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Liang K, Feliciano JL, Marrone KA, Murray JC, Hann CL, Anagnostou V, Tackett SA, Shin EJ, Hales RK, Voong KR, Battafarano RJ, Yang SC, Broderick SR, Ha JS, Forde PM, Brahmer JR, Lam VK. Clinical features and outcomes of advanced HER2+ esophageal/GEJ cancer with brain metastasis. ESMO Open 2024; 9:102199. [PMID: 38071928 PMCID: PMC10837776 DOI: 10.1016/j.esmoop.2023.102199] [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: 06/13/2023] [Revised: 10/30/2023] [Accepted: 11/15/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Brain metastasis (BRM) is uncommon in gastroesophageal cancer. As such, clinicopathologic and molecular determinants of BRM and impact on clinical outcome remain incompletely understood. METHODS We retrospectively analyzed clinicopathologic data from advanced esophageal/gastroesophageal junction (E/GEJ) patients at Johns Hopkins from 2003 to 2021. We investigated the association between several clinical and molecular features and the occurrence of BRM, with particular focus on human epidermal growth factor receptor 2 (HER2) overexpression. Survival outcomes and time to BRM onset were also evaluated. RESULTS We included 515 patients with advanced E/GEJ cancer. Tumors were 78.3% esophageal primary, 82.9% adenocarcinoma, 31.0% HER2 positive. Cumulative incidence of BRM in the overall cohort and within HER2+ subgroup was 13.8% and 24.3%, respectively. HER2 overexpression was associated with increased risk of BRM [odds ratio 2.45; 95% confidence interval (CI) 1.10-5.46]. On initial presentation with BRM, 50.7% had a solitary brain lesion and 11.3% were asymptomatic. HER2+ status was associated with longer median time to onset of BRM (14.0 versus 6.3 months, P < 0.01), improved median progression free survival on first-line systemic therapy (hazard ratio 0.35, 95% CI 0.16-0.80), and improved median overall survival (hazard ratio 0.20, 95% CI 0.08-0.54) in patients with BRM. CONCLUSION HER2 overexpression identifies a gastroesophageal cancer molecular subtype that is significantly associated with increased risk of BRM, though with later onset of BRM and improved survival likely reflecting the impact of central nervous system-penetrant HER2-directed therapy. The prevalence of asymptomatic and solitary brain lesions suggests that brain surveillance for HER2+ patients warrants prospective investigation.
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Affiliation(s)
- K Liang
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, USA
| | - J L Feliciano
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, USA
| | - K A Marrone
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, USA
| | - J C Murray
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, USA
| | - C L Hann
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, USA
| | - V Anagnostou
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, USA
| | - S A Tackett
- Department of Medicine, Biostatistics, Epidemiology and Data Management (BEAD) Core, Johns Hopkins University School of Medicine, Baltimore, USA
| | - E J Shin
- Department of Gastroenterology & Hepatology, Johns Hopkins University School of Medicine, Baltimore, USA
| | - R K Hales
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, USA; Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, USA
| | - K R Voong
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, USA; Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, USA
| | - R J Battafarano
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, USA
| | - S C Yang
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, USA
| | - S R Broderick
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, USA
| | - J S Ha
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, USA
| | - P M Forde
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, USA
| | - J R Brahmer
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, USA
| | - V K Lam
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, USA.
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Zou MH, Cao F, Ma L, Xia YS, Yang SC, Chen WD, Li WL, Chen XX. [Outcomes after surgical repair of pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries: a series of 104 cases]. Zhonghua Wai Ke Za Zhi 2023; 61:1093-1098. [PMID: 37932146 DOI: 10.3760/cma.j.cn112139-20230108-00012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
Objective: To examine the early and midterm surgical outcome of pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries (PA/VSD/MAPCA) using revised surgical strategies. Methods: A retrospective analysis of clinical data, surgical methods, and follow-up results was performed of 104 cases of PA/VSD/MAPCA in Department of Cardiovascular Surgery, Guangzhou Women and Children's Medical Center from January 2017 to September 2022. There were 55 males and 49 females, aged (M(IQR)) 33.9(84.0) months (range: 0.5 to 209.6 months) at the first surgical procedures. The anatomical classification included 89 cases of type B and 15 cases of type C. The number of major aortopulmonary collateral arteries was 4.2 (3.0) (range: 1 to 8). The Kaplan-Meier method was used for survival estimation. Results: In the first stage of surgery, 50 patients underwent a complete primary repair, 12 patients underwent partial repair, 32 patients underwent palliative right ventricular-pulmonary artery connection, and only 10 patients chose the Blalock-Taussig shunt. There were 10 cases of early death. In the second stage, 14 patients underwent complete repair and 4 patients underwent partial repair with no early death. The interval between the two surgeries was 19 (10) months (range: 9 to 48 months). Finally, during the 40 (34) months follow-up period, a total of 64 patients were complete repair and the right/left ventricular pressure ratio after complete repair was 0.63±0.16 (range: 0.36 to 1.00). Survival analysis showed that survival rates at 1 and 5 years after first-stage surgery were both 89.4% (95%CI: 83.5% to 95.3%). At 28 (34) months (range: 1 to 67 months) of follow-up after complete repair, the survival analysis showed that the survival rates at 1 and 5 years were both 95.2% (95%CI: 89.9% to 100%). Conclusions: Using combined approaches tailored to individual patients and optimized unifocalization strategy, the complete repair rate at one stage and the cumulative complete repair rate at 5 years improved significantly with a lower right/left ventricular pressure ratio and satisfactory early and intermediate survival.
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Affiliation(s)
- M H Zou
- Department of Cardiovascular Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China
| | - F Cao
- Department of Cardiovascular Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China
| | - L Ma
- Department of Cardiovascular Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China
| | - Y S Xia
- Department of Cardiovascular Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China
| | - S C Yang
- Department of Cardiovascular Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China
| | - W D Chen
- Department of Cardiovascular Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China
| | - W L Li
- Department of Cardiovascular Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China
| | - X X Chen
- Department of Cardiovascular Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China
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Ding YQ, Yang SC, Lyu J, Li LM. [A review on cardiovascular disease risk prediction models in the elderly]. Zhonghua Liu Xing Bing Xue Za Zhi 2023; 44:1013-1020. [PMID: 37380427 DOI: 10.3760/cma.j.cn112338-20221104-00940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Risk prediction models play an important role in the primary prevention of cardiovascular diseases (CVD) in the elderly population. There are fifteen papers about CVD risk prediction models developed for the elderly domestically and internationally, of which the definitions of disease outcome vary widely. Ten models were reported with insufficient information about study methods or results. Ten models were at high risk of bias. Thirteen models presented moderate discrimination in internal validation, and only four models have undertaken external validation. The CVD risk prediction models for the elderly differed from those for the general population in terms of model algorithm and the effect size of association between predictor and outcome, and the prediction performance of the models for the elderly attenuated. In the future, high-quality external validation researches are necessary to provide more solid evidence. Different ways, including adding new predictors, using competing risk model algorithms, machine learning methods, or joint models, and altering the prediction time horizon, should be explored to optimize the current models.
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Affiliation(s)
- Y Q Ding
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - S C Yang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - J Lyu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China
| | - L M Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China
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Zeng ZQ, Yang SC, Yu CQ, Zhang LX, Lyu J, Li LM. [Progress in research of risk prediction model for chronic kidney disease]. Zhonghua Liu Xing Bing Xue Za Zhi 2023; 44:498-503. [PMID: 36942348 DOI: 10.3760/cma.j.cn112338-20220908-00771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
Chronic kidney disease (CKD) is an important global public health problem that greatly threatens population health. Application of risk prediction model is a crucial way for the primary prevention of CKD, which can stratify the risk for developing CKD and identify high-risk individuals for more intensive interventions. By now, more than twenty risk prediction models for CKD have been developed worldwide. There are also four domestic risk prediction models developed for Chinese population. However, none of these models have been recommended in clinical guidelines yet. The existing risk prediction models have some limitations in terms of outcome definition, predictors, strategies for handling missing data, and model derivation. In the future, the applications of emerging biomarkers and polygenic risk scores as well as advances in machine learning methods will provide more possibilities for the further improvement of the model.
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Affiliation(s)
- Z Q Zeng
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - S C Yang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - C Q Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China
| | - L X Zhang
- National Institute of Health Data Science of Peking University, Beijing 100191, China Department of Nephrology, Peking University First Hospital/Institute of Nephrology, Peking University, Beijing 100034, China
| | - J Lyu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China
| | - L M Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China
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Yang SC, Sun ZJ, Lyu J, Li L. [Research progress on risk prediction models of cardiovascular disease]. Zhonghua Xin Xue Guan Bing Za Zhi 2022; 50:1243-1251. [PMID: 36517448 DOI: 10.3760/cma.j.cn112148-20220324-00202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Affiliation(s)
- S C Yang
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Z J Sun
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - J Lyu
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing 100191, China Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China
| | - Liming Li
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing 100191, China Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China
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6
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Yang SC, Li CY, Hu YZ, Sun QF, Pan JQ, Sun DJY, Ma BS, Lyu J, Li LM. [gwasfilter: an R script to filter genome-wide association study]. Zhonghua Liu Xing Bing Xue Za Zhi 2021; 42:1876-1881. [PMID: 34814627 DOI: 10.3760/cma.j.cn112338-20200731-01003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Objective: To develop an R script that can efficiently and accurately filter genome-wide association studies (GWASs) from the GWAS Catalog Website. Methods: The selection principles of GWASs were established based on previous studies. The process of manual filtering in the GWAS Catalog was abstracted as standard algorithms. The R script (gwasfilter.R) was written by two programmers and tested many times. Results: It takes six steps for gwasfilter.R to filter GWASs. There are five main self-defined functions among this R script. GWASs can be filtered based on "whether the GWAS has been replicated" "sample size" "ethnicity of the study population" and other conditions. It takes no more than 1 second for this script to filter GWASs of a single trait. Conclusions: This R script (gwasfilter.R) is user-friendly and provides an efficient and standard process to filter GWASs flexibly. The source code is available at github (https://github.com/lab319/gwas_filter).
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Affiliation(s)
- S C Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - C Y Li
- College of Information Science and Technology, Dalian Maritime University, Dalian 116026, China
| | - Y Z Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Q F Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - J Q Pan
- College of Information Science and Technology, Dalian Maritime University, Dalian 116026, China
| | - D J Y Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - B S Ma
- College of Information Science and Technology, Dalian Maritime University, Dalian 116026, China
| | - J Lyu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing 100191, China
| | - L M Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing 100191, China
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Fan JN, Yang SC, Sun ZJ, Wang H, Ma Y, Wang B, Yu CQ, Ning Y, Lyu J, Li LM. [Transitions on frailty status and related risk factors for its status worsening: finding from the Beijing MJ Health Screening Center]. Zhonghua Liu Xing Bing Xue Za Zhi 2021; 42:1453-1459. [PMID: 34814567 DOI: 10.3760/cma.j.cn112338-20201217-01416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Objective: To evaluate the transitions of frailty status and related factors influencing its worsening in middle-aged and elderly adults. Methods: Data was obtained from the Beijing MJ Health Screening Center. A total of 13 689 participants who attended health checkups at least twice during 2008-2019 and had more than three years' intervals during these two health checkups were included in the study. The frailty index comprising 28 variables was used to measure frailty status. Frailty was defined as frailty index ≥0.25, and prefrailty was defined as frailty index >0.10 and <0.25. Logistic regression analysis was performed to investigate the association of socio-demographic factors and lifestyle characteristics with the worsening of frailty status, stratified by frailty status at the first health checkup. Results: The mean age at the first and last health checkups were (42.3±9.2) and (47.9±9.3) years, respectively. The mean interval during these two health checkups was (5.7±1.9) years. At the first health checkup, the prevalence of frailty and prefrailty were 2.5% and 50.3%, respectively. While at the last health checkup, the prevalence of frailty and prefrailty rose to 3.9% and 55.4%. Of all participants, 67.3% remained in the same frailty state, 21.2% worsening, and 12.5% improving. In robust participants at the first health checkup, older age, female, low education level, smoking cessation, daily smoking, being general obesity measured by BMI or central obesity measured by WHR showed an increased the risk of worsening frailty status. However, in prefrail participants at the first health checkup, older age, female, general, or central obesity presented as risk factors for worsening frailty status. Conclusion: Modifiable factors such as low education level, smoking, and obesity may increase the risk of worsening frailty status.
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Affiliation(s)
- J N Fan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - S C Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Z J Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - H Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Y Ma
- Meinian Institute of Health, Beijing 100191, China
| | - B Wang
- Meinian Institute of Health, Beijing 100191, China Peking University Health Science Center Meinian Public Health Institute, Beijing 100191, China
| | - C Q Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Peking University Health Science Center Meinian Public Health Institute, Beijing 100191, China Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing 100191, China
| | - Y Ning
- Meinian Institute of Health, Beijing 100191, China Peking University Health Science Center Meinian Public Health Institute, Beijing 100191, China
| | - J Lyu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Peking University Health Science Center Meinian Public Health Institute, Beijing 100191, China Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing 100191, China
| | - L M Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Peking University Health Science Center Meinian Public Health Institute, Beijing 100191, China Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing 100191, China
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Gao Y, Yang SC, Zhu MH, Zhu XD, Luan X, Liu XL, Lai X, Yuan Y, Lu Q, Sun P, Lovell JF, Chen HZ, Fang C. Metal Phenolic Network-Integrated Multistage Nanosystem for Enhanced Drug Delivery to Solid Tumors. Small 2021; 17:e2100789. [PMID: 34142432 DOI: 10.1002/smll.202100789] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 03/29/2021] [Indexed: 06/12/2023]
Abstract
Metal-phenolic networks (MPNs) are an emerging class of supramolecular surface modifiers with potential use in various fields including drug delivery. Here, the development of a unique MPN-integrated core-satellite nanosystem (CS-NS) is reported. The "core" component of CS-NS comprises a liposome loaded with EDTA (a metal ion chelator) in the aqueous core and DiR (a near-infrared photothermal transducer) in the bilayer. The "satellite" component comprises mesoporous silica nanoparticles (MSNs) encapsulating doxorubicin and is coated with a Cu2+ -tannic acid MPN. Liposomes and MSNs self-assemble into the CS-NS through adhesion mediated by the MPN. When irradiated with an 808 nm laser, CS-NS liberated the entrapped EDTA, leading to Cu2+ chelation and subsequent disassembly of the core-satellite nanostructure. Photo-conversion from the large assembly to the small constituent particles proceeded within 5 min. Light-triggered CS-NS disassembly enhanced the carrier and cargo penetration and accumulation in tumor spheroids in vitro and in orthotopic murine mammary tumors in vivo. CS-NS is long circulating in the blood and conferred improved survival outcomes to tumor-bearing mice treated with light, compared to controls. These results demonstrate an MPN-integrated multistage nanosystem for improved solid tumor treatment.
