1
|
Zhang B, Su Y, Chen Y, Qi S, Li M, Zou W, Jiang G, Zhang W, Gao Y, Pan C, Song H, Cui Z, Zhang CJ, Liang Z, Du L. A Dielectric MXene-Induced Self-Built Electric Field in Polymer Electrolyte Triggering Fast Lithium-Ion Transport and High-Voltage Cycling Stability. Angew Chem Int Ed Engl 2024:e202403949. [PMID: 38613188 DOI: 10.1002/anie.202403949] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 04/01/2024] [Accepted: 04/12/2024] [Indexed: 04/14/2024]
Abstract
Quasi-solid polymer electrolyte (QPE) lithium (Li)-metal battery holds significant promise in the application of high-energy-density batteries, yet it suffers from low ionic conductivity and poor oxidation stability. Herein, a novel self-built electric field (SBEF) strategy is proposed to enhance Li+ transportation and accelerate the degradation dynamics of carbon-fluorine bond cleavage in LiTFSI by optimizing the termination of MXene. Among them, the SBEF induced by dielectric Nb4C3F2 MXene effectively constructs highly conductive LiF-enriched SEI and CEI stable interfaces, moreover, enhances the electrochemical performance of the QPE. The related Li-ion transfer mechanism and dual-reinforced stable interface are thoroughly investigated using ab initio molecular dynamics, COMSOL, XPS depth profiling, and ToF-SIMS. This comprehensive approach results in a high conductivity of 1.34 mS cm-1, leading to a small polarization of approximately 25 mV for Li//Li symmetric cell after 6000 h. Furthermore, it enables a prolonged cycle life at a high voltage of up to 4.6 V. Overall, this work not only broadens the application of MXene for QPE but also inspires the great potential of the self-built electric field in QPE-based high-voltage batteries.
Collapse
Affiliation(s)
- Baolin Zhang
- Guangdong Provincial Key Laboratory of Fuel Cell Technology, School of Chemistry and Chemical Engineering, South China University of Technology, Guangzhou, 510641, China
| | - Yufeng Su
- Guangdong Provincial Key Laboratory of Fuel Cell Technology, School of Chemistry and Chemical Engineering, South China University of Technology, Guangzhou, 510641, China
| | - Yangyang Chen
- Guangdong Provincial Key Laboratory of Fuel Cell Technology, School of Chemistry and Chemical Engineering, South China University of Technology, Guangzhou, 510641, China
| | - Shengguang Qi
- Guangdong Provincial Key Laboratory of Fuel Cell Technology, School of Chemistry and Chemical Engineering, South China University of Technology, Guangzhou, 510641, China
| | - Mianrui Li
- Guangdong Provincial Key Laboratory of Fuel Cell Technology, School of Chemistry and Chemical Engineering, South China University of Technology, Guangzhou, 510641, China
| | - Wenwu Zou
- Guangdong Provincial Key Laboratory of Fuel Cell Technology, School of Chemistry and Chemical Engineering, South China University of Technology, Guangzhou, 510641, China
| | - Guoxing Jiang
- Guangdong Provincial Key Laboratory of Fuel Cell Technology, School of Chemistry and Chemical Engineering, South China University of Technology, Guangzhou, 510641, China
| | - Weifeng Zhang
- Guangdong Provincial Key Laboratory of Fuel Cell Technology, School of Chemistry and Chemical Engineering, South China University of Technology, Guangzhou, 510641, China
| | - Yuqing Gao
- Guangdong Provincial Key Laboratory of Fuel Cell Technology, School of Chemistry and Chemical Engineering, South China University of Technology, Guangzhou, 510641, China
| | - Chenhui Pan
- Guangdong Provincial Key Laboratory of Fuel Cell Technology, School of Chemistry and Chemical Engineering, South China University of Technology, Guangzhou, 510641, China
| | - Huiyu Song
- Guangdong Provincial Key Laboratory of Fuel Cell Technology, School of Chemistry and Chemical Engineering, South China University of Technology, Guangzhou, 510641, China
| | - Zhiming Cui
- Guangdong Provincial Key Laboratory of Fuel Cell Technology, School of Chemistry and Chemical Engineering, South China University of Technology, Guangzhou, 510641, China
| | - Chuanfang John Zhang
- College of Materials Science & Engineering, Sichuan University, Chengdu, Sichuan, 610065, China
