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Li X, Gao XS, Li H. Real-World Evaluation of Adjuvant Radiotherapy in Upper Tract Urothelial Carcinoma Patients: A Prospective Cohort Study. Int J Radiat Oncol Biol Phys 2023; 117:e407. [PMID: 37785353 DOI: 10.1016/j.ijrobp.2023.06.1547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Recommendations of adjuvant therapy after surgical resection of UTUC was updated in NCCN guideline of 2021.Adjuvant radiotherapy combined with chemotherapy was recommended for patients of T3-4 or N+. However, the renal insufficiency after RNU limits the use of adjuvant chemotherapy of UTUC. Adjuvant radiotherapy alone may be another option. This study aims to verify the real-world choices and effectiveness of adjuvant therapies in UTUC patients with recurrence risk factors. MATERIALS/METHODS Patients with high recurrence factors (T2-4, N+, G3 and multifocal tumor) of UTUC patients after radical nephroureterectomy (RNU) in our hospital since 2020 were prospectively recommended to use adjuvant therapy. Patients' adverse events, recurrence and survival rates were investigated. This trial was registered at Chinese Clinical Trial Registry (ChiCTR2100044477). RESULTS Between 2020 and 2022, 195 UTUC patients with recurrence factors had been enrolled. The median follow up time was 13 months. Nearly half of the patients (90 patient) with high-risk factors refused to receive adjuvant treatment. The other 105 patients received adjuvant therapy. Thirty-six patients (34.3%) received adjuvant chemotherapy; 43 patients (41.0%) received adjuvant radiotherapy. Fifteen patients (14.3%) received adjuvant combination therapy (chemo-radiotherapy). The 1-year recurrence-free survival (RFS) rates were59.4% and77.5%, respectively in control group and adjuvant therapy group (P = 0.008). The 1-year overall survival (OS) rates were 89.7% and 98.2%, respectively in control group and adjuvant therapy group (P = 0.011). The 1-year recurrence-free survival (RFS) rates of adjuvant chemotherapy and radiotherapy were 58.6%.and 90.2% (P = 0.003). The combination therapy group had the most serious side effects, grade 3 and 2 hematotoxicity were 40% and 20% respectively. Grade 3 hematotoxicity were 22.2% for adjuvant chemotherapy group. Side effects of adjuvant radiotherapy alone were mild. Only one patient had grade 3 hematotoxicity. CONCLUSION Although both NCCN guidelines suggest UTUC patient with more than T2 stage and N+ to receive adjuvant therapy, nearly half of them refused any adjuvant therapies. The prognosis of these patients without adjuvant therapy were poor. The side effects of chemoradiotherapy in UTUC is serious. Adjuvant radiotherapy has less side effects and the effectiveness are equivalent to adjuvant chemotherapy in high risk UTUC patients.
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Affiliation(s)
- X Li
- Department of Radiation Oncology, Peking University First Hospital, Beijing, China
| | - X S Gao
- Department of Radiation Oncology, Peking University First Hospital, Beijing, China
| | - H Li
- Department of Radiation Oncology, Peking University First Hospital, Beijing, China
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Huang JW, Yang YF, Gao XS, Zhou M, Xiao N, Kuang JX, Xu ZH. The impact of preoperative single low-dose dexamethasone on in-hospital prognosis in geriatric intertrochanteric fracture patients: Analysis of secondary outcomes in a randomized controlled trial. Surgery 2023; 174:1041-1049. [PMID: 37481423 DOI: 10.1016/j.surg.2023.06.013] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 04/03/2023] [Accepted: 06/18/2023] [Indexed: 07/24/2023]
Abstract
BACKGROUND Intertrochanteric fracture in the geriatric population is associated with poor prognosis, which may be attributed to consistent stress and the systemic inflammatory response. Dexamethasone is an exogenous glucocorticoid commonly used in clinical practice for broad anti-inflammatory action. The purpose is to investigate whether a single preoperative low-dose dexamethasone can improve the in-hospital prognosis in geriatric intertrochanteric fracture patients undergoing internal fixation surgery. METHODS Between June 2020 and October 2022, 219 eligible patients with intertrochanteric fractures were in this study. After meeting the inclusion and exclusion criteria, 160 patients were randomly allocated to the dexamethasone or placebo groups (80 patients who are geriatric with an intertrochanteric fracture in each group). The patients in the dexamethasone group received 10 mg (2 mL) of dexamethasone intravenously, whereas the patients in the placebo group received 2 mL of saline intravenously within 30 minutes before being sent to the operating room. The efficacy-related outcomes (the first bed-chair transfer ability, in-hospital mortality, and length of stay) and safety-related outcomes (infection events and hyperglycemia) were collected for analysis. RESULTS There were no significant differences in the baseline characteristics between the 2 groups. The dexamethasone group had a significantly higher rate of the first bed-chair transfer than the placebo group (65.0% [52/80] vs 48.8% [39/80], relative risk = 1.46, 95% confidence interval = 1.02 to 2.11; P = .038). One patient in the dexamethasone group and 7 patients in the placebo group died during hospitalization (1.3% [1/80] vs 8.8% [7/80], relative risk = 0.92, 95% confidence interval = 0.86 to 0.99; P = .07). No differences were found in the length of stay, infections, and hyperglycemia between the 2 groups. CONCLUSION A single preoperative low-dose of dexamethasone can improve the in-hospital prognosis (increase the ability of the first bed-chair transfer and potentially decrease the in-hospital mortality) in geriatric intertrochanteric fracture patients after internal fixation surgery.
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Affiliation(s)
- Jian-Wen Huang
- Department of Orthopaedic Surgery, Guangzhou First People's Hospital, The Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangdong, China
| | - Yun-Fa Yang
- Department of Orthopaedic Surgery, Guangzhou First People's Hospital, The Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangdong, China.
| | - Xiao-Sheng Gao
- Department of Orthopaedic Surgery, Guangzhou First People's Hospital, The Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangdong, China
| | - Mi Zhou
- Department of Orthopaedic Surgery, Guangzhou First People's Hospital, The Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangdong, China
| | - Na Xiao
- Department of Orthopaedic Surgery, Guangzhou First People's Hospital, The Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangdong, China
| | - Jiong-Xiang Kuang
- Department of Orthopaedic Surgery, Guangzhou First People's Hospital, The Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangdong, China
| | - Zhong-He Xu
- Department of Orthopaedic Surgery, Guangzhou First People's Hospital, The Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangdong, China
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Ma MW, Gao XS, Xie M, Wang K, Wang D. Integration of Multiparameter MRI into Conventional Pretreatment Risk Factors to Predict Adverse Features after Radical Prostatectomy. Int J Radiat Oncol Biol Phys 2023; 117:e413. [PMID: 37785367 DOI: 10.1016/j.ijrobp.2023.06.1560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The purpose of this study was to Integration of Multiparameter MRI into conventional pretreatment risk factors to develop nomogram for the prediction of adverse features (i.e., positive margin (PM) or extra-prostatic extension (EPE)) indicated for postoperative radiotherapy in patients with prostate cancer. MATERIALS/METHODS We analyzed 203 histologically proven prostate cancer patients underwent preoperative 3T multiparametric MRI including high b value (0, 1500 s/mm2) diffusion-weighted imaging between 2019 and 2022 at our hospital. Patients with a history of neoadjuvant hormonal therapy, or patients whose surgeon's experience was ≤3 years were excluded. Age, surgical technique, serum PSA level, PSA density, clinical T stage, and biopsy Gleason score were clinical predictors. MRI parameters include prostate volume, tumor size, ECE score, seminal vesicle invasion score, tumor location (apex, peripheral region, or bladder neck), apparent diffusion coefficient (ADC), tumor contact length (TCL), PI-RADS score. Predictors were used in nomograms developed from multivariable logistic regression analysis to estimate the probability of positive margin (PM) or extra-prostatic extension (EPE) after RP. The nomogram's predictive accuracy and discriminative ability were determined by the concordance index with calibration and receiver operating characteristic (ROC) curves. RESULTS (1) Patient characters: Table 1 lists the MRI characteristics of the patients. Median PSA level is 17.6ng/ml. All patients received extra-fascial resection. 44% of the patients underwent robotic surgery. 24% of the patients had positive margins. In 226 patients who was clinically confined to the prostate, 100 (44%) had a postoperative pathological upgrade of pT3a or above. 46 (29%) of the 158 patients with biopsy grade group (GG)1 was confirmed GG3-5 after RP. CONCLUSION Using mpMRI parameters and clinicopathological information, we produced nomograms that may accurately predict adverse Features that are indications for postoperative radiotherapy after RP, which may help individualize treatment decision-making.