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Affiliation(s)
- Yuhao Gao
- Hongqiao International Institute of Medicine, Tongren Hospital and State Key Laboratory of Oncogenes and Related Genes, Department of Pharmacology and Chemical Biology, Shanghai Jiao Tong University School of Medicine (SJTU-SM), Shanghai, 200025, China
| | - Si-Cong Yang
- Hongqiao International Institute of Medicine, Tongren Hospital and State Key Laboratory of Oncogenes and Related Genes, Department of Pharmacology and Chemical Biology, Shanghai Jiao Tong University School of Medicine (SJTU-SM), Shanghai, 200025, China
| | - Mao-Hua Zhu
- Hongqiao International Institute of Medicine, Tongren Hospital and State Key Laboratory of Oncogenes and Related Genes, Department of Pharmacology and Chemical Biology, Shanghai Jiao Tong University School of Medicine (SJTU-SM), Shanghai, 200025, China
| | - Xin-Di Zhu
- Hongqiao International Institute of Medicine, Tongren Hospital and State Key Laboratory of Oncogenes and Related Genes, Department of Pharmacology and Chemical Biology, Shanghai Jiao Tong University School of Medicine (SJTU-SM), Shanghai, 200025, China
| | - Xin Luan
- Institute of Interdisciplinary Integrative Biomedical Research, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Xue-Liang Liu
- Hongqiao International Institute of Medicine, Tongren Hospital and State Key Laboratory of Oncogenes and Related Genes, Department of Pharmacology and Chemical Biology, Shanghai Jiao Tong University School of Medicine (SJTU-SM), Shanghai, 200025, China
| | - Xing Lai
- Hongqiao International Institute of Medicine, Tongren Hospital and State Key Laboratory of Oncogenes and Related Genes, Department of Pharmacology and Chemical Biology, Shanghai Jiao Tong University School of Medicine (SJTU-SM), Shanghai, 200025, China
| | - Yihang Yuan
- Hongqiao International Institute of Medicine, Tongren Hospital and State Key Laboratory of Oncogenes and Related Genes, Department of Pharmacology and Chemical Biology, Shanghai Jiao Tong University School of Medicine (SJTU-SM), Shanghai, 200025, China
| | - Qin Lu
- Hongqiao International Institute of Medicine, Tongren Hospital and State Key Laboratory of Oncogenes and Related Genes, Department of Pharmacology and Chemical Biology, Shanghai Jiao Tong University School of Medicine (SJTU-SM), Shanghai, 200025, China
| | - Peng Sun
- Department of General Surgery, Tongren Hospital, SJTU-SM, Shanghai, 200336, China
| | - Jonathan F Lovell
- Department of Biomedical Engineering, University at Buffalo, State University of New York, Buffalo, NY, 14260, USA
| | - Hong-Zhuan Chen
- Institute of Interdisciplinary Integrative Biomedical Research, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Chao Fang
- Hongqiao International Institute of Medicine, Tongren Hospital and State Key Laboratory of Oncogenes and Related Genes, Department of Pharmacology and Chemical Biology, Shanghai Jiao Tong University School of Medicine (SJTU-SM), Shanghai, 200025, China
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9
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Feng HY, Yuan Y, Zhang Y, Liu HJ, Dong X, Yang SC, Liu XL, Lai X, Zhu MH, Wang J, Lu Q, Lin Q, Chen HZ, Lovell JF, Sun P, Fang C. Targeted Micellar Phthalocyanine for Lymph Node Metastasis Homing and Photothermal Therapy in an Orthotopic Colorectal Tumor Model. Nanomicro Lett 2021; 13:145. [PMID: 34146159 PMCID: PMC8214644 DOI: 10.1007/s40820-021-00666-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 05/11/2021] [Indexed: 05/04/2023]
Abstract
UNLABELLED Small-sized trastuzumab-targeted micelles (T-MP) were engineered using a surfactant-stripping approach that yielded concentrated phthalocyanines with strong near infrared absorption. T-MP accumulated more in the lymph node (LN) metastases of orthotopic colorectal cancer compared to the micelles conjugated with control IgG. Following surgical resection of the primary tumor, minimally invasive photothermal treatment of the metastatic LN with T-MP, but not the control micelles, extended mouse survival. ABSTRACT Tumor lymph node (LN) metastasis seriously affects the treatment prognosis. Studies have shown that nanoparticles with size of sub-50 nm can directly penetrate into LN metastases after intravenous administration. Here, we speculate through introducing targeting capacity, the nanoparticle accumulation in LN metastases would be further enhanced for improved local treatment such as photothermal therapy. Trastuzumab-targeted micelles (< 50 nm) were formulated using a unique surfactant-stripping approach that yielded concentrated phthalocyanines with strong near-infrared absorption. Targeted micellar phthalocyanine (T-MP) was an effective photothermal transducer and ablated HT-29 cells in vitro. A HER2-expressing colorectal cancer cell line (HT-29) was used to establish an orthotopic mouse model that developed metastatic disease in mesenteric sentinel LN. T-MP accumulated more in the LN metastases compared to the micelles conjugated with control IgG. Following surgical resection of the primary tumor, minimally invasive photothermal treatment of the metastatic LN with T-MP, but not the control micelles, extended mouse survival. Our findings demonstrate for the first time that targeted small-sized nanoparticles have potential to enable superior paradigms for dealing with LN metastases. [Image: see text] SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s40820-021-00666-8.
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Affiliation(s)
- Hai-Yi Feng
- Hongqiao International Institute of Medicine, Tongren Hospital and State Key Laboratory of Oncogenes and Related Genes, Department of Pharmacology and Chemical Biology, Shanghai Jiao Tong University School of Medicine (SJTU-SM), Shanghai, 200025, People's Republic of China
- Department of General Surgery, Tongren Hospital, SJTU-SM, Shanghai, 200336, People's Republic of China
| | - Yihang Yuan
- Hongqiao International Institute of Medicine, Tongren Hospital and State Key Laboratory of Oncogenes and Related Genes, Department of Pharmacology and Chemical Biology, Shanghai Jiao Tong University School of Medicine (SJTU-SM), Shanghai, 200025, People's Republic of China
| | - Yunpeng Zhang
- Department of General Surgery, Tongren Hospital, SJTU-SM, Shanghai, 200336, People's Republic of China
| | - Hai-Jun Liu
- Hongqiao International Institute of Medicine, Tongren Hospital and State Key Laboratory of Oncogenes and Related Genes, Department of Pharmacology and Chemical Biology, Shanghai Jiao Tong University School of Medicine (SJTU-SM), Shanghai, 200025, People's Republic of China
| | - Xiao Dong
- Hongqiao International Institute of Medicine, Tongren Hospital and State Key Laboratory of Oncogenes and Related Genes, Department of Pharmacology and Chemical Biology, Shanghai Jiao Tong University School of Medicine (SJTU-SM), Shanghai, 200025, People's Republic of China
| | - Si-Cong Yang
- Hongqiao International Institute of Medicine, Tongren Hospital and State Key Laboratory of Oncogenes and Related Genes, Department of Pharmacology and Chemical Biology, Shanghai Jiao Tong University School of Medicine (SJTU-SM), Shanghai, 200025, People's Republic of China
| | - Xue-Liang Liu
- Hongqiao International Institute of Medicine, Tongren Hospital and State Key Laboratory of Oncogenes and Related Genes, Department of Pharmacology and Chemical Biology, Shanghai Jiao Tong University School of Medicine (SJTU-SM), Shanghai, 200025, People's Republic of China
| | - Xing Lai
- Hongqiao International Institute of Medicine, Tongren Hospital and State Key Laboratory of Oncogenes and Related Genes, Department of Pharmacology and Chemical Biology, Shanghai Jiao Tong University School of Medicine (SJTU-SM), Shanghai, 200025, People's Republic of China
| | - Mao-Hua Zhu
- Hongqiao International Institute of Medicine, Tongren Hospital and State Key Laboratory of Oncogenes and Related Genes, Department of Pharmacology and Chemical Biology, Shanghai Jiao Tong University School of Medicine (SJTU-SM), Shanghai, 200025, People's Republic of China
| | - Jue Wang
- Department of General Surgery, Tongren Hospital, SJTU-SM, Shanghai, 200336, People's Republic of China
| | - Qin Lu
- Hongqiao International Institute of Medicine, Tongren Hospital and State Key Laboratory of Oncogenes and Related Genes, Department of Pharmacology and Chemical Biology, Shanghai Jiao Tong University School of Medicine (SJTU-SM), Shanghai, 200025, People's Republic of China
| | - Quanjun Lin
- Department of General Surgery, Tongren Hospital, SJTU-SM, Shanghai, 200336, People's Republic of China
| | - Hong-Zhuan Chen
- Institute of Interdisciplinary Integrative Biomedical Research, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, People's Republic of China
| | - Jonathan F Lovell
- Department of Biomedical Engineering, University at Buffalo, State University of New York, Buffalo, NY, 14260, USA
| | - Peng Sun
- Department of General Surgery, Tongren Hospital, SJTU-SM, Shanghai, 200336, People's Republic of China.
| | - Chao Fang
- Hongqiao International Institute of Medicine, Tongren Hospital and State Key Laboratory of Oncogenes and Related Genes, Department of Pharmacology and Chemical Biology, Shanghai Jiao Tong University School of Medicine (SJTU-SM), Shanghai, 200025, People's Republic of China.
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Zou MH, Ma L, Yang SC, Xia YS, Chen WD, Li WL, Chen XX. [The early results of pulmonary autograft mitral valve replacement (Ross Ⅱ) in infants]. Zhonghua Wai Ke Za Zhi 2020; 58:793-797. [PMID: 32993268 DOI: 10.3760/cma.j.cn112139-20191007-00492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To evaluate the early results of pulmonary autograft mitral valve replacement (Ross Ⅱ procedure) in infants with intractable congenital mitral valve lesions. Methods: Between August 2018 and September 2019, 6 infants underwent mitral valve replacement with a pulmonary autograft in Department of Cardiovascular Surgery, Guangzhou Women and Children's Medical Center. There were 2 males and 4 females.The age at surgery ranged from 50 days to 1 year old.Preoperative diagnoses included severe to critic mitral valve insuffiency in all patients, moderate mitral valve stenosis in 3 patients, and mitral valve prolapse in one. When the pulmonary autograft was harvested, a cuff of bovine or autologous pericardium was sewn onto the proximal (infundibular) end of the autograft ( "top-hat" configuration). The distal (pulmonary) end of the autograft was secured to the mitral annulus.At the level of the left atrial free wall, the pericardial cuff was progressively tailored and sewn onto the atrial wall to remain away from the ostia of the pulmonary veins and to maintain normal morphology of the autograft. The bovine jugular valved conduit was used to reconstruct the right ventricular outflow tract. Results: There was one early death due to sudden cardiac arrest at the night of surgery day. The remaining 5 patients were successfully recovered and discharged. Follow-up of survivors ranged from 3 to 13 months. Echocardiographic follow-up demonstrated the flow velocity across the mitral valve position was 1.5 to 2.3 m/s, with a means gradient of 4 to 6 mmHg (1 mmHg=0.133 kPa). Four patients showed mild mitral insuffiency, normal left atrium and ventricle size and left ventricle ejection fraction.One patient had moderate mitral insuffiency, pulmonary valve endocarditis, and reduced left ventricle ejection fraction. The clinical symptoms of all survivals improved significantly and the weight gain were satisfactory. Conclusion: Pulmonary autograft mitral valve replacement may be a feasible and effective remedial surgical strategy for young infants with intractable congenital mitral valve lesions.
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Affiliation(s)
- M H Zou
- Department of Cardiovascular Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China
| | - L Ma
- Department of Cardiovascular Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China
| | - S C Yang
- Department of Cardiovascular Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China
| | - Y S Xia
- Department of Cardiovascular Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China
| | - W D Chen
- Department of Cardiovascular Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China
| | - W L Li
- Department of Cardiovascular Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China
| | - X X Chen
- Department of Cardiovascular Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China
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11
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Feng HY, Zhang Y, Liu HJ, Dong X, Yang SC, Lu Q, Meng F, Chen HZ, Sun P, Fang C. Erratum: Characterization of an orthotopic gastric cancer mouse model with lymph node and organ metastases using bioluminescence imaging. Oncol Lett 2020; 20:3061. [PMID: 32782624 PMCID: PMC7400970 DOI: 10.3892/ol.2020.11860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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12
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Deng RH, Li J, Zhang HX, Li J, Fu Q, Huang G, Liu LS, Fei JG, Chen WF, Yang SC, Wang CX, Deng SX. [Therapeutic effect of tonsillectomy on IgA nephropathy after kidney transplantation]. Zhonghua Yi Xue Za Zhi 2020; 100:2378-2382. [PMID: 32791815 DOI: 10.3760/cma.j.cn112137-20191120-02526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To observe the clinical effect of tonsillectomy on IgA nephropathy (IgAN) after renal transplantation. Methods: From March 2011 to July 2018, 201 kidney transplantation recipients who were diagnosed of IgAN by transplant renal biopsy in the Department of Organ Transplantation of the First Affiliated Hospital of Sun Yat-sen University were retrospectively reviewed, of which 18 patients underwent tonsillectomy after renal biopsy. The clinical data of the 18 patients were collected, patient and kidney survival time and function of the transplanted kidney were analyzed. Results: Of the 18 recipients, 13 were male and 5 were female, with an average age of (36.0±10.9) years. All 18 patients survived during follow-up. Two patients returned to dialysis treatment 10 months and 14 months after tonsillectomy, respectively. The creatinine was 94 (78, 133) μmol/L, 95 (74, 139) μmol/L, 106 (87, 158) μmol/L and 95(81, 147) μmol/L before tonsillectomy, 3 months, 1 year and 2 years after tonsillectomy, respectively (P=0.206). Urinary protein quantification was 0.31 (0.16, 1.38) g/24 h, 0.34 (0.10, 1.42) g/24 h, 0.33 (0.11, 0.56) g/24 h and 0.25 (0.10, 0.50) g/24 h at the same time points, respectively (P=0.104). The two patients who returned to dialysis were diagnosed of IgAN by transplant renal biopsy because of elevated creatinine, proteinuria and hematuria, 9 years and 4 years after kidney transplant respectively. Renal biopsy suggested that glomerular and segmental sclerosis were 7/24, 5/24 and 1/6, 2/6, respectively. Additionally, interstitial fibrosis and tubular atrophy (IF/TA) were both occupied 30% in the biopsies, and tonsillectomy was performed 461 days and 1 077 days after diagnosis of IgAN, respectively. Conclusions: Tonsillectomy can maintain the stability of renal function and prevent the aggravation of proteinuria in IgAN patients after renal transplantation. However, if pathology suggests obvious glomerulosclerosis or IF/TA, tonsillectomy may not be effective.
