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Feng X, Zhang L, Niu H, Zhang H, Yang L, Wen Y, Chen SY, Shi Y, He Z, Yu L, Wang Y, Huang X, Wang Z, Qin M, Wen X, Zhang Z, Song J, Zheng Z, Yin H, Zhang H, Ma L, Wei J, Wu X, Zhang L, Zhao Y, Lu Q, Xiao H, Liu T, Fang P, Wei L, Gandhi RT, Dong J. Selective internal radiation therapy with yttrium-90 resin microspheres followed by anatomical hepatectomy: A potential curative strategy in advanced hepatocellular carcinoma. Asia Pac J Clin Oncol 2024; 20:319-322. [PMID: 36658669 DOI: 10.1111/ajco.13900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 10/17/2022] [Accepted: 10/21/2022] [Indexed: 01/21/2023]
Abstract
About 80% of hepatocellular carcinoma (HCC) patients are in advanced stages and ineligible for curative surgery. Palliative treatments just maintained limited survival, thus an effective downstaging therapy is badly needed. Here we report an initially unresectable patient who underwent radical hepatectomy after successful downstaging with selective internal radiation therapy (SIRT). A 34-year-old man was diagnosed with China Liver Cancer Staging (CNLC) IIIa HCC. Due to insufficient future liver remnant and vascular involvement, the patient was suggested to be unresectable. SIRT with yttrium-90 resin microspheres was given. At three months post-SIRT, a complete response was achieved. The tumor was downstaged to CNLC Ia stage. The patient underwent anatomical hepatectomy 5 months after SIRT. Histopathological examination of the resected specimen showed 4% viable tumor cells inside a necrotic mass. To our knowledge, this is the first case who underwent SIRT with yttrium-90 resin microspheres in China mainland. The success of the downstaging in this case renders a possible cure to be achieved in an initially unresectable patient. In addition, the nearly complete tumor necrosis in the resected specimen indicates a good prognosis post-surgery. This is the first case who underwent SIRT with yttrium-90 resin microspheres in China mainland. SIRT followed by anatomical hepatectomy is a potentially curative strategy for unresectable HCC, which deserves a confirmative trial in the future.
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Affiliation(s)
- Xiaobin Feng
- Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Lin Zhang
- Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | | | - Hui Zhang
- The Southwest Hospital of Army Medical University, Chongqing, China
| | - Li Yang
- Hainan Bo'ao Super Hospital, Qionghai, China
| | - Yong Wen
- Hainan Bo'ao Super Hospital, Qionghai, China
| | - Steve Y Chen
- Department of Radiology, Banner University Medical Center-Phoenix, University of Arizona College of Medicine, Phoenix, Arizona, USA
| | - Yuhong Shi
- The Second Affiliated Hospital of Chengdu Medical College, China National Nuclear Corporation 416 Hospital, Chengdu, China
| | - Zuoxiang He
- Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Lijuan Yu
- Hainan Cancer Hospital, Haikou, China
| | | | - Xin Huang
- Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | | | - Mengmeng Qin
- Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Xiaoxi Wen
- Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Zhenyu Zhang
- Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Jiyong Song
- Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Zhuozhao Zheng
- Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Hongfang Yin
- Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Huan Zhang
- Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Lijuan Ma
- Hainan Bo'ao Super Hospital, Qionghai, China
| | - Jixiang Wei
- Hainan Bo'ao Super Hospital, Qionghai, China
| | - Xinlai Wu
- Hainan Cancer Hospital, Haikou, China
| | - Leida Zhang
- The Southwest Hospital of Army Medical University, Chongqing, China
| | - Yue Zhao
- Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Qian Lu
- Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Hui Xiao
- Hainan Bo'ao Super Hospital, Qionghai, China
| | | | - Pihua Fang
- Hainan Bo'ao Super Hospital, Qionghai, China
| | - Lai Wei
- Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Ripal T Gandhi
- Department of Interventional Radiology, Florida International University Herbert Wertheim College of Medicine, Miami, Florida, USA
| | - Jiahong Dong
- Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
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Chen W, Bai Y, Fang P, Chen J, Wang X, Li Y, Luo X, Xiao Z, Iyer R, Shan F, Yuan T, Wu M, Huang X, Fang D, Yang Q, Zhang Y. Body mass index's effect on CRSwNP extends to pathological endotype and recurrence. Rhinology 2024; 0:3161. [PMID: 38416065 DOI: 10.4193/rhin23.402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
BACKGROUND Elevated body mass index (BMI) has been recognized as an important contributor to corticosteroid insensitivity in chronic rhinosinusitis with nasal polyps (CRSwNP). We aimed to delineate the effects of elevated BMI on immunological endotype and recurrence in CRSwNP individuals. METHODOLOGY A total of 325 patients with CRSwNP undergoing FESS were recruited and stratified by BMI. H&E staining was employed for histological evaluation. Characteristics of inflammatory patterns were identified by immunohistochemical staining. The predictive factors for recurrence were determined and evaluated by multivariable logistic regression analysis and the receiver operating characteristic (ROC) curves across all subjects and by weight group. RESULTS In all patients with CRSwNP, 26.15% subjects were classified as overweight/obese group across BMI categories and exhibited a higher symptom burden. The upregulated eosinophil/neutrophil-dominant cellular endotype and amplified type 2/ type 3 coexisting inflammation was present in overweight/obese compared to underweight/normal weight controls. Additionally, a higher recurrent proportion was shown in overweight/obese patients than that in underweight/normal weight cohorts. Multivariable logistic regression analysis identified BMI as an independent predictor for recurrence. The predictive capacity of each conventional parameter (tissue eosinophil and CLCs count, and blood eosinophil percentage) alone or in combination was poor in overweight/obese subjects. CONCLUSIONS Overweight/obese CRSwNP stands for a unique phenotype and endotype. Conventional parameters predicting recurrence are compromised in overweight/obese CRSwNP, and there is an urgent need for novel biomarkers that predict recurrence for these patients.
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Affiliation(s)
- W Chen
- Department of Otolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Y Bai
- Department of Otolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - P Fang
- Department of Otolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - J Chen
- Department of Otolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - X Wang
- Department of Otolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Y Li
- Department of Otolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - X Luo
- Department of Otolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Z Xiao
- Department of Otolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - R Iyer
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - F Shan
- Department of Otolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - T Yuan
- Department of Otolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - M Wu
- Department of Otolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - X Huang
- Department of Otolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - D Fang
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Q Yang
- Department of Otolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Y Zhang
- Department of Otolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Diabetology, Guangzhou Key Laboratory of Mechanistic and Translational Obesity Research, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
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Manzar GS, Wu SY, Dudzinski SO, Jallouk A, Yoder AK, Nasr LF, Corrigan KL, Gunther JR, Ahmed S, Fayad L, Nair R, Steiner R, Westin J, Neelapu SS, Dabaja B, Strati P, Nastoupil L, Pinnix CC, Fang P, Rooney MK. Outcomes with Bridging Radiation Therapy Prior to CAR-T Cell Therapy in Pts with Aggressive B Cell Lymphomas. Int J Radiat Oncol Biol Phys 2023; 117:e483-e484. [PMID: 37785529 DOI: 10.1016/j.ijrobp.2023.06.1708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Select patient (pts) with relapsed/refractory aggressive B cell lymphoma may benefit from bridging radiation (bRT) prior to anti-CD19-directed chimeric antigen receptor T cell therapy (CART). Here, we examined pt and treatment factors associated with outcome after bRT and CART. MATERIALS/METHODS We retrospectively reviewed adults with DLBCL who received bRT prior to axicabtagene ciloleucel 11/2017-12/2022. Clinical/treatment characteristics, response, and toxicity were extracted. Progression free survival (PFS), disease specific survival (DSS) and overall survival (OS) were modeled using Kaplan-Meier for events distributed over time, or binary logistic regression for disease response. Fisher's Exact Test or Mann-Whitney U methods were used. RESULTS Among 40 pts, 11 (28%) had limited stage disease at apheresis, and 14 (35%) received bRT in addition to bridging systemic therapy. Thirty-two (80%) pts received bRT post-leukapheresis. bRT was delivered with a median dose of 30 Gy (range: 4-46) in 10 fractions (range: 2-23). Eighteen (45%) pts received <30 Gy. Twenty-two pts (55%) received bRT comprehensively to all sites of disease, including 9 pts who had limited stage. Eleven pts had bulky disease (≥ 10 cm) at the time of bRT. After CART, 4 pts (10%) experienced Grade ≥3 cytokine release syndrome (CRS), 16 (40%) had Grade ≥2 CRS, and 16 (38%) had Grade ≥3 neurotoxicity. Twenty-three pts (57.5%) had CR at 30 days post-CART infusion. Nine had PR (22.5%), of whom 2 pts eventually developed CR at three months and 1 at nine months. Eight pts (20%) had either PD or SD. Of 23 pts who experienced CR, 11 relapsed-6 at three months and 5 at six months. At a median follow up of 9.6 months (95% CI: 6.6-16.2), 22 pts relapsed: 6 (27.3%) in-field, 10 (5.5%) out-of-field, 4 (18.2%) both, and 2 (9.1%) unknown. The median PFS was 8.87 months and median OS was 22 months. PFS at 1 year was 70% (53-82) and at 2 years was 42% (27-57). OS at 1 and 2 years was 72.5% (56-84) and 51% (34-65), respectively. Seventeen pts (42.5%) remain alive at last follow-up, 13 (76.5%) of whom have no evidence of disease (NED). On univariate analysis, OS and PFS at 1 year were 67% (43-83) and 49% (27-68) for those who received RT comprehensively (n = 22), and 41.9% (19-64) and 33.3% (14-54) for those who did not (n = 18; both p≤0.03). Disease bulk (≥10 cm) was associated with significant decrement in DSS (p = 0.03), but not PFS (p = 0.16) or OS (p = 0.24). Among pts treated comprehensively with bRT (n = 22), there was no association of tumor bulk with OS, PFS, or DSS (p>0.2). IPI ≥3 was associated with worse DSS (p = 0.045) and trended towards worse PFS (p = 0.054), but not OS (p = 0.23). There was no difference in PFS, OS, or DSS between pts who received bRT or chemoRT (p>0.3). CONCLUSION bRT and CART is a good treatment strategy for select pts with aggressive B cell lymphoma. When feasible, and with a caveat that other variables influence patient disposition, bRT for CART is associated with improved outcomes after comprehensive RT to all sites of disease.
