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Yan Y, Zheng X, Liu G, Shi G, Li C, Chen H, He X, Lin K, Deng Z, Zhang H, Li WG, Chen H, Tong X, Zhu Z. Gut microbiota-derived cholic acid mediates neonatal brain immaturity and white matter injury under chronic hypoxia. iScience 2024; 27:109633. [PMID: 38638560 PMCID: PMC11025012 DOI: 10.1016/j.isci.2024.109633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 02/18/2024] [Accepted: 03/26/2024] [Indexed: 04/20/2024] Open
Abstract
Chronic hypoxia, common in neonates, disrupts gut microbiota balance, which is crucial for brain development. This study utilized cyanotic congenital heart disease (CCHD) patients and a neonatal hypoxic rat model to explore the association. Both hypoxic rats and CCHD infants exhibited brain immaturity, white matter injury (WMI), brain inflammation, and motor/learning deficits. Through 16s rRNA sequencing and metabolomic analysis, a reduction in B. thetaiotaomicron and P. distasonis was identified, leading to cholic acid accumulation. This accumulation triggered M1 microglial activation and inflammation-induced WMI. Administration of these bacteria rescued cholic acid-induced WMI in hypoxic rats. These findings suggest that gut microbiota-derived cholic acid mediates neonatal WMI and brain inflammation, contributing to brain immaturity under chronic hypoxia. Therapeutic targeting of these bacteria provides a non-invasive intervention for chronic hypoxia patients.
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Affiliation(s)
- Yichen Yan
- Department of Cardiothoracic Surgery, Congenital Heart Center, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Center for Brain Science, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoli Zheng
- Songjiang Hospital and Songjiang Research Institute, Shanghai Key Laboratory of Emotions and Affective Disorders, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Center for Brain Science, Shanghai Children’s Medical Center, Department of Anatomy and Physiology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Gang Liu
- Department of Cardiothoracic Surgery, Congenital Heart Center, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Guocheng Shi
- Department of Cardiothoracic Surgery, Congenital Heart Center, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Cong Li
- Department of Cardiothoracic Surgery, Congenital Heart Center, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hongtong Chen
- Department of Cardiothoracic Surgery, Congenital Heart Center, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaomin He
- Department of Cardiothoracic Surgery, Congenital Heart Center, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Kana Lin
- Center for Brain Science, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Pharmacy, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhaohui Deng
- Department of Gastroenterology, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hao Zhang
- Department of Cardiothoracic Surgery, Congenital Heart Center, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei-Guang Li
- Center for Brain Science, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huiwen Chen
- Department of Cardiothoracic Surgery, Congenital Heart Center, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoping Tong
- Songjiang Hospital and Songjiang Research Institute, Shanghai Key Laboratory of Emotions and Affective Disorders, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Center for Brain Science, Shanghai Children’s Medical Center, Department of Anatomy and Physiology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhongqun Zhu
- Department of Cardiothoracic Surgery, Congenital Heart Center, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Center for Brain Science, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Yan Y, Wang YM, Wang YD, Mao WX, Tian WY, Xue FX. [Incidence and mortality of endometrial cancer in China, data from China Cancer Registry Annual Report, 2004-2017]. Zhonghua Yi Xue Za Zhi 2024; 104:721-728. [PMID: 38462351 DOI: 10.3760/cma.j.cn112137-20231017-00784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Objective: To analysis the incidence rate and mortality rate of endometrial cancer in China from 2004 to 2017 according to the data from China Cancer Registry Annual Report. Methods: The incidence and mortality data of endometrial cancer were extracted from the China Cancer Registry Annual Report 2004 to 2017, and the incidence, mortality, number of new cases, number of deaths were extracted according to the region (national, urban, rural and eastern, middle and western areas) and the age composition of population to estimate the incidence and mortality of endometrial cancer nationwide. The age-standardized incidence rate and mortality rate were calculated based on the Chinese standard population in 2000 (ASIRC, ASIRW) and Segi's world population (ASMRC, ASMRW). Join Point regression was used to calculate the annual percentage change of morbidity rate, and Cochran-Armitage trend test was used to analyze the changing trend of morbidity and mortality. Results: From 2004 to 2017, the number of women covered by the China Cancer Registry Annual Report has increased from 35 571 657 to 215 201 995, and the total population of the covered areas has increased from 5.53% to 31.39%. The crude incidence rate of endometrial cancer increased from 6.20/100 000 to 10.06/100 000, and showed an upward trend over time (P<0.001). After adjusting for age, ASIRC increased from 5.75/100 000 in 2004 to 6.79/100 000 in 2017, and ASIRW increased from 5.60/100 000 in 2004 to 6.56/100 000 in 2017, both showing an upward trend over time (all P<0.001). The crude incidence rates in urban area and rural area were respectively 10.89/100 000 and 9.25/100 000 in 2017, and the ASIRC was higher in urban than rural areas (7.14/100 000 vs 6.43/100 000) after adjusting for age. The ASIRW was higher in eastern areas than middle areas and western areas (7.16/100 000 vs 6.44/100 000 vs 5.60/100 000). The incidence rate in rural areas showed more significant growth than urban areas [annual percent change (APC): 3.2% vs 0.7%, P<0.001]. The age-specific incidence rate increased with age and reached a peak in the age group of 50-54 years (25.70/100 000). Incidence rate in the under-40 age group increased more in rural areas than in urban areas (69.84% vs-7.09%). From 2004 to 2017, the age-standardized mortality rate shows a decreasing trend, with the ASMRC from 1.83/100 000 to 1.47/100 000, and the ASMRW from 1.81/100, 000 to 1.46/100, 000. There was no significant difference between urban and rural areas in mortality of endometrial cancer. Age-specific mortality rates increased with age, reaching a peak in the age group 85 years and older (13.16/100 000). Conclusions: Recent years, there was an increasing incidence rate of endometrial cancer in China. Especially in rural areas, the incidence rate of endometrial cancer is increasing rapidly in young women under 40 years of age. There were differences between urban and rural areas and regions in the incidence rate of endometrial cancer. The incidence rates of endometrial cancer in some high-income cities have occupied the first place of female reproductive system malignant cancers. The age-standardized mortality rate of endometrial cancer shows a decreasing trend.
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Affiliation(s)
- Y Yan
- Department of Gynecology and Obstetrics, Tianjin Key Laboratory of Female Reproductive Health and Eugenics, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Y M Wang
- Department of Gynecology and Obstetrics, Tianjin Key Laboratory of Female Reproductive Health and Eugenics, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Y D Wang
- Department of Gynecology and Obstetrics, Tianjin Key Laboratory of Female Reproductive Health and Eugenics, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - W X Mao
- Department of Gynecology and Obstetrics, Tianjin Key Laboratory of Female Reproductive Health and Eugenics, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - W Y Tian
- Department of Gynecology and Obstetrics, Tianjin Key Laboratory of Female Reproductive Health and Eugenics, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - F X Xue
- Department of Gynecology and Obstetrics, Tianjin Key Laboratory of Female Reproductive Health and Eugenics, Tianjin Medical University General Hospital, Tianjin 300052, China
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Yan Y, Shi X, Li J, Duan W, Zheng S. Five image performances of dual-phase 99mTc-MIBI SPECT/CT in ectopic parathyroid gland localization. QJM 2024; 117:69-72. [PMID: 37802885 DOI: 10.1093/qjmed/hcad230] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Indexed: 10/08/2023] Open
Affiliation(s)
- Y Yan
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - X Shi
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - J Li
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - W Duan
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - S Zheng
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
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Huang S, Bai B, Yan Y, Gao Y, Xi X, Shi H, He H, Wang S, Yang J, Li Y. Prognostic value of the baseline magnetic resonance score in patients with acute posterior circulation ischaemic stroke after mechanical thrombectomy. Clin Radiol 2024; 79:e112-e118. [PMID: 37872027 DOI: 10.1016/j.crad.2023.09.023] [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: 05/01/2023] [Revised: 07/27/2023] [Accepted: 09/15/2023] [Indexed: 10/25/2023]
Abstract
AIM To investigate the prognostic value of the composite posterior circulation Acute Stroke Prognosis Early Computed tomography (CT) Score (ASPECTS)-Collaterals (pcASCO) score, which combines diffusion-weighted imaging (DWI) posterior circulation ASPECTS (pcASPECTS) and the magnetic resonance angiography (MRA)-collateral circulation score at baseline among patients with acute posterior circulation ischaemic stroke after mechanical thrombectomy. MATERIALS AND METHODS Patients with acute posterior circulation ischaemic stroke who underwent mechanical thrombectomy were analysed retrospectively. The DWI-pcASPECTS and MRA-collateral circulation score before treatment and the modified Rankin Scale (mRS) at 90 days after treatment were used as the endpoints. An mRS ≤2 was defined as a good prognosis, and an mRS ≥3 was defined as a poor prognosis. Multivariate logistic regression was used to analyse independent predictors of functional outcome 90 days after mechanical thrombectomy. RESULTS Mechanical thrombectomy was performed in 57 patients; 38 patients had a good prognosis, 19 patients had a poor prognosis, and 33 patients were successfully recanalised. Univariate logistic regression found that National Institute of Health Stroke Scale (NIHSS) score (OR: 1.18, p<0.001), pcASPECTS (OR: 1.91, p=0.028) and pcASCO score (OR: 0.51, p=0.001) were factors of good functional outcome. Receiver operating characteristic curve (ROC curve) analysis showed that the diagnostic efficiency of the NIHSS and pcASCO was better (AUC = 0.88, 0.83, p<0.05) than that of the pcASPECTS (AUC = 0.65). The prediction model was established by age, NIHSS, and pcASCO, and the diagnostic efficiency of the prediction model was better (AUC = 0.94). CONCLUSIONS The composite MR-pcASCO score can be used as an important predictor of the prognosis of patients with acute posterior circulation ischaemic stroke after mechanical thrombectomy.
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Affiliation(s)
- S Huang
- Department of Radiology, Xi'an No. 1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an 710002, China
| | - B Bai
- Department of Radiology, Xi'an No. 1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an 710002, China
| | - Y Yan
- Department of Radiology, Xi'an No. 1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an 710002, China
| | - Y Gao
- Department of Radiology, Xi'an No. 1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an 710002, China
| | - X Xi
- Department of Radiology, Xi'an No. 1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an 710002, China
| | - H Shi
- Department of Radiology, Xi'an No. 1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an 710002, China
| | - H He
- Department of Radiology, Xi'an No. 1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an 710002, China
| | - S Wang
- MR Scientific Marketing, Siemens Healthineers, Shanghai 201318, China
| | - J Yang
- Xi'an No.3 Hospital, The Affiliated Hospital of Northwest University, Xi'an 710018, China.
| | - Y Li
- Department of Radiology, Xi'an No. 1 Hospital, The First Affiliated Hospital of Northwest University, Xi'an 710002, China.
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Cui Y, Yang W, Shuai J, Ma Y, Yan Y. Lifestyle and Socioeconomic Transition and Health Consequences of Alzheimer's Disease and Other Dementias in Global, from 1990 to 2019. J Prev Alzheimers Dis 2024; 11:88-96. [PMID: 38230721 DOI: 10.14283/jpad.2023.63] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
BACKGROUND Previous studies only focused on changes in the global age-specific incidence and mortality for Alzheimer's disease and other dementias, failed to distinguish between cohort and period effects, and did not discuss risk factors separately. METHODS In this study, Alzheimer's disease disability-adjusted life years (DALYs) data to estimate the burden by gender, age, locations, and social-demographic status for 21 regions from 1990 to 2019. Additionally, trend analysis was performed using the age-period-cohort (APC) model and Join-point model. RESULTS In most regions, indicators (incidence, mortality, and DALYs) increased steadily with socio-demographic index(SDI) increased. The age effects for Alzheimer's disease and other dementias showed a significant increase from 40 to 95 years. The cohort effects rate ratios (RRs) had a rapid reduction attributed to smoking, high fasting plasma glucose, and high body mass index (BMI). CONCLUSIONS Countries in middle-low and low SDI regions have higher levels of risk factor exposure. As a result, rapid and effective government responses are necessary to control dementia risk factors and reduce the disease burden in these countries.
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Affiliation(s)
- Y Cui
- Yan Yan , Department of Epidemiology and Medical Statistics, Xiangya school of public health, Central South university, Changsha 410078, China. Tel: 86-18942514496;
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Wu D, Wu S, Narongdej P, Duan S, Chen C, Yan Y, Liu Z, Hong W, Frenkel I, He X. Fast and Facile Liquid Metal Printing via Projection Lithography for Highly Stretchable Electronic Circuits. Adv Mater 2023:e2307632. [PMID: 38126914 DOI: 10.1002/adma.202307632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 12/19/2023] [Indexed: 12/23/2023]
Abstract
Soft electronic circuits are crucial for wearable electronics, biomedical technologies, and soft robotics, requiring soft conductive materials with high conductivity, high strain limit, and stable electrical performance under deformation. Liquid metals (LMs) have become attractive candidates with high conductivity and fluidic compliance, while effective manufacturing methods are demanded. Digital light processing (DLP)-based projection lithography is a high-resolution and high-throughput printing technique for primarily polymers and some metals. If LMs can be printed with DLP as well, the entire soft devices can be fabricated by one printer in a streamlined and highly efficient process. Herein, fast and facile DLP-based LM printing is achieved. Simply with 5-10 s of patterned ultraviolet (UV)-light exposure, a highly conductive and stretchable pattern can be printed using a photo-crosslinkable LM particle ink. The printed eutectic gallium indium traces feature high resolution (≈20 µm), conductivity (3 × 106 S m-1 ), stretchability (≈2500%), and excellent stability (consistent performance at different deformation). Various patterns are printed in diverse material systems for broad applications including stretchable displays, epidermal strain sensors, heaters, humidity sensors, conformal electrodes for electrography, and multi-layer actuators. The facile and scalable process, excellent performance, and diverse applications ensure its broad impact on soft electronic manufacturing.