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Affiliation(s)
- R H Deng
- Department of Organ Transplantation, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - J Li
- Department of Otolaryngology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - H X Zhang
- Department of Organ Transplantation, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - J Li
- Department of Organ Transplantation, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Q Fu
- Department of Organ Transplantation, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - G Huang
- Department of Organ Transplantation, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - L S Liu
- Department of Organ Transplantation, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - J G Fei
- Department of Organ Transplantation, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - W F Chen
- Department of Pathology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - S C Yang
- Department of Pathology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - C X Wang
- Department of Organ Transplantation, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - S X Deng
- Department of Organ Transplantation, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
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Duan YJ, Yang SC, Han YT, Fan JN, Wang SJ, Wu XP, Yu M, Zhou JY, Tian XC, Xu XY, Liang MB, Hua YJ, Chen L, Yu CQ, Gao WJ, Cao WH, Lyu J, Li LM. [Association between perceived built environment attributes and adults' leisure-time physical activity in four cities of China]. Zhonghua Liu Xing Bing Xue Za Zhi 2020; 41:1280-1285. [PMID: 32867436 DOI: 10.3760/cma.j.cn112338-20200227-00203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the associations between perceived built environment attributes and adults' leisure-time physical activity in four cities of China. Methods: Multistage cluster random sampling method was used to select adults aged 25 to 64 in Hangzhou, Suzhou, Chengdu, and Qingdao. Data were collected from June 2017 to July 2018. The perception of the urban built environment was assessed by the neighborhood environment walkability scale-abbreviated (NEWS-A), and the physical activity was assessed by the International Physical Activity Questionnaire. Generalized linear mixed models were used to explore the relationship between the perceived built environment and leisure-time physical activities. Results: A total of 3 789 participants were included in the analysis. After adjusting for potential confounders, better access to public services (OR=1.34, 95%CI: 1.02-1.75) and higher aesthetic quality (OR=1.37, 95%CI: 1.09-1.73) were positively associated with the possibility of engaging in leisure-time physical activity in the past week. Similarly, these two attributes were positively associated with leisure-time walking. Higher scores on the perception of street connectivity were positively associated with leisure-time walking [exp(β)=1.09, 95%CI: 1.00-1.19]. Higher residential density [exp(β)=1.000 4, 95%CI:1.000 0-1.000 8], better access to physical activity destinations[exp(β)=1.09, 95%CI: 1.00-1.19], and better aesthetics [exp(β)=1.11, 95%CI:1.00-1.22] were associated with higher leisure-time physical activity. Similarly, these three attributes were positively associated with the possibility of meeting the WHO recommendations. Conclusion: Changing some urban built environment attributes may increase leisure-time physical activity.
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Affiliation(s)
- Y J Duan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - S C Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Y T Han
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - J N Fan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - S J Wang
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao 266033, China
| | - X P Wu
- Sichuan Center for Disease Control and Prevention, Chengdu 610041, China
| | - M Yu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
| | - J Y Zhou
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - X C Tian
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao 266033, China
| | - X Y Xu
- Sichuan Center for Disease Control and Prevention, Chengdu 610041, China
| | - M B Liang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
| | - Y J Hua
- Suzhou Center for Disease Control and Prevention, Suzhou 215004, China
| | - L Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - C Q Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - W J Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - W H Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - J Lyu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - L M Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
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Chen ZJ, Yang SC, Liu XL, Gao Y, Dong X, Lai X, Zhu MH, Feng HY, Zhu XD, Lu Q, Zhao M, Chen HZ, Lovell JF, Fang C. Nanobowl-Supported Liposomes Improve Drug Loading and Delivery. Nano Lett 2020; 20:4177-4187. [PMID: 32431154 DOI: 10.1021/acs.nanolett.0c00495] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Liposomal drug delivery for cancer therapy can be limited due to drug leakage in circulation. Here, we develop a new method to enhance the stability of actively loaded liposomal doxorubicin (DOX) through embedding a stiff nanobowl in the liposomal water cavity. Nanobowl-supported liposomal DOX (DOX@NbLipo) resists the influence of plasma protein and blood flow shear force to prevent drug leakage. This approach yields improved drug delivery to tumor sites and enhanced antitumor efficacy. Compared to alternative methods of modifying liposome surface and composition for stability, this approach designs a physical support for an all-aqueous nanoliposomal cavity. Nanobowl stabilization of liposomes is a simple and effective method to improve carrier stability and drug delivery.
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Affiliation(s)
- Zhong-Jian Chen
- Hongqiao International Institute of Medicine, Tongren Hospital and State Key Laboratory of Oncogenes and Related Genes, Department of Pharmacology and Chemical Biology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Si-Cong Yang
- Hongqiao International Institute of Medicine, Tongren Hospital and State Key Laboratory of Oncogenes and Related Genes, Department of Pharmacology and Chemical Biology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Xue-Liang Liu
- Hongqiao International Institute of Medicine, Tongren Hospital and State Key Laboratory of Oncogenes and Related Genes, Department of Pharmacology and Chemical Biology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Yuhao Gao
- Hongqiao International Institute of Medicine, Tongren Hospital and State Key Laboratory of Oncogenes and Related Genes, Department of Pharmacology and Chemical Biology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Xiao Dong
- Hongqiao International Institute of Medicine, Tongren Hospital and State Key Laboratory of Oncogenes and Related Genes, Department of Pharmacology and Chemical Biology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Xing Lai
- Hongqiao International Institute of Medicine, Tongren Hospital and State Key Laboratory of Oncogenes and Related Genes, Department of Pharmacology and Chemical Biology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Mao-Hua Zhu
- Hongqiao International Institute of Medicine, Tongren Hospital and State Key Laboratory of Oncogenes and Related Genes, Department of Pharmacology and Chemical Biology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Hai-Yi Feng
- Hongqiao International Institute of Medicine, Tongren Hospital and State Key Laboratory of Oncogenes and Related Genes, Department of Pharmacology and Chemical Biology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Xin-Di Zhu
- Hongqiao International Institute of Medicine, Tongren Hospital and State Key Laboratory of Oncogenes and Related Genes, Department of Pharmacology and Chemical Biology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Qin Lu
- Hongqiao International Institute of Medicine, Tongren Hospital and State Key Laboratory of Oncogenes and Related Genes, Department of Pharmacology and Chemical Biology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Mei Zhao
- Department of Pharmacy, Shanghai University of Medicine and Health Sciences, 279 Zhouzhu Road, Shanghai 201318, China
| | - Hong-Zhuan Chen
- Institute of Interdisciplinary Integrative Biomedical Research, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Jonathan F Lovell
- Department of Biomedical Engineering, University at Buffalo, State University of New York, Buffalo, New York 14260, United States
| | - Chao Fang
- Hongqiao International Institute of Medicine, Tongren Hospital and State Key Laboratory of Oncogenes and Related Genes, Department of Pharmacology and Chemical Biology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
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Abstract
Epidemiology is a discipline integrating methodology and applied science, whose mission is to prevent and control diseases and promote health. This review introduces the new progress of epidemiology from five aspects: communicable diseases, chronic diseases, systems epidemiology, implementation research and big data of health care. New projects and constantly emerging technologies in the field of infectious diseases are inspiring, while more attention should be paid to the environmental factors of pathogen variation. In the field of chronic diseases, there is an urgent need to study the multimorbidity of the elderly. The role of infectious inducers and human microbiota in the occurrence and development of chronic diseases has been gradually revealed. Systems epidemiology, which is of great significance to achieve precision prevention is a new branch and an important supplement of modern epidemiology. Implementation research, is a bridge connecting basic scientific research and public health practice and will provide evidence to support the effective implementation of the Health China Action Plan. The development of health care big data is based on digital public health, which provides a broad research platform and abundant data resources for epidemiology, and will promote the fundamental transformation of the service and management mode of public health.
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Affiliation(s)
- S C Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - J Lyu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Peking University, Beijing 100191, China
| | - L M Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
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Yang SC, Fan MY, Yu CQ, Guo Y, Bian Z, Pei P, Chen JS, Chen ZM, Lyu J, Li LM. [Frequency of bowel movements and risk of Parkinson's disease: a prospective cohort study in adults in China]. Zhonghua Liu Xing Bing Xue Za Zhi 2020; 41:48-54. [PMID: 32062942 DOI: 10.3760/cma.j.issn.0254-6450.2020.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To evaluate the association between the frequency of bowel movement (BMF) and the risk of Parkinson's disease (PD). Methods: In this study, 510 134 participants from the China Kadoorie Biobank (CKB) were included after excluding those who reported to had been diagnosed with cancer at baseline survey. The baseline survey was conducted from 2004 to 2008. The study used the data from the baseline survey and follow-up until December 31, 2016. Cox proportional hazards regression models were used to estimate the HRs and the 95%CIs of risk of PD diagnosis with BMF. Results: During an average follow-up period of (9.9±1.9) years, 808 participants were diagnosed with PD. Compared with participants who had bowel movements every day, the multivariable-adjusted HR (95%CI) for those who had bowel movements<3 times/week, once every 2-3 days, and>1 time/day were 3.62 (2.88-4.54), 2.13 (1.74-2.60), and 0.81 (0.63-1.05), respectively. The linear trend test results of the association between BMF and risk of PD diagnosis was significant (P<0.001). Compared with the participants who had bowel movements ≥1 time/day, the multivariable-adjusted HR (95%CI) for those who had bowel movements<1 time/day was 3.13 (2.32-4.23) within the 5 years of follow- up and was 2.48 (2.05-3.01) beyond the 5 years of follow-up. The gender specific results were similar. The association of BMF<1 time/day with risk of PD diagnosis was stronger in older participants. Conclusions: The participants with low BMF at baseline survey would have higher risk for PD diagnosis in the subsequent 10 years on average. Since abnormal decrease of BMF is easy to be found, programs could be set up for the early screening of PD in older people, along with other early symptoms of PD.
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Affiliation(s)
- S C Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - M Y Fan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - C Q Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Y Guo
- Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Z Bian
- Chinese Academy of Medical Sciences, Beijing 100730, China
| | - P Pei
- Chinese Academy of Medical Sciences, Beijing 100730, China
| | - J S Chen
- China National Center for Food Safety Risk Assessment, Beijing 100022, China
| | - Z M Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - J Lyu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Peking University, Beijing 100191, China
| | - L M Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
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17
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Cottrell TR, Thompson ED, Forde PM, Stein JE, Duffield AS, Anagnostou V, Rekhtman N, Anders RA, Cuda JD, Illei PB, Gabrielson E, Askin FB, Niknafs N, Smith KN, Velez MJ, Sauter JL, Isbell JM, Jones DR, Battafarano RJ, Yang SC, Danilova L, Wolchok JD, Topalian SL, Velculescu VE, Pardoll DM, Brahmer JR, Hellmann MD, Chaft JE, Cimino-Mathews A, Taube JM. Pathologic features of response to neoadjuvant anti-PD-1 in resected non-small-cell lung carcinoma: a proposal for quantitative immune-related pathologic response criteria (irPRC). Ann Oncol 2019; 29:1853-1860. [PMID: 29982279 DOI: 10.1093/annonc/mdy218] [Citation(s) in RCA: 285] [Impact Index Per Article: 57.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background Neoadjuvant anti-PD-1 may improve outcomes for patients with resectable NSCLC and provides a critical window for examining pathologic features associated with response. Resections showing major pathologic response to neoadjuvant therapy, defined as ≤10% residual viable tumor (RVT), may predict improved long-term patient outcome. However, %RVT calculations were developed in the context of chemotherapy (%cRVT). An immune-related %RVT (%irRVT) has yet to be developed. Patients and methods The first trial of neoadjuvant anti-PD-1 (nivolumab, NCT02259621) was just reported. We analyzed hematoxylin and eosin-stained slides from the post-treatment resection specimens of the 20 patients with non-small-cell lung carcinoma who underwent definitive surgery. Pretreatment tumor biopsies and preresection radiographic 'tumor' measurements were also assessed. Results We found that the regression bed (the area of immune-mediated tumor clearance) accounts for the previously noted discrepancy between CT imaging and pathologic assessment of residual tumor. The regression bed is characterized by (i) immune activation-dense tumor infiltrating lymphocytes with macrophages and tertiary lymphoid structures; (ii) massive tumor cell death-cholesterol clefts; and (iii) tissue repair-neovascularization and proliferative fibrosis (each feature enriched in major pathologic responders versus nonresponders, P < 0.05). This distinct constellation of histologic findings was not identified in any pretreatment specimens. Histopathologic features of the regression bed were used to develop 'Immune-Related Pathologic Response Criteria' (irPRC), and these criteria were shown to be reproducible amongst pathologists. Specifically, %irRVT had improved interobserver consistency compared with %cRVT [median per-case %RVT variability 5% (0%-29%) versus 10% (0%-58%), P = 0.007] and a twofold decrease in median standard deviation across pathologists within a sample (4.6 versus 2.2, P = 0.002). Conclusions irPRC may be used to standardize pathologic assessment of immunotherapeutic efficacy. Long-term follow-up is needed to determine irPRC reliability as a surrogate for recurrence-free and overall survival.
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Affiliation(s)
- T R Cottrell
- Department of Pathology, Johns Hopkins University SOM, Baltimore, USA
| | - E D Thompson
- Department of Pathology, Johns Hopkins University SOM, Baltimore, USA; Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University SOM, Baltimore, USA; The Johns Hopkins Bloomberg-Kimmel Institute for Cancer Immunotherapy, Baltimore, USA
| | - P M Forde
- Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University SOM, Baltimore, USA; The Johns Hopkins Bloomberg-Kimmel Institute for Cancer Immunotherapy, Baltimore, USA
| | - J E Stein
- Department of Dermatology, Johns Hopkins University SOM, Baltimore, USA
| | - A S Duffield
- Department of Pathology, Johns Hopkins University SOM, Baltimore, USA
| | - V Anagnostou
- Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University SOM, Baltimore, USA
| | - N Rekhtman
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - R A Anders
- Department of Pathology, Johns Hopkins University SOM, Baltimore, USA; The Johns Hopkins Bloomberg-Kimmel Institute for Cancer Immunotherapy, Baltimore, USA
| | - J D Cuda
- Department of Pathology, Johns Hopkins University SOM, Baltimore, USA; Department of Dermatology, Johns Hopkins University SOM, Baltimore, USA
| | - P B Illei
- Department of Pathology, Johns Hopkins University SOM, Baltimore, USA; Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University SOM, Baltimore, USA
| | - E Gabrielson
- Department of Pathology, Johns Hopkins University SOM, Baltimore, USA; Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University SOM, Baltimore, USA
| | - F B Askin
- Department of Pathology, Johns Hopkins University SOM, Baltimore, USA
| | - N Niknafs
- Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University SOM, Baltimore, USA
| | - K N Smith
- Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University SOM, Baltimore, USA; The Johns Hopkins Bloomberg-Kimmel Institute for Cancer Immunotherapy, Baltimore, USA
| | - M J Velez
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - J L Sauter
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - J M Isbell
- Thoracic Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, USA
| | - D R Jones
- Thoracic Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, USA
| | - R J Battafarano
- Department of Surgery, Johns Hopkins University SOM, Baltimore, USA
| | - S C Yang
- Department of Surgery, Johns Hopkins University SOM, Baltimore, USA
| | - L Danilova
- The Johns Hopkins Bloomberg-Kimmel Institute for Cancer Immunotherapy, Baltimore, USA; Division of Biostatistics and Bioinformatics, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University SOM, Baltimore, USA
| | - J D Wolchok
- Melanoma and Immunotherapeutics Service, Division of Solid Tumor Oncology, Department of Medicine, Ludwig Center for Cancer Immunotherapy, Memorial Sloan Kettering Cancer Center, New York, USA; Weill Cornell Medical College, New York, USA; Parker Institute for Cancer Immunotherapy, Memorial Sloan Kettering Cancer Center, New York, USA
| | - S L Topalian
- The Johns Hopkins Bloomberg-Kimmel Institute for Cancer Immunotherapy, Baltimore, USA; Department of Surgery, Johns Hopkins University SOM, Baltimore, USA
| | - V E Velculescu
- Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University SOM, Baltimore, USA; The Johns Hopkins Bloomberg-Kimmel Institute for Cancer Immunotherapy, Baltimore, USA
| | - D M Pardoll
- Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University SOM, Baltimore, USA; The Johns Hopkins Bloomberg-Kimmel Institute for Cancer Immunotherapy, Baltimore, USA
| | - J R Brahmer
- Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University SOM, Baltimore, USA; The Johns Hopkins Bloomberg-Kimmel Institute for Cancer Immunotherapy, Baltimore, USA
| | - M D Hellmann
- Weill Cornell Medical College, New York, USA; Parker Institute for Cancer Immunotherapy, Memorial Sloan Kettering Cancer Center, New York, USA; Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - J E Chaft
- Weill Cornell Medical College, New York, USA; Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - A Cimino-Mathews
- Department of Pathology, Johns Hopkins University SOM, Baltimore, USA; Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University SOM, Baltimore, USA
| | - J M Taube
- Department of Pathology, Johns Hopkins University SOM, Baltimore, USA; Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University SOM, Baltimore, USA; The Johns Hopkins Bloomberg-Kimmel Institute for Cancer Immunotherapy, Baltimore, USA; Department of Dermatology, Johns Hopkins University SOM, Baltimore, USA.
