun AN, Wu DP. [Improved clinical outcome of acute myeloid leukemia with FLT3-ITD mutation treated with sorafenib]. Zhonghua Nei Ke Za Zhi 2016; 55:293-7. [PMID: 27030618 DOI: 10.3760/cma.j.issn.0578-1426.2016.04.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To analyze the efficacy of sorafenib on the treatment of patients diagnosed as acute myeloid leukemia(AML) with FLT3-ITD mutation. METHODS From January 2012 to February 2015, 42 cases of AML with FLT3-ITD mutation according to MICM (morphology, immunology, cytogenetics and molecular) diagnosis system in our hospital were retrospectively analyzed. Thirty-two cases were refractory to chemotherapy or relapsed, who were treated with sorafenib or combined with chemotherapy. Ten patients relapsed after allogeneic hematopoietic stem cell transplantation (allo-HSCT), who were retreated with sorafenib or combined with donor lymphocyte infusion (DLI) or chemotherapy. In the first group, 13 of 32 patients accepted allo-HSCT. RESULTS The overall response rate of all 42 patients was 73.8%, including 4 (9.5%) complete molecular remission (CMR), 9 (21.4%) complete remission (CR), 8 (19%) complete remission with incomplete hematologic recovery (CRi), 10 (23.8%) partial remission (PR), and 11 (26.2%) none remission (NR). The response rate of sorafenib alone for 17 patients was 70.6%, and that of sorafenib plus chemotherapy was 66.7% (P=0.555). Thirteen patients who received allo-HSCT included 6 CMR/CR/CRi, 4 PR, and 3 NR before transplant. The 2-year overall survival (OS) rate and progress free survival (PFS) rate in all patients were 36.9% and 28.7%, and the corresponding median time were 18 months and 9 months respectively. The 2-year OS rate in 23 patients who received sorafenib combined with allo-HSCT was superior to that in 19 patients not receiving allo-HSCT (45.5% vs 23.9%, P=0.041), so was PFS rate (44.0% vs 9.7%, P=0.014). Twelve cases died of disease progression, four of infection, and one of chronic graft versus host disease after transplant. CONCLUSIONS Sorafenib combined with chemotherapy improves response rate of AML patients with FLT3-ITD mutation. Those who are treated with sorafenib plus allo-HSCT obtain better long-term survival.
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Affiliation(s)
- B Gu
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Collaborative Innovation Center of Hematology, Suzhou Institute of Blood and Marrow Transplantation, Suzhou 215006, China
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Yang M, Yuan H, Miao M, Xu W. The osteogenic potential of ligament fibroblasts is greater in ankylosing spondylitis patients than in patients with osteoarthritis. Z Rheumatol 2016; 74:340-5. [PMID: 25876050 DOI: 10.1007/s00393-014-1394-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [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: 12/20/2022]
Abstract
BACKGROUND The goal of the present study was to investigate the osteogenic potential of ligament fibroblasts from patients with ankylosing spondylitis (AS). MATERIALS AND METHODS Ligament fibroblasts were isolated from tissues harvested from AS patients and patients with aseptic necrosis of the femoral head (ANFH) who had undergone total hip arthroplasty (THA). Cells were cultured in osteogenic induction medium (OIM) with or without bone morphogenetic protein 2 (BMP-2) for 30 days. During this time, the levels of alkaline phosphatase (ALP) and osteocalcin (OC) were determined as markers of osteogenesis. RESULTS Ligament fibroblasts isolated from patients with AS exhibited significantly greater potential for differentiation than those isolated from patients with osteoarthritis (ANFH). CONCLUSION These findings illuminate osteogenesis as a new pathway for studying the mechanism underlying ankylosis in AS patients. Factors which cause localized stromal remodeling at the enthesis significantly influence formation of new bone and further research is required to determine the mechanisms responsible for the osteogenic potential of enthesis cells and ligament fibroblasts in AS patients.