| | - Zhenxing Liang
- Guangdong Provincial Key Laboratory of Fuel Cell Technology, School of Chemistry and Chemical Engineering, South China University of Technology, Guangzhou, 510641, China
- Guangdong Provincial Laboratory of Chemistry and Fine Chemical Engineering Jieyang Center, Jieyang, 515200, China
| | - Li Du
- Guangdong Provincial Key Laboratory of Fuel Cell Technology, School of Chemistry and Chemical Engineering, South China University of Technology, Guangzhou, 510641, China
- Guangdong Provincial Laboratory of Chemistry and Fine Chemical Engineering Jieyang Center, Jieyang, 515200, China
| |
Collapse
|
2
|
Ritchie JL, Qi S, Christian RJ, Greenwood MJ, Grenz HI, Swatzell SE, Krych PJ, Fuchs RA. Requisite role of dorsal raphé in contextual cocaine-memory reconsolidation. Neuropharmacology 2024; 246:109832. [PMID: 38176535 PMCID: PMC10901441 DOI: 10.1016/j.neuropharm.2023.109832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 12/27/2023] [Accepted: 12/28/2023] [Indexed: 01/06/2024]
Abstract
Memory reconsolidation is a process by which labile drug memories are restabilized in long-term memory stores, permitting their enduring control over drug-seeking behaviors. In the present study, we investigated the involvement of the dorsal raphé nuclei (DRN) in cocaine-memory reconsolidation. Sprague-Dawley rats (male, female) were trained to self-administer cocaine in a distinct environmental context to establish contextual drug memories. They then received extinction training in a different context. Next, the rats were re-exposed to the cocaine-predictive context for 15 min to reactivate their cocaine memories or remained in their home cages (no-reactivation control). Memory reactivation was sufficient to increase c-Fos expression, an index of neuronal activation, in the DRN, but not in the median raphé nuclei, during reconsolidation, compared to no reactivation. To determine whether DRN neuronal activity was necessary for cocaine-memory reconsolidation, rats received intra-DRN baclofen plus muscimol (BM; GABAB/A agonists) or vehicle microinfusions immediately after or 6 h after a memory reactivation session conducted with or without lever access. The effects of DRN functional inactivation on long-term memory strength, as indicated by the magnitude of context-induced cocaine seeking, were assessed 72 h later. Intra-DRN BM treatment immediately after memory reactivation with or without lever access attenuated subsequent context-induced cocaine-seeking behavior, independent of sex. Conversely, BM treatment in the adjacent periaqueductal gray (PAG) immediately after memory reactivation, or BM treatment in the DRN 6 h after memory reactivation, did not alter responding. Together, these findings indicate that the DRN plays a requisite role in maintaining cocaine-memory strength during reconsolidation.
Collapse
Affiliation(s)
- J L Ritchie
- Department of Integrative Physiology and Neuroscience, Washington State University College of Veterinary Medicine, Pullman, WA, USA
| | - S Qi
- Department of Integrative Physiology and Neuroscience, Washington State University College of Veterinary Medicine, Pullman, WA, USA
| | - R J Christian
- Department of Integrative Physiology and Neuroscience, Washington State University College of Veterinary Medicine, Pullman, WA, USA
| | - M J Greenwood
- Department of Integrative Physiology and Neuroscience, Washington State University College of Veterinary Medicine, Pullman, WA, USA
| | - H I Grenz
- Department of Integrative Physiology and Neuroscience, Washington State University College of Veterinary Medicine, Pullman, WA, USA
| | - S E Swatzell
- Department of Integrative Physiology and Neuroscience, Washington State University College of Veterinary Medicine, Pullman, WA, USA
| | - P J Krych
- Department of Integrative Physiology and Neuroscience, Washington State University College of Veterinary Medicine, Pullman, WA, USA
| | - R A Fuchs
- Department of Integrative Physiology and Neuroscience, Washington State University College of Veterinary Medicine, Pullman, WA, USA; Washington State University Alcohol and Drug Abuse Research Program, Pullman, WA, USA.