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Affiliation(s)
- Dong Wu
- Department of Materials Science and Engineering, University of California, Los Angeles (UCLA), Los Angeles, CA, 90095, USA
| | - Shuwang Wu
- Department of Materials Science and Engineering, University of California, Los Angeles (UCLA), Los Angeles, CA, 90095, USA
| | - Poom Narongdej
- Department of Materials Science and Engineering, University of California, Los Angeles (UCLA), Los Angeles, CA, 90095, USA
| | - Sidi Duan
- Department of Materials Science and Engineering, University of California, Los Angeles (UCLA), Los Angeles, CA, 90095, USA
| | - Chi Chen
- Department of Materials Science and Engineering, University of California, Los Angeles (UCLA), Los Angeles, CA, 90095, USA
| | - Yichen Yan
- Department of Materials Science and Engineering, University of California, Los Angeles (UCLA), Los Angeles, CA, 90095, USA
| | - Zixiao Liu
- Department of Materials Science and Engineering, University of California, Los Angeles (UCLA), Los Angeles, CA, 90095, USA
| | - Wen Hong
- Department of Materials Science and Engineering, University of California, Los Angeles (UCLA), Los Angeles, CA, 90095, USA
| | - Imri Frenkel
- Department of Materials Science and Engineering, University of California, Los Angeles (UCLA), Los Angeles, CA, 90095, USA
| | - Ximin He
- Department of Materials Science and Engineering, University of California, Los Angeles (UCLA), Los Angeles, CA, 90095, USA
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Wei A, Zhu GH, Qin MQ, Jia CG, Wang B, Yang J, Luo YH, Jing YF, Yan Y, Zhou X, Wang TY. [Analysis of clinical presentation and genetic characteristics of malignant infantile osteopetrosis]. Zhonghua Er Ke Za Zhi 2023; 61:1038-1042. [PMID: 37899344 DOI: 10.3760/cma.j.cn112140-20230822-00124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
Objective: To investigate the clinical presentation and genetic characteristics of malignant infantile osteopetrosis. Methods: This was a retrospective case study. Thirty-seven children with malignant infantile osteopetrosis admitted into Beijing Children's Hospital from January 2013 to September 2022 were enrolled in this study. According to the gene mutations, the patients were divided into the CLCN7 group and the TCIRG1 group. Clinical characteristics, laboratory tests, and prognosis were compared between two groups. Wilcoxon test or Fisher exact test were used in inter-group comparison. The survival rate was estimated with the Kaplan-Meier method and the Log-Rank test was used to compare the difference in survival between groups. Results: Among the 37 cases, there were 22 males and 15 females. The age of diagnosis was 0.5 (0.2, 1.0) year. There were 13 patients (35%) and 24 patients (65%) with mutations in CLCN7 and TCIRGI gene respectively. Patients in the CLCN7 group had an older age of diagnosis than those in the TCIRGI group (1.2 (0.4, 3.6) vs. 0.4 (0.2, 0.6) years, Z=-2.60, P=0.008). The levels of serum phosphorus (1.7 (1.3, 1.8) vs. 1.1 (0.8, 1.6) mmol/L, Z=-2.59, P=0.010), creatine kinase isoenzyme (CK-MB) (457 (143, 610) vs. 56 (37, 82) U/L, Z=-3.38, P=0.001) and the level of neutrophils (14.0 (9.9, 18.1) vs. 9.2 (6.7, 11.1) ×109/L, Z=-2.07, P=0.039) at diagnosis were higher in the CLCN7 group than that in the TCIRG1 group. However, the level of D-dimer in the CLCN7 group was lower than that in the TCIRGI group (2.7 (1.0, 3.1) vs. 6.3 (2.5, 9.7) μg/L, Z=2.83, P=0.005). After hematopoietic stem cell transplantation, there was no significant difference in 5-year overall survival rate between the two groups (92.3%±7.4% vs. 83.3%±7.6%, χ²=0.56, P=0.456). Conclusions: TCIRGI gene mutations are more common in children with osteopetrosis. Children with TCIRGI gene mutations have younger age, lower levels of phosphorus, CK-MB, and neutrophils and higher level of D-dimer at the onset. After hematopoietic stem cell transplantation, patients with CLCN7 or TCIRGI gene mutations have similar prognosis.
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Affiliation(s)
- A Wei
- Hematology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
| | - G H Zhu
- Hematology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
| | - M Q Qin
- Hematology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
| | - C G Jia
- Hematology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
| | - B Wang
- Hematology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
| | - J Yang
- Hematology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
| | - Y H Luo
- Hematology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
| | - Y F Jing
- Hematology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
| | - Y Yan
- Hematology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
| | - X Zhou
- Hematology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
| | - T Y Wang
- Hematology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
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Hsu EJ, Yan Y, Wardak Z, Dan T, Vo DT, Stojadinovic S. Modeling Gamma Knife Radiosurgical Toxicity for Multiple Brain Metastases. Int J Radiat Oncol Biol Phys 2023; 117:e109. [PMID: 37784643 DOI: 10.1016/j.ijrobp.2023.06.886] [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) Dosing for single fraction radiosurgery has traditionally relied on tumor measurements from a single maximum diameter. Most protocols recommend setting dosing criteria based on assumed risk of radionecrosis roughly correlating with tumor size. However, the risk of radionecrosis after radiosurgery is best modeled by a function of dose and volume treated, with the largest body of evidence supporting the use of brain tissue receiving ≥12 Gy in one fraction (V12, i.e., > 10.9 cm3). Here we show that tumor surface area (SA) and second order dimensions are superior predictors for Gamma Knife radiosurgical toxicity and can be used to estimate V12. MATERIALS/METHODS A total of 1217 brain metastases from 245 patients treated with a prescribed dose from 13 to 27 Gy in one fraction were retrospectively reviewed. Eight independent modeling parameters were considered; 3 geometric tumor characteristics: SA, volume (V), and largest axial dimension (LAD) and 5 treatment planning variables: prescription dose (Rx), coverage, selectivity, gradient index, and number of shots. Linear regression and power-law formulations were performed to determine which parameters were the most accurate predictors of V12. The power model is dependent on a conceptualized "pseudo surface area" (PSA), defined as the surface area of a sphere with a diameter of LAD of a lesion (PSA = π*LAD2). At the aggregate patient level, the model predicts total brain V12 by summing the V12 values for each singular lesion only by using LAD and Rx as input variables. RESULTS Tumor SA was the best univariate linear predictor of V12 (adjR2 = 0.770), followed by LAD (adjR2 = 0.755) and V (adjR2 = 0.745). The SA predictive model improves for lesions that have high sphericity > 0.85 (adjR2 = 0.837), with a measure of 1 indicating a perfect sphere. Using bivariable regression analysis, we formulated a single term power model that even more accurately predicts for V12 (V12 = 0.0137 * Rx1.5 * LAD2, adjR2 = 0.906) and is proportional to PSA. At the patient level, this model also accurately predicts for total brain V12 (adjR2 = 0.896) and V12 > 10.9 cm3 (Sensitivity = 99.1%, Specificity = 90.5%). CONCLUSION Conceptually, SA univariately predicts for V12 more accurately than other tumor physical dimensions or treatment planning parameters, while the best bivariable power model involves PSA. We provide a preplan model for brain metastases that can help better estimate radionecrosis risk, determine prescription doses given a target V12, and provide safe dose escalation strategies without the use of any planning software.
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Affiliation(s)
- E J Hsu
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Y Yan
- University of Texas Southwestern Medical Center, Dallas, TX
| | - Z Wardak
- University of Texas Southwestern Medical Center, Dallas, TX
| | - T Dan
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - D T Vo
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - S Stojadinovic
- University of Texas Southwestern Medical Center, Dallas, TX
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Gallagher KJ, Oh K, Hyun M, Jenkins C, Graff B, Schott D, Wisnoskie SB, Lei Y, Hendley S, Rutar F, Wong J, Wang S, Ahmed M, McNeur J, Taylor J, Schmidt M, Dogan SK, Senadheera L, Smith W, Enke CA, Yan Y, Zhou SM. Initial Experience with the Commercial Electron FLASH Research Extension. Int J Radiat Oncol Biol Phys 2023; 117:S141-S142. [PMID: 37784362 DOI: 10.1016/j.ijrobp.2023.06.552] [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 introduce a new commercial electron FLASH system that has the potential to become widely available for FLASH researchers globally. In this study, we first present the initial acceptance and commissioning tests for the FLASH system, and second, we highlight preliminary FLASH effect results from our cell studies. MATERIALS/METHODS A linear accelerator was converted into a commercial research platform with the FLASH Research Extension, enabling the generation of a powerful 16 MeV electron FLASH beam. The dosimetric and stability tests were conducted using various dosimeters (i.e., radiochromic film, optically stimulated luminescent dosimeters (OSLDs), and a plane-parallel ionization chamber). To evaluate the FLASH effect, normal and cancer cell lines were FLASH irradiated using different pulse repetition frequencies (PRF) of 18 pulses/s and 180 pulses/s. RESULTS The electron FLASH mode was able to generate over 1 Gy per pulse at the isocenter and a dose rate of up to 690 Gy/s near the accessory mount of the Linac gantry head. The charge collected by the plane-parallel ionization chamber at the highest PRF (i.e., 180 pulses/s) showed a linear relationship with the delivered number of pulses (i.e., 1 to 99 pulses) with a coefficient of determination (R2) of 0.9996. The absorbed dose measured using radiochromic film and OSLDs agreed within 3%, on average, and followed an inverse square law as the source-to-axis distance (SAD) varied for which the R2 values were 0.9972 and 0.9955 for radiochromic film and OSLDs, respectively. The profile of the FLASH beam was symmetrical but was not as flat as the conventional 16 MeV electron beam due to the use of a thinner custom scattering foil to reduce the degradation of the ultra-high dose rate. The depth-dose curve beyond the build-up region for the FLASH beam was similar to the conventional 16 MeV electron beam for which the range at 50% the maximum dose (R50) agreed within 0.5 mm. The FLASH beam output remained consistent over a 4-month period with a variation of 2.5%, on average. The FLASH sparing effect was observed in vitro for healthy human pancreatic cells. Furthermore, we observed that the highest PRF beam (180 pulses/s) was more effective at destroying pancreatic cancerous cells while minimizing damage to healthy cells compared to the lowest PRF beam (18 pulses/s). CONCLUSION The novel commercial FLASH Research Extension system was dosimetrically characterized for pre-clinical FLASH research, and preliminary in vitro results demonstrated the FLASH effect. Given the prevalence of linear accelerators, this new commercial system has the potential to greatly increase the access to FLASH research.
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Affiliation(s)
| | - K Oh
- University of Nebraska Medical Center, Omaha, NE
| | - M Hyun
- University of Nebraska Medical Center, Omaha, NE
| | - C Jenkins
- University of Nebraska Medical Center, Omaha, NE
| | - B Graff
- University of Nebraska Medical Center, Omaha, NE
| | - D Schott
- University of Nebraska Medical Center, Omaha, NE
| | | | - Y Lei
- University of Nebraska Medical Center, Omaha, NE
| | - S Hendley
- University of Nebraska Medical Center, Omaha, NE
| | - F Rutar
- University of Nebraska Medical Center, Omaha, NE
| | - J Wong
- University of Nebraska Medical Center, Omaha, NE
| | - S Wang
- University of Nebraska Medical Center, Omaha, NE
| | - M Ahmed
- Varian Medical Systems, Palo Alto, CA
| | - J McNeur
- Varian Medical Systems, Palo Alto, CA
| | - J Taylor
- Varian Medical Systems, Palo Alto, CA
| | - M Schmidt
- Varian Medical Systems, Palo Alto, CA
| | - S K Dogan
- Varian Medical Systems, Palo Alto, CA
| | | | - W Smith
- Varian Medical Systems, Palo Alto, CA
| | - C A Enke
- University of Nebraska Medical Center, Omaha, NE
| | - Y Yan
- University of Nebraska Medical Center, Omaha, NE
| | - S M Zhou
- University of Nebraska Medical Center, Omaha, NE
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Wu L, Yan Y, Xu Y. Induction Immunochemotherapy Followed by Definitive Chemoradiotherapy for Unresectable Locally Advanced Non-Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e75. [PMID: 37786171 DOI: 10.1016/j.ijrobp.2023.06.813] [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) Concurrent chemoradiotherapy (cCRT) followed by immune checkpoint inhibitors (ICIs) consolidation is the current standard of care for unresectable locally advanced non-small cell lung cancer (LA-NSCLC). However, most patients diagnosed with unresectable LA-NSCLC will not meet the criteria for adjuvant ICIs in the real world. Theoretically, adjusting the ICIs from the consolidation phase to the induction setting could greatly improve the patient' s compliance to receive ICIs therapy. Consequently, we performed this study to evaluate the efficacy and safety of induction ICIs and chemotherapy followed by definitive CRT for unresectable LA-NSCLC. MATERIALS/METHODS A total of 102 unresectable stage III NSCLC patients who received neoadjuvant immunochemotherapy followed by definitive CRT between 2019 and 2022 were identified. The primary endpoint of this study was to determine the efficacy of this treatment pattern, including overall survival (OS) and progression free survival (PFS). Disease control rate (DCR) and toxicities were the secondary objective. RESULTS The median age was 64 years (range 34-81), including 58 (56.9%) squamous cell carcinoma and 37 (36.3%) non-squamous cell carcinoma patients. There were 34 (33.3%), 39 (38.2%) and 29 (28.4%) patients with stage IIIA, IIIB and IIIC disease, respectively. The DCR at the end of induction immunochemotherapy was 87.3%. The median PFS was 20.4 months (95% CI, 15.7-25.1), with PFS rates of 90.1% at 6 months, 70.4% at 1 year, 55.2% at 18 months and 41.9% at 2 years. The rates of OS were 92.8%, and 76.2% at 1 year, and 2 years, respectively, and the median OS was not reached. For patients without progression before CRT, the median OS was also not reached, and the median PFS was 21.3 months. Patients receiving concurrent CRT manifested significantly better OS, compared with sequential CRT (12-month OS, 89.4% vs. 100.0%; 24-month OS, 70.2% vs. 87.3%; P = 0.030). Patients with PD-L1 expression of 50% or more manifested significantly higher partial response rate (70.4% vs. 45.3%, P = 0.033), along with better survival (median PFS, 17.3 months vs. NR, P = 0.034; median OS, 26.5 months vs. NR, P = 0.037), compared to those less than 50%. Treatment was well tolerated, with an incidence of 4.9% for grade 3 or greater pneumonitis or radiation pneumonitis (RP). The most common severe (grade ≥3) adverse events were hematologic toxicities and no unexpected treatment related toxicities occurred. CONCLUSION Induction immunochemotherapy followed by definitive CRT showed promising efficacy and tolerable toxicities for unresectable LA-NSCLC, especially for those with tumoral PD-L1 expression over 50%.
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Affiliation(s)
- L Wu
- Department of Radiation Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Y Yan
- Department of Radiation Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Y Xu
- Department of Radiation Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
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11
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Oh K, Gallagher KJ, Schott D, Wisnoskie SB, Lei Y, Hendley S, Wang S, Graff B, Jenkins C, Hyun M, Granatowicz A, Schmidt M, Smith W, McNeur J, Baine M, Enke CA, Yan Y, Zhou SM. Commissioning and Initial Validation of Commercial Treatment Planning System for the Electron FLASH Research Extension. Int J Radiat Oncol Biol Phys 2023; 117:e702-e703. [PMID: 37786060 DOI: 10.1016/j.ijrobp.2023.06.2190] [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 aim of this study was to investigate the feasibility of commissioning the 16 MeV electron FLASH beam in a commercial treatment planning system (TPS) for pre-clinical research purposes. The delivery system consisted of a new commercial solution for which a linear accelerator was modified into a FLASH Research Extension platform. Additionally, preliminary radiation biology results were highlighted to showcase the future use of this system. MATERIALS/METHODS To commission a commercial electron Monte Carlo (MC) for dose calculation of a 16 MeV FLASH beam in the TPS, radiochromic film was used to measure the vendor-required beam data, e.g., profiles and percent depth dose (PDD) curves for cone sizes of 6 × 6 cm2, 10 × 10 cm2, and 15 × 15 cm2 as well as an in-air profile for a 40 × 40 cm2 open field (no cone). Once the electron MC beam model was generated, additional measurements were collected for validation and compared against the calculated dose from the TPS. A treatment planning comparison between the newly commissioned FLASH beam and the conventional electron beam was conducted. Specifically, the dose-volume histograms (DVHs) for target volumes and organs at risk were investigated for skin cancer cases previously treated with conventional electron beams. Lastly, the FLASH dose distribution predicted by the electron MC for an in vitro cell study setup was validated with radiochromic film measurements, and initial radiobiology tests were conducted using FLASH and conventional dose-rate electron beams. RESULTS The electron MC calculated dose for the 16 MeV electron FLASH beam agreed with measured PDDs within 1% for all field sizes. The beam profile characteristics, such as penumbra, shape, and full width at half maximum, demonstrated good agreement with less than 0.5 mm difference between the TPS and measurements. There were noticeable differences in the profiles of large fields between the FLASH and conventional dose-rate beam models due to the more forward-peaked FLASH beam. For treatment planning, Regarding DVH, the FLASH dose-rate plan provided comparable plan quality to the conventional dose-rate plan, achieving adequate coverage for the target volumes and sparing the healthy organs and tissues. The electron MC dose prediction for the FLASH beam was also found to be in good agreement with the film measurements of the in vitro cell study setup. Furthermore, the FLASH beam was observed to be more effective with a 20 % increase in killing pancreatic cancer cells compared to the conventional dose rate. CONCLUSION The study successfully incorporated the 16 MeV electron FLASH Research Extension into the commercial TPS using electron Monte Carlo for dose calculation. This will be valuable for pre-clinical cell and animal studies. This research also enables FLASH treatment planning studies, a key component for the future implementation of FLASH into clinical care. Further research is necessary to incorporate the radiation biology effect of FLASH into the treatment planning system.