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Affiliation(s)
- G S Manzar
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S Y Wu
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S O Dudzinski
- Vanderbilt University School of Medicine, Nashville, TN
| | - A Jallouk
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - A K Yoder
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - L F Nasr
- Department of Lymphoma-Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - K L Corrigan
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - J R Gunther
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S Ahmed
- Department of Lymphoma-Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - L Fayad
- Department of Lymphoma-Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - R Nair
- Department of Lymphoma-Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - R Steiner
- Department of Lymphoma-Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - J Westin
- Department of Lymphoma-Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S S Neelapu
- Department of Lymphoma-Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - B Dabaja
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - P Strati
- Department of Lymphoma-Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - L Nastoupil
- Department of Lymphoma-Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - C C Pinnix
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - P Fang
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - M K Rooney
- Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
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4
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Schrank BR, Manzar GS, Wu SY, Gunther JR, Fang P, Jabbour EJ, Lim TY, Daver NG, Cykowski MD, Fuller GN, Cachia D, Kamiya-Matsuoka C, Woodman KH, DiNardo CD, Jain N, Short NJ, Sasaki K, Dabaja B, Kantarjian HM, Pinnix CC. Dorsal Column Myelopathy Following Intrathecal Chemotherapy for Leukemia. Int J Radiat Oncol Biol Phys 2023; 117:e486-e487. [PMID: 37785537 DOI: 10.1016/j.ijrobp.2023.06.1715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Intrathecal (IT) methotrexate (Mtx) and/or cytarabine (AraC) improve CNS disease control in patients (pts) with hematologic malignancies. There are increasing number of case reports of irreversible, primarily dorsal column myelopathy in pts treated with IT chemotherapy. By describing the largest case series of myelopathy following IT chemotherapy, we aim to raise awareness about this devastating albeit rare complication. MATERIALS/METHODS We retrospectively reviewed 25 pts with leukemia who developed paraplegia following IT chemotherapy between 2/2006 and 9/2021. Clinical/treatment characteristics, response, and toxicity were extracted from the medical records. RESULTS Seventeen pts (68%) were male, 16 had B-cell ALL (64%), 4 had AML (16%), 2 had CML (8%), 2 had T-ALL (8%), and 1 had BPDCN (4%). The median age at diagnosis was 38 years (IQR 30-59). All pts required systemic salvage treatment after induction chemotherapy with a median number of 3 regimens received (IQR 2-5.5). In total, the median number of IT treatments was 19 per pt (IQR 14-27). Most pts (84%, n = 21) received single agent IT Mtx alternating with single agent AraC. Fifteen pts (60%) received triple IT therapy with a median of 3 treatments (IQR 0-8). Prior to the onset of myelopathy, 10 pts (40%) received allogeneic SCT and 9 pts (36%) were treated with radiation therapy. Median follow-up from diagnosis was 1.9 yrs (IQR 1.3-4.1). Myelopathy was progressive and irreversible in all pts (n = 25); 84% (n = 21) experienced sensory loss, and all pts had extremity weakness. Symptoms were ascending in 11 pts (44%) and descending in 4 pts (16%). Irreversible bowel/bladder incontinence developed in 12 pts (48%). CSF analysis at the time of symptom onset was negative for leukemia cells in most pts (n = 21, 84%) and showed malignant cells in 4 pts (16%). CSF studies showed elevated protein in 21 pts (84%). Myelin basic protein was elevated in all 13 assessed pts. On T2 weighted spinal MRI, all pts had enhancement of the dorsal columns, including 80% of pts with this dorsal column abnormality reported at the time of the study and 20% of pts (n = 5) with the dorsal enhancement noted retrospectively. Due to concern for occult disease, 20 pts (80%) received additional CNS-directed therapy after symptom onset. Twenty-two pts (88%) died at last follow-up. The time between neurological symptom onset and death was a median 3.5 months (IQR 2.6 and 5). Three pts (12%) are alive with paraplegia at a median of 4.4 years from symptom onset. CONCLUSION Dorsal column myelopathy is a rare but devastating condition that can occur after IT chemotherapy in heavily pre-treated leukemia pts. T2 weighted spinal MRI can be helpful in the evaluation of pts that present with unexplained weakness and sensory changes. We recommend delaying additional CNS-directed therapy until work-up to rule out alternative etiologies is complete. Future strategies are desperately needed to address this irreversible treatment complication.
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Affiliation(s)
- B R Schrank
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - G S Manzar
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S Y Wu
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - J R Gunther
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - P Fang
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - E J Jabbour
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - T Y Lim
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - N G Daver
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - M D Cykowski
- Department of Pathology and Genomic Medicine, Houston Methodist, Houston, TX
| | - G N Fuller
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - D Cachia
- Department of Neurology, UMass Memorial Health, Worcester, MA
| | - C Kamiya-Matsuoka
- Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - K H Woodman
- Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - C D DiNardo
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - N Jain
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - N J Short
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - K Sasaki
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - B Dabaja
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - H M Kantarjian
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - C C Pinnix
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
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5
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Cha E, Manzar GS, Corrigan KL, Yoder AK, Schrank BR, Nasr LF, Gunther JR, Strati P, Ahmed S, Fayad L, Nair R, Steiner R, Westin J, Nastoupil L, Neelapu SS, Pinnix CC, Dabaja B, Wu SY, Fang P. Outcomes and Toxicities in Patients with Diffuse Large B-Cell Lymphoma of the Gastrointestinal Tract. Int J Radiat Oncol Biol Phys 2023; 117:e460. [PMID: 37785475 DOI: 10.1016/j.ijrobp.2023.06.1655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Diffuse large B-cell lymphoma (DLBCL) involving the gastrointestinal (GI) tract is rare and long-term outcomes are not well defined. Combined modality therapy (CMT) with radiotherapy (RT) in addition to systemic therapy in this setting is not commonly pursued. We aim to characterize outcomes in patients with GI DLBCL treated with systemic therapy, with or without RT. MATERIALS/METHODS Patients diagnosed with DLBCL of the GI tract (with or without mesenteric involvement) treated at a single institution from 1988-2022 were retrospectively reviewed on an IRB-approved protocol. Clinical and treatment data were collected including adverse events (AE; acute vs late defined as before or 4 weeks after therapy end). Kaplan-Meier and Cox regression models were used to estimate survival. RESULTS Of 207 patients, 62% were male and median age at diagnosis was 63 (IQR 52-73). Gastric involvement was most common (n = 130, 63%), followed by small intestines (n = 48, 23%) and colon/rectum (n = 24, 12%). Most presented with early-stage disease (n = 124, 60%), with a median IPI score of 1. All patients received chemotherapy. Of 182 treated with CHOP/EPOCH, 36 (20%) were treated in the pre-rituximab era while 146 (80%) received rituximab. 66 patients (32%) were treated with RT, 89% as part of first line CMT. 50 cases (76%) received consolidative RT, while 10 (15%) targeted residual gross disease and 4 (6%) targeted distant sites. Median dose and fractionation were 36Gy (IQR 30.6-39.6) in 18 fractions (IQR 17-22). Over half (n = 132, 64%) developed grade 3+ acute chemotherapy AEs, and the most common were anemia (n = 64), febrile neutropenia (n = 40), and neutropenia (n = 20). Grade 3+ late chemotherapy AEs occurred in 14 patients (7%). Acute grade 3+ radiation AEs were uncommon (n = 2, 3%; colitis, emesis). No grade 3+ late radiation AEs were noted. Median follow-up was 46 months (IQR 16-97). 169 (81.6%) had a complete response (CR), with 154 (91%) after first line chemotherapy, 9 (5%) after second line, and 6 (4%) after RT. CR was defined by PET (62%), endoscopy (22%), CT (9%), or other methods (7%). The 5-year progression-free survival for those treated with one line of chemotherapy with or without RT was 95%. Median overall survival (OS) was not reached. Improved OS was associated with early-stage disease (p = 0.003), low IPI (p = 0.001), fewer chemotherapy lines (p<0.001), and CR (p<0.001). OS did not differ by gender, age, immunophenotype, GI site, SUVmax, or RT. Patients with early stage DLBCL treated with RT in the post-rituximab era received fewer chemotherapy cycles compared to those treated without RT (p = 0.02; median of 4 (IQR 3-6) vs 6 cycles (IQR 4-6)), with no OS difference. CONCLUSION GI DLBCL patients have favorable outcomes after CMT with minimal late toxicity. CMT with RT to the GI tract is well tolerated with no OS difference compared to chemotherapy alone, and may mitigate risks from additional chemotherapy cycles for selected early-stage patients.
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Affiliation(s)
- E Cha
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - G S Manzar
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - K L Corrigan
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - A K Yoder
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - B R Schrank
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - L F Nasr
- Department of Lymphoma-Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - J R Gunther
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - P Strati
- Department of Lymphoma-Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S Ahmed
- Department of Lymphoma-Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - L Fayad
- Department of Lymphoma-Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - R Nair
- Department of Lymphoma-Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - R Steiner
- Department of Lymphoma-Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - J Westin
- Department of Lymphoma-Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - L Nastoupil
- Department of Lymphoma-Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S S Neelapu
- Department of Lymphoma-Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - C C Pinnix
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - B Dabaja
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S Y Wu
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - P Fang
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
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6
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Gan Y, Ma L, Fang P. Perioperative management of a patient with haemophilia B and PSVT undergoing radiofrequency ablation: A case report. J Int Med Res 2023; 51:3000605231208599. [PMID: 37890144 PMCID: PMC10612451 DOI: 10.1177/03000605231208599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 10/02/2023] [Indexed: 10/29/2023] Open
Abstract
Haemophilia B is a rare inherited bleeding disorder in which patients have impaired coagulation. This study describes a patient with Haemophilia B and paroxysmal supraventricular tachycardia (PSVT) who underwent radio frequency catheter ablation (RFCA). The perioperative replacement therapy with coagulation factor IX (FIX) was agreed upon after an interdisciplinary consultation involving a team of specialists in haematology, cardiovascular medicine and cardiothoracic surgery. There were no obvious bleeding points or complications during the perioperative period following the treatment, nor recurrence of PSVT within a three-year follow-up period. In summary, RFCA can be performed safely in patients with haemophilia B on the premise of developing an individualized perioperative exogenous coagulation factor supplementation regimen based upon an adequate preoperative evaluation and clinical monitoring and management by an interdisciplinary team.
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Affiliation(s)
- Yu Gan
- The Second School of Medicine, Zhejiang Chinese Medical University, Hangzhou, China
- Zhejiang Shuren University Shulan International Medical College, Department of Cardiovascular Medicine, Hangzhou, Zhejiang, CN
| | - Liping Ma
- Department of Cardiovascular Medicine, Shu Lan (Hangzhou) Hospital, Hangzhou, China
| | - Pihua Fang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Zhejiang Shuren University Shulan International Medical College, Department of Cardiovascular Medicine, Hangzhou, Zhejiang, CN
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7
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Wu SY, Gunther JR, Manzar GS, Corrigan KL, Damron EP, Schrank BR, Nasr LF, Chihara D, Malpica Castillo LE, Nair R, Steiner R, Jain P, Neelapu SS, Samaniego F, Rodriguez MA, Strati P, Nastoupil L, Dabaja B, Pinnix CC, Fang P. Ultra Low-Dose Radiation for Extranodal Marginal Zone Lymphoma of the Lung. Int J Radiat Oncol Biol Phys 2023; 117:e492. [PMID: 37785552 DOI: 10.1016/j.ijrobp.2023.06.1725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Definitive radiation treatment (RT) for extranodal marginal zone lymphoma (ENMZL) of mucosal associated lymphoid tissue historically involves treatment to 24-30 Gy. There is increasing data supporting the use of ultra-low dose RT as part of a response-adapted approach in the treatment of orbital and gastric ENMZL. With this approach, patients receive initial treatment with 4 Gy, and additional RT is considered for those with persistent or locally progressive disease. However limited data to date assesses the efficacy of 4 Gy in the management of ENMZL of the lung. MATERIALS/METHODS We performed an IRB-approved retrospective review of 17 patients with ENMZL of the lung treated with 4 Gy between 7/2015 and 12/2022 with response assessed after RT. Clinical/treatment characteristics, response, and toxicity were extracted from medical records. Statistics were performed using Mann-Whitney U and Fisher's Exact Test. RESULTS Eight patients (47%) were female, 15 (88%) white, and 1 (6%) Hispanic. Median age at RT was 66 (interquartile range (IQR) 59-77). All had disease limited to the lung at diagnosis and 15 had stage IE disease. Four patients (24%) were diagnosed incidentally on screening/surveillance imaging in the absence of symptoms. Sixteen patients received 4 Gy in 2 fractions, while one patient received a single fraction of 4 Gy. Median SUVmax prior to RT was 4.5 (IQR 3.2-7.2). Median planning target volume (PTV) was 74 cc (IQR 47-130cc). Six patients (35%) had respiratory symptoms prior to RT, which improved or resolved in 3 (50%). A larger PTV was associated with improvement in symptoms following RT with a median PTV of 266 cc (IQR 171-402) in those who experienced improvement vs. 64 cc (IQR 42-100) in those who did not (p = 0.032). One patient experienced toxicity following RT with pleuritic chest pain, which resolved with corticosteroids. At a median follow-up of 15 months following RT (IQR 7-43 months), the overall response rate (ORR) was 100% (CR, n = 15; PR, n = 2). Fourteen patients had follow-up PET/CT, of whom 13 had a complete metabolic response (CMR) at a median of 3 months following RT (IQR 3-5 months). Two additional patients had a complete response (CR) on CT while one had a partial response on CT. Achieving a CR was not associated with SUV prior to RT (p = 0.50) or PTV size (p = 0.62). In patients with stage IE disease, the ORR rate was 100% and there have been no distant failures to date. Fifteen of 17 patients were alive at last follow-up; two passed away of unrelated causes (one from Alzheimer's disease and one from recurrent squamous cell carcinoma). CONCLUSION Ultra-low dose radiation of 4 Gy is associated with excellent local control in the management of ENMZL of the lung and is very well tolerated. Four Gy was effective for local control and symptom palliation even for larger tumors and is an effective initial therapy as part of a response-adapted approach even in limited stage patients.