| |
Collapse
|
3
|
Zhang B, Zou W, Ju Z, Qi S, Luo J, Zhang CJ, Tao X, Du L. Separator Engineering Based on Cl-Terminated MXene Ink: Enhancing Li + Diffusion Kinetics with a Highly Stable Double-Halide Solid Electrolyte Interphase. ACS Nano 2023; 17:22755-22765. [PMID: 37931128 DOI: 10.1021/acsnano.3c07413] [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] [Indexed: 11/08/2023]
Abstract
Separator engineering is a promising route to designing advanced lithium (Li) metal anodes for high-performance Li metal batteries (LMBs). Conventional separators are incapable of regulating the Li+ diffusion across the solid electrolyte interphase (SEI), leading to severe dendritic deposition. To address this issue, a polypropylene (PP) separator modified by spray coating the Cl-terminated titanium carbonitride MXene ink is designed (PP@Ti3CNCl2). The lithiophilic MXene provides excellent electrolyte wettability and low Li+ diffusion barriers, finally enhancing the Li+ diffusion kinetics of excessively stable SEI. The X-ray photoelectron spectroscopy depth profiling as well as cryo-transmission electron microscopy reveals that a gradient SEI hierarchy with evenly distributed LiF and LiCl is spontaneously formed during the electrochemical process. As a consequence, PP@Ti3CNCl2 delivers a high Coulombic efficiency (99.15%) coupled with a prolonged lifespan of over 5500 h in half cells and 3100 cycles at 2 C in full cells. This work offers an effective strategy for constructing dendrite-free and Li+ permeable interfaces toward high-energy-density LMBs.
Collapse
Affiliation(s)
- Baolin Zhang
- Guangdong Provincial Key Laboratory of Fuel Cell Technology, School of Chemistry and Chemical Engineering, South China University of Technology, Guangzhou 510641, China
| | - Wenwu Zou
- Guangdong Provincial Key Laboratory of Fuel Cell Technology, School of Chemistry and Chemical Engineering, South China University of Technology, Guangzhou 510641, China
| | - Zhijin Ju
- College of Materials Science and Engineering, Zhejiang University of Technology, Hangzhou 310014, China
| | - Shengguang Qi
- Guangdong Provincial Key Laboratory of Fuel Cell Technology, School of Chemistry and Chemical Engineering, South China University of Technology, Guangzhou 510641, China
| | - Jianmin Luo
- College of Materials Science and Engineering, Zhejiang University of Technology, Hangzhou 310014, China
| | - Chuanfang John Zhang
- College of Materials Science & Engineering, Sichuan University, Chengdu, Sichuan 610065, China
| | - Xinyong Tao
- College of Materials Science and Engineering, Zhejiang University of Technology, Hangzhou 310014, China
| | - Li Du
- Guangdong Provincial Key Laboratory of Fuel Cell Technology, School of Chemistry and Chemical Engineering, South China University of Technology, Guangzhou 510641, China
| |
Collapse
|
4
|
Qi S, Li M, Gao Y, Zhang W, Liu S, Zhao J, Du L. Enabling Scalable Polymer Electrolyte with Dual-Reinforced Stable Interface for 4.5 V Lithium-Metal Batteries. Adv Mater 2023; 35:e2304951. [PMID: 37467170 DOI: 10.1002/adma.202304951] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/09/2023] [Accepted: 07/18/2023] [Indexed: 07/21/2023]
Abstract
Hitherto, it remains a great challenge to stabilize electrolyte-electrode interfaces and impede lithium dendrite proliferation in lithium-metal batteries with high-capacity nickel-rich LiNx Coy Mn1- x-y O2 (NCM) layer cathodes. Herein, a special molecular-level-designed polymer electrolyte is prepared by the copolymerization of hexafluorobutyl acrylate and methylene bisacrylamide to construct dual-reinforced stable interfaces. Verified by X-ray photoelectron spectroscopy depth profiling, there are favorable solid electrolyte interphase (SEI) layers on Li metal anodes and robust cathode electrolyte interphase (CEI) on Ni-rich cathodes. The SEI enriched in lithiophilic N-(C)3 guides the homogenous distribution of Li+ and facilitates the transport of Li+ through LiF and Li3 N, promoting uniform Li+ plating and stripping. Moreover, the CEI with antioxidative amide groups can suppress the parasitic reactions between cathode and electrolyte and the structural degradation of cathode. Meanwhile, a unique two-stage rheology-tuning UV polymerization strategy is utilized, which is quite suited for continuous electrolyte fabrication with environmental friendliness. The fabricated polymer electrolyte exhibits a high ionic conductivity of 1.01 mS cm-1 at room temperature. 