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Zhang XX, Ji YL, Zhu LP, Wang ZH, Fang CQ, Jiang CH, Pan K, Zhang J, Yin ZQ. Arjunolic acid from Cyclocarya paliurus ameliorates diabetic retinopathy through AMPK/mTOR/HO-1 regulated autophagy pathway. J Ethnopharmacol 2022; 284:114772. [PMID: 34688801 DOI: 10.1016/j.jep.2021.114772] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 10/05/2021] [Accepted: 10/19/2021] [Indexed: 06/13/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Cyclocarya paliurus (CP) is a traditional Chinese herb and possesses a variety of biological activities including anti-hyperglycemia, anti-hyperlipidemia, antioxidant and anti-inflammation. Arjunolic acid (AA) is an abundant and bioactive ingredient in CP that shows significant protection against many metabolic diseases such as diabetic complication. Diabetic retinopathy (DR) is a serious complication of diabetes and may lead to vision loss. However, the protective effects and underlying mechanisms of AA against DR is not still understood. AIM OF THE STUDY We aimed to investigate whether AA activates AMPK/mTOR/HO-1 regulated autophagy pathway to alleviate DR. MATERIALS AND METHODS In the study, the STZ-induced diabetic model of rats was established, and AA with 10 and 30 mg/kg dosages was given orally for ten weeks to investigate their effect on retinal injury of DR. H2O2-induced ARPE-19 cells were applied to evaluate anti-apoptosis and anti-oxidant effect of AA. RESULTS The results revealed that AA could prevent STZ-induced weight loss and increase the retinal thickness and nuclei counts. The level of HO-1 protein was upregulated both in vivo and in vitro. In addition, AA prevented retinal damage and cell apoptosis through the AMPK-mTOR-regulated autophagy pathway. Furthermore, anti-apoptosis capacity, as well as the expression of HO-1 and LC3 protein, were effectively locked by AMPK inhibitor dorsomorphin dihydrochloride (compound C). CONCLUSIONS This finding implies that AA may be a promising candidate drug by protecting retinal cells from STZ-induced oxidative stress and inflammation through the AMPK/mTOR/HO-1 regulated autophagy pathway.
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Affiliation(s)
- Xuan-Xuan Zhang
- Department of TCMs Pharmaceuticals & Department of Natural Medicinal Chemistry, School of Traditional Chinese Medicine, China Pharmaceutical University, Nanjing, 211198, PR China; Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, PR China; Department of Endocrinology, Nanjing Lishui District Hospital of Traditional Chinese Medicine, Nanjing, 211200, PR China
| | - Ya-Li Ji
- Department of TCMs Pharmaceuticals & Department of Natural Medicinal Chemistry, School of Traditional Chinese Medicine, China Pharmaceutical University, Nanjing, 211198, PR China; Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, PR China
| | - Li-Ping Zhu
- Department of TCMs Pharmaceuticals & Department of Natural Medicinal Chemistry, School of Traditional Chinese Medicine, China Pharmaceutical University, Nanjing, 211198, PR China
| | - Zi-Han Wang
- Department of TCMs Pharmaceuticals & Department of Natural Medicinal Chemistry, School of Traditional Chinese Medicine, China Pharmaceutical University, Nanjing, 211198, PR China; Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, PR China
| | - Chang-Qian Fang
- Department of Endocrinology, Nanjing Lishui District Hospital of Traditional Chinese Medicine, Nanjing, 211200, PR China
| | - Cui-Hua Jiang
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, PR China
| | - Ke Pan
- Department of TCMs Pharmaceuticals & Department of Natural Medicinal Chemistry, School of Traditional Chinese Medicine, China Pharmaceutical University, Nanjing, 211198, PR China
| | - Jian Zhang
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, PR China.
| | - Zhi-Qi Yin
- Department of TCMs Pharmaceuticals & Department of Natural Medicinal Chemistry, School of Traditional Chinese Medicine, China Pharmaceutical University, Nanjing, 211198, PR China.