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Affiliation(s)
- S Y Wu
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - J R Gunther
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - G S Manzar
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - K L Corrigan
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - E P Damron
- The University of Texas McGovern Medical School, Houston, TX
| | - B R Schrank
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - L F Nasr
- Department of Lymphoma-Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - D Chihara
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - R Nair
- Department of Lymphoma-Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - R Steiner
- Department of Lymphoma-Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - P Jain
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S S Neelapu
- Department of Lymphoma-Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - F Samaniego
- MD Anderson Cancer Center, Department of Lymphoma and Myeloma, Houston, TX
| | - M A Rodriguez
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - P Strati
- Department of Lymphoma-Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - L Nastoupil
- Department of Lymphoma-Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - B Dabaja
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - C C Pinnix
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - P Fang
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
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8
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Manzar GS, Wu SY, Dudzinski SO, Rooney MK, Jallouk A, Yoder AK, Nasr LF, Gunther JR, Sallard G, Ahmed S, Fayad L, Nair R, Steiner R, Westin J, Nastoupil L, Neelapu SS, Dabaja B, Pinnix CC, Strati P, Fang P. Characterization of Lymphopenia during Bridging Radiation Therapy Prior to CAR-T Cell Therapy in Patients with Aggressive B Cell Lymphomas. Int J Radiat Oncol Biol Phys 2023; 117:S53-S54. [PMID: 37784520 DOI: 10.1016/j.ijrobp.2023.06.337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Bridging RT (bRT) may be used as a strategy for disease control in patients with relapsed/refractory aggressive B cell lymphoma treated with anti-CD19-directed chimeric antigen receptor T-cell therapy (CART). The correlation of treatment-related lymphopenia with adverse outcomes in patients has been widely documented in several malignancies. Here, we assessed lymphocyte kinetics during bRT and impact on clinical outcome. MATERIALS/METHODS After IRB-approval, records were retrospectively reviewed for adults with DLBCL who received bRT for axicabtagene ciloleucel 11/2017-12/2022. Clinical/treatment characteristics, lab values, and outcomes were extracted. ALC Δ RT was computed by subtracting pre-RT ALC from post-RT ALC count. Survival was modeled using Kaplan-Meier for events distributed over time, or binary logistic regression for disease response. Fisher's Exact Test or Mann-Whitney U methods were used. RESULTS Forty patients met inclusion criteria. Fourteen (35%) received bRT with systemic therapy. Thirty-two (80%) patients received bRT that started post-leukapheresis. bRT was delivered with a median dose of 30 Gy (range: 4-46) in 10 fractions (range: 2-23). Twenty-three patients (57.5%) had CR at 30 days post-CART infusion. Nine had PR (22.5%), and 8 patients (20%) had PD or SD. Median PFS was 8.9 months and median OS was 22 months. The pre-RT ALC mean ± SD was 0.74 ± 0.49 K/µL, and post-RT was 0.43 ± 0.35 K/µL. The absolute ALC Δ RT was 0.31 ± 0.43 K/µL, and ratio post-RT/pre-RT was 0.74 ± 0.64. Stratifying by receipt of bRT alone or with systemic therapy, there was no statistically significant difference in ALC count post-RT (chemoRT: 0.33 ± 0.23 vs. RT: 0.48 ± 0.4, p = 0.2), but there was a lower ALC count pre-RT in the chemoRT group (0.5 ± 0.3 vs. 0.87 ± 0.52 for RT alone, p = 0.02). Post-RT ALC was not significantly associated with CR/PR vs. PD/SD, or with DSS, PFS, or OS. A greater drop in ALC Δ RT trended towards association with improved 90-day response (p = 0.066), without correlation with DSS, OS, or response at 30 days. Median dose per fraction was lower among patients that got pre-leukapheresis RT (2.25 vs. 2.5, p = 0.04), but total dose of bRT or number of fractions was not significantly different. Otherwise, the groups were similar in terms of stage, disease bulk, or comprehensive vs. focal bRT. The average decrease in ALC post-RT for patients who received bRT prior to apheresis was 0.215 K/µL, compared to 0.268 K/µL for patients who received bRT post-apheresis (p = 0.75). Treatment with pre-leukapheresis bRT or ALC Δ RT among these patients were not associated with worse DFS, PFS, or OS (p>0.15). CONCLUSION Post-bRT ALC and reduction in ALC during bRT is not associated with worse treatment response or survival outcomes after CAR-T cell treatment in aggressive B cell lymphoma. Pre-leukapheresis bRT did not appear to substantially impact ALC, and ALC Δ RT among these patients were not associated with worse outcomes.
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Affiliation(s)
- G S Manzar
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S Y Wu
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S O Dudzinski
- Vanderbilt University School of Medicine, Nashville, TN
| | - M K Rooney
- Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - A Jallouk
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - A K Yoder
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - L F Nasr
- Department of Lymphoma-Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - J R Gunther
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - G Sallard
- Baylor College of Medicine, Houston, TX
| | - S Ahmed
- Department of Lymphoma-Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - L Fayad
- Department of Lymphoma-Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - R Nair
- Department of Lymphoma-Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - R Steiner
- Department of Lymphoma-Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - J Westin
- Department of Lymphoma-Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - L Nastoupil
- Department of Lymphoma-Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S S Neelapu
- Department of Lymphoma-Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - B Dabaja
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - C C Pinnix
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - P Strati
- Department of Lymphoma-Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - P Fang
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
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9
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Pinnix C, Dabaja B, Gunther J, Fang P, Wu S, Nastoupil L, Strati P, Nair R, Ahmed S, Steiner R, Westin J, Neelapu S, Rodriguez M, Lee H, Wang M, Fowler N, Flowers C, Feng L, Chi L, Esmaeli B. Response Adapted Ultra Low Dose Radiation Therapy for the Definitive Management of Orbital Indolent B-Cell Lymphoma. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.2322] [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: 11/29/2022]
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10
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Wu S, Damron E, Xu J, Fang P, Dai J, Nair R, Castillo LM, Torres-Cabala C, Fayad L, Medeiros L, Vazquez FV, Miranda R, Duvic M, Pinnix C, Dabaja B, Heberton M, Iyer S, Huen A, Gunther J. Radiotherapy in the Treatment of Primary Cutaneous CD4+ Small/Medium T-Cell Lymphoproliferative Disorder. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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11
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Manzar G, Wu S, Khan M, Corrigan K, Yoder A, Gunther J, Thomas S, Manasanch E, Lee H, Lim T, Amini B, Lin P, Orlowski R, Patel K, Becnel M, Kaufman G, Weber D, Dabaja B, Pinnix C, Fang P. Outcome of Patients with Central Nervous System Multiple Myeloma (CNS-MM) Treated with CNS-Directed Radiation Therapy. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1473] [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: 10/31/2022]
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12
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Chen X, Xia Y, Lin Y, Li X, Wang C, Chen Y, Fang P, Liu J. Cryoballoon Ablation for Treatment of Atrial Fibrillation in a Chinese Population: Five-Year Outcomes and Predictors of Recurrence After a Single Procedure. Front Cardiovasc Med 2022; 9:836392. [PMID: 35571157 PMCID: PMC9091437 DOI: 10.3389/fcvm.2022.836392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 03/25/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe 5-year outcomes and predictors of atrial fibrillation (AF) recurrence following cryoballoon (CB) ablation in Chinese population remain scarce. Our aim was to report 5-year outcomes and predictors of AF recurrence following a single CB ablation procedure in a Chinese population.MethodsFrom December 2013 to August 2016, we included 256 consecutive patients (mean age: 58 ± 10.9 years old; female: 41.0%) with paroxysmal or persistent AF successfully underwent first-generation CB ablation at Fuwai hospital in this prospective study. All patients were followed at least 5 years or when there was recurrent AF. Independent predictors of AF recurrence were determined by Cox proportional hazards regression analysis.ResultsThe 5-year success rate after pulmonary vein isolation (PVI) by a single procedure was 59.4%. The recurrence rate was the highest (14.5%) within the first year after the index procedure, and then stabilized. Patients with paroxysmal AF had a higher incidence of freedom from AF recurrence than patients with persistent AF (63.2% vs. 36.4%, log-rank P < 0.01). The overall incidence of complications related to CB ablation was 7.8%. Phrenic nerve injury (PNI) was the most common complication, with an incidence of 3.5%, and patients with PNI were recovered within the 1-year follow-up. Only persistent AF (HR 1.72, 95%CI 1.028–2.854, P < 0.05) was significantly and independently associated with an increased risk of AF recurrence after adjusting for other factors.ConclusionPulmonary vein isolation using CB ablation was safe and effective with an acceptable complication and 5-year success rate in a Chinese population with AF, and persistent AF was the independent predictor for 5-year AF recurrence after a single CB ablation procedure.
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Affiliation(s)
- Xiongbiao Chen
- Department of Cardiology, Peking University Shenzhen Hospital, Shenzhen, China
- State Key Laboratory of Cardiovascular Disease, Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yu Xia
- State Key Laboratory of Cardiovascular Disease, Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- *Correspondence: Yu Xia,
| | - Yuan Lin
- Department of General Practice, School of General Practice and Continuing Education, Capital Medical University, Beijing, China
| | - Xiaofeng Li
- State Key Laboratory of Cardiovascular Disease, Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chun Wang
- Department of Cardiology, Peking University Shenzhen Hospital, Shenzhen, China
| | - Yanjun Chen
- Department of Cardiology, Peking University Shenzhen Hospital, Shenzhen, China
| | - Pihua Fang
- State Key Laboratory of Cardiovascular Disease, Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jun Liu
- State Key Laboratory of Cardiovascular Disease, Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Jun Liu,
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Reddy J, Lei X, Bloom E, Reed V, Schlembach P, Arzu I, Gopal R, Mayo L, Chun S, Ahmad N, Stauder M, Chronowski G, Weed D, Delclos M, Garg A, Shaitelman S, Fang P, Tereffe W, Woodward W, Smith B. Optimizing Preventive Adjuvant LINAC (OPAL) Radiation: A Phase II Trial of Daily Partial Breast Irradiation. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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14
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Wu S, Fang P, Huen A, Iyer S, Nair R, Steiner R, Castillo L, Duvic M, Ahmed S, Jain P, Fayad L, Strati P, Westin J, Neelapu S, Nastoupil L, Pinnix C, Dabaja B, Gunther J. Concurrent Radiation Therapy With the Antibody-Drug Conjugates Brentuximab Vedotin and Polatuzumab Vedotin. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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15
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Liu Z, Xia Y, Guo C, Li X, Fang P, Yin X, Yang X. Low-Voltage Zones as the Atrial Fibrillation Substrates: Relationship With Initiation, Perpetuation, and Termination. Front Cardiovasc Med 2021; 8:705510. [PMID: 34409078 PMCID: PMC8365032 DOI: 10.3389/fcvm.2021.705510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 06/24/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Low-voltage zones (LVZs) were usually targeted for ablation in atrial fibrillation (AF). However, its relationship with AF initiation, perpetuation, and termination remains to be studied. This study aimed to explore such relationships. Methods: A total of 126 consecutive AF patients were enrolled, including 71 patients for AF induction protocol and 55 patients for AF termination protocol. Inducible and sustainable AF were defined as induced AF lasting over 30 and 300 s, respectively. Terminable AF was defined as those that could be terminated into sinus rhythm within 1 h after ibutilide administration. Voltage mapping was performed in sinus rhythm for all patients. LVZ was quantified as the percentage of the LVZ area (LVZ%) to the left atrium surface area. Results: The rates of inducible, sustainable, and terminable AF were 29.6, 18.3, and 38.2%, respectively. Inducible AF patients had no significant difference in overall LVZ% compared with uninducible AF patients (10.2 ± 11.8 vs. 8.5 ± 12.6, p = 0.606), while sustainable and interminable AF patients had larger overall LVZ% than unsustainable (16.2 ± 11.5 vs. 0.5 ± 0.7, p < 0.001) and terminable AF patients (44.6 ± 26.4 vs. 26.3 ± 22.3, p < 0.05), respectively. The segmental LVZ distribution pattern was diverse in the different stages of AF. Segmental LVZ% difference was initially observed in the anterior wall for patients with inducible AF, and the septum was further affected in those with sustainable AF, and the roof, posterior wall, and floor were finally affected in those with interminable AF. Conclusions: The associations between LVZ with AF initiation, perpetuation, and termination were different depending on its size and distribution.