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18
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Yang SC, Chiu YC, Liu PH, Hsieh TJ, Kao YH, Tu YK. Effect of benign prostatic hyperplasia on the development of spine, hip, and wrist fractures. Osteoporos Int 2019; 30:1043-1049. [PMID: 30706096 DOI: 10.1007/s00198-019-04863-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 01/20/2019] [Indexed: 10/27/2022]
Abstract
UNLABELLED Benign prostatic hyperplasia is one of the most common diseases in the elderly male population. The urinary tract symptoms may increase the risk of falls and fractures. The results indicated that patients with benign prostatic hyperplasia could increase the risk of vertebral compression fractures in both the thoracic and lumbar spine and also hip fractures, but did not increase the risk of wrist fracture. INTRODUCTION The relationship between benign prostatic hyperplasia and the development of fall-related fractures, especially vertebral compression fractures, has been seldom mentioned in the literature. This study aimed to evaluate the risk of developing vertebral compression fracture, hip fracture, and wrist fracture in patients with benign prostatic hyperplasia. METHODS This study obtained claims data retrospectively from the National Health Insurance Research Database of Taiwan and identified 48,114 patients who were diagnosed as having benign prostatic hyperplasia. Subjects of the control cohort were individually matched at a ratio of 4:1 with those in the benign prostatic hyperplasia cohort according to age and the index day. Comorbidities were classified as those existing before the index day and included a previous fracture history, osteoporosis, myocardial infarction, congestive heart failure, diabetes mellitus, hypertension, cerebrovascular accident, etc. The end of the follow-up period of the analyses was the day when the patient developed new vertebral compression fractures, hip fractures, or wrist fractures, terminated enrollment from the National Health Insurance, or died or until the end of 2012. The study used the Cox proportion hazard model to determine the hazard ratio for developing new hip fractures. RESULTS Patients with benign prostatic hyperplasia were significantly more likely than those in the control cohort to develop new vertebral compression fractures in the thoracic spine (0.43% vs. 0.40%, adjusted hazard ratio 3.03, confidence interval 2.12-4.31) and lumbar spine (1.26% vs. 1.23%, adjusted hazard ratio 4.12, confidence interval 3.39-5.01), and hip fracture (1.47% vs. 2.09%, adjusted hazard ratio 1.22, confidence interval 1.10-1.36), but does not increase the risk of wrist fracture (0.61% vs. 0.67%, adjusted hazard ratio 1.07, confidence interval 0.85-1.34). CONCLUSIONS Patients with benign prostatic hyperplasia exhibited an increased risk of developing vertebral compression fractures in both the thoracic and lumbar spine and also hip fractures, but did not increase the risk of wrist fracture. However, more research is needed to confirm this trend in the clinical setting.
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Affiliation(s)
- S C Yang
- Department of Orthopedic Surgery, E-Da Hospital / I-Shou University, No.1, E-Da Road, Kaohsiung City, Taiwan, 82445, People's Republic of China.
| | - Y C Chiu
- Department of Orthopedic Surgery, E-Da Hospital, No.1, E-Da Road, Kaohsiung City, Taiwan, 82445, People's Republic of China.
| | - P H Liu
- Department of Biomedical Engineering, I-Shou University, No.8, E-Da Road, Kaohsiung City, Taiwan, 82445, People's Republic of China
| | - T J Hsieh
- Department of Orthopedic Surgery, E-Da Hospital, No.1, E-Da Road, Kaohsiung City, Taiwan, 82445, People's Republic of China
| | - Y H Kao
- Department of Orthopedic Surgery, E-Da Hospital, No.1, E-Da Road, Kaohsiung City, Taiwan, 82445, People's Republic of China
| | - Y K Tu
- Department of Orthopedic Surgery, E-Da Hospital / I-Shou University, No.1, E-Da Road, Kaohsiung City, Taiwan, 82445, People's Republic of China
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19
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Yang SC, Shen ZW, Yu CQ, Guo Y, Bian Z, Tan YL, Pei P, Wei YY, Chen F, Chen JS, Chen ZM, Lyu J, Li LM. [Association between the frequency of bowel movements and the risk of colorectal cancer in Chinese adults]. Zhonghua Liu Xing Bing Xue Za Zhi 2019; 40:382-388. [PMID: 31006195 DOI: 10.3760/cma.j.issn.0254-6450.2019.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To examine the association between the frequencies of bowel movement (BMF) and the risk of colorectal cancer (CRC). Methods: In this study, 510 134 participants from the China Kadoorie Biobank (CKB) were included, after excluding those who reported as having been diagnosed with cancer at the baseline survey. The baseline survey was conducted from June 2004 to July 2008. The present study included data from baseline and follow-up until December 31, 2016. We used the Cox proportional hazards regression models to estimate the HR and the 95%CI of incident CRC with BMF. Results: During an average follow-up period of 9.9 years, 3 056 participants were documented as having developed colorectal cancer. In the site-specific analysis, 1 548 colon cancer and 1 475 rectal cancer were included. Compared with participants who had bowel movements on the daily base, the multivariable-adjusted HR (95%CI) for those who had more than once of BMF were 1.24 (1.12-1.39) for CRC, 1.12 (0.95-1.31) for colon cancer, and 1.37 (1.18-1.59) for rectal cancer. We further examined the association between BMF and CRC, according to the stages of follow-up, the corresponding HR (95%CI) for CRC, colon and rectal cancer were 1.59 (1.36-1.86), 1.43 (1.14- 1.80), and 1.76 (1.41-2.19) for the first five years, while such associations became statistically insignificant in the subsequent follow-up (P for all interactions were <0.05), as time went on. As for CRC, colon or rectal cancers among participants who had lower bowel movements, the risks were not significantly different from those who had bowel movements everyday. Conclusions: Participants who had BMF more than once a day, appeared an increased risk of CRC in the subsequent five years. Since abnormal increase of bowel movements is easily recognizable, programs should be set up on health self- management and early screening for CRC.
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Affiliation(s)
- S C Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Z W Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - C Q Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Y Guo
- Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Z Bian
- Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Y L Tan
- Chinese Academy of Medical Sciences, Beijing 100730, China
| | - P Pei
- Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Y Y Wei
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - F Chen
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - J S Chen
- China National Center for Food Safety Risk Assessment, Beijing 100022, China
| | - Z M Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - J Lyu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Peking University, Beijing 100191, China
| | - L M Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
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20
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Liu F, Wang D, Yang SC, Zhu JH, Li JM, Shi K, Du R, Zhao Q. Prevalence and Risk Factors of Brucellosis, Toxoplasmosis, and Neosporosis Among Yanbian Yellow Cattle in Jilin Province, China. Vector Borne Zoonotic Dis 2019; 19:217-221. [DOI: 10.1089/vbz.2018.2288] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Fei Liu
- College of Animal Science and Technology, Jilin Agricultural University, Changchun, People's Republic of China
| | - Dan Wang
- College of Animal Science and Technology, Jilin Agricultural University, Changchun, People's Republic of China
| | - Si-Cong Yang
- College of Animal Science and Technology, Jilin Agricultural University, Changchun, People's Republic of China
| | - Jun-Hui Zhu
- College of Animal Science and Technology, Jilin Agricultural University, Changchun, People's Republic of China
| | - Jian-Ming Li
- College of Chinese Medicinal Materials, Jilin Agricultural University, Changchun, People's Republic of China
| | - Kun Shi
- College of Chinese Medicinal Materials, Jilin Agricultural University, Changchun, People's Republic of China
| | - Rui Du
- College of Chinese Medicinal Materials, Jilin Agricultural University, Changchun, People's Republic of China
| | - Quan Zhao
- College of Animal Science and Technology, Changchun Sci-Tech University, Shuangyang, Jilin, People's Republic of China
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21
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Zou MH, Cao F, Ma L, Xia YS, Yang SC, Chen WD, Chen XX. [Effect of multistage surgery in patients with functional single ventricle and risk factors of postoperative death]. Zhonghua Xin Xue Guan Bing Za Zhi 2019; 47:141-150. [PMID: 30818942 DOI: 10.3760/cma.j.issn.0253-3758.2019.02.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the efficacy of multistage surgery in patients with functional single ventricle (FSV) and risk factors of postoperative death. Methods: The clinical data of all consecutive patients with FSV undergoing multistage single ventricle palliation surgery in Guangzhou women and children's medical center from January 2008 to December 2017 were retrospectively reviewed. The study included 289 patients. The age was 10.0 (6.0, 35.4) months,and there were 198 male and 91 female patients. The patients were followed up at outpatient clinic. Survival rates were calculated with Kaplan-Meier. Multivariate Cox regression analysis was made to determine the risk factors of postoperative death. Results: Seventy-nine patients required the first stage palliation surgery, 232 patients received the Glenn shunt surgery, and 162 patients completed the Fontan procedure. Overall, postoperative death occurred in 39 patients including 21 after the first stage palliation surgery (early stage 13 cases, late stage 8 cases) , 10 after the Glenn shunt surgery (early stage 5 cases, late stage 5 cases) , and 8 following the Fontan procedure (early stage 6 cases, late stage 2 cases) . Kaplan-Meier analysis showed that survival rate of the entire cohort was 90.2% (95%CI 86.7%-93.7%) , 85.9% (95%CI 81.8%-90.0%) ,and 84.6% (95%CI 79.7%-89.5%) at 1 year, 5 years and 10 years post operation. Survival rate was 74.4% (95%CI 64.8%-84.0%) , 73.0% (95%CI 63.2%-82.8%) , and 73.0% (95%CI 63.2%-82.8%) at 1 year, 5 years, and 10 years post the first stage palliation surgery, 97.8% (95%CI 95.8%-99.7%) , 95.2% (95%CI 92.3%-98.1%) , and 95.2% (95%CI 92.3%-98.1%) at 1 year, 5 years, and 10 years post Glenn shunt surgery, 95.6% (95%CI 92.5%-98.7%) and 93.7% (95%CI 88.8%-98.6%) at 1 year and 5 years post Fontan surgery. Multivariate Cox regression analysis revealed that total anomalous pulmonary venous connection (HR=5.47, 95%CI 2.71-11.04, P<0.001), atrioventricular valve regurgitation more than moderate (HR=2.52, 95%CI 1.32-4.79, P=0.005), systemic ventricular outflow tract obstruction (HR=3.47, 95%CI 1.30-9.29, P=0.013), and required the first palliation surgery (HR=3.12, 95%CI 1.59-6.15, P=0.001) were risk factors of postoperative death. Conclusions: The multistage surgery can effectively improve the survival of patientswith functional single ventricle and is associated with satisfactory long-term prognosis. Total anomalous pulmonary venous connection, atrioventricular valve regurgitation more than moderate, systemic ventricular outflow tract obstruction, and required the first palliation surgery are risk factors of postoperative death in these patients.
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Affiliation(s)
- M H Zou
- Heart Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China
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22
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Dong X, Liu HJ, Feng HY, Yang SC, Liu XL, Lai X, Lu Q, Lovell JF, Chen HZ, Fang C. Enhanced Drug Delivery by Nanoscale Integration of a Nitric Oxide Donor To Induce Tumor Collagen Depletion. Nano Lett 2019; 19:997-1008. [PMID: 30676760 DOI: 10.1021/acs.nanolett.8b04236] [Citation(s) in RCA: 131] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Delivery of therapeutics into the solid tumor microenvironment is a major challenge for cancer nanomedicine. Administration of certain exogenous enzymes which deplete tumor stromal components has been proposed as a method to improve drug delivery. Here we present a protein-free collagen depletion strategy for drug delivery into solid tumors, based on activating endogenous matrix metalloproteinases (MMP-1 and -2) using nitric oxide (NO). Mesoporous silica nanoparticles (MSN) were loaded with a chemotherapeutic agent, doxorubicin (DOX) as well as a NO donor ( S-nitrosothiol) to create DN@MSN. The loaded NO results in activation of MMPs which degrade collagen in the tumor extracellular matrix. Administration of DN@MSN resulted in enhanced tumor penetration of both the nanovehicle and cargo (DOX), leading to significantly improved antitumor efficacy with no overt toxicity observed.