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Affiliation(s)
- M W Ma
- Department of Radiation Oncology, Peking University First Hospital, Beijing, China
| | - X S Gao
- Department of Radiation Oncology, Peking University First Hospital, Beijing, China
| | - M Xie
- Department of Radiation Oncology, Beijing Hospital, Beijing, China
| | - K Wang
- Department of Radiology, Peking University First Hospital, Beijing, China
| | - D Wang
- Rush University Medical Center, Chicago, IL
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Liu MZ, Li XY, Gao XS, Ma MW, Li HZ, Lyu F, Xie M, Chen J, Ren X, Gao Y. Safety and Efficacy of Radiotherapy Combined with Chemotherapy for Recurrent Metastatic Renal Pelvic and Ureteral Carcinoma. Int J Radiat Oncol Biol Phys 2023; 117:e409. [PMID: 37785357 DOI: 10.1016/j.ijrobp.2023.06.1552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To retrospectively investigate the safety and efficacy of radiotherapy combined with systemic chemotherapy for recurrent metastatic renal pelvic and ureteral carcinoma. MATERIALS/METHODS A total of 109 patients were enrolled in this study, including 44 patients in the Radio-chemotherapy group and 65 patients in the Chemotherapy group. Propensity score matching (PSM) was used to balance the clinical baseline characteristics of the two groups by 1:1 matching. Kaplan-Meier method was used to calculate progression-free survival (PFS) and overall survival (OS) before and after matching. Prognostic factors were analyzed by Cox proportional risk model. Treatment-related adverse events were graded according to the Common Terminology Criteria for Adverse Events (CTCAE), version 5.0. RESULTS The median follow-up time was 14.5 months. Multivariate analysis showed that radiotherapy was a good independent prognostic factor for OS in patients with recurrent metastatic renal pelvic and ureteral carcinoma (HR: 0.327, 95% CI: 0.157∼0.680, P = 0.003). After matching, there were 40 patients in the Radio-chemotherapy group and 40 patients in the Chemotherapy group, and the median PFS and median OS in the Radio-chemotherapy group were better than those in the Chemotherapy group (PFS: 10.4 months vs. 6.7 months, P = 0.035; OS: 43.5 months vs. 18.8 months, P<0.001). The 1-year OS and 2-year OS of the Radio-chemotherapy group were higher than those of the Chemotherapy group (1-year OS: 88.1% vs. 70.4%; 2-year OS: 81.1% vs. 39.3%). In addition, in the Radio-chemotherapy group, patients treated with radiotherapy before first-line chemotherapy failure had longer PFS than those treated with radiotherapy after chemotherapy failure (median PFS: 15.7 months vs. 6 months, P = 0.003). There was no significant difference in the incidence of grade 3∼4 toxicities between the Radio-chemotherapy group and the Chemotherapy group (52.3% vs. 50.8%, P = 0.878). CONCLUSION For patients with advanced renal pelvic and ureteral carcinoma, adding radiotherapy on the basis of systemic chemotherapy is well tolerable and expected to bring long-term survival benefits to patients, and the benefits of early interventional radiotherapy may be more obvious.
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Affiliation(s)
- M Z Liu
- Peking University First Hospital, Beijing, China
| | - X Y Li
- Department of Radiation Oncology, Peking University First Hospital, Beijing, China
| | - X S Gao
- Department of Radiation Oncology, Peking University First Hospital, Beijing, China
| | - M W Ma
- Department of Radiation Oncology, Peking University First Hospital, Beijing, China
| | - H Z Li
- Department of Radiation Oncology, Peking University First Hospital, Beijing, China
| | - F Lyu
- Department of Radiation Oncology, Peking University First Hospital, Beijing, China
| | - M Xie
- Department of Radiation Oncology, Beijing Hospital, Beijing, China
| | - J Chen
- Department of Radiation Oncology, Peking University First Hospital, Beijing, China
| | - X Ren
- Department of Radiation Oncology, Peking University First Hospital, Beijing, China
| | - Y Gao
- Department of Radiation Oncology, Peking University First Hospital, Beijing, China
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Qin SB, Gao XS, Yu W, Zhang CJ, Hao H, Yao L, Bai Y, Li HZ, He ZS, Wang D. Stereotactic Ablative Radiotherapy Boost to Bladder Tumor for Bladder Preservation in Patients with Muscle-Invasive Bladder Cancer. Int J Radiat Oncol Biol Phys 2023; 117:S111. [PMID: 37784292 DOI: 10.1016/j.ijrobp.2023.06.438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Previous studies showed that selective bladder-sparing approach using TMT is an established therapy of MIBC with outcomes that are comparable to those of radical cystectomy. However, it has been shown that the 5-year local recurrence in the bladder is greater than 40% after TMT. One of the possible reasons was that the RT dose to the bladder tumor or tumor bed was insufficient. Thus, we assessed the effectiveness and safety of Stereotactic Ablative Radiotherapy (SABR) boost to bladder tumor or tumor bed for patients with muscle invasive bladder cancer (MIBC). MATERIALS/METHODS A total of 59 consecutive patients with cT2-4 bladder cancer underwent transurethral resection of bladder tumor (TURBT). TURBT was visibly complete in 25 cases. Patients received SABR to the tumor or tumor bed in the bladder followed by conventionally fractionated RT (CFRT) to pelvis and total bladder with concomitant weekly radio-sensitizing chemotherapy. During SABR intravesical installation of isovolumetric saline through urinary catheter ensured adequate bladder filling. Response rate was assessed by cystoscopic evaluation and pelvic MRI or CT. Toxicities were reported per the RTOG acute and late Radiation Morbidity Scoring Schema. RESULTS The median age of all patients was 76 years (35-90 years). All patients completed SBRT boost and 61% patients received concurrent Gemcitabine chemotherapy. After a median follow-up time of 28 months, the rate of local control (LC) at 3 years was 90.0%. The overall survival (OS) and cancer-specific survival (CSS) rates at 3 years were 61.6% and 77.5%, respectively. Of the surviving patients, 84.4% have a disease-free and functioning bladder. Acute grade 3 gastrointestinal (GI) or genitourinary (GU) toxicities occurred in only 1.7% of the patients. Late grade 3 GU toxicity occurred in 5.1% of the patients. No patients experienced grade 4 GI or GU toxicities. CONCLUSION SABR boost followed by chemoradiation to the pelvis was found to be a well-tolerated and effective treatment for MIBC patients who are either not candidates for cystectomy or who desire bladder preservation. Randomized study is required to further evaluate this novel tri-modality treatment paradigm.
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Affiliation(s)
- S B Qin
- Department of Radiation Oncology, Peking University First Hospital, Beijing, China
| | - X S Gao
- Department of Radiation Oncology, Peking University First Hospital, Beijing, China
| | - W Yu
- Department of Urology, Peking University First Hospital, Beijing, China
| | - C J Zhang
- Department of Urology, Peking University First Hospital, Beijing, China
| | - H Hao
- Department of Urology, Peking University First Hospital, Beijing, China
| | - L Yao
- Department of Urology, Peking University First Hospital, Beijing, China
| | - Y Bai
- Department of Radiation Oncology, Peking University First Hospital, Beijing, China
| | - H Z Li
- Department of Radiation Oncology, Peking University First Hospital, Beijing, China
| | - Z S He
- Department of Urology, Peking University First Hospital, Beijing, China
| | - D Wang
- Rush University Medical Center, Chicago, IL
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Ma MW, Gao XS, Li HZ, Li XY, Yu W, Wu SK. Effect of Adjuvant Chemotherapy in Highly Malignant Non-Metastatic Prostate Cancer: An Interim Analysis of Non-Randomized Comparative Trials. Int J Radiat Oncol Biol Phys 2023; 117:e412-e413. [PMID: 37785366 DOI: 10.1016/j.ijrobp.2023.06.1559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Gleason grade group 5 (GG5) prostate cancers is aggressive with high metastatic rates and is not sensitive to androgen deprivation therapy (ADT). Even the presence of a limited (tertiary) Gleason pattern 5 component may have high aggressive biological behavior. This study aims to prospectively evaluate whether a non-androgen receptor pathway therapy - adjuvant chemotherapy could improve clinical outcomes among non-metastatic prostate cancer with the above highly malignant characters. MATERIALS/METHODS This prospective non-randomized clinical trial included non-metastatic prostate cancer patients with pathologically proven Gleason score of 9-10 or tertiary Gleason pattern 5. Each subject was allowed to decide whether to receive four to six cycles chemotherapy of docetaxel after receiving a standard treatment (i.e., radical surgery ± radiotherapy or radical radiotherapy combined with long-term ADT). The primary endpoint was event-free survival (EFS). Event was defined as any of biochemical failure or imaging failure, or change of systemic therapy due to PSA arises, or death. The secondary end points were distant metastasis-free survival (MFS), overall survival (OS), and treatment-related adverse events. RESULTS A total of 188 consecutive patients were enrolled from November 2019 to November 2022. Median prostate-specific antigen was 26.6 ng/ml. 52% had T3b to T4 disease, 27% had N1 disease. 140 patients received standard therapy only, and 48 patients received adjuvant chemotherapy after radical therapy. The median follow-up time was 18.4 (3.0-36.7) months. The estimated 36-month EFS of the chemotherapy group and the control group were 94.7% vs. 72.8% (p = 0.044). There were 1 event who added novel endocrine therapy in the chemotherapy group, and 21 events in the control group, including 6 cases of biochemical recurrence and 9 cases of lymph node and distant metastasis, 4 cases that changed systemic therapy and 2 cases died. The MFS of the two groups at 36 months were 100% and 90.7%, respectively (P = 0.143). After the 1:1 propensity score match, the EFS and MFS of the two groups were 94.7% and 80.8% (P = 0.069), and 100% and 93.1% (P = 0.132), respectively. The urinary toxicity of grade 2 and 3 in the chemotherapy group and the control group were 4.2% and 7.1% (P = 0.134) while the grade 2 rectal toxicity were 5.0% and 10.4% (P = 0.317), respectively. No grade 4 toxicity occurred. Considering the chemotherapy-related side effects, grade 3 or above toxicity were leukopenia (41.7%), alopecia (27.1%), thrombocytopenia (2.1%) and edema (2.1%). CONCLUSION Results of this interim analysis shows that the addition of adjuvant chemotherapy after standard radical therapy tends to improve the overall recurrence and metastasis free survival of patients with highly malignant prostate cancer, and the adverse effects are tolerable, which should be confirmed by long-term follow-up results.