4.5 V NCM622//Li batteries achieve prolonged operation with a retention rate of 85.0% after 500 cycles at 0.5 C. This work provides new insights into molecular design and processibility design for polymer-based high-voltage batteries.
Collapse
Affiliation(s)
- Shengguang Qi
- Guangdong Provincial Key Laboratory of Fuel Cell Technology, School of Chemistry and Chemical Engineering, South China University of Technology, Guangzhou, 510641, China
- School of Materials Science and Engineering, South China University of Technology, Guangzhou, 510641, China
| | - Mianrui Li
- Guangdong Provincial Key Laboratory of Fuel Cell Technology, School of Chemistry and Chemical Engineering, South China University of Technology, Guangzhou, 510641, China
| | - Yuqing Gao
- Guangdong Provincial Key Laboratory of Fuel Cell Technology, School of Chemistry and Chemical Engineering, South China University of Technology, Guangzhou, 510641, China
| | - Weifeng Zhang
- Guangdong Provincial Key Laboratory of Fuel Cell Technology, School of Chemistry and Chemical Engineering, South China University of Technology, Guangzhou, 510641, China
| | - Shumei Liu
- School of Materials Science and Engineering, South China University of Technology, Guangzhou, 510641, China
| | - Jianqing Zhao
- School of Materials Science and Engineering, South China University of Technology, Guangzhou, 510641, China
| | - Li Du
- Guangdong Provincial Key Laboratory of Fuel Cell Technology, School of Chemistry and Chemical Engineering, South China University of Technology, Guangzhou, 510641, China
| |
Collapse
|
5
|
Qi S, Li C, Shi MC, Yue FX, Song KJ, Zhang WB, Wang SC. [Efficacy and safety of endovascular therapy after 24 h from ischemic stroke onset in patients with acute anterior circulation ischemic stroke]. Zhonghua Nei Ke Za Zhi 2023; 62:1311-1316. [PMID: 37935497 DOI: 10.3760/cma.j.cn112138-20230120-00030] [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: 11/09/2023]
Abstract
Objective: To explore the effectiveness and safety of endovascular treatment (EVT) for patients with acute anterior circulation ischemic stroke with symptom onset exceeding 24 h. Methods: In this retrospective cohort study, data were extracted from patients who underwent endovascular treatment for acute anterior circulation ischemic stroke at the First Hospital of Jilin University from February 2019 to April 2022. A total of 569 patients were included, with a mean age of 63 (54-70) years. Among them, 398 (69.9%) were male. The patients were divided into two groups based on symptom onset time:>24 h group and≤24 h group. Propensity score matching (PSM) was used to match the patients in a 1︰1 ratio between the>24 h group and the≤24 h group. Logistic regression was used to evaluate the impact of symptom onset time on outcome events. Results: Before PSM, compared with≤24 h group, the>24 h group had a younger age [56 (48, 64) vs. 64 (55, 70), Z=-3. 