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Affiliation(s)
- Xiao Dong
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital and Department of Pharmacology and Chemical Biology, Institute of Medical Sciences , Shanghai Jiao Tong University School of Medicine (SJTU-SM) , 280 South Chongqing Road , Shanghai 200025 , China
| | - Hai-Jun Liu
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital and Department of Pharmacology and Chemical Biology, Institute of Medical Sciences , Shanghai Jiao Tong University School of Medicine (SJTU-SM) , 280 South Chongqing Road , Shanghai 200025 , China
| | - Hai-Yi Feng
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital and Department of Pharmacology and Chemical Biology, Institute of Medical Sciences , Shanghai Jiao Tong University School of Medicine (SJTU-SM) , 280 South Chongqing Road , Shanghai 200025 , China
| | - Si-Cong Yang
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital and Department of Pharmacology and Chemical Biology, Institute of Medical Sciences , Shanghai Jiao Tong University School of Medicine (SJTU-SM) , 280 South Chongqing Road , Shanghai 200025 , China
| | - Xue-Liang Liu
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital and Department of Pharmacology and Chemical Biology, Institute of Medical Sciences , Shanghai Jiao Tong University School of Medicine (SJTU-SM) , 280 South Chongqing Road , Shanghai 200025 , China
| | - Xing Lai
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital and Department of Pharmacology and Chemical Biology, Institute of Medical Sciences , Shanghai Jiao Tong University School of Medicine (SJTU-SM) , 280 South Chongqing Road , Shanghai 200025 , China
| | - Qin Lu
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital and Department of Pharmacology and Chemical Biology, Institute of Medical Sciences , Shanghai Jiao Tong University School of Medicine (SJTU-SM) , 280 South Chongqing Road , Shanghai 200025 , China
| | - Jonathan F Lovell
- Department of Biomedical Engineering , University at Buffalo, State University of New York , Buffalo , New York 14260 , United States
| | - Hong-Zhuan Chen
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital and Department of Pharmacology and Chemical Biology, Institute of Medical Sciences , Shanghai Jiao Tong University School of Medicine (SJTU-SM) , 280 South Chongqing Road , Shanghai 200025 , China
| | - Chao Fang
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital and Department of Pharmacology and Chemical Biology, Institute of Medical Sciences , Shanghai Jiao Tong University School of Medicine (SJTU-SM) , 280 South Chongqing Road , Shanghai 200025 , China
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23
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Wang CH, Chang KA, Chen CL, Cheng KW, Wu SC, Huang CJ, Shih TH, Yang SC, Juang SE, Huang CE, Jawan B, Lee YE. Anesthesia Management and Fluid Therapy in Right and Left Lobe Living Donor Hepatectomy. Transplant Proc 2018; 50:2654-2656. [PMID: 30401370 DOI: 10.1016/j.transproceed.2018.03.102] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 02/24/2018] [Accepted: 03/06/2018] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Right lobe living donor hepatectomy poses a greater risk for the donor in relation to blood loss. The aims of this study were to compare anesthetic and intraoperative fluid management in right and left lateral segment living donor hepatectomy. PATIENTS AND METHODS The anesthesia records of living donor hepatectomy patients were retrospectively reviewed. Donor age and weight, anesthesia time, central venous pressure, blood loss, blood product transfusion, intravenous fluids used, doses of furosemide, and urine output were compared and analyzed between groups using the Mann Whitney U test. RESULTS Forty-six patients underwent living donor left lateral segment hepatectomy (Group I); while 31 patients underwent right lobe hepatectomy (Group II). The mean blood loss in Group II was significantly higher compared to Group I (118 ± 81 mL vs 68 ± 64 mL), but clinically such amount of blood loss was not high enough to affect the hemodynamics. The fluid management was therefore not meaningfully different between the two groups. No blood transfusions or colloid infusions were required for either group. Urine output, hemoglobin changes, blood urea nitrogen, and serum creatinine pre- and postoperatively were not significantly different between groups. CONCLUSIONS As long as blood loss is minimal, we found no difference in the anesthetic management and fluid replacements between right and left lateral segment living donor hepatectomy.
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Affiliation(s)
- C-H Wang
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan City, Taiwan
| | - K-A Chang
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan City, Taiwan
| | - C-L Chen
- Liver Transplantation Program, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan City, Taiwan
| | - K-W Cheng
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan City, Taiwan
| | - S-C Wu
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan City, Taiwan
| | - C-J Huang
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan City, Taiwan
| | - T-H Shih
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan City, Taiwan
| | - S C Yang
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan City, Taiwan
| | - S-E Juang
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan City, Taiwan
| | - C-E Huang
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan City, Taiwan
| | - B Jawan
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan City, Taiwan
| | - Y-E Lee
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan City, Taiwan.
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24
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Tian Y, Yang SC, Yu CQ, Guo Y, Bian Z, Tan YL, Pei P, Chen JS, Chen ZM, Lyu J, Li LM. [Association between central obesity and risk for heart disease in adults in China: a prospective study]. Zhonghua Liu Xing Bing Xue Za Zhi 2018; 39:1172-1178. [PMID: 30293305 DOI: 10.3760/cma.j.issn.0254-6450.2018.09.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To understand the association between central obesity, assessed by waist circumference, and the risks for ischemic heart disease (IHD), major coronary event (MCE), and IHD death. Methods: After excluding participants with heart disease, stroke, cancer, COPD, and diabetes at baseline survey, we included a total of 428 595 participants from the China Kadoorie Biobank for the analysis. The baseline survey was conducted from June 2004 to July 2008. We used Cox proportional hazards model to estimate the hazard ratio (HR) and 95%CI. Results: During an average 9.1 years of follow-up (3 803 637 person-years), we documented 26 900 incident cases of IHD, 4 320 cases of MCE, and 2 787 of deaths from IHD. After adjustment for possible confounders and BMI, central obesity was found to be associated with increased risks for IHD, MCE, and IHD death. The adjusted HRs (for the participants who had waist circumference of 85.0-89.9 cm in men and 80.0-84.9 cm in women were 1.13 (95%CI: 1.09-1.17) for IHD, 1.15 (95%CI: 1.05-1.26) for MCE and 1.11 (95%CI: 0.98-1.24) for IHD death. The respective HRs for those central obese participants (men ≥90.0 cm, women ≥85.0 cm) were 1.29 (95%CI: 1.24-1.34), 1.30 (95%CI: 1.17-1.44) and 1.32 (95%CI: 1.16-1.51). Further stratification analysis according to BMI showed that the risks for incident IHD, MCE, and IHD death increased along with the increase of waist circumference even in the participants with normal weight. Conclusion: This large-scale prospective study revealed that central obesity was an independent risk factor for IHD in adults in China, and the risk of IHD would increase with the increase of waist circumference.
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Affiliation(s)
- Y Tian
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - S C Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - C Q Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Y Guo
- Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Z Bian
- Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Y L Tan
- Chinese Academy of Medical Sciences, Beijing 100730, China
| | - P Pei
- Chinese Academy of Medical Sciences, Beijing 100730, China
| | - J S Chen
- China National Center for Food Safety Risk Assessment, Beijing 100022, China
| | - Z M Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, United Kingdom
| | - J Lyu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - L M Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Chinese Academy of Medical Sciences, Beijing 100730, China
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Feng HY, Zhang Y, Liu HJ, Dong X, Yang SC, Lu Q, Meng F, Chen HZ, Sun P, Fang C. Characterization of an orthotopic gastric cancer mouse model with lymph node and organ metastases using bioluminescence imaging. Oncol Lett 2018; 16:5179-5185. [PMID: 30250585 PMCID: PMC6144215 DOI: 10.3892/ol.2018.9313] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 07/16/2018] [Indexed: 12/19/2022] Open
Abstract
Lymph node (LN) metastasis of gastric cancer (GC) is the strongest prognostic indicator for this disease; however, the majority of the LN metastasis profiles of GC remain unknown, which notably hinders the therapeutic efficacy in clinic. In the present study, an orthotopic model of human GC was established for investigation of time-dependent LN metastasis patterns in mice. Luciferase-expressing NCI-N87 human GC cells were injected into the subserosa of the gastric body, resulting in a tumor formation rate of 100%. LN metastasis at four different anatomical positions in the abdomen were characterized until week 10 after tumor cell injection using sensitive bioluminescence imaging and histopathological analyses. Skip LN metastases were observed at later stages (weeks 8-10) of the experiment. Metastases in other major organs, including liver, spleen and lung, were also examined. Characterization of this orthotopic GC model and metastasis patterns in LNs and major organs should aid in the preclinical GC research regarding the metastatic mechanism and drug development.
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Affiliation(s)
- Hai-Yi Feng
- Department of General Surgery, Shanghai Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, P.R. China.,Hongqiao International Institute of Medicine, Shanghai Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, P.R. China.,Department of Pharmacology and Chemical Biology, Institute of Medical Sciences, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, P.R. China.,College of Medicine, Yanbian University, Yanji, Jilin 133002, P.R. China
| | - Yunpeng Zhang
- Department of General Surgery, Shanghai Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, P.R. China
| | - Hai-Jun Liu
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, P.R. China.,Department of Pharmacology and Chemical Biology, Institute of Medical Sciences, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, P.R. China
| | - Xiao Dong
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, P.R. China.,Department of Pharmacology and Chemical Biology, Institute of Medical Sciences, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, P.R. China
| | - Si-Cong Yang
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, P.R. China.,Department of Pharmacology and Chemical Biology, Institute of Medical Sciences, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, P.R. China
| | - Qin Lu
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, P.R. China.,Department of Pharmacology and Chemical Biology, Institute of Medical Sciences, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, P.R. China
| | - Fanping Meng
- College of Medicine, Yanbian University, Yanji, Jilin 133002, P.R. China
| | - Hong-Zhuan Chen
- Department of Pharmacology and Chemical Biology, Institute of Medical Sciences, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, P.R. China
| | - Peng Sun
- Department of General Surgery, Shanghai Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, P.R. China
| | - Chao Fang
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, P.R. China.,Department of Pharmacology and Chemical Biology, Institute of Medical Sciences, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, P.R. China
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Cao F, Zou MH, Ma L, Xia YS, Yang SC, Chen WD, Huang GD, Chen XX. [Improving outcomes of patients with heterotaxy and functional single ventricle: a 10-year follow-up of 70 cases in a single institution]. Zhonghua Wai Ke Za Zhi 2018; 56:379-385. [PMID: 29779315 DOI: 10.3760/cma.j.issn.0529-5815.2018.05.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To review current-era palliation outcomes of patients with heterotaxy and functional single ventricle in a single institution. Methods: The clinical data of 70 consecutive patients with heterotaxy undergoing multistage single ventricle palliation in Guangzhou Women and Children's Medical Center from January 2008 to December 2017 were retrospectively reviewed, and the prognosis factors for mortality were analyzed. There were 53 male and 17 female patients.The median age was 13.3 months (range: 6 days to 150 months). Single ventricle multistage palliation included 1(st) stage palliation surgery, 2(nd) bidirectional Glenn shunt, and 3(rd) stage modified Fontan.The Kaplan-Meier method was used to estimate the probability of survival. Multivariate analysis was performed by Cox regression model. Results: Sixty-two patients had right atrial isomerism while eight had left atrial isomerism. Eighteen patients (25.7%) required the first stage palliation. Fifty-five patients received the Glenn shunt, and the Fontan procedure was completed in 27 patients. Overall, mortality occurred in 17 patients (24.3%) including 9 after the first stage palliation, 6 after the Glenn shunt, and 2 following the Fontan procedure. Survival estimates for the entire cohort following surgery were 81% (95%CI: 72% to 90%), 74%(95%CI: 64% to 85%), and 74% (95%CI: 64% to 85%) at 1 year, 5 years and 10 years, respectively. Survival estimates following the first stage palliation were 56% (95%CI: 33% to 79%) and 49% (95%CI: 26% to 73%) at 1 year and 5 years, respectively. Multivariate Cox regression analysis revealed that total anomalous pulmonary venous connection (TAPVC) (HR=6.16, 95%CI: 1.65 to 22.95, P=0.007), atrioventricular valve regurgitation more than moderate (HR=3.81, 95%CI: 1.32 to 10.94, P=0.013) and required the first palliation surgery (HR=4.58, 95%CI: 1.34 to 15.72, P=0.016) were prognosis factors for overall mortality. Conclusions: The management of heterotaxy patients with functional single ventricle remains challenging, and the outcomes are continously improving in china. TAPVC, atrioventricular valve regurgitation more than moderate and required the first palliation surgery still are prognosis factors for overall mortality in heterotaxy syndrome.
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Affiliation(s)
- F Cao
- Department of Cardiac Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China
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Suo XQ, Yang SC, Ma ZH, Sun TT, Zhang WY, Cong HL, Lin WH, Lu CZ, Tian FS, Fu NK. [Effect of probucol on preventing contrast-induced nephropathy in patients undergoing percutaneous coronary intervention]. Zhonghua Yi Xue Za Zhi 2017; 97:3234-3238. [PMID: 29141361 DOI: 10.3760/cma.j.issn.0376-2491.2017.41.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the preventive effect, possible mechanism and safety of probucol on contrast-induced nephropathy (CIN) after percutaneous coronary intervention (PCI) in patients with coronary heart disease (CHD). Methods: A total of 641 patients with coronary heart disease were consecutively enrolled from Department of Cardiology, in Tianjin Chest Hospital, Tianjin TEDA International Cardiovascular Hospital, Tianjin First Central Hospital, Tianjin Fourth Central Hospital. They were randomly divided into probucol group (n=321) and control group (n=320). The probucol group was given oral probucol 500 mg twice daily for day 0 to day 3 after PCI; the control group was given only conventional therapy. All patients were given intravenous drip 0.9% sodium chloride solution before 12 to 24 hours of operation. The levels of serum creatinine (Scr), blood urea nitrogen (BUN), evaluate glomerular filtration rate (eGFR), cystatin C (Cys-C), and high-sensitivity C-reactive protein (hs-CRP), neutrophil gelatinase associated lipocalin (NGAL), superoxide dismutase (SOD) and glutathione (GSH) were measured before and 72 h after the PCI operation in both groups. The incidence rates of CIN, the adverse events during hospitalization and postoperative 14-day follow-up were recorded in two groups. Results: There was no statistically significantly difference in the levels of Scr, BUN, eGFR, Cys-C, hs-CRP, NGAL, SOD and GSH between the two groups before PCI (P>0.05). The levels of serum Scr, BUN, Cys-C, hs-CRP, NGAL, SOD and GSH after operation in the two groups were higher than those before the operation (P<0.05). The levels of hs-CRP and NGAL in the probucol group were lower than those in the control group [(10±4) vs (11±4)mg/L, (25±8)vs (34±7)U/ml, P<0.05]. The levels of eGFR, SOD and GSH in probucol group were higher than those in control group [(80±27) vs (72±26) ml·min(-1)·1.73 m(-2,) (67±9) vs (58±8)U/ml, (4.6±0.9) vs (3.9±0.8)U/ml, P<0.05]. The incidence of CIN was 4.0% in the probucol group and 10.9% in the control group, and the difference was statistically significant (P<0.05, χ(2)=-3.31). Multivariate Logistic regression analysis showed that probucol was an independent protective factor for CIN (OR=0.334, 95%CI 0.172-0.648, P=0.001). There were no adverse events such as myasthenia gravis, abnormal liver function and cardiovascular events during the hospitalization and 14-day follow-up. Conclusions: Probucol can reduce the incidence of contrast-induced nephropathy after PCI. The protection mechanism is related with its anti-inflammatory and anti-oxidative stress effects, and it has good safety.
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Affiliation(s)
- X Q Suo
- Graduate School of Tianjin Medical University, Tianjin 300070, China
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Chao SY, Chang YC, Yang SC, Clark MJ. Development, implementation, and effects of an integrated web-based teaching model in a nursing ethics course. Nurse Educ Today 2017; 55:31-37. [PMID: 28511085 DOI: 10.1016/j.nedt.2017.04.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 02/22/2017] [Accepted: 04/07/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Ethical competence, which is reflected in the ability to detect ethical challenges in clinical situations and engage in deliberate thinking on ethical actions, is one of the core competencies of nursing practice. PURPOSE The purpose of this study was to develop and implement an interactive situational e-learning system, integrating nursing ethical decisions into a nursing ethics course, and to evaluate the effects of this course on student nurses' ethical decision-making competence. PROJECT DESIGN The project was designed to be carried out in two phases. In the first phase, an interactive situated e-learning system was developed and integrated into the nursing ethics course. The second phase involved implementing the course and evaluating its effects in a quasi-experimental study. The course intervention was designed for 2h per week over one semester (18weeks). PARTICIPANTS A total of 100 two-year technical college nursing students in their second year of the program participated in the study, with 51 in the experimental group and 49 in the control group. RESULTS After completing the course, the students in the experimental group showed significant improvement in nursing ethical decision-making competence, including skills in "raising questions," "recognizing differences," "comparing differences," "self-dialogue," "taking action," and "identifying the implications of decisions made," compared to their performance prior to the class. After controlling for factors influencing learning effects, students in the experimental group showed superiority to those in the control group in the competency of "recognizing differences." The students in the experimental group reported that the course pushed them to search for and collect information needed to resolve the ethical dilemma. CONCLUSIONS The interactive situational e-learning system developed by our project was helpful in developing the students' competence in ethical reasoning. The e-learning system and the situational teaching materials used in this study may be applicable in nursing and related professional ethics courses.