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Affiliation(s)
- M W Ma
- Department of Radiation Oncology, Peking University First Hospital, Beijing, China
| | - X S Gao
- Department of Radiation Oncology, Peking University First Hospital, Beijing, China
| | - H Z Li
- Department of Radiation Oncology, Peking University First Hospital, Beijing, China
| | - X Y Li
- Department of Radiation Oncology, Peking University First Hospital, Beijing, China
| | - W Yu
- Department of Urology, Peking University First Hospital, Beijing, China
| | - S K Wu
- PEKING UNIVERSITY FIRST HOSPITAL, BEIJING, China
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Ma MW, Gao XS, Li HZ, Yang KW, Yu W, He ZS, Bai Y, Chen J, Wang ZS. Outcomes of Targeted Therapy Plus Immunotherapy and High-Dose Stereotactic Ablative Body Radiotherapy (SABR) for Metastatic Renal Cell Cancer Patients. Int J Radiat Oncol Biol Phys 2023; 117:e412. [PMID: 37785365 DOI: 10.1016/j.ijrobp.2023.06.1558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Stereotactic ablative body radiotherapy (SABR) is one of the treatment options for metastatic renal cell carcinoma (mRCC) but is limited by a lack of data to evaluate targeted therapy plus immunotherapy concurrently with high-dose SABR to multiple sites. We evaluated the safety and disease control for mRCC patients who concurrently received the above tri-modality treatment. MATERIALS/METHODS Patients were treated with SABR (40-70 Gy/5-10 fractions) for small lesions or partial-SABR (tumor center boosted with 6-8 Gy/3-5 fractions with 50-60 Gy/20-25 fractions to the whole tumor volume) for bulky tumors or tumors adjacent to critical organs. When SABR/partial-SABR was not feasible, a moderate fractionated radiotherapy plan, usually 60Gy/20 fractions were applied. of Targeted therapy plus immunotherapy (PD-1 inhibitor) was not interrupted during or after radiotherapy (RT). Adverse events (AEs) were evaluated. Disease control rate (DCR), objective response rate (ORR), progression-free survival (PFS) and overall survival (OS) were calculated. The PFS1 was defined as the first progression since the start of RT. The PFS2 was defined as the second progression after the second RT course, if new metastases occurred after first RT were all re-irradiated, and the systemic therapy was not changed. The Kaplan-Meier method was used for time-to-event endpoints. RESULTS A total of 51 patients, with a median age of 57 yr, were enrolled. The median follow-up was 12 months. There were 75% of patients with intermediate-risk and 18% with favorable-risk disease. 61% of the patients were oligometastatic. 71% had clear cell renal cancer. There were 241 metastases while 161 (67%) were irradiated. 80% of the lesions received SABRP/partial SABR. 1 patient with 14 lesions irradiated received proton therapy. All the surviving patients are continuing using targeted therapy while 81% patients complete at least 1-year PD-1 therapy. 10 patients (20%) had grade 3 drug-related AEs: pneumonitis (n = 2), elevated alanine transaminase (n = 4), myositis (n = 1), hand-foot syndrome myositis (n = 1), enteritis (n = 1), fatigue (n = 1). There were 1 grade 4 AEs of upper gastrointestinal bleeding. No grade 3-5 RT-related AEs was found. ORR and DCR for irradiated lesion were 51% and 98%. Median OS and PFS2 was not reached. Median PFS1 was 14(6-22) months. Estimated 1- and 2-yr OS, PFS1 and PFS2 were 90% and 90%, 56% and 38%, 74% and 51% respectively. Univariate analysis showed that an PFS1 benefit was found in patients who received radiation before systemic therapy failure (p = 0.038). CONCLUSION We investigated the high-dose RT in combination of concurrent targeted and immunotherapy in patients with metastatic RCC. We found that this treatment regimen was well tolerated, with good cancer control. Early use of high-dose RT to multi-lesions may improve PFS. Partial-SABR for bulky lesions close to critical organs could be safely and effectively applied under certain circumstances. These encouraging findings warrant further investigation.
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Affiliation(s)
- M W Ma
- Department of Radiation Oncology, Peking University First Hospital, Beijing, China
| | - X S Gao
- Department of Radiation Oncology, Peking University First Hospital, Beijing, China
| | - H Z Li
- Department of Radiation Oncology, Peking University First Hospital, Beijing, China
| | - K W Yang
- Department of Urology, Peking University First Hospital, Beijing, China
| | - W Yu
- Department of Urology, Peking University First Hospital, Beijing, China
| | - Z S He
- Department of Urology, Peking University First Hospital, Beijing, China
| | - Y Bai
- Department of Radiation Oncology, Peking University First Hospital, Beijing, China
| | - J Chen
- Department of Radiation Oncology, Peking University First Hospital, Beijing, China
| | - Z S Wang
- Hebei Yizhou Proton Center, Zhuozhou, China
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Huang JW, Yang YF, Gao XS, Xu ZH. A single preoperative low-dose dexamethasone may reduce the incidence and severity of postoperative delirium in the geriatric intertrochanteric fracture patients with internal fixation surgery: an exploratory analysis of a randomized, placebo-controlled trial. J Orthop Surg Res 2023; 18:441. [PMID: 37337260 DOI: 10.1186/s13018-023-03930-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 06/13/2023] [Indexed: 06/21/2023] Open
Abstract
OBJECTIVE Postoperative delirium (POD) is a common complication along with poor prognosis in geriatric intertrochanteric fracture (ITF) patients. However, the prevention and treatment of POD remain unclear. Previous studies have confirmed that POD is essentially a consequence of neuro-inflammatory responses. Dexamethasone is a glucocorticoid with comprehensive anti-inflammatory effects, while a high dose of dexamethasone correlates with many side effects or even adverse consequences. Thus, this prospective study aims to discuss whether a single preoperative low-dose dexamethasone can reduce the impact of POD on geriatric ITF patients with internal fixation surgery. METHODS Between June 2020 and October 2022, there were 219 consecutive ITF patients assessed in our department. Of the 219 ITF patients, 160 cases who met the inclusion and exclusion criteria were finally enrolled and randomly allocated to the dexamethasone group and the placebo group (80 geriatric ITF patients in each group) in this prospective study. The patients in the dexamethasone group received intravenous 10 mg (2 ml) dexamethasone while the patients in the placebo group received intravenous 2 ml saline in 30 min before being sent to the operating room, respectively. The baseline characteristics, surgical information, incidence and severity of POD as the efficacy-related outcomes, and infection events and hyperglycemia as safety-related outcomes (adverse events), were collected and analyzed between the two groups. The severity of POD was evaluated by Memorial Delirium Assessment Scale (MDAS) score. RESULTS There were no differences in baseline characteristics and surgical information between the dexamethasone group and the placebo group. The dexamethasone group had a lower incidence of POD than the placebo group within the first 5 days after surgery [(9/80, 11.3% vs. 21/80, 26.3%, RR = 0.83, 95% CI 0.71-0.97, P = 0.015]. The dexamethasone group had lower MDAS scores (Mean ± SD) than the placebo group [13.2 ± 1.0 (range 11 to 15) vs. 15.48 ± 2.9 (range 9 to 20), P = 0.011, effect size = 0.514]. There were no differences in infection events and hyperglycemia between the two groups. CONCLUSIONS A single preoperative low-dose dexamethasone may reduce the incidence and severity of POD in geriatric ITF patients with internal fixation surgery. TRIAL REGISTRATION ChiCTR2200055281.
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Affiliation(s)
- Jian-Wen Huang
- Department of Orthopaedic Surgery, Guangzhou First People's Hospital, The Second Affiliated Hospital, School of Medicine, South China University of Technology, 1 Panfu Road, Guangzhou, 510180, Guangdong, China
| | - Yun-Fa Yang
- Department of Orthopaedic Surgery, Guangzhou First People's Hospital, The Second Affiliated Hospital, School of Medicine, South China University of Technology, 1 Panfu Road, Guangzhou, 510180, Guangdong, China.
| | - Xiao-Sheng Gao
- Department of Orthopaedic Surgery, Guangzhou First People's Hospital, The Second Affiliated Hospital, School of Medicine, South China University of Technology, 1 Panfu Road, Guangzhou, 510180, Guangdong, China
| | - Zhong-He Xu
- Department of Orthopaedic Surgery, Guangzhou First People's Hospital, The Second Affiliated Hospital, School of Medicine, South China University of Technology, 1 Panfu Road, Guangzhou, 510180, Guangdong, China
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Yang YF, Huang JW, Gao XS, Xu ZH. Standardized Tip-Apex Distance (STAD): a modified individualized measurement of cephalic fixator position based on its own femoral head diameter in geriatric intertrochanteric fractures with internal fixation. BMC Musculoskelet Disord 2023; 24:189. [PMID: 36915071 PMCID: PMC10009924 DOI: 10.1186/s12891-023-06286-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 03/02/2023] [Indexed: 03/16/2023] Open
Abstract
OBJECTIVE To design a standardized Tip-Apex Distance (STAD) and analyze the clinical significance of STAD in predicting cut-out in geriatric intertrochanteric fractures with internal fixation. METHODS Firstly, we designed STAD according to the rule of TAD. We measured the STAD individually based on its own femoral head diameter (iFHD) instead of the known diameter of the lag screw in calculating TAD, resulting in that the STAD is simply the relative quantitation relationship of iFHD (the times of iFHD). In this study, we assumed that all the iFHD was 6D (1iFHD = 6D, or 1D = 1/6 of iFHD) in order for complete match of the Cleveland zone system, easy comparison of the STAD, and convenient identification for artificial intelligence. Secondly, we calculated and recorded all the STAD of cephalic fixator in 123 eligible ITF patients. Thirdly, we grouped all the ITF patients into the Failure and Non-failure groups according to whether cut-out or not, and analyzed the correlation between the cut-out and the STAD. RESULTS Cleveland zone, Parker's ratio (AP), TAD, and STAD were associated with the cut-out in univariate analysis. However, only STAD was the independent predictor of the cut-out by multivariate analysis. No cut-out was observed when STAD ≤ 2D (1/3 of iFHD). The Receiver Operating Characteristic (ROC) curve indicated that STAD was a reliable predictor of cut-out, and the best cut-off value of STAD was 2.92D. Cut-out rate increased dramatically when STAD increased, especially when STAD > 3D (1/2 of iFHD). CONCLUSION Essentially, the STAD is a relative quantitation relationship of iFHD. The STAD is a reliable measurement of cephalic fixator position in predicting cut-out in geriatric ITF patients with single-screw cephalomedullary nail fixations. For avoiding cut-out, the STAD should be no more than a half of iFHD. LEVEL OF EVIDENCE Level III, Prognostic Study.