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Affiliation(s)
- M Yang
- Department of Orthopedics, Changhai Hospital, the Second Military Medical University, 200433, Shanghai, P. R. China
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Liu D, Chi Z, Yang H, Miao M, Jing Z. SU-E-P-48: Evaluation of Intensity Modulated Radiotherapy (IMRT) with Three Different Commercial Planning Systems for the Treatment of Cervical Cancer. Med Phys 2015. [DOI: 10.1118/1.4923982] [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: 11/07/2022] Open
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Yang J, Liu D, Miao M, Jing Z, Li Z. SU-E-P-53: A Plan Quality Comparison for Volumetric-Modulated Arc Therapy by Different Maximum Delivery Time Setting for Cervical and Upper Thoracic Esophageal Cancer. Med Phys 2015. [DOI: 10.1118/1.4923987] [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: 11/07/2022] Open
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Eibaid AI, Miao M, Jiang B, Bashari MO, Musa A. Improvement of 2-O-α-D-Glucopyranosyl-L-Ascorbic Acid Biosynthesis Using Ultrasonic Radiation. TROP J PHARM RES 2015. [DOI: 10.4314/tjpr.v14i4.6] [Citation(s) in RCA: 2] [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: 11/17/2022] Open
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Li W, Miao M, Gan Y, Zhang Z, Cheng G. The relationship between meaning discrepancy and emotional distress among patients with cancer: the role of posttraumatic growth in a collectivistic culture. Eur J Cancer Care (Engl) 2015; 25:491-501. [PMID: 25711851 DOI: 10.1111/ecc.12298] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2015] [Indexed: 11/30/2022]
Affiliation(s)
- W.J. Li
- Department of Oncology; Beijing Hospital; Beijing China
| | - M. Miao
- Department of Psychology; Peking University; Beijing China
| | - Y.Q. Gan
- Department of Psychology; Peking University; Beijing China
| | - Z.J. Zhang
- Department of Oncology; Beijing Hospital; Beijing China
| | - G. Cheng
- Department of Oncology; Beijing Hospital; Beijing China
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Liu D, Yang J, Li Z, Shang K, Jing Z, Wang J, Miao M. SU-E-T-164: Evaluation of Electron Dose Distribution Using Two Algorithms. Med Phys 2014. [DOI: 10.1118/1.4888493] [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: 11/07/2022] Open
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Ren Y, Wang B, Liu X, Li Z, Yuan W, Sun Y, Miao M. Association between body fat distribution and androgen deficiency in middle-aged and elderly men in China. Int J Impot Res 2013; 26:116-9. [PMID: 24352246 DOI: 10.1038/ijir.2013.48] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2012] [Revised: 08/17/2013] [Accepted: 11/06/2013] [Indexed: 11/09/2022]
Abstract
The objective of the present study was to examine the association between body fat distribution and total testosterone (TT) and free testosterone (FT) levels among middle-aged and elderly men. A total of 922 male residents aged 40-70 years from a community in Shanghai, China, participated in the study. Their waist circumference (WC), waist-height ratio (WHtR), body mass index (BMI), and TT and FT concentrations were measured. Logistic regression models were used to estimate testosterone deficiency risk on the basis of anthropometric indices. BMI, WC and WHtR were all associated with TT deficiency. The participants in the highest quartiles of above-mentioned anthropometric indices had the highest risk of TT deficiency (BMI: odds ratio (OR)=4.40, 95% confidence interval (CI)=2.69-7.19; WC: OR=3.47, 95% CI=2.14-5.60; WHtR: OR=2.89, 95% CI=1.76-4.76). WC and WHtR were associated with FT deficiency. The participants in the highest quartiles had the highest risk of FT deficiency (WC: OR=1.87, 95% CI=1.18-2.97; WHtR: OR=1.67, 95% CI=1.04-2.66). The association between BMI and FT deficiency was not statistically significant (OR=1.21 for the highest quartile, 95% CI=0.78-1.87). Our study demonstrated that both general and abdominal obesity were associated with TT deficiency, whereas only abdominal obesity was found to be associated with FT deficiency.