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Affiliation(s)
- K Oh
- University of Nebraska Medical Center, Omaha, NE
| | | | - D Schott
- University of Nebraska Medical Center, Omaha, NE
| | | | - Y Lei
- University of Nebraska Medical Center, Omaha, NE
| | - S Hendley
- University of Nebraska Medical Center, Omaha, NE
| | - S Wang
- University of Nebraska Medical Center, Omaha, NE
| | - B Graff
- University of Nebraska Medical Center, Omaha, NE
| | - C Jenkins
- University of Nebraska Medical Center, Omaha, NE
| | - M Hyun
- University of Nebraska Medical Center, Omaha, NE
| | | | - M Schmidt
- Varian Medical Systems, Palo Alto, CA
| | - W Smith
- Varian Medical Systems, Palo Alto, CA
| | - J McNeur
- Varian Medical Systems, Palo Alto, CA
| | - M Baine
- University of Nebraska Medical Center, Omaha, NE
| | - C A Enke
- University of Nebraska Medical Center, Omaha, NE
| | - Y Yan
- University of Nebraska Medical Center, Omaha, NE
| | - S M Zhou
- University of Nebraska Medical Center, Omaha, NE
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12
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Yang M, Hou SM, Yuan L, Wang M, Zheng J, Lu KQ, Yan Y, Zhang SY, Li M, Cao JY, Yang M, Zhang XL, Liu H, Liu BC, Wang Y, Wang B. [The consistency of skeletal muscle mass measured by CT at L 1 and L 3 levels and the correlation of skeletal muscle density at L 1 level with prognosis in dialysis patients]. Zhonghua Yi Xue Za Zhi 2023; 103:2850-2858. [PMID: 37726991 DOI: 10.3760/cma.j.cn112137-20230608-00970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
Objective: To investigate the consistency of skeletal muscle mass by CT at 1st lumbar vertebrae (L1) and 3rd lumbar vertebrae (L3) levels and the correlation of skeletal muscle density (SMD) at L1 level with prognosis in dialysis patients. Methods: A total of 1 020 patients who underwent initial dialysis and had CT examination data in four centers (Zhongda Hospital Affiliated to Southeast University, the Third Affiliated Hospital of Soochow University, Taizhou People's Hospital Affiliated to Nanjing Medical University and the Affiliated Hospital of Yangzhou University) from January 2014 to December 2019 were retrospectively collected. The skeletal muscle index (SMI) and SMD at L1 and L3 CT images were measured and calculated in patients with both L1 and L3 level CT images. The consistency of SMI and SMD at L1 and L3 levels was analyzed, and the cut-off value of SMI and SMD at L1 level for predicting all-cause mortality and their correlation with the prognosis of dialysis patients were studied. Cox regression model was used to analyze the risk factors for all-cause death and cardiac death. Results: A total of 383 patients had both L1 and L3 level images, including 233 males and 150 females. The average SMD value of 16 samples (4.2%) exceeded the 95% consistency limit range (-8.71 to 7.75 HU), and the average SMI value of 15 samples (3.9%) exceeded the 95% consistency limit range (-20.45 to 9.53 HU). The optimal cut-off value of SMD at L1 level for predicting all-cause mortality was 36.46 HU and the area under curve (AUC) of receiver operating characteristic (ROC) curve was 0.658 (95%CI: 0.596-0.721, P<0.001), with the sensitivity and specificity of 83.8% and 57.5%, respectively. SMI at L1 level was not significantly associated with all-cause mortality (P=0.299). Multivariate Cox regression analysis showed that low SMD at L1 level was associated with all-cause mortality (HR=2.861, 95%CI: 1.576-5.193, P=0.001) and cardiac death (HR=3.771, 95%CI:1.462-9.724, P=0.006). Conclusions: SMD at L1 levelis consistent with SMD at L3 level and can be used to evaluate muscle mass. Low SMD is a risk factor for mortality in dialysis patients.
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Affiliation(s)
- M Yang
- Department of Nephrology, Affiliated Hospital of Yangzhou University, Yangzhou 225001, China
| | - S M Hou
- Institute of Nephrology, Zhongda Hospital Affiliated to Southeast University, Nanjing 210009, China
| | - L Yuan
- Department of Nephrology, Affiliated Hospital of Yangzhou University, Yangzhou 225001, China
| | - M Wang
- Department of Nephrology, Affiliated Hospital of Yangzhou University, Yangzhou 225001, China
| | - J Zheng
- Institute of Nephrology, Zhongda Hospital Affiliated to Southeast University, Nanjing 210009, China
| | - K Q Lu
- Institute of Nephrology, Zhongda Hospital Affiliated to Southeast University, Nanjing 210009, China
| | - Y Yan
- Institute of Nephrology, Zhongda Hospital Affiliated to Southeast University, Nanjing 210009, China
| | - S Y Zhang
- Department of Nephrology, Taizhou People's Hospital Affiliated to Nanjing Medical University, Taizhou 225300, China
| | - M Li
- Department of Nephrology, the Third Affiliated Hospital of Soochow University, Changzhou 213000, China
| | - J Y Cao
- Department of Nephrology, Taizhou People's Hospital Affiliated to Nanjing Medical University, Taizhou 225300, China
| | - M Yang
- Department of Nephrology, Affiliated Hospital of Yangzhou University, Yangzhou 225001, China
| | - X L Zhang
- Institute of Nephrology, Zhongda Hospital Affiliated to Southeast University, Nanjing 210009, China
| | - H Liu
- Institute of Nephrology, Zhongda Hospital Affiliated to Southeast University, Nanjing 210009, China
| | - B C Liu
- Institute of Nephrology, Zhongda Hospital Affiliated to Southeast University, Nanjing 210009, China
| | - Y Wang
- Department of Nephrology, Affiliated Hospital of Yangzhou University, Yangzhou 225001, China
| | - B Wang
- Institute of Nephrology, Zhongda Hospital Affiliated to Southeast University, Nanjing 210009, China
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13
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Wang M, Yan Y, Wang BX. [Research progress of vitamin D in inflammatory skin disease]. Zhonghua Yu Fang Yi Xue Za Zhi 2023; 57:1497-1503. [PMID: 37743314 DOI: 10.3760/cma.j.cn112150-20221021-01022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
It is well known that vitamin D is engaged in calcium and phosphorus metabolism. However, vitamin D also plays an important role in other aspects over the past decades, such as immune response. Vitamin D has thus aroused the interest of the scientific community, especially the field of dermatology. The major source of vitamin D comes from the exposure of the skin to ultraviolet B. In turn, vitamin D regulates the proliferation and differentiation of keratinocytes, prevents opportunistic infection, and regulates the inflammatory response and immune response of the skin. Acne, psoriasis, atopic dermatitis, and other inflammatory skin diseases have been found to have a certain relationship with vitamin D. This article review the correlation between vitamin D and inflammatory skin diseases.
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Affiliation(s)
- M Wang
- Department of Dermatology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100144, China
| | - Y Yan
- Department of Dermatology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100144, China
| | - B X Wang
- Department of Dermatology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100144, China
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14
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You MY, Jiang W, Hu YH, Wang MM, Wang TQ, Li XD, Yan Y, Yin DP. [Effect of the varicella vaccination on the clinical characteristics of herpes zoster cases aged 20 years and under]. Zhonghua Yu Fang Yi Xue Za Zhi 2023; 57:1059-1062. [PMID: 37482741 DOI: 10.3760/cma.j.cn112150-20220905-00868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
To discuss the effect of varicella vaccination on the clinical characteristics of herpes zoster (shingles) cases aged 20 years and under, and analyze its clinical features. Based on the Yichang Health Big Data Platform, a descriptive study was conducted to collect the information of cases aged 20 years and under in three medical institutions of Yichang Central People's Hospital, Yichang First People's Hospital and Yichang Second People's Hospital from March 2019 to September 2020. According to the history of varicella vaccine, cases were divided into vaccination group and non-vaccination group, and their clinical features and outcomes were compared. The results showed that 46 shingles cases, aged from 7 to 20 years old, were included in this study. 26 males (56.5%), 20 females (43.5%), 15 cases in vaccination group (32.6%) and 31 cases in non-vaccination group (67.4%). 28 cases had thoracic involvement, followed by lumbar (n=8), cranial (n=7) involvements and extremities (n=7). The spread of herpes skin area: 2 cases involved too large area, 21 cases of 10 cm×10 cm, 14 cases of 5 cm×5 cm, 9 cases of 1 cm×1 cm. Herpes number: 26 cases had 10-49 herpes, followed by <10 herpes (n=9), uncountable herpes (n=7) and 50-99 herpes (n=4). The clinical course[M(Q1,Q3)] lasted 20.5 (13.5,24.8) d averagely, 5 cases had postherpetic neuralgia (PHN) and 1 case had respiratory complications. Shingles decrustation time was significantly shorter in vaccination group (Z=-2.01, P<0.05), and there was no significant difference in other characteristics by vaccination. In conclusion, the number and spread of shingles in most children and adolescents are less, and the complications such as PHN are less. Varicella vaccination can reduce the decrustation time and relieve shingles cases with some clinical symptoms.
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Affiliation(s)
- M Y You
- Office of Epidemiology, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - W Jiang
- Institute of Immunization Program, Yichang Center for Disease Control and Prevention, Yichang 443000, China
| | - Y H Hu
- Office of Epidemiology, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - M M Wang
- Office of Epidemiology, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - T Q Wang
- Office of Epidemiology, Chinese Center for Disease Control and Prevention, Beijing 102206, China Data Resources and Statistics Department, Beijing Municipal Health Big Data and Policy Research Center, Beijing 100034, China
| | - X D Li
- Office of Epidemiology, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Y Yan
- Institute of Immunization Program, Yichang Center for Disease Control and Prevention, Yichang 443000, China
| | - D P Yin
- Hainan Center for Disease Control and Prevention, Haikou 570203, China
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15
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Zhang YJ, Qiao LY, Qi M, Yan Y, Kang WW, Liu GZ, Wang MY, Xi YF, Wang SF. [Development and validation of risk prediction model for new-onset cardiovascular diseases among breast cancer patients: Based on regional medical data of Inner Mongolia]. Beijing Da Xue Xue Bao Yi Xue Ban 2023; 55:471-479. [PMID: 37291923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To develop and validate a three-year risk prediction model for new-onset cardiovascular diseases (CVD) among female patients with breast cancer. METHODS Based on the data from Inner Mongolia Regional Healthcare Information Platform, female breast cancer patients over 18 years old who had received anti-tumor treatments were included. The candidate predictors were selected by Lasso regression after being included according to the results of the multivariate Fine & Gray model. Cox proportional hazard model, Logistic regression model, Fine & Gray model, random forest model, and XGBoost model were trained on the training set, and the model performance was evaluated on the testing set. The discrimination was evaluated by the area under the curve (AUC) of the receiver operator characteristic curve (ROC), and the calibration was evaluated by the calibration curve. RESULTS A total of 19 325 breast cancer patients were identified, with an average age of (52.76±10.44) years. The median follow-up was 1.18 [interquartile range (IQR): 2.71] years. In the study, 7 856 patients (40.65%) developed CVD within 3 years after the diagnosis of breast cancer. The final selected variables included age at diagnosis of breast cancer, gross domestic product (GDP) of residence, tumor stage, history of hypertension, ischemic heart disease, and cerebrovascular disease, type of surgery, type of chemotherapy and radiotherapy. In terms of model discrimination, when not considering survival time, the AUC of the XGBoost model was significantly higher than that of the random forest model [0.660 (95%CI: 0.644-0.675) vs. 0.608 (95%CI: 0.591-0.624), P < 0.001] and Logistic regression model [0.609 (95%CI: 0.593-0.625), P < 0.001]. The Logistic regression model and the XGBoost model showed better calibration. When considering survival time, Cox proportional hazard model and Fine & Gray model showed no significant difference for AUC [0.600 (95%CI: 0.584-0.616) vs. 0.615 (95%CI: 0.599-0.631), P=0.188], but Fine & Gray model showed better calibration. CONCLUSION It is feasible to develop a risk prediction model for new-onset CVD of breast cancer based on regional medical data in China. When not considering survival time, the XGBoost model and the Logistic regression model both showed better performance; Fine & Gray model showed better performance in consideration of survival time.
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Affiliation(s)
- Y J Zhang
- Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - L Y Qiao
- Inner Mongolia Integrative Center for Disease Control and Prevention, Hohhot 010031, China
| | - M Qi
- Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education; Breast Center, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Y Yan
- Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education; Department of Breast Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - W W Kang
- Inner Mongolia Integrative Center for Disease Control and Prevention, Hohhot 010031, China
| | - G Z Liu
- Beijing PD Cloud Medical Technology Co., LTD, Beijing 100080, China
| | - M Y Wang
- Beijing PD Cloud Medical Technology Co., LTD, Beijing 100080, China
| | - Y F Xi
- Inner Mongolia Integrative Center for Disease Control and Prevention, Hohhot 010031, China
| | - S F Wang
- Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
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16
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Nandi S, Yan Y, Yuan X, Wang C, He X, Li Y, Das SK. Investigation of reversible metal ion (Li +, Na +, Mg 2+, Al 3+) insertion in MoTe 2 for rechargeable aqueous batteries. Phys Chem Chem Phys 2023; 25:13833-13837. [PMID: 37162519 DOI: 10.1039/d3cp00354j] [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: 05/11/2023]
Abstract
In this work, we report the electrochemical reactivity of MoTe2 for various metal ions with special emphasis on Al3+ ion storage in aqueous electrolytes for the first time. A stable discharge capacity of 100 mA h g-1 over 250 cycles at a current density of 1 Ag-1 could be obtained for the Al3+ ion, whereas inferior storage capacities were shown for other metal ions.
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Affiliation(s)
- Sunny Nandi
- Department of Physics, Tezpur University, Assam 784028, India.