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Affiliation(s)
- Yun-Fa Yang
- Department of Orthopaedic Surgery, the Second Affiliated Hospital, School of Medicine, Guangzhou First People's Hospital, South China University of Technology, 1 Panfu Road, 510180, Guangzhou, Guangdong, China.
| | - Jian-Wen Huang
- Department of Orthopaedic Surgery, the Second Affiliated Hospital, School of Medicine, Guangzhou First People's Hospital, South China University of Technology, 1 Panfu Road, 510180, Guangzhou, Guangdong, China
| | - Xiao-Sheng Gao
- Department of Orthopaedic Surgery, the Second Affiliated Hospital, School of Medicine, Guangzhou First People's Hospital, South China University of Technology, 1 Panfu Road, 510180, Guangzhou, Guangdong, China
| | - Zhong-He Xu
- Department of Orthopaedic Surgery, the Second Affiliated Hospital, School of Medicine, Guangzhou First People's Hospital, South China University of Technology, 1 Panfu Road, 510180, Guangzhou, Guangdong, China
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Huang JW, Gao XS, Yang YF. Risk factors for cut-outs in geriatric intertrochanteric fractures with cephalomedullary nailing after obtaining acceptable reduction: a case-control study. BMC Musculoskelet Disord 2022; 23:354. [PMID: 35414068 PMCID: PMC9004191 DOI: 10.1186/s12891-022-05296-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 04/01/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It is irresponsible if we disregard reduction quality to talk about cut-outs in intertrochanteric fractures (ITF) with internal fixation. The aim of this study is to analyze the risk-factors for cut-outs in geriatric ITF with cephalomedullary nailing after obtaining acceptable reduction. METHODS In order to investigate the risk-factors for cut-outs in geriatric ITF after obtaining acceptable reduction, we retrospectively reviewed 367 patients who underwent cephalomedullary nail for ITF in our department between September 2016 and December 2021. Potential variables including demographic data and radiological parameters (namely the fracture type, Singh index, lateral wall fracture, cephalic nail position, Parker's ratio index, tip-apex-distance (TAD), and calcar-referenced TAD (CalTAD)) were collected. Logistic regression analysis was performed to identify the significant risk factors for cut-outs. RESULTS One hundred twenty-one patients were suitable for this study. Of the 121 cases, nine cases (7.4%) were observed with cut-out or pending cut-out. We found that Age (adjusted odds ratio (OR) 1.158, 95% confidence interval (CI) 1.016 to 1.318, p = 0.028), lateral wall fracture (adjusted OR 11.07, 95%CI 1.790 to 68.380, p = 0.01), and CalTAD (adjusted OR 1.277, 95%CI 1.005 to 1.622, p = 0.045) were independent risk-factors for cut-outs. CONCLUSIONS Age, lateral wall fracture and CalTAD are independent risk-factors for cut-outs in geriatric ITF with cephalomedullary nailing after obtaining acceptable reduction. In order to avoid cut-outs, an optimal CalTAD is necessary even obtaining acceptable reduction, especially in the over-aged patients with lateral wall fracture.
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Affiliation(s)
- Jian-Wen Huang
- Department of Orthopaedic Surgery, Guangzhou First People's Hospital, the Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, 510180, People's Republic of China
| | - Xiao-Sheng Gao
- Department of Orthopaedic Surgery, Guangzhou First People's Hospital, the Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, 510180, People's Republic of China
| | - Yun-Fa Yang
- Department of Orthopaedic Surgery, Guangzhou First People's Hospital, the Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, 510180, People's Republic of China.
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Yang YF, Huang JW, Gao XS. CalTAD is the Key Evaluation Tool for Measurement of Cephalic Fixation Position for Predicting Cut-Out in Geriatric Intertrochanteric Fracture Patients with Internal Fixations after Achieving Acceptable Reduction. Geriatr Orthop Surg Rehabil 2022; 13:21514593221083820. [PMID: 35386949 PMCID: PMC8977687 DOI: 10.1177/21514593221083820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 02/02/2022] [Accepted: 02/09/2022] [Indexed: 11/16/2022] Open
Abstract
Objective To discover the key evaluation tool of the cephalic fixation position for
predicting implant failures in geriatric intertrochanteric fracture (ITF)
patients treated with internal fixations after achieving an acceptable
reduction. Methods We measured the geriatric ITF patients undergoing single-screw
cephalomedullary nailing (CMN) fixation surgery after obtaining the
acceptable reduction (including anatomical reduction and positive medial
cortex support reduction) in our treatment group between September 2016 and
March 2020 by using four kinds of cephalic fixation position evaluation
tools including Cleveland zone system, Parker’s ratio index, tip–apex
distance (TAD), calcar-referenced TAD (CalTAD), and analyzed which were the
key evaluation tools for measurement of cephalic fixation position for
prediction of implant failures in geriatric ITF patients with internal
fixations. Results Seventy-four ITF patients treated with single-screw CMN fixation after
obtaining the acceptable reduction were enrolled in this study. Of the 74
patients, nine cases were observed with implant failures. There were six
cases of cut-out and three of pending cut-out. We found that TAD (odds ratio
(OR)=1.149; 95% confidence interval (CI), 1.00–1.32; P=.046) and CalTAD
(OR=1.140; 95% CI, 1.00–1.30; P=.037) were risk factors for implant failures
by univariate analysis, while only CalTAD (OR=1.200; 95% CI, 1.032–1.395;
P=.018) was the independent risk factor for implant failures by multivariate
analysis. The Kappa coefficient (κ) of CalTAD was .976 (95% CI, .966–.984)
by ICC analysis. The ROC analysis showed that the best cut-off value of
CalTAD was 23.76 mm with a sensitivity of 77.8% and specificity of 72.3%
(area under the curve, AUC =.775; P = .001). Conclusions CalTAD is the key evaluation tool for measurement of cephalic fixation
position for predicting implant failures in geriatric ITF patients treated
with single-screw CMN after obtaining the acceptable reduction.
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Affiliation(s)
- Yun-Fa Yang
- Department of Orthopaedic Surgery, Guangzhou First People's Hospital, the Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangdong, China
| | - Jian-Wen Huang
- Department of Orthopaedic Surgery, Guangzhou First People's Hospital, the Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangdong, China
| | - Xiao-Sheng Gao
- Department of Orthopaedic Surgery, Guangzhou First People's Hospital, the Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangdong, China
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Huang JW, Gao XS, Yang YF. Early prediction of implant failures in geriatric intertrochanteric fractures with single-screw cephalomedullary nailing fixation. Injury 2022; 53:576-583. [PMID: 34973829 DOI: 10.1016/j.injury.2021.12.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 12/17/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The implant failures of intertrochanteric fractures (ITF) after single-screw cephalomedullary nailing (CMN) were multifactorially associated with various related factors. However, a comprehensive scoring system for the early prediction of implant failures is still lacking. Thus, this study aims to establish a quantification scoring system (QSS) and verify whether the QSS is reliable for predicting implant failures in geriatric ITF patients. METHODS We established the QSS of geriatric ITF with single-screw cephalomedullary nailing within three days after surgery. The QSS included eight points totally at eight parameters, including bone quality, fracture type, reduction quality, and internal fixation placement. Then we retrospectively analyzed seventy-seven ITF (seventy-six patients) with surgical treatment between October 2016 and July 2020 in our hospital to verify whether the QSS scoring is suitable for predicting implant failures in ITF patients. RESULTS Implant failures were in fifteen fractures (fifteen patients), including six cases of cut-out, eight of pending cut-out, and one of cut-through. There were three cases with 2 points in QSS, three with 3 points, five with 4 points, four with 5 points in these fifteen fractures. No fractures were with 1 point in QSS, and no implant failures when scoring over 5 points in QSS. Except for QSS scoring, no significant difference was in the collected data by binary logistic regression analysis. QSS scoring was significantly associated with implant failures (Adjusted odds ratio (OR) = 7.312; 95% confidence intervals (CI), 2.561 to 20.871; p < 0.001). In the analysis of Spearman's correlation, there was a strong correlation between QSS scoring and the occurrences of implant failures (RQSS = -0.964, p < 0.001). The ROC result indicated that QSS was reliable in predicting implant failures at the cut-off of 5 points (AUC (the area under the curve) = 0.944; 95% CI, 0.866 to 0.983; p < 0.001). CONCLUSION The QSS is a useful early prediction of implant failures in geriatric ITF with cephalomedullary nailing fixation. QSS scoring more than 5 points can effectively reduce the risk of implant failures.
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Affiliation(s)
- Jian-Wen Huang
- Department of Orthopaedic Surgery, Guangzhou First People's Hospital, the Second Affiliated Hospital, School of Medicine, South China University of Technology, 1 Panfu Road, Guangzhou, Guangdong 510180, China
| | - Xiao-Sheng Gao
- Department of Orthopaedic Surgery, Guangzhou First People's Hospital, the Second Affiliated Hospital, School of Medicine, South China University of Technology, 1 Panfu Road, Guangzhou, Guangdong 510180, China
| | - Yun-Fa Yang
- Department of Orthopaedic Surgery, Guangzhou First People's Hospital, the Second Affiliated Hospital, School of Medicine, South China University of Technology, 1 Panfu Road, Guangzhou, Guangdong 510180, China.