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Affiliation(s)
- Y Ren
- Weifang Medical University, Weifang, China
| | - B Wang
- National Population and Family Planning Key Laboratory of Contraceptive Drugs and Devices, Shanghai Institute of Planned Parenthood Research, Shanghai, China
| | - X Liu
- National Population and Family Planning Key Laboratory of Contraceptive Drugs and Devices, Shanghai Institute of Planned Parenthood Research, Shanghai, China
| | - Z Li
- Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - W Yuan
- National Population and Family Planning Key Laboratory of Contraceptive Drugs and Devices, Shanghai Institute of Planned Parenthood Research, Shanghai, China
| | - Y Sun
- Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - M Miao
- National Population and Family Planning Key Laboratory of Contraceptive Drugs and Devices, Shanghai Institute of Planned Parenthood Research, Shanghai, China
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Miao M, Zhou X, Li Y, Zhang O, Zhou Z, Li T, Yuan W, Li R, Li DK. LINE-1 hypomethylation in spermatozoa is associated with Bisphenol A exposure. Andrology 2013; 2:138-44. [PMID: 24293158 DOI: 10.1111/j.2047-2927.2013.00166.x] [Citation(s) in RCA: 58] [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: 05/22/2013] [Revised: 10/24/2013] [Accepted: 10/29/2013] [Indexed: 11/30/2022]
Abstract
Bisphenol A (BPA) is an endocrine disruptor with potentially harmful effects on humans. However, epigenetic mechanisms that modulate the effects of BPA remain unclear. Methylation of long interspersed nucleotide elements (LINE-1) is a marker of genome-wide methylation status. This study aims to examine whether BPA exposure was associated with LINE-1 methylation changes in men. Male factory workers in Hunan, China (N = 149) were studied, 77 with BPA exposure in workplace (BPA-exposed group) and 72 without BPA exposure in workplace (control group). Pre-shift and post-shift urine samples were collected from the BPA-exposed group and spot urine samples were collected from the control group. Urine samples were assessed for BPA. In addition, blood and semen samples were collected from both groups for LINE-1 methylation analysis. In multivariate analysis adjusted for age, education, smoking habits and alcohol consumption, sperm LINE-1 methylation level was significantly lower in BPA exposed workers (p < 0.001) compared to that in the unexposed workers. Linear regression analysis also showed that log-transformed urine BPA levels were inversely associated with sperm LINE-1 methylation (p < 0.0001), but not peripheral blood cell LINE-1 methylation. Moreover, the association between urine BPA level and semen quality was not attenuated after adjustments for LINE-1 level. In summary, the observed independent relationship between BPA exposure and LINE-1 methylation may have public health implications on reproductive health in men because of ubiquitous exposure to BPA.
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Affiliation(s)
- M Miao
- WHO Collaborating Center for Research in Human Reproduction, Shanghai, China; Key Laboratory of Contraceptive Drugs and Devices of NPFPC, Shanghai Institute of Planned Parenthood Research, Shanghai, China
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Li DK, Zhou Z, Miao M, He Y, Qing D, Wu T, Wang J, Weng X, Ferber J, Herrinton LJ, Zhu Q, Gao E, Yuan W. Relationship Between Urine Bisphenol-A Level and Declining Male Sexual Function. ACTA ACUST UNITED AC 2010; 31:500-6. [DOI: 10.2164/jandrol.110.010413] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Lou H, Ding W, Dong M, Zhu Y, Zhou C, Wang Z, Yang X, Yao Q, Li D, Miao M. The Presence of Hepatitis B Surface Antigen in the Ova of Pregnant Women and Its Relationship with Intra-Uterine Infection by Hepatitis B Virus. J Int Med Res 2010; 38:214-9. [PMID: 20233532 DOI: 10.1177/147323001003800125] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Vertical transmission of hepatitis B virus (HBV) has been proposed to play an important role in mother-to-child transmission, although the extent to which vertical transmission via oocytes contributes to neonatal HBV infection remains unknown. Ovarian biopsies were collected during caesarean sections in 68 clinically asymptomatic pregnant women who were carriers of HBV. The presence of hepatitis B surface antigen (HBsAg) in the ova of pregnant women was determined by immunohistochemistry. Serum markers of HBV infection in pregnant women and their neonates were analysed. It was found that, of 68 women, the ova were positive for HBsAg in only one woman and her neonate was negative for any serum HBV markers 3 days after birth. Of 68 neonates, one was positive for serum HBV markers 3 days after birth and his mother's ova were negative for HBsAg. These findings indicate that vertical transmission via oocytes may not be the major route of HBV intra-uterine infection.
