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Shi Y, Cao K, Wang ZJ, Han JG. [Mechanisms and clinical management of small bowel obstruction caused by kinking of the jejunojejunal anastomosis after laparoscopic Roux-en-Y gastric bypass]. Zhonghua Wai Ke Za Zhi 2024; 62:457-461. [PMID: 38548616 DOI: 10.3760/cma.j.cn112139-20231130-00247] [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: 05/09/2024]
Abstract
Currently, obesity and its complications have become increasingly serious health issues. Bariatric surgery is an effective method of treating obesity and related metabolic complications. Among them, Roux-en-Y gastric bypass (RYGB) is still considered the "gold standard" procedure for bariatric surgery. Small bowel obstruction is one of the possible complications after RYGB, and in addition to the formation of intra-abdominal hernias, kinking of the jejunojejunal anastomosis is an important cause of small bowel obstruction. The early clinical symptoms of kinking of the jejunojejunal anastomosis often lack clarity in the early stages. Therefore, early diagnosis, prevention, and effective treatment of kinking of the jejunojejunal anastomosis are challenging but crucial. The occurrence of kinking of the jejunojejunal anastomosis may be related to surgical techniques and the surgeon's experience. The use of anti-obstruction stitch, mesenteric division, and bidirectional jejunojejunal anastomosis may be beneficial in preventing kinking of the jejunojejunal anastomosis. If kinking of the jejunojejunal anastomosis occurs, timely abdominal CT scans and endoscopic examinations should be performed. Gastric and intestinal decompression should be initiated immediately, and exploratory surgery should be prepared.
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Affiliation(s)
- Y Shi
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - K Cao
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Z J Wang
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - J G Han
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
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Jin Y, Zhai ZW, Sun LT, Xia PD, Hu H, Jiang CQ, Zhao BC, Qu H, Qian Q, Dai Y, Yao HW, Wang ZJ, Han JG. [Construction of a model based on multipoint full-layer puncture biopsy for predicting pathological complete response after neoadjuvant therapy for locally advanced rectal cancer]. Zhonghua Wei Chang Wai Ke Za Zhi 2024; 27:403-411. [PMID: 38644246 DOI: 10.3760/cma.j.cn441530-20240101-00002] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Objective: To investigate the value of transanal multipoint full-layer puncture biopsy (TMFP) in predicting pathological complete response (pCR) after neoadjuvant radiotherapy and chemotherapy (nCRT) in patients with locally advanced rectal cancer (LARC) and to establish a predictive model for providing clinical guidance regarding the treatment of LARC. Methods: In this multicenter, prospective, cohort study, we collected data on 110 LARC patients from four hospitals between April 2020 and March 2023: Beijing Chaoyang Hospital of Capital Medical University (50 patients), Beijing Friendship Hospital of Capital Medical University (41 patients), Qilu Hospital of Shandong University (16 patients), and Zhongnan Hospital of Wuhan University (three patients). The patients had all received TMFP after completing standard nCRT. The variables studied included (1) clinicopathological characteristics; (2) clinical complete remission (cCR) and efficacy of TMFP in determining pCR after NCRT in LARC patients; and (3) hospital attended, sex, age, clinical T- and N-stages, distance between the lower margin of the tumor and the anal verge, baseline and post-radiotherapy serum carcinoembryonic antigen (CEA) and carbohydrate antigen (CA)19-9 concentrations, chemotherapy regimen, use of immunosuppressants with or without radiotherapy, radiation therapy dosage, interval between surgery and radiotherapy, surgical procedure, clinical T/N stage after radiotherapy, cCR, pathological results of TMFP, puncture method (endoscopic or percutaneous), and number and timing of punctures. Single-factor and multifactorial logistic regression analysis were used to determine the factors affecting pCR after NCRT in LARC patients. A prediction model was constructed based on the results of multivariat analysis and the performance of this model evaluated by analyzing subject work characteristics (ROC), calibration, and clinical decision-making (DCA) curves. pCR was defined as complete absence of tumor cells on microscopic examination of the surgical specimens of rectal cancer (including lymph node dissection) after NCRT, that is, ypT0+N0. cCR was defined according to the Chinese Neoadjuvant Rectal Cancer Waiting Watch Database Study Collaborative Group criteria after treatment, which specify an absence of ulceration and nodules on endoscopy; negative rectal palpation; no tumor signals on rectal MRI T2 and DWI sequences; normal serum CEA concentrations, and no evidence of recurrence on pelvic computed tomography/magnetic resonance imaging. Results: Of the 110 patients, 45 (40.9%) achieved pCR after nCRT, which was combined with immune checkpoint inhibitors in 34 (30.9%). cCR was diagnosed before puncture in 38 (34.5%) patients, 43 (39.1%) of the punctures being endoscopic. There were no complications of puncture such as enterocutaneous fistulae, vaginal injury, prostatic injury, or presacral bleeding . Only one (2.3%) patient had a small amount of blood in the stools, which was relieved by anal pressure. cCR had a sensitivity of 57.8% (26/45) for determining pCR, specificity of 81.5% (53/65), accuracy of 71.8% (79/110), positive predictive value 68.4% (26/38), and negative predictive value of 73.6% (53/72). In contrast, the sensitivity of TMFP pathology in determining pCR was 100% (45/45), specificity 66.2% (43/65), accuracy 80.0% (88/110), positive predictive value 67.2% (45/67), and negative predictive value 100.0% (43/43). In this study, the sensitivity of TMFP for pCR (100.0% vs. 57.8%, χ2=24.09, P<0.001) was significantly higher than that for cCR. However, the accuracy of pCR did not differ significantly (80.0% vs. 71.8%, χ2=2.01, P=0.156). Univariate and multivariate logistic regression analyses showed that a ≥4 cm distance between the lower edge of the tumor and the anal verge (OR=7.84, 95%CI: 1.48-41.45, P=0.015), non-cCR (OR=4.81, 95%CI: 1.39-16.69, P=0.013), and pathological diagnosis by TMFP (OR=114.29, the 95%CI: 11.07-1180.28, P<0.001) were risk factors for pCR after NCRT in LARC patients. Additionally, endoscopic puncture (OR=0.02, 95%CI: 0.05-0.77, P=0.020) was a protective factor for pCR after NCRT in LARC patients. The area under the ROC curve of the established prediction model was 0.934 (95%CI: 0.892-0.977), suggesting that the model has good discrimination. The calibration curve was relatively close to the ideal 45° reference line, indicating that the predicted values of the model were in good agreement with the actual values. A decision-making curve showed that the model had a good net clinical benefit. Conclusion: Our predictive model, which incorporates TMFP, has considerable accuracy in predicting pCR after nCRT in patients with locally advanced rectal cancer. This may provide a basis for more precisely selecting individualized therapy.
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Affiliation(s)
- Y Jin
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Z W Zhai
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - L T Sun
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - P D Xia
- Department of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, China
| | - H Hu
- Department of General Surgery, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - C Q Jiang
- Department of General Surgery, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - B C Zhao
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - H Qu
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Q Qian
- Department of General Surgery, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Y Dai
- Department of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, China
| | - H W Yao
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Z J Wang
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - J G Han
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
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Zhu X, Shen Z, Wang ZJ, Liu Z, Miao Y, Yue S, Fu Z, Li Z, Zhang Y, Hong R, Wu S, Chen X, Cai J, Fu D, Zhang F. Effects of gamma-ray irradiation on material and electrical properties of AlN gate dielectric on 4H-SiC. Nanotechnology 2024; 35:275704. [PMID: 38574479 DOI: 10.1088/1361-6528/ad3a6e] [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: 01/17/2024] [Accepted: 04/04/2024] [Indexed: 04/06/2024]
Abstract
This article investigates the radiation effects on as-deposited and annealed AlN films on 4H-SiC substrates under gamma-rays. The AlN films are prepared using plasma-enhanced-atomic-layer-deposition on an n-type 4H-SiC substrate. The AlN/4H-SiC MIS structure is subjected to gamma-ray irradiation with total doses of 0, 300, and 600 krad(Si). Physical, chemical, and electrical methods were employed to study the variations in surface morphology, charge transport, and interfacial trapping characteristics induced by irradiation. After 300 krad(Si) irradiation, the as-deposited and annealed samples exhibit their highest root mean square values of 0.917 nm and 1.190 nm, respectively, which is attributed to N vacancy defects induced by irradiation. Under irradiation, the flatband voltage (Vfb) of the as-deposited sample shifts from 2.24 to 0.78 V, while the annealed sample shifts from 1.18 to 2.16 V. X-ray photoelectron spectrum analysis reveals the decomposition of O-related defects in the as-deposited AlN and the formation of Al(NOx)ycompounds in the annealed sample. Furthermore, the space-charge-limits-conduction (SCLC) in the as-deposited sample is enhanced after radiation, while the barrier height of the annealed sample decreases from 1.12 to 0.84 eV, accompanied by the occurrence of the SCLC. The physical mechanism of the degradation of electrical performance in irradiated devices is the introduction of defects like N vacancies and O-related defects like Al(NOx)y. These findings provide valuable insights for SiC power devices in space applications.
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Affiliation(s)
- Xiaogang Zhu
- Department of Physics, College of Physical Science and Technology, Xiamen University, Xiamen 361005, People's Republic of China
| | - Zhanwei Shen
- Key Laboratory of Semiconductor Materials Science, Institute of Semiconductors Chinese Academy of Sciences, Beijing 100083, People's Republic of China
| | - Z J Wang
- Key Laboratory of Semiconductor Materials Science, Institute of Semiconductors Chinese Academy of Sciences, Beijing 100083, People's Republic of China
| | - Zhengran Liu
- Department of Physics, College of Physical Science and Technology, Xiamen University, Xiamen 361005, People's Republic of China
| | - Yuyang Miao
- Department of Physics, College of Physical Science and Technology, Xiamen University, Xiamen 361005, People's Republic of China
| | - Shizhong Yue
- Key Laboratory of Semiconductor Materials Science, Institute of Semiconductors Chinese Academy of Sciences, Beijing 100083, People's Republic of China
| | - Zhao Fu
- Department of Physics, College of Physical Science and Technology, Xiamen University, Xiamen 361005, People's Republic of China
| | - Zihao Li
- Department of Physics, College of Physical Science and Technology, Xiamen University, Xiamen 361005, People's Republic of China
| | - Yuning Zhang
- Department of Physics, College of Physical Science and Technology, Xiamen University, Xiamen 361005, People's Republic of China
| | - Rongdun Hong
- Department of Physics, College of Physical Science and Technology, Xiamen University, Xiamen 361005, People's Republic of China
| | - Shaoxiong Wu
- Department of Physics, College of Physical Science and Technology, Xiamen University, Xiamen 361005, People's Republic of China
| | - Xiaping Chen
- Department of Physics, College of Physical Science and Technology, Xiamen University, Xiamen 361005, People's Republic of China
| | - Jiafa Cai
- Department of Physics, College of Physical Science and Technology, Xiamen University, Xiamen 361005, People's Republic of China
| | - Deyi Fu
- Department of Physics, College of Physical Science and Technology, Xiamen University, Xiamen 361005, People's Republic of China
| | - Feng Zhang
- Department of Physics, College of Physical Science and Technology, Xiamen University, Xiamen 361005, People's Republic of China
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Yan XQ, Ye MJ, Zou Q, Chen P, He ZS, Wu B, He DL, He CH, Xue XY, Ji ZG, Chen H, Zhang S, Liu YP, Zhang XD, Fu C, Xu DF, Qiu MX, Lv JJ, Huang J, Ren XB, Cheng Y, Qin WJ, Zhang X, Zhou FJ, Ma LL, Guo JM, Ding DG, Wei SZ, He Y, Guo HQ, Shi BK, Liu L, Liu F, Hu ZQ, Jin XM, Yang L, Zhu SX, Liu JH, Huang YH, Xu T, Liu B, Sun T, Wang ZJ, Jiang HW, Yu DX, Zhou AP, Jiang J, Luan GD, Jin CL, Xu J, Hu JX, Huang YR, Guo J, Zhai W, Sheng XN. Toripalimab plus axitinib versus sunitinib as first-line treatment for advanced renal cell carcinoma: RENOTORCH, a randomized, open-label, phase III study. Ann Oncol 2024; 35:190-199. [PMID: 37872020 DOI: 10.1016/j.annonc.2023.09.3108] [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: 09/03/2023] [Revised: 09/21/2023] [Accepted: 09/21/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Immune checkpoint inhibitors in combination with tyrosine kinase inhibitors are standard treatments for advanced clear cell renal cell carcinoma (RCC). This phase III RENOTORCH study compared the efficacy and safety of toripalimab plus axitinib versus sunitinib for the first-line treatment of patients with intermediate-/poor-risk advanced RCC. PATIENTS AND METHODS Patients with intermediate-/poor-risk unresectable or metastatic RCC were randomized in a ratio of 1 : 1 to receive toripalimab (240 mg intravenously once every 3 weeks) plus axitinib (5 mg orally twice daily) or sunitinib [50 mg orally once daily for 4 weeks (6-week cycle) or 2 weeks (3-week cycle)]. The primary endpoint was progression-free survival (PFS) assessed by an independent review committee (IRC). The secondary endpoints were investigator-assessed PFS, overall response rate (ORR), overall survival (OS), and safety. RESULTS A total of 421 patients were randomized to receive toripalimab plus axitinib (n = 210) or sunitinib (n = 211). With a median follow-up of 14.6 months, toripalimab plus axitinib significantly reduced the risk of disease progression or death by 35% compared with sunitinib as assessed by an IRC [hazard ratio (HR) 0.65, 95% confidence interval (CI) 0.49-0.86; P = 0.0028]. The median PFS was 18.0 months in the toripalimab-axitinib group, whereas it was 9.8 months in the sunitinib group. The IRC-assessed ORR was significantly higher in the toripalimab-axitinib group compared with the sunitinib group (56.7% versus 30.8%; P < 0.0001). An OS trend favoring toripalimab plus axitinib was also observed (HR 0.61, 95% CI 0.40-0.92). Treatment-related grade ≥3 adverse events occurred in 61.5% of patients in the toripalimab-axitinib group and 58.6% of patients in the sunitinib group. CONCLUSION In patients with previously untreated intermediate-/poor-risk advanced RCC, toripalimab plus axitinib provided significantly longer PFS and higher ORR than sunitinib and had a manageable safety profile TRIAL REGISTRATION: ClinicalTrials.gov NCT04394975.
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Affiliation(s)
- X Q Yan
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Genitourinary Oncology, Peking University Cancer Hospital & Institute, Beijing
| | - M J Ye
- Department of Urology, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha
| | - Q Zou
- Department of Urology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & Affiliated Cancer Hospital of Nanjing Medical University, Nanjing
| | - P Chen
- Department of Urology, Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi
| | - Z S He
- Department of Urology, First Hospital of Peking University, Beijing
| | - B Wu
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang
| | - D L He
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an
| | - C H He
- Department of Urology, Cancer Hospital of Henan Province, Zhengzhou
| | - X Y Xue
- Department of Urology, The First Affiliated Hospital, Fujian Medical University, Fuzhou
| | - Z G Ji
- Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing
| | - H Chen
- Department of Urology, Harbin Medical University Cancer Hospital, Harbin
| | - S Zhang
- Department of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu
| | - Y P Liu
- Department of Oncology, The First Hospital of China Medical University, Shenyang
| | - X D Zhang
- Department of Urology, Beijing Chaoyang Hospital, Capital Medical University, Beijing
| | - C Fu
- Department of Urology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang
| | - D F Xu
- Department of Urology, Ruijin Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai
| | - M X Qiu
- Department of Urology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu
| | - J J Lv
- Department of Urology, Provincial Hospital Affiliated to Shandong First Medical University, Jinan
| | - J Huang
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou
| | - X B Ren
- Department of Immunology and Biotherapy, Cancer Institute & Hospital, Tianjin Medical University, Tianjin
| | - Y Cheng
- Department of Medical Thoracic Oncology, Jilin Provincial Cancer Hospital, Changchun
| | - W J Qin
- Department of Urology, Xijing Hospital of Air Force Military Medical University, Xi'an
| | - X Zhang
- Department of Urology, The Third Medical Center, Chinese PLA General Hospital, Beijing
| | - F J Zhou
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou
| | - L L Ma
- Department of Urology, Peking University Third Hospital, Beijing
| | - J M Guo
- Department of Urology, Zhongshan Hospital, Fudan University, Shanghai
| | - D G Ding
- Department of Urology, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou
| | - S Z Wei
- Department of Urology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan
| | - Y He
- Department of Urology, The Affiliated Hospital of Jiaxing University, Jiaxing
| | - H Q Guo
- Department of Urology, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing
| | - B K Shi
- Department of Urology, Qilu Hospital of Shandong University, Jinan
| | - L Liu
- Department of Urology, Qilu Hospital of Shandong University, Jinan
| | - F Liu
- Department of Urology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou
| | - Z Q Hu
- Department of Urology, Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science & Technology, Wuhan
| | - X M Jin
- Department of Oncology, General Hospital of Ningxia Medical University, Yinchuan
| | - L Yang
- Department of Urology, The Second Hospital of Lanzhou University, Lanzhou
| | - S X Zhu
- Department of Urology, Fujian Medical University Union Hospital, Fuzhou
| | - J H Liu
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, Kunming
| | - Y H Huang
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou
| | - T Xu
- Department of Urology, Peking University People's Hospital, Beijing
| | - B Liu
- Department of Urology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou
| | - T Sun
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang
| | - Z J Wang
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing
| | - H W Jiang
- Department of Urology, Huashan Hospital, Fudan University, Shanghai
| | - D X Yu
- Department of Urology, The Second Affiliated Hospital of Anhui Medical University, Hefei
| | - A P Zhou
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing
| | - J Jiang
- Department of Urology, The PLA General Hospital Army Characteristic Medical Center, Chongqing
| | - G D Luan
- Shanghai Junshi Biosciences Co., Ltd., Shanghai
| | - C L Jin
- Shanghai Junshi Biosciences Co., Ltd., Shanghai
| | - J Xu
- Shanghai Junshi Biosciences Co., Ltd., Shanghai
| | - J X Hu
- Shanghai Junshi Biosciences Co., Ltd., Shanghai
| | - Y R Huang
- Department of Urology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - J Guo
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Genitourinary Oncology, Peking University Cancer Hospital & Institute, Beijing
| | - W Zhai
- Department of Urology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - X N Sheng
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Genitourinary Oncology, Peking University Cancer Hospital & Institute, Beijing.