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Xu YJ, Zhu WG, Liao ZX, Kong Y, Wang WW, Li JC, Huang R, He H, Yang XM, Liu LP, Sun ZW, He HJ, Bao Y, Zeng M, Pu J, Hu WY, Ma J, Jiang H, Liu ZG, Zhuang TT, Tan BX, Du XH, Qiu GQ, Zhou X, Ji YL, Hu X, Wang J, Ma HL, Zheng X, Huang J, Liu AW, Liang XD, Tao H, Zhou JY, Liu Y, Chen M. [A multicenter randomized prospective study of concurrent chemoradiation with 60 Gy versus 50 Gy for inoperable esophageal squamous cell carcinoma]. Zhonghua Yi Xue Za Zhi 2020; 100:1783-1788. [PMID: 32536123 DOI: 10.3760/cma.j.cn112137-20200303-00574] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Objective: To determine whether 60 Gy is superior to standard 50 Gy for definitive concurrent chemoradiation(CCRT) in esophageal squamous cell carcinoma (ESCC) using modern radiation technology in a phase Ⅲ prospective randomized trial. Methods: From April 2013 to May 2017, 331 patients from 22 hospitals who were pathologically confirmed with stage ⅢA-ⅣA ESCC were randomized to 60 Gy or 50 Gy with random number table. Total of 305 patients were analyzed, including 152 in 60 Gy group and 153 in 50 Gy group. The median age was 63 years, 242(79.3%) males and 63(20.7%) females. The median length of primary tumor was 5.6 cm. The clinical characteristics between two groups were comparable. All patients were delivered 2 Gy per fraction, 5 fractions per week. Concurrent weekly chemotherapy with docetaxel (25 mg/m(2)) and cisplatin (25 mg/m(2)) and 2 cycles consolidation chemotherapy with docetaxel (70 mg/m(2)) and cisplatin (25 mg/m(2), d1-3) were administrated. The primary endpoint was local/regional progression-free survival (LRPFS). The data were compared with Pearson chi-square test or Fisher's exact test. Results: At a median follow-up of 27.3 months, the disease progression rate was 37.5% (57/152), 43.8% (67/153) in the high and standard-dose group, respectively (χ(2)=1.251, P=0.263). The 1, 2, 3-year LRPFS rate was 75.4%, 56.8%, 52.1% and 74.2%, 58.4%, 50.1%, respectively (HR: 0.95, 95%CI: 0.69-1.31, P=0.761). The 1, 2, 3-year overall survival rate was 84.1%, 64.8%, 54.1% and 85.4%, 62.9%, 54.0%, respectively (HR: 0.98, 95%CI: 0.71-1.38, P=0.927). The 1, 2, 3-year progression-free survival rate was 70.8%, 54.2%, 48.5% and 65.5%, 51.9%, 45.1%, respectively (HR: 0.93, 95%CI: 0.68-1.26, P=0.621). The incidence rates in toxicities between the two groups were similar except for higher rate of severe pneumonitis in high dose group (χ(2)=11.596, P=0.021). Conclusions: The efficacy in disease control is similar between 60 Gy and 50 Gy using modern radiation technology concurrent with chemotherapy for ESCC. The 50 Gy should be recommended as the regular radiation dose with CCRT for ESCC.
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Affiliation(s)
- Y J Xu
- Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, the Department of Thoracic Radiation Oncology, Cancer Hospital of University of Chinese Academy of Sciences; Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - W G Zhu
- the Department of Radiation Oncology, Huai'an First People's Hospital, Huai'an 223300, China
| | - Z X Liao
- the Department of Radiation Oncology, University of Taxes, M.D. Anderson Cancer Center, Houston 77030, the United States
| | - Y Kong
- Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, the Department of Thoracic Radiation Oncology, Cancer Hospital of University of Chinese Academy of Sciences; Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - W W Wang
- the Department of Radiation Oncology, Huai'an First People's Hospital, Huai'an 223300, China
| | - J C Li
- the Department of Thoracic Radiation Oncology, Fujian Cancer Hospital, Fuzhou 350014, China
| | - R Huang
- the Department of Radiation Oncology, Foshan First People's Hospital, Foshan 528000, China
| | - H He
- the Department of Radiation Oncology, Foshan First People's Hospital, Foshan 528000, China
| | - X M Yang
- the Department of Medical Oncology, Jiaxing First People's Hospital, Jiaxing 314000, China
| | - L P Liu
- the Department of Oncology, Jining First People's Hospital, Jining 272011, China
| | - Z W Sun
- the Department of Oncology, Jining First People's Hospital, Jining 272011, China
| | - H J He
- the Department of Radiation Oncology, Quzhou People's Hospital, Quzhou 324000, China
| | - Y Bao
- the Department of Radiation Oncology, Affiliated Cancer Hospital, Sun Yat-Sen University, Guangzhou 510080, China(is working in the First Affiliated Hospital of Sun Yat-Sen University)
| | - M Zeng
- the Department of Radiation Oncology, Sichuan Provincial People's Hospital, Chengdu 610072, China
| | - J Pu
- the Department of Radiation Oncology, Lianshui People's Hospital, Lianshui 223400, China