- Department of Chemical and Biomolecular Engineering, University of California, Los Angeles 90095, USA.
| | - Yichen Yan
- Department of Material Science and Engineering, University of California, Los Angeles 90095, USA
| | - Xintong Yuan
- Department of Chemical and Biomolecular Engineering, University of California, Los Angeles 90095, USA.
| | - Chongzhen Wang
- Department of Chemical and Biomolecular Engineering, University of California, Los Angeles 90095, USA.
| | - Ximin He
- Department of Material Science and Engineering, University of California, Los Angeles 90095, USA
| | - Yuzhang Li
- Department of Chemical and Biomolecular Engineering, University of California, Los Angeles 90095, USA.
| | - Shyamal K Das
- Department of Physics, Tezpur University, Assam 784028, India.
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17
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Yan Y, Duan S, Liu B, Wu S, Alsaid Y, Yao B, Nandi S, Du Y, Wang TW, Li Y, He X. Tough Hydrogel Electrolytes for Anti-Freezing Zinc-Ion Batteries. Adv Mater 2023; 35:e2211673. [PMID: 36932878 DOI: 10.1002/adma.202211673] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/04/2023] [Indexed: 05/05/2023]
Abstract
As the soaring demand for energy storage continues to grow, batteries that can cope with extreme conditions are highly desired. Yet, existing battery materials are limited by weak mechanical properties and freeze-vulnerability, prohibiting safe energy storage in devices that are exposed to low temperature and unusual mechanical impacts. Herein, a fabrication method harnessing the synergistic effect of co-nonsolvency and "salting-out" that can produce poly(vinyl alcohol) hydrogel electrolytes with unique open-cell porous structures, composed of strongly aggregated polymer chains, and containing disrupted hydrogen bonds among free water molecules, is introduced. The hydrogel electrolyte simultaneously combines high strength (tensile strength 15.6 MPa), freeze-tolerance (< -77 °C), high mass transport (10× lower overpotential), and dendrite and parasitic reactions suppression for stable performance (30 000 cycles). The high generality of this method is further demonstrated with poly(N-isopropylacrylamide) and poly(N-tertbutylacrylamide-co-acrylamide) hydrogels. This work takes a further step toward flexible battery development for harsh environments.
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Affiliation(s)
- Yichen Yan
- Department of Materials Science and Engineering, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Sidi Duan
- Department of Materials Science and Engineering, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Bo Liu
- Department of Chemical and Biomolecular Engineering, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Shuwang Wu
- Department of Materials Science and Engineering, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Yousif Alsaid
- Department of Materials Science and Engineering, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Bowen Yao
- Department of Materials Science and Engineering, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Sunny Nandi
- Department of Chemical and Biomolecular Engineering, University of California, Los Angeles, Los Angeles, CA, 90095, USA
- Department of Physics, Tezpur University, Assam, 784028, India
| | - Yingjie Du
- Department of Materials Science and Engineering, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Ta-Wei Wang
- Department of Materials Science and Engineering, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Yuzhang Li
- Department of Chemical and Biomolecular Engineering, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Ximin He
- Department of Materials Science and Engineering, University of California, Los Angeles, Los Angeles, CA, 90095, USA
- California Nanosystems Institute, Los Angeles, CA, 90095, USA
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18
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Cao F, Hu XJ, Kang RF, Chen TY, Deng H, Xia YZ, Yan Y. [Clinical application of a quantitative method of atlantoaxial reduction angle in basilar invagination]. Zhonghua Wai Ke Za Zhi 2023; 61:412-417. [PMID: 36987676 DOI: 10.3760/cma.j.cn112139-20221202-00511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
Objectives: To investigate the clinical application effect of a quantitative method of atlantoaxial reduction angle in basilar invagination. Methods: A retrospective analysis of clinical and radiographic data was conducted of 38 patients with complicated atlantoaxial dislocation and basilar invagination admitted to the Department of Neurosurgery, First Affiliated Hospital of Chongqing Medical University from May 2020 to May 2022. There were 5 males and 33 females, aged (53.5±9.9) years (range: 38 to 80 years). All patients underwent C1-2 interarticular fusion cage implantation+occipital-cervical fixation by pressing rob with the cantilever technique. The atlantoaxial reduction model of previous studies by our team was used to calculate the reduction angles before surgery. Then titanium rods of prebending angle were prepared according to the calculation before the operation. After that quantitative reduction of angle was performed during the operation. The paired t-test was used to compare the difference between the theoretical and actual reset value. Results: The theoretical reduction angle of all patients was (10.62±1.78)° (range: 6.40° to 13.20°), the actual reduction angle was (10.53±1.63)° (range: 6.70° to 13.30°) and there was no statistical difference between them (t=1.688, P=0.100). The theoretical posterior occipitocervical angle after the operation of all patients was (117.37±5.88)° (range: 107.00° to 133.00°), the actual posterior occipitocervical angle after the operation was (118.25±6.77)° (range: 105.40° to 135.80°) and there was no statistical difference between them (t=-0.737, P=0.466). The postoperative follow-up time of the patients was more than 6 months and the symptoms of all patients were relieved. All patients had satisfactory fusion between small joints without incision infection, internal fixation fracture, displacement, atlantoaxial redislocation, and other long-term complications. Conclusion: The quantitative method of atlantoaxial reduction angle in basilar invagination can calculate the theoretical reduction angle of the clivus axis angle and guide the preparation of the pre-bending titanium rod before surgery, so as to realize the quantification of the atlantoaxial reduction angle.
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Affiliation(s)
- F Cao
- Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - X J Hu
- Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - R F Kang
- Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - T Y Chen
- Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - H Deng
- Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Y Z Xia
- Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Y Yan
- Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
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Sherman E, Lee JL, Debruyne PR, Keam B, Shin SJ, Gramza A, Caro I, Amin R, Shah K, Yan Y, Huddart R, Powles T. Safety and efficacy of cobimetinib plus atezolizumab in patients with solid tumors: a phase II, open-label, multicenter, multicohort study. ESMO Open 2023; 8:100877. [PMID: 36947985 PMCID: PMC10163002 DOI: 10.1016/j.esmoop.2023.100877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 12/21/2022] [Accepted: 01/16/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND Although introduction of immune checkpoint inhibitors has revolutionized the treatment of cancer, their response rates are generally low. Preclinical and early phase clinical data suggest that MEK inhibition may sensitize tumors to immune checkpoint inhibitors by upregulating tumor antigen expression, programmed death-ligand 1 (PD-L1) expression, and tumor T-cell infiltration. We evaluated the efficacy and safety of cobimetinib plus atezolizumab in patients with advanced solid tumors in the open-label, multicohort phase II COTEST study. PATIENTS AND METHODS This analysis of the COTEST trial included patients from cohorts 1-4 [1-3: anti-programmed cell death protein 1 (PD-1)/PD-L1 treatment-naive patients; 4: patients with disease progression on anti-PD-1/anti-PD-L1 treatment] who received cobimetinib 60 mg once daily for the first 21 days and intravenous infusions of atezolizumab 840 mg on days 1 and 15 of each 28-day cycle. Efficacy endpoints included objective response rate, overall survival, progression-free survival (PFS), and disease control rate. RESULTS Overall, 77 patients were enrolled in cohorts 1-4 (78% male; median age 62.8 years). Objective response rate was 20% in cohort 1 [squamous cell carcinoma of the head and neck (SCCHN)], 30% in cohort 2 (urothelial carcinoma), and 18% in cohort 3 (renal cell carcinoma); there were no responders among 20 patients in cohort 4 (SCCHN). The disease control rates in cohorts 1-4 were 50%, 40%, 24%, and 25%, respectively. The median PFS was 5.5, 3.4, 3.4, and 3.6 months in cohorts 1-4, respectively, and the median overall survival was 16.8, 18.7, 21.7, and 7.7 months, respectively. Most adverse events were of grade 1/2 and were manageable. CONCLUSIONS Cobimetinib plus atezolizumab had moderate activity in patients with anti-PD-1/PD-L1 treatment-naive SCCHN and urothelial carcinoma, and weak activity in anti-PD-1/PD-L1 treatment-naive renal cell carcinoma, and no activity in checkpoint inhibitor-treated patients.
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Affiliation(s)
- E Sherman
- Memorial Sloan Kettering Cancer Center, Head and Neck Oncology Service, New York, USA.
| | - J L Lee
- University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - P R Debruyne
- Kortrijk Cancer Centre, AZ Groeninge, Kortrijk, Belgium; Anglia Ruskin University, School of Life Sciences, Cambridge, UK
| | - B Keam
- Seoul National University Hospital, Department of Internal Medicine, Seoul
| | - S J Shin
- Yonsei Cancer Center, Department of Internal Medicine, Seoul, South Korea
| | - A Gramza
- Georgetown University Medical Center, Division of Hematology and Oncology, Washington DC
| | - I Caro
- Genentech, Inc, South San Francisco, USA
| | - R Amin
- Genentech, Inc, South San Francisco, USA
| | - K Shah
- Genentech, Inc, South San Francisco, USA
| | - Y Yan
- Genentech, Inc, South San Francisco, USA
| | - R Huddart
- The Royal Marsden, Royal Marsden Hospital Fulham, Urology Unit, Chelsea, London. https://twitter.com/robert_huddart
| | - T Powles
- Barts & London School of Medicine, Garrod Building, London, UK. https://twitter.com/tompowles1
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20
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Wang B, Chen H, Peng S, Li X, Liu X, Ren H, Yan Y, Zhang Q. Multifunctional magnesium-organic framework doped biodegradable bone cement for antibacterial growth, inflammatory regulation and osteogenic differentiation. J Mater Chem B 2023; 11:2872-2885. [PMID: 36896799 DOI: 10.1039/d2tb02705d] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
Degradable bone cement has superior osteoconductivity and plasticity and is commonly used to treat defects greater than the critical-size. Magnesium gallate metal-organic frameworks (MOFs) (Mg-MOF), with antibacterial and anti-inflammatory properties, are doped into a composite cement composed of calcium sulfate, calcium citrate, and dicalcium hydrogen phosphate anhydrous (CS/CC/DCPA). The doping of the Mg-MOF slightly influences the microstructure and curing properties of the composite cement, with the mechanical strength of the cement displaying a significant increase from 27 to 32 MPa. Antibacterial tests reveal that the Mg-MOF bone cement has excellent antibacterial characteristics and can effectively inhibit bacterial growth in 4 h (Staphyloccocus aureus survival rate <10%). Herein, lipopolysaccharide (LPS)-induced macrophage models are used to investigate the anti-inflammatory characteristics of composite cement. The Mg-MOF bone cement can regulate the inflammatory factors and polarization of macrophages (M1 and M2). In addition, the composite cement promotes cell proliferation and osteo-differentiation of mBMSCs, and the activity of alkaline phosphatase and calcium nodules are increased. The bone related transcription factor and specific proteins, such as runt-related transcription factor 2 (Runx2), bone morphogenetic protein 2, osteocalcin (OCN), osteopontin (OPN), and collagen type 1 (COL1), were highly expressed by the Mg-MOF bone cements. Therefore, Mg-MOF doped CS/CC/DCPA bone cement is multifunctional for bone repair, which will promote bone formation and avoid the infection of wounds, and it is suitable for use with non-load-bearing bone defects.
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Affiliation(s)
- B Wang
- School of Chemical Engineering, Sichuan University, Chengdu, Sichuan 610065, P. R. China.
| | - H Chen
- College of Physical Science and Technology, Sichuan University, Chengdu, Sichuan 610065, P. R. China.
| | - S Peng
- School of Chemical Engineering, Sichuan University, Chengdu, Sichuan 610065, P. R. China.
| | - X Li
- College of Physical Science and Technology, Sichuan University, Chengdu, Sichuan 610065, P. R. China.
| | - X Liu
- College of Physical Science and Technology, Sichuan University, Chengdu, Sichuan 610065, P. R. China.
| | - H Ren
- College of Physical Science and Technology, Sichuan University, Chengdu, Sichuan 610065, P. R. China.
| | - Y Yan
- College of Physical Science and Technology, Sichuan University, Chengdu, Sichuan 610065, P. R. China.
| | - Q Zhang
- School of Chemical Engineering, Sichuan University, Chengdu, Sichuan 610065, P. R. China.
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21
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Zhang Q, Zhu F, Shi G, Hu C, Zhang W, Huang P, Zhu C, Gu H, Yang D, Li Q, Niu Y, Chen H, Ma R, Pan Z, Miao H, Zhang X, Li G, Tang Y, Qiao G, Yan Y, Zhu Z, Zhang H, Han F, Li Y, Lin J, Chen H. Maternal Outcomes Among Pregnant Women With Congenital Heart Disease-Associated Pulmonary Hypertension. Circulation 2023; 147:549-561. [PMID: 36780387 DOI: 10.1161/circulationaha.122.057987] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
BACKGROUND Studies focused on pregnant women with congenital heart disease (CHD)-associated pulmonary hypertension (PH) are scarce and limited by small sample sizes and single-center design. This study sought to describe the pregnancy outcomes in women with CHD with and without PH. METHODS Outcomes for pregnant women with CHD were evaluated retrospectively from 1993 to 2016 and prospectively from 2017 to 2019 from 7 tertiary hospitals. PH was diagnosed on the basis of echocardiogram or catheterization. The incidence of maternal death, cardiac complications, and obstetric and offspring complications was compared for women with CHD and no PH, mild, and moderate-to-severe PH. RESULTS A total of 2220 pregnant women with CHD had completed pregnancies. PH associated with CHD was identified in 729 women, including 398 with mild PH (right ventricle to right atrium gradient 30-50 mm Hg) and 331 with moderate-to-severe PH (right ventricle to right atrium gradient >50 mm Hg). Maternal mortality occurred in 1 (0.1%), 0, and 19 (5.7%) women with CHD and no, mild, or moderate-to-severe PH, respectively. Of the 729 patients with PH, 619 (85%) had CHD-associated pulmonary arterial hypertension, and 110 (15%) had other forms of PH. Overall, patients with mild PH had better maternal outcomes than those with moderate-to-severe PH, including the incidence of maternal mortality or heart failure (7.8% versus 39.6%; P<0.001), other cardiac complications (9.0% versus 32.3%; P<0.001), and obstetric complications (5.3% versus 15.7%; P<0.001). Brain natriuretic peptide >100 ng/L (odds ratio, 1.9 [95% CI, 1.0-3.4], P=0.04) and New York Heart Association class III to IV (odds ratio, 2.9 [95% CI, 1.6-5.3], P<0.001) were independently associated with adverse maternal cardiac events in pregnancy with PH, whereas follow-up with a multidisciplinary team (odds ratio, 0.4 [95% CI, 0.2-0.6], P<0.001) and strict antenatal supervision (odds ratio, 0.5 [95% CI, 0.3-0.7], P=0.001) were protective. CONCLUSIONS Women with CHD-associated mild PH appear to have better outcomes compared with women with CHD-associated moderate-to-severe PH, and with event rates similar for most outcomes with women with CHD and no PH. Multimodality risk assessment, including PH severity, brain natriuretic peptide level, and New York Heart Association class, may be useful in risk stratification in pregnancy with PH. Follow-up with a multidisciplinary team and strict antenatal supervision during pregnancy may also help to mitigate the risk of adverse maternal cardiac events.