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Li TX, Zhang T, Zuo XX, Liu H, Wang ZJ. [Application of modified fusion convergence index in intermittent exotropia]. Zhonghua Yan Ke Za Zhi 2024; 60:56-63. [PMID: 38199769 DOI: 10.3760/cma.j.cn112142-20231008-00124] [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: 01/12/2024]
Abstract
Objective: To investigate a modified fusional convergence parameter-total convergence amplitude/distance angle and its relationship with exotropia control, stereoacuity, and other visual functions in intermittent exotropia. Methods: The cross-sectional study included children diagnosed with intermittent exotropia at the First Affiliated Hospital of Nanjing Medical University from August 2020 to June 2021. A modification was made by combining total convergence amplitude using synoptophore and distance angle at distance using prism bars to calculate total convergence amplitude/distance angle. Exotropia control at distance and near measured by Office-based Scale for Assessing Control was classified as good control (scale 0-1) and poor control (scale 2-5). Statistical analysis was performed using Spearman correlation analysis, Mann-Whitney U test, Fisher's exact test, χ2 test, logistic regression analysis, and mediation effect analysis. Results: The study included 212 patients, of which 105 (49.5%) were male and 107 (50.5%) were female. The median (interquartile range) age was 9.0 (8.0, 10.0) years. Of 211 cases, 201 (94.8%) had binocular fusional function, while 11 cases (5.2%) did not have binocular fusional function. Among patients with binocular fusional function, inverse correlation was observed between total convergence amplitude and exotropia control scores for both distance (r=-0.427, P<0.001) and near (r=-0.194, P=0.006). Total convergence amplitude/distance angle was an independent predictive factor for exotropia control at distance (OR=0.195; 95%CI, 0.060-0.630; P=0.006) and near (OR=0.252; 95%CI, 0.085-0.746; P=0.013). Stereoacuity at distance (OR=3.110; 95%CI, 1.311-7.379; P=0.010) and near (OR=2.780; 95%CI, 1.401-5.517; P=0.003) were also factors associated with distance exotropia control. Mediation analysis revealed that stereoacuity was not a mediating factor between the ratio and distance control (distance: P=0.066; near: P=0.181). In patients with ratio≥1.5 °/PD, all the 15 patients demonstrated good control. On the contrary, patients with ratio<1.5 °/PD showed worse exotropia control (distance: P=0.001; near: P=0.040) and larger angles of deviation (distance: P<0.001; near: P<0.001). Conclusion: The modified fusional ratio, total convergence amplitude/distance angle, combining synoptophore and prism bars, could be used to evaluate the severity of intermittent exotropia. A higher ratio may be associated with poorer exotropia control. Though it may also be associated with distance exotropia control, stereoacuity is not the mediating factor between the modified ratio and distance exotropia control.
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Affiliation(s)
- T X Li
- Department of Ophthalmology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - T Zhang
- Department of Ophthalmology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - X X Zuo
- Department of Ophthalmology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - H Liu
- Department of Ophthalmology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Z J Wang
- Department of Ophthalmology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
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Jin Y, Cao K, Wang ZJ, Han JG. [Research progress of bariatric and metabolic surgery in the prevention of gastroesophageal reflux disease]. Zhonghua Wei Chang Wai Ke Za Zhi 2023; 26:1088-1098. [PMID: 37974356 DOI: 10.3760/cma.j.cn441530-20230216-00039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Gastroesophageal reflux disease (GERD) is a common digestive tract disease. Obesity is an independent risk factor for GERD. Laparoscopic sleeve gastrectomy (laparoscopic sleeve gastrectomy, LSG) is becoming more popular in bariatric metabolic surgery and is simple to perform with fewer complications, but its efficacy in treating postoperative anti-reflux in obese patients remains controversial. LSG has been reported to disrupt anti-reflux barrier function, such as altered cardiac notch, disruption of diaphragmatic continuity, and increased hiatal hernia after surgery. The cardiac notch is one of the important anti-reflux barriers at the gastroesophageal junction, and its accentuation has been shown to be effective in alleviating the symptoms of GERD, and LSG combined with angle of cardiac notch accentuation is expected to be an effective measure to prevent GERD after obesity surgery. Therefore, this article mainly reviews the research on the prevention of GERD by bariatric surgery, aiming to explore the effective treatment of GERD in obese patients after surgery, so as to improve the symptoms and quality of life of patients with GERD, and provide reference for the surgical treatment of GERD.
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Affiliation(s)
- Y Jin
- Department of General Surgery, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China
| | - K Cao
- Department of General Surgery, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China
| | - Z J Wang
- Department of General Surgery, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China
| | - J G Han
- Department of General Surgery, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China
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Han JG, Wang ZJ. [Evaluation strategy of complete response after neoadjuvant therapy for rectal cancer]. Zhonghua Wai Ke Za Zhi 2023; 61:738-743. [PMID: 37491164 DOI: 10.3760/cma.j.cn112139-20230417-00171] [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: 07/27/2023]
Abstract
Currently, the standard of clinical complete response (cCR) after neoadjuvant chemoradiotherapy (nCRT) for local advanced rectal cancer generally lacks pathological examination, the cCR judged by the current standard is still far from the real pathological complete response. After nCRT, due to the presence of tissue edema and fibrosis, MRI is highly uncertain in determining the staging of local lesions. The precision of colonoscopy biopsy is generally low because residual cancer foci exist primarily in the muscular layer, which limits the determination of cCR by colonoscopy biopsy. Local excision through the anus can resect the whole intestinal wall tissue, which is relatively accurate and close to the real state of remission of the lesion, but there are many problems, such as affecting anal function, high rate of complications, and increased difficulty of following radical surgery. Based on the present diagnosis of cCR, the authors put forward the concept of modified cCR (m-cCR) which combined with the pathological standard of transanal multipoint full-layer puncture biopsy. It is possible to improve the accuracy of cCR, and improve the safety of cCR patients who receive wait-and-watch therapy without increasing complications or affecting anal function. The exact conclusion needs to be confirmed by further studies.
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Affiliation(s)
- J G Han
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Z J Wang
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
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Han JG, Sun LT, Zhai ZW, Xia PD, Hu H, Zhang D, Jiang CQ, Zhao BC, Qu H, Qian Q, Dai Y, Yao HW, Wang ZJ. [The value of transanal multipoint full-layer puncture biopsy in determining the response degree of rectal cancer following neoadjuvant therapy: a prospective multicenter study]. Zhonghua Wai Ke Za Zhi 2023; 61:768-774. [PMID: 37491169 DOI: 10.3760/cma.j.cn112139-20230417-00170] [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: 07/27/2023]
Abstract
Objective: To verify the feasibility and accuracy of the transanal multipoint full-layer puncture biopsy (TMFP) technique in determining the residual status of cancer foci after neoadjuvant therapy (nCRT) in rectal cancer. Methods: Between April 2020 and November 2022, a total of 78 patients from the Beijing Chaoyang Hospital of Capital Medical University, the Beijing Friendship Hospital of Capital Medical University, the Qilu Hospital of Shandong University, the Zhongnan Hospital of Wuhan University with advanced rectal cancer received TMFP after nCRT participated in this prospective multicenter trial. There were 53 males and 25 females, aged (M(IQR)) 61 (13) years (range: 35 to 77 years). The tumor distance from the anal verge was 5 (3) cm (range: 2 to 10 cm). The waiting time between nCRT and TMFP was 73 (26) days (range: 33 to 330 days). 13-point transanal puncture was performed with a 16 G tissue biopsy needle with the residual lesion as the center. The specimens were submitted for independent examination and the complications of the puncture were recorded. The consistency of TMFP and radical operation specimen was compared. The consistency of TMPF with clinical remission rates for the diagnosis of complete pathological remission was compared by sensitivity, specificity, negative predictive value, positive predictive value and accuracy. Statistical analysis between groups was performed using the χ2 analysis, and a paired χ2 test was used to compare diagnostic validity. Results: Before TMFP, clinical complete response (cCR) was evaluated in 27 cases. Thirty-six cases received in vivo puncture, the number of punctures in each patient was 13 (8) (range: 4 to 20), 24 cases of tumor residue were found in the puncture specimens. The sensitivity to judgment (100% vs. 60%, χ2=17.500, P<0.01) and accuracy (88.5% vs. 74.4%, χ2=5.125, P=0.024) of TMFP for the pathologic complete response (pCR) were significantly higher than those of cCR. Implement TMFP based on cCR judgment, the accuracy increased from 74.4% to 92.6% (χ2=4.026, P=0.045). The accuracy of the in vivo puncture was 94.4%, which was 83.3% of the in vitro puncture (χ2=1.382, P=0.240). Overall, the accuracy of TMFP improved gradually with an increasing number of cases (χ2=7.112, P=0.029). Conclusion: TMFP is safe and feasible, which improves the sensitivity and accuracy of rectal cancer pCR determination after nCRT, provides a pathological basis for cCR determination, and contributes to the safe development of the watch and wait policy.
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Affiliation(s)
- J G Han
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - L T Sun
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Z W Zhai
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - P D Xia
- Department of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, China
| | - H Hu
- Department of General Surgery, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - D Zhang
- Department of Clinical Epidemiology Laboratory, Beijing Institute of Respiratory Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - C Q Jiang
- Department of General Surgery, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - B C Zhao
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - H Qu
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Q Qian
- Department of General Surgery, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Y Dai
- Department of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, China
| | - H W Yao
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Z J Wang
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
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Cao K, Jin Y, Shi BH, Shi XY, Wang ZJ, Han JG. [Meta-analysis comparing long-term outcomes of intersphincteric resection versus abdominoperineal resection for low rectal cancer]. Zhonghua Wei Chang Wai Ke Za Zhi 2023; 26:595-602. [PMID: 37583014 DOI: 10.3760/cma.j.cn441530-20230315-00083] [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: 08/17/2023]
Abstract
Objective: To compare the long-term outcomes of intersphincteric (trans-internal and external) sphincter resection (ISR) and abdominoperineal proctocolectomy (APR) for low-grade rectal cancer. Methods: We used a meta-analytic approach to compare these procedures . Published reports comparing ISR and APR for low rectal cancer in Pubmed, Medline, EMBASE and Cochrane, China Knowledge Network (CNKI), China Biomedical Literature Database, and Vipers databases between January 2005 and January 2023 were searched and those meeting the eligibility criteria were selected for extraction of data for analysis. Inclusion criteria were as follows: (1) all reports comparing ISR and APR for low rectal cancer before January 2023; and (2) prospective randomized controlled studies or well-designed cohort studies. Exclusion criteria were as follows: (1) full text not available; (2) duplicate publications, missing primary outcome indicators, and unknown data; and (3) invalid statistical analysis. Results: Sixteen studies with 2498 patients were included in this study. Compared with the APR group, patients in the ISR group were relatively younger (weighted mean difference [WMD]=-1.82, 95%CI=-2.94 to -0.70, P=0.01), had tumors farther from the anal verge (WMD=0.43, 95%CI=0.18 to 0.67, P<0.01), and lower pathological T-stage (T3-4 stage: OR=0.54, 95%CI=0.36 to 0.81, P<0.01). In contrast, there were no statistically significant differences between the two groups in gender (P=0.78), body mass index (P=0.77), or pathological N stage (P=0.09). Compared with the APR group, patients in the ISR group had a lower rate of postoperative complications (OR=0.77, 95%CI=0.60 to 0.99, P=0.04), shorter hospital stay (WMD=-4.30, 95%CI=-7.07 to -1.53, P<0.01), higher 5-year overall survival (HR=0.54, 95%CI=0.33 to 0.88, P=0.01), and higher 5-year disease-free survival (HR=0.65, 95%CI=0.47 to 0.90, P<0.01). Five-year locoregional failure (HR=0.66, 95%CI=0.40 to 1.10, P=0.11) and time to surgery (WMD=-9.71, 95%CI=-41.89 to 22.47, P=0.55) did not differ significantly between the two groups. Conclusion: ISR is a safe and effective alternative to APR for early-stage low-grade rectal cancer.
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Affiliation(s)
- K Cao
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Y Jin
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - B H Shi
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - X Y Shi
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Z J Wang
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - J G Han
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
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Cheng CH, Su T, Wang J, Zhu QL, Wu HH, Wang ZJ, Han F, Chen R. [Alertness and task processing speed impairment status and influencing factors of young-middle aged men with obstructive sleep apnea hypopnea syndrome]. Zhonghua Yi Xue Za Zhi 2023; 103:1685-1691. [PMID: 37302859 DOI: 10.3760/cma.j.cn112137-20220909-01910] [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: 06/13/2023]
Abstract
Objective: To investigate the alertness and task processing speed impairment status in young-mild aged men with obstructive sleep apnea hypopnea syndrome (OSAHS), and analyze its influencing factors. Methods: This prospective study recruited 251 snoring patients aged 18 to 59 (38.9±7.6) years in the Sleep Center of the Second Affiliated Hospital of Soochow University from July 2020 to September 2021 and all patients were diagnosed by polysomnography (PSG). Clinical information, Epworth Sleepiness Scale (ESS) and PSG date were collected. All patients were assessed with the Montreal Cognitive Assessment (MoCA) questionnaires, Mini-mental State Examination (MMSE) and Computerized Neurocognitive Assessment System which includes the reaction time of Motor Screening Task (MOT) for alertness, the reaction time of pattern recognition memory (PRM), spatial span (SSP) and spatial working memory (SWM) for task processing speed. Based on AHI tertiles, all patients were divided into Q1 group (AHI<15 times/h, n=79), Q2 group (15 times/h≤AHI<45 times/h, n=88), and Q3 group (AHI≥45 times/h, n=84). The characteristics of clinical information, ESS, PSG parameters and cognitive scores among three groups were compared. Multiple linear stepwise regression was conducted to analyze the influencing factors of cognitive impairment. Results: There were no statistically significant differences in age, years of education, history of smoking and drinking, and past disease history (except for the prevalence of hypertension) among the 3 groups (P>0.05). There were statistically significant among-group differences in the body mass index (BMI), ESS, prevalence of hypertension and complaints of daytime sleepiness (P<0.05). Compared with Q1 and Q2 group, the arousal index (ArI), oxygen desaturation index (ODI),the proportion of non-rapid eye movement phase 1 and 2 (N1+N2) and percentage of total sleep time with oxygen saturation level<90% (TS90) of Q3 group were higher (all P<0.05). In the cognitive assessment, there was no statistically significant difference in the MoCA total and individual scores and MMSE scores among the three groups (P>0.05). Compared with the Q1 group, the task processing speed and alertness were worse in Q3 group, as shown by slower PRM immediate and delayed reaction time, SSP reaction time and MOT reaction time (all P<0.05). The total time of SWM in Q2 group was slower than that in Q1 group (P<0.05). Multiple linear stepwise regression showed that years of education (β=-40.182, 95%CI:-69.847--10.517), ODI (β=3.539, 95%CI: 0.600-6.478) were the risk factors of PRM immediate reaction time. Age(β=13.303,95%CI: 2.487-24.119), years of education(β=-32.329, 95%CI:-63.162--1.497), ODI (β=4.515, 95%CI: 1.623-7.407) were the risk factors of PRM delayed reaction time. ODI was the risk factor of SSP reaction time (β=1.258, 95%CI: 0.379-2.137). TS90 was the risk factor of MOT reaction time (β=1.796, 95%CI: 0.664-2.928). Conclusions: The early cognitive impairment in young-mild aged OSAHS patients was manifested in decreased alertness and task processing speed, and intermittent nocturnal hypoxia was its influencing factor in addition to age and years of education.