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Yang YF, Wang JW, Gao XS, Huang JW, Xu ZH. Joint Salvage and Biological Repair of Massive-Cavity Bone Defects After Extensive Curettage of Campanacci Grade II or III Giant Cell Tumor Around the Knee With Vascularized Fibular Autograft and Cancellous Allograft. Ann Plast Surg 2021; 87:537-541. [PMID: 34176896 DOI: 10.1097/sap.0000000000002893] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of the study was to report the clinical outcomes of repair of massive-cavity bone defects after extensive curettage of Campanacci grade II or III giant cell tumor (GCT) around knee with vascularized fibular autograft and cancellous allograft. METHODS There were 12 consecutive patients with Campanacci grade II or III GCT around knee treated in our department between 2004 and 2016. All the patients underwent clinical evaluation, plain radiography, and/or magnetic resonance imaging of the knee right after admission. To preserve their knee function, we repaired the massive-cavity bone defects after extensive curettage of GCT by vascularized fibular autografts and cancellous allograft. All the patients were evaluated through clinical examinations, plain radiography of the knee and chest, and Musculoskeletal Tumor Society (MSTS) scores of the lower extremity in the follow-ups. RESULTS The follow-up ranged from 1.5 to 12.0 years (mean, 4.2 years). There were no local recurrences or lung metastasis in any of the 12 patients at the last follow-up. Ten patients had no pain or experienced occasional pain, and 9 were able to resume their previous work. The mean range of motion of knee flexion was 117 degrees, and the extension was -6 degrees. The mean MSTS score was 24.7, and a total of 10 patients had excellent or good MSTS scores. CONCLUSIONS It is reliable to achieve knee joint salvage and repair massive-cavity bone defects after extensive curettage with vascularized fibular autograft and cancellous allograft in patients with Campanacci grade II or III GCT around the knee.
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Affiliation(s)
- Yun-Fa Yang
- From the Department of Orthopaedic Surgery, Guangzhou First People's Hospital, the Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, People's Republic of China
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Yang YF, Gao XS, Liu ZL, Huang JW, Wang JW, Xu ZH. Repair of Small-Size Wound With Achilles Tendon Exposure With Proximal Pedicled Cutaneous Neurovascular Flap. Ann Plast Surg 2021; 87:457-460. [PMID: 33512822 DOI: 10.1097/sap.0000000000002730] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate the clinical outcomes associated with repairing of small-sized wounds of Achilles tendon exposure with proximal pedicled cutaneous neurovascular flap in the dorsolateral foot. METHODS After thorough debridement, 16 cases with small-sized wounds of Achilles tendon exposure were repaired by proximal pedicled cutaneous neurovascular flap of the dorsolateral foot, and their clinical outcomes were observed. RESULTS All the flaps in the 16 cases survived completely, excluding the marginal part necrosis in 1 case, and all the wounds were healed. The 2-point discrimination of the flaps was 14.53 ± 1.55 mm (range, 12-17 mm) in patients without sural nerve injury after 3 to 18 months follow-up. No discomfort was felt in wearing normal shoes by all the 16 patients. CONCLUSIONS It is reasonable to repair the small-sized wounds of Achilles tendon exposure with proximal pedicled cutaneous neurovascular flap of dorsolateral foot due to its effective repair of the wound, relatively uncomplicated surgery, and had satisfactory healing recovery.
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Affiliation(s)
- Yun-Fa Yang
- From the Department of Orthopaedic Surgery, Guangzhou First People's Hospital, the Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, P.R. China
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Yang YF, Huang JW, Gao XS, Liu ZL, Wang JW, Xu ZH. The Correlation Between Timing of Surgery and the Need for RBC Transfusions in the Geriatric Intertrochanteric Fracture Population. Geriatr Orthop Surg Rehabil 2021; 12:2151459321998614. [PMID: 33717635 PMCID: PMC7917848 DOI: 10.1177/2151459321998614] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 01/02/2021] [Accepted: 01/04/2021] [Indexed: 01/27/2023] Open
Abstract
Objective: To identify whether the timing of surgery affects red blood cell (RBC)
transfusion requirements in the elderly with intertrochanteric
fractures. Methods: We retrospectively studied all patients undergoing surgical fixation of their
intertrochanteric fractures in our hospital between January 2009 and
December 2018 and analyzed the relationship between the timing of surgery
and RBC transfusion. Results: A total of 679 patients were included in this study. The need for RBC
transfusion was lower in the patients who underwent surgery within 12 h
after admission (timing of surgery <12 h, <12 h group) than those who
underwent surgery over 12 h after admission (timing of surgery >12 h,
>12 h group) (P = 0.046); lower in the the patients who underwent surgery
within 24 h after admission (timing of surgery <24 h, <24 h group)
than in those who underwent surgery over 24 h after admission (timing of
surgery >24 h, >24 h group) (P = 0.008), and lower in the <24 h
group compared to the patients who underwent surgery within 48 h after
admission (timing of surgery <48 h, <48 h group) (P = 0.035).
Moreover, the need for RBC transfusion was lower in the <24 h group (in
the first 24 h from admission to surgery) than in the 24-48 h group (in the
second 24 h from admission to surgery) (P = 0.016), and also lower in the
<24 h group compared to the 48-72 h group (in the third 24 h from
admission to surgery) (P = 0.047). However, there were no differences
between the <12 h group and 12-24 h group, between the <12 h group and
<24 h group, and between the 12-24 h group and <24 h group,
respectively. Conclusion: Timing of surgery within 24 h contributes to the reduction of RBC transfusion
in the elderly with intertrochanteric fractures.
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Affiliation(s)
- Yun-Fa Yang
- Guangzhou First People's Hospital, Guangzhou, China
| | | | | | - Zai-Li Liu
- Guangzhou First People's Hospital, Guangzhou, China
| | | | - Zhong-He Xu
- Guangzhou First People's Hospital, Guangzhou, China
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Zhang XM, Liu RM, Jin Z, Liu TT, Chen DY, Fan Z, Zeng M, Lu XB, Gao XS, Qin MH, Liu JM. Phase transitions in the classical exchange-anisotropic Kitaev-Heisenberg model. Phys Rev E 2020; 102:042132. [PMID: 33212739 DOI: 10.1103/physreve.102.042132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 10/10/2020] [Indexed: 06/11/2023]
Abstract
The Kitaev model on the honeycomb lattice has been receiving substantial attention due to the discovery of quantum spin liquid state associated with this model. Consequently, its classical partners such as the Kitaev-Heisenberg (KH) model and associated phase transitions become concerned. Specifically, an intermediate Kosterlitz-Thouless (KT) phase engaged in the transition from the high-temperature (T) disordered state to the low-T sixfold degenerate state is predicted in the isotropic KH model [Phys. Rev. Lett. 109, 187201 (2012)10.1103/PhysRevLett.109.187201], but so far no sufficient experimental proof has been reported. In this work, we consider an essential extension of this KH model on the honeycomb lattice by including the Kitaev exchange anisotropy that is non-negligible in realistic materials. The associated phase transitions are thus investigated using the Monte Carlo simulations. It is found that such an anisotropy will result in a degradation of the sixfold degeneracy of the ground state in the isotropic KH model down to the fourfold or twofold degenerate ground state, and the finite-T phase transitions will also be modified remarkably. Interestingly, the intermediate KT phase can be suppressed by this Kitaev exchange anisotropy. This work thus provides a more realistic description of the physics ingredient with the KH model and presents a possible explanation on absence of the intermediate phase in real materials where the Kitaev exchange anisotropy can be more or less available.
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Affiliation(s)
- X M Zhang
- Guangdong Provincial Key Laboratory of Quantum Engineering and Quantum Materials, and Institute for Advanced Materials, South China Academy of Advanced Optoelectronics, South China Normal University, Guangzhou 510006, China
| | - R M Liu
- Guangdong Provincial Key Laboratory of Quantum Engineering and Quantum Materials, and Institute for Advanced Materials, South China Academy of Advanced Optoelectronics, South China Normal University, Guangzhou 510006, China
| | - Z Jin
- Guangdong Provincial Key Laboratory of Quantum Engineering and Quantum Materials, and Institute for Advanced Materials, South China Academy of Advanced Optoelectronics, South China Normal University, Guangzhou 510006, China
| | - T T Liu
- Guangdong Provincial Key Laboratory of Quantum Engineering and Quantum Materials, and Institute for Advanced Materials, South China Academy of Advanced Optoelectronics, South China Normal University, Guangzhou 510006, China
| | - D Y Chen
- Guangdong Provincial Key Laboratory of Quantum Engineering and Quantum Materials, and Institute for Advanced Materials, South China Academy of Advanced Optoelectronics, South China Normal University, Guangzhou 510006, China
| | - Z Fan
- Guangdong Provincial Key Laboratory of Quantum Engineering and Quantum Materials, and Institute for Advanced Materials, South China Academy of Advanced Optoelectronics, South China Normal University, Guangzhou 510006, China
| | - M Zeng
- Guangdong Provincial Key Laboratory of Quantum Engineering and Quantum Materials, and Institute for Advanced Materials, South China Academy of Advanced Optoelectronics, South China Normal University, Guangzhou 510006, China
| | - X B Lu
- Guangdong Provincial Key Laboratory of Quantum Engineering and Quantum Materials, and Institute for Advanced Materials, South China Academy of Advanced Optoelectronics, South China Normal University, Guangzhou 510006, China
| | - X S Gao
- Guangdong Provincial Key Laboratory of Quantum Engineering and Quantum Materials, and Institute for Advanced Materials, South China Academy of Advanced Optoelectronics, South China Normal University, Guangzhou 510006, China
| | - M H Qin
- Guangdong Provincial Key Laboratory of Quantum Engineering and Quantum Materials, and Institute for Advanced Materials, South China Academy of Advanced Optoelectronics, South China Normal University, Guangzhou 510006, China
| | - J-M Liu
- Guangdong Provincial Key Laboratory of Quantum Engineering and Quantum Materials, and Institute for Advanced Materials, South China Academy of Advanced Optoelectronics, South China Normal University, Guangzhou 510006, China
- Laboratory of Solid State Microstructures, Nanjing University, Nanjing 210093, China
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Cai WP, Yan ZR, Liu RM, Qin MH, Zeng M, Lu XB, Gao XS, Liu JM. Magnetic impurity doping induced spin-glass state and short-range zigzag order in the honeycomb iridate Na 2IrO 3. J Phys Condens Matter 2017; 29:405806. [PMID: 28695843 DOI: 10.1088/1361-648x/aa7eec] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Based on the modified Heisenberg-Kitaev model, the effects of magnetic substitution on the magnetic properties of the honeycomb-lattice iridate [Formula: see text] [Formula: see text] are studied using Monte Carlo simulations. It is observed that the long-range zigzag state of the original system is rather fragile and can be replaced by a spin-glass state even for small substitution, well consistent with the experimental observation in Ru-substituted samples (Mehlawat et al 2015 Phys. Rev. B 92 134412). Both the disordered Heisenberg and Kitaev interactions caused by the magnetic ion-doping are suggested to be responsible for the magnetic phase transitions in the system. More interestingly, a short-range zigzag order is suggested to survive above the freezing temperature even at high magnetic impurity doping levels.