| | - W Y Hu
- the Department of Radiation Oncology, Jinhua Central Hospital, Jinhua 321000, China
| | - J Ma
- the Department of Radiation Oncology, Anhui Provincial Hospital, Hefei 230001, China
| | - H Jiang
- the Department of Radiation Oncology, Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China
| | - Z G Liu
- the Department of Radiation Oncology, Hunan Cancer Hospital, Changsha 410013, China(is working in the Fifth Affiliated Hospital of Sun Yat-Sen University now)
| | - T T Zhuang
- the Department of Radiation Oncology, Affiliated Cancer Hospital of Shantou University Medical College, Shantou 515031, China
| | - B X Tan
- the Department of Radiation Oncology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China
| | - X H Du
- Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, the Department of Thoracic Radiation Oncology, Cancer Hospital of University of Chinese Academy of Sciences; Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - G Q Qiu
- Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, the Department of Thoracic Radiation Oncology, Cancer Hospital of University of Chinese Academy of Sciences; Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - X Zhou
- Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, the Department of Thoracic Radiation Oncology, Cancer Hospital of University of Chinese Academy of Sciences; Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - Y L Ji
- Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, the Department of Thoracic Radiation Oncology, Cancer Hospital of University of Chinese Academy of Sciences; Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - X Hu
- Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, the Department of Thoracic Radiation Oncology, Cancer Hospital of University of Chinese Academy of Sciences; Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - J Wang
- Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, the Department of Thoracic Radiation Oncology, Cancer Hospital of University of Chinese Academy of Sciences; Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - H L Ma
- Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, the Department of Thoracic Radiation Oncology, Cancer Hospital of University of Chinese Academy of Sciences; Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - X Zheng
- Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, the Department of Thoracic Radiation Oncology, Cancer Hospital of University of Chinese Academy of Sciences; Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - J Huang
- the Department of Radiation Oncology, Changzhou First People's Hospital, Changzhou 213003, China
| | - A W Liu
- the Department of Radiation Oncology, Second Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - X D Liang
- the Department of Radiation Oncology, Zhejiang People's Hospital, Hangzhou 310014, China
| | - H Tao
- the Department of Radiation Oncology, Jiangsu Cancer Hospital, Nanjing 210009, China
| | - J Y Zhou
- the Department of Radiation Oncology, First Affiliated Hospital of Suzhou University, Suzhou 215006, China
| | - Y Liu
- the Department of Radiation Oncology, Affiliated Cancer Hospital of Guangzhou Medical University, Guangzhou 510095, China
| | - M Chen
- Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, the Department of Thoracic Radiation Oncology, Cancer Hospital of University of Chinese Academy of Sciences; Zhejiang Cancer Hospital, Hangzhou 310022, China
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Ji WH, Jiang YH, Ji YL, Li B, Mao WM. Prechemotherapy neutrophil : lymphocyte ratio is superior to the platelet : lymphocyte ratio as a prognostic indicator for locally advanced esophageal squamous cell cancer treated with neoadjuvant chemotherapy. Dis Esophagus 2016; 29:403-11. [PMID: 25625421 DOI: 10.1111/dote.12322] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [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] [Indexed: 12/11/2022]
Abstract
The study aimed to evaluate the prognostic significance of prechemotherapy neutrophil to lymphocyte ratio and platelet to lymphocyte ratio, and preoperative neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in locally advanced esophageal squamous cell cancer. We analyzed retrospectively locally advanced esophageal squamous cell cancer patients who had received neoadjuvant chemotherapy before undergoing a radical esophagectomy between 2009 and 2012. Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio before chemotherapy and before the surgery were calculated. Univariate analyses showed that prechemotherapy neutrophil to lymphocyte ratio >5 (P = 0.048, hazard ratio = 2.86; 95% confidence interval: 1.01-8.12) and prechemotherapy platelet to lymphocyte ratio >130 (P = 0.025, hazard ratio = 5.50; 95% confidence interval: 1.23-24.55) were associated significantly with overall survival (OS), and prechemotherapy platelet to lymphocyte ratio >130 (P = 0.026, hazard ratio = 3.18; 95% confidence interval: 1.15-8.85) was associated significantly with progression-free survival. However, only prechemotherapy neutrophil to lymphocyte ratio >5 (P = 0.024, hazard ratio = 3.50; 95% confidence interval: 1.18-10.40) remained significantly associated with OS in multivariate analyses. Neither preoperative neutrophil to lymphocyte ratio nor platelet to lymphocyte ratio was associated with OS or progression-free survival. The prechemotherapy neutrophil to lymphocyte ratio >5 to preoperative neutrophil to lymphocyte ratio ≤5 group showed significantly worse OS than the prechemotherapy neutrophil to lymphocyte ratio ≤5 to preoperative neutrophil to lymphocyte ratio ≤5 group (P = 0.050). The prechemotherapy platelet to lymphocyte ratio >130 to preoperative platelet to lymphocyte ratio ≤130 group (P = 0.016) and platelet to lymphocyte ratio >130 to preoperative platelet to lymphocyte ratio >130 group (P = 0.042) showed significantly worse OS than the prechemotherapy platelet to lymphocyte ratio ≤30 to preoperative platelet to lymphocyte ratio ≤130 group. In conclusions, prechemotherapy neutrophil to lymphocyte ratio is an independent prognostic factor for OS in patients with advanced esophageal squamous cell cancer treated with neoadjuvant chemotherapy, and, as an adverse prognostic predictor, increased prechemotherapy neutrophil to lymphocyte ratio is superior to platelet to lymphocyte ratio. Maintaining a low neutrophil to lymphocyte ratio and platelet to lymphocyte ratio throughout treatment is a predictor of better OS.
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Affiliation(s)
- W H Ji
- Zhejiang Key Laboratory of Radiation Oncology, Zhejiang Cancer Research Institute, Zhejiang Cancer Hospital, Hangzhou, China
| | - Y H Jiang
- Zhejiang Key Laboratory of Radiation Oncology, Zhejiang Cancer Research Institute, Zhejiang Cancer Hospital, Hangzhou, China
| | - Y L Ji
- Zhejiang Key Laboratory of Radiation Oncology, Zhejiang Cancer Research Institute, Zhejiang Cancer Hospital, Hangzhou, China
| | - B Li
- Zhejiang Key Laboratory of Radiation Oncology, Zhejiang Cancer Research Institute, Zhejiang Cancer Hospital, Hangzhou, China
| | - W M Mao
- Zhejiang Key Laboratory of Radiation Oncology, Zhejiang Cancer Research Institute, Zhejiang Cancer Hospital, Hangzhou, China
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Wei L, Shan ZG, Flower RL, Wang Z, Wen JZ, Luo GP, Ji YL. The distribution of MNS hybrid glycophorins with Mur antigen expression in Chinese donors including identification of a novel GYP.Bun allele. Vox Sang 2016; 111:308-314. [PMID: 27232276 DOI: 10.1111/vox.12421] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 04/28/2016] [Accepted: 05/02/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND OBJECTIVES MNS hybrid glycophorins are identified by characteristic antigen profiles. One of these is the Mur antigen, which is expressed on red cell hybrid glycophorins of several phenotypes of the 'Miltenberger' series found predominantly in East Asian population. The aim of this study was to investigate the distribution of Mur-positive hybrid glycophorins and clarify the genetic basis in the donors from southern China. MATERIALS AND METHODS Blood samples from 528 donors were collected for Mur antigen serological typing. Sequencing of GYPB pseudoexon 3 and MNS phenotyping were conducted in Mur-positive samples. The multiplex ligation-dependent probe amplification (MLPA) was used to confirm the zygosity of the GYP.Mur allele and determine the MNSs genotype. The expression of Mur antigen was evaluated by flow cytometry. RESULTS Fifty-one Mur-positive samples were identified by serological testing. Sequencing analysis showed 50 donors (50/528, 9.5%) with the GYP.Mur allele (48 heterozygotes and two homozygotes), which were confirmed by the MLPA genotyping analysis, and one donor (1/528, 0.19%) with a novel GYP.Bun allele. Flow cytometry analysis revealed higher Mur antigen expression on GP.Mur (Mi.III) homozygotes than heterozygotes. For the GYP.Mur homozygotes, an incorrect 'N' positive typing with anti-N lectin was obtained. CONCLUSION GP.Mur (Mi.III) is the main Mur-positive hybrid glycophorin in Guangzhou donors. The dosage effect of Mur antigen observed provides a basis for selecting the homozygous GP.Mur RBCs as the reagent cells to avoid neglecting weak antibodies. A separate GYP.Bun lineage found in the southern China provides evidence for further complexity in the MNS system.