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Affiliation(s)
- Zheng Liu
- Heart Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Yu Xia
- State Key Laboratory of Cardiovascular Disease, Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Changyan Guo
- Department of Cardiology, Xilin Gol League Central Hospital, Inner Mongolia, Xilinhot, China
| | - Xiaofeng Li
- State Key Laboratory of Cardiovascular Disease, Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Pihua Fang
- State Key Laboratory of Cardiovascular Disease, Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiandong Yin
- Heart Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Xinchun Yang
- Heart Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
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16
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Gu K, Bi M, Zhao D, Cheng H, Qian H, Wang F, Wang G, Song W, Xia X, Xu L, Zhu Y, Cao Q, Li X, Fang P. P78.16 Real-World Outcomes of Camrelizumab (SHR-1210) in Treating Advanced Non-Small Cell Lung Cancer: A Multicenter Prospective Study. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.1179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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17
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Guo L, He B, Fang P, Bo P, Zhang Z. Activation of central galanin receptor 2 mitigated insulin resistance in adipocytes of diabetic rats. J Endocrinol Invest 2021; 44:515-522. [PMID: 32588381 DOI: 10.1007/s40618-020-01336-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 03/06/2020] [Accepted: 06/12/2020] [Indexed: 12/11/2022]
Abstract
PURPOSE Our and other's studies showed that administration of neuropeptide galanin may mitigate insulin resistance via promoting glucose transporter 4 (GLUT4) expression and translocation in rats. The objective of this study is to investigate whether galanin receptor 2 (GAL2-R) in brain mediates the ameliorative effect of galanin on insulin resistance in adipose tissues of type 2 diabetic rats. METHODS In this study galanin, GAL2-R agonist M1145 and GAL2-R antagonist M871 were respectively or cooperatively injected into intracerebroventricles of type 2 diabetic rats once a day for successive fifteen days. Then the plasma and fat tissues of rats were used to estimate the alterations of insulin resistance indexes. RESULTS The central administration of galanin enhanced 2-deoxy-[3H]-D-glucose, peroxisome proliferator-activated receptor γ and adiponectin levels, food intake and body weight, GLUT4 mRNA expression and GLUT4 concentration in plasma membranes, as well as homeostasis model assessment-insulin resistance index. Those effects of galanin may be blocked by M817, and imitated by M1145 except for food intake and body weight. CONCLUSION Those results suggest that central GAL2-R mediates the beneficial effects of galanin on insulin sensitivity in type 2 diabetic rats. GAL2-R agonist may be taken as a potential antidiabetic agent to treat insulin resistance and type 2 diabetes.
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Affiliation(s)
- L Guo
- Department of Physical Education, Chuzhou College, Chuzhou, 239012, Anhui, China
| | - B He
- Department of Endocrinology, Clinical Medical College, Yangzhou University, Nantong Street #98, Yangzhou, 225001, China
| | - P Fang
- Department of Endocrinology, Clinical Medical College, Yangzhou University, Nantong Street #98, Yangzhou, 225001, China
| | - P Bo
- Department of Endocrinology, Clinical Medical College, Yangzhou University, Nantong Street #98, Yangzhou, 225001, China
| | - Z Zhang
- Department of Endocrinology, Clinical Medical College, Yangzhou University, Nantong Street #98, Yangzhou, 225001, China.
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Zhang H, Yu M, Xia Y, Li X, Liu J, Fang P. The differences of atrial thrombus locations and variable response to anticoagulation in nonvalvular atrial fibrillation with ventricular cardiomyopathy. J Arrhythm 2020; 36:1016-1022. [PMID: 33335618 PMCID: PMC7733561 DOI: 10.1002/joa3.12422] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 08/03/2020] [Accepted: 08/06/2020] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVES This study aims to research the clinical features of atrial thrombi in patients with nonvalvular atrial fibrillation (AF). METHODS This study included 191 patients of AF who had atrial thrombi. One hundred and twenty-eight of them were assigned into nonventricular cardiomyopathy group (non-VCM), and the remaining 63 into ventricular cardiomyopathy group (VCM). After atrial thrombi diagnosed, all patients had taken oral anticoagulant therapy. The resolution rates of thrombi within 12 months were compared between the two groups, as well as the locations of thrombi. RESULTS Of all 191 patients, 161 had thrombi only detected in left atrial appendage (LAA), 20 in both left atrium (LA) and LAA, six in LA only, and four in right atrium only. More patients had thrombi out of LAA in the VCM group than in the non-VCM group (30.2% vs 8.6%, P < .001). After propensity score matching, the atrial thrombi were resolved faster in the non-VCM group than in the VCM group (mean time length: 22 ± 2 weeks vs 30 ± 3 weeks, P = .038), and the resolution rate within 12 months was higher in the non-VCM group than in the VCM group (88.7% vs 61.4%, Log-rank, P = .038). In Cox proportional hazards model, absence of ventricular cardiomyopathy was an independent predictor for the resolution of atrial thrombus (hazard ratio: 1.76; P = .035). CONCLUSIONS The patients of atrial fibrillation with ventricular cardiomyopathies have higher incidence of thrombosis in the body of left atrium or right atrium. And the resolution rate was lower in these patients.
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Affiliation(s)
- Hao Zhang
- Chinese Academy of Medical Sciences and Peking Union Medical CollegeFuwai HospitalBeijingChina
- Department of CardiologyChongqing General HospitalUniversity of Chinese Academy of SciencesChongqingChina
| | - Miao Yu
- Chinese Academy of Medical Sciences and Peking Union Medical CollegeFuwai HospitalBeijingChina
| | - Yu Xia
- Chinese Academy of Medical Sciences and Peking Union Medical CollegeFuwai HospitalBeijingChina
| | - Xiaofeng Li
- Chinese Academy of Medical Sciences and Peking Union Medical CollegeFuwai HospitalBeijingChina
| | - Jun Liu
- Chinese Academy of Medical Sciences and Peking Union Medical CollegeFuwai HospitalBeijingChina
| | - Pihua Fang
- Chinese Academy of Medical Sciences and Peking Union Medical CollegeFuwai HospitalBeijingChina
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Liu Y, Augustyn A, Gunther J, Fang P, Nastoupil L, Ahmed S, Strati P, Nair R, Steiner R, Westin J, Rodriguez M, Neelapu S, Flowers C, Khoury J, Medeiros L, Dabaja B, Pinnix C. Radiation Therapy for Refractory High-grade B-cell Lymphoma with MYC and BCL2 and/or BCL6 Rearrangements. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.939] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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20
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Ng S, Cardenas C, Elhalawani H, Elgohari B, Fang P, Meheissen M, Bahig H, Garden A, Reddy J, Fuller C, Phan J. Tumor Target Delineation in Head and Neck ReIrradiation Cases: Comparison Between DECT and MRI. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2497] [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: 11/16/2022]
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21
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Fang P, Gunther J, Pinnix C, Dong W, Strati P, Nastoupil L, Fowler N, Steiner R, Nair R, Ahmed S, Westin J, Neelapu S, Ha C, Dabaja B. A Prospective Trial of Radiation Therapy Efficacy and Toxicity for Localized Mucosa-associated Lymphoid Tissue (MALT) Lymphoma. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.913] [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: 11/24/2022]
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22
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Pezzi T, Fang P, Gjyshi O, Feng L, Liu S, Komaki R, Lin S. The Role of Prophylactic Cranial Irradiation in Limited Stage Small Cell Lung Cancer in the MRI Era. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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23
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Fang P, Zhang LX, Hu Y, Zhang L, Zhou LW. Long non-coding RNA DANCR induces chondrogenesis by regulating the miR-1275/MMP-13 axis in synovial fluid-derived mesenchymal stem cells. Eur Rev Med Pharmacol Sci 2020; 23:10459-10469. [PMID: 31841200 DOI: 10.26355/eurrev_201912_19685] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The aim of this study was to examine the role of lncRNA-differentiation antagonizing non-protein coding RNA (DANCR) and its underlying mechanisms in chondrogenesis, more specifically in synovial fluid-derived mesenchymal stem cell (SFMSCs). MATERIALS AND METHODS The expression levels of DANCR in SFMSCs were measured by qRT-PCR. Luciferase reporter assay and RIP assay were used to investigate the direct target of DANCR and miR-1275 in SFMSCs. The expression of matrix metallopeptidase 13 (MMP13, also known as chondrogenic marker) protein was examined by Western blot. Cell proliferation was analyzed by Cell Counting Kit-8 (CCK-8) assay, while chondrogenic differentiation was explored by sGAG assay. RESULTS Our data indicated that DANCR can promote SFMSCs proliferation and chondrogenesis. In addition, miR-1275 was indicated as a direct target of DANCR. MiR-1275 was negatively regulated by DANCR via competing endogenous RNA (ceRNA) mechanism. Moreover, our data revealed that miR-1275 could bind to MMP13 and regulate its expression. CONCLUSIONS Our findings suggested that DANCR was involved in SFMSCs proliferation and chondrogenesis. Mechanistically, DANCR functions as a sponge RNA for miR-1275 that regulates the expression of target gene MMP13. These data provide a therapeutic option for Osteoarthritis (OA).
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Affiliation(s)
- P Fang
- Department of Orthopedics, Jinling Hospital, Nanjing University, School of Medicine, Nanjing, China.