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Affiliation(s)
- W P Cai
- Institute for Advanced Materials, South China Academy of Advanced Optoelectronics and Guangdong Provincial Key Laboratory of Quantum Engineering and Quantum Materials, South China Normal University, Guangzhou 510006, People's Republic of China
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Liu RM, Zhuo WZ, Chen J, Qin MH, Zeng M, Lu XB, Gao XS, Liu JM. Ashkin-Teller criticality and weak first-order behavior of the phase transition to a fourfold degenerate state in two-dimensional frustrated Ising antiferromagnets. Phys Rev E 2017; 96:012103. [PMID: 29347150 DOI: 10.1103/physreve.96.012103] [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: 12/23/2016] [Indexed: 11/07/2022]
Abstract
We study the thermal phase transition of the fourfold degenerate phases (the plaquette and single-stripe states) in the two-dimensional frustrated Ising model on the Shastry-Sutherland lattice using Monte Carlo simulations. The critical Ashkin-Teller-like behavior is identified both in the plaquette phase region and the single-stripe phase region. The four-state Potts critical end points differentiating the continuous transitions from the first-order ones are estimated based on finite-size-scaling analyses. Furthermore, a similar behavior of the transition to the fourfold single-stripe phase is also observed in the anisotropic triangular Ising model. Thus, this work clearly demonstrates that the transitions to the fourfold degenerate states of two-dimensional Ising antiferromagnets exhibit similar transition behavior.
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Affiliation(s)
- R M Liu
- Institute for Advanced Materials, South China Academy of Advanced Optoelectronics, and Guangdong Provincial Key Laboratory of Quantum Engineering and Quantum Materials, South China Normal University, Guangzhou 510006, China
| | - W Z Zhuo
- Institute for Advanced Materials, South China Academy of Advanced Optoelectronics, and Guangdong Provincial Key Laboratory of Quantum Engineering and Quantum Materials, South China Normal University, Guangzhou 510006, China
| | - J Chen
- Institute for Advanced Materials, South China Academy of Advanced Optoelectronics, and Guangdong Provincial Key Laboratory of Quantum Engineering and Quantum Materials, South China Normal University, Guangzhou 510006, China
| | - M H Qin
- Institute for Advanced Materials, South China Academy of Advanced Optoelectronics, and Guangdong Provincial Key Laboratory of Quantum Engineering and Quantum Materials, South China Normal University, Guangzhou 510006, China
| | - M Zeng
- Institute for Advanced Materials, South China Academy of Advanced Optoelectronics, and Guangdong Provincial Key Laboratory of Quantum Engineering and Quantum Materials, South China Normal University, Guangzhou 510006, China
| | - X B Lu
- Institute for Advanced Materials, South China Academy of Advanced Optoelectronics, and Guangdong Provincial Key Laboratory of Quantum Engineering and Quantum Materials, South China Normal University, Guangzhou 510006, China
| | - X S Gao
- Institute for Advanced Materials, South China Academy of Advanced Optoelectronics, and Guangdong Provincial Key Laboratory of Quantum Engineering and Quantum Materials, South China Normal University, Guangzhou 510006, China
| | - J-M Liu
- Laboratory of Solid State Microstructures and Innovative Center of Advanced Microstructures, Nanjing University, Nanjing 210093, China
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Yang L, Li X, Liu MF, Li PL, Yan ZB, Zeng M, Qin MH, Gao XS, Liu JM. Understanding the multiferroicity in TmMn 2O 5 by a magnetically induced ferrielectric model. Sci Rep 2016; 6:34767. [PMID: 27713482 PMCID: PMC5054431 DOI: 10.1038/srep34767] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 09/19/2016] [Indexed: 11/30/2022] Open
Abstract
The magnetically induced electric polarization behaviors in multiferroic TmMn2O5 in response to varying temperature and magnetic field are carefully investigated by means of a series of characterizations including the high precision pyroelectric current technique. Here polycrystalline rather than single crystal samples are used for avoiding the strong electrically self-polarized effect in single crystals, and various parallel experiments on excluding the thermally excited current contributions are performed. The temperature-dependent electric polarization flop as a major character is identified for different measuring paths. The magneto-current measurements indicate that the electric polarization in the low temperature magnetic phase region has different origin from that in the high temperature magnetic phase. It is suggested that the electric polarization does have multiple components which align along different orientations, including the Mn3+-Mn4+-Mn3+ exchange striction induced polarization PMM, the Tm3+-Mn4+-Tm3+ exchange striction induced polarization PTM, and the low temperature polarization PLT probably associated with the Tm3+ commensurate phase. The observed electric polarization flop can be reasonably explained by the ferrielectric model proposed earlier for DyMn2O5, where PMM and PTM are the two antiparallel components both along the b-axis and PLT may align along the a-axis. Finally, several issues on the unusual temperature dependence of ferroelectric polarizations are discussed.
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Affiliation(s)
- L Yang
- Institute for Advanced Materials and Laboratory of Quantum Engineering and Quantum Materials, South China Normal University, Guangzhou 510006, China
| | - X Li
- Laboratory of Solid State Microstructures, Nanjing University, Nanjing 210093, China
| | - M F Liu
- Laboratory of Solid State Microstructures, Nanjing University, Nanjing 210093, China
| | - P L Li
- Institute for Advanced Materials and Laboratory of Quantum Engineering and Quantum Materials, South China Normal University, Guangzhou 510006, China
| | - Z B Yan
- Laboratory of Solid State Microstructures, Nanjing University, Nanjing 210093, China
| | - M Zeng
- Institute for Advanced Materials and Laboratory of Quantum Engineering and Quantum Materials, South China Normal University, Guangzhou 510006, China
| | - M H Qin
- Institute for Advanced Materials and Laboratory of Quantum Engineering and Quantum Materials, South China Normal University, Guangzhou 510006, China
| | - X S Gao
- Institute for Advanced Materials and Laboratory of Quantum Engineering and Quantum Materials, South China Normal University, Guangzhou 510006, China
| | - J-M Liu
- Institute for Advanced Materials and Laboratory of Quantum Engineering and Quantum Materials, South China Normal University, Guangzhou 510006, China.,Laboratory of Solid State Microstructures, Nanjing University, Nanjing 210093, China.,Institute for Advanced Materials, Hubei Normal University, Huangshi 435003, China
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Chen J, Zhuo WZ, Qin MH, Dong S, Zeng M, Lu XB, Gao XS, Liu JM. Effect of further-neighbor interactions on the magnetization behaviors of the Ising model on a triangular lattice. J Phys Condens Matter 2016; 28:346004. [PMID: 27356040 DOI: 10.1088/0953-8984/28/34/346004] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
In this work, we study the magnetization behaviors of the classical Ising model on the triangular lattice using Monte Carlo simulations, and pay particular attention to the effect of further-neighbor interactions. Several fascinating spin states are identified to be stabilized in certain magnetic field regions, respectively, resulting in the magnetization plateaus at 2/3, 5/7, 7/9 and 5/6 of the saturation magnetization M S, in addition to the well-known plateaus at 0, 1/3 and 1/2 of M S. The stabilization of these interesting orders can be understood as the consequence of the competition between Zeeman energy and exchange energy.
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Affiliation(s)
- J Chen
- Institute for Advanced Materials and Guangdong Provincial Key Laboratory of Quantum Engineering and Quantum Materials, South China Normal University, Guangzhou 510006, People's Republic of China
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Liu RM, Zhuo WZ, Dong S, Lu XB, Gao XS, Qin MH, Liu JM. Role of further-neighbor interactions in modulating the critical behavior of the Ising model with frustration. Phys Rev E 2016; 93:032114. [PMID: 27078299 DOI: 10.1103/physreve.93.032114] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Indexed: 06/05/2023]
Abstract
In this work, we investigate the phase transitions and critical behaviors of the frustrated J(1)-J(2)-J(3) Ising model on the square lattice using Monte Carlo simulations, and particular attention goes to the effect of the second-next-nearest-neighbor interaction J(3) on the phase transition from a disordered state to the single stripe antiferromagnetic state. A continuous Ashkin-Teller-like transition behavior in a certain range of J(3) is identified, while the four-state Potts-critical end point [J(3)/J(1)](C) is estimated based on the analytic method reported in earlier work [Jin, Sen, and Sandvik, Phys. Rev. Lett. 108, 045702 (2012)]. It is suggested that the interaction J(3) can tune the transition temperature and in turn modulate the critical behaviors of the frustrated model. Furthermore, it is revealed that an antiferromagnetic J(3) can stabilize the staggered dimer state via a phase transition of strong first-order character.