60, P<0.001]; lower proportion of prior atrial fibrillation [1.8% (1/57) vs. 21.1% (108/512), χ2=12.39, P<0.001]; lower proportion of wake-up stroke [7.0% (4/57) vs. 27.7% (142/512), χ2=11.54, P<0.001]; lower baseline NIHSS score [11.0 (7.5, 14.0) vs. 13.0 (10.0, 16.0), Z=-3.22, P<0.001]; and a higher American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology(ASITN/SIR) grading (P<0.001). After PSM, there were no significant differences in baseline characteristics between the two groups. There was no significant difference in the proportion of patients with a modified Rankin Scale (mRS) score≤2 at 90 days after surgery between the two groups (before matching: 42.0% vs. 40.4%, OR=0.745, 95%CI 0.407-1.362, P=0.339; after matching: 51.8% vs. 39.3%, OR=0.511, 95%CI 0.212-1.236, P=0.136). No significant differences were observed in the incidence of any safety outcomes between the>24 h group and the≤24 h group. Conclusion: For patients with acute anterior circulation ischemic stroke with symptom onset exceeding 24 h, EVT is feasible after strict radiological screening and has similar safety and effectiveness as for patients with symptom onset under 24 h.
Collapse
Affiliation(s)
- S Qi
- Stroke Center, Department of Neurology, the First Hospital of Jilin University, Changchun 130021, China
| | - C Li
- Stroke Center, Department of Neurology, the First Hospital of Jilin University, Changchun 130021, China
| | - M C Shi
- Stroke Center, Department of Neurology, the First Hospital of Jilin University, Changchun 130021, China
| | - F X Yue
- Stroke Center, Department of Neurology, the First Hospital of Jilin University, Changchun 130021, China
| | - K J Song
- Stroke Center, Department of Neurology, the First Hospital of Jilin University, Changchun 130021, China
| | - W B Zhang
- Stroke Center, Department of Neurology, the First Hospital of Jilin University, Changchun 130021, China
| | - S C Wang
- Stroke Center, Department of Neurology, the First Hospital of Jilin University, Changchun 130021, China
| |
Collapse
|
6
|
Zhu Y, Qi S, Li Y. Development and Validation of Clinical-Metabolic-Radiomics Model Based on Nomogram-Revised Risk Index for Prognosis Prediction in Patients with Extranodal Natural Kill/T Cell Lymphoma. Int J Radiat Oncol Biol Phys 2023; 117:e500. [PMID: 37785574 DOI: 10.1016/j.ijrobp.2023.06.1744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To identify clinical-metabolic-radiomics model using clinical data and 18F-FDG PET/CT image for predicting progression-free survival (PFS) of nasal-type extranodal natural killer/T cell lymphoma (ENKTCL) on the basis of the nomogram-revised risk index (NRI) model previously established and validated by our research group. MATERIALS/METHODS A total of 133 ENKTCL patients were prospectively included and randomly divided into a training cohort (n = 73) and a validation cohort (n = 50). 107 features and 7 commonly used metabolic parameters (SUVmax, MTV, TLG, SD, TLR, TAR and TBR) were extracted from baseline PET images of the patients. Least absolute shrinkage and selection operator (LASSO) following Cox regression were used to select optimal features and parameters. NRI-metabolic-radiomics model was developed and validated in the two cohorts and compared with NRI model and NRI-metabolic model. RESULTS TLG and 5 radiomics features were selected after LASSO and Cox regression. NRI-metabolic (NRI-TLG) model and NRI-metabolic-radiomics (NRI-TLG-RAD) model was developed based on NRI, TLG and selected 5 radiomics features. For PFS, NRI-TLG-RAD showed better PFS discrimination than NRI-TLG model and NRI model in both training cohort (C-index = 0.791, 0.743 and 0.690, respectively) and validation cohort (C-index = 0.785, 0.707, and 0.610 respectively). Moreover, NRI-TLG-RAD model and NRI-TLG model divided more patients into low-risk group (No. of patients: 66, 42 vs. 20) and very high-risk group (No. of patients: 25, 25 vs. 9), compared to preexisting NRI model. CONCLUSION The addition of metabolic and radiomics information improved the prognostic performance of preexisting NRI model greatly. Better prognostic discrimination and more reasonable patient division of the new NRI-TLG and NRI-TLG-RAD model may provide the basis for more precise treatment modality in the future.