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Affiliation(s)
- C H Cheng
- Department of Respiratory and Critical Care Medicine/Sleep Center, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - T Su
- Department of Respiratory and Critical Care Medicine/Sleep Center, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - J Wang
- Department of Respiratory and Critical Care Medicine/Sleep Center, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - Q L Zhu
- Department of Respiratory and Critical Care Medicine/Sleep Center, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - H H Wu
- Department of Respiratory and Critical Care Medicine/Sleep Center, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - Z J Wang
- Department of Respiratory and Critical Care Medicine/Sleep Center, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - F Han
- Department of Respiratory and Critical Care Medicine/Sleep Center, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - R Chen
- Department of Respiratory and Critical Care Medicine/Sleep Center, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
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Ni YB, Tian ZR, Yang JP, Wang YQ, Tian B, Gong R, Zhao W, Wang ZJ. [Quantitative study of supraspinatus tendon injury grading based on synthetic magnetic resonance imaging]. Zhonghua Yi Xue Za Zhi 2023; 103:1603-1610. [PMID: 37248059 DOI: 10.3760/cma.j.cn112137-20220926-02029] [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: 05/31/2023]
Abstract
Objective: To investigate the diagnostic value of quantitative parameters of synthetic magnetic resonance imaging (SyMRI) in the grade of supraspinatus tendon injury. Methods: Ninety-seven patients with clinical definite of supraspinatus tendon injury from July 2021 to July 2022 in General Hospital of Ningxia Medical University were prospectively collected (case group), including 54 males and 43 females, with an age of 29 to 56 (37.4±9.6) years. According to the results of shoulder arthroscopy, the case group were divided into three subgroups included tendinopathy group (37 cases, grade Ⅱ), partial tear group (34 cases, grade Ⅲ) and complete tear group (26 cases, grade Ⅳ). During the same period, 28 normal rotator cuff volunteers without supraspinatus tendon injury were recruited (control group), including 16 males and 12 females, aged 23 to 49 (36.1±7.2) years, and marked as grade Ⅰ. All the subjects underwent MRI scan of articulatio humeri included T1-weighted imaging(T1WI) fast spin echo(FSE) sequences in axial view, T2-weighted imaging(T2WI) fat suppression(FS) sequences in axial view, T2WI FS sequences in oblique coronal view, proton density-weighted (PDW) imaging in oblique sagittal view and SyMRI in oblique coronal view. The supraspinatus tendon was divided into lateral, medial and middle subregions according to its shape in oblique coronal T2WI view, two radiologists measured the T1, T2 and PD values of the supraspinatus tendon. The interclass correlation coefficient (ICC) were used to compare the consistency between and within observers. One-way analysis of variance or Kruskal-Wallis H test were used to compare the differences of quantitative parameters in different grades, the multivariate logistic regression model was used to analyze the risk factors of supraspinatus tendon injury grade, and the receiver operating characteristic (ROC) curves and area under curve (AUC) was drawn and calculated to evaluate the diagnostic efficacy. The Spearman correlation was used to analyze the correlation between the quantitative values and grades of supraspinatus tendon injury. Results: The ICC values of T1, T2 and PD values for the three subregions of the supraspinatus tendon were greater than 0. 700. The differences of T1 values in the lateral subregion, T2 values in the lateral and middle subregions were statistically significant in the overall comparison across different grades (all P<0. 001).The differences of T1 values in the middle and medial subregions, T2 values in the medial subregion and PD values in the lateral, middle and medial subregions were not statistically significant in the overall comparison of different grades (all P>0. 05). Multiple logistic regression model analysis showed that T2 values in the lateral and middle subregions were related factors for the grade of supraspinatus tendon injury[ OR (95%CI):1.123 (1.037-1.216), 0.122 (1.151-1.197);all P<0.001 ]. The AUC of the T2 values in lateral subregion diagnosing grade Ⅰ vs grade Ⅳ, grade Ⅱ vs grade Ⅳ and grade Ⅲ vs grade Ⅳ were 0.891(95%CI: 0.801-0.981), 0.797(95%CI: 0.680-0.914), 0.723(95%CI: 0.594-0.853) (all P<0.001), and the AUC of the T2 values in middle subregion diagnosing grade Ⅰ vs Ⅳ, grade Ⅱ vs Ⅳ, grade Ⅱ vs Ⅲ, and grade Ⅰ vs Ⅲ were 0.946 (95%CI: 0.849-0.989), 0.886 (95%CI: 0.809-0.962), 0.746 (95%CI: 0.631-0.861), 0.843 (95%CI: 0.745-0.941)(all P<0.001). The T2 values in the lateral and middle subregions were positively correlated with the grade of supraspinatus tendon injury (r=0.542, 0.615; both P<0.001), while T1 values and T2 values in the medial subregions were not significantly correlated with the grade of supraspinatus tendon injury (both P>0.05). Conclusion: SyMRI has high clinical application value in the grading of supraspinatus tendon injury, especially T2 value can be used as an effective quantitative parameter for the grading of supraspinatus tendon injury.
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Affiliation(s)
- Y B Ni
- Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan 750001, China
| | - Z R Tian
- Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan 750001, China
| | - J P Yang
- Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan 750001, China
| | - Y Q Wang
- Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan 750001, China
| | - B Tian
- Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan 750001, China
| | - R Gong
- Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan 750001, China
| | - W Zhao
- Basic Medical College of Ningxia Medical University, Yinchuan 750001, China
| | - Z J Wang
- Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan 750001, China
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Jin W, Feng L, Hu XS, Wang ZJ, Hao XZ, Lin L. [Efficacy and safety of epidermal growth factor receptor tyrosine kinase inhibitors combined with chemotherapy as first-line treatment for epidermal growth factor receptor-mutant advanced non-small cell lung cancer]. Zhonghua Yi Xue Za Zhi 2023; 103:1196-1201. [PMID: 37087402 DOI: 10.3760/cma.j.cn112137-20221110-02364] [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: 04/24/2023]
Abstract
Objective: To observe the clinical efficacy and safety of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) combined with chemotherapy as first-line treatment for EGFR mutant advanced non-small cell lung cancer (NSCLC). Methods: It was a retrospective, single-arm real-world study and a total of 39 patients with stage ⅢB to Ⅳ EGFR mutant NSCLC diagnosed in Cancer Hospital of Chinese Academy of Medical Sciences from July 2018 to December 2020 were collected. There were 16 males and 23 females, the age ranged from 25 to 73 years, with a median age of 53 years. All patients received EGFR-TKIs synchronously combined with pemetrexed and platinum-containing chemotherapy for 4-6 cycles as first-line treatment, followed by EGFR-TKI monotherapy with or without pemetrexed maintenance therapy. The objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS) and adverse reactions were evaluated. Median follow-up time was 18.6 months (95%CI: 16.2-21.0 months). The Kaplan-Meier method was used for survival analysis. Results: The ORR was 61.5% (24/39), the DCR was 94.9% (37/39) and the median PFS was 16.4 months (95%CI: 12.1-20.7 months). The main adverse reactions were liver function injury (59.0%, 23/39), myelosuppression (43.6%, 17/39), skin reaction (25.6%, 10/39), gastrointestinal reaction (17.9%, 7/39), fatigue (12.8%, 5/39) and kidney injury (5.1%, 2/39). Most of the patients had grade 1-2 adverse reactions, and the rate of grade 3 adverse events were 12.8%(5/39), which were effectively alleviated after symptomatic support treatment, no grade 4 serious adverse events occurred. Conclusion: EGFR-TKIs synchronously combined with chemotherapy followed by EGFR-TKI monotherapy with or without pemetrexed maintenance therapy has a certain therapeutic effect and fairly good safety, which can prolong PFS in patients with EGFR mutated advanced NSCLC.
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Affiliation(s)
- W Jin
- Department of Traditional Chinese Medicine, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - L Feng
- Department of Traditional Chinese Medicine, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - X S Hu
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Z J Wang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - X Z Hao
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - L Lin
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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Cao K, Wang ZJ, Han JG. [Treatment of obstructive colorectal cancer]. Zhonghua Wei Chang Wai Ke Za Zhi 2023; 26:44-50. [PMID: 36649999 DOI: 10.3760/cma.j.cn441530-20221114-00465] [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: 01/19/2023]
Abstract
Obstructive colorectal cancer is a common malignant bowel obstruction. Colostomy or colostomy following tumor resection may be the first choice for emergency surgery. The intestinal and systemic conditions of patients undergoing emergency surgery are often poor, and patients need to undergo multiple operations, which increase the surgical risk and economic burden and reduce the quality of life of patients. Poor intraoperative visualization may also affect the radical operation of emergency surgery. Transanal decompression tube (TDT) can rapidly decompress and drain the obstructed bowel, effectively relieve obstruction symptoms, and improve the success rate of primary radical resection. The TDT squeeze the tumor lightly, causing no spread of tumor cells, and is cheap, but the cavity of transanal decompression tube is small and easily blocked, and requires tedious flushing or regular replacement. Self-expanding metallic stents (SEMS) can relieve intestinal obstruction effectively, provide sufficient preparation time for preoperative examination and improvement of nutritional status. By improving patient's tolerance to radical surgery, SEMS might be used as an important treatment strategy choice for obstructive colorectal cancer. However, SEMS may squeeze the tumor, leading to the spread of tumor cells, increase the recurrence rate and metastasis rate, and reduce the survival rate. Moreover, intestinal wall edema still existed during the operation following SEMS, and the rate of ostomy after anastomosis was as high as 34%. We hypothesized that prolonging the interval between stent insertion and surgery to 2 months, with neoadjuvant chemotherapy administered during this interval (SEMS-neoadjuvant chemotherapy strategy), would help improve outcomes. The SEMS-neoadjuvant chemotherapy strategy is a safe, effective, and well tolerated treatment approach with a high laparoscopic resection rate, low stoma formation rate and improvement in the overall survival for patients with left-sided colon cancer obstruction. The patient physical status is improved, the primary tumor is downstaged, and intestinal wall edema is relieved during the relatively longer interval between SEMS placement and surgery. The SEMS-neoadjuvant chemotherapy strategy may be a preferred therapeutic strategy for obstructive left colon cancer.
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Affiliation(s)
- K Cao
- Department of General Surgery, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China
| | - Z J Wang
- Department of General Surgery, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China
| | - J G Han
- Department of General Surgery, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China
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Liu XN, Li J, Chen RX, Shao C, Huang H, Xu X, Zhang MZ, Wang ZJ, Xu Z. [Retrospective analysis and a cross-sectional questionnaire survey of lung cancer concomitant with interstitial lung disease]. Zhonghua Jie He He Hu Xi Za Zhi 2022; 45:1192-1198. [PMID: 36480849 DOI: 10.3760/cma.j.cn112147-20220815-00682] [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: 12/13/2022]
Abstract
Objective: To describe the clinical characteristics and prognosis of lung cancer concomitant with interstitial lung disease (LC-ILD), and to understand the current status of knowledge of LC-ILD by physicians in the departments related to the treatment of the disease. Methods: We conducted a retrospective analysis of in-hospitalized pathology identified lung cancer (LC) patients who were admitted to our hospital between January 2014 and December 2018. After reviewing their chest CT imagings and pathological reports, 70 patients who were concomitant with interstitial lung disease (ILD) were enrolled in our study. On the other hand, a cross-sectional survey using an online questionnaire was conducted in LC-ILD management doctors who came from 29 provincial hospitals. The perceptions of demographic features, LC characteristics and management, ILD characteristics and management, and the prognosis of LC-ILD were investigated. Results: Among the 70 enrolled LC-ILD cases, there were 52 males, and the mean age was (64.3±7.63) years (ranged from 49 years to 84 years). There were 51 patients who were older than 59 years. The most common pathological pattern of LC was adenocarcinoma. Most of them were diagnosed with LC and ILD simultaneously, and they were usually treated with chemotherapy while unresectable. There were 11 patients (15.7%) with positive EGFR or ALK mutation. Forty-five patients (64.3%) died during the follow-up, and 33 were died from LC progression. There were no significant differences between the surgical group and non-surgical group on age, pathological patterns, EGFR or ALK mutation. However, LC-ILD patients in the surgical group were diagnosed with earlier TNM classification and with better prognosis. A total of 1 014 doctors answered the questionnaire completely. In the feedback, patients aged 60 years and older (785 doctors/77.4%), and male patients (720 doctors/71%) were the predominant LC-ILD patients. Adenocarcinoma (390 doctors/38.5%), adenocarcinoma or squamous-cell cancer (SCC) (182 doctors/17.9%), and SCC (151 doctors/14.9%) were considered as the common pathological patterns of LC-ILD patients. In most doctors' feedback, the EGFR or ALK mutation was not common for LC-ILD: low (646 doctors/63.7%) or hardly (306 doctors/30.5%) positive mutation. The diagnosis of ILD was earlier than LC (506 doctors/49.9%) or there was no identified precedence of LC and ILD diagnosis (208 doctors/20.5%). Most of the doctors (693 doctors/68.3%) agreed that the vital factor for surgery or not was the severity of ILD for LC-ILD patients. There were great divergences on the treatment protocol both for the advanced LC and ILD. The patients with LC-ILD were died mostly from LC progression and ILD exacerbation (542 doctors/53.5%), followed by ILD exacerbation (237 doctors/23.4%) or LC progression (226 doctors/22.3%). Conclusions: The elderly male patients were predisposed to LC-ILD, and adenocarcinoma was the common pathological pattern. The LC-ILD patients with non-advanced LC who were performed with surgery had better prognosis. However, it is recommended to consider whether to perform surgery in combination with the severity of the ILD.
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Affiliation(s)
- X N Liu
- Internal Medical Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - J Li
- Pathological Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - R X Chen
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - C Shao
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - H Huang
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - X Xu
- Radiological Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - M Z Zhang
- Medical Records Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Z J Wang
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Zuojun Xu
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
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Zhang T, Jin Y, Wang HG, You MA, Huang X, Zhou FW, Wang ZJ, Li JY, Wang Y, Zhu L, Zeng MT, Yuan FY, Li YS, Ruan GX, Yu GD. [Minutes of the 2022 China Rhinology Annual Meeting]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2022; 57:1516-1519. [PMID: 36707962 DOI: 10.3760/cma.j.cn115330-20221111-00680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- T Zhang
- Department of Otorhinolaryngology, the Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China
| | - Y Jin
- Department of Otorhinolaryngology, the Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China
| | - H G Wang
- Department of Otorhinolaryngology, the Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China
| | - M A You
- Department of Otorhinolaryngology, the Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China
| | - X Huang
- Department of Otorhinolaryngology, the Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China
| | - F W Zhou
- Guizhou Medical University, Guiyang 550004, China
| | - Z J Wang
- Guizhou Medical University, Guiyang 550004, China
| | - J Y Li
- Guizhou Medical University, Guiyang 550004, China
| | - Y Wang
- Guizhou Medical University, Guiyang 550004, China
| | - L Zhu
- Guizhou Medical University, Guiyang 550004, China
| | - M T Zeng
- Guizhou Medical University, Guiyang 550004, China
| | - F Y Yuan
- Guizhou Medical University, Guiyang 550004, China
| | - Y S Li
- Guizhou Medical University, Guiyang 550004, China
| | - G X Ruan
- the First People's Hospital of Guiyang, Guiyang 550002, China
| | - G D Yu
- Department of Otorhinolaryngology, the Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China
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16
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Abstract
Parastomal hernia is one of the common complications of stoma surgery with an incidence of more than 30%, which can be diagnosed by physical examination and abdominal CT. Risk factors of parastomal hernia might include stoma approaches including the selection of intestine, relationship between stoma and peritoneum, stoma location, aperture size, operation time and the patient's own conditions. It is essential to prevent parastomal hernia in order to improve patients' quality of life. Prophylactic mesh and perioperative care might prevent parastomal hernias. The mesh type might also influence the incidence of parastomal hernia. To reduce the incidence of recurrence of parastomal hernia, placement of mesh by the laparoscopic Sugarbaker technique was an effective surgical approach. How to prevent and repair parastomal hernia and cure parastomal hernia repair still needs further high-quality research to provide evidence.
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Affiliation(s)
- H Y Zhang
- Department of General Surgery, Beijing Chaoyang Hosptial,Capital Medical University, Beijing 100020, China
| | - Z J Wang
- Department of General Surgery, Beijing Chaoyang Hosptial,Capital Medical University, Beijing 100020, China
| | - J G Han
- Department of General Surgery, Beijing Chaoyang Hosptial,Capital Medical University, Beijing 100020, China
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Cao K, Diao XL, Yu JF, Li GB, Zhai ZW, Zhao BC, Wang ZJ, Han JG. [Effect of intestinal obstruction stent combined with neoadjuvant chemotherapy on the pathological characteristics of surgical specimens in patients with complete obstructive colorectal cancer]. Zhonghua Wei Chang Wai Ke Za Zhi 2022; 25:1012-1019. [PMID: 36396377 DOI: 10.3760/cma.j.cn441530-20220406-00135] [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 compare the effects of three treatment options: emergency surgery, stent-surgery, and stent-neoadjuvant chemotherapy-surgery, on the pathological characteris- tics of surgically-resected specimens from patients with completely obstructive colorectal cancer. Methods: This was a retrospective cohort study analyzing clinicopathological data of patients with complete obstructive colorectal cancer who were admitted to the General Surgery Department of Beijing Chaoyang Hospital, Capital Medical University, between May 2012 and August 2020. The inclusion criteria were diagnosed with complete colorectal obstruction, pathologically confirmed as adenocarcinoma, resectable on imaging assessment, and without distant metastasis, combined with the patients' clinical manifestations and imaging examination findings. Patients with multiple colorectal cancers, refusal to undergo surgery, and concurrent peritonitis or intestinal perforation before stenting of the intestinal obstruction were excluded. Eighty-nine patients with completely obstructive colorectal cancer were enrolled in the study and were divided into emergency surgery group (n=30), stent-surgery group (n=34), and stent-neoadjuvant chemotherapy- surgery group (n=25) according to the treatment strategy. Differences in the pathological features (namely perineural infiltration, lymphovascular infiltration, tumor deposits, specimen intravascular necrosis, inflammatory infiltration, abscesses, mucus lake formation, foreign body giant cells, calcification, and tumor cell ratio) and biomolecular markers (namely cluster of differentiation (CD)34, Ki67, Bcl-2, matrix metalloproteinase-9, and hypoxia-inducible factor alpha) were recorded. Pathological evaluation was based on the presence or absence of qualitative evaluation of pathological features, such as peripheral nerve infiltration, vascular infiltration, and cancer nodules within the specimens. The evaluation criteria for the pathological features of the specimens were as follows: Semi-quantitative graded evaluation based on the proportion of tissue necrosis, inflammatory infiltrates, abscesses, mucus lake formation, foreign body giant cells, calcification, and tumor cells in the field of view within the specimen were classified as: grade 0: not seen within the specimen; grade 1: 0-25%; grade 2: 25%-50%; grade 3: 50%-75%; and grade 4: 75%-100%. The intensity of cellular immunity was classified as none (0 points), weak (1 point), moderate (2 points), and strong (3 points). The two evaluation scores were then multiplied to obtain a total score of 0-12. The immunohistochemical results were also evaluated comprehensively, and the results were defined as: negative (grade 0): 0 points; weakly positive (grade 1): 1-3 points; moderately positive (grade 2): 4-6 points; strongly positive (grade 3): 7-9 points; and very strong positive (grade 4): 10-12 points. Normally-distributed values were expressed as mean±standard deviation, and one-way analysis of variance was used to analyze the differences between the groups. Non-normally-distributed values were expressed as median (interquartile range: Q1, Q3). A nonparametric test (Kruskal-Wallis H test) was used for comparisons between groups. Results: The differences were not statistically significant when comparing the baseline data for age, gender, tumor site, American Society of Anesthesiologists score, tumor T-stage, N-stage, and degree of differentiation among the three groups (all P>0.05). The differences were not statistically significant when comparing the pathological characteristics of the resected tumor specimens, such as foreign body giant cells, inflammatory infiltration, and mucus lake formation among the three groups (all P>0.05). The rates of vascular infiltration were 56.6% (17/30), 41.2% (15/34), and 20.0% (5/25) in the emergency surgery, stent-surgery, and stent- neoadjuvant chemotherapy-surgery groups, respectively, with statistically significant differences between the groups (χ2=7.142, P=0.028). Additionally, the rate of vascular infiltration was significantly lower in the stent-neoadjuvant chemotherapy-surgery group than that in the emergency surgery group (P=0.038). Peripheral nerve infiltration rates were 55.3% (16/30), 41.2% (14/34), and 16.0% (4/25), in the emergency surgery, stent-surgery, and stent-neoadjuvant chemotherapy-surgery groups, respectively, with statistically significant differences (χ2=7.735, P=0.021). The infiltration peripheral nerve rates in the stent-neoadjuvant chemotherapy-surgery group were significantly lower than those in the emergency surgery group (P=0.032). The necrosis grade was 2 (1, 2), 2 (1, 3), and 2 (2, 3) in the emergency surgery, stent- surgery, and stent-neoadjuvant chemotherapy-surgery groups, respectively, with statistically significant differences (H=10.090, P=0.006). Post hoc comparison revealed that the necrosis grade was higher in the stent-surgery and stent-neoadjuvant chemotherapy-surgery groups compared with the emergency surgery group (both P<0.05). The abscess grade was 2 (1, 2), 3 (1, 3), and 2 (2, 3) in the emergency surgery, stent-surgery, and stent-neoadjuvant chemotherapy-surgery groups, respectively, with statistically significant differences (H=6.584, P=0.037). Post hoc comparison revealed that the abscess grade in the emergency surgery group was significantly lower than that in the stent-surgery group (P=0.037). The fibrosis grade was 2 (1, 3), 3 (2, 3), and 3 (2, 3), in the emergency surgery, stent-surgery, and stent-neoadjuvant chemotherapy-surgery groups, respectively, with statistically significant differences (H=11.078, P=0.004). Post hoc analysis revealed that the fibrosis degree was higher in both the stent-surgery group and the stent- neoadjuvant chemotherapy-surgery group compared with the emergency surgery group (both, P<0.05). The tumor cell ratio grades were 4 (3, 4), 4 (3, 4), and 3 (2, 4), in the emergency surgery, stent-surgery, and stent-neoadjuvant chemotherapy-surgery groups, respectively, with statistically significant differences (H=8.594, P=0.014). Post hoc analysis showed that the tumor cell ratio in the stent-neoadjuvant chemotherapy-surgery group was significantly lower than that in the emergency surgery group (P=0.012). The CD34 grades were 2 (2, 3), 3 (2, 4), and 3 (2, 3) in the emergency surgery, stent-surgery, and stent-neoadjuvant chemotherapy-surgery groups, respectively, and the difference was statistically significant (H=9.786, P=0.007). Post hoc analysis showed that the CD34 grades in the emergency surgery, stent-surgery, and stent-neoadjuvant chemotherapy-surgery groups were 2 (2, 3), 3 (2, 4), and 3 (2,3), respectively. Post hoc analysis revealed that the CD34 concentration was higher in the stent-surgery group than that in the emergency surgery group (P=0.005). Conclusion: Stenting may increase the risk of distant metastases in obstructive colorectal cancer. The stent-neoadjuvant chemotherapy-surgery treatment model promotes tumor cell necrosis and fibrosis and reduces the proportion of tumor cells, vascular infiltration, and peripheral nerve infiltration, which may help decrease local tumor infiltration and distant metastasis in completely obstructive colorectal cancer after stent placement.