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Affiliation(s)
- Qian Zhang
- Department of Cardiothoracic Surgery, Heart Center (Q.Z., F.Z., G.S., C.H., R.M., Y.Y., Z.Z., H.Z., Huiwen Chen), China
| | - Fang Zhu
- Department of Cardiothoracic Surgery, Heart Center (Q.Z., F.Z., G.S., C.H., R.M., Y.Y., Z.Z., H.Z., Huiwen Chen), China.,Shanghai Children's Medical Center, Department of Surgical Oncology, Shanghai Lung Cancer Center, Shanghai Chest Hospital (F.Z.), China
| | - Guocheng Shi
- Department of Cardiothoracic Surgery, Heart Center (Q.Z., F.Z., G.S., C.H., R.M., Y.Y., Z.Z., H.Z., Huiwen Chen), China
| | - Chen Hu
- Department of Cardiothoracic Surgery, Heart Center (Q.Z., F.Z., G.S., C.H., R.M., Y.Y., Z.Z., H.Z., Huiwen Chen), China.,Department of Cardiovascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China (C.H.)
| | | | - Puzhen Huang
- Shanghai Jiao Tong University School of Medicine (P.H., Z.P.), China
| | - Chunfeng Zhu
- Department of Obstetrics and Gynecology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, China (C.Z., F.H.)
| | - Hong Gu
- Department of Pediatric Cardiology (H.G., Q.L.), Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, China
| | - Dong Yang
- Department of Obstetrics and Gynecology (D.Y., X.Z., Y.L.), Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, China
| | - Qiangqiang Li
- Department of Pediatric Cardiology (H.G., Q.L.), Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, China
| | - Yonghua Niu
- Department of Ultrasound (Y.N.), Renji Hospital, Shanghai Jiao Tong University School of Medicine, China
| | - Hao Chen
- Department of Cardiology, Heart Center (Hao Chen), China
| | - Ruixiang Ma
- Department of Cardiothoracic Surgery, Heart Center (Q.Z., F.Z., G.S., C.H., R.M., Y.Y., Z.Z., H.Z., Huiwen Chen), China
| | - Ziyi Pan
- Shanghai Jiao Tong University School of Medicine (P.H., Z.P.), China
| | - Huixian Miao
- Department of Obstetrics and Gynecology (J.L., H.M.), Renji Hospital, Shanghai Jiao Tong University School of Medicine, China.,Department of Gynecology, Jiangsu Province Hospital, The First Affiliated Hospital with Nanjing First Medical University, China (H.M.)
| | - Xin Zhang
- Department of Obstetrics and Gynecology (D.Y., X.Z., Y.L.), Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, China
| | - Genxia Li
- Department of Obstetrics, Third Affiliated Hospital of Zhengzhou University, Henan, China (G.L.)
| | - Yabing Tang
- Department of Obstetrics Section 3, Hunan Provincial Maternal and Child Health Care Hospital, China (Y.T.)
| | - Guyuan Qiao
- Department of Obstetrics and Gynecology, Xijing Hospital, Fourth Military Medical University, Xi'an, China (G.Q.)
| | - Yichen Yan
- Department of Cardiothoracic Surgery, Heart Center (Q.Z., F.Z., G.S., C.H., R.M., Y.Y., Z.Z., H.Z., Huiwen Chen), China
| | - Zhongqun Zhu
- Department of Cardiothoracic Surgery, Heart Center (Q.Z., F.Z., G.S., C.H., R.M., Y.Y., Z.Z., H.Z., Huiwen Chen), China
| | - Hao Zhang
- Department of Cardiothoracic Surgery, Heart Center (Q.Z., F.Z., G.S., C.H., R.M., Y.Y., Z.Z., H.Z., Huiwen Chen), China
| | - Fengzhen Han
- Department of Obstetrics and Gynecology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, China (C.Z., F.H.)
| | - Yanna Li
- Department of Obstetrics and Gynecology (D.Y., X.Z., Y.L.), Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, China
| | - Jianhua Lin
- Department of Obstetrics and Gynecology (J.L., H.M.), Renji Hospital, Shanghai Jiao Tong University School of Medicine, China
| | - Huiwen Chen
- Department of Cardiothoracic Surgery, Heart Center (Q.Z., F.Z., G.S., C.H., R.M., Y.Y., Z.Z., H.Z., Huiwen Chen), China.,Clinical Research Center (Huiwen Chen), China.,Guizhou Branch (Huiwen Chen), China
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22
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Shi G, Zhu F, Wen C, Yan Y, Zhang H, Zhu Z, Chen H. Cardiac-type total anomalous pulmonary venous return is not benign. J Thorac Cardiovasc Surg 2023; 165:449-459.e4. [PMID: 35570017 DOI: 10.1016/j.jtcvs.2022.03.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 03/25/2022] [Accepted: 03/30/2022] [Indexed: 01/18/2023]
Abstract
OBJECTIVE The objective of this study was to investigate the association between morphological variation and postsurgical pulmonary vein (PV) stenosis (PPVS) in patients with cardiac total anomalous pulmonary venous connection (TAPVC). METHODS This single-center, retrospective study included 168 pediatric patients who underwent surgical repair of cardiac TAPVC from 2013 to 2019 (connection to the coronary sinus [CS], n = 136; connection directly to the right atrium [RA], n = 32). Three-dimensional computed tomography modeling and geometric analysis were performed to investigate the morphological features; their relevance to the PPVS was examined. RESULTS The connection type had no association with PPVS (CS type: 18% vs right atrial type: 19%; P = .89) but there was a higher incidence of PPVS in patients with a single PV orifice than > 1 orifice (P < .001). Confluence-to-total PV area ratio (hazard ratio, 4.78, 95% CI, 1.86-12.32; P = .001) and length of drainage route (hazard ratio, 1.22; 95% CI, 1.14-1.31; P < .001) had a 4- and 1-fold increase in the risk for PPVS in the CS type after adjustment for age and preoperative pulmonary venous obstruction. In the right atrial type, those with anomalous PV return to the RA roof were more likely to develop PPVS than to the posterior wall of the RA (P < .001). CONCLUSIONS The number of inter-junction PV orifice correlated with PPVS development in cardiac TAPVC. The confluence-to-total PV ratio, length of drainage route, and anomalous PV return to the RA roof are important predictors for PPVS. Morphological subcategorization in this clinical setting can potentially assist in surgical decision-making.
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Affiliation(s)
- Guocheng Shi
- Department of Cardio-thoracic Surgery, Congenital Heart Center, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fang Zhu
- Department of Cardio-thoracic Surgery, Congenital Heart Center, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chen Wen
- Department of Cardio-thoracic Surgery, Congenital Heart Center, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yichen Yan
- Department of Cardio-thoracic Surgery, Congenital Heart Center, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hao Zhang
- Department of Cardio-thoracic Surgery, Congenital Heart Center, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhongqun Zhu
- Department of Cardio-thoracic Surgery, Congenital Heart Center, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Huiwen Chen
- Department of Cardio-thoracic Surgery, Congenital Heart Center, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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23
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Lin QD, Liu LN, Liu XY, Yan Y, Fang BJ, Zhang YL, Zhou J, Li YF, Zuo WL, Song YP. Author Correction: Experimental study on thioredoxin redox inhibitor 1-methylpropyl 2-imidazolyl disulfide promoting apoptosis of multiple myeloma cells in vitro and in vivo. Eur Rev Med Pharmacol Sci 2023; 27:2. [PMID: 36647846 DOI: 10.26355/eurrev_202301_30845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Correction to: European Review for Medical and Pharmacological Sciences 2022; 26 (4): 1283-1292. DOI: 10.26355/eurrev_202202_28121-PMID: 35253185-published online on December 15, 2022. After publication, the authors corrected the order of the author's affiliations as follows: Q.-D. Lin1,2,3,4, L.-N. Liu1,2,3,4, X.-Y. Liu1,2, Y. Yan1,2, B.-J. Fang1,2,3,4, Y.-L. Zhang1,2,3,4, J. Zhou1,2,3,4, Y.-F. Li1,2,3,4, W.-L. Zuo1,2,3,4, Y.-P. Song1,2,3,4 1Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou City, Henan Province, China 2Henan Cancer Hospital, Zhengzhou City, Henan Province, China 3Henan Key Lab of Experimental Hematology, Zhengzhou City, Henan Province, China 4Henan Institute of Hematology, Zhengzhou City, Henan Province, China There are amendments to this paper. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/28121.
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Affiliation(s)
- Q-D Lin
- Henan Key Lab of Experimental Hematology, Henan Institute of Hematology, Henan Cancer Hospital, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
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Yan Y, Wang S, Lin C. BCL11B Upregulates the Expression of RelA in T Cells Stimulated with Staphylococcal Enterotoxin A. Bull Exp Biol Med 2022; 174:259-264. [PMID: 36602602 DOI: 10.1007/s10517-023-05685-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Indexed: 01/06/2023]
Abstract
We explored the potential link between RelA and BCL11B transcription factors. To this end, Jurkat and Raji cells (Jurkat:Raji 10:1), as well as normal human peripheral blood T cells, were activated by staphylococcal enterotoxin A (SEA) and the expressions of both BCL11B and RelA mRNA and proteins were detected. BCL11B small interfering RNA was then transduced into Jurkat cells. Under the effect of SEA stimulation, the expression of BCL11B and RelA mRNA increased in two types of T cell lines over time, and the results were comparable with the levels of expression of BCL11B and RelA proteins. In the BCL11B-knockdown cells, the expression of RelA protein did not increase. These findings suggest that BCL11B regulates RelA expression in Jurkat cells and human peripheral blood T cells from healthy donors via the T-cell receptor signaling pathway.
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Affiliation(s)
- Y Yan
- State Key Laboratory for Organ Failure Research & National Clinical Research Center for Kidney Disease, Guangdong Provincial Clinical Research Center for Kidney Disease, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
| | - S Wang
- Affiliated Maternity and Child Health Hospital of Anhui Medical University, Maternity and Child Health Hospital of Anhui Province, Hefei, China
| | - C Lin
- Department of Microbiology and Immunology, Jinan University, Guangzhou, China
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Duan WR, Zhang BY, Qi MY, Xin Z, Du YQ, Zhang C, Liu ZL, Yan Y, Lu YT, Jian FZ, Chen Z. [Surgical treatment strategy for difficult-reducible atlantoaxial dislocation]. Zhonghua Yi Xue Za Zhi 2022; 102:3443-3448. [PMID: 36396360 DOI: 10.3760/cma.j.cn112137-20220427-00940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Objective: To discuss the surgical strategy for difficult-reducible atlantoaxial dislocation. Methods: Clinical data of 82 patients with difficult-reducible atlantoaxial dislocation underwent surgical treatment in the Department of Neurosurgery, Xuanwu Hospital from January 2018 to February 2019 were retrospectively reviewed. Total of 32 men and 50 women were included, with a mean age of (41.8±12.9) years. Most cases (n=80) were treated with one-staged posterior atlantoaxial joint distraction and cage implantation, a few (n=2) underwent ventral decompression. All cases were followed up, postoperative improvement of clinical symptoms and radiology parameters were analyzed. Results: Of the patients, 80 cases (97.6%) received one-staged posterior atlantoaxial joint distraction and cage implantation; lateral facet joint bony fusion was found in 4 patients and was cut off with an osteotome. Transoral odontoidectomy was performed in 2 cases (2.4%) with fused atlanto-odontoid joint. All the patients were followed-up for (18.6±7.3) months. Postoperative CT showed complete reduction of ADI was achieved in 60 patients (75.0%). The ADI decreased significantly after the operation [(2.1±1.4) mm vs (5.0±1.5) mm, P<0.05]. The postoperative vertical distance between odontoid process and the Chamberlain line decreased significantly when compared with that before the operation [(3.9±3.8) mm vs (10.2±5.2) mm, P<0.05]. The mean JOA score at 6 months post operation improved significantly than that before the operation (13.7±1.5 vs 11.2±1.7, P<0.05). Seventy-five patients (93.8%) had atlantoaxial intra-articular bony fusion at 1 year follow-up. Conclusion: Most difficult-reducible atlantoaxial dislocations can be managed well by posterior one-staged atlantoaxial joint distraction and Cage implantation.
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Affiliation(s)
- W R Duan
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - B Y Zhang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - M Y Qi
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Z Xin
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Y Q Du
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - C Zhang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Z L Liu
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Y Yan
- Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Y T Lu
- Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou 102413, China
| | - F Z Jian
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Z Chen
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
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Lin J, Chen M, Lai Y, Trivedi Z, Wu J, Foo T, Gonzalez Y, Lin M, Reynolds R, Park J, Yan Y, Godley A, Pompos A, Jiang S, Jia X, Lu W. Improving Online Adaptive Radiotherapy Quality Assurance with Streamlined Clinical Workflow through In-House Development. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.2260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Huang B, Chen L, Chiou Y, Whang G, Luo Y, Yan Y, Wei K, He X, Dunn B, Wu P. Bubble-Channeling Electrophoresis of Honeycomb-Like Chitosan Composites. Adv Sci (Weinh) 2022; 9:e2203948. [PMID: 36180403 PMCID: PMC9661845 DOI: 10.1002/advs.202203948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/23/2022] [Indexed: 06/16/2023]
Abstract
A chitosan composite with a vertical array of pore channels is fabricated via an electrophoretic deposition (EPD) technique. The composite consists of chitosan and polyethylene glycol, as well as nanoparticles of silver oxide and silver. The formation of hydrogen bubbles during EPD renders a localized increase of hydroxyl ions that engenders the precipitation of chitosan. In addition, chemical interactions among the constituents facilitate the establishment of vertical channels occupied by hydrogen bubbles that leads to the unique honeycomb-like microstructure; a composite with a porosity of 84%, channel diameter of 488 µm, and channel length of 2 mm. The chitosan composite demonstrates an impressive water uptake of 2100% and a two-stage slow release of silver. In mass transport analysis, both Disperse Red 13 and ZnO powders show a much enhanced transport rate over that of commercial gauze. Due to its excellent structural integrity and channel independence, the chitosan composite is evaluated in a passive suction mode for an adhesive force of 9.8 N (0.56 N cm-2 ). The chitosan composite is flexible and is able to maintain sufficient adhesive force toward objects with different surface curvatures.