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Affiliation(s)
- H Lou
- Department of Obstetrics, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - W Ding
- Department of Pathology, The First Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - M Dong
- Department of Obstetrics, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Y Zhu
- Department of Obstetrics, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - C Zhou
- Department of Pathology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Z Wang
- Department of Obstetrics, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - X Yang
- Department of Obstetrics, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Q Yao
- Department of Obstetrics, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - D Li
- Department of Obstetrics, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - M Miao
- Department of Obstetrics, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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Li D, Zhou Z, Qing D, He Y, Wu T, Miao M, Wang J, Weng X, Ferber J, Herrinton L, Zhu Q, Gao E, Checkoway H, Yuan W. Occupational exposure to bisphenol-A (BPA) and the risk of Self-Reported Male Sexual Dysfunction. Hum Reprod 2009; 25:519-27. [DOI: 10.1093/humrep/dep381] [Citation(s) in RCA: 204] [Impact Index Per Article: 13.6] [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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Yi Z, Chen Z, Warren A, Roberts D, Al-Rasheid KAS, Miao M, Gao S, Shao C, Song W. Molecular phylogeny ofPseudokeronopsis(Protozoa, Ciliophora, Urostylida), with reconsideration of three closely related species at inter- and intra-specific levels inferred from the small subunit ribosomal RNA gene and the ITS1-5.8S-ITS2 region sequences. J Zool (1987) 2008. [DOI: 10.1111/j.1469-7998.2008.00438.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Miao M, Bruce AEE, Bhanji T, Davis EC, Keeley FW. Differential expression of two tropoelastin genes in zebrafish. Matrix Biol 2006; 26:115-24. [PMID: 17112714 DOI: 10.1016/j.matbio.2006.09.011] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2006] [Revised: 09/19/2006] [Accepted: 09/19/2006] [Indexed: 11/15/2022]
Abstract
Elastin is the extracellular matrix protein responsible for properties of extensibility and elastic recoil in large blood vessels, lung and skin of most vertebrates. Elastin is synthesized as a monomer, tropoelastin, but is rapidly transformed into its final polymeric form in the extracellular matrix. Until recently information on sequence and developmental expression of tropoelastins was limited to mammalian and avian species. We have recently identified and characterized two expressed tropoelastin genes in zebrafish. This was the first example of a species with multiple tropoelastin genes, raising the possibility of differential expression and function of these tropoelastins in elastic tissues of the zebrafish. Here we have investigated the temporal expression and tissue distribution of the two tropoelastin genes in developing and adult zebrafish. Expression was detected early in skeletal cartilage structures of the head, in the developing outflow tract of the heart, including the bulbus arteriosus and the ventral aorta, and in the wall of the swim bladder. While the temporal pattern of expression was similar for both genes, the upregulation of eln2 was much stronger than that of eln1. In general, both genes were expressed and their gene products deposited in most of the elastic tissues examined, with the notable exception of the bulbus arteriosus in which eln2 expression and its gene product was predominant. This finding may represent a sub-specialization of eln2 to provide the unique architecture of elastin and the specific mechanical properties required by this organ.