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Affiliation(s)
- K Cao
- Department of General Surgery, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China
| | - X L Diao
- Department of Pathology, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China
| | - J F Yu
- Department of Gastroenterology, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China
| | - G B Li
- Department of General Surgery, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China
| | - Z W Zhai
- Department of General Surgery, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China
| | - B C Zhao
- Department of General Surgery, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China
| | - Z J Wang
- Department of General Surgery, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China
| | - J G Han
- Department of General Surgery, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China
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Li TX, Liu H, Wang ZJ. [The progress in the clinical application of accommodative convergence/accommodation (AC/A)]. Zhonghua Yan Ke Za Zhi 2022; 58:989-993. [PMID: 36348547 DOI: 10.3760/cma.j.cn112142-20220104-00006] [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
Accommodative convergence/accommodation (AC/A) ratio is an important concept in strabismus and amblyopia. Although AC/A ratio is a commonly used clinical index, most ophthalmologists do not have a thorough understanding of it, and there may be some deviations in its empirical application. In this paper, we reviewed the normal range, measuring method, classification, influencing factors and clinical application value of AC/A, aiming to provide the basis for the application of AC/A ratio in physical check-up of normal population, disease evaluation, diagnosis and treatment of strabismus patients.
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Affiliation(s)
- T X Li
- Department of Ophthalmology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - H Liu
- Department of Ophthalmology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Z J Wang
- Department of Ophthalmology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
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Li GB, Zhai ZW, Zhang HY, Cao K, Wang ZJ, Han JG. [Short-term efficacy of laparoscopic sleeve gastrectomy plus uncut jejunojejunostomy (SG-uncut JJB) for treatment of obesity: a prospective study]. Zhonghua Wei Chang Wai Ke Za Zhi 2022; 25:906-912. [PMID: 36245116 DOI: 10.3760/cma.j.cn441530-20211231-00539] [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 analyze the short-term efficacy of sleeve gastrectomy plus uncut jejunojejunostomy (SG+uncut JJB) for patients with obesity. Methods: This prospective study was conducted in the General Surgery Department of Beijing Chaoyang Hospital from January to December 2020 (NCT04534504). The inclusion criteria were patients with a body mass index (BMI) of >32.5 kg/m2, type 2 diabetes mellitus (T2DM) or at least two comorbidities with a BMI of 27.5-32.5 kg/m2, a waist circumference of >90 cm (male) or >85 cm (female), and those aged between 16 and 65 years. The exclusion criteria included patients who were pregnant, diagnosed with severe neurological or mental illnesses, long-term users of antidepressants and immunosuppressants, and diagnosed with severe gastroesophageal reflux disease or underwent revision surgery. Patients with incomplete follow-up data or insufficient follow-up time were also excluded. Patients were divided into SG-uncut JJB group and SG group according to doctor's recommendation and patients' wills. The primary endpoint was the percentage of excess weight loss (%EWL), and the secondary endpoints were the percentage of total weight loss (%TWL) and the T2DM remission rate. All patients were regularly followed up until the end of December 2020. Results: After excluding seven patients who did not meet the inclusion criteria, 47 eligible patients were finally identified, with 21 in the SG+uncut JJB group and 26 in the SG group. The operation time (140 [110-180] minutes vs. 90 [70-180] minutes, Z=-3.642, P=0.001) and total cost ([54,000 ± 6000] yuan vs. [49,000 ± 7000] yuan, t=2.590, P=0.013) were slightly higher in the SG+uncut JJB group than in the SG group (all P<0.05). However, no significant differences were observed in terms of postoperative hospital stay, operative blood loss, and postoperative complications between the two groups (all P>0.05). The incidence of nausea and vomiting was significantly lower in the SG+uncut JJB group than in the SG group (9.5% [2/21] vs. 46.2% [12/26], χ2=7.453, P=0.006}. The %EWL and %TWL in the SG+uncut JJB group tended to increase gradually with time. The same trend was also observed in the SG group during the first 6 months of follow-up. The 12-month %EWL and %TWL in the SG group were slightly lower compared with the 6-month %EWL and %TWL (P=0.001). The 12-month %EWL values in the SG+uncut JJB and SG groups were (72.4%±12.3%) and (63.6%±25.7%), respectively. However, no significant differences were observed between the two groups in terms of %EWL. Moreover, the 1-month ([11.1%±2.4%] vs. [8.2%±4.4%], P=0.011) and 12-month %TWL ([29.7%±6.9%] vs. [20.3%±7.2%], P=0.001) were significantly higher in the SG+uncut JJB group than in the SG group. No significant differences were observed in terms of T2DM and hypertension remission (all P>0.05). Conclusion: SG+uncut JJB might achieve a promising weight-loss effect similar to SG with a relatively lower incidence of postoperative nausea and vomiting, and it might be an effective and safe approach for obesity management.
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Affiliation(s)
- G B Li
- Department of General Surgery, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China
| | - Z W Zhai
- Department of General Surgery, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China
| | - H Y Zhang
- Department of General Surgery, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China
| | - K Cao
- Department of General Surgery, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China
| | - Z J Wang
- Department of General Surgery, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China
| | - J G Han
- Department of General Surgery, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China
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20
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Liu WL, Zhang X, Nie SM, Liu ZT, Sun XY, Wang HY, Ding JY, Jiang Q, Sun L, Xue FH, Huang Z, Su H, Yang YC, Jiang ZC, Lu XL, Yuan J, Cho S, Liu JS, Liu ZH, Ye M, Zhang SL, Weng HM, Liu Z, Guo YF, Wang ZJ, Shen DW. Spontaneous Ferromagnetism Induced Topological Transition in EuB_{6}. Phys Rev Lett 2022; 129:166402. [PMID: 36306743 DOI: 10.1103/physrevlett.129.166402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 08/09/2022] [Accepted: 09/12/2022] [Indexed: 06/16/2023]
Abstract
The interplay between various symmetries and electronic bands topology is one of the core issues for topological quantum materials. Spontaneous magnetism, which leads to the breaking of time-reversal symmetry, has been proven to be a powerful approach to trigger various exotic topological phases. In this Letter, utilizing the combination of angle-resolved photoemission spectroscopy, magneto-optical Kerr effect microscopy, and first-principles calculations, we present the direct evidence on the realization of the long-sought spontaneous ferromagnetism induced topological transition in soft ferromagnetic EuB_{6}. Explicitly, we reveal the topological transition is from Z_{2}=1 topological insulator in paramagnetic state to χ=1 magnetic topological semimetal in low temperature ferromagnetic state. Our results demonstrate that the simple band structure near the Fermi level and rich topological phases make EuB_{6} an ideal platform to study the topological phase physics.
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Affiliation(s)
- W L Liu
- Center for Excellence in Superconducting Electronics, State Key Laboratory of Functional Materials for Informatics, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai 200050, China
- School of Physical Science and Technology, ShanghaiTech University, Shanghai 201210, China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences, Beijing 100049, China
| | - X Zhang
- School of Physical Science and Technology, ShanghaiTech University, Shanghai 201210, China
| | - S M Nie
- Department of Materials Science and Engineering, Stanford University, Stanford, California 94305, USA
| | - Z T Liu
- Center for Excellence in Superconducting Electronics, State Key Laboratory of Functional Materials for Informatics, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai 200050, China
| | - X Y Sun
- School of Physical Science and Technology, ShanghaiTech University, Shanghai 201210, China
| | - H Y Wang
- School of Physical Science and Technology, ShanghaiTech University, Shanghai 201210, China
| | - J Y Ding
- Center for Excellence in Superconducting Electronics, State Key Laboratory of Functional Materials for Informatics, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai 200050, China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Q Jiang
- Center for Excellence in Superconducting Electronics, State Key Laboratory of Functional Materials for Informatics, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai 200050, China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences, Beijing 100049, China
| | - L Sun
- School of Information Science and Technology, ShanghaiTech University, Shanghai 201210, China
| | - F H Xue
- School of Information Science and Technology, ShanghaiTech University, Shanghai 201210, China
| | - Z Huang
- Center for Excellence in Superconducting Electronics, State Key Laboratory of Functional Materials for Informatics, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai 200050, China
| | - H Su
- School of Physical Science and Technology, ShanghaiTech University, Shanghai 201210, China
| | - Y C Yang
- Center for Excellence in Superconducting Electronics, State Key Laboratory of Functional Materials for Informatics, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai 200050, China
| | - Z C Jiang
- Center for Excellence in Superconducting Electronics, State Key Laboratory of Functional Materials for Informatics, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai 200050, China
| | - X L Lu
- Center for Excellence in Superconducting Electronics, State Key Laboratory of Functional Materials for Informatics, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai 200050, China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences, Beijing 100049, China
| | - J Yuan
- School of Physical Science and Technology, ShanghaiTech University, Shanghai 201210, China
| | - Soohyun Cho
- Center for Excellence in Superconducting Electronics, State Key Laboratory of Functional Materials for Informatics, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai 200050, China
| | - J S Liu
- Center for Excellence in Superconducting Electronics, State Key Laboratory of Functional Materials for Informatics, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai 200050, China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Z H Liu
- Center for Excellence in Superconducting Electronics, State Key Laboratory of Functional Materials for Informatics, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai 200050, China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences, Beijing 100049, China
| | - M Ye
- Center for Excellence in Superconducting Electronics, State Key Laboratory of Functional Materials for Informatics, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai 200050, China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences, Beijing 100049, China
| | - S L Zhang
- School of Physical Science and Technology, ShanghaiTech University, Shanghai 201210, China
| | - H M Weng
- Institute of Physics and Beijing National Laboratory for Condensed Matter Physics, Chinese Academy of Sciences, Beijing 100190, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Z Liu
- School of Physical Science and Technology, ShanghaiTech University, Shanghai 201210, China
| | - Y F Guo
- School of Physical Science and Technology, ShanghaiTech University, Shanghai 201210, China
| | - Z J Wang
- Institute of Physics and Beijing National Laboratory for Condensed Matter Physics, Chinese Academy of Sciences, Beijing 100190, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - D W Shen
- Center for Excellence in Superconducting Electronics, State Key Laboratory of Functional Materials for Informatics, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai 200050, China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences, Beijing 100049, China
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21
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Zhang M, Wu P, Duan YL, Jin L, Yang J, Huang S, Liu Y, Hu B, Zhai XW, Wang HS, Fu Y, Li F, Yang XM, Liu AS, Qin S, Yuan XJ, Dong YS, Liu W, Zhou JW, Zhang LP, Jia YP, Wang J, Qu LJ, Dai YP, Guan GT, Sun LR, Jiang J, Liu R, Jin RM, Wang ZJ, Wang XG, Zhang BX, Chen KL, Zhuang SQ, Zhang J, Zhou CJ, Gao ZF, Zheng MC, Zhang Y. [Mid-term efficacy of China Net Childhood Lymphoma-mature B-cell lymphoma 2017 regimen in the treatment of pediatric Burkitt lymphoma]. Zhonghua Er Ke Za Zhi 2022; 60:1011-1018. [PMID: 36207847 DOI: 10.3760/cma.j.cn112140-20220429-00390] [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 analyze the clinical characteristics of children with Burkitt lymphoma (BL) and to summarize the mid-term efficacy of China Net Childhood Lymphoma-mature B-cell lymphoma 2017 (CNCL-B-NHL-2017) regimen. Methods: Clinical features of 436 BL patients who were ≤18 years old and treated with the CNCL-B-NHL-2017 regimen from May 2017 to April 2021 were analyzed retrospectively. Clinical characteristics of patients at disease onset were analyzed and the therapeutic effects of patients with different clinical stages and risk groups were compared. Survival analysis was performed by Kaplan-Meier method, and Cox regression was used to identify the prognostic factors. Results: Among 436 patients, there were 368 (84.4%) males and 68 (15.6%) females, the age of disease onset was 6.0 (4.0, 9.0) years old. According to the St. Jude staging system, there were 4 patients (0.9%) with stage Ⅰ, 30 patients (6.9%) with stage Ⅱ, 217 patients (49.8%) with stage Ⅲ, and 185 patients (42.4%) with stage Ⅳ. All patients were stratified into following risk groups: group A (n=1, 0.2%), group B1 (n=46, 10.6%), group B2 (n=19, 4.4%), group C1 (n=285, 65.4%), group C2 (n=85, 19.5%). Sixty-three patients (14.4%) were treated with chemotherapy only and 373 patients (85.6%) were treated with chemotherapy combined with rituximab. Twenty-one patients (4.8%) suffered from progressive disease, 3 patients (0.7%) relapsed, and 13 patients (3.0%) died of treatment-related complications. The follow-up time of all patients was 24.0 (13.0, 35.0) months, the 2-year event free survival (EFS) rate of all patients was (90.9±1.4) %. The 2-year EFS rates of group A, B1, B2, C1 and C2 were 100.0%, 100.0%, (94.7±5.1) %, (90.7±1.7) % and (85.9±4.0) %, respectively. The 2-year EFS rates was higher in group A, B1, and B2 than those in group C1 (χ2=4.16, P=0.041) and group C2 (χ2=7.21, P=0.007). The 2-year EFS rates of the patients treated with chemotherapy alone and those treated with chemotherapy combined with rituximab were (79.3±5.1)% and (92.9±1.4)% (χ2=14.23, P<0.001) respectively. Multivariate analysis showed that stage Ⅳ (including leukemia stage), serum lactate dehydrogenase (LDH)>4-fold normal value, and with residual tumor in the mid-term evaluation were risk factors for poor prognosis (HR=1.38,1.23,8.52,95%CI 1.05-1.82,1.05-1.43,3.96-18.30). Conclusions: The CNCL-B-NHL-2017 regimen show significant effect in the treatment of pediatric BL. The combination of rituximab improve the efficacy further.