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Affiliation(s)
- Bo‐Han Huang
- Department of Materials Science and EngineeringNational Yang Ming Chiao Tung UniversityHsinchu300Taiwan
| | - Li‐Jie Chen
- Department of Materials Science and EngineeringNational Yang Ming Chiao Tung UniversityHsinchu300Taiwan
| | - Yu‐Jie Chiou
- Department of Materials Science and EngineeringNational Yang Ming Chiao Tung UniversityHsinchu300Taiwan
| | - Grace Whang
- Department of Materials Science and EngineeringUCLALos AngelesCA90095USA
| | - Yunkai Luo
- Department of Materials Science and EngineeringUCLALos AngelesCA90095USA
| | - Yichen Yan
- Department of Materials Science and EngineeringUCLALos AngelesCA90095USA
| | - Kung‐Hwa Wei
- Department of Materials Science and EngineeringNational Yang Ming Chiao Tung UniversityHsinchu300Taiwan
| | - Ximin He
- Department of Materials Science and EngineeringUCLALos AngelesCA90095USA
| | - Bruce Dunn
- Department of Materials Science and EngineeringUCLALos AngelesCA90095USA
| | - Pu‐Wei Wu
- Department of Materials Science and EngineeringNational Yang Ming Chiao Tung UniversityHsinchu300Taiwan
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Wang K, Morgan H, Yan Y, Desai N, Hannan R, Chambers E, Dohopolski M, Cai B, Lin M, Sher D, Wang J, Wang A, Jiang S, Timmerman R, Park J, Garant A. Time Dependence of Coverage of the Prostatic Fossa: Implications for Daily Adaptive Radiotherapy. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.2296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Yan Y. Hospitalist System under the Covid-19 Pandemic: The Perspective of Value Co-creation. Eur J Public Health 2022. [PMCID: PMC9594258 DOI: 10.1093/eurpub/ckac131.289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background The core spirit of the Hospitalist system aims to set up dedicated wards, integrate physician manpower, focus on whole-person care, in order to cope with the aging population and Covid-19 pandemic, and to ensure that both parties, the medical personnel and patients, can provide or receive complete medical care. As the Taiwan medical system is facing a paradigm shift, the Taiwan hospitalist system will play an essential role in the transition as moving forward to provide professional care for inpatients. Methods Hospitalists from 12 hospitals across Taiwan completed a cross-sectional survey. The target population was identified through Taiwan Doctors and Nurses. Survey questionnaire was accessed by 342, incomplete response (18) were excluded and 324 completed responses were analysed. Results That the higher the cognition of medical staff on whole-person care, the higher the motivation to participate in cross-team cooperation (F = 35.914, p < 0.001); when the motivation to participate in cross-team cooperation was higher, the behavior of participating in whole-person care also increased. Will be higher (F = 36.483, p < 0.001); whole-person care behavior participation behavior has a significant impact on value creation (F = 21.068, p < 0.001) Conclusions As the Taiwan medical system is facing a paradigm shift, the Taiwan hospitalist system will play an essential role in the transition as moving forward to provide professional care for inpatients. This change will make possible the improvement of patient safety and quality medical care. The research results can be provided for reference in European and American countries. Key messages • A hospitalist support system is essential for establishing an efficient medical environment and reducing administrative work, which can help hospitals introduce a hospitalist system. • To build a more stable and sustainable system, it is necessary to create a systemic operational foundation for proceeding with this new hospitalist system.
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Affiliation(s)
- Y Yan
- Superintendent Office, Tainan Municipal Hospital , Tainan, Taiwan
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Jiang L, Wan RX, Li JT, Yan Y. Comparative effectiveness of exercise-based cardiac rehabilitation for heart failure: a Bayesian network analysis of 44 randomized trials and 5896 patients. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.994] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
The prevalence of heart failure (HF) is increasing nowadays. Exercise-based cardiac rehabilitation (CR) reduces mortality and further improves the outcome of patients with HF. However, the effect of different types of CR on HF remains unclear. Data comparing these CR have not been synthesized. Thus, the purpose of this study is to determine the relative efficacy of different types of exercise-based CR for individuals with HF using a Bayesian network meta-analysis.
Methods
We followed a pre-specified protocol (PROSPERO: CRD42021278351). We conducted a systematic literature review of any randomized controlled trials which evaluated exercise-based CR for patients with HF. Databases including Embase, Medline, the Cochrane Central Register of Controlled Trials, and Web of Science were screened up to 31 December 2021. The primary outcomes focus on functional capacity (peak oxygen uptake and 6-minute walk distance) and health-related quality of life (hr-QOL). The main analysis was complemented by network subanalysis, standard pairwise comparisons, and subgroup and sensitivity analyses. The pooled estimates were quantified as mean differences (MD) or standardized mean difference (SMD)where appropriate, at 95% confidence intervals (CI).
Results
We identified 44 randomized controlled trials with a total of 5896 HF participants. Among 23 studies that compared exercise-based CR and usual care, participants in center-based CR (CBCR) had improvement of peak oxygen uptake (MD: 2.30 mL/kg per minute; 95% CI, 0.43–4.40) and 6-minute walk distance (MD: 33 meters; 95% CI, 11.00–58.00).18 studies that compared exercise-based CR with usual care showed that CBCR and cardiac telerehabilitation (CTR) had greater improvements in hr-QOL (SMD: −0.38; 95% CI, −0.49 to −0.15 and SMD: −0.18,95% CI, −0.36 to −0.00 respectively). Treatment ranking indicated CTR has the highest probability (46.0%, 50.2%) of being the most effective CR for peak oxygen uptake and hr-QOL elevation respectively. CBCR was similarly indicated as the most effective treatment for 6-min walk distance (38.7%).
Conclusion
Exercise-based CR programs provide broader cardiovascular benefits compared with UC. CBCR significantly improved functional capacity. CBCR and CTR have favorable effects on hr-QOL.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): China Scholarship Council
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Affiliation(s)
- L Jiang
- University Hospital Ulm , Ulm , Germany
| | - R X Wan
- University of Washington , Seattle , United States of America
| | - J T Li
- Tsinghua University , Beijing , China
| | - Y Yan
- Nanjing Medical University , Nanjing , China
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Yan D, Yan Y, Ma RY, Chu JL, Mao XM, Li LL. Ameliorating effect of Trigonella foenum-graecum L. (fenugreek) extract tablet on exhaustive exercise-induced fatigue in rats by suppressing mitophagy in skeletal muscle. Eur Rev Med Pharmacol Sci 2022; 26:7321-7332. [PMID: 36314302 DOI: 10.26355/eurrev_202210_30001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Trigonella foenum-graecum L. (fenugreek) is widely used as a leafy vegetable and spice in China and North Africa. Recent studies have reported that fenugreek can reduce fatigue; however, its antifatigue mechanism remains unclear. Therefore, this study aimed to investigate the potential antifatigue effects of fenugreek extract (FE) on mitophagy and the underlying mechanisms. MATERIALS AND METHODS We evaluated the potential effects of FE tablet on an exhaustive exercise-induced fatigue (EEF) rat model. Oxidative stress indicators and fatigue biomarkers in the serum and skeletal muscle were detected. Mitophagy and mitochondrial morphology were observed using transmission electron microscopy. The expression levels of mitochondrial autophagy-related proteins were detected using western blot and immunofluorescence. RESULTS Compared with the model group, FE enhanced the activities of the antioxidant enzymes superoxide dismutase and glutathione peroxidase as well as total antioxidant capacity; however, it decreased the level of malondialdehyde in the serum and skeletal muscle after a 7-day treatment. Moreover, certain indicators of mitochondrial function, such as reactive oxygen species levels, ATP levels, cellular and mitochondrial Ca2+ levels, and ATPase activity, were significantly improved in the FE group compared with the model group. Finally, we found that mitophagy was induced by exhaustive exercise and inhibited by FE. Regarding mitochondrial autophagy-related proteins, the expression levels of LC3B, FUNDC1, PGAM5, PARKIN, and PINK1 in the skeletal muscle tissue were increased in the EEF group compared with the control group. After administration of FE and a positive control drug, a significant reversal in the expression of the above-mentioned proteins was noted. CONCLUSIONS Our findings demonstrate that FE exerted antifatigue effects in the EEF rat model by regulating the mitophagy-related FUNDC1/LC3B signaling pathway rather than the PINK1/PARKIN signaling pathway.
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Affiliation(s)
- D Yan
- College of Pharmacy, Xinjiang Medical University, Xinjiang Uygur Autonomous Region, Urumqi, China.
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Gong W, Yan Y, Nie SP. [Research progress in diagnosis and treatment of acute myocardial infarction complicated with cardiac rupture]. Zhonghua Xin Xue Guan Bing Za Zhi 2022; 50:928-933. [PMID: 36096714 DOI: 10.3760/cma.j.cn112148-20220610-00458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- W Gong
- Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Y Yan
- Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - S P Nie
- Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
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Guo Q, Wang X, Guo RF, Guo YY, Yan Y, Gong W, Zheng W, Wang H, Xu L, Ai H, Que B, Nie SP. [The value of CMR high-risk attributes in predicting ventricular remodeling in ST-segment-elevation myocardial infarction patients with mildly reduced or preserved ejection fraction]. Zhonghua Xin Xue Guan Bing Za Zhi 2022; 50:864-872. [PMID: 36096703 DOI: 10.3760/cma.j.cn112148-20220611-00462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To evaluate the predictive value of a multiparametric cardiac magnetic resonance (CMR) approach for ventricular remodeling in ST-segment-elevation myocardial infarction (STEMI) patients with mildly reduced or preserved left ventricular ejection fraction (LVEF). Methods: This study is a prospective cohort study. STEMI patients with acute LVEF>40% after primary percutaneous coronary intervention (PCI) in Beijing Anzhen Hospital from October 2019 to September 2021 were enrolled. All patients received acute (3-7 days) and follow-up (3 months) CMR post-PCI. According to absence or presence of ventricular remodeling, patients were divided into ventricular remodeling group and non-ventricular remodeling group. Basic clinical characteristics and CMR indicators were analyzed and compared between the two groups. Logistic regression and receiver operating characteristic (ROC) curves were used to explore the predictive performance of CMR high-risk attributes for ventricular remodeling in STEMI patients with mildly reduced or preserved LVEF. The predictive value of combining multiple high-risk characteristics of CMR for ventricular remodeling was analyzed and compared with the traditional clinical risk factor model. Results: A total of 123 STEMI patients were enrolled (aged (57.1±11.1) years, 102 (82.9%) males). There were 97 cases (78.9%) patients in the non-ventricular remodeling group and 26 cases (21.1%) in the ventricular remodeling group. After adjustment for clinical risk factors, stroke volume<51.6 ml, global circumferential strain>-13.7%, infarct size>39.2%, microvascular obstruction>0.5%, and myocardial salvage index<43.9 were independently associated with ventricular remodeling in STEMI patients with mildly reduced or preserved LVEF. The incidence of ventricular remodeling increased with the increasing number of CMR high-risk attributes (P<0.01). The number of CMR high-risk attributes ≥3 was an independent predictor of adverse remodeling (adjusted OR=5.95, 95 CI%: 2.25-15.72, P<0.01) in STEMI patients with mildly reduced or preserved LVEF. Furthermore, the number of CMR high-risk attributes had incremental predictive value over baseline clinical risk factors (area under curve: 0.843 vs. 0.696, P<0.01). Conclusions: In STEMI patients with mild reduced or preserved LVEF, 5 CMR characteristics are associated with ventricular remodeling. The combination of ≥3 CMR high-risk characteristics is an independent predictor of ventricular remodeling, which has incremental predictive value beyond traditional risk factors in this patient cohort.
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Affiliation(s)
- Q Guo
- Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing 100029, China
| | - X Wang
- Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing 100029, China
| | - R F Guo
- Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing 100029, China
| | - Y Y Guo
- Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing 100029, China
| | - Y Yan
- Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing 100029, China
| | - W Gong
- Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing 100029, China
| | - W Zheng
- Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing 100029, China
| | - H Wang
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing 100029, China
| | - L Xu
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing 100029, China
| | - H Ai
- Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing 100029, China
| | - B Que
- Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing 100029, China
| | - S P Nie
- Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing 100029, China
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Chen H, Yan Y, Li C, Zheng X, Wang G, Jin Z, Shi G, He X, Tong X, Chen H, Zhu Z. Inattention and hyperactivity in children and adolescents with repaired D-transposition of the great arteries: Prevalence, perioperative risk factors, and clinical outcomes. Front Cardiovasc Med 2022; 9:937311. [PMID: 36204574 PMCID: PMC9530033 DOI: 10.3389/fcvm.2022.937311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 08/11/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveThe present study objectives were to determine the prevalence of attention-deficit/hyperactivity disorder symptoms (ADHD-like symptoms) in children and adolescent with d-transposition of great artery (D-TGA) after arterial switch operation (ASO) and examine associated risk factors and adverse personal, family dysfunctions.MethodsThis cohort study included 103 patients with D-TGA who underwent ASO in early infancy at Shanghai Children’s Medical Center between 2011 and 2016 and then follow-up. Data analysis was conducted from September 2020 to April 2022. A standardized Swanson, Nolan, and Pelham IV (SNAP-IV) questionnaire is used to evaluate inattention and hyperactivity symptoms. Demographic, preoperative, intraoperative, and postoperative factor were collected. Univariate and multivariable regression analyses were performed with odds ratios (OR) and 95% confidence intervals (CIs).ResultsPrevalence of ADHD-like symptoms was 27.18% (28/103). Attention-deficit (18/28, 64.29%) symptom was the predominant subphenotype. After underwent TGA surgery, 39% of patients with ADHD-like symptoms receive remedial special academic services. There is none had repeated grade. Univariate analysis showed that, positive inotropic drug score (P = 0.03) and delayed sternal closure (P = 0.02) were risk factors of ADHD-like symptoms; increased preoperative oxygen saturation (SpO2) (P = 0.01) and surgical height (P = 0.01) and TGA subtype (VSD) (P = 0.02) were protective factor of ADHD-like symptoms. Multivariable analysis showed that delayed sternal closure (DSC) (OR, 1.50; 95% CI, 1.02–2.18) is a risk factor for the occurrence of ADHD-like symptom while increased preoperative oxygen saturation [odds ratio (OR), 0.95; 95% confidence interval (CI), 0.92–0.99] is a protective factor of ADHD-like symptom.ConclusionThe children and adolescents with D-TGA after ASO were at high risk of ADHD-like symptoms. Preoperative hypoxic status and postoperative DSC became predominant risk factors. Modification of the risk factors may be helpful to relieve ADHD-like symptoms for these patients.