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Affiliation(s)
- M Miao
- Cardiovascular Research, Hospital for Sick Children, Toronto, ON, Canada
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Chen Z, Li B, Miao M, Yang G, Yin J, Su Q. Simultaneous Determination of Palladium, Platinum and Rhodium by On-Line Column Enrichment and HPLC with 4-Hydroxy-1-Naphthalthiorhodanine as Pre-Column Derivatization Reagents. Mikrochim Acta 2005. [DOI: 10.1007/s00604-005-0385-9] [Citation(s) in RCA: 3] [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: 11/28/2022]
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He G, Wang X, Miao M, Wu D, Ruan C. P-86 Changes of subsets of Th cellsand DC1 in the bone marrow of severe aplastic anemia and myelodysplastic syndrome. Leuk Res 2005. [DOI: 10.1016/s0145-2126(05)80150-x] [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: 10/25/2022]
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Affiliation(s)
- P-J Zhang
- Institute for Animal Husbandry and Veterinary Science, Beijing Academy of Agricultural and Forestry Sciences, Beijing, China
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Lim BS, Willer MW, Miao M, Holm RH. Monodithiolene molybdenum(V, VI) complexes: a structural analogue of the oxidized active site of the sulfite oxidase enzyme family. J Am Chem Soc 2001; 123:8343-9. [PMID: 11516283 DOI: 10.1021/ja010786g] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.1] [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
The active sites of the xanthine oxidase and sulfite oxidase enzyme families contain one pterin-dithiolene cofactor ligand bound to a molybdenum atom. Consequently, monodithiolene molybdenum complexes have been sought by exploratory synthesis for structural and reactivity studies. Reaction of [MoO(S(2)C(2)Me(2))(2)](1-) or [MoO(bdt)(2)](1-) with PhSeCl results in removal of one dithiolate ligand and formation of [MoOCl(2)(S(2)C(2)Me(2))](1-) (1) or [MoOCl(2)(bdt)](1-) (2), which undergoes ligand substitution reactions to form other monodithiolene complexes [MoO(2-AdS)(2)(S(2)C(2)Me(2))](1-) (3), [MoO(SR)(2)(bdt)](1-) (R = 2-Ad (4), 2,4,6-Pr(i)(3)C(6)H(2) (5)), and [MoOCl(SC(6)H(2)-2,4,6-Pr(i)(3))(bdt)](1-) (6) (Ad = 2-adamantyl, bdt = benzene-1,2-dithiolate). These complexes have square pyramidal structures with apical oxo ligands, exhibit rhombic EPR spectra, and 3-5 are electrochemically reducible to Mo(IV)O species. Complexes 1-6 constitute the first examples of five-coordinate monodithiolene Mo(V)O complexes; 6 approaches the proposed structure of the high-pH form of sulfite oxidase. Treatment of [MoO(2)(OSiPh(3))(2)] with Li(2)(bdt) in THF affords [MoO(2)(OSiPh(3))(bdt)](1-) (8). Reaction of 8 with 2,4,6-Pr(i)(3)C(6)H(2)SH in acetonitrile gives [MoO(2)(SC(6)H(2)-2,4,6-Pr(i)(3))(bdt)](1-) (9, 55%). Complexes 8 and 9 are square pyramidal with apical and basal oxo ligands. With one dithiolene and one thiolate ligand of a square pyramidal Mo(VI)O(2)S(3) coordination unit, 9 closely resembles the oxidized sites in sulfite oxidase and assimilatory nitrate reductase as deduced from crystallography (sulfite oxidase) and Mo EXAFS. The complex is the first structural analogue of the active sites in fully oxidized members of the sulfite oxidase family. This work provides a starting point for the development of both structural and reactivity analogues of members of this family.
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Affiliation(s)
- B S Lim
- Department of Chemistry and Chemical Biology, Harvard University, Cambridge, MA 02138, USA
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Miao M, Qin ZL, Niu XT. [Trace elements and extracellular matrix]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2001; 15:188-90. [PMID: 11393965] [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
OBJECTIVE To investigate the effects of trace elements on the metabolism of extracellular matrix and explore the physiological and pathological mechanism of trauma. METHODS Based on the experimental and clinical data, it was studied that the action of trace elements in the metabolism of extracellular matrix in trauma repairing. RESULTS During wound healing, the trace elements were the components of many kinds of enzymes, carriers and proteins. They took part in the synthesis of hormones and vitamins as well as the transmission of information system. They activated many different kinds of enzymes and regulate the levels of free radicals. The trace elements had the complicated effects on the synthesis, decompose, deposition and reconstruction of collagen and other extracellular matrix. CONCLUSION The trace elements play an important role in regulating the metabolism of extracellular matrix.