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Affiliation(s)
- M Zhang
- Medical Oncology Department, Pediatric Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing Key Laboratory of Pediatric Hematology Oncology, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
| | - P Wu
- Department of Hematology, Hunan Children's Hospital, Changsha 410007, China
| | - Y L Duan
- Medical Oncology Department, Pediatric Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing Key Laboratory of Pediatric Hematology Oncology, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
| | - L Jin
- Medical Oncology Department, Pediatric Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing Key Laboratory of Pediatric Hematology Oncology, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
| | - J Yang
- Medical Oncology Department, Pediatric Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing Key Laboratory of Pediatric Hematology Oncology, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
| | - S Huang
- Medical Oncology Department, Pediatric Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing Key Laboratory of Pediatric Hematology Oncology, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
| | - Y Liu
- Department of Pediatric Lymphoma, Beijing GoBroad Boren Hospital, Beijing 100070, China
| | - B Hu
- Department of Pediatric Lymphoma, Beijing GoBroad Boren Hospital, Beijing 100070, China
| | - X W Zhai
- Department of Hematology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
| | - H S Wang
- Department of Hematology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
| | - Y Fu
- Department of Hematology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
| | - F Li
- Hematology & Oncology Department, Children's Hospital Affiliated to Shandong University, Jinan 250022, China
| | - X M Yang
- Hematology & Oncology Department, Children's Hospital Affiliated to Shandong University, Jinan 250022, China
| | - A S Liu
- Department of Hematology & Oncology, Xi'an Children's Hospital, Xi'an 710002, China
| | - S Qin
- Department of Hematology & Oncology, Xi'an Children's Hospital, Xi'an 710002, China
| | - X J Yuan
- Department of Pediatric Hematology/Oncology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Y S Dong
- Department of Pediatric Hematology/Oncology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - W Liu
- Department of Hematology & Oncology, Zhengzhou Children's Hospital, Zhengzhou 450018, China
| | - J W Zhou
- Department of Hematology & Oncology, Zhengzhou Children's Hospital, Zhengzhou 450018, China
| | - L P Zhang
- Department of Pediatrics, Peking University People's Hospital, Beijing 100044, China
| | - Y P Jia
- Department of Pediatrics, Peking University People's Hospital, Beijing 100044, China
| | - J Wang
- Department of Hematology & Oncology, Anhui Children's Hospital, Hefei 230022, China
| | - L J Qu
- Department of Hematology & Oncology, Anhui Children's Hospital, Hefei 230022, China
| | - Y P Dai
- Department of Pediatric Hematology & Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
| | - G T Guan
- Department of Pediatric Hematology & Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
| | - L R Sun
- Department of Pediatric Hematology & Oncology, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - J Jiang
- Department of Pediatric Hematology & Oncology, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - R Liu
- Department of Hematology, Children's Hospital, Capital Pediatric Research Institute, Beijing 100020, China
| | - R M Jin
- Department of Pediatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Z J Wang
- Department of Pediatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - X G Wang
- Department of Hematology and Oncology, Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052
| | - B X Zhang
- Department of Pediatrics, Second Hospital of Hebei Medical University, Shijiazhuang 050004, China
| | - K L Chen
- Department of Hematology and Oncology, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430016, China
| | - S Q Zhuang
- Department of Pediatrics, First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou 362002, China
| | - J Zhang
- Department of Hematology & Oncology, the First People's Hospital of Urumqi, Urumqi 830002, China
| | - C J Zhou
- Pathology Department, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Z F Gao
- Department of Pathology, Peking University Third Hospital, Beijing 100191, China
| | - M C Zheng
- Department of Hematology, Hunan Children's Hospital, Changsha 410007, China
| | - Yonghong Zhang
- Medical Oncology Department, Pediatric Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing Key Laboratory of Pediatric Hematology Oncology, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
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22
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Chen XX, He SF, Xia DH, Wang ZJ, Pan Y. Synthesis of two quasi-optical polarizers for the multi-frequency high-power millimeter wave system. Rev Sci Instrum 2022; 93:104707. [PMID: 36319337 DOI: 10.1063/5.0110833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 09/13/2022] [Indexed: 06/16/2023]
Abstract
Millimeter wave systems based on powerful gyrotron can deliver megawatt microwave power, which is an important auxiliary heating method for magnetic confinement fusion devices. Reflective gratings are normally used as quasi-optical polarizers for polarization control of the wave in such systems. Based on the coordinate transformation method, we developed a numerical code to study the broadband polarization strategy. By considering the synthesis of two polarizers, we designed a pair of polarizers in the W band. Calculation results indicated that almost arbitrary polarization can be achieved in a wide frequency range. To verify the design, we set up a low-power test platform and experiments were carried out. The performance of the polarizers was tested from 80 to 105 GHz with a step of 5 GHz. The test results agreed well with the numerical results, indicating that the design is reasonable. With the development of multi-frequency gyrotrons, the study in this paper can be used as a reference for the design of broadband polarizers of multi-frequency millimeter wave systems.
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Affiliation(s)
- X X Chen
- International Joint Research Laboratory of Magnetic Confinement Fusion and Plasma Physics, State Key Laboratory of Advanced Electromagnetic Engineering and Technology, School of Electrical and Electronic Engineering, Huazhong University of Science and Technology, Wuhan 430074, China
| | - S F He
- International Joint Research Laboratory of Magnetic Confinement Fusion and Plasma Physics, State Key Laboratory of Advanced Electromagnetic Engineering and Technology, School of Electrical and Electronic Engineering, Huazhong University of Science and Technology, Wuhan 430074, China
| | - D H Xia
- International Joint Research Laboratory of Magnetic Confinement Fusion and Plasma Physics, State Key Laboratory of Advanced Electromagnetic Engineering and Technology, School of Electrical and Electronic Engineering, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Z J Wang
- International Joint Research Laboratory of Magnetic Confinement Fusion and Plasma Physics, State Key Laboratory of Advanced Electromagnetic Engineering and Technology, School of Electrical and Electronic Engineering, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Y Pan
- International Joint Research Laboratory of Magnetic Confinement Fusion and Plasma Physics, State Key Laboratory of Advanced Electromagnetic Engineering and Technology, School of Electrical and Electronic Engineering, Huazhong University of Science and Technology, Wuhan 430074, China
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23
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Du ZX, Li Y, Wang ZJ, Zhou DM, Yang JH. [Bioinformatics analysis of differentially expressed genes associated with chronic schistosomiasis japonica-induced hepatic fibrosis]. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi 2022; 34:352-360. [PMID: 36116924 DOI: 10.16250/j.32.1374.2022053] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To screen differentially expressed genes (DEGs) associated with chronic schistosomiasis japonica-induced hepatic fibrosis and analyze their functions. METHODS The dataset of gene expression profiles of patients with chronic schistosomiasis japonica-induced hepatic fibrosis was downloaded from the Gene Expression Omnibus (GEO) database, and DEGs were screened using R package. The biological functions of DEGs were characterized using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses. In addition, the protein-protein interaction (PPI) network of DEGs was created to screen the hub genes. RESULTS A total of 62 DEGs were identified, including 12 down-regulated genes and 50 up-regulated genes. GO enrichment analysis showed that DEGs were mainly enriched in 116 biological processes, including fatty acid, sulfur compound, acyl-coenzyme A and thioester metabolism; 19 cellular components, including mitochondrial matrix, outer mitochondrial membrane and organelle outer membrane; and 7 molecular functions, including insulin-like growth factor binding and oxidoreductase activity. KEGG pathway enrichment analysis that the DEGs were significantly enriched in phosphatidylinositol-3-kinase/serine/threonine protein kinase (PI3K/Akt), mitogen-activated protein kinase (MAPK), calcium metabolism and cyclic adenosine monophosphate (cAMP) signaling. PPI network analysis identified six hub genes involved in the development of chronic schistosomiasis japonica-induced hepatic fibrosis, including ACACA, ACSL1, GPAM, THRSP, PLIN1 and DGAT2, and ACSL1, ACACA and PLIN1 were the top 3 hub genes. CONCLUSIONS ACSL1, ACACA and PLIN1 may be the hub genes associated with the development of chronic schistosomiasis japonica-induced hepatic fibrosis, and abnormal lipid metabolism mediated by these DEGs may play an important role in the development of chronic schistosomiasis japonica-induced hepatic fibrosis.
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Affiliation(s)
- Z X Du
- Department of Infectious Diseases, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui 241001, China
| | - Y Li
- Department of Infectious Diseases, People's Hospital of Taizhou City, Jiangsu Province, China
| | - Z J Wang
- Department of Infectious Diseases, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui 241001, China
| | - D M Zhou
- Department of Infectious Diseases, People's Hospital of Taizhou City, Jiangsu Province, China
| | - J H Yang
- Department of Infectious Diseases, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui 241001, China
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24
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Lou Y, Ma WJ, Wang ZJ, Yang N, Sun YJ, Liu YL, Lei RB, Zhao JX, Luo XF, Wang L, Chen YL, Han YL, Sun YX, Li YM, Cai J. [Writing protocols for the Chinese clinical practice guidelines of hypertension]. Zhonghua Xin Xue Guan Bing Za Zhi 2022; 50:671-675. [PMID: 35856223 DOI: 10.3760/cma.j.cn112148-20211126-01021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Y Lou
- Hypertension Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - W J Ma
- Hypertension Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Z J Wang
- Evidence-Based Medicine Centre, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
| | - N Yang
- Evidence-Based Medicine Centre, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
| | - Y J Sun
- School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - Y L Liu
- School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - R B Lei
- Pediatric Research Institute, Children's Hospital of Chongqing Medical University, Chongqing 400014, China
| | - J X Zhao
- School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - X F Luo
- School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - L Wang
- Hypertension Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Y L Chen
- Evidence-Based Medicine Centre, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
| | - Y L Han
- Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110000, China
| | - Y X Sun
- Department of Cardiology, First Hospital of China Medical University, Shenyang 110000, China
| | - Y M Li
- Department of Cardiology, TEDA International Cardiovascular Hospital, Tianjin 300450, China
| | - J Cai
- Hypertension Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing 100037, China
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25
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Wang ZJ, Luo XF, Chen YL. [Key points and standards on establishing the writing protocols for the guidelines]. Zhonghua Xin Xue Guan Bing Za Zhi 2022; 50:627-629. [PMID: 35856217 DOI: 10.3760/cma.j.cn112148-20220415-00273] [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)
- Z J Wang
- Research Unit of Evidence-Based Evaluation and Guidelines, Chinese Academy of Medical Sciences, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
| | - X F Luo
- School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - Y L Chen
- Research Unit of Evidence-Based Evaluation and Guidelines, Chinese Academy of Medical Sciences, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
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26
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Li GB, Wang ZJ, Han JG. [Current management status of hereditary colorectal cancer]. Zhonghua Wei Chang Wai Ke Za Zhi 2022; 25:546-551. [PMID: 35754221 DOI: 10.3760/cma.j.cn441530-20211111-00457] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Hereditary colorectal cancer accounts for approximately 5% of all colorectal cancer cases, mainly including familial adenomatous polyposis and Lynch syndrome. Total proctocolectomy plus ileal pouch-anal anastomosis and total colectomy plus ileorectal anastomosis are two major procedures for familial adenomatous polyposis, however, the exact impact of these two procedures on surgical efficacy, oncologic efficacy as well as functional results still remains uncertain. Segmental colectomy and total colectomy are two major procedures for Lynch syndrome, each of them both has advantages and disadvantages, and there still lacks a consensus about the optimal strategy because of the nature of retrospective study with a relatively insufficient evidence support. As a result, we would make a review about the current surgical treatment status and future perspectives of hereditary colorectal cancer.
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Affiliation(s)
- G B Li
- Department of General Surgery, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China
| | - Z J Wang
- Department of General Surgery, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China
| | - J G Han
- Department of General Surgery, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China
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27
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Wang ZJ, Han YQ, Li Q, Mo HN, Li YQ, Guan XW, Chen YM, Lin SY, Xu BH, Li Q, Zhang P, Ma F. [A real world study on the relationship between drug resistance of targeted therapy and prognosis of HER-2-positive advanced breast cancer]. Zhonghua Zhong Liu Za Zhi 2022; 44:360-363. [PMID: 35448925 DOI: 10.3760/cma.j.cn112152-20200409-00325] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To explore the effect of primary and acquired resistance to anti-human epidermal growth factor receptor 2 (HER-2) on the overall survival of patients with HER-2 positive advanced breast cancer. Methods: The clinical characteristics of HER-2 positive patients with advanced breast cancer admitted to Cancer Hospital of Chinese Academy of Medical Sciences from January 1998 to December 2018 were collected, and their neoadjuvant/adjuvant and advanced three-line chemotherapy were summarized. Among them, targeted drugs for HER-2 included trastuzumab, pertuzumab, T-DM1, RC48-ADC, lapatinib, pyrotinib, allitinib, sipatinib, seratinib. Based on the duration of benefit from anti HER-2 treatment, the patients were divided into two groups: primary anti HER-2 resistance group and acquired anti HER-2 resistance group. In this study, the overall survival (OS) was used as the main end point. Kaplan-Meier analysis and Cox proportional risk regression model were used to analyze the effects of different drug resistance mechanisms on the overall survival. Results: The whole group of 284 patients were included. The median age of recurrence and metastasis was 48 years old, 155 (54.6%) were hormone receptor (HR) positive and 129 (45.4%) were HR negative, 128 cases (45.1%) were premenopausal and 156 cases (54.9%) were postmenopausal, 277 cases (97.5%) had a score of 0-1 in ECoG PS and 7 cases (2.5%) had a score of more than 2 in the first diagnosis of relapse and metastasis. There were 103 cases (36.3%) in the primary drug resistance group and 181 cases (63.7%) in the secondary drug resistance group. The median overall survival time of the two groups was 24.9 months and 40.4 months, respectively, with statistical significance (P<0.001). Conclusion: Primary resistance to HER-2 is one of the factors of poor prognosis in HER-2 positive breast cancer, and its mechanism needs to be further explored.
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Affiliation(s)
- Z J Wang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
| | - Y Q Han
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
| | - Q Li
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
| | - H N Mo
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
| | - Y Q Li
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
| | - X W Guan
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
| | - Y M Chen
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
| | - S Y Lin
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
| | - B H Xu
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
| | - Q Li
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
| | - P Zhang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
| | - F Ma
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
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Zhang CJ, Su YJ, Chen Y, Wang ZJ, Hu SL, Xu HH, Liu YP, Li XY, Zhu HM, Yi HL, Guan J, Teng YC, Yin S. [Sleep quality and sleep disturbances in Chinese pregnant women: a multicenter cross-sectional study]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2022; 57:308-316. [PMID: 35325943 DOI: 10.3760/cma.j.cn115330-20210603-00326] [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: 06/14/2023]
Abstract
Objective: This study aims to investigate the sleep quality of pregnant women in Xuhui District, Shanghai, and the related factors of sleep disturbances during pregnancy. Methods: From February 2019 to February 2021, we used online integrated sleep questionnaire (including PSQI, BQ, ESS, AIS) in Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, The International Peace Maternity and Child Health Hospitals of China Welfare Institution, and Shanghai Eighth People's Hospital, to investigate the sleep quality across pregnancy. We also collected maternal physical examination results, childbearing history, sociodemographic, and other clinical data. The prevalences and related factors of various sleep disturbances in pregnant women were analyzed, including insufficient/excessive nighttime sleep, low sleep efficiency, difficulty falling asleep, poor sleep quality, insomnia, daytime sleepiness, and high risk of sleep-disordered breathing (SDB). Results: This study includes 1 898 cases in the first trimester (T1), 3 099 cases in the second trimester (T2), and 1 539 cases in the third trimester (T3). Poor sleep quality (38.6%), daytime sleepiness (mild 41.9%, moderate 17.7%, severe 2.1%), and suspicious insomnia (32.3%) are most prevalent among women in T1 (P<0.01). In comparison, short sleep time (2.7%), long sleep time (8.6%), difficulty falling asleep (12.2%), poor sleep efficiency (35.4%), very poor sleep quality (6.7%), clinical insomnia (21.8%), and high-risk SDB (6.4%) are most prevalent among women in T3 (P<0.05). During pregnancy, late gestation (OR=1.016, 95%CI: 1.006-1.025) and multiple induced/drug abortions (OR=1.329, 95%CI: 1.043-1.692) are risk factors for poor sleep quality (PSQI>5), while multiple full-term deliveries (OR=0.800, 95%CI: 0.675-0.949) is its protective factor. Advanced maternal age (OR=0.976, 95%CI: 0.956-0.997), multiple full-term deliveries (OR=0.808, 95%CI: 0.680-0.959), late gestation (OR=0.983, 95%CI: 0.974-0.992) and hypertension (OR=0.572, 95%CI: 0.401-0.814) are protective factors for daytime sleepiness (ESS>6). The high-risk pregnancy category (OR=9.312, 95%CI: 1.156-74.978) is a risk factor for insomnia (AIS≥4), while multiple full-term deliveries (OR=0.815, 95%CI: 0.691-0.961) is its protective factor. High BMI (OR=1.334, 95%CI: 1.270-1.402) and hypertension (OR=4.427, 95%CI: 2.539-7.719) are risk factors for high-risk SDB in pregnant women. Conclusions: The prevalences of various sleep disturbances are high throughout pregnancy. Noticeably, symptoms of maternal SDB develop along with pregnancy. Different types of sleep disturbances are associated with different factors. Women of high-risk pregnancy category, in late gestation, with high BMI, hypertension, a history of induced/drug abortion, or without a history of full-term delivery can be at high risk of sleep disturbances during pregnancy.