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Affiliation(s)
- Hongtong Chen
- Department of Cardiothoracic Surgery, Heart Center, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Center for Brain Science, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yichen Yan
- Department of Cardiothoracic Surgery, Heart Center, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Center for Brain Science, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Cong Li
- Department of Cardiothoracic Surgery, Heart Center, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Center for Brain Science, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiangyu Zheng
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
| | - Guanghai Wang
- Center for Brain Science, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Developmental and Behavioral Pediatrics, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhijuan Jin
- Department of Developmental and Behavioral Pediatrics, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guocheng Shi
- Department of Cardiothoracic Surgery, Heart Center, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaomin He
- Department of Cardiothoracic Surgery, Heart Center, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoping Tong
- Center for Brain Science, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Anatomy and Physiology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huiwen Chen
- Department of Cardiothoracic Surgery, Heart Center, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhongqun Zhu
- Department of Cardiothoracic Surgery, Heart Center, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Center for Brain Science, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Zhongqun Zhu,
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Chang J, Li Q, Yan Y, Shi J, Zhou J, Lu M, Zhang M, Ding H, Chen Y, Li S, Lan Y. Covalent‐Bonding Oxidation Group and Titanium Cluster to Synthesize a Porous Crystalline Catalyst for Selective Photo‐Oxidation Biomass Valorization. Angew Chem Int Ed Engl 2022; 61:e202209289. [DOI: 10.1002/anie.202209289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Jia‐Nan Chang
- Jiangsu Collaborative Innovation Centre of Biomedical Functional Materials Jiangsu Key Laboratory of New Power Batteries School of Chemistry and Materials Science Nanjing Normal University Nanjing 210023 P. R. China
| | - Qi Li
- Jiangsu Collaborative Innovation Centre of Biomedical Functional Materials Jiangsu Key Laboratory of New Power Batteries School of Chemistry and Materials Science Nanjing Normal University Nanjing 210023 P. R. China
| | - Y. Yan
- School of Chemistry South China Normal University Guangzhou 510006 P. R. China
| | - Jing‐Wen Shi
- Jiangsu Collaborative Innovation Centre of Biomedical Functional Materials Jiangsu Key Laboratory of New Power Batteries School of Chemistry and Materials Science Nanjing Normal University Nanjing 210023 P. R. China
| | - Jie Zhou
- School of Chemistry South China Normal University Guangzhou 510006 P. R. China
| | - Meng Lu
- School of Chemistry South China Normal University Guangzhou 510006 P. R. China
| | - Mi Zhang
- School of Chemistry South China Normal University Guangzhou 510006 P. R. China
| | - Hui‐Min Ding
- Jiangsu Collaborative Innovation Centre of Biomedical Functional Materials Jiangsu Key Laboratory of New Power Batteries School of Chemistry and Materials Science Nanjing Normal University Nanjing 210023 P. R. China
| | - Yifa Chen
- School of Chemistry South China Normal University Guangzhou 510006 P. R. China
| | - Shun‐Li Li
- School of Chemistry South China Normal University Guangzhou 510006 P. R. China
| | - Ya‐Qian Lan
- School of Chemistry South China Normal University Guangzhou 510006 P. R. China
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Fan Y, Jianying Z, Yuanyuan Z, Yan Y, Nong Y, Juan L, Jialei W, Jun Z, Zhehai W, Jun C, Zhu T, Li H, Li Z. EP08.02-052 Safety and Efficacy of Dabrafenib Plus Trametinib in Chinese Patients With BRAF V600E- Mutation Positive Metastatic NSCLC. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Yan Y, Sun L, Yang Y. 327P Traditional Chinese medicine jianpi-bushen sequential formula modulating gut microbiota for stage II&III colon cancer patients during adjuvant chemotherapy: Results from a multi-center randomized double-blind placebo-controlled clinical trial in China. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Du R, Ming J, Geng J, Sui X, Li S, Liu Z, Zhu X, Cai Y, Wang Z, L. Tang, Zhang X, Peng Z, Yan Y, Li Z, Peng Y, Wu A, Li Y, Li Z, Wang W, Ji J. 1215P Neoadjuvant concurrent chemoradiotherapy combined with immunotherapy in the treatment of adenocarcinoma of the oesophagogastric junction: A phase II study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Sun P, Wang Z, An S, Zhao J, Yan Y, Zhang D, Wu Z, Shen B, Lyu H. Biochar-supported nZVI for the removal of Cr(VI) from soil and water: Advances in experimental research and engineering applications. J Environ Manage 2022; 316:115211. [PMID: 35561491 DOI: 10.1016/j.jenvman.2022.115211] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [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: 03/04/2022] [Revised: 04/22/2022] [Accepted: 04/30/2022] [Indexed: 06/15/2023]
Abstract
Over the past decade, biochar-supported nZVI composites (nZVI/biochar) have been developed and applied to treat various pollutants due to their excellent physical and chemical properties, especially in the field of chromium (VI) removal. This paper reviewed the factors influencing the preparation and experiments of nZVI/biochar composites, optimization methods, column experimental studies and the mechanism of Cr(VI) removal. The results showed that the difference in raw materials and preparation temperature led to the difference in functional groups and electron transfer capabilities of nZVI/biochar materials. In the experimental process, pH and test temperature can affect the surface chemical properties of materials and involve the electron transfer efficiency. Elemental doping and microbial coupling can effectively improve the performance of nZVI/biochar composites. In conclusion, biochar can stabilize nZVI and enhance electron transfer in nZVI/biochar materials, enabling the composite materials to remove Cr(VI) efficiently. The study of column experiments provides a theoretical basis for applying nZVI/biochar composites in engineering. Finally, the future work prospects of nZVI/biochar composites for heavy metal removal are introduced, and the main challenges and further research directions are proposed.
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Affiliation(s)
- Peng Sun
- Tianjin Key Laboratory of Clean Energy and Pollution Control, School of Energy and Environmental Engineering, Hebei University of Technology, Tianjin, 300401, China
| | - Zhiqiang Wang
- Tianjin Key Laboratory of Clean Energy and Pollution Control, School of Energy and Environmental Engineering, Hebei University of Technology, Tianjin, 300401, China
| | - Shengwei An
- Tianjin Key Laboratory of Clean Energy and Pollution Control, School of Energy and Environmental Engineering, Hebei University of Technology, Tianjin, 300401, China
| | - Jian Zhao
- Tianjin Key Laboratory of Clean Energy and Pollution Control, School of Energy and Environmental Engineering, Hebei University of Technology, Tianjin, 300401, China
| | - Yichen Yan
- Tianjin Key Laboratory of Clean Energy and Pollution Control, School of Energy and Environmental Engineering, Hebei University of Technology, Tianjin, 300401, China
| | - Daijie Zhang
- Tianjin Key Laboratory of Clean Energy and Pollution Control, School of Energy and Environmental Engineering, Hebei University of Technology, Tianjin, 300401, China
| | - Zhineng Wu
- Tianjin Key Laboratory of Clean Energy and Pollution Control, School of Energy and Environmental Engineering, Hebei University of Technology, Tianjin, 300401, China.
| | - Boxiong Shen
- School of Chemical Engineering and Technology, Hebei University of Technology, Tianjin, 300401, China
| | - Honghong Lyu
- Tianjin Key Laboratory of Clean Energy and Pollution Control, School of Energy and Environmental Engineering, Hebei University of Technology, Tianjin, 300401, China.
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Luo NX, Jiang SY, Cao SJ, Li JY, Han Q, Zhou MM, Li JZ, Guo GY, Liu ZM, Yang C, Ji BQ, Zhang ZF, Huang J, Yuan DD, Pan JY, Shi XF, Hu S, Lin Q, Zhao CG, Yan Y, Wang QF, Wei Q, Kan JQ, Gao CQ, Liu SY, Jiang XG, Liu HQ, Sun J, Du L, He L. [Outcomes at discharge of preterm infants born <34 weeks' gestation]. Zhonghua Er Ke Za Zhi 2022; 60:774-780. [PMID: 35922187 DOI: 10.3760/cma.j.cn112140-20220103-00002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To investigate the incidence and trend of short-term outcomes among preterm infants born <34 weeks' gestation. Methods: A secondary analysis of data from the standardized database established by a multicenter cluster-randomized controlled study "reduction of infection in neonatal intensive care units (NICU) using the evidence-based practice for improving quality (REIN-EPIQ) study". This study was conducted in 25 tertiary NICU. A total of 27 192 infants with gestational age <34 weeks at birth and admitted to NICU within the first 7 days of life from May 2015 to April 2018 were enrolled. Infants with severe congenital malformation were excluded. Descriptive analyses were used to describe the mortality and major morbidities of preterm infants by gestational age groups and different admission year groups. Cochran-Armitage test and Jonckheere-Terpstra test were used to analyze the trend of incidences of mortality and morbidities in 3 study-years. Multiple Logistic regression model was constructed to analyze the differences of outcomes in 3 study-years adjusting for confounders. Results: A total of 27 192 preterm infants were enrolled with gestational age of (31.3±2.0) weeks at birth and weight of (1 617±415) g at birth. Overall, 9.5% (2 594/27 192) of infants were discharged against medical advice, and the overall mortality rate was 10.7% (2 907/27 192). Mortality for infants who received complete care was 4.7% (1 147/24 598), and mortality or any major morbidity was 26.2% (6 452/24 598). The incidences of moderate to severe bronchopulmonary dysplasia, sepsis, severe intraventricular hemorrhage or periventricular leukomalacia, proven necrotizing enterocolitis, and severe retinopathy of prematurity were 16.0% (4 342/27 192), 11.9% (3 225/27 192), 6.8% (1 641/24 206), 3.6% (939/25 762) and 1.5% (214/13 868), respectively. There was a decreasing of the overall mortality (P<0.001) during the 3 years. Also, the incidences for sepsis and severe retinopathy of prematurity both decreased (both P<0.001). However, there were no significant differences in the major morbidity in preterm infants who received complete care during the 3-year study period (P=0.230). After adjusting for confounders, infants admitted during the third study year showed significantly lower risk of overall mortality (adjust OR=0.62, 95%CI 0.55-0.69, P<0.001), mortality or major morbidity, moderate to severe bronchopulmonary dysplasia, sepsis and severe retinopathy of prematurity, compared to those admitted in the first study year (all P<0.05). Conclusions: From 2015 to 2018, the mortality and major morbidities among preterm infants in Chinese NICU decreased, but there is still space for further efforts. Further targeted quality improvement is needed to improve the overall outcome of preterm infants.
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Affiliation(s)
- N X Luo
- Department of Neonatology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
| | - S Y Jiang
- Department of Neonatology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
| | - S J Cao
- Department of Neonatology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
| | - J Y Li
- Department of Neonatology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
| | - Q Han
- National Health Commission (NHC) Key Laboratory of Neonatal Diseases, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
| | - M M Zhou
- Department of Neonatology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
| | - J Z Li
- Department of Neonatology, Women's Hospital of Nanjing Medical University, Nanjing 210004, China
| | - G Y Guo
- Department of Neonatology, Northwest Women's and Children's Hospital, Xi'an 200001, China
| | - Z M Liu
- Department of Neonatology, Maternal and Child Hospital of Hubei Province, Wuhan 430064, China
| | - C Yang
- Department of Neonatology, Suzhou Municipal Hospital, Suzhou 215008, China
| | - B Q Ji
- Department of Neonatology, Shanxi Children's Hospital, Taiyuan 030006, China
| | - Z F Zhang
- Department of Neonatology, Fujian Maternity and Child Health Hospital, Fuzhou 350005, China
| | - J Huang
- Department of Neonatology, the Affiliated Shenzhen Maternity and Child Healthcare Hospital of Southern Medical University, Shenzhen 518047, China
| | - D D Yuan
- Department of Neonatology, Qingdao Women and Children's Hospital of Southern Medical University, Qingdao 266011, China
| | - J Y Pan
- Department of Neonatology, Guiyang Maternal and Child Health Care Hospital, Guiyong Children's Hospital, Guiyang 550002, China
| | - X F Shi
- Department of Neonatology, Gansu Provincial Maternal and Child-care Hospital, Lanzhou 730050, China
| | - S Hu
- Department of Neonatology, Shanghai First Maternal and Infant Hospital, Shanghai 201204, China
| | - Q Lin
- Department of Neonatology, the 2nd Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325088, China
| | - C G Zhao
- Department of Neonatology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Y Yan
- Department of Neonatology, Jiangxi Provincial Children's Hospital, Nanchang 330006, China
| | - Q F Wang
- Department of Neonatology, the First Affiliated Hospital of Xinjiang Medical University, Urumchi 830054, China
| | - Q Wei
- Department of Neonatology, Maternity and Child Health Care of Guangxi Zhuang Autonomous Region, Nanning 530002, China
| | - J Q Kan
- Department of Neonatology, Children's Hospital of Nanjing Medical University, Nanjing 210008, China
| | - C Q Gao
- Department of Neonatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430014, China
| | - S Y Liu
- Department of Neonatology, Children's Hospital of Hebei Province, Shijiazhuang 050031, China
| | - X G Jiang
- Department of Neonatology, Wuxi Maternal and Child Health Care Hospital, Wuxi 214002, China
| | - H Q Liu
- Department of Neonatology, Children's Hospital Affiliated to Shandong University, Jinan 250022, China
| | - J Sun
- Division of Neonatology, Children's Hospital Affiliated to Zhengzhou University, Jinan Children's Hospital, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou 450018, China
| | - L Du
- Department of Neonatology, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
| | - Li He
- Department of Neonatology, the Third Xiangya Hospital of Central South University, Changsha 410013, China
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Yan Y, Smith N, Pan Y, Zhao J, Williams J, Zhang J, Tian T, Pan T, Wu K, Villani A, Kupper T. 060 Heterogeneity and lineage development of memory CD8+ T cells after viral infection of skin. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Peters L, Bidzhekov K, Jansen Y, Bayasgalan S, Gencer S, Sundararaman S, Bonnin-Marquez A, Yan Y, Jans A, Bartneck M, Doering Y, Weber C, Van Der Vorst E. Micromanaging atherosclerosis: Myeloid cell-specific microRNA-26b attenuates atherosclerosis development. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Sun HF, Li N, Yan Y, Wei MY, Wang H, Yang HY. First Report of Alternaria alternata Causing Leaf Blight on Clematis terniflora var. mandshurica in China. Plant Dis 2022; 106:PDIS10212139PDN. [PMID: 35072497 DOI: 10.1094/pdis-10-21-2139-pdn] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- H F Sun
- College of Pharmacy, Heilongjiang University of Chinese Medicine, 150040, Harbin, China
| | - N Li
- College of Pharmacy, Heilongjiang University of Chinese Medicine, 150040, Harbin, China
| | - Y Yan
- College of Pharmacy, Heilongjiang University of Chinese Medicine, 150040, Harbin, China
| | - M Y Wei
- College of Pharmacy, Heilongjiang University of Chinese Medicine, 150040, Harbin, China
| | - H Wang
- College of Pharmacy, Heilongjiang University of Chinese Medicine, 150040, Harbin, China
| | - H Y Yang
- College of Pharmacy, Heilongjiang University of Chinese Medicine, 150040, Harbin, China
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Peters L, Bidzhekov K, Jansen Y, Bayasgalan S, Gencer S, Sundararaman SS, Bonnin-Marquez A, Yan Y, Jans AM, Bartneck M, Doering Y, Weber C, Van Der Vorst E. Micromanaging atherosclerosis: myeloid cell-specific microRNA-26b attenuates atherosclerosis development. Cardiovasc Res 2022. [DOI: 10.1093/cvr/cvac066.195] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Increasing evidence has shown that microRNAs (miRs) are fundamental players in atherosclerosis, but the exact role of various miRs remains elusive. Preliminary data showed that, with a 5-fold increase, miR-26b was the most highly expressed miR in human atherosclerotic plaques compared to healthy vessels. Therefore, we aimed to determine its cell-specific effects on atherosclerosis development.
We examined the role of miR-26b in atherosclerosis by using full-body knockout (KO) mice on a 4 weeks and 12 weeks Western type diet (WTD) and myeloid cell-specific miR-26b KO (LysM-Cre) mice on 12 weeks WTD on an apolipoprotein E-deficient background. Atherosclerotic plaque size and phenotype were analyzed via immunohistochemical and immunofluorescent stainings. The phenotype and function of bone marrow-derived macrophages (BMDMs) from full body KO mice were analyzed via PCR, ELISA and gelatinase assays. Lipid nanoparticles (LNPs) served as vehicles for miR-26b mimics to restore miR-26b levels in knockout BMDMs.