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Affiliation(s)
- R M Liu
- Institute for Advanced Materials and Guangdong Provincial Key Laboratory of Quantum Engineering and Quantum Materials, South China Normal University, Guangzhou 510006, China
| | - W Z Zhuo
- Institute for Advanced Materials and Guangdong Provincial Key Laboratory of Quantum Engineering and Quantum Materials, South China Normal University, Guangzhou 510006, China
| | - S Dong
- Department of Physics, Southeast University, Nanjing 211189, China
| | - X B Lu
- Institute for Advanced Materials and Guangdong Provincial Key Laboratory of Quantum Engineering and Quantum Materials, South China Normal University, Guangzhou 510006, China
| | - X S Gao
- Institute for Advanced Materials and Guangdong Provincial Key Laboratory of Quantum Engineering and Quantum Materials, South China Normal University, Guangzhou 510006, China
| | - M H Qin
- Institute for Advanced Materials and Guangdong Provincial Key Laboratory of Quantum Engineering and Quantum Materials, South China Normal University, Guangzhou 510006, China
| | - J-M Liu
- Institute for Advanced Materials and Guangdong Provincial Key Laboratory of Quantum Engineering and Quantum Materials, South China Normal University, Guangzhou 510006, China
- Laboratory of Solid State Microstructures, Nanjing University, Nanjing 210093, China
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Yau HM, Yan ZB, Chan NY, Au K, Wong CM, Leung CW, Zhang FY, Gao XS, Dai JY. Low-field Switching Four-state Nonvolatile Memory Based on Multiferroic Tunnel Junctions. Sci Rep 2015; 5:12826. [PMID: 26239505 PMCID: PMC4523833 DOI: 10.1038/srep12826] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Accepted: 05/20/2015] [Indexed: 11/26/2022] Open
Abstract
Multiferroic tunneling junction based four-state non-volatile memories are very promising for future memory industry since this kind of memories hold the advantages of not only the higher density by scaling down memory cell but also the function of magnetically written and electrically reading. In this work, we demonstrate a success of this four-state memory in a material system of NiFe/BaTiO3/La0.7Sr0.3MnO3 with improved memory characteristics such as lower switching field and larger tunneling magnetoresistance (TMR). Ferroelectric switching induced resistive change memory with OFF/ON ratio of 16 and 0.3% TMR effect have been achieved in this multiferroic tunneling structure.
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Affiliation(s)
- H M Yau
- Department of Applied Physics, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, P. R. China
| | - Z B Yan
- Laboratory of Solid State Microstructures, Nanjing University, Nanjing 210093, China
| | - N Y Chan
- Department of Applied Physics, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, P. R. China
| | - K Au
- Department of Applied Physics, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, P. R. China
| | - C M Wong
- Department of Applied Physics, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, P. R. China
| | - C W Leung
- Department of Applied Physics, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, P. R. China
| | - F Y Zhang
- Institute for Advanced Materials and Laboratory of Quantum Engineering and Quantum Materials, South China Normal University, Guangzhou 510006, China
| | - X S Gao
- Institute for Advanced Materials and Laboratory of Quantum Engineering and Quantum Materials, South China Normal University, Guangzhou 510006, China
| | - J Y Dai
- Department of Applied Physics, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, P. R. China
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Huang WC, Huo L, Tian G, Qian HR, Gao XS, Qin MH, Liu JM. Multi-step magnetization of the Ising model on a Shastry-Sutherland lattice: a Monte Carlo simulation. J Phys Condens Matter 2012; 24:386003. [PMID: 22927561 DOI: 10.1088/0953-8984/24/38/386003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The magnetization behaviors and spin configurations of the classical Ising model on a Shastry-Sutherland lattice are investigated using Monte Carlo simulations, in order to understand the fascinating magnetization plateaus observed in TmB(4) and other rare-earth tetraborides. The simulations reproduce the 1/2 magnetization plateau by taking into account the dipole-dipole interaction. In addition, a narrow 2/3 magnetization step at low temperature is predicted in our simulation. The multi-step magnetization can be understood as the consequence of the competitions among the spin-exchange interaction, the dipole-dipole interaction, and the static magnetic energy.
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Affiliation(s)
- W C Huang
- Institute for Advanced Materials, South China Academy of Advanced Photonics Engineering, South China Normal University, Guangzhou 510006, People's Republic of China
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24
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Rodriguez BJ, Gao XS, Liu LF, Lee W, Naumov II, Bratkovsky AM, Hesse D, Alexe M. Vortex polarization states in nanoscale ferroelectric arrays. Nano Lett 2009; 9:1127-1131. [PMID: 19191502 DOI: 10.1021/nl8036646] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Two-dimensional arrays of ferroelectric lead zirconate titanate (PZT) nanodots were fabricated using pulsed laser deposition through ultrathin anodic aluminum oxide membrane stencil masks. The static distribution of polarization configurations was investigated using in- and out-of-plane piezoresponse force microscopy (PFM). The observed presence of an in-plane polarization component in nominally (001) oriented PZT suggests the existence of a significant deviation from the regular tetragonal structure that allows the formation of complex core-polarization states. Core-polarization states may indicate the presence of quasi-toroidal polarization ordering. The experimental results are compared with a theoretical model to determine the fingerprint of a vortex polarization state in PFM.
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Affiliation(s)
- B J Rodriguez
- Max Planck Institute of Microstructure Physics, Weinberg 2, D-06120 Halle, Germany
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25
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Zhang YL, Wang SL, Gao XS. [Experimental study of allogenic tendon with sheath grafting in chicken]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2001; 15:92-5. [PMID: 11286170] [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: 02/19/2023]
Abstract
OBJECTIVE To investigate availability of deep freeze stored allogenic tendon with sheath grafting in repairing the tendon and sheath defect in the II area of flexor digitorum tendon. METHODS Sixty chickens with tendon and sheath defect were divided into 2 groups randomly, group A was treated with allogenic grafting and group B was treated with autogenic grafting, these two groups were divided into two subgroups respectively, they were, group A1 allogenic tendon with whole sheath grafting, group A2 allogenic tendon with partial sheath grafting, group B1 autogenic tendon with whole sheath grafting and group B2 autogenic tendon with whole sheath grafting. All the allogenic grafts were treated by deep freeze. Histomorphological study, histoimmunological study and slipping function of the grafts were measured after operation. RESULTS In group A1 and B1, the local reaction was sever, the nutrition of tendon graft was barricaded by the whole sheath resulting in adhesion, degeneration and necrosis. In group A2 and B2, the tendon graft healed well and little adhesion existed between tendon and sheath. The results showed that there were significant differences between tendon grafting with whole sheath and tendon grafting with partial sheath. CONCLUSION Deep freeze store can reduce the immunogenicity of allogenic tendon with sheath. Allogenic tendon with partial sheath grafting can be used as a new biological material for repairing the tendon and sheath defect.
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Affiliation(s)
- Y L Zhang
- Department of Hand Surgery, Beijing Ji Shui Tan Hospital, Beijing, P. R. China 100035
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26
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Asaumi JI, Kawasaki S, Gao XS, Kuroda M, Hiraki Y. Influence of cell membrane potential, and selectivity of the Na+/H+ exchanger and Cl-/HCO3- exchanger on the intracellular accumulation of adriamycin. Anticancer Res 1996; 16:725-8. [PMID: 8687120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Intracellular accumulation of adriamycin (ADR) has been reported to be influenced by cell membrane potential. We first evaluated intracellular accumulation of ADR and 3,3'-(di-n-hexyl)-2,2'-oxacarbocyanine iodide (NK-2280), an indicator of cell membrane potential, and found a good correlation between ADR and NK-2280 intracellular accumulation in several cell lines. This suggests that ADR accumulation may be influenced by cell membrane potential or the mechanisms of NK-2280 accumulation may be similar to those of ADR accumulation. Next, we observed the influence of the NA+/H+ exchanger and Cl-/HCO3- exchanger on the intracellular accumulation of ADR and NK-2280, and found that ADR accumulation decreased with increasing concentrations of 3,5-diamino-6-chloro-N-(diaminomethylene)pyrazinecarboxamide (amiloride), an inhibitor of the Na+/H+ exchanger, and 4,4'-diisothiocyanato-stilbene-2,2'-disulfonic acid (DIDS), an inhibitor of the Cl-/HCO3- exchanger, however, NK-2280 accumulation was increased by amiloride, and decreased by DIDS. The increased accumulation of NK-2280 induced by amiloride may be due to the increased cell membrane potential caused by the inhibition of H+ ion efflux and NA+ ion influx due to the inhibition of the Na+/H+ exchanger. The decreased accumulation of NK-2280 may be also due to the decreased cell membrane potential caused by the inhibition of Cl- ion efflux due to the inhibition of the Cl-/HCO3- exchanger by DIDS. However, the decreased rate caused by DIDS was greater than the increased rate caused by amiloride. Therefore, it is suggested that the decreased accumulation of NK-2280 by DIDS may be influenced by other factors apart from cell membrane potential. These results suggest that the Cl-/HCO3- exchanger may be related to both ADR accumulation, and NK-2280 accumulation, and that the Na+/H+ exchanger may be related to ADR accumulation, but not NK-2280. This suggests that the Cl-/HCO3- exchanger is of low selectivity.
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Affiliation(s)
- J I Asaumi
- Department of Radiology, Okayama University Medical School, Japan
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27
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Gao XS, Asaumi J, Kawasaki S, Nishikawa K, Kuroda M, Takeda Y, Hiraki Y, Ihara M, Ohnishi T. Sensitivity of anticancer drugs in NIH3T3' cells transfected with oncogenes accompanied by pSV2neo vector. Anticancer Res 1995; 15:1911-4. [PMID: 8572577] [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: 01/31/2023]
Abstract
NIH3T3 cells and NIH3T3 cell lines, which were transfected with several oncogenes accompanied by pSV2neo vector, were observed for their survival rate when treated with commonly used anticancer drugs. The survival rates in the cell line transfected with the pSV2neo vector only did not differ significantly from that of parental NIH3T3 cells against bleomycin, nimustine and adriamycin, but it was significantly more resistant to cisplatin and more sensitive to mitomycin C. Therefore, the survival rate in each transfectant was compared with that in the pSV2neo transfectant. The Val-12, v-Ha-ras, v-int-2, v-erbB or v-abl transfectants accompanied by pSV2neo vector were significantly more sensitive to cisplatin than transfection with pSV2neo vector only. The Val-12, v-Ha-ras, v-int-2 and v-abl transfectants were significantly more sensitive, and the v-erbB transfectant more resistant to bleomycin than the pSV2neo transfectant. The v-int-2, v-erbB, frg, v-raf and v-myc transfectants were more sensitive, and the v-Ha-ras transfectant more resistant to nimustine than the pSV2neo transfectant. The N-ras, v-Ha-ras, v-sis, v-int, v-abl and v-myc transfectants were significantly more sensitive to adriamycin than the pSV2neo transfectant. The v-sis and v-int-2 transfectants were more sensitive, and the c-Ki-ras, Val-12, v-erbB and the v-src transfectants more resistant to mitomycin C than the pSV2neo transfectant. Thus there was no relationship between the drug sensitivity and the location of oncogenes, but the transfection was associated with either increased or decreased sensitivity to a number of commonly used anticancer drugs. Therefore, it may be important to take into consideration or overexpression of oncogenes in cancer chemotherapy.