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Affiliation(s)
- C J Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai 200233, China Otorhinolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China
| | - Y J Su
- Otorhinolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China Department of Nursing, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Y Chen
- Department of Obstetrics, the International Peace Maternity and Child Health Hospitals of China Welfare Institution, Shanghai 200233, China
| | - Z J Wang
- Department of Gynecology and Obstetrics, Shanghai Eighth People's Hospital, Shanghai 200233, China
| | - S L Hu
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China Department of Nursing, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - H H Xu
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai 200233, China Otorhinolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China
| | - Y P Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai 200233, China Otorhinolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China
| | - X Y Li
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai 200233, China Otorhinolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China
| | - H M Zhu
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai 200233, China Otorhinolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China
| | - H L Yi
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai 200233, China Otorhinolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China
| | - J Guan
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai 200233, China Otorhinolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China
| | - Y C Teng
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China Department of Gynecology and Obstetrics, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Shankai Yin
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai 200233, China Otorhinolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China
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Wang ZJ, Wu HH, Shen JC, Wang J, Wang QJ, Han F, Gui H, Chen R. [Clinical characteristics of patients with obstructive sleep apnea hypopnea syndrome combined with alveolar hypoventilation]. Zhonghua Yi Xue Za Zhi 2022; 102:555-562. [PMID: 35196777 DOI: 10.3760/cma.j.cn112137-20210630-01476] [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: 06/14/2023]
Abstract
Objective: To evaluate the clinical characteristics of patients with obstructive sleep apnea hypopnea syndrome (OSAHS) combined with alveolar hypoventilation. Methods: This retrospective study included patients who were diagnosed as OSAHS by polysomnography (PSG) and underwent daytime awake transcutaneous carbon dioxide (PtcCO2) monitoring from November 2019 to February 2021 at the Sleep Center of the Second Affiliated Hospital of Soochow University. A total of 177 patients were enrolled in the analysis, including 167 males and 10 females, aged (40±8) years old. Patients with daytime awake PtcCO2>45 mmHg (1 mmHg=0.133 kPa) were diagnosed as daytime alveolar hypoventilation, with which participants were divided into the daytime alveolar hypoventilation group and non-daytime alveolar hypoventilation group. Body mass index (BMI) cut-off value predicting daytime alveolar hypoventilation was calculated and the patients were divided into the high BMI group and low BMI group. The continuous nocturnal PtcCO2 data was available for a subset of 128 patients, and the patients were divided into two groups according the daytime alveolar hypoventilation or not. Across-group differences were compared, respectively. Results: Compared with the non-daytime alveolar hypoventilation group (n=125), the BMI [27.57 (26.55, 30.33) vs 26.60 (25.06, 28.09) kg/m2], Epworth sleepiness score(ESS) score [9.50 (6.25, 12.00) vs 7.00 (4.00, 10.75)], higher oxygen desaturation index (ODI) [38.00 (15.23, 64.93) vs 26.80 (11.30, 44.30) events/h] and percentage of total time with oxygen saturation level<90% (TS90%) [11.24% (1.88%, 32.44%) vs 4.35% (0.72%, 9.87%)] of the daytime alveolar hypoventilation group(n=52) were significantly higher (P<0.05), and lowest arterial oxygen saturation (LSaO2) [74.50% (60.25%, 82.00%) vs 79.00% (73.00%, 84.50%)], mean arterial oxygen saturation (MSaO2) [94.00% (91.00%, 95.00%) vs 95.00% (94.00%, 96.00%)] were significantly lower (P<0.05). The BMI cut-off value for predicting daytime alveolar hypoventilation was 27.04 kg/m2. Of the 177 enrolled patients, 90 were in the high BMI group and 87 were in low group. Compared with the low BMI group, the proportion of daytime sleepiness, the ESS score, the prevalence of hypertension, AHI and daytime awake PtcCO2 in the high BMI group were significantly higher (P<0.05). Among the subset of 128 patients with nocturnal PtcCO2 data available, the BMI, daytime PtcCO2 level, the nocturnal CO2 level and the prevalence of sleep related alveolar hypoventilation in the daytime alveolar hypoventilation group (n=40) were significantly higher than those in the non-daytime alveolar hypoventilation group (n=88) (P<0.05). Conclusions: The OSAHS patients with alveolar hypoventilation have higher BMI and more severe nocturnal hypoxia. OSAHS patients with BMI>27.04 kg/m2 are more likely to develop sleep related alveolar hypoventilation disorder.
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Affiliation(s)
- Z J Wang
- Sleep Center, Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - H H Wu
- Sleep Center, Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - J C Shen
- Sleep Center, Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - J Wang
- Sleep Center, Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - Q J Wang
- Sleep Center, Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - F Han
- Sleep Center, Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - H Gui
- Sleep Center, Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - R Chen
- Sleep Center, Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
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Li GB, Wang ZJ, Han JG. [The current status and future perspectives of bariatric and metabolic surgery in the management of obesity and its co-morbidities]. Zhonghua Wai Ke Za Zhi 2022; 60:188-192. [PMID: 35012280 DOI: 10.3760/cma.j.cn112139-20211118-00540] [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: 06/14/2023]
Abstract
Bariatric-metabolic surgery (BMS) has the potential of decreasing body weight and improving obesity-related metabolic syndrome by restricting food intake and malabsorption. Laparoscopic sleeve gastrectomy, Roux-en-Y gastric bypass, adjustable gastric banding, biliopancreatic diversion with duodenal switch are four major BMS procedures. Sleeve plus surgery, one-anastomosis gastric bypass, intragastric balloon and endoscopic surgery are also arising and gaining popularity due to their specific efficacy. Currently, BMS is now experiencing an era with deeply integrated interdisciplinarity, optimizing and innovating of surgeries and well-illustrated clinical efficacy, as a result, more obese patients would benefit from BMS.
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Affiliation(s)
- G B Li
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Z J Wang
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - J G Han
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
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Li SD, Su F, Zhou CY, Hu QL, Li YQ, Wang ZJ. Syntheses, structures and magnetic properties of two Co II/Ni II isostructural coordination polymers based on an asymmetric semirigid tricarboxylate ligand. Acta Crystallogr C 2022; 78:23-29. [PMID: 34982046 DOI: 10.1107/s2053229621012973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 12/07/2021] [Indexed: 11/11/2022] Open
Abstract
Two new isostructural complexes, namely, poly[aqua[μ3-2-(4-carboxyphenoxy)terephthalato-κ3O1:O4:O4'](1,10-phenanthroline-κ2N,N')cobalt(II)], [Co(C15H8O7)(C12H8N2)(H2O)]n or [Co(μ3-Hcpota)(phen)(H2O)]n, I, and poly[aqua[μ3-2-(4-carboxyphenoxy)terephthalato-κ3O1:O4:O4'](1,10-phenanthroline-κ2N,N')nickel(II)], [Ni(C15H8O7)(C12H8N2)(H2O)]n or [Ni(μ3-Hcpota)(phen)(H2O)]n, II, have been synthesized by solvothermal reactions. Complexes I and II were fully characterized by IR spectroscopy, elemental analyses, thermogravimetric analyses, and powder and single-crystal X-ray diffraction. They both present two-dimensional structures based on [M2(μ-COO)2]2+ (M = CoII or NiII) dinuclear metal units with a fes topology and a vertex symbol (4·82). Interestingly, the positions of the two dimeric metal motifs and the two partially deprotonated Hcpota2- ligands reproduce regular flying butterfly arrangements flipped upside down and sharing wings in the ab plane. Magnetic studies indicate antiferromagnetic interactions (J = -5.21 cm-1 for I and -11.53 cm-1 for II) in the dimeric units, with Co...Co and Ni...Ni distances of 4.397 (1) and 4.358 (1) Å, respectively, that are related to double syn-anti carboxylate bridges.
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Affiliation(s)
- Shao Dong Li
- Department of Chemistry, Changzhi University, Changzhi 046011, People's Republic of China
| | - Feng Su
- Department of Chemistry, Changzhi University, Changzhi 046011, People's Republic of China
| | - Cheng Yong Zhou
- Department of Chemistry, Changzhi University, Changzhi 046011, People's Republic of China
| | - Qi Long Hu
- Department of Chemistry, Changzhi University, Changzhi 046011, People's Republic of China
| | - Ya Qi Li
- Department of Chemistry, Changzhi University, Changzhi 046011, People's Republic of China
| | - Zhi Jun Wang
- Department of Chemistry, Changzhi University, Changzhi 046011, People's Republic of China
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Tao Y, Wang ZJ, Han JG. [Biological mesh versus primary closure for pelvic floor reconstruction following extralevator abdominoperineal excision: a meta-analysis]. Zhonghua Wei Chang Wai Ke Za Zhi 2021; 24:910-918. [PMID: 34674467 DOI: 10.3760/cma.j.cn.441530-20200509-00268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To compare the morbidity of perineum-related complication between biological mesh and primary closure in closing pelvic floor defects following extralevator abdominoperineal excision (ELAPE). Methods: A literature search was performed in PubMed, Embase, Cochrane Library, Web of Science, Wanfang database, Chinese National Knowledge Infrastructure, VIP database, and China Biological Medicine database for published clinical researches on perineum-related complications following ELAPE between January 2007 and August 2020. Literature inclusion criteria: (1) study subjects: patients undergoing ELAPE with rectal cancers confirmed by colonoscopy pathological biopsy or surgical pathology; (2) study types: randomized controlled studies or observational studies comparing the postoperative perineum-related complications between the two groups (primary perineal closure and reconstruction with a biological mesh) following ELAPE; (3) intervention measures: biological mesh reconstruction used as the treatment group, and primary closure used as the control group; (4) outcome measures: the included literatures should at least include one of the following postoperative perineal complications: overall perineal wound complications, perineal wound infection, perineal wound dehiscence, perineal hernia, chronic sinus, chronic perineal pain (postoperative 12-month), urinary dysfunction and sexual dysfunction. Literature exclusion criteria: (1) data published repeatedly; (2) study with incomplete or wrong original data and unable to obtain original data. Two reviewers independently performed screening, data extraction and assessment on the quality of included studies. Review Manager 5.3 software was used for meta-analysis. The mobidities of perineum-related complications, including overall perineal wound (infection, dehiscence, hernia, chronic sinus) and perineal chronic pain (postoperative 12-month), were compared between the two pelvic floor reconstruction methods. Finally, publication bias was assessed, and sensitivity analysis was used to evaluate the stability of the results. Results: A total of five studies, including two randomized controlled studies and three observational controlled studies, with 650 patients (399 cases in the biological mesh group and 251 cases in primary closure group) were finally included. Compared with primary closure, biological mesh reconstruction had significantly lower ratio of perineal hernia (RR=0.37, 95%CI: 0.21-0.64, P<0.001). No significant differences in ratios of overall perineal wound complication, perineal wound infection, perineal wound dehiscence, perineal chronic sinus and perineal chronic pain (postoperative 12-month) were found between the two groups (all P>0.05). Conclusion: Compared with primary closure, pelvic floor reconstruction following ELAPE with biological mesh has the advantage of a lower incidence of perineal hernia.
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Affiliation(s)
- Y Tao
- Department of General Surgery, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing 100020, China
| | - Z J Wang
- Department of General Surgery, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing 100020, China
| | - J G Han
- Department of General Surgery, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing 100020, China
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Wu HH, Wang ZJ, Cheng CH, Wang J, Wang QJ, Chen R. [Effects of daytime hypercapnia on logical memory and working memory in patients with obstructive sleep apnea hypopnea syndrome]. Zhonghua Jie He He Hu Xi Za Zhi 2021; 44:873-879. [PMID: 34565113 DOI: 10.3760/cma.j.cn112147-20210210-00105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the effects of daytime hypercapnia on logical memory and working memory in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods: This prospective study recruited patients complaining of snoring and diagnosed with OSAHS at the Sleep Center of the Second Affiliated Hospital of Soochow University from January to November 2020. Patients were assessed clinically and scored for their memory function. All patients underwent daytime transcutaneous carbon dioxide (PtcCO2) test, and overnight polysomnography (PSG). Logical memory was scored using the Logical Memory Test (LMT), while working memory was evaluated by Digit Span Test (DST) and Cambridge Neuropsychological Test Automated Battery (CANTAB) which included Pattern Recognition Memory (PRM), Spatial Span (SSP), and Spatial Working Memory (SWM). Patients were divided into the normocapnic group and the hypercapnic group using the daytime PtcCO2 test. The clinical and PSG parameters and the memory test scores between the two groups were compared. Binary logistic stepwise regression was conducted to identify risk factors of memory impairment in OSAHS patients. Results: Among the 123 enrolled OSAHS patients, 79 were normocapnic and 44 were hypercapnic. There was no significant difference in the general clinical parameters between the two groups. The snoring history in years in the hypercapnic group was longer than that in the normocapnic group (P<0.05). Compared with the normocapnic group, the apnea-hyponea index (AHI), oxygen desaturation index (ODI) and percentage of total sleep time with oxygen saturation level<90% (TS90) of the hypercapnic group were higher (all P<0.05), while other PSG parameters exhibited no statistically significant differences. There was no statistically significant difference in the immediate logical memory and PRM immediate accuracy rate between the two groups, while the delayed logical memory, verbal and spatial working memory, and executive function were worse in the hypercapnic group, as shown by lower total LMT scores, lower DST, lower SSP scores (all P<0.05), and higher between errors and strategy scores (P<0.01) of SWM in the hypercapnic group. Binary logistic stepwise regression showed that PtcCO2 ≥45 mmHg (1 mmHg=0.133 kPa, OR=3.055, 95%CI 1.359-6.868, P=0.007) and higher body mass index (BMI) (OR=1.132, 95%CI 1.005-1.275, P=0.041) were risk factors for poor performance in Digit Span Backwards Test. Therefore, PtcCO2 ≥45 mmHg was an independent risk factors for poor performance in delayed LMT, SSP, and between errors and strategy scores in SWM (OR=3.109, 3.941, 3.238 and 2.785, respectively, all P<0.05). Conclusion: Hypercapnia had negative impacts on logical memory and working memory of OSAHS patients, especially on the delayed logical memory, verbal working memory and spatial working memory impairment.
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Affiliation(s)
- H H Wu
- Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - Z J Wang
- Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - C H Cheng
- Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - J Wang
- Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - Q J Wang
- Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - R Chen
- Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
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Zhang YC, Wei QZ, Hu YK, Wu L, Li DL, Wang ZJ, Liu QZ, Yang XF. [mTOR signaling pathway-mediated autophagy involved in inhibition of osteoblast differentiation induced by cadmium in human bone marrow mesenchymal stem cells]. Zhonghua Yu Fang Yi Xue Za Zhi 2021; 55:1123-1128. [PMID: 34619931 DOI: 10.3760/cma.j.cn112150-20210721-00697] [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: 11/05/2022]
Abstract
Objective: To investigate the role of autophagy mediated by mTOR signaling pathway in the inhibition of osteogenic differentiation of human bone marrow mesenchymal stem cells (hBMSCs) induced by cadmium. Methods: HBMSCs were divided into 0, 2.5 or 5.0 μmol/L groups according to the exposure dose of cadmium chloride (CdCl2), and each group was treated for 1 day, 4 days and (or) 7 days. The ALP activity and mRNA and protein expression levels of osteogenesis markers (ALP, RUNX2 and OSTERIX), autophagy-related proteins (LC3 and Beclin-1) and mTOR signaling pathway related proteins (mTOR, p-mTOR and p-p70S6K) expression, alkaline phosphatase staining and alizarin red staining were detected. MHY 1485 was selected as the signaling pathway activator. The control group, CdCl2 group (5.0 μmol/L), MHY 1485 group and CdCl2+MHY 1485 combined treatment group were set. After 7 days of treatment, the expression levels of autophagy related proteins and mTOR signaling pathway related proteins of hBMSCs in each group were detected. Results: There was no significant difference in ALP activity between 0, 2.5 and 5.0 μmol/L groups on day 1 and 4 (P>0.05); On day 7, compared with the 0 μmol/L group, the ALP activity, expression of osteogenic markers (ALP, RUNX2, OSTERIX) and mTOR signaling pathway related proteins (mTOR, p-mTOR, p-p70S6K) expression decreased in the 2.5 and 5.0 μmol/L group (P<0.05). Compared with the 0 μmol/L group, the staining of the 2.5 and 5.0 μmol/L groups became lighter, and the formation of ALP and mineralized nodules was reduced. Compared with the CdCl2 group, the autophagy related protein expression in the CdCl2+MHY 1485 combined treatment group decreased, and the mTOR signaling pathway related protein expression increased. The difference was statistically significant (P<0.05). Conclusion: The inhibition of osteogenic differentiation of hBMSCs by cadmium may be related to autophagy mediated by mTOR signaling pathway.
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Affiliation(s)
- Y C Zhang
- Food Safety and Health Research Center School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Q Z Wei
- Food Safety and Health Research Center School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Y K Hu
- School of Medicine, Jinan University, Guangzhou 510632, China
| | - L Wu
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - D L Li
- Food Safety and Health Research Center School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Z J Wang
- Food Safety and Health Research Center School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Q Z Liu
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - X F Yang
- Food Safety and Health Research Center School of Public Health, Southern Medical University, Guangzhou 510515, China
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Wang ZJ, Liu Z, Liang JW, Zhang MG, Mei SW, Shen HY, Chen JN, Li J, Zhao FQ, Wei FZ, Xiao TX, Liu Q. [Comparison on efficacy between fascia-oriented versus vascular-oriented lateral lymph node dissection in patients with rectal cancer]. Zhonghua Wei Chang Wai Ke Za Zhi 2021; 24:611-618. [PMID: 34289546 DOI: 10.3760/cma.j.issn.441530-20210131-00046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To compare the postoperative function, the short-term and long-term outcomes between fascia-oriented and vascular-oriented lateral lymph node dissection (LLND) in patients with rectal cancer. Methods: A retrospective cohort study was performed. Clinical data of patients who received total mesorectal excision (TME) with LLND at National Cancer Center, Cancer Hospital of Chinese Academy of Medical Science from January 2014 to December 2019 were retrospectively collected. Inclusion criteria were as follows: (1) rectal cancer was pathologically diagnosed, and the lower margin was below the peritoneal reflection. (2) resectable advanced rectal cancer with suspected lateral lymph node metastasis was evaluated based on rectal MRI assessment. (3) preoperative MRI showed lateral lymph node short diameter ≥5 mm and/or lymph node morphology (spike, blur, irregular) as well as heterogenous signal intensity. Lymph node shrinkage was less than 60% after receiving neoadjuvant therapy based on the reassessment of rectal MRI. (4) TME+LLND surgery was performed synchronously. Exclusion criteria were as follows: (1) previous history of pelvic surgery; (2) preoperative cystitis, urethritis, moderate and severe prostatic hyperplasia and other diseases resulting in abnormal urination function; (3) preoperative sexual dysfunction or loss of function; (4) patients receiving LLND due to lateral recurrence after TME; (5) distant metastasis of the tumor at initial diagnosis; (6) Incomplete collection of clinical data. A total of 73 consecutive patients were enrolled in this study. Based on the surgical approaches in performing LLND, patients were divided into fascia-oriented group (n=30) and vascular-oriented group (n=43). There were no significant differences in baseline data between the two groups (all P>0.05). The main outcome indicators of this study were the incidence of postoperative urinary and male sexual dysfunction, the efficacy, the number of lateral lymph nodes harvested and the detection rate of positive lymph nodes. Overall survival (OS) rates and progression free survival (PFS) rates were calculated by the Kaplan-Meier method and compared by log-rank test. Results: All patients in both groups completed surgery successfully. There were no significant differences in operation time, intraoperative blood loss, postoperative complications, and the length of hospital stay between the two groups (all P>0.05). In the whole group, the incidence of postoperative urinary dysfunction and male sexual dysfunction was 43.8% (32/73) and 62.5% (25/40), respectively. The median number of lateral lymph nodes harvested was 8.0(4.0,11.0) with a positive rate of 20.5%(15/73). Compared to the vascular-oriented group, the fascia-oriented group demonstrated a decreased rate of urinary dysfunction [26.7% (8/30) vs. 55.8% (24/43), χ(2)=6.098, P=0.014], lower rate of sexual dysfunction in males [6/15 vs. 76% (19/25), χ(2)=5.184, P=0.023], more harvested lateral lymph nodes [M (P25, P75): 9.5 (6.8, 15.3) vs. 6.0 (3.0, 9.0), Z=-2.849, P=0.004]. There was no significant difference in the positvie rate of lateral lymph nodes between the two groups [20% (6/30) versus 20.9% (9/43), χ(2)=0.009, P=0.923]. Three(4.1%) patients were lost during a median follow-up of 34 (1-66) months. The 3-year PFS and OS of the whole cohort were 69.5% and 88.3%, respectively. No significant difference in 3-year PFS rates (79.6% vs. 62.0%, P=0.172) and 3-year OS rates (91.2% vs. 85.9%, P=0.333) were observed between the fascia-oriented group and the vascular-oriented group (both P>0.05). Conclusion: Fascia-oriented LLND is associated with lower risk of postoperative urinary and male sexual dysfunction in patients with rectal carcinoma, and harvest of more lymph nodes, but no significant advantage in long-term survival.