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Weng S, Tang M, Zhou B, Yu F, Dong X, Ma Y, Qi Y, Wang X, Jiang Y, Fang P, Zhang S. Supraventricular tachycardia in patients with coronary sinus stenosis/atresia: Prevalence, anatomical features, and ablation outcomes. J Cardiovasc Electrophysiol 2020; 31:3223-3231. [PMID: 33022772 DOI: 10.1111/jce.14773] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 09/10/2020] [Accepted: 10/02/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Supraventricular tachycardia (SVT) with coronary sinus (CS) ostial atresia (CSA) or coronary sinus stenosis (CSS) causes difficulty in electrophysiological procedures, but its characteristics are poorly understood. OBJECTIVE Study the anatomical and clinical features of SVT patients with CSA/CSS. METHODS Of 6128 patients with SVT undergoing electrophysiological procedures, consecutive patients with CSA/CSS were enrolled, and the baseline characteristics, imaging materials, intraoperative data, and follow-up outcomes were analyzed. RESULTS Thirteen patients, seven with CSA and six with CSS, underwent the electrophysiological procedure. Decapolar catheters were placed into the proximal CS in three cases, while the rest were placed at the free wall of the right atrium. Fourteen arrhythmias were confirmed: four atrioventricular nodal reentrant tachycardias, five left-sided accessory pathways, three paroxysmal atrial fibrillations, and two atrial flutters (AFLs). In addition to three patients who underwent only an electrophysiological study, the acute ablation success rate was 100% in 10 cases, with no procedure-related complications. After a median follow-up period of 59.6 months, only one case of atypical AFL recurred. For those cases (seven CSA and two CSS) with a total of 10 anomalous types of CS drainage, three types were classified: from the CS to the persistent left superior vena cava (n = 3), from an unroofed CS (n = 3), and from the CS to the small cardiac vein (n = 3) or Thebesian vein (n = 1). CONCLUSION Patients with CSA/CSS may develop different kinds of SVT. Electrophysiological procedures for such patients are feasible and effective. An individualized mapping strategy based on the three types of CS drainage will be helpful.
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Affiliation(s)
- Sixian Weng
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Cardiovascular Institute, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Min Tang
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Cardiovascular Institute, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Bin Zhou
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Cardiovascular Institute, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Fengyuan Yu
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Cardiovascular Institute, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Xiaonan Dong
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Cardiovascular Institute, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Yazhe Ma
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Cardiovascular Institute, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Yingjie Qi
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Cardiovascular Institute, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Xiaoqin Wang
- Department of Cardiovascular Medicine, Jingmen No. 1 People's Hospital, Jingmen, China
| | - Yizhou Jiang
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Cardiovascular Institute, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Pihua Fang
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Cardiovascular Institute, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Shu Zhang
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Cardiovascular Institute, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
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Xia Y, Liu J, Jia Y, Zhang H, Yu M, Li X, Fang P. Redefining the Blanking Period by a Long-Term Follow-Up after Atrial Fibrillation Ablation Using Second-Generation Cryoballoon. Int Heart J 2020; 61:936-943. [PMID: 32879265 DOI: 10.1536/ihj.20-234] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
On the basis of radiofrequency ablation of atrial fibrillation (AF), some studies suggested that early recurrences of atrial tachyarrhythmia (ERATs) were associated with late AF recurrence (LAFR), and some also suspected and challenged the current recommended 90 day blanking period. We aim to evaluate the impact of ERAT on long-term success and to determine the optimum blanking period after AF ablation using second-generation cryoballoon (sg-CB). From August 2016 to October 2018, 369 consecutive patients who successfully underwent initial AF ablation using sg-CB at the Fuwai Hospital were finally enrolled. All patients were followed up no less than 12 months. Receiver operating characteristic curve analysis was used to determine the optimum blanking period after AF ablation. There were 62 (16.8%) who experienced ERAT. After a median follow-up of 615 days, 74.5% were free of LAFR after the 90 day blanking period. Incidence of freedom from LAFR during the long-term follow-up was markedly lower in patients with ERAT than in those without ERAT (27.4% versus 84.0%; log-rank P < 0.001). Furthermore, only ERAT (HR 8.579; 95% CI 5.604-13.133; P < 0.001) was significantly associated with an increased risk of LAFR after adjusting for other factors. The optimum cut-off time point for the blanking period was 21.5 days (sensitivity: 71.1%, specificity: 94.1%). In conclusion, ERAT was an independent predictor of LAFR after AF ablation using sg-CB. Based on our findings, blanking period was advised to be shorten to 21.5 days or about 3 weeks instead of 90 days after CB ablation.
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Affiliation(s)
- Yu Xia
- State Key Laboratory of Cardiovascular Disease, Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Jun Liu
- State Key Laboratory of Cardiovascular Disease, Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Yuhe Jia
- State Key Laboratory of Cardiovascular Disease, Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Hao Zhang
- Department of Cardiology, Chongqing General Hospital
| | - Miao Yu
- State Key Laboratory of Cardiovascular Disease, Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Xiaofeng Li
- State Key Laboratory of Cardiovascular Disease, Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Pihua Fang
- State Key Laboratory of Cardiovascular Disease, Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College
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Yu M, Li X, Zhang H, Xia Y, Liu J, Fang P. A Simplified Two-Stepwise Electrocardiographic Algorithm to Distinguish Left from Right Ventricular Outflow Tract Tachycardia Origin. Cardiology 2020; 145:710-719. [PMID: 32841940 DOI: 10.1159/000507360] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 03/13/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND There are several electrocardiographic algorithms to predict the origin of idiopathic outflow tract ventricular arrhythmias (OT-VAs). This study aimed to develop a more accurate and efficient stepwise electrocardiographic algorithm to discriminate left ventricular outflow tract (LVOT) from right ventricular outflow tract (RVOT) origin. METHODS AND RESULTS We analyzed 12-lead electrocardiographic characteristics of 173 consecutive OT-VAs patients who underwent successful radiofrequency catheter ablation in the RVOT (n = 124) or LVOT (n = 49). Based on the areas under the receiver operating characteristic curves, the combination of transitional zone (TZ) index <0 and V2S/V3R index ≤1.5 exhibited 93.5% sensitivity, 85.9% specificity, and 87.3% accuracy. A further analysis was performed in the 71 OT-VAs with a V3-lead precordial transition. The sensitivity, specificity, and accuracy of the integration of V2S/V3R index ≤1.5 and R-wave deflection interval in lead V3 >80 ms were 91.7, 83.1, and 85.9%, respectively. In the prospective evaluation, the combination of TZ index and V2S/V3R index could identify the correct origin sites with 91.2% accuracy in the overall analysis, and the integration of V2S/V3R index ≤1.5 and R-wave deflection interval in lead V3 >80 ms exhibited 94% accuracy in V3-lead precordial transition. CONCLUSIONS The combination of TZ index <0 and V2S/V3R index ≤1.5 is a simple and efficient stepwise electrocardiographic algorithm for predicting LVOT origin. For the OT-VAs with a V3-lead precordial transition, the integration of V2S/V3R index ≤1.5 and R-wave deflection interval in lead V3 >80 ms would be a better choice.
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Affiliation(s)
- Miao Yu
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaofeng Li
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hao Zhang
- Department of Cardiology, Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing, China
| | - Yu Xia
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jun Liu
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Pihua Fang
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,
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Abstract
The gut microbiome is increasingly implicated in modifying susceptibility to and progression of neurodegenerative diseases (NDs). In this review, we discuss roles for the microbiome in aging and in NDs. In particular, we summarize findings from human studies on microbiome alterations in Parkinson's disease, Alzheimer's disease, amyotrophic lateral sclerosis, and Huntington's disease. We assess animal studies of genetic and environmental models for NDs that investigate how manipulations of the microbiome causally impact the development of behavioral and neuropathological endophenotypes of disease. We additionally evaluate the likely immunological, neuronal, and metabolic mechanisms for how the gut microbiota may modulate risk for NDs. Finally, we speculate on cross-cutting features for microbial influences across multiple NDs and consider the potential for microbiome-targeted interventions for NDs.
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Affiliation(s)
- P Fang
- Department of Integrative Biology & Physiology, University of California, Los Angeles, Los Angeles, CA 90095, USA.
| | - S A Kazmi
- Department of Integrative Biology & Physiology, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - K G Jameson
- Department of Integrative Biology & Physiology, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - E Y Hsiao
- Department of Integrative Biology & Physiology, University of California, Los Angeles, Los Angeles, CA 90095, USA
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Ukmar-Godec T, Fang P, Ibáñez de Opakua A, Henneberg F, Godec A, Pan KT, Cima-Omori MS, Chari A, Mandelkow E, Urlaub H, Zweckstetter M. Proteasomal degradation of the intrinsically disordered protein tau at single-residue resolution. Sci Adv 2020; 6:eaba3916. [PMID: 32832664 PMCID: PMC7439447 DOI: 10.1126/sciadv.aba3916] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 06/05/2020] [Indexed: 05/28/2023]
Abstract
Intrinsically disordered proteins (IDPs) can be degraded in a ubiquitin-independent process by the 20S proteasome. Decline in 20S activity characterizes neurodegenerative diseases. Here, we examine 20S degradation of IDP tau, a protein that aggregates into insoluble deposits in Alzheimer's disease. We show that cleavage of tau by the 20S proteasome is most efficient within the aggregation-prone repeat region of tau and generates both short, aggregation-deficient peptides and two long fragments containing residues 1 to 251 and 1 to 218. Phosphorylation of tau by the non-proline-directed Ca2+/calmodulin-dependent protein kinase II inhibits degradation by the 20S proteasome. Phosphorylation of tau by GSK3β, a major proline-directed tau kinase, modulates tau degradation kinetics in a residue-specific manner. The study provides detailed insights into the degradation products of tau generated by the 20S proteasome, the residue specificity of degradation, single-residue degradation kinetics, and their regulation by posttranslational modification.
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Affiliation(s)
- T. Ukmar-Godec
- German Center for Neurodegenerative Diseases (DZNE), Von-Siebold-Str. 3a, 37075 Göttingen, Germany
- Department of Neurology, University Medical Center Göttingen, University of Göttingen, Waldweg 33, 37073 Göttingen, Germany
| | - P. Fang
- Max Planck Institute for Biophysical Chemistry, Research group Mass Spectrometry, Am Fassberg 11, 37077 Göttingen, Germany
| | - A. Ibáñez de Opakua
- German Center for Neurodegenerative Diseases (DZNE), Von-Siebold-Str. 3a, 37075 Göttingen, Germany
| | - F. Henneberg
- Department for Structural Dynamics, Max-Planck Institute for Biophysical Chemistry, Am Fassberg 11, 37077 Göttingen, Germany
| | - A. Godec
- Mathematical Biophysics Group, Max Planck Institute for Biophysical Chemistry, Am Fassberg 11, 37077 Göttingen, Germany
| | - K.-T. Pan
- Max Planck Institute for Biophysical Chemistry, Research group Mass Spectrometry, Am Fassberg 11, 37077 Göttingen, Germany
| | - M.-S. Cima-Omori
- German Center for Neurodegenerative Diseases (DZNE), Von-Siebold-Str. 3a, 37075 Göttingen, Germany
| | - A. Chari
- Department for Structural Dynamics, Max-Planck Institute for Biophysical Chemistry, Am Fassberg 11, 37077 Göttingen, Germany
| | - E. Mandelkow
- German Center for Neurodegenerative Diseases (DZNE), Venusberg-Campus 1, Geb. 99, 53127 Bonn, Germany
- CAESAR Research Center, Ludwig-Erhard-Allee 2, 53175 Bonn, Germany
| | - H. Urlaub
- Max Planck Institute for Biophysical Chemistry, Research group Mass Spectrometry, Am Fassberg 11, 37077 Göttingen, Germany
- Bioanalytics, Institute for Clinical Chemistry, University Medical Center, Robert-Koch-Strasse 420, 37075 Göttingen, Germany
| | - M. Zweckstetter
- German Center for Neurodegenerative Diseases (DZNE), Von-Siebold-Str. 3a, 37075 Göttingen, Germany
- Department of Neurology, University Medical Center Göttingen, University of Göttingen, Waldweg 33, 37073 Göttingen, Germany
- Department for NMR-based Structural Biology, Max Planck Institute for Biophysical Chemistry, Am Fassberg 11, 37077 Göttingen, Germany
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Xia Y, Li X, Zhang H, Liu L, Fu L, Yan W, Li Q, Zhang Y, Yu M, Liu J, Fang P. Diagnostic Capability and Influence Factors for a New Electrocardiogram Criterion in the Diagnosis of Left Ventricular Hypertrophy in a Chinese Population. Cardiology 2020; 145:294-302. [PMID: 32289773 DOI: 10.1159/000505421] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 12/11/2019] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Based on a small sample of patients with hypertension, a few studies have reported that the newly proposed SD + SV4 criterion for left ventricular hypertrophy (LVH) is better than traditional criteria. This study aimed to verify the diagnostic capability of the SD + SV4 criterion in a Chinese population with or without hypertension and to analyze the factors affecting the diagnostic accuracy of LVH. METHODS A total of 248 patients with LVH or paroxysmal supraventricular tachycardia (PSVT) discharged from Fuwai Hospital from January 2010 to July 2018 were enrolled. Patients with LVH were diagnosed according to the left ventricular mass index calculated by the echocardiogram parameter as the gold standard in this study. The receiver operating curve (ROC) curve was performed to assess the diagnostic capability and cut-off values of the SD + SV4, RavL + SV3, and SV1 + RV5/RV6 criteria for LVH. Then, multivariate logistic regression analyses were performed to in-vestigate the factors affecting the accuracy of the SD + SV4 criterion. RESULTS There were 170 (68.5%) patients with hypertension and 110 (44.4%) with PSVT. According to echocardiography, 107 (43.1%) patients were diagnosed with LVH. The area under the curve (AUC) of the SD + SV4 criterion was the largest compared with that of the RavL + SV3 and SV1 + RV5/RV6 criteria (AUC 0.765 vs. 0.718 vs. 0.713, respectively). The sex-specific SD + SV4 criterion had the highest consistency with the gold standard (r = 0.532 ± 0.054, p < 0.01), accompanied by the highest sensitivity (70.1%) and specificity (85.8%). The cut-off values of the sex-specific SD + SV4 criterion for LVH were ≥2.65 mV (male)/2.15 mV (female). The left ventricular ejection fraction (LVEF; OR 0.920, 95% CI 0.882-0.959, p < 0.001) was significantly different between the SD + SV4 criterion and the gold standard for LVH after adjusting for hypertension, PSVT history, body surface area, interventricular septum thickness, posterior wall thickness, and left ventricular internal diameter. CONCLUSION The newly proposed SD + SV4 criterion provides improved sensitivity and accuracy for the diagnosis of LVH in the Chinese population. A decrease in LVEF is an independent factor affecting the diagnostic accuracy of LVH.