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Affiliation(s)
- S-Y Chao
- Department of Nursing, Hungkuang University, Taiwan.
| | - Y-C Chang
- Department of Computer Science and Information Engineering, Hungkuang University, Taiwan
| | - S C Yang
- Department of Cultural and Creative Industries, Hungkuang University, Taiwan
| | - M J Clark
- Hahn School of Nursing and Health Science, University of San Diego, U.S.A
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Lim KI, Chiu YC, Chen CL, Wang CH, Huang CJ, Cheng KW, Wu SC, Shih TH, Yang SC, Juang SE, Huang CE, Jawan B, Lee YE. Effects of Pre-Existing Liver Disease on Acute Pain Management Using Patient-Controlled Analgesia Fentanyl With Parecoxib After Major Liver Resection: A Retrospective, Pragmatic Study. Transplant Proc 2017; 48:1080-2. [PMID: 27320562 DOI: 10.1016/j.transproceed.2015.11.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 11/06/2015] [Indexed: 12/29/2022]
Abstract
BACKGROUND The aim of this study was to compare the outcomes of pain management with the use of patient-controlled analgesia (PCA) fentanyl with IV parecoxib between patients with healthy liver with patients with diseased liver undergoing major liver resection. METHODS Patients with healthy liver undergoing partial hepatectomy as liver donors for liver transplantation (group 1) and patients with liver cirrhosis (Child's criteria A) undergoing major liver resection for hepatoma (group 2) were identified retrospectively. Both groups routinely received post-operative IV PCA fentanyl and a single dose of parecoxib 40 mg. They were followed up for 3 days or until PCA fentanyl was discontinued post-operatively. Daily Visual Analog Scale, PCA fentanyl usage, rescue attempts, and common drug side effects were collected and analyzed with the use of SPSS version 20. RESULTS One hundred one patients were included in the study: 54 in group 1, and 47 in group 2. There were no statistical differences between the two groups in terms of the daily and total fentanyl usage, VAS resting, and incidence of itchiness. The rate of rescue analgesia on post-operative day (POD) 1 was lower in group 2, with a value of P = .045. VAS dynamics were better on POD 1 and 2 for group 2, with P = .05 and P = .012, respectively. CONCLUSIONS We found that combining a single dose of IV parecoxib 40 mg with PCA fentanyl is an easy and effective method of acute pain control after major liver resection. We propose the careful usage of post-operative fentanyl and parecoxib in patients with diseased liver, given the difference in effect as compared with healthy liver.
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Affiliation(s)
- K I Lim
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Y C Chiu
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - C L Chen
- Department of Liver Transplantation Program and Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - C H Wang
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - C J Huang
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - K W Cheng
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - S C Wu
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - T H Shih
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - S C Yang
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - S E Juang
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - C E Huang
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - B Jawan
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Y E Lee
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
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Shih TH, Huang CE, Chen CL, Wang CH, Huang CJ, Cheng KW, Wu SC, Juang SE, Lee YE, Wong ZW, Jawan B, Yang SC. Correlation Between Changes in End-Tidal Carbon Dioxide Concentration and Cardiac Output During Inferior Vena Cava Clamping and Unclamping in Living-donor Liver Transplantation. Transplant Proc 2016; 48:1077-9. [PMID: 27320561 DOI: 10.1016/j.transproceed.2015.10.061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 10/03/2015] [Indexed: 01/10/2023]
Abstract
BACKGROUND To test the hypothesis that low end-tidal carbon dioxide tension encountered during anhepatic phase in liver transplantation is related to hemodynamic status rather than ventilatory status, and can be used to predict the change in cardiac output during anhepatic phase. METHODS We retrospectively analyzed and compared data, included end-tidal carbon dioxide tension (ETCO2), arterial blood pressure, heart rate, central venous pressure, cardiac output, cardiac index, and stroke volume, before and after inferior vena cava clamping, and 0, 5, 10, 30 minutes during the anhepatic, and 5 minutes after the release of IVC cross clamp during the reperfusion phase, with paired Student t test, repeated measurement, and linear regression. P < .05 was regarded as significant. RESULTS The cardiac output and ETCO2 decrease significantly after clamping the inferior vena cava and increase concomitantly after unclamping. There is a positive correlation between the changes in % in cardiac output and ETCO2 (Pearson coefficient r = 0.741). CONCLUSION The changes in ETCO2 can be used to predict the changes of the cardiac output in % when cardiac output monitoring is not available. Before unclamping of the IVC, mild hyperventilation is suggested to prevent excessive increase in PaCO2.
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Affiliation(s)
- T H Shih
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - C E Huang
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - C L Chen
- Department of Liver Transplantation Program and Surgery, Kaohsiung Chang Gung Memorial and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - C H Wang
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - C J Huang
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - K W Cheng
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - S C Wu
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - S E Juang
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Y E Lee
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Z W Wong
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - B Jawan
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - S C Yang
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
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Lee YE, Huang CE, Yang SC, Chen CL, Wang CH, Huang CJ, Cheng KW, Wu SC, Shih TH, Wong ZW, Jawan B, Juang SE. Relationship Between Patients With or Without a History of Esophageal Varices Bleeding and the Changes in Hemodynamics During Inferior Vena Cava Clamping in Living Donor Liver Transplantation. Transplant Proc 2016; 48:1052-4. [PMID: 27320554 DOI: 10.1016/j.transproceed.2015.11.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 10/12/2015] [Accepted: 11/11/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND Whether the history of esophageal variceal bleeding (EVB) can be used clinically to predict the tolerability or hemodynamic instability during clamping of the inferior vena cava (IVC) and portal vein in liver transplantation is unknown and, therefore, needs to be elucidated. PATIENTS AND METHODS A total of 50 anesthesia charts of patients who underwent living donor liver transplantation were reviewed, analyzed and compared retrospectively. Patients without a history of EVB were classified as group 1 and patients with a history of EVB were classified as group 2. The numbers of patients with a decrease in cardiac index (CI) of ≥20%, ≥30%, or ≥40% from their preclamping values after IVC clamping were compared with a χ(2), and a P value of .05 was regarded as statistically significant. RESULTS The measured hemodynamic parameters before and 5 minutes after clamping of the IVC and portal vein were all significantly different in comparison with the patient's preclamping values. The incidence of a decrease in CI of ≥20%, ≥30%, or ≥40% 5 minutes after clamping of the IVC and portal vein were not significantly different between groups. CONCLUSIONS Clamping of the portal vein and IVC without performing veno-venous bypass in living donor liver transplantation had a significant negative impact on CI in both groups due to the drastic reduction in the venous return. Statistical analysis revealed that a history of EVB affects hemodynamics in a manner similar to that in patients without history of EVB during IVC clamping.
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Affiliation(s)
- Y-E Lee
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - C-E Huang
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - S C Yang
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - C-L Chen
- Liver Transplant Program, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - C-H Wang
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - C-J Huang
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - K-W Cheng
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - S-C Wu
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - T-H Shih
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Z-W Wong
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - B Jawan
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - S-E Juang
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
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Luan X, Guan YY, Lovell JF, Zhao M, Lu Q, Liu YR, Liu HJ, Gao YG, Dong X, Yang SC, Zheng L, Sun P, Fang C, Chen HZ. Tumor priming using metronomic chemotherapy with neovasculature-targeted, nanoparticulate paclitaxel. Biomaterials 2016; 95:60-73. [PMID: 27130953 DOI: 10.1016/j.biomaterials.2016.04.008] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Revised: 04/06/2016] [Accepted: 04/09/2016] [Indexed: 02/06/2023]
Abstract
Normalization of the tumor microenvironment is a promising approach to render conventional chemotherapy more effective. Although passively targeted drug nanocarriers have been investigated to this end, actively targeted tumor priming remains to be explored. In this work, we demonstrate an effective tumor priming strategy using metronomic application of nanoparticles actively targeted to tumor neovasculature. F56 peptide-conjugated paclitaxel-loaded nanoparticles (F56-PTX-NP) were formulated from PEGylated polylactide using an oil in water emulsion approach. Metronomic F56-PTX-NP specifically targeted tumor vascular endothelial cells (ECs), pruned vessels with strong antiangiogenic activity and induced thrombospondin-1 (TSP-1) secretion from ECs. The treatment induced tumor vasculature normalization as evidenced by significantly increased coverage of basement membrane and pericytes. The tumor microenvironment was altered with enhanced pO2, lower interstitial fluid pressure, and enhanced vascular perfusion and doxorubicin delivery. A "normalization window" of at least 9 days was induced, which was longer than other approaches using antiangiogenic agents. Together, these results show that metronomic, actively-targeted nanomedicine can induce tumor vascular normalization and modulate the tumor microenvironment, opening a window of opportunity for effective combination chemotherapies.
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Affiliation(s)
- Xin Luan
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital and Department of Pharmacology, Institute of Medical Sciences, Shanghai Jiao Tong University School of Medicine (SJTU-SM), 280 South Chongqing Road, Shanghai 200025, China
| | - Ying-Yun Guan
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital and Department of Pharmacology, Institute of Medical Sciences, Shanghai Jiao Tong University School of Medicine (SJTU-SM), 280 South Chongqing Road, Shanghai 200025, China; Department of Pharmacy, Ruijin Hospital, SJTU-SM, 197 Rui Jin Er Road, Shanghai 200025, China
| | - Jonathan F Lovell
- Department of Biomedical Engineering, University at Buffalo, State University of New York, Buffalo, NY 14260, USA
| | - Mei Zhao
- Department of Pharmacy, Shanghai University of Medicine & Health Sciences, 279 Zhouzhu Road, Shanghai 201318, China
| | - Qin Lu
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital and Department of Pharmacology, Institute of Medical Sciences, Shanghai Jiao Tong University School of Medicine (SJTU-SM), 280 South Chongqing Road, Shanghai 200025, China
| | - Ya-Rong Liu
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital and Department of Pharmacology, Institute of Medical Sciences, Shanghai Jiao Tong University School of Medicine (SJTU-SM), 280 South Chongqing Road, Shanghai 200025, China
| | - Hai-Jun Liu
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital and Department of Pharmacology, Institute of Medical Sciences, Shanghai Jiao Tong University School of Medicine (SJTU-SM), 280 South Chongqing Road, Shanghai 200025, China
| | - Yun-Ge Gao
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital and Department of Pharmacology, Institute of Medical Sciences, Shanghai Jiao Tong University School of Medicine (SJTU-SM), 280 South Chongqing Road, Shanghai 200025, China
| | - Xiao Dong
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital and Department of Pharmacology, Institute of Medical Sciences, Shanghai Jiao Tong University School of Medicine (SJTU-SM), 280 South Chongqing Road, Shanghai 200025, China
| | - Si-Cong Yang
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital and Department of Pharmacology, Institute of Medical Sciences, Shanghai Jiao Tong University School of Medicine (SJTU-SM), 280 South Chongqing Road, Shanghai 200025, China
| | - Lin Zheng
- Pathology Center, Shanghai First People's Hospital, SJTU-SM, 280 South Chongqing Road, Shanghai 200025, China
| | - Peng Sun
- Department of General Surgery, Shanghai Tongren Hospital, SJTU-SM, 1111 Xianxia Road, Shanghai 200336, China
| | - Chao Fang
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital and Department of Pharmacology, Institute of Medical Sciences, Shanghai Jiao Tong University School of Medicine (SJTU-SM), 280 South Chongqing Road, Shanghai 200025, China.
| | - Hong-Zhuan Chen
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital and Department of Pharmacology, Institute of Medical Sciences, Shanghai Jiao Tong University School of Medicine (SJTU-SM), 280 South Chongqing Road, Shanghai 200025, China.
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Abstract
Endophyte microorganisms live inside plants without causing them any apparent damage. Recently, endophytic microorganisms have attracted attention because they can produce bioactive compounds of biotechnological interest. The endophytic microorganisms in Paris polyphylla var. yunnanensis (Liliaceae) - a species used since antiquity in traditional Chinese medicine - are under scrutiny because they may be responsible for producing the bioactive metabolites associated with the plant. The levels of bioactive metabolites in the rhizomes of P. polyphylla increase with rhizome age. To elucidate the roles played by endophytes in the accumulation of bioactive metabolites, we investigated the community structure and diversity of the endophytic microorganisms in P. polyphylla rhizomes of different ages (4, 6, and 8 years) using 16S rRNA and internal transcribed spacer (ITS) sequence analysis. 16S rDNA amplicon pyrosequencing revealed that the number of operational taxonomic units was lower in the 8-year-old samples than in the other samples. A total of 28 phyla were observed in the P. polyphylla samples and the predominant bacteria were of the Cyanobacteria and Proteobacteria phyla. Moreover, the percentage of Cyanobacteria increased with rhizome age. Similarly, ITS1 amplicon pyrosequencing identified developmental changes in the most abundant fungal classes; some classes were more prevalent in the 8-year-old rhizomes than in younger rhizomes, indicating the importance in secondary metabolism in older rhizomes. Our study showed that endophyte microorganism diversity and prevalence depend on P. polyphylla rhizome age. There was also an indication that some endophyte microorganisms contribute to the higher saponin content in older P. polyphylla specimens.
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Affiliation(s)
- Y Yang
- China Tobacco Yunnan Industrial Co., Ltd., Kunming, Yunnan Province, China
| | - S C Yang
- Yunnan Research Center on Good Agricultural Practice for Dominant Chinese Medicinal Materials, Yunnan Agricultural University, Kunming, Yunnan Province, China
| | - J Zhao
- Yunnan Research Center on Good Agricultural Practice for Dominant Chinese Medicinal Materials, Yunnan Agricultural University, Kunming, Yunnan Province, China
| | - S Udikeri
- Department of Agricultural Entomology, University of Agricultural Sciences, Hubli, Karnataka, India
| | - T Liu
- Yunnan Research Center on Good Agricultural Practice for Dominant Chinese Medicinal Materials, Yunnan Agricultural University, Kunming, Yunnan Province, China
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Yoon YE, Choi KH, Kim KH, Yang SC, Han WK. Clinical assessment of lipid profiles in live kidney donors. Transplant Proc 2015; 47:584-7. [PMID: 25891691 DOI: 10.1016/j.transproceed.2014.12.035] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2014] [Accepted: 12/31/2014] [Indexed: 01/11/2023]
Abstract
BACKGROUND Abnormal serum lipid profiles are an issue in chronic kidney disease (CKD), but the clinical ramifications of dyslipidemia in live kidney donors are unclear. Thus, we explored the relationship between serum lipids and residual renal function in living donors post-nephrectomy. METHODS Charts of living donors who underwent nephrectomy between January 2010 and March 2013 were reviewed, targeting those with 6-month follow-up examinations at minimum. Altogether, 282 donors were studied, examining total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) levels assayed before donation by standard techniques. Median follow-up time was 14 months. The relationship between postoperative renal function and allograft biopsy results was assessed. Recursive partitioning was applied to identify optimal cut-off points for each parameter. RESULTS Median (interquartile range) serum TC, TG, LDL, and HDL levels were 183 (161-205) mg/dL, 86 (63-131) mg/dL, 108 (92-128) mg/dL, and 53 (44-62) mg/dL, respectively. The glomerular filtration rate at last follow-up was associated with TC (r = -0.187; P = .002) and LDL (r = -0.172; P = .005) levels, but showed no correlation with TG and HDL. Root nodes of TC and LDL determinations in recursive partitioning were 170.5 mg/dL and 80.5 mg/dL, respectively, serving as thresholds for further evaluation. On logistic regression analysis, the likelihood of CKD (glomerular filtration rate < 60 mL/min/1.73 m(2)) at last follow-up was greater in donors with elevated TC and LDL levels (odds ratio = 1.96 and 3.33; P = .021 and .029, respectively). CONCLUSION Kidney donors with serum TC and LDL elevations require close observation, given their demonstrable predisposition to CKD after donation.