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Affiliation(s)
- X S Gao
- Department of Radiology, Okayama University Medical School, Japan
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28
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Weng WM, Gao XS, Zhuang NL, Xu ML, Xue ZT. The glycinin A3B4 mRNA from wild soybean Glycine soja Sieb. et ZUCC. Plant Physiol 1995; 107:665-6. [PMID: 7724684 PMCID: PMC157178 DOI: 10.1104/pp.107.2.665] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Affiliation(s)
- W M Weng
- Laboratory of Plant Molecular Genetics, Shanghai Institute of Plant Physiology, Academia Sinica, China
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29
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Kuroda M, Hizuta A, Iwagaki H, Makihata E, Asaumi J, Nishikawa K, Gao XS, Nakagawa T, Togami I, Takeda Y. Hyperthermotherapy for postoperative local recurrences of rectal cancer. Acta Med Okayama 1993; 47:249-54. [PMID: 8213219 DOI: 10.18926/amo/31557] [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: 01/29/2023]
Abstract
Between November 1984 and August 1992 we used hyperthermotherapy in six cases of local recurrence of rectal cancer. Hyperthermotherapy was performed on the average 8.7 times (range: 3-18) for each patient for 60 min each. All patients underwent combined radiotherapy and received a mean radiation dose of 42.5 Gy (range: 9-60 Gy). Five patients underwent heating within 1 h after irradiation and one patient simultaneously with the irradiation. Four patients underwent combined chemotherapy and two patients immunotherapy. Before the treatment all patients had painful lesions, but pain decreased posttherapeutically in five patients. Performance status improved in two patients. High carcinoembryonic antigen levels prior to the therapy in four patients decreased in all cases after treatment. Posttherapeutical computed tomograms revealed only minor response or no changes. After the treatment, four patients died of exacerbations of recurrent tumors and one patient of distant metastases. The patient who underwent simultaneous radiohyperthermotherapy is presently alive, in August 1992, 38 months after initiation of the treatment. The 50% survival time after initiation of the treatment was 25 months (range: 10-38 months). Hyperthermotherapy combined with radiotherapy, chemotherapy and/or immunotherapy was useful for the alleviation of pain in patients who developed local recurrence after surgery, and improved survival after recurrences can be expected.
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Affiliation(s)
- M Kuroda
- Department of Radiology, Okayama University Medical School, Japan
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30
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Gao XS. [Absorptive capacity of upper gastrointestinal tract with Chinese herbal medicine]. Zhongguo Zhong Xi Yi Jie He Za Zhi 1993; 13:433-5, 390. [PMID: 8251731] [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: 01/29/2023]
Abstract
285 reports on the intoxication of Chinese herbal medicine per os were reviewed. The toxic symptoms occurred after oral administration for less than 10 min in about 110 reports. Some components of these herbal medicines might be absorbed and then reach effective level more rapidly. By segmental ligation of GI tract, experiments in rabbits, cats, rats or mice were conducted, in which principal ingredients of Rheum palmatum, Coptis chinensis, Veratrum nigrum, and aconitine were absorbed in esophagus or stomach within short period of time was observed. It suggested that the absorptive capacity of upper GI tract might have universal significance. The treatment of acute diseases by oral administration of Chinese herbal medicines is feasible.
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Affiliation(s)
- X S Gao
- China Academy of TCM, Beijing
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31
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Kuroda M, Tsushima T, Nasu Y, Asaumi J, Nishikawa K, Gao XS, Joja I, Takeda Y, Togami I, Makihata E. Hyperthermotherapy added to the multidisciplinary therapy for penile cancer. Acta Med Okayama 1993; 47:169-74. [PMID: 8379345 DOI: 10.18926/amo/31599] [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: 01/30/2023]
Abstract
We performed a long-term follow-up of 4 patients with penile cancer who underwent hyperthermotherapy from August 1985 until August 1992. Hyperthermia was applied using a frequency of 350 MHz with a waveguide applicator twice a week for 60 min each for an average of 9.5 times (varying from 6 to 13 times). The total heating time that the temperature of urethra could be kept above 42 degrees C, was 166 min on the average (ranging from 0 to 463 min). Two patients classified as stage I according to the Jackson classification and 1 patient classified as stage IV underwent combined radiotherapy and received an average radiation dose of 53 Gy (range, 40-70 Gy). Among these patients 2 underwent combined chemotherapy with bleomycin or peplomycin. Malignant cells disappeared posttherapeutically and in August 1992, after an average of 5 years and 9 months (varying from 4 years 6 months to 6 years 10 months), the patients were free of recurrences. The one patient on stage IV had extensive invasion of the abdominal wall, but still recovered completely. One patient on stage III underwent combined chemotherapy and hyperthermotherapy, but heating had obviously been insufficient. There was a residue of malignant cells after the treatment and we performed a penectomy. Regarding functional preservation of the penis a multidisciplinary therapy incorporating hyperthermotherapy can be expected to increase the curativity. This indicates that it could induce in an advanced case, where an operation would be difficult, complete remission.
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Affiliation(s)
- M Kuroda
- Department of Radiology, Okayama University Medical School, Japan
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32
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Gao XS, Chen FQ, Liu LX, Li JR, Li N, Wang XH, Niu HZ, Wu ZL, Zhu J. [18 incompatible medicaments that impair treatment]. Zhongguo Zhong Yao Za Zhi 1992; 17:754-6, 761. [PMID: 1304760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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33
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Gao XS. [Rhubarb application for global health--a review on the articles of the first international symposium on rhubarb]. Zhong Xi Yi Jie He Za Zhi 1990; 10:754-7. [PMID: 2292125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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34
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Lin ZH, Gao XS, Yuan XB. [Clinical uses of the scapular flap]. Zhonghua Wai Ke Za Zhi 1988; 26:41-3, 62. [PMID: 3197539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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35
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He QL, Lin ZH, Liu Q, Yang FW, Yuan XB, Zhang HL, Gao XS. One-stage penis reconstruction with the abdominal fasciocutaneous flap based on the double arteries. Report of 16 cases. Chin Med J (Engl) 1987; 100:255-9. [PMID: 2958249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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36
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Liu Q, Gao XS. [A 5-flap procedure for the treatment of an axillary webbed scar]. Zhonghua Zheng Xing Shao Shang Wai Ke Za Zhi 1986; 2:117-8, 120, 159. [PMID: 3151804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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37
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Gao XS, Liu L, Yuan XB. [Median-knee saphenous neurovascular flap for ipsilateral or cross-leg transfer]. Zhonghua Wai Ke Za Zhi 1986; 24:36-7, 63. [PMID: 3720447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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38
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Abstract
We present the use of a medial arm free flap with the superior ulnar collateral artery as the arterial supplier in 8 patients. The flaps succeeded in 7 cases. In addition, by cadaver dissections the vascular anatomy of this flap was reevaluated. We found that the direct cutaneous arterial branches other than the superior ulnar collateral artery could be used for vascular anastomosis, in case the latter artery is not available.
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Abstract
Experimental end-to-side anastomoses of rabbit arteries less than 1.0 mm in diameter were performed. Technical details, angle of inset, and vessel opening discrepancy are discussed. We emphasize the value of end-to-side arterial anastomoses in increasing the patency rates of anastomoses and consequently the survival rates of composite graft transfers. Twenty-eight clinical free composite tissue transfers using end-to-side arterial anastomoses were completed with total graft survival.
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40
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Gao XS. [Experience with clinical application with end-to-end and end-to-side small arterial anastomosis]. Zhonghua Zheng Xing Shao Shang Wai Ke Za Zhi 1985; 1:14-6. [PMID: 3939756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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41
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Gao XS. [Plastic reconstruction of burned hand deformities in the late stage]. Zhonghua Zheng Xing Shao Shang Wai Ke Za Zhi 1985; 1:56-7. [PMID: 3939798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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42
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Gao XS, Yuang XB, He QL. [Medial plantar island skin flap for repair of soft tissue defects of the heel: report of 3 cases]. Zhonghua Wai Ke Za Zhi 1985; 23:104-5, 128. [PMID: 3987463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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43
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Gao XS. [One-stage reconstruction of the penis with free skin flap from the forearm--report of 5 cases]. Zhonghua Yi Xue Za Zhi 1984; 64:470-3. [PMID: 6440691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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44
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Zhou YQ, Li GF, Zhong JX, Dong ZF, Gao XS. [Antimalarial activity of some 2,4-diamino-6-substituted amino sulfonyl quinazoline derivatives]. Yao Xue Xue Bao 1984; 19:245-50. [PMID: 6496100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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45
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Gao XS. [End-to-side arterial anastomosis: experimental research and clinical application]. Zhonghua Wai Ke Za Zhi 1983; 21:113-7. [PMID: 6872729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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46
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Li FL, Wang LH, Ding DB, Yang JD, Gao XS. [Studies on antimalarials synthesis of 4-arylamino-tert-butylaminomethyl phenols (author's transl)]. Yao Xue Xue Bao 1982; 17:77-9. [PMID: 7090832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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47
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Gao XS. [Effects of processed Chinese rhubarbs on activities of four digestive enzymes (author's transl)]. Zhong Yao Tong Bao 1981; 6:24-6. [PMID: 6176344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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48
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Gao XS. [The effect of raw Chinese rhubarb on the activities of four digestive enzymes and the discussion on its medicine property (author's transl)]. Zhong Yao Tong Bao 1981; 6:25-9. [PMID: 6177435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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49
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Gao XS. [Reconstruction of penis: report of 4 cases (author's transl)]. Zhonghua Wai Ke Za Zhi 1980; 18:67-8. [PMID: 7215057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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