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Affiliation(s)
- Yu Xia
- State Key Laboratory of Cardiovascular Disease, Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaofeng Li
- State Key Laboratory of Cardiovascular Disease, Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hao Zhang
- State Key Laboratory of Cardiovascular Disease, Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Li Liu
- Department of Cardiology, Qitaihe City People's Hospital, Heilongjiang, China
| | - Lijuan Fu
- Department of Cardiology, Chuiyangliu Hospital, Tsinghua University, Beijing, China
| | - Wei Yan
- Department of Cardiology, Youjiang Medical University for Nationalities, Guangxi, China
| | - Qingxia Li
- Intensive Care Unit, Gansu Provincial Hospital of Traditional Chinese Medicine, Gansu, China
| | - Yukun Zhang
- Department of Cardiology, Guizhou Aerospace Hospital, Guizhou, China
| | - Miao Yu
- State Key Laboratory of Cardiovascular Disease, Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jun Liu
- State Key Laboratory of Cardiovascular Disease, Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Pihua Fang
- State Key Laboratory of Cardiovascular Disease, Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,
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Zhou Y, Wang S, Zhao J, Fang P. Correlations of complication with coronary arterial lesion with VEGF, PLT, D-dimer and inflammatory factor in child patients with Kawasaki disease. Eur Rev Med Pharmacol Sci 2019; 22:5121-5126. [PMID: 30178831 DOI: 10.26355/eurrev_201808_15706] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To investigate the correlations of complication with coronary arterial lesion (CAL) or not with vascular endothelial growth factor (VEGF), platelet (PLT), D-dimer, and inflammatory factor in child patients with Kawasaki disease (KD). PATIENTS AND METHODS A total of 60 KD child patients meeting the inclusion criteria diagnosed and treated from January 2016 to October 2017 were collected. There were 27 child patients complicated with CAL enrolled as observation group and 33 child patients not complicated with CAL selected as control group. The venous blood of the two groups of patients was acquired after admission to hospital. Enzyme-linked immunosorbent assay (ELISA) was utilized to detect the content of serum VEGF and interleukin-6 (IL-6); the content of serum PLT and D-dimer was measured using a fully automatic biochemistry analyzer, and the coronary artery diameter was determined through color Doppler ultrasound. RESULTS Compared with those in control group, the content of VEGF, IL-6, PLT, and D-dimer in the serum was increased remarkably in the observation group, and the differences were statistically significant (p<0.05). The thickness of the coronary artery in the observation group was markedly greater than that in the control group, with a statistically significant difference (p<0.05). The content of VEGF, IL-6, PLT, and D-dimer in the serum was positively correlated with the thickness of the coronary artery. CONCLUSIONS For KD child patients, the complication with CAL or not has a close correlation with VEGF, PLT, D-dimer, and inflammatory factor; and VEGF, IL-6, PLT, and D-dimer are the important risk factors for KD complicated with CAL.
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Affiliation(s)
- Y Zhou
- Department of Pediatrics, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.
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van Rossum P, Fang P, Musall B, Son J, Fellman B, Hobbs B, Ma J, Lin S. Final Trial Results of Repeated Diffusion-Weighted MRI and FDG-PET Imaging for the Prediction of Response to Chemoradiation Therapy in Esophageal Cancer. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Ma J, Fang P, Wang D, Liu YJ. [Endoscopic transnasal approach for surgical treatment of skull base clival area chordomas (Report of 2 cases)]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2018; 32:230-232. [PMID: 29775030 DOI: 10.13201/j.issn.1001-1781.2018.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Indexed: 11/12/2022]
Abstract
The case 1 performanced submandibular trauma because of the faint Suddenly. There were no obvious abnormality in physical examination. CT result showed that the tumour located in the lower clivus, and the atlas was infringed. MRI imaging showed the tumour located in the both sides of the internal carotid artery, infringed clivus and atlas front, forwarded into the nasal cavity and oral cavity. The case 2 performanced the left nose stuffy and increased gradually, nasopharyngeal mirror showed the left nasal cavity filled with new life. CT showed the lesions located in the cranial fossa under the sella turcica and sphenoid bone, down into the sphenoid sinus and the nasopharyngeal cavity. MRI imaging showed the lesions located in the front of clivus. According to the CT and MRI imaging features before surgery, the two cases adopted endoscopic transsphenoidal approach, and the postoperative pathology were chordoma in the central line of the skull base.
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Chen X, Fang P, Liu Z, He J, Tang M, Liu J, Lu B, Zhang S. Pulmonary Vein Anatomy is Associated with Cryo Kinetics during Cryoballoon Ablation for Atrial Fibrillation. Arq Bras Cardiol 2018; 110:440-448. [PMID: 29898044 PMCID: PMC5967138 DOI: 10.5935/abc.20180071] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 11/09/2017] [Indexed: 11/24/2022] Open
Abstract
Background The influence of pulmonary vein (PV) anatomy on cryo kinetics during
cryoballoon (CB) ablation is unclear. Objective To investigate the relationship between PV anatomy and cryo kinetics during
CB ablation for atrial fibrillation (AF). Methods Sixty consecutive patients were enrolled. PV anatomy, including ostial
diameters (long, short and corrected), ratio between short and long
diameters, ostium shape (round, oval, triangular, and narrow), and drainage
pattern (typical, with common trunk, common antrum, ostial branch and
supernumerary PV) were evaluated on multi-detector computed tomography
(MDCT) images pre-procedure. Cryo kinetics parameters [balloon freeze
time from 0 to -30ºC (BFT), balloon nadir temperature (BNT) and
balloon warming time from -30 to +15ºC (BWT)] were recorded
during procedure. All p values are two-sided, with values of p < 0.05
considered to be statistically significant. Results 606 times of freezing cycle were accomplished. Moderate negative correlation
was documented between BNT and corrected PV diameter (r = -0.51, p <
0.001) when using 23-mm CBs, and mild negative correlation (r = - 0.32, p =
0.001) was found when using 28-mm CBs. Multivariate logistic regression
analysis revealed that PV corrected ostial diameter (OR, 1.4; p = 0.004)
predicted a BNT < -51ºC when using 23-mm CBs, while PV ostium oval
shape (OR, 0.3; p = 0.033) and PV locations (left inferior PV: OR, 0.04; p =
0.005; right superior PV: OR, 4.3; p = 0.025) predicted BNT <
-51ºC when using 28-mm CBs. Conclusions MDCT can provide PV anatomy accurate evaluation prior CB ablation. PV anatomy
is associated with cryo kinetics during ablation.
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Affiliation(s)
- Xiongbiao Chen
- Department of Cardiac Arrhythmia - State Key Laboratory of Cardiovascular Disease - Fuwai Hospital - National Center for Cardiovascular Diseases - Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing - China
| | - Pihua Fang
- Department of Cardiac Arrhythmia - State Key Laboratory of Cardiovascular Disease - Fuwai Hospital - National Center for Cardiovascular Diseases - Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing - China
| | - Zheng Liu
- Department of Cardiac Arrhythmia - State Key Laboratory of Cardiovascular Disease - Fuwai Hospital - National Center for Cardiovascular Diseases - Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing - China
| | - Jia He
- Department of Cardiac Arrhythmia - State Key Laboratory of Cardiovascular Disease - Fuwai Hospital - National Center for Cardiovascular Diseases - Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing - China
| | - Min Tang
- Department of Cardiac Arrhythmia - State Key Laboratory of Cardiovascular Disease - Fuwai Hospital - National Center for Cardiovascular Diseases - Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing - China
| | - Jun Liu
- Department of Cardiac Arrhythmia - State Key Laboratory of Cardiovascular Disease - Fuwai Hospital - National Center for Cardiovascular Diseases - Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing - China
| | - Bin Lu
- Department of Radiology - State Key Laboratory of Cardiovascular Disease - Fuwai Hospital - National Center for Cardiovascular Disease - Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing - China
| | - Shu Zhang
- Department of Cardiac Arrhythmia - State Key Laboratory of Cardiovascular Disease - Fuwai Hospital - National Center for Cardiovascular Diseases - Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing - China
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Gao S, Jia JY, Yan TK, Yu YM, Shang WY, Wei L, Zheng ZF, Fang P, Chang BC, Lin S. [Effects of ammonium pyrrolidine dithiocarbamate (PDTC) on osteopontin expression and autophagy in tubular cells in streptozotocin-induced diabetic nephropathy rat]. Zhonghua Yi Xue Za Zhi 2018; 96:3590-3595. [PMID: 27916082 DOI: 10.3760/cma.j.issn.0376-2491.2016.44.012] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the effects of ammonium pyrrolidine dithiocarbamate (PDTC) on tubulointerstitial inflammatory molecules and autophagy in diabetic nephropathy (DN) rats. Methods: Twenty-four male Sprague-Dawley rats were assigned to DN group (n=6) and DN+ PDTC group (n=6, PDTC, ip, 100 mg·kg-1·d-1), all received streptozotocin (STZ) 60 mg/kg intraperitoneally, and the other 12 rats were randomly divided into control group (n=6) and PDTC group (n=6). At the end of 12 weeks, after serum creatine (Scr) and 24-hour urinary protein were determined, rats were sacrificed to determined the renal pathological damages and the changes of nuclear factor (NF)-κB p65, p62, osteopontin (OPN), microtubule associated protein 1 light chain 3 (LC3)-Ⅱ/LC3-Ⅰ, nuclear p-NF-κB p65 by immunohistological stainning and Western blot, and ultrastructural changes of autophagic process was observed by electron microscopy (EM). Results: Scr was similar among the four groups (P>0.05). The levels of urinary protein in DN group and DN + PDTC group were significantly higher than the other two groups (all P<0.01), but the level of urinary protein in DN + PDTC group was lower than that of DN group (P<0.05). DN + PDTC group had less tubulointerstitial damage compared with DN group (P<0.05). Among the four groups, expressions of p62, p65, OPN of tubulointerstitial area in DN group were significantly higher than that of the other groups (all P<0.05), and Western blot showed that DN+ PDTC group had less expressions of NF-κB p65, nuclear p-p65, OPN and more expresssion of LC3-Ⅱ/LC3-Ⅰ compared with DN group (all P<0.05), which were consistent with the decreased autophagic vacuoles and increased mitochondria dysfunction revealed by EM. Correlation analysis showed that renal LC3-Ⅱ/LC3-Ⅰ was negatively correlated the expressions of nuclear p-p65 and OPN (r=-0.45, P=0.02; r=-0.50, P=0.01), and p62 was positively correlated the expressions of nuclear p-p65 and OPN (r=0.33, P=0.01; r=0.41, P=0.01). Conclusion: Tubular NF-κB activation is closely related to autophagy dysfunction in DN rats, and PDTC may enhance autophagy activity in tubule cells by blocking NF-κB activity.