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Affiliation(s)
- Y E Yoon
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - K H Choi
- Department of Urology, CHA Bundang Medical Center, CHA University, Seongnam-si, Korea
| | - K H Kim
- Department of Urology, Ewha Women's University Mokdong Hospital, Seoul, Korea
| | - S C Yang
- Department of Urology, CHA Bundang Medical Center, CHA University, Seongnam-si, Korea
| | - W K Han
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
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Yoon YE, Choi KH, Lee KS, Kim KH, Yang SC, Han WK. Impact of metabolic syndrome on postdonation renal function in living kidney donors. Transplant Proc 2015; 47:290-4. [PMID: 25769562 DOI: 10.1016/j.transproceed.2014.10.051] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Revised: 10/13/2014] [Accepted: 10/28/2014] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Optimization of kidney donor selection is critical to ensure recovery of the donor. The goal of this study was to determine the influence of metabolic syndrome on renal histology and perioperative renal function in living kidney donors. PATIENTS AND METHODS Between January 2010 and March 2013, a total of 363 living kidney donors who underwent donor nephrectomy at our institution were enrolled. Metabolic syndrome was diagnosed in patients according to the National Cholesterol Education Program's Adult Treatment Panel III, and renal histology of implantation biopsy specimens and perioperative renal function were compared in participants with or without metabolic syndrome. Using multivariate regression analysis, the goal was to identify which component of metabolic syndrome induces chronic histologic changes and delayed renal function recovery. RESULTS We identified 30 donors (8.45%) with metabolic syndrome. Donors with metabolic syndrome were older (48.4 ± 9.2 years vs 39.7 ± 11.4 years; P < .001) and more likely to have chronic histologic changes (36.8% vs 9.7%; P = .001) than subjects without metabolic syndrome. Results of the multivariate regression analysis indicated that obesity, hyperglycemia, and hypertriglyceridemia were independently associated with chronic histologic changes. Perioperative renal function was correlated with the presence of metabolic syndrome rather than with chronic histologic changes, and patients with metabolic syndrome were more likely to experience delayed renal function recovery. Linear regression models found that the sum of the metabolic components correlated with renal function 6 months postoperatively, but among all risk factors, only obesity was significantly associated with the occurrence of delayed renal function recovery (odds ratio, 2.67; P = .001). CONCLUSIONS Although metabolic syndrome in living kidney donors is characterized by chronic histologic changes, perioperative renal function is affected by the syndrome itself rather than by the histologic changes. Obesity is the most important metabolic factor for predicting delayed renal function recovery in living kidney donors, providing an important clinical indicator of postoperative renal function in these patients.
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Affiliation(s)
- Y E Yoon
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - K H Choi
- Department of Urology, CHA Bundang Medical Center, CHA University, Seongnam-si, South Korea
| | - K S Lee
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - K H Kim
- Department of Urology, Ewha Women's University Mokdong Hospital, Seoul, South Korea
| | - S C Yang
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - W K Han
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, South Korea.
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Liu YR, Guan YY, Luan X, Lu Q, Wang C, Liu HJ, Gao YG, Yang SC, Dong X, Chen HZ, Fang C. Delta-like ligand 4-targeted nanomedicine for antiangiogenic cancer therapy. Biomaterials 2014; 42:161-71. [PMID: 25542804 DOI: 10.1016/j.biomaterials.2014.11.039] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [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: 08/20/2014] [Revised: 11/08/2014] [Accepted: 11/24/2014] [Indexed: 01/20/2023]
Abstract
Tumor angiogenesis is a multistep process involved with multiple molecular events in cancer microenvironment. Several molecular-targeted agents aiming to suppress tumor angiogenesis have been successfully translated into cancer clinic. However, new strategies are still urgently desired to be excavated to overcome the poor response and resistance in some antiangiogenic therapies. Recently, Delta-like ligand 4 (Dll4) is identified to be specifically over-expressed on tumor vascular endothelial cells (EC), and the Dll4-Notch pathway serves as a critical regulator in the development and maintenance of tumor angiogenesis. The intensively up-regulated phenotype of Dll4 on the membrane of tumor vascular EC implies that Dll4 may act as a targetable address for drug delivery system (DDS) to achieve targeted antiangiogenic cancer therapy. Here, a nano-DDS, GD16 peptide (H2N-GRCTNFHNFIYICFPD-CONH2, containing a disulfide bond between Cys3 and Cys13) conjugated nanoparticles loading paclitaxel (GD16-PTX-NP), which can specifically target the angiogenic marker Dll4, was fabricated for the investigation of antiangiogenic therapeutic efficacy in human head and neck cancer FaDu (Dll4-negative) xenograft in nude mice. The results demonstrate that GD16-PTX-NP achieved controlled drug release and exhibited favorable in vivo long-circulating feature. GD16-PTX-NP exerted enhanced antiangiogenic activity in the inhibition of human umbilical vein endothelial cell (HUVEC) viability, motility, migration, and tube formation, and in the Matrigel plug model as well, which can be definitely ascribed to the active internalization mediated by the interaction of GD16 and the over-expressed Dll4 on EC. GD16-PTX-NP showed accurate in vivo tumor neovasculature targeting property in FaDu tumor, where the paclitaxel was specifically delivered into the tumor vascular EC, leading to significant apoptosis of tumor vascular EC and necrosis of tumor tissues. The antiangiogenic activity of GD16-PTX-NP significantly contributed to its in vivo anticancer efficacy in Fadu tumor; moreover, no overt toxicity to the mice was observed. Our research firstly presents the potency and significance of a Dll4-targeted nanomedicine in antiangiogenic cancer therapy.
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Affiliation(s)
- Ya-Rong Liu
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital and Department of Pharmacology, Institute of Medical Sciences, Shanghai Jiao Tong University School of Medicine, 280 South Chongqing Road, Shanghai 200025, China
| | - Ying-Yun Guan
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital and Department of Pharmacology, Institute of Medical Sciences, Shanghai Jiao Tong University School of Medicine, 280 South Chongqing Road, Shanghai 200025, China
| | - Xin Luan
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital and Department of Pharmacology, Institute of Medical Sciences, Shanghai Jiao Tong University School of Medicine, 280 South Chongqing Road, Shanghai 200025, China
| | - Qin Lu
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital and Department of Pharmacology, Institute of Medical Sciences, Shanghai Jiao Tong University School of Medicine, 280 South Chongqing Road, Shanghai 200025, China
| | - Chao Wang
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital and Department of Pharmacology, Institute of Medical Sciences, Shanghai Jiao Tong University School of Medicine, 280 South Chongqing Road, Shanghai 200025, China
| | - Hai-Jun Liu
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital and Department of Pharmacology, Institute of Medical Sciences, Shanghai Jiao Tong University School of Medicine, 280 South Chongqing Road, Shanghai 200025, China
| | - Yun-Ge Gao
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital and Department of Pharmacology, Institute of Medical Sciences, Shanghai Jiao Tong University School of Medicine, 280 South Chongqing Road, Shanghai 200025, China
| | - Si-Cong Yang
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital and Department of Pharmacology, Institute of Medical Sciences, Shanghai Jiao Tong University School of Medicine, 280 South Chongqing Road, Shanghai 200025, China
| | - Xiao Dong
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital and Department of Pharmacology, Institute of Medical Sciences, Shanghai Jiao Tong University School of Medicine, 280 South Chongqing Road, Shanghai 200025, China
| | - Hong-Zhuan Chen
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital and Department of Pharmacology, Institute of Medical Sciences, Shanghai Jiao Tong University School of Medicine, 280 South Chongqing Road, Shanghai 200025, China.
| | - Chao Fang
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital and Department of Pharmacology, Institute of Medical Sciences, Shanghai Jiao Tong University School of Medicine, 280 South Chongqing Road, Shanghai 200025, China.
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Slooten E, Wang JY, Dungan SZ, Forney KA, Hung SK, Jefferson TA, Riehl KN, Rojas-Bracho L, Ross PS, Wee A, Winkler R, Yang SC, Chen CA. Impacts of fisheries on the Critically Endangered humpback dolphin Sousa chinensis population in the eastern Taiwan Strait. ENDANGER SPECIES RES 2013. [DOI: 10.3354/esr00518] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Richard E, Schmand B, Eikelenboom P, Yang SC, Ligthart SA, Moll van Charante EP, van Gool WA. Symptoms of apathy are associated with progression from mild cognitive impairment to Alzheimer's disease in non-depressed subjects. Dement Geriatr Cogn Disord 2012; 33:204-9. [PMID: 22722671 DOI: 10.1159/000338239] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/15/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Apathy is a common symptom in various neuropsychiatric diseases including mild cognitive impairment (MCI) and dementia. Apathy may be associated with an increased risk of cognitive decline. The objective of this study was to investigate if apathy predicts the progression from MCI to Alzheimer's disease (AD). METHODS The Alzheimer's Disease Neuroimaging Initiative is a prospective multicentre cohort study. At baseline, 397 patients with MCI without major depression were included. Clinical data and the Geriatric Depression Scale at baseline were used. Apathy was defined based on the 3 apathy items of the 15-item Geriatric Depression Scale. The main outcome measure was the association of apathy with progression from MCI to AD. RESULTS During an average follow-up of 2.7 years (SD 1.0), 166 (41.8%) patients progressed to AD. The presence of symptoms of apathy without symptoms of depressive affect increased the risk of progression from MCI to AD (hazard ratio = 1.85, 95% CI = 1.09-3.15). Apathy in the context of symptoms of depressive affect or symptoms of depressive affect alone, without apathy, did not increase the risk of progression to AD. CONCLUSIONS Symptoms of apathy, but not symptoms of depressive affect, increase the risk of progression from MCI to AD. Apathy in the context of symptoms of depressive affect does not increase this risk. Symptoms of apathy and depression have differential effects on cognitive decline.
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Affiliation(s)
- E Richard
- Department of Neurology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
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Ou CY, Yang SC, Chen CW. Influence of different flow-triggering levels on the breathing effort of mechanically ventilated patients. Minerva Anestesiol 2012; 78:996-1004. [PMID: 22531563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Although a sensitive flow triggering (FT) level is supposed to be associated with reduced breathing effort, the incidence of autotriggering (AT) is likely to be increased. The actual effects of various FT levels on the work of breathing and occurrence of AT in mechanically ventilated patients are unknown. We investigated the effects of different FT levels (1-8 L/min) on breathing effort and incidence of AT in mechanically ventilated patients under pressure support ventilation using a Puritan-Bennett 840 ventilator. METHODS Eight FT levels were randomly studied in mechanically ventilated patients under pressure support ventilation. The triggering effort (pressure-time product of triggering, PTPtr) was assessed by quantitating a segment of the pressure-time product of the esophagus (PTPes). The total PTPes, inspiratory work of breathing (Wi) and P0.1 were determined. RESULTS Nine patients with appropriately recorded signals were included. The incidence of AT significantly decreased with increasing FT level (FT1, 1 L/min: 30.7%, FT8: 0.2%). PTPtr significantly increased with increasing FT level (0.020 ± 0.004 cmH2O • S in FT1 to 0.190 ± 0.017 cmH2O • S in FT8), but P0.1 remained similar. PTPtr accounted for only1-3% of total PTPes. Wi and PTPes were significantly lower only at FT1, but there was no significant difference in Wi and PTPes at different FT levels when AT breaths were excluded. CONCLUSION A higher FT level was associated with lower incidence of AT, but without a significant increase in breathing effort. A higher FT level may be more reasonable in mechanically ventilated patients with this particular ventilator.
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Affiliation(s)
- C Y Ou
- Division of Chest Medicine, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Choi CM, Yang SC, Jo HJ, Song SY, Jeon YJ, Jang TW, Kim DJ, Jang SH, Yang SH, Kim YD, Lee KH, Jang SJ, Kim YT, Kim DK, Chung DH, Kim L, Nam HS, Cho JH, Kim HJ, Ryu JS. Proteins involved in DNA damage response pathways and survival of stage I non-small-cell lung cancer patients. Ann Oncol 2012; 23:2088-2093. [PMID: 22317771 DOI: 10.1093/annonc/mdr606] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Biological complexity leads to significant variation in the survival of patients with stage I non-small-cell lung cancer (NSCLC). DNA damage response (DDR) pathways play a critical role in maintaining genomic stability and in the progression of NSCLC. Therefore, the development of a prognostic biomarker focusing on DDR pathways is an intriguing issue. PATIENTS AND METHODS Expression of several proteins (ATM, ATMpS1981, γH2AX, 53BP1, 53BP1pS25, Chk2, Chk2pT68, MDC1, MDC1pS964, BRCA1pS1423, and ERCC1) and overall survival were investigated in 889 pathological stage I NSCLC patients. RESULTS Low expression of BRCA1pS1423 or ERCC1 was significantly associated with worse survival in the whole cohort of patients. Analysis performed based on histology revealed that low expression of γH2AX, Chk2pT68, or ERCC1 was a poor prognostic factor in squamous cell carcinoma patients [adjusted hazard ratio (aHR), Cox P: 1.544, 0.012 for γH2AX; 1.624, 0.010 for Chk2pT68; 1.569, 0.011 for ERCC1]. The analysis of the interaction between two proteins showed that this effect was more pronounced in squamous cell carcinoma patients. However, these effects were not detected in adenocarcinoma patients. CONCLUSIONS The proteins involved in DDR pathways exhibited differential expression between squamous cell carcinoma and adenocarcinoma and were important determinants of survival in stage I squamous cell carcinoma patients.