Collapse
Affiliation(s)
- Y Zhu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - S Qi
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Y Li
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| |
Collapse
|
7
|
Luo F, Xin L, Wang J, Qi S, Wang S, Li YX. Optimizing the Combination of Cytotoxic Drugs Along with Radiotherapy as Effective Treatment for Extranodal NK/T-Cell Lymphoma. Int J Radiat Oncol Biol Phys 2023; 117:e476-e477. [PMID: 37785509 DOI: 10.1016/j.ijrobp.2023.06.1691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The optimal combination of cytotoxic drugs along with radiotherapy (RT) is unknown. We undertook multidrug screening process to identify the most efficacious cytotoxic drugs, and appraise the efficacy of various drug combinations. MATERIALS/METHODS We reviewed 3105 patients who received 40 chemotherapy regimens with different combinations of nine drug classes and/or RT. Least absolute shrinkage and selection operator (LASSO) and multivariable Cox regression analyses were used to screen efficacious single drugs and identify optimal combinations for overall survival (OS). Inverse probability of treatment weighting (IPTW) and multivariable analyses were used to compare survival between treatment regimens. RESULTS Screening and validation revealed RT, asparaginase (ASP), and gemcitabine (GEM) to be the most efficacious single modality/drugs. RT remained an important component of first-line treatment, whereas ASP was a fundamental drug of non-anthracycline (ANT)-based regimens. Addition of RT to non-ANT-based or ASP/GEM-based regimens, or addition of an ASP-drug into ANT-based or GEM/PLA-based regimens, improved 5-year OS significantly. Use of ASP/GEM-based regimens led to significantly higher 5-year OS (79.9%) compared with ASP/ANT-based (69.2%, P = 0.001), ASP/MTX-based (63.5%, P = 0.011), or ASP/NOS-based (63.2%, P<0.001) regimens. The survival benefit of ASP/GEM-based regimens over other ASP-based regimens was substantial across risk-stratified and advanced-stage subgroups. The survival benefits of a combination of RT, ASP, and GEM were consistent after adjustment for confounding factors by IPTW. CONCLUSION These results suggest that combining ASP/GEM with RT for ENKTCL is an efficacious and feasible therapeutic option, and provides a rationale and strategy for developing combination therapies.
Collapse
Affiliation(s)
- F Luo
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - L Xin
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - J Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - S Qi
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - S Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Y X Li
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| |
Collapse
|
8
|
Chen SY, Tang Y, Jing H, Fang H, Song YW, Liu YP, Jin J, Lu NN, Qi S, Chen B, Tang Y, Li YX, Wang SL. Early Cardiotoxicity in Patients Receiving Hypofractionated Radiotherapy after Breast Conserving Surgery: Analysis of a Prospective Study. Int J Radiat Oncol Biol Phys 2023; 117:e169. [PMID: 37784775 DOI: 10.1016/j.ijrobp.2023.06.1008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To evaluate the early cardiotoxicity of hypofractionated radiotherapy (HFRT) in patients with left-sided breast cancer after breast-conserving surgery, and to investigate the correlation between cardiotoxicity and cardiac dose. MATERIALS/METHODS A total of 103 women from 2017 to 2018 who received left-sided whole-breast with or without regional nodal irradiation either using deep inspiration breath-hold (DIBH) or free-breathing (FB) technique were prospectively enrolled. N-terminal pro-B-type natriuretic peptide (NT-proBNP), electrocardiogram, and radionuclide myocardial perfusion imaging were conducted before and after HFRT. Logistic regression analyses were performed to determine the association of cancer treatment, cardiac dose, and cardiovascular risk factors with cardiotoxic effects. RESULTS The mean dose (Dmean) of the heart, left anterior descending coronary artery (LAD), left ventricular (LV), and right ventricular (RV) in all patients was 403 cGy, 1685 cGy, 627 cGy, and 444 cGy, respectively. In comparison to FB, DIBH significantly reduced cardiac dose (heart Dmean 250 cGy vs. 570 cGy, LAD Dmean 1250 cGy vs. 