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Affiliation(s)
- S Gao
- *Department of Nephrology, the General Hospital of Tianjin Medical University, Tianjin 300052, China
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Tang ZJ, Fang P, Huang JH, Zhong PY. Emission characteristics of Cl2 and ClO2 during simultaneous removal of SO2 and NO using NaClO2 solution. ACTA ACUST UNITED AC 2018. [DOI: 10.1088/1755-1315/113/1/012148] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Liu Z, Liu X, Ren L, Yin X, Han H, Wang Y, Deng W, Jia Y, Fang P, Yang X. Recurrence after successful catheter ablation for ventricular arrhythmia from the aortic root. Acta Cardiol 2018; 73:29-39. [PMID: 28691870 DOI: 10.1080/00015385.2017.1324658] [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] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The mechanism underlying recurrence after successful ablation of ventricular arrhythmias (VAs) was unclear. Spectrum analysis can help to identify near-field activation. The purpose of this study was to quantify the changes of near-field activation in response to ablation at the VAs origin in the aortic root (AR-VAs) and to assess its relationship with late ablation outcome. METHODS AND RESULTS Patients who underwent acutely successful ablation for AR-VAs were analysed. Ventricular electrograms acquired before and after ablation at VAs origin were subjected to spectrum analysis. The area under the curve of the high frequency component (HFC, 50-200 Hz) and the low frequency component (LFC, 0-50 Hz) was measured. The proportion of HFC to the frequency spectrum of 0-200 Hz was defined as the HFC ratio (HFCR). The reduction of HFC and HFCR in response to ablation was defined as HFC pre-post and HFCR pre-post, respectively. Documentation of VAs with the same morphology after an acute successful procedure was defined as recurrence. Fifty-six patients were analysed, and VAs recurred in 17 patients. HFCR pre-post, HFC pre-post, and HFC pre-ablation were significantly higher in patients without recurrence. And HFCR pre-post has the highest predictive value (area under the receiver-operating characteristic curve: 0.975). A HFCR pre-post of 1.0% differentiated two groups (sensitivity = 84.6%, specificity = 100%). Higher HFCR pre-post was correlated with shorter VAs termination time (correlation coefficient = -0.399, p = .009). CONCLUSIONS HFCR pre-post can quantify the near-field activation change during ablation. Incomplete destruction to the VAs foci could underlie recurrence after successful ablation.
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Affiliation(s)
- Zheng Liu
- Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Xiaoqin Liu
- Department of Cardiology, Beijing Jishuitan Hospital, Peking University, Beijing, People’s Republic of China
| | - Lan Ren
- Department of Cardiology, Beijing Jishuitan Hospital, Peking University, Beijing, People’s Republic of China
| | - Xiandong Yin
- Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Hao Han
- Department of Cardiology, Beijing Jishuitan Hospital, Peking University, Beijing, People’s Republic of China
| | - Yuxin Wang
- Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Wenning Deng
- Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Yuhe Jia
- Arrhythmia Center, Fuwai Hospital, Beijing, People’s Republic of China
| | - Pihua Fang
- Arrhythmia Center, Fuwai Hospital, Beijing, People’s Republic of China
| | - Xinchun Yang
- Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People's Republic of China
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Zhai Z, Tang M, Zhang S, Fang P, Jia Y, Feng T, Wang J. Transoesophageal echocardiography prior to catheter ablation could be avoided in atrial fibrillation patients with a low risk of stroke and without filling defects in the late-phase MDCT scan: A retrospective analysis of 783 patients. Eur Radiol 2017; 28:1835-1843. [PMID: 29218612 DOI: 10.1007/s00330-017-5172-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 04/24/2017] [Revised: 10/11/2017] [Accepted: 11/03/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To test whether multidetector computed tomography (MDCT) could completely replace transoesophageal echocardiography (TEE) to detect left atrial appendage (LAA) thrombi in atrial fibrillation (AF) patients using a large sample size. METHODS 783 patients with AF who underwent MDCT and TEE before catheter ablation were retrospectively included. Demographic data were obtained. Two radiologists blinded to clinical data made the imaging diagnosis. RESULTS Most of the patients (96.2 %) had a CHA2DS2-VASc score (congestive heart failure, hypertension, age ≥ 75 years old (doubled), diabetes, stroke/transient ischaemic attack/thromboembolism (doubled), vascular disease, age 65-74 years, female sex) ≤ 3. Eight thrombi were identified by TEE, all of which were detected by MDCT; no thrombus was observed with TEE without the observation of filling defects by late-phase MDCT scanning in any of the patients. Using TEE as reference standard, the sensitivity, specificity, positive predictive value and negative predictive value of MDCT for thrombus detection were 100 %, 95.74 % (95 % CI 94.33 %-97.15 %), 19.51 % (95 % CI 16.73 %-22.29 %) and 100 %, respectively. CONCLUSIONS For AF patients with low risk of stroke, when MDCT images showed no filling defect in the late phase, TEE prior to catheter ablation can be avoided. KEY POINTS • MDCT can help detect the presence of LAA thrombus. • TEE can be avoided when late-phase MDCT shows no filling defect. • TEE is required in patients whose MDCT images indicate thrombus.
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Affiliation(s)
- Zhengqin Zhai
- Department of Arrhythmia, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, NO.167, Beilishi Road, Xicheng District, Beijing, China
| | - Min Tang
- Department of Arrhythmia, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, NO.167, Beilishi Road, Xicheng District, Beijing, China.
| | - Shu Zhang
- Department of Arrhythmia, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, NO.167, Beilishi Road, Xicheng District, Beijing, China
| | - Pihua Fang
- Department of Arrhythmia, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, NO.167, Beilishi Road, Xicheng District, Beijing, China
| | - Yuhe Jia
- Department of Arrhythmia, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, NO.167, Beilishi Road, Xicheng District, Beijing, China
| | - Tianjie Feng
- Department of Arrhythmia, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, NO.167, Beilishi Road, Xicheng District, Beijing, China
| | - Jiande Wang
- Department of Arrhythmia, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, NO.167, Beilishi Road, Xicheng District, Beijing, China
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Abstract
BACKGROUND Obesity is strongly linked to increased blood pressure, which increases the risk of cardiovascular diseases. To our knowledge, little literature reported the information about galanin levels in obese individuals with hypertension. Therefore, the aim of this study was to investigate the possible involvement of galanin in the pathogenesis of obese subjects with hypertension. METHODS We measured body mass index and blood pressure of 38 obese patients with hypertension, 44 obese controls with normal blood pressure and 44 lean controls with normal blood pressure. Blood samples from all cases were collected at 8:00 a.m. after an overnight fast to determine the fasting plasma concentration of galanin, glucose, insulin, triglyceride, total cholesterol, high- and low-density lipoprotein cholesterol. RESULTS We found that plasma galanin levels were significantly decreased in obese patients with hypertension compared with the obese control group, whereas the galanin levels were significantly increased in obese controls compared with lean controls. Furthermore, in both obese groups the galanin levels were negatively correlative to diastolic blood pressure and positively correlative to insulin and triglyceride levels, but not to heart rate. CONCLUSIONS Low galanin levels were one of characters of obese patients with high blood pressure, and this levels may be taken as a novel biomarker to predict the development of high blood pressure in obese patients.
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Affiliation(s)
- P Fang
- Department of Physiology, Nanjing University of Chinese Medicine Hanlin College, Taizhou, 225300, China
- Department of Endocrinology, Clinical Medical College, Yangzhou University, Yangzhou, 225001, China
- Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Medical College, Yangzhou University, Yangzhou, 225001, China
| | - M Yu
- Department of Physiology, Nanjing University of Chinese Medicine Hanlin College, Taizhou, 225300, China
- Department of Endocrinology, Clinical Medical College, Yangzhou University, Yangzhou, 225001, China
| | - X Gu
- Department of Pathology, Clinical Medical College, Yangzhou University, Yangzhou, 225001, Jiangsu, China
| | - M Shi
- Department of Endocrinology, Clinical Medical College, Yangzhou University, Yangzhou, 225001, China
- Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Medical College, Yangzhou University, Yangzhou, 225001, China
| | - Y Zhu
- Department of Endocrinology, Clinical Medical College, Yangzhou University, Yangzhou, 225001, China
| | - Z Zhang
- Department of Endocrinology, Clinical Medical College, Yangzhou University, Yangzhou, 225001, China.
| | - P Bo
- Department of Endocrinology, Clinical Medical College, Yangzhou University, Yangzhou, 225001, China.
- Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Medical College, Yangzhou University, Yangzhou, 225001, China.
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Chen FB, Yao QL, Liu HF, Fang P. Evaluation on the germplasm of maize (Zea mays L.) landraces from southwest China. Genet Mol Res 2016; 15:gmr-15-04-gmr.15049160. [PMID: 28081280 DOI: 10.4238/gmr15049160] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Because of their local adaptation and economic factors that limit the adoption of commercial hybrids, farmer-saved maize landraces are still grown over a considerable area concentrated in southwest China. To evaluate the potential of using maize landraces, the germplasm characteristics of 96 landraces from southwest China were evaluated at phenotypic, cellular, and molecular levels. The existence of high phenotypic variation and elite germplasm tolerant to low-N, low-P, as well as drought stress was observed. Of the total landraces, 81.25, 7.29, 5.21, and 2.08% were found with 0, 1, 2, 3, and 4 B chromosomes. Using 42 microsatellite (simple sequence repeat) loci, 246 alleles were detected among the landraces. The number of alleles per SSR locus varied from 2 to 10, averaging 5.67 allele per locus, which revealed a high level of genetic diversity of maize landraces in southwest China. Cluster analysis showed that 96 landraces could distinctly be clustered into four groups, which tended to associate with their geographic origins. We propose that the genetic diversity center of maize landraces in southwest China might be in Sichuan. A sharp genetic deviation from Hardy-Weinberg equilibrium was observed from heterozygosity deficiency and a considerable genetic variation was revealed within, rather than among, the landraces. Based on their germplasm characteristics, the innovation and utilization of maize landraces in southwestern China for theoretical and applied research could be achieved by constructing heterosis groups, developing inbred lines with high combining ability, and maintaining the landraces with elite germplasm and B chromosomes using bulked pollen.