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Affiliation(s)
- Z J Wang
- National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Z Liu
- National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - J W Liang
- National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - M G Zhang
- National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - S W Mei
- National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - H Y Shen
- National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - J N Chen
- National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - J Li
- National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - F Q Zhao
- National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - F Z Wei
- National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - T X Xiao
- National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Q Liu
- National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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Zhang HY, Wang ZJ, Han JG. [Influencing factors of anastomotic leak after right hemicolon surgery and progress in diagnosis and treatment strategies]. Zhonghua Wei Chang Wai Ke Za Zhi 2021; 24:544-549. [PMID: 34148320 DOI: 10.3760/cma.j.issn.441530-20210220-00071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Anastomotic leak is one of the most severe complications following right hemicolectomy but rarely happens, which should be diagnosed based on clinical manifestations, laboratory and radiographic examinations. Influencing factors of anastomotic leak after right hemicolectomy include bowel preparation, emergency surgery, anastomotic procedure (side-to-side anastomosis vs. end-to-side anastomosis, instrument anastomosis vs. manual technigue and intracorporeal vs. extracorporeal anastomosis), surgical resection range and patient's characteristics. The occurrence of anastomotic leak might be avoided by standardized operations and indocyanine green fluorescence imaging. Active treatment is recommended once anastomotic leak is diagnosed. Most patients can be cured by non-surgical treatments such as adequate drainage and anti-infection therapy. When severe sepsis happens or non-surgical treatment fails, surgical treatment should be carried out in time.
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Affiliation(s)
- H Y Zhang
- Department of General Surgery, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China
| | - Z J Wang
- Department of General Surgery, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China
| | - J G Han
- Department of General Surgery, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China
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Ma XT, Cheng YJ, Lyu S, Sun Y, Shen H, Wang ZJ, Liu XL, Liu YY, Shi DM, Zhou YJ. [Literature review on the risk assessment and timing of aortic valve replacement for asymptomatic severe aortic stenosis]. Zhonghua Xin Xue Guan Bing Za Zhi 2021; 49:528-534. [PMID: 34034392 DOI: 10.3760/cma.j.cn112148-20200720-00573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- X T Ma
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing 100029, China
| | - Y J Cheng
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing 100029, China
| | - S Lyu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing 100029, China
| | - Y Sun
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing 100029, China
| | - H Shen
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing 100029, China
| | - Z J Wang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing 100029, China
| | - X L Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing 100029, China
| | - Y Y Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing 100029, China
| | - D M Shi
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing 100029, China
| | - Y J Zhou
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing 100029, China
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Wang ZJ, Lin Y, Yin JJ, Zhang LY, Wang T, Wang YH, Wu N, Kong FL, Duan HW. [Dose-effect relationship between serum polycyclic aromatic hydrocarbon adducts and serum complements among children in a city of East China]. Zhonghua Yu Fang Yi Xue Za Zhi 2021; 55:653-659. [PMID: 34034407 DOI: 10.3760/cma.j.cn112150-20210112-00031] [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: 11/05/2022]
Abstract
Objective: To investigate the dose-response relationship between serum polycyclic aromatic hydrocarbon adducts and serum complement C3 and C4 levels among children from a city in East China. Methods: In September 2016, two boarding schools in the air pollution exposure area and the control area (beyond the upwind of 30 km in the air pollution exposure area) in a city in East China were selected as the research site, and the eligible school-age children were recruited as the research objects. A total of 273 children were included, including 163 in the exposure group and 110 in the control group. The annual air pollutant data (PM2.5, PM10 and NO2) of the two regions during the study period were collected. The exposure level of tobacco was evaluated by cotinine in urine. The levels of serum complement C3 and C4 were determined by automatic biochemical analyzer. The serum anti-7, 8, -dihydrodiol-9, 10-epoxide benzo[a]pyrene (BPDE)-albumin adduct levels were detected by ELISA. Linear regression model was used to explore the dose-response relationship between BPDE-albumin adducts and serum complement C3 and C4. Results: The age of 273 subjects was (13.67±0.37) years old, including 165 boys (60.4%). The average annual exposure levels of PM2.5, PM10 and NO2 and the level of serum BPDE-albumin adducts in the exposure group were higher than those in the control group (P<0.05). The results of linear regression model analysis showed that after adjusting age, sex, BMI z-score and urinary cotinine level, when the serum BPDE-albumin adduct level increased by 10%, the serum complement C4 level decreased by 1.2% (P=0.017). After adjusting age, BMI z-score and urinary cotinine level, for every 10% increase in serum BPDE-albumin adduct level in boys, the serum complement C4 level decreased by 1.68% (P=0.024). After adjusting age, sex and BMI z-score, the levels of serum complement C3 and C4 decreased by 1.31% and 3.57% respectively for every 10% increase in serum BPDE-albumin adducts among children in the urinary cotinine detection group (P<0.05). Conclusion: There is a significant dose-response relationship between serum BPDE-albumin adducts and the complement C4 among children.
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Affiliation(s)
- Z J Wang
- National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Y Lin
- National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - J J Yin
- National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - L Y Zhang
- National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - T Wang
- National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Y H Wang
- National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - N Wu
- National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - F L Kong
- Shandong Center for Disease Control and Prevention, Jinan 250014, China
| | - H W Duan
- National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing 100050, China
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Wang ZJ, Zhou X, Tomek J, Wang L, Rodriguez B. Post myocardial infarction ionic remodelling promotes repolarisation dispersion and electrocardiogram abnormalities in acute and chronic stages. Europace 2021. [DOI: 10.1093/europace/euab116.575] [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: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Wellcome Trust
Background
Sudden cardiac death (SCD) occurs in both acute and chronic stages post myocardial infarction (MI), and the left ventricular ejection fraction (LVEF) and electrocardiogram (ECG) characteristics are important biomarkers for clinical decision making. While various ionic remodelling has been reported in literature at various stages post-MI, the effect of them on clinical biomarkers have not been fully explored.
Purpose
Evaluate the effects of cellular ionic remodelling in acute and chronic post myocardial infarction on ECG and LVEF biomarkers through computational modelling and simulations of human biventricular electromechanics.
Methods
An electromechanical coupled biventricular model with ToR-ORd (Tomek 2019) human electrophysiology coupled with human excitation-contraction machinery (Land 2017) and orthotropic passive mechanics (Holzapfel 2009) was used as baseline model. The 12-lead ECG were simulated at standard body-surface electrode locations, and the biventricular pressure volume loop was simulated to quantify the simulated LVEF. A cardiac magnetic resonance (CMR) derived human biventricular geometry (Strocchi 2020) was used in combination with rigidly aligned torso geometry (Minchole 2019). An anterior sub-endocardial infarction was delineated with infarct, border zone (BZ) and remote zone (RZ) regions. For acute infarction, three types of BZ ionic remodelling from literature, and their effects on simulated LVEF and ECG characteristics were quantified. For chronic infarction, a single chronic BZ ionic remodelling was combine with two different models of RZ ionic remodelling from literature, and the effects of these remodelling on the simulated LVEF and ECG were quantified. The electromechanical properties of the sub-endocardial infarct region did not significantly affect simulated ECG or LVEF biomarkers.
Results
For the acute phase, simulations showed pre-cordial ECG abnormalities for all three BZ models, with T-wave inversion and QT prolongation (80 ms) in BZ1, ST-segment elevation with T-wave inversion in BZ2, and decreased T-wave amplitude in BZ3. Activation maps showed conduction block in BZ2 simulations, leading to ST-segment elevation. Repolarisation maps showed high dispersion in BZ1 simulations, leading to T-wave inversion. LVEF for BZ2 decreased by 4% (from 57% in control) due to conduction block in BZ and lack of contraction in that region, LVEF remained constant for BZ1 and BZ3 simulations. For the chronic phase, there was QT prolongation in both RZ1 (80 ms) and RZ2 (170 ms) as well as decreased T-wave amplitude, reflected by elevated repolarisation dispersion. LVEF was not significantly altered for either simulations.
Conclusions
Post-MI ionic remodelling at the acute and chronic stages cause varying degrees of dispersion of repolarisation and T-wave and ST-segment abnormalities, with minimal effect on mechanical function, except in the case of severe conduction abnormality. Abstract Figure.
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Affiliation(s)
- ZJ Wang
- University of Oxford, Department of Computer Science, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - X Zhou
- University of Oxford, Department of Computer Science, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - J Tomek
- University of Oxford, Department of Physiology, Anatomy and Genetics, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - L Wang
- University of Oxford, Department of Computer Science, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - B Rodriguez
- University of Oxford, Department of Computer Science, Oxford, United Kingdom of Great Britain & Northern Ireland
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Li GB, Han JG, Wang ZJ, Wei GH, Qu H, Zhai ZW, Yi BQ, Yang Y, Ma HC, Wang JL, Li ZL. [A comparative study of the effects of different treatment strategies on postoperative anal function and quality of life in patients with complete obstructive left hemicolon cancer]. Zhonghua Wei Chang Wai Ke Za Zhi 2021; 24:335-343. [PMID: 33878823 DOI: 10.3760/cma.j.cn.441530-20201203-00636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To compare the effects of 3 treatment strategies (emergent surgery, self-expanding metallic stents, self-expanding metallic stents plus neoadjuvant chemotherapy) on postoperative anal function and quality of life in patients with complete obstructive left hemicolon cancer. Methods: A retrospective cohort study was conducted. Clinical data of patients with complete obstructive left hemicolon cancer admitted to General Surgery Department of Beijing Chaoyang Hospital between January 2017 and October 2019 were retrospectively collected. Patient inclusion criteria: (1) complete obstructive left hemicolon cancer was confirmed through clinical manifestation and abdominal computed tomography; (2) adenocarcinoma was confirmed by postoperative pathology; (3) emergent radical resection of primary tumor was performed with temporary stoma, or radical resection of primary tumor and primary anastomosis was performed without stoma, 7 to 14 days after completion of insertion of self-expanding metallic stents. Patients who did not receive stoma reversion after emergent operation were excluded. According to different therapies, patients were divided into three groups: emergent surgery (ES) group, self-expanding metallic stents (SEMS) group and self-expanding metallic stents plus neoadjuvant chemotherapy (SEMS+NAC) group. Wexner score for incotinence (higher score indicates the worse anal function), Vaizey score (>10 indicates fecal incontinence) and low anterior resection syndrome (LARS) scale (higher score indicates the worse anal function) were applied to evaluate anal function of patients among groups at postoperative 1-, 6- and 12-month. EORTC QLQ-C30 questionnaire was used to assess the quality of life. Risk factors of decreased anal function were identified by logistic regression analysis. Results: A total of 72 patients were enrolled, including 27 (37.5%) patients in ES group, 23 (31.9%) in SEMS group and 22 (30.6%) in SEME+NAC group. The baseline characteristics including age, gender, tumor location, comorbidities, total blood loss, operation time and postoperative complications, were comparable among groups, except that the proportion of laparoscopic surgery was significantly lower in ES group (4/27, 14.9%) than that in SEMS (15/23, 65.2%) and SEMS+NAC group (16/22, 72.7%) with significant difference (P<0.001). The follow-up ended up to October 2020, and the overall follow-up rate was 79.2% (57/72). No significant differences existed in the Wexner score of patients among groups at postoperative 1-, 6- and 12-month (all P>0.05). The Vaizey scores at postoperative 1-month in ES, SEMS and SEMS+NAC group were 7 (0-17), 3 (0-7) and 4 (0-8) respectively with significant difference (H=18.415, P=0.001), and the scores in SEMS and SEMS+NAC groups were significantly lower than that in ES group (both P<0.05), while no significant difference existed between SEMS and SEMS+NAC group (P>0.05). Vaizey scores at postoperative 6- and 12-month among 3 groups were not significantly different (both P>0.05). The LARS scores at postoperative 1-month in ES, SEMS and SEMS+NAC groups were 20 (0-37), 15 (0-24) and 16 (0-28) respectively with significant difference (H=3.660, P=0.036), and the scores in SEMS and SEMS+NAC groups were significantly lower than that in ES group (both P<0.05), while no significant difference existed between SEMS and SEMS+NAC groups (P>0.05). LARS scores at postoperative 6- and 12-month among 3 groups were not significantly different (both P>0.05). The QLQ-C30 score revealed that the social function of patients in SEMS group and SEMS+NAC group was significantly better than that in ES group (both P<0.05), while no significant difference existed between SEMS and SEMS+NAC group (P>0.05). The logistic regression analysis revealed that only ES was an independent risk factor of decreased anal function (OR=2.264, 95% CI: 1.098-4.667, P=0.027). Conclusion: Compared to ES, SEMS may improve quality of life and short-term anal function of patients with complete obstructive left hemicolon cancer.
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Affiliation(s)
- G B Li
- Department of General Surgery, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China
| | - J G Han
- Department of General Surgery, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China
| | - Z J Wang
- Department of General Surgery, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China
| | - G H Wei
- Department of General Surgery, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China
| | - H Qu
- Department of General Surgery, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China
| | - Z W Zhai
- Department of General Surgery, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China
| | - B Q Yi
- Department of General Surgery, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China
| | - Y Yang
- Department of General Surgery, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China
| | - H C Ma
- Department of General Surgery, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China
| | - J L Wang
- Department of General Surgery, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China
| | - Z L Li
- Department of General Surgery, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China
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41
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Wang ZJ, Yang CQ. [The application of lipidomics in drug-induced liver injury]. Zhonghua Nei Ke Za Zhi 2021; 60:274-278. [PMID: 33663182 DOI: 10.3760/cma.j.cn112138-20200509-00463] [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: 06/12/2023]
Affiliation(s)
- Z J Wang
- Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China
| | - C Q Yang
- Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China
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Abstract
For the wounds caused by burns and other various reasons, the key of therapy is to close the open wounds in time by surgical operation. One of the most important methods is autologous skin grafting. However, for large area and long-term chronic trauma, the lack of autologous skin makes the treatment a huge challenge. For this reason, clinical medical workers have gradually developed miniature free skin grafting through continuous research. This paper reviews the relevant skin grafting techniques, including pinch free skin grafting, stamp free skin grafting, meek grafting, microne free skin grafting, etc.
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Affiliation(s)
- Z J Wang
- Burn Institute of PLA, Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University, Research Unit of Key Techniques for Treatment of Burns and Combined Burns and Trauma Injury, Chinese Academy of Medical Sciences, Shanghai 200433, China
| | - H H Li
- Burn Institute of PLA, Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University, Research Unit of Key Techniques for Treatment of Burns and Combined Burns and Trauma Injury, Chinese Academy of Medical Sciences, Shanghai 200433, China
| | - C Ben
- Burn Institute of PLA, Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University, Research Unit of Key Techniques for Treatment of Burns and Combined Burns and Trauma Injury, Chinese Academy of Medical Sciences, Shanghai 200433, China
| | - H Lu
- Burn Institute of PLA, Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University, Research Unit of Key Techniques for Treatment of Burns and Combined Burns and Trauma Injury, Chinese Academy of Medical Sciences, Shanghai 200433, China
| | - S H Zhu
- Burn Institute of PLA, Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University, Research Unit of Key Techniques for Treatment of Burns and Combined Burns and Trauma Injury, Chinese Academy of Medical Sciences, Shanghai 200433, China
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Ou KP, Li Q, Luo Y, Lyu JJ, Zhou H, Yang Y, Cai YJ, Wang ZJ, Wang X, Qi LQ, Ma F, Xu BH. [Efficacy and safety of neoadjuvant apatinib in combination with dose-dense paclitaxel and carboplatin in locally advanced triple negative breast cancer patients]. Zhonghua Zhong Liu Za Zhi 2021; 42:966-971. [PMID: 33256310 DOI: 10.3760/cma.j.cn112152-20200224-00122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To observe the short-term efficacy and safety of apatinib in combination with dose-dense paclitaxel and carboplatin in locally advanced triple-negative breast cancer (TNBC) patients. Methods: From September 2018 to September 2019, 17 stage Ⅱ/Ⅲ TNBC patients were enrolled in this single arm, single center prospective phase Ⅱ study. They received neoadjuvant treatment of apatinib 250 mg per day, paclitaxel 175 mg/m(2) on 1(st) day and a dose of carboplatin according to the area under curve (AUC)=4 on 2(nd) day, every 14 days as a cycle. Results: By January 2020, 16 cases completed 4-7 cycles of apatinib treatment and 4-8 cycles of chemotherapy. The median cycles of apatinib treatment and chemotherapy were 5 cycles and 6 cycles, respectively. Two cases achieved complete responses (CR), 12 achieved partial responses (PR), 2 achieved stable diseases (SD) and no progressive disease was observed. The objective response rate (ORR) was 87.5%, disease control rate (DCR) was 100%. By January 2020, among 12 patients who received surgery, 8 achieved pathologic complete response (pCR, 66.7%). The grade Ⅲ/Ⅳ adverse events included: neutropenia, thrombocytopenia in 3 cases (18.8%) each, anemia, fatigue, arrhythmia and alanine aminotransferase (ALT) elevation in 1 case each. Apatinib was interrupted in 5 cases, and was discontinued in 3 cases; chemotherapy dosage was reduced in 1 case. Conclusion: Apatinib in combination with dose-dense paclitaxel and carboplatin neoadjuvant therapy are effective and well tolerated in locally advanced TNBC patients.