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Affiliation(s)
- L Wei
- Institute of Clinical Blood Transfusion, Guangzhou Blood Center, Guangzhou, China
| | - Z G Shan
- Institute of Clinical Blood Transfusion, Guangzhou Blood Center, Guangzhou, China
| | - R L Flower
- Clinical Services and Research, Australian Red Cross Blood Service, Brisbane, Australia
| | - Z Wang
- Institute of Clinical Blood Transfusion, Guangzhou Blood Center, Guangzhou, China
| | - J Z Wen
- Institute of Clinical Blood Transfusion, Guangzhou Blood Center, Guangzhou, China
| | - G P Luo
- Institute of Clinical Blood Transfusion, Guangzhou Blood Center, Guangzhou, China.
| | - Y L Ji
- Institute of Clinical Blood Transfusion, Guangzhou Blood Center, Guangzhou, China.
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Affiliation(s)
- Shu-Qin Feng
- a State Key Laboratory for Modification of Chemical Fibers and Polymer Materials , Donghua University , Shanghai, China
| | - Xin-Yuan Shen
- a State Key Laboratory for Modification of Chemical Fibers and Polymer Materials , Donghua University , Shanghai, China
| | - Ya-Li Ji
- a State Key Laboratory for Modification of Chemical Fibers and Polymer Materials , Donghua University , Shanghai, China
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Wang Z, Ji Y, Zhang F. Bond strengths of an epoxy resin-based fiber post with four adhesive systems. Quintessence Int 2010; 41:e173-e180. [PMID: 20806094] [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: 05/29/2023]
Abstract
OBJECTIVES To investigate the push-out bond strengths of one epoxy resin-based quartz-fiber post with four adhesive systems. METHOD AND MATERIALS Forty-four single-rooted, single-canal teeth were randomly divided into four groups (n = 11): One-step (One-Step + Duo-link; Bisco), Variolink II (Excite DSC + Variolink II; Ivoclar Vivadent), Panavia F (ED primer + Panavia F; Kuraray), and RelyX (RelyX Unicem; 3M ESPE). All teeth crowns were removed, and the roots were treated with root canal therapy. Four adhesive systems were employed for bonding of one type of quartz-fiber post, strictly according to the manufacturers' instructions. Ten roots in each group were transversely sectioned into cervical, middle, and apical third slices 2 mm thick, and the bond strengths were measured with the push-out test. The other root was processed for SEM analysis. Two-way ANOVA, one-way ANOVA, and Student-Newman-Keuls test were used for statistical analysis. RESULTS The push-out bond strengths were 7.15 +/- 3.43 MPa (RelyX), 12.48 +/- 9.33 MPa (One-step), 2.96 +/- 2.76 MPa (Panavia F), and 13.43 +/- 6.14 MPa (Variolink II). Two-way ANOVA showed statistically significant differences among adhesive systems (P < .05) and root regions (P < .05). The bond strengths of One-step and Variolink II groups were statistically higher than those of RelyX and Panavia F groups. The bond strengths of the cervical region of One-step and Panavia F groups were statistically significantly higher than those of the other two regions. The SEM images showed uniform and long resin tags in One-step and Variolink II groups, whereas few or no resin tags were visible in the other two groups. CONCLUSION The type of adhesive system and root region had a significant influence on the bond strengths of the adhesively luted fiber posts. Total-etching technique achieved better bond strength than did the self-etching technique.