A full-body miR-26b-KO on a 12 weeks WTD resulted in a striking 3.5-fold increase in atherosclerotic lesion size, compared to control. Consistent with a more advanced plaque phenotype, collagen content, smooth muscle cell percentage and relative necrotic core area were all significantly increased in plaques from miR-26b KO mice whilst the relative macrophage content was significantly reduced. Interestingly, the full-body KO mice on a 4 weeks WTD showed a remarkable 10-fold increase in plaque size and the respective plaques also had a reduced macrophage percentage, showing that miR-26b has very strong effects on both atherogenesis as well as atherosclerosis progression. Intriguingly, relative plaque size in the arches of miR-26b LysM-Cre mice were increased by 3-fold and collagen content was also increased significantly, suggesting a role for myeloid-specific miR-26b in atherosclerosis development. Further highlighting its myeloid-specific effects, miR-26b KO BMDMs showed an increase in IL-6 and TNFα secretion, which could be rescued by LNPs containing miR-26b mimics. Additionally, these miR-26b KO BMDMs showed a reduction in collagen breakdown.
Overall, our results clearly demonstrate an atheroprotective role of myeloid cell-specific miR-26b by attenuating lesion initiation as well as progression, mainly by suppressing inflammation and stimulating collagen breakdown. Our study leads to exciting new insights into the role of miR-26b in atherosclerosis development, providing an important back-bone for future research and potential new treatment options.
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Affiliation(s)
- L Peters
- RWTH University Hospital Aachen , Aachen , Germany
| | - K Bidzhekov
- Institute for Cardiovascular Prevention (IPEK-LMU) , Munich , Germany
| | - Y Jansen
- Institute for Cardiovascular Prevention (IPEK-LMU) , Munich , Germany
| | - S Bayasgalan
- Institute for Cardiovascular Prevention (IPEK-LMU) , Munich , Germany
| | - S Gencer
- Institute for Cardiovascular Prevention (IPEK-LMU) , Munich , Germany
| | | | | | - Y Yan
- Institute for Cardiovascular Prevention (IPEK-LMU) , Munich , Germany
| | - AM Jans
- RWTH University Hospital Aachen , Aachen , Germany
| | - M Bartneck
- RWTH University Hospital Aachen , Aachen , Germany
| | - Y Doering
- Institute for Cardiovascular Prevention (IPEK-LMU) , Munich , Germany
| | - C Weber
- Institute for Cardiovascular Prevention (IPEK-LMU) , Munich , Germany
| | - E Van Der Vorst
- Institute for Cardiovascular Prevention (IPEK-LMU) , Munich , Germany
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Pustovaya A, Yan Y, Gutkevich E. Features of addictive beliefs with different types of addictions. Eur Psychiatry 2022. [PMCID: PMC9567616 DOI: 10.1192/j.eurpsy.2022.2105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
Today, a number of researchers consider the problem of addictive behavior as one of the most global problems for Kazakhstan and Russia. Some scientists consider CBT to be the most effective way to work with addictions. In our country there are no scientific works devoted to the study of addictive beliefs, so we decided to conduct such a study.
Objectives
The Objective of the study was to identify the characteristic addictive beliefs of drug addicts with different type of addiction: opioids and synthetic cathinones (designer drugs called “salts”, “bath salts”).
Methods
Questionnaire of addictive beliefs by A, Beck, questionnaire of beliefs about cravings by A. Beck and F. Wright, clinical interview. Descriptive statistics and chi-square test were used for data processing.
Results
People with opioid addiction are more likely to believe that their lives will become more depressive if they stop using drugs (p= 0.0347); that drug use is the only way to cope with pain in their life (p= 0.0347) and that they cannot cope with anxiety without drugs (p=0.009). Respondents who use synthetic psychostimulants endorse to believe that addiction is not a problrm for them (p= 0.0358).
Conclusions
Having categorized these beliefs in accordance with A. Beck’s classification, we came to the conclusion that “relief-oriented beliefs” are more typical for people who use opiates. The motive for use is often the desire to alleviate a negative emotional or physical state. For people using psychostimulants “salt”, “anticipatory beliefs” are more characteristic - the desire to experience euphoria and pleasant experiences.
Disclosure
No significant relationships.
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He Y, Wu S, Ding C, Fan L, Ke L, Yan Y, Li M, Luo H, Hu X, Niu J, Li H, Xu H, Chen W, Cao L. P-151 PRO-based symptom management for patients with gastric and esophageal cancer who have undergone previous surgery. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Yan Y, Gutkevich E. Differences in addictive beliefs in people with psychostimulant addiction and in opioid addicts. Eur Psychiatry 2022. [PMCID: PMC9568173 DOI: 10.1192/j.eurpsy.2022.2117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Introduction Today, a number of researchers consider the problem of addictive behavior as one of the most global problems for Kazakhstan and Russia. Some scientists consider CBT to be the most effective way to work with addictions. In our country there are no scientific works devoted to the study of addictive beliefs, so we decided to conduct such a study Objectives The Objective of the study was to identify the characteristic addictive beliefs of drug addicts with different type of addiction: opioids and synthetic cathinones (designer drugs called “salts”, “bath salts”) Methods Questionnaire of addictive beliefs by A, Beck, questionnaire of beliefs about cravings by A. Beck and F. Wright, clinical interview. Descriptive statistics and chi-square test were used for data processing Results People with opioid addiction are more likely to believe that their lives will become more depressive if they stop using drugs (p= 0.0347); that drug use is the only way to cope with pain in their life (p= 0.0347) and that they cannot cope with anxiety without drugs (p=0.009). Respondents who use synthetic psychostimulants endorse to believe that addiction is not a problrm for them (p= 0.0358). Conclusions Having categorized these beliefs in accordance with A. Beck’s classification, we came to the conclusion that “relief-oriented beliefs” are more typical for people who use opiates. The motive for use is often the desire to alleviate a negative emotional or physical state. For people using psychostimulants “salt”, “anticipatory beliefs” are more characteristic - the desire to experience euphoria and pleasant experiences Disclosure No significant relationships.
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Zhou F, Jiang L, Yan Y, Yang W, Tang F, Chen P, Tang R. POS0397 SSD6453, A NOVEL AND HIGHLY SELECTIVE BTK/JAK3 DUAL INHIBITOR IS EFFICACIOUS IN MULTIPLE PRE-CLINICAL MODELS OF INFLAMMATION. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundThe mechanism of inflammatory diseases is complicated and dysfunction of multiple immune cells is thought to be directly related to the pathogenesis. Targeting either JAK-STAT or BCR signaling has been proved solid clinical efficacy in multiple inflammatory diseases, such as rheumatoid arthritis (RA) and multiple sclerosis (MS). And the combination of BTK and JAK inhibitors demonstrated synergistic effects for the treatment of inflammation models in pre-clinic. JAK3 expression is largely restricted to leukocytes and involves functions in JAK1/JAK3 heterodimer in signal transduction, it might be a more effective and safer target. Meanwhile, both BTK and JAK3 possess a cysteine residue in their active site and this feature makes it possible to design a dual inhibitor. SSD6453 is a highly selective and irreversible JAK3/BTK dual inhibitor which may have synergistic effects for the treatment of RA and other inflammatory diseases such as MS.ObjectivesTo develop a potent, oral, highly selective JAK3/BTK inhibitor for treatment of multiple inflammatory diseases.MethodsADP-GLO based biochemical assays were performed to determine the enzymatic inhibitory effect and selectivity for JAK family. The target engagement was evaluated by IgM induced pBTK and IL-2 induced pSTAT5 in human PBMCs. In vivo efficacy was evaluated by rat collagen-induced arthritic (CIA) model and mice experimental autoimmune encephalomyelitis (EAE) models induced by MOG1-125 or MOG35-55, respectively. BTK occupancy in spleens post last dose 24h and IL-2 induced pSTAT5 in whole blood post last dose 0.5h were used to evaluate targets inhibitions. Osteoclast was stained by IHC in pathological section of rat paws.ResultsIn biochemical assays, SSD6453 inhibited BTK and JAK3 with the IC50 values of 3.4 nM and 1.1 nM, respectively. Notably, SSD6453 displayed high selectivity against JAK1 (510 fold), JAK2 (75 fold) and TYK2 (525 fold). In cellular assays, SSD6453 inhibited anti-IgM induced pBTK and IL-2 induced pSTAT5 in human PBMCs with the IC50 values of 18.8 nM and 168.8 nM, respectively. SSD6453 demonstrated favorable PK properties in broad pre-clinical species. Single oral administration of SSD6453 in rat or mouse, resulted in dose-dependent inhibition of BTK and JAKs concurrently. In the rat CIA model in which disease development was accompanied by a robust T-cell and B-cell inflammation response to collagen, SSD6453 dose-dependently inhibited paw edema. And SSD6453 at 10mpk achieved complete (95%) BTK occupancy and JAK3 inhibition and superior efficacy in comparison of tofacitinib (JAK@10 mpk) or evobrutinib (BTK @30mpk) alone, suggesting that concurrent inhibition of JAK3 and BTK lead to synergistic anti-inflammation effects. In addition, ED-1+ osteoclast count decrease was observed in paws, suggesting the prevention of SSD6453 in joint destruction. In two EAE models either induced by MOG1-125 or MOG35-55, which represented T or B dominant inflammation model, respectively, SSD6453 robustly ameliorated disease in both two models. In comparison, BTK inhibitor is efficacious only in the MOG1-125 induced model.ConclusionSSD6453 is a novel and high selective BTK/JAK3 dual inhibitor, and demonstrated synergistic efficacy in multiple pre-clinic inflammation models. SSD6453 showed good pharmacokinetic characteristics and well-tolerant in multiple pre-clinical species, and is moving to IND in 2022.Disclosure of InterestsFeng Zhou Shareholder of: I own the shares of Simcere, Grant/research support from: The work is financially support by Simcere, Employee of: Simcere, Lei Jiang Shareholder of: I own the shares of Simcere, Grant/research support from: The work is financially supported by Simcere, Employee of: I am employee of Simcere, Yuxi Yan Grant/research support from: The work is financially supported by Simcere, Employee of: I am employee of Simcere, Wenqing Yang Shareholder of: I own the shares of Simcere, Grant/research support from: the work is financially supported by Simcere, Employee of: I am employee of Simcere, Feng Tang Shareholder of: I own the shares of Simcere, Grant/research support from: The work is financially supported by Simcere, Employee of: I am employee of simcere, Ping Chen Shareholder of: I own the shares of Simcere, Grant/research support from: The work is financially supported by Simcere, Employee of: I am employee of Simcere, Renhong Tang Shareholder of: I own the shares of Simcere, Grant/research support from: The work is financially supported by Simcere, Employee of: I am employee of Simcere.
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Chen Y, Qi A, Teng D, Li S, Yan Y, Hu S, Du X. Probiotics and synbiotics for preventing postoperative infectious complications in colorectal cancer patients: a systematic review and meta-analysis. Tech Coloproctol 2022; 26:425-436. [PMID: 35348943 DOI: 10.1007/s10151-022-02585-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 01/22/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND The health benefits of probiotics and synbiotics in healthy adults are well established, but their role in preventing infectious complications after surgery for colorectal cancer remains controversial. The aim of this meta-analysis was to assess the impact of probiotics/synbiotics on the incidence of infectious complications in patients who had surgery for colorectal cancer. METHODS A comprehensive literature search of all randomized control trials (RCTs) was conducted using PubMed, Embase, World Health Organization (WHO) Global Index Medicus, WHO clinical trial registry, and Clinicaltrials.gov. Inclusion criteria included RCTs comparing the use of any strain or dose of a specified probiotic/synbiotic with placebo or a "standard care" control group. The incidence of postoperative infectious complications was analyzed. RESULTS Fourteen RCTs involving 1566 patients (502 receiving probiotics, 273 receiving synbiotics, and 791 receiving placebo) were analyzed. Overall, probiotic or synbiotic administration significantly reduced the risk of developing postoperative infectious complications by 37% (relative risk (RR) = 0.63, 95% confidence interval (CI) 0.54-0.74, p < 0.001). Furthermore, when considering the six different types of postoperative infectious complications (septicemia, incision infection, central line infection, pneumonia infection, urinary infection, and incidence of diarrhea), probiotic or synbiotic administration was beneficial in reducing the incidence of each one of them. The quality of evidence was listed below: incidence of diarrhea (high), septicemia (moderate), incision infection (moderate), pneumonia infection (moderate), urinary infection (moderate), and central line infection (low). However, for the main outcome of infectious complications, we found evidence of possible publication bias, although estimates still showed a reduction following trim-and-fill analysis (RR = 0.72, 95% CI 0.62-0.84, p < 0.001). CONCLUSIONS The use of probiotic/synbiotic supplementation is associated with a significant reduction in the risk of developing postoperative infectious complications in patients who had surgery for colorectal cancer. Additional studies are needed to confirm the findings due to publication bias and low quality of evidence.
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Affiliation(s)
- Y Chen
- Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Haidian, Beijing, 100853, China
| | - A Qi
- Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Haidian, Beijing, 100853, China
| | - D Teng
- Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Haidian, Beijing, 100853, China
| | - S Li
- Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Haidian, Beijing, 100853, China
| | - Y Yan
- Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Haidian, Beijing, 100853, China
| | - S Hu
- Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Haidian, Beijing, 100853, China
| | - X Du
- Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Haidian, Beijing, 100853, China.
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Yan Y, Gong W, Wang X, Fang JY, Nie SP. [Multimorbidity in elderly patients with acute coronary syndrome: insights from BleeMACS registry]. Zhonghua Xin Xue Guan Bing Za Zhi 2022; 50:443-449. [PMID: 35589592 DOI: 10.3760/cma.j.cn112148-20220210-00097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To assess the prevalence, pattern and outcome of multimorbidity in elderly patients with acute coronary syndrome (ACS). Methods: Secondary analysis was performed based on the data from the BleeMACS registry, which was conducted between 2003 and 2014. We stratified elderly patients (≥65 years) according to their multimorbidity. Multimorbidity was defined as two or more chronic diseases in the same individual. Kaplan-Meier methods were used to estimate 1 year event rates for each endpoint, and comparisons between the study groups were performed using the log-rank test. The primary endpoint was net adverse clinical events (NACE), which is a composite of all-cause mortality, myocardial infarction, or bleeding. Results: Of 7 120 evaluable patients, 6 391 (89.8%) were with morbidity (1 594 with 1, 2 156 with 2, and 2 641 with ≥3 morbidity). Patients with morbidity were older, percent of female sex and non-ST-elevation acute coronary syndromes and implantation rate with drug-eluting stents and blood creatine level were higher compared to patients without morbidity. Compared with the patients without morbidity, the proportion of participants with oral anticoagulant increased in proportion to increased number of morbidities (5.8% vs. 6.4% with 1 morbidity, 7.3% with 2 morbidities, 9.0% with ≥3 morbidities, P trend<0.01) and the proportion of participants with clopidogrel prescription decreased in proportion to increased number of morbidity (91.9% vs. 89.7% with 1 morbidity, 87.9% with 2 morbidities, 88.6% with ≥3 morbidities, P trend = 0.01). During 1 year follow-up, compared with those with no morbidity, the hazard ratio (HR) and 95% confidence interval (CI) of risk of NACE for those with 1, 2, and ≥ 3 morbidities was 1.18 (0.86-1.64), 1.49 (1.10-2.02), and 2.74 (2.06-3.66), respectively (P < 0.01). Multimorbidity was not associated with an increased risk of bleeding of various organs (P>0.05). Conclusion: Multimorbidity is common in elderly patients with ACS. These patients might benefit from coordinated and integrated multimorbidity management by multidisciplinary teams.
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Affiliation(s)
- Y Yan
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - W Gong
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - X Wang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - J Y Fang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - S P Nie
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
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