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Affiliation(s)
- K P Ou
- Department of Medicine, Beijing Chaoyang Sanhuan Cancer Hospital, Beijing 100122, China
| | - Q Li
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Y Luo
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - J J Lyu
- Department of Medicine, Beijing Chaoyang Sanhuan Cancer Hospital, Beijing 100122, China
| | - H Zhou
- Department of Medicine, Beijing Chaoyang Sanhuan Cancer Hospital, Beijing 100122, China
| | - Y Yang
- Department of Medicine, Beijing Chaoyang Sanhuan Cancer Hospital, Beijing 100122, China
| | - Y J Cai
- Department of Medicine, Beijing Chaoyang Sanhuan Cancer Hospital, Beijing 100122, China
| | - Z J Wang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - X Wang
- Department of Breast Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - L Q Qi
- Department of Breast Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - F Ma
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - B H Xu
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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Li GB, Han JG, Wang ZJ. [Investigation of prevention and treatment of anastomotic bleeding after colorectal surgery]. Zhonghua Wei Chang Wai Ke Za Zhi 2021; 23:1149-1154. [PMID: 33353268 DOI: 10.3760/cma.j.cn.441530-20190906-00340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Anastomotic bleeding is a common complication after colorectal surgery, mainly manifesting as continuous or intermittent bloody stool. The risk factors for anastomotic bleeding mainly include suboptimal surgical skill, surgical methods (such as laparoscopic anastomosis), close distance between the tumor and the anal margin, benign colorectal diseases, anastomotic leakage after colorectal surgery, severe pelvic and abdominal infections, and the patient's own condition, etc. Anastomotic bleeding can be prevented by standardized operation and intraoperative endoscopic examination. Anastomotic bleeding is mostly a self-limited disease, which can be cured by conservative treatments such as fluid resuscitation, blood transfusion and endoscopic treatment. When serious anastomotic bleeding threatens the life of patients, surgical treatment should be taken into consideration decisively.
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Affiliation(s)
- G B Li
- Department of General Surgery, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China
| | - J G Han
- Department of General Surgery, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China
| | - Z J Wang
- Department of General Surgery, Beijing Chaoyang Hosptial, Capital Medical University, Beijing 100020, China
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45
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Li GB, Tao Y, Han JG, Wang ZJ. [Duplication of colon: a case report]. Zhonghua Wei Chang Wai Ke Za Zhi 2020; 23:1109. [PMID: 33212563 DOI: 10.3760/cma.j.cn.441530-20200106-00008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
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Tao Y, Han JG, Wang ZJ, Zheng Y, Cui JJ, Zhao BC, Yang XQ. [Long-term effect of anal fistula plug treatment on postoperative anal function in patients with trans-sphincteric perianal fistula and risk factors associated with anal function]. Zhonghua Wei Chang Wai Ke Za Zhi 2020; 23:774-779. [PMID: 32810949 DOI: 10.3760/cma.j.cn.441530-20190424-00184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To evaluate the long-term effects of anal fistula plug treatment on postoperative anal function in patients with trans-sphincteric perianal fistula, and identify risk factors associated with anal function. Methods: A case-control study was conducted. Clinical and follow-up data of 123 patients with trans-sphincteric perianal fistula receiving anal fistula plug treatment in Beijing Chaoyang Hospital from August 2008 to September 2012 were retrospectively analyzed. The follow-up deadline was April 30, 2020. The Wexner score for incontinence was used to evaluate pre-and postoperative anal function (range from 0 to 20, with higher score representing worse function). The potential risk factors affecting postoperative anal function, including gender, age, fasting blood glucose, diabetes, smoking, alcoholism, location of external opening of anal fistula, surgeon expertise and operation time, were statistically analyzed. Results: Among the 123 patients, 114 were male and 9 were female, the median age was 39 (15-69) years, body mass index (BMI) was (26.2±3.9) kg/m(2), and the median distance between the external opening of anal fistula and the anal verge was 2.6 (1.0-5.0) cm. The median operation time was 30.4 (15.0-60.0) minutes. The median follow-up time was 120 (93-141) months. Sixty-nine patients (56.5%) were healed. The assessment of anal function by Wexner incontinence score showed that 33 (26.8%) patients had anal functional decline after surgery, and the postoperative median Wexner score was 1.34 (0-8), which was significantly higher than preoperative score of 0.17 (0-4) (Z=-5.057, P<0.001). Compared with preoperative levers, postoperative subscores of flatus incontinence, liquid incontinence, solid incontinence and alteration in lifestyle were increased significantly (all P<0.05). Subgroup analysis showed that both in the healed and unhealed groups, the postoperative Wexner scores were higher than those before surgery [healed group: 1.22 (0-8) vs. 0.17 (0-1), Z=-3.796, P<0.001; unhealed group: 1.5 (0-8) vs.0.17 (0-3), Z=-3.422, P=0.001]. Univariate analysis revealed that 33 patients with postoperative anal functional decline had higher BMI, higher fasting blood glucose, higher proportion of alcoholism, longer distance between external opening of anal fistula and the anal verge, and longer operation time (all P<0.05). Multivariate logistic regression analysis testified that higher BMI (OR=1.485, 95% CI: 1.220-1.807, P<0.001) and longer distance between external opening and anal verge (OR=2.207, 95% CI: 1.276-3.220, P=0.003) were independent risk factors for postoperative anal functional decline. Conclusions: The treatment for trans-sphincteric anal fistula with anal fistula plug leads to long-term postoperative anal function decline. For patients with obesity and longer distance between external opening of anal fistula and the anal verge, this procedure should be performed with particular caution, and the anal sphincter should be preserved as much as possible during the operation.
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Affiliation(s)
- Y Tao
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - J G Han
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Z J Wang
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Y Zheng
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - J J Cui
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - B C Zhao
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - X Q Yang
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
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Du SN, Wang ZJ, Yu GW, Cui YL, Chen JJ, Hu N, Zhang TC, Meng Y, Hu YH, Zhang HC, Liu ZG. [Epidemiological characteristics of human brucellosis in Tongliao city of Inner Mongolia Autonomous Region, 2004-2018]. Zhonghua Liu Xing Bing Xue Za Zhi 2020; 41:1063-1067. [PMID: 32741171 DOI: 10.3760/cma.j.cn112338-20190901-00642] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To analyze the epidemiological characteristics of human brucellosis (HB), evolution and origin feature of Brucella strains in Tongliao city, Inner Mongolia Autonomous Region during 2004-2018, and to provide evidence for strategy development against the disease. Methods: Data from the reports on HB in Tongliao during 2004-2018 were extracted from the China Information System for Disease Control and Prevention before being analyzed with software Excel 2016. Epidemiologic feature was described, using the number of cases, constituent ratio and related rates. Conventional biotypes methods were used for identification of species/biovars strains while species of six Brucella strains were further verified by AMOS-PCR. Cluster analyze on six Brucella strains were performed with Bio-Numerics 5.0 software and for examining and revealing the genetic characteristics of the related strains. Results: During 2004-2018, a total of 16 704 HB cases were reported, with the incidence rate as 35.41/100 000. The incidence rates appeared as 110.51/100 000 in Jarud Banner and 67.84/100 000 in Kulun flag, which were both higher than the other areas. Most of the cases were reported in the 40-54 year olds, which accounted for 48.75% (8 143/16 704). The number of HB in farmers appeared as 14 873, which counted for 89.04% (14 873/16 704) of all the cases. Male to female ratio of incidence was 2.40∶1. Most of the reported cases appeared between March to May, which accounted for 56.30% (9 405/16 704). Peak of the disease was seen in April. Using the conventional identification method, results showed that the available six strains all belonged to B. melitensis, including three of them as B. melitensis bv.1 and others three strains as B. melitensis bv. 3. Results from the amplified AMOS-PCR showed that all the strains were B. melitensis. The six strains clustered in two MLVA-11 genotypes (111 and 116) and all belonged to the Eastern Mediterranean lineage. Based on the MLVA-16 cluster analysis, results suggested that strains from this study were having close genetic relationship with B. melitensis strains that were from Jilin and Heilongjiang provinces. Conclusions: Human brucellosis identified in Tongliao area was with greater risk in spreading the disease to the vicinity. Our findings indicated that the programs on detection and control of the disease should be strengthened.
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Affiliation(s)
- S N Du
- Tongliao Institute for Endemic Disease Control and Prevention of Inner Mongolia Autonomous Region, Tongliao 028000, China
| | - Z J Wang
- Tongliao Institute for Endemic Disease Control and Prevention of Inner Mongolia Autonomous Region, Tongliao 028000, China
| | - G W Yu
- Tongliao Institute for Endemic Disease Control and Prevention of Inner Mongolia Autonomous Region, Tongliao 028000, China
| | - Y L Cui
- Tongliao Institute for Endemic Disease Control and Prevention of Inner Mongolia Autonomous Region, Tongliao 028000, China
| | - J J Chen
- Tongliao Institute for Endemic Disease Control and Prevention of Inner Mongolia Autonomous Region, Tongliao 028000, China
| | - N Hu
- Tongliao Institute for Endemic Disease Control and Prevention of Inner Mongolia Autonomous Region, Tongliao 028000, China
| | - T C Zhang
- Tongliao Institute for Endemic Disease Control and Prevention of Inner Mongolia Autonomous Region, Tongliao 028000, China
| | - Y Meng
- Tongliao Institute for Endemic Disease Control and Prevention of Inner Mongolia Autonomous Region, Tongliao 028000, China
| | - Y H Hu
- Tongliao Institute for Endemic Disease Control and Prevention of Inner Mongolia Autonomous Region, Tongliao 028000, China
| | - H C Zhang
- Tongliao Institute for Endemic Disease Control and Prevention of Inner Mongolia Autonomous Region, Tongliao 028000, China
| | - Z G Liu
- National Institute of Infectious Diseases Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; Inner Mongolia Autonomous Region Central for Comprehensive Disease Control and Prevention, Huhhot 010031, China
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Han JG, Zhou JP, Wang GY, Zhang H, Yang YC, Lu Y, Wu B, Wu AW, Yao HW, Wang ZJ. [Gunsight closure versus purse-string closure techniques in loop stoma reversal: a multicenter prospective randomized controlled trial]. Zhonghua Wai Ke Za Zhi 2020; 58:608-613. [PMID: 32727192 DOI: 10.3760/cma.j.cn112139-20200421-00315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To compare the wound healing time, Surgical site infection (SSI) rate and other postoperative outcomes between the gunsight closure and purse-string closure technique in loop stoma closure. Methods: Between November 2013 and December 2017, a total of 143 patients who underwent gunsight stoma reversal were included in this multicenter prospective randomized controlled trial. The patients were randomized to undergo gunsight (gunsight group, n=72) or purse-string closure technique (purse-string group, n=71). The primary endpoint was wound healing time. The second endpoints were the incidence of SSI, morbidity, and patient satisfaction. Statistical analysis between groups was performed using the t-test, repeated measures analysis of variance, Mann-Whitney U test, χ(2) test or Fisher's exact test. Results: There were 45 males and 27 females with age of 67 (11) (M(Q(R))) years in gunsight group, 42 males and 29 females with age of 65 (20) years in purse-string group. The body mass index, American Society of Anesthesiologist classification, comorbidities, primary diagnosis, the type of ostomy, intraoperative blood loss, perioperative complications, postoperative hospital stay, hospitalization cost, SSI rate and incisional hernia (stoma site) between the 2 groups were not significantly different (P>0.05). Although had a statistically longer operating time (80(10) minutes vs. 70(10) minutes, Z=-2.381, P=0.017), patients who underwent gunsight procedure and a significantly shorter wound healing time (17(2) days vs. 25(4) days, Z=-10.199, P<0.01), higher patient satisfaction score with regards to wound healing time (3(1) vs. 3(1), Z=-4.526, P<0.01), and higher total patient satisfaction score (25(3) vs. 25(3), Z=-2.529, P=0.011) compared with those who underwent purse-string procedure. Conclusions: The gunsight and purse-string techniques are effective procedures for stoma reversal and both have low SSI rate. The gunsight technique is associated with shorter wound healing time, higher levels of patient satisfaction compared with purse-string technique, and is recommended as the closure technique of choice.
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Affiliation(s)
- J G Han
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - J P Zhou
- Department of General Surgery, the First Hospital of China Medical University, Shenyang 110001, China
| | - G Y Wang
- Department of General Surgery, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050051, China
| | - H Zhang
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Y C Yang
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University,Beijing 100050, China
| | - Y Lu
- Department of General Surgery, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - B Wu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China
| | - A W Wu
- Gastrointestinal Cancer Center, Peking University Cancer Hospital, Beijing 100142, China
| | - H W Yao
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University,Beijing 100050, China
| | - Z J Wang
- Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
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Ben C, Li HH, Liu T, Wang ZJ, Cheng DS, Zhu SH. [Advances in the research of artificial intelligence technology assisting the diagnosis of burn depth]. Zhonghua Shao Shang Za Zhi 2020; 36:244-246. [PMID: 32241051 DOI: 10.3760/cma.j.cn501120-20190403-00162] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The early accurate diagnosis of burn depth is of great significance in determining the corresponding clinical intervention methods and judging the prognosis quality of burn patients. However, the current diagnostic method of burn depth still relies mainly on the empirical subjective judgment of clinicians, with low diagnostic accuracy. Especially for deep partial-thickness burn wounds, the error of early diagnosis is pretty big. In recent years, with the rapid development of artificial intelligence technology, deep learning algorithm combined with image analysis technology can better identify and analyze the information of medical images. This article reviews the research progress of artificial intelligence technology in the diagnosis of burn depth.
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Affiliation(s)
- C Ben
- Burn Institute of PLA, Department of Burn Surgery, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - H H Li
- Burn Institute of PLA, Department of Burn Surgery, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - T Liu
- Burn Institute of PLA, Department of Burn Surgery, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - Z J Wang
- Burn Institute of PLA, Department of Burn Surgery, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - D S Cheng
- Burn Institute of PLA, Department of Burn Surgery, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - S H Zhu
- Burn Institute of PLA, Department of Burn Surgery, Changhai Hospital, Naval Medical University, Shanghai 200433, China
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Wang ZJ, Yang JH. [Effect of schistosomiasis japonica on the development of gastric and colorectal cancer]. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi 2020; 32:148-153. [PMID: 32458603 DOI: 10.16250/j.32.1374.2019240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To examine the effect of schistosomiasis on the development of gastric cancer and colorectal cancer. METHODS The clinical data of patients with gastric cancer and colorectal cancer with and without schistosomiasis japonica that were admitted to the Yijishan Hospital Affiliated to Wannan Medical College from January 2014 to December 2018 were collected. All cases were divided into schistosomal gastric cancer group and non - schistosomal gastric cancer group, schistosomal colorectal cancer group and non-schistosomal colorectal cancer group. The risk factors of gastric cancer and colorectal cancer were identified using univariate analysis and multivariate logistic regression analysis, and the effects of schistosomiasis on the development and progression of gastric cancer and colorectal cancer were evaluated. In addition, the survival of 32 patients with schistosomal colorectal cancer and 68 cases with non-schistosomal colorectal were estimated using telephone follow-up, and compared. RESULTS There were 113 patients with schistosomal gastric cancer and 3 741 cases with non-schistosomal gastric cancer enrolled in this study, and there were significant differences between them in terms of sex ratio, age and prevalence of Helico-bacter pylori infection (all P values < 0.05). Logistic regression analysis revealed that age, H. pylori infection, and schistosomiasis were independent risk factors for gastric cancer (all P values < 0.05). There were 184 patients with schistosomal colorectal cancer and 2 205 cases with non-schistosomal colorectal cancer recruited in this study, and there were significant differences between them in terms of age, sex ratio, rate of history of alcohol consumption and rate of positive fecal occult blood test (all P values < 0.05). The phenotypes of both schistosomal and non-schistosomal colorectal cancer were predominantly ulcerative; however, the proportion of patients with invasive and protruded colorectal cancer was significantly greater than that of patients with non-schistosomal colorectal cancer (P = 0.003). Logistic regression analysis revealed that age (P = 0.003), gender (P = 0.002), phenotype (P = 0.005) and schistosomiasis (P = 0.029) were independent risk factors for colorectal cancer. The 5-year survival rate was significantly higher in patients with schistosomal colorectal cancer (68.90%) than in those with non-schistosomal colorectal cancer (46.40%), and the dead patients with schistosomal colorectal cancer had a significantly greater mean age than those with non-schistosomal colorectal cancer [ (66.33 ± 3.08) years vs. (56.29 ± 1.94), P < 0.05]. CONCLUSIONS Schistosomiasis may alter the pathogenesis of colorectal cancer, resulting in the differences in the epidemiology, clinical characteristics and 5-year survival rate between patients with schistosomal and non-schistosomal colorectal cancer. Periodical gastrointestinal endoscopy and other examinations are recommended to exclude the likelihood of gastrointestinal cancers in men with anemia of unknown causes and at ages of 60 years living in schistosomiasis-endemic areas.
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Affiliation(s)
- Z J Wang
- Graduate School of Wannan Medical College, Wuhu 241001, China
| | - J H Yang
- Yijishan Hospital, The First Affiliated Hospital of Wannan Medical College, Wuhu City, Anhui Province, China
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