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Affiliation(s)
- ZhiGang Wang
- Department of Stomatology, The People's Hospital of Henan Province, Zhengzhou, China
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Wang CX, Liu LS, Chen LZ, Chen SY, Wu PG, Fei JG, Qiu J, Deng SX, Zheng KL, Ji YL, Zhu LY, Shen QR, He XS. Characteristics of Neoplasm Occurrence and the Therapeutic Effect of Sirolimus in South Chinese Kidney Transplant Recipients. Transplant Proc 2006; 38:3536-9. [PMID: 17175325 DOI: 10.1016/j.transproceed.2006.10.070] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2006] [Indexed: 11/29/2022]
Abstract
Kidney transplantation (KTx) recipients are at a higher risk of oncogenesis when compared to the general population. Sirolimus (SRL), a potent immunosuppressant, has shown promising antineoplastic effects in vitro and in vivo. This study retrospectively analyzed the neoplasm occurrence and the efficiency of SRL on unresectable malignancies in South Chinese KTx recipients. Thirty-three (1.64%) of 2017 patients who received KTx from January 1984 to December 2004 developed neoplasms at 4 to 117 months posttransplant, mostly in digestive organs (33.3%), the hematologic system (15.2%), or the skin (12.1%). The most common type was liver cancer (24.2%), followed by skin cancer, lymphoma, and thyroid cancer (9.1%). The median survival times were 41.5 and 6.0 months for those who did (n = 10) receive radical surgery or did not (n = 23), respectively. The 20-month survival rates were 70.0% versus 13.0% (P < .01). For unresectable patients, the median survival time of those treated with SRL (n = 8) was 14.5 months compared to 3.0 months for those who did not (n = 15). The survival rates at 12(th) and 20(th) months were 75.0% and 37.5% in the SRL group and 6.7% and 0% in the non-SRL group (P < .05). In conclusion, when compared with Western studies, a lower incidence and unique location pattern (liver cancer-dominant) are characteristics of de novo posttransplant neoplasms in South Chinese KTx recipients. Early diagnosis and feasible radical surgery are favorable for prognosis, and SRL is a treatment of choice for KTx recipients with neoplasms.
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Affiliation(s)
- C X Wang
- Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
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Liu L, Ji YL, Jia DZ, Liu GF, Yu KB. Crystal Structure of Bis{1-methylthio-1-[1-phenyl-1-(1-phenyl-3-methyl-5-oxo-4,5-dihydropyrazol-4-ylene)-methylamino]-iminomethyl} Disulfide with the ?U? Conformation. CHINESE J CHEM 2005. [DOI: 10.1002/cjoc.200590014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Chan TM, Li FK, Tang CS, Wong RW, Fang GX, Ji YL, Lau CS, Wong AK, Tong MK, Chan KW, Lai KN. Efficacy of mycophenolate mofetil in patients with diffuse proliferative lupus nephritis. Hong Kong-Guangzhou Nephrology Study Group. N Engl J Med 2000; 343:1156-62. [PMID: 11036121 DOI: 10.1056/nejm200010193431604] [Citation(s) in RCA: 638] [Impact Index Per Article: 26.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND The combination of cyclophosphamide and prednisolone is effective for the treatment of severe lupus nephritis but has serious adverse effects. Whether mycophenolate mofetil can be substituted for cyclophosphamide is not known. METHODS In 42 patients with diffuse proliferative lupus nephritis we compared the efficacy and side effects of a regimen of prednisolone and mycophenolate mofetil given for 12 months with those of a regimen of prednisolone and cyclophosphamide given for 6 months, followed by prednisolone and azathioprine for 6 months. Complete remission was defined as a value for urinary protein excretion that was less than 0.3 g per 24 hours, with normal urinary sediment, a normal serum albumin concentration, and values for serum creatinine and creatinine clearance that were no more than 15 percent above the base-line values. Partial remission was defined as a value for urinary protein excretion that was between 0.3 and 2.9 g per 24 hours, with a serum albumin concentration of at least 30 g per liter. RESULTS Eighty-one percent of the 21 patients treated with mycophenolate mofetil and prednisolone (group 1) had a complete remission, and 14 percent had a partial remission, as compared with 76 percent and 14 percent, respectively, of the 21 patients treated with cyclophosphamide and prednisolone followed by azathioprine and prednisolone (group 2). The improvements in the degree of proteinuria and the serum albumin and creatinine concentrations were similar in the two groups. One patient in each group discontinued treatment because of side effects. Infections were noted in 19 percent of the patients in group 1 and in 33 percent of those in group 2 (P = 0.29). Other adverse effects occurred only in group 2; they included amenorrhea (in 23 percent of the patients), hair loss (19 percent), leukopenia (10 percent), and death (10 percent). The rates of relapse were 15 percent and 11 percent, respectively. CONCLUSIONS For the treatment of diffuse proliferative lupus nephritis, the combination of mycophenolate mofetil and prednisolone is as effective as a regimen of cyclophosphamide and prednisolone followed by azathioprine and prednisolone but is less toxic.
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Affiliation(s)
- T M Chan
- Department of Medicine, University of Hong Kong and Queen Mary Hospital, Hong Kong, China.
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