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Affiliation(s)
- C M Choi
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul
| | - S C Yang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul
| | - H J Jo
- Department of Pathology, College of Medicine, Wonkwang University, Iksan
| | - S Y Song
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hwasun Hospital, Hwasun-gun
| | - Y J Jeon
- Department of Internal Medicine, School of Medicine, Keimyung University, Daegu
| | - T W Jang
- Department of Internal Medicine, College of Medicine, Kosin University, Busan
| | - D J Kim
- Division of Respiratory and Allergy Medicine, Soonchunhyang University Hospital, College of Medicine, Bucheon
| | - S H Jang
- Division of Pulmonary, Allergy & Critical Care Medicine, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang
| | - S H Yang
- Department of Internal Medicine, Wonkwang University Hospital, Iksan
| | - Y D Kim
- Department of Thoracic Surgery, School of Medicine, Pusan National University, Busan
| | - K H Lee
- Department of Internal Medicine, Yeungnam University School of Medicine, Daegu
| | - S J Jang
- Department of Pathology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul
| | - Y T Kim
- Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul
| | - D K Kim
- Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul
| | - D H Chung
- Department of Pathology, Seoul National University College of Medicine, Seoul
| | | | - H S Nam
- Pulmonary Division, Department of Internal Medicine, Inha University Hospital, Incheon, Korea
| | - J H Cho
- Pulmonary Division, Department of Internal Medicine, Inha University Hospital, Incheon, Korea
| | - H J Kim
- Pulmonary Division, Department of Internal Medicine, Inha University Hospital, Incheon, Korea
| | - J S Ryu
- Pulmonary Division, Department of Internal Medicine, Inha University Hospital, Incheon, Korea.
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Hong JY, Yang SC, Yi J, Kil HK. Epidural ropivacaine and sufentanil and the perioperative stress response after a radical retropubic prostatectomy. Acta Anaesthesiol Scand 2011; 55:282-9. [PMID: 21108620 DOI: 10.1111/j.1399-6576.2010.02360.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND The effects of an epidural opioid and a local anesthetic on the perioperative stress responses have not been fully investigated in elderly patients undergoing cancer surgery. We hypothesized that the stress response after a radical retropubic prostatectomy (RRP) would be attenuated by epidural ropivacaine and sufentanil. METHODS In this randomized, double-blinded study, we included patients above 65 years of age who were scheduled for a RRP. In addition to general anesthesia, they received either epidural saline continuously (5 ml/h) (C group, n=20); 0.3% ropivacaine (R group, n=20); or 0.3% ropivacaine combined with 1 μg/ml sufentanil (RS group; n=20). We determined the concentrations of glucose, insulin, cortisol, epinephrine, norepinephrine, and prolactin before, during, and up to 48 h after surgery. RESULTS The concentrations of glucose and insulin increased in all the groups. The cortisol level increased in the C group while it decreased significantly in the RS group. Epinephrine and norepinephrine concentrations increased significantly after surgery in the C group, but not in the R and RS groups. The prolactin concentration increased in all the groups, and was higher in the RS group than in the other groups (P=0.002). Post-operative pain scores and analgesic requirement were lower in the R and RS groups. CONCLUSION Epidural ropivacaine blunted the perioperative stress responses in elderly patients undergoing a RRP. The combination of epidural ropivacaine and sufentanil was associated with the most pronounced attenuation of the stress response. ClinicalTrial.gov registration number: NCT01086956.
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Affiliation(s)
- J-Y Hong
- Department of Anaesthesiology and Pain Medicine, College of Medicine, Asan Medical Center, University of Ulsan, Seoul, Korea
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Ma CG, Chen MK, Yang SC, Bai S, Liao QM. Successful treatment of recurrent and refractory cervical condylomata acuminata with topical 5% imiquimod cream in five patients. Int J STD AIDS 2011; 21:528-9. [PMID: 20852209 DOI: 10.1258/ijsa.2010.010125] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Han WK, Lee HY, Jeon HG, Joo DJ, Rha KH, Yang SC. Quality of life comparison between open and retroperitoneal video-assisted minilaparotomy surgery for kidney donors. Transplant Proc 2010; 42:1479-83. [PMID: 20620458 DOI: 10.1016/j.transproceed.2010.01.070] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2009] [Accepted: 01/25/2010] [Indexed: 11/30/2022]
Abstract
This study compared open and video-assisted minilaparotomy surgery in live kidney donors for quality of life (QoL), pain, cosmesis, and recovery. Between January 2003 and March 2006, we reviewed data from 205 patients who underwent live-donor nephrectomy: 116 by video-assisted minilaparotomy and 89 by open surgery. Pain and satisfaction were evaluated using scales from 1 to 10, and QoL, with the 36-item Short Form questionnaire. Hospital stay was significantly shorter among the video-assisted (5.1 +/- 1.6 days) than the open group (6.9 +/- 1.3 days; P < .01). Time to resumption of walking without difficulty and normal activity was significantly shorter among the video-assisted than the open group (P<.01). The video-assisted group showed better QoL scores in 6 of 8 QoL categories, including physical role (P < .01), bodily pain (P < .01), general health (P < .01), vitality (P < .01), emotional health (P < .01), and mental health (P < .01). Patients in the video-assisted group (score, 7.3 +/- 2.4) were more satisfied with the cosmetic outcome than those in the open group (score, 5.1 +/- 3.0; P < .01). In conclusion, donors who underwent nephrectomy via video-assisted minilaparotomy showed better outcomes regarding pain, convalescence, cosmesis, and QoL than those who underwent open surgery.
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Affiliation(s)
- W K Han
- Yonsei University College of Medicine, Urological Science Institute, Seoul, Korea
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Yang SC, Zandstra T, van der Poel AFB. Starch gelatinization and physical quality of pea flakes in canine dinners as affected by soaking, steam treatment and infrared radiation. J Anim Physiol Anim Nutr (Berl) 2008; 92:310-5. [PMID: 18477311 DOI: 10.1111/j.1439-0396.2007.00777.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2023]
Abstract
Cleaned, whole smooth green peas (Pisum sativum L.) were reconstituted by soaking in tap water of 40 degrees C (15, 20 or 25 min) and subsequently either toasted (100 degrees C during 1.5 min) and infrared (IR) radiated or just IR radiated. For IR radiation, a small-scale, propane-fired IR radiation plant was used with average residence times of 58 and 92 s respectively. After exiting the conveyor belt, peas were held for a pre-determined period (holding: 0, 15 or 30 min respectively) in a well-insulated container. Finally, all radiated peas were flaked (roll distance 0.75 mm) in a flaking mill located posterior to the IR plant and analysed for chemical and physical properties. Initial pea starch gelatinization degree (SGD) was 10.1% at a total starch content of 410.1 g/kg. Infrared processing during 92 s significantly improved the SGD (from 10.1% to 32.8%) of pea flakes compared to treatment during 58 s (SGD of 18.6%). The SGD was further improved with steam treatment of peas, prior to IR. For all determined parameters, no effect of holding time could be observed. Starch gelatinization degree can be improved by soaking, toasting and IR processing. The substantial improvement of SGD, however can be only obtained by a longer IR residence time as well as through toasting, prior to the IR processing. The improvements in SGD, however are paralleled by a lower durability of flakes (range 34.9% to 87.4%).
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Affiliation(s)
- S C Yang
- Animal Nutrition Group, Department of Animal Sciences, Wageningen University, Wageningen, The Netherlands
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Wang JY, Frasier TR, Yang SC, White BN. Detecting recent speciation events: the case of the finless porpoise (genus Neophocaena). Heredity (Edinb) 2008; 101:145-55. [PMID: 18478026 DOI: 10.1038/hdy.2008.40] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Shin JC, Kim YW, Park CI, Kang SW, Yang SC. Effect of the intravesical resiniferatoxin instillation evaluated by the ice provocative urodynamic study. Spinal Cord 2006; 44:309-14. [PMID: 16186855 DOI: 10.1038/sj.sc.3101851] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Prospective urodynamic investigation before and after intravesical resiniferatoxin instillation treatment. OBJECTIVE To evaluate the effectiveness of intravesical resiniferatoxin instillation for the treatment of neurogenic detrusor overactivity (NDO), using conventional and ice provocative urodynamic studies to monitor the activity of the unmyelinated C-fiber. SETTING Spinal Cord Injury Unit, Yonsei Rehabilitation Hospital, Seoul, Korea. METHODS A measure of 100 ml of resiniferatoxin solution, at a concentration of 100 nM diluted in 10% ethanol, was intravesically instilled into the bladder of 15 spinal cord injury patients with NDO. Conventional and ice provocative urodynamic studies were performed to evaluate the change in the involuntary detrusor activity, reflex volume, maximal bladder capacity, compliance, maximal detrusor pressure and reflex volume ratio 7 days before and 30 days after the instillation. RESULTS Before the intravesical resiniferatoxin instillation, all patients exhibited NDO in both the conventional and ice provocative urodynamic studies, with a mean reflex volume ratio of 0.45+/-0.22. There was no significant change in the maximal bladder capacity, compliance and maximal detrusor pressure at the follow-up urodynamic study, but the reflex volume ratio was significantly increased (P<0.05) after the intravesical resiniferatoxin instillation. Among the 15 patients, three (20%) showed complete and nine (60%) partial suppression of the unmyelinated C-fiber activities. CONCLUSION Intravesical resiniferatoxin instillation was partially controlled by the unmyelinated C-fiber activities, which were estimated by an ice provocative urodynamic study. Therefore, further studies on the optimal dosage and accurate indications for resiniferatoxin instillation are required.
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Affiliation(s)
- J C Shin
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea
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Abstract
OBJECTIVE To evaluate clinical outcomes of pregnancies with one elevated glucose tolerance test. METHODS We performed a 50 g glucose challenge test (GCT) in 5,019 pregnant women at 24-28 weeks of gestation. In 1,170 women with plasma glucose levels over 130 mg/dl, a 100 g oral glucose tolerance test (OGTT) was performed at 28-32 weeks of gestation. During follow-up, 282 patients were lost and in the 888 cases that were followed-up, 189 were excluded because of GDM. Therefore 699 study patients were divided into four groups: No Elevated group (NE, N = 577) with all four normal 100 g OGTT values, and Groups 1 (N = 16), 2 (N = 35), and 3 (N = 71) with one elevated 100 g OGTT value after 1, 2 and 3 h, respectively. RESULTS Poor maternal outcomes (NE group, Group 1, Group 2, Group 3: 17.5%, 37.6%, 22.9%, 25.3%) with pre-eclampsia, cesarean delivery for cephalopelvic disproportion, failure to progress, or fetal distress, was highest in Group 1 (odds ratio 2.94; 95% confidence interval 1.02-8.42). Poor perinatal outcomes (15.8%, 43.1%, 14.3%, 21.1%) with any one of the following; fetal distress, Apgar score of < 7 at 5 min, hypoglycemia, respiratory distress syndrome, small for gestational age and perinatal death, was also highest in Group 1 (odds ratio 4.24; 95% confidence interval 1.02-17.52). CONCLUSION Pregnancies with one elevated glucose tolerance test value after 1 h exhibited increased adverse maternal and perinatal outcomes compared with the group with all normal OGTT values or the groups with an elevated glucose tolerance test value after 2 or 3 h.
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Affiliation(s)
- H S Kim
- Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, South Korea
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48
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Chan PC, Lu CY, Lee PI, Yang TY, Chen RT, Ho YH, Yang SC, Lee CY, Huang L. Haemophilus influenzae type b meningitis with subdural effusion: a case report. J Microbiol Immunol Infect 2002; 35:61-4. [PMID: 11950123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Haemophilus influenzae type b causes invasive infection in children under 2 years of age. The disease may be complicated with hearing impairment, lowered learning ability, and other neurologic sequelae. The incidence of invasive H. influenzae type b has declined dramatically after the introduction of routine administration of protein-conjugated H. influenzae type b vaccine in the United States and some other countries. Because of its low incidence in Taiwan, many clinicians are not familiar with the initial symptoms and management of H. influenzae type b. This case report describes a 7-month-old H. influenzae type b meningitis patient who had initial presentations of prolonged intermittent fever and vague neurologic signs. Left peripheral facial palsy with hearing loss in left ear and bilateral frontal subdural effusion developed during the first 5 days of cefotaxime therapy. Betamethasone was then given for 4 days to relieve the severe inflammation. Drug-induced fever was observed after 11 days of antibiotic use and subsided with prednisolone treatment. Left ear hearing impairment persisted during the follow-up period, but the children did not experience other significant development delay.
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Affiliation(s)
- P C Chan
- Department of Pediatrics, National Taiwan University Hospital, Taipei, ROC
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49
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Brock MV, Borja MC, Ferber L, Orens JB, Anzcek RA, Krishnan J, Yang SC, Conte JV. Induction therapy in lung transplantation: a prospective, controlled clinical trial comparing OKT3, anti-thymocyte globulin, and daclizumab. J Heart Lung Transplant 2001; 20:1282-90. [PMID: 11744411 DOI: 10.1016/s1053-2498(01)00356-4] [Citation(s) in RCA: 94] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND Because acute rejection is associated with inferior outcomes in lung transplantation, we have routinely employed OKT3, anti-thymocyte globulin (ATG), or daclizumab as adjuncts to reduce rejection. METHOD We performed a 4-year prospective, controlled clinical trial of these 3 therapies to determine differences in post-operative infection, rejection, survival, and bronchiolitis obliterans syndrome (BOS). Eighty-seven consecutive lung transplant patients received OKT3 (n = 30), ATG (n = 34), and daclizumab (n = 23) as induction agents. The groups had similar demographics and immunosuppression protocols differing only in induction agents used. RESULTS No differences were observed in immediate post-operative outcomes such as length of hospitalization, ICU stay, or time on ventilators. Twelve months post-transplant, OKT3 had more infections per patient than the other agents, a difference that only became significant 2 months post-operatively (p = 0.009). The most common infection was bacterial and OKT3 had more bacterial infections than any other agent. Daclizumab had more patients remain infection free in the first year (p = 0.02), having no fungal infections and a low rate of viral infections. No patient receiving daclizumab developed drug specific side-effects. Only those patients with episodes of acute rejection developed BOS. There were no significant differences in the freedom from acute rejection or BOS between the groups. The 2-year survival for the entire cohort was 68%, with no differences observed in patient survival. CONCLUSIONS This study again reveals the importance of acute rejection in the subsequent development of BOS. Although daclizumab offers a low risk of post-transplant infection and drug specific side-effects, no drug is superior in delaying rejection or BOS or in prolonging long-term survival.
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Affiliation(s)
- M V Brock
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA
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50
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Wang CM, Yang SC, Chung PC, Chang CI, Lo CS, Chen CC, Yang CW, Wen CH. Orthogonal subspace projection-based approaches to classification of MR image sequences. Comput Med Imaging Graph 2001; 25:465-76. [PMID: 11679208 DOI: 10.1016/s0895-6111(01)00015-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Orthogonal subspace projection (OSP) approach has shown success in hyperspectral image classification. Recently, the feasibility of applying OSP to multispectral image classification was also demonstrated via SPOT (Satellite Pour 1'Observation de la Terra) and Landsat (Land Satellite) images. Since an MR (magnetic resonance) image sequence is also acquired by multiple spectral channels (bands), this paper presents a new application of OSP in MR image classification. The idea is to model an MR image pixel in the sequence as a linear mixture of substances (such as white matter, gray matter, cerebral spinal fluid) of interest from which each of these substances can be classified by a specific subspace projection operator followed by a desired matched filter. The experimental results show that OSP provides a promising alternative to existing MR image classification techniques.
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Affiliation(s)
- C M Wang
- Department of Electrical Engineering, National Cheng Kung University, 1 University Road, Tainan, Taiwan
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