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Affiliation(s)
- M Miao
- Department of Plastic Surgery, Third Hospital of Peking University, Beijing, P. R. China 100083
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Low WK, Lin Q, Stathakis C, Miao M, Fletcher GL, Hew CL. Isolation and characterization of skin-type, type I antifreeze polypeptides from the longhorn sculpin, Myoxocephalus octodecemspinosus. J Biol Chem 2001; 276:11582-9. [PMID: 11136728 DOI: 10.1074/jbc.m009293200] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [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: 11/06/2022] Open
Abstract
The antifreeze polypeptides (AFPs) are found in several marine fish and have been grouped into four distinct biochemical classes (type I-IV). Recently, the new subclass of skin-type, type I AFPs that are produced intracellularly as mature polypeptides have been identified in the winter flounder (Pleuronectes americanus) and the shorthorn sculpin (Myoxocephalus scorpius). This study demonstrates the presence of skin-type AFPs in the longhorn sculpin (Myoxocephalus octodecemspinosus), which produces type IV serum AFPs. Using polymerase chain reaction-based methods, a clone that encoded for a type I AFP was identified. The clone lacked a signal sequence, indicating that the mature polypeptide is produced in the cytosol. A recombinant protein was produced in Escherichia coli and antifreeze activity was characterized. Four individual Ala-rich polypeptides with antifreeze activity were isolated from the skin tissue. One polypeptide was completely sequenced by tandem MS. This study provides the first evidence of a fish species that produces two different biochemical classes of antifreeze proteins (type I and type IV), and enforces the notion that skin-type AFPs are a widespread biological phenomenon in fish.
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Affiliation(s)
- W K Low
- Division of Structural Biology and Biochemistry, Hospital for Sick Children, Toronto, Ontario, M5G 1X8, Canada
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Miao M, Chan SL, Fletcher GL, Hew CL. The rat ortholog of the presumptive flounder antifreeze enhancer-binding protein is a helicase domain-containing protein. Eur J Biochem 2000; 267:7237-46. [PMID: 11106437 DOI: 10.1046/j.1432-1327.2000.01836.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The expression of winter flounder liver-type antifreeze protein (wflAFP) genes is tissue-specific and under seasonal and hormonal regulation. The only intron of the major wflAFP gene was demonstrated to be a liver-specific enhancer in both mammalian cell lines and flounder hepatocytes. Element B, the core enhancer sequence, was shown to interact specifically with a liver-enriched transcription factor, CCAAT/enhancer-binding protein alpha (C/EBPalpha), as well as a presumptive antifreeze enhancer-binding protein (AEP). In this study, the identity of the rat AEP ortholog was revealed via its DNA-protein interaction with element B. It is a helicase-domain-containing protein, 988 amino acids in length, and is homologous to mouse Smubp-2, hamster Rip-1 and human Smubp-2. The specific binding between element B and AEP was confirmed by South-Western analysis and gel retardation assays. Residues in element B important to this interaction were identified by methylation interference assays. Mutation on one of the residues disrupted the binding between element B and AEP and its enhancer activity was significantly reduced, suggesting that AEP is essential for the transactivation of the wflAFP gene intron. The rat AEP is ubiquitously expressed in various tissues, and the flounder homolog is present as shown by genomic Southern analysis. The potential role of AEP in regulating the flounder AFP gene expression is discussed.
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Affiliation(s)
- M Miao
- Division of Structural Biology and Biochemistry, Hospital for Sick Children, and Departments of Biochemistry and Laboratory Medicine & Pathobiology, University of Toronto, Toronto, Ontario, Canada.
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