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Affiliation(s)
- F B Chen
- Department of Life Sciences, Yangtze Normal University, Chongqing, China
| | - Q L Yao
- Department of Life Sciences, Yangtze Normal University, Chongqing, China
| | - H F Liu
- Department of Life Sciences, Yangtze Normal University, Chongqing, China
| | - P Fang
- Department of Life Sciences, Yangtze Normal University, Chongqing, China
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Zhang Y, Chen H, Lu H, Shen Y, Chen R, Fang P, Du X, Bao Y, Wang C, Jia W. Prevalence and risk of diabetes based on family history in the Shanghai High-Risk Diabetic Screen (SHiDS) study. Diabet Med 2016; 33:1705-1711. [PMID: 26511673 DOI: 10.1111/dme.13013] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 09/08/2015] [Accepted: 10/26/2015] [Indexed: 12/26/2022]
Abstract
AIMS To evaluate the prevalence and risk of diabetes based on family history in high-risk subjects and also to evaluate insulin sensitivity and insulin secretion in these subjects. METHODS Data were analysed from 9756 participants in the Shanghai High-Risk Diabetic Screen (SHiDS) Project. Family history of diabetes was classified according to parental and sibling diabetes status. The prevalence and odds ratios were calculated for each grouping after adjusting for other risk factors. Insulin resistance and sensitivity were evaluated using oral glucose tolerance test-derived indices that were validated by hyperinsulinaemic-euglycaemic and hyperglycaemic clamps. RESULTS A total of 30.4% of the subjects had a family history of diabetes in a first-degree relative. The proportions of subjects with a father, mother or sibling with diabetes were 7.5, 11.9 and 5.5%, respectively. The prevalence rates of diabetes in subjects with sibling history, maternal history or paternal history of diabetes were 39.3, 38.3 and 36.4%, respectively. Sibling history was a strong risk factor for diabetes (odds ratio 1.53, 95% CI 1.27-1.84; P < 0.05). Insulin secretion was significantly lower in those with a maternal or sibling history of diabetes; however, insulin sensitivity was not significantly different among subjects with a family history of diabetes. CONCLUSIONS Sibling history of diabetes was more strongly associated with diabetes risk than parental history among high-risk subjects. Subjects with a sibling or maternal history of diabetes had significantly lower insulin secretion. Sibling history is an important and independent risk factor for diabetes even among multi-risk populations. Those with a sibling history of diabetes warrant intensive care and follow-up screening.
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Affiliation(s)
- Y Zhang
- Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Key Laboratory of Diabetes, Shanghai, China
- Center for Translational Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- The Metabolic Diseases Biobank, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - H Chen
- Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Key Laboratory of Diabetes, Shanghai, China
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Centre of Diabetes, Shanghai Diabetes Institute, Shanghai, China
| | - H Lu
- Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Key Laboratory of Diabetes, Shanghai, China
- The Metabolic Diseases Biobank, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Y Shen
- Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Key Laboratory of Diabetes, Shanghai, China
- The Metabolic Diseases Biobank, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - R Chen
- Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Key Laboratory of Diabetes, Shanghai, China
- The Metabolic Diseases Biobank, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - P Fang
- Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Key Laboratory of Diabetes, Shanghai, China
- The Metabolic Diseases Biobank, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - X Du
- Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Key Laboratory of Diabetes, Shanghai, China
- The Metabolic Diseases Biobank, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Y Bao
- Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Key Laboratory of Diabetes, Shanghai, China
- The Metabolic Diseases Biobank, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - C Wang
- Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Key Laboratory of Diabetes, Shanghai, China
- The Metabolic Diseases Biobank, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - W Jia
- Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Key Laboratory of Diabetes, Shanghai, China
- The Metabolic Diseases Biobank, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Centre of Diabetes, Shanghai Diabetes Institute, Shanghai, China
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Davuluri R, Jiang W, Fang P, Xu C, Komaki R, Hsu C, Lin S, Welsh J, Cox J, Crane C. Absolute Lymphocyte Count Nadir During Chemoradiation as a Prognostic Indicator of Esophageal Cancer Survival Outcomes. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Fang P, Hobbs B, Fellman B, Son J, Ma J, Lin S. Early Apparent Diffusion Coefficient Change During Neoadjuvant Chemoradiation Predicts Pathologic and Clinical Response in Esophageal Cancer. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Fang P, Rao X, Wang J, Maru D, Lin S. Differential Expression of Immuno-oncologic Genes in Esophageal Cancer Patients With Complete Pathologic Response to Chemoradiation. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1009] [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: 11/16/2022]
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Fang P, Jiang W, Davuluri R, Xu C, Welsh J, Komaki R, Crane C, Hsu C, Lin S. Immune Profile-to-Lymphocyte Ratios During Chemoradiation are Predictors of Clinical Outcomes in Esophageal Cancer. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.2081] [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: 11/28/2022]
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Jiang W, Davuluri R, Fang P, Xu C, Welsh J, Crane C, Komaki R, Cox J, Hsu C, Lin S. Circulating Lymphocyte Count During Neoadjuvant Chemoradiation Therapy for Esophageal Cancer as a Predictive Biomarker of Pathologic Complete Response. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Liu XH, Yuan S, Zhao YL, Fang P, Chen H, Zhang JY. Morphological and molecular characterization of Myxobolus sheyangensis n. sp. (Myxosporea: Myxobolidae) with intralamellar sporulation in allogynogenetic gibel carp, Carassius auratus gibelio (Bloch) in China. Parasitol Res 2016; 115:3567-74. [DOI: 10.1007/s00436-016-5122-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 05/10/2016] [Indexed: 10/21/2022]
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Chen FB, Liu HF, Yao QL, Fang P. Evolution of mustard (Brassica juncea Coss) subspecies in China: evidence from the chalcone synthase gene. Genet Mol Res 2016; 15:gmr8045. [PMID: 27173323 DOI: 10.4238/gmr.15028045] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
To explore the phylogenetic relationship, genome donor, and evolutionary history of the polyploid mustard (Brassica juncea) from China, eighty-one sequences of the chalcone synthase gene (Chs) were analyzed in 43 individuals, including 34 B. juncea, 2 B. rapa, 1 B. nigra, 2 B. oleracea, 1 B. napus, 1 B. carinata, and 2 Raphanus sativus. A maximum likelihood analysis showed that sequences from B. juncea were separated into two well-supported groups in accordance with the A and B genomes, whereas the traditional phenotypic classification of B. juncea was not wholly supported by the molecular results. The SplitsTree analysis recognized four distinct groups of Brassicaceae, and the median-joining network analysis recognized four distinct haplotypes of Chs. The estimates of Tajima's D, Fu and Li's D, and Fu and Li's F statistic for the Chs gene in the B genome were negative, while those in the A genome were significant. The results indicated that 1) the Chs sequences revealed a high level of sequence variation in Chinese mustard, 2) both tree and reticulate evolutions existed, and artificial selection played an important role in the evolution of Chinese mustard, 3) the original parental species of Chinese mustard are B. rapa var. sinapis arvensis and B. nigra (derived from China), 4) nucleotide variation in the B genome was higher than that in the A genome, and 5) cultivated mustard evolved from wild mustard, and China is one of the primary origins of B. juncea.
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Affiliation(s)
- F B Chen
- Department of Life Sciences, Yangtze Normal University, Fuling, Chongqing, China
| | - H F Liu
- Department of Life Sciences, Yangtze Normal University, Fuling, Chongqing, China
| | - Q L Yao
- Department of Life Sciences, Yangtze Normal University, Fuling, Chongqing, China
| | - P Fang
- Department of Life Sciences, Yangtze Normal University, Fuling, Chongqing, China
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Wang D, Fang P, Liu YH, Zhao Y, Gao CB. [A clinical reaserch of endoscopic endonasal transsphenoidal surgery for pituitary macroadenoma]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2016; 30:551-553. [PMID: 29871067 DOI: 10.13201/j.issn.1001-1781.2016.07.011] [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] [Received: 10/21/2015] [Indexed: 11/12/2022]
Abstract
Objective:To share our exprience with the surgical management of pituitary macroadenoma and giant adenoma excision technique through the endoscopic transsphenoidal approach. Method:A retrospective analysis data of 27 patients with pituitary macroadenoma and giant adenoma surgery methods, postoperative complications and follow-up results. Result:All patients have no postoperative complications happened such as: nasal bleeding, intracranial hemorrhage, cerebrospinal fluid leak, blood sugar increased. Tumors invaded cavernous sinus in 5 cases, surrounded internal carotid artery in 2 cases, compressed optic chiasma in 7 cases and encroached optic nerve in 1 case. Postoperative vision decline occurred in 2 cases: 1 case recovered to the preoperative level after being taken out nasal stuffing and with conservative treatment, 1 case (preoperative visual acuity 0.1) restored light perception after conservative treatment. Postoperative diabetes insipidus occurred in 4 cases, and recovered in next week with corresponding therapy. Conclusion:Endoscopic endonasal transsphenoidal surgery is a safe and effective surgical technique.
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Affiliation(s)
- D Wang
- Department of Otolaryngology, the First Affiliated Hospital of Anhui Medical University, 230000, Hefei, China
| | - P Fang
- Department of Otolaryngology, the First Affiliated Hospital of Anhui Medical University, 230000, Hefei, China
| | - Y H Liu
- Department of Otolaryngology, the First Affiliated Hospital of Anhui Medical University, 230000, Hefei, China
| | - Yi Zhao
- Department of Otolaryngology, the First Affiliated Hospital of Anhui Medical University, 230000, Hefei, China
| | - C B Gao
- Department of Otolaryngology, the First Affiliated Hospital of Anhui Medical University, 230000, Hefei, China
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Liu Z, Zhang S, Fang P. GW26-e3595 Methods for steadily right phrenic nerve pacing in patients with cryoballoon ablation for atrial fibrillation. J Am Coll Cardiol 2015. [DOI: 10.1016/j.jacc.2015.06.707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Fang P, Batra S, Hollander AB, Lin A, Hill-Kayser CE, Levin LM, Mupparapu M, Thompson RF. Development and evaluation of a standardized method and atlas for contouring primary and permanent dentition. Dentomaxillofac Radiol 2015; 44:20150034. [PMID: 25812046 DOI: 10.1259/dmfr.20150034] [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] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Radiation toxicity of the dentition may present significant treatment-related morbidity in the paediatric head and neck cancer population. However, clear dose-effect relationships remain undetermined and must be predicated upon accurate structure delineation and dosimetry at the individual tooth level. Radiation oncologists generally have limited familiarity or experience with relevant dental anatomy. METHODS We therefore developed a detailed CT atlas of permanent and primary dentition. After studying this atlas, five radiation oncology clinicians delineated all teeth for each of eight different cases (selected for breadth of dental maturity and anatomical variability). They were asked to record confidence in their contours on a per-tooth basis as well as the duration of time required per case. Contour accuracy and interclinician variability were assessed by Hausdorff distance and Dice similarity coefficient. All analyses were performed using R v. 3.1.1 and the RadOnc v. 1.0.9 package. RESULTS Participating clinicians delineated teeth with varying degrees of completeness and accuracy, stratified primarily by the age of the subject. On a per-tooth basis, delineation of permanent dentition was feasible for incisors, canines, premolars and first molars among all subjects, even at the youngest ages. However, delineation of second and third molars was less consistent, commensurate with approximate timing of tooth development. Within each tooth contour, uncertainty was the greatest at the level of the dental roots. CONCLUSIONS Delineation of individual teeth is feasible and serves as a necessary precursor for dental dose assessment and avoidance. Among the paediatric radiation oncology community in particular, this atlas may serve as a useful tool and reference.
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Affiliation(s)
- P Fang
- 1 Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA, USA
| | - S Batra
- 1 Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA, USA
| | - A B Hollander
- 1 Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA, USA
| | - A Lin
- 1 Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA, USA
| | - C E Hill-Kayser
- 1 Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA, USA
| | - L M Levin
- 2 Department of Oral and Maxillofacial Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - M Mupparapu
- 3 Department of Oral and Maxillofacial Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - R F Thompson
- 1 Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA, USA
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