2170 cGy, LV Dmean 420 cGy vs. 850 cGy, RV Dmean 260 cGy vs. 650 cGy; all p<0.001). With a median follow-up of 49 months (range, 2-65 months), no patients had clinical cardiac abnormalities or cardiac-related symptoms, but 42 (41%) patients had subclinical cardiac events. Among them, 41 were electrocardiogram changes, and one had LV ejection fraction decreased by 10% compared with the baseline level. Twenty-five (60%) recovered during follow-up, of which 17 (40%) experienced subclinical changes only once. The mean value of NT-proBNP did not change significantly before and after HFRT. In univariate analyses, DIBH technique significantly decreased the risk of subclinical cardiac events compared with FB (OR 0.31, 95% CI 0.14-0.71; p = 0.006); however, higher mean doses of heart and LV, anthracycline-based chemotherapy, obesity, and hypertension were associated with increased risk of subclinical cardiac events (all p<0.05). CONCLUSION Early subclinical cardiac damage after HFRT in left-sided breast cancer is dose-related, and mostly manageable and reversible without medical intervention.
Collapse
Affiliation(s)
- S Y Chen
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Y Tang
- GCP center/Clinical research center, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - H Jing
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - H Fang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Y W Song
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Y P Liu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - J Jin
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - N N Lu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - S Qi
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - B Chen
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Y Tang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Y X Li
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - S L Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| |
Collapse
|
9
|
Gao LR, Qin S, Wei R, Tian Y, Xia W, Song YW, Wang S, Fang H, Yu T, Jing H, Liu Y, Tang Y, Qi S, Chen B, Li YX, Lu NN. Adaptive Ultra-Hypofractionated Whole-Pelvic Radiotherapy in High-Risk and Very High-Risk Prostate Cancer on 1.5-1.5 MR Linac: The Estimated Delivered Dose and Early Toxicity Results. Int J Radiat Oncol Biol Phys 2023; 117:e384. [PMID: 37785297 DOI: 10.1016/j.ijrobp.2023.06.2500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To study the feasibility and safety for patients with high-risk (HR) and very high-risk (VHR) prostate cancer treated with adaptive ultra-hypofractionated whole-pelvic radiotherapy (UHF-WPRT) on 1.5 magnetic resonance (MR)-Linac. MATERIALS/METHODS Sevenpatients with clinical stage T3a-4N0-1M0-1c consecutively treated with UHF-WPRT on a 1.5-T MR-Linac were recruited prospectively in a phase II trial (NCT05183074, ChiCTR2000033382). A 36.25 Gy dose in five fractions was delivered every other day with a boost of 40 Gy to the whole prostate, as well as 25 Gy to whole pelvic nodal area with a concomitant boost of 35 Gy to metastatic regional nodes. To estimate the delivered dose, we collected data by 3D-MR for the following stages: pre-MR, position verification-MR (PV-MR) in the Adapt-To-Shape (ATS) workflow, and 3D-MR during the beam-on phase (Bn-MR) and at the end of RT (post-MR). The target and organ-at-risk contours in the PV-MR, Bn-MR, and post-MR stages were projected from the pre-MR data by deformable image registration and manually adapted by the physician, followed by dose recalculation for the ATS plan. The cumulative acute genitourinary (GU) and gastrointestinal (GI) toxicities were evaluated as per NCI-CTCAE 5.0 criteria. The primary endpoints were acute ≥grade 3 genitourinary (GU) and gastrointestinal (GI) toxicities during the first 3 months. RESULTS Overall, 133 MR scans were collected (35 pre-MR, 35 PV-MR, 31 Bn-MR and 32 post-MR scans). With a median on-couch time of 61 minutes, the mean prostate and pelvic planning target volume (PTV)-V95% of all scans was 96.98 ± 3.06% and 96.44 ± 2.85%, respectively. The corresponding mean prostate clinical target volume (CTV)-V100% was 99.89 ± 0.32%, 98.71 ± 1.90%, 97.77 ± 2.89%, and 98.56 ± 1.72%, and the mean pelvic CTV-V100% was 97.57% ± 3.70%, 96.54 ± 3.80%, 95.43 ± 4.31%, and 94.39 ± 4.47% on pre-MR, PV-MR, Bn-MR and post-MR scans, respectively. For the 4 patients with positive nodes, the mean V100% of metastatic regional nodes was 99.89 ± 0.81%. The median V29 Gy change in the rectal wall was -1% (-18%-20%). The V29 Gy of the rectal wall increased by >15% was observed in one scan. A slight increase in the high dose of bladder wall was noted due to gradual bladder growth during the workflow. With median follow-up time of 7.3 (4.6-12.2) months, all patients were followed-up for more than 3 months. No patient was observed with acute CTCAE grade 2 or more severe GU or GI toxicities (0%). CONCLUSION UHF-RT to prostate and pelvic with ATS workflow is well tolerated by patients with HR and VHR prostate cancer, with only mild GU and GI toxicities. The 3D-MR-based dosimetry analysis demonstrated clinically acceptable estimated dose coverage of target volumes during the beam-on period.
Collapse
Affiliation(s)
- L R Gao
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - S Qin
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - R Wei
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Y Tian
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - W Xia
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Y W Song
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - S Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - H Fang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - T Yu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - H Jing
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Y Liu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Y Tang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - S Qi
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - B Chen
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Y X Li
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - N N Lu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| |
Collapse
|
10
|
Watson L, Link C, Qi S, DeIure A, Barbera L. Engaging Ambulatory Cancer Patients to Develop and Validate a Comprehensive New Patient-Reported Outcomes Measure. Int J Radiat Oncol Biol Phys 2023; 117:e219-e220. [PMID: 37784896 DOI: 10.1016/j.ijrobp.2023.06.1120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The ambulatory cancer program in Alberta, Canada routinely collects Patient-Reported Outcomes (PROs) using a common symptom rating measure, the Edmonton Symptom Assessment System-Revised (ESAS-r). The purpose of this study was to redesign, test, and validate a modified ESAS-r (the ESAS-r Cancer) for use in the province's new clinical information system and online patient portal. MATERIALS/METHODS Patient advisors participated in regular meetings to redesign the measure, creating expanded definitions for the original symptoms and new symptoms, added based on trends identified in our historical PRO data. To test the modified measure, patient advisors first completed the measure online to test the feasibility of remote electronic completion. Next, the advisors participated in cognitive interviews to discuss and finalize the wording of each symptom definition for clarity. To test the validity and reliability of the finalized measure, 1600 randomly sampled patients were mailed paper copies of the ESAS-r Cancer, ESAS-r, and a validated PRO measure called the Memorial System Assessment Scale-Short Form (MSAS-SF), which is often used with cancer patients. Canonical Correlation Analysis and exploratory factor analyses were performed to assess concurrent and construct validity of the ESAS-r Cancer against ESAS-r, using MSAS-SF as the gold standard. Cronbach's α was calculated to assess reliability. RESULTS The nine original ESAS-r symptoms were retained and six new symptoms were added to create the ESAS-r Cancer. All but one of the 26 patient advisors (96.2%) who completed the online measure did so without assistance. After two rounds of cognitive interviews all symptom definitions were finalized and deemed clear by almost all advisors. 461 patients (29% response rate) completed all three questionnaires. Using MSAS-SF as the gold standard, ESAS-r Cancer showed stronger canonical correlation than ESAS-r, indicating higher concurrent validity and fitting degree. ESAS-r Cancer also accounted for more information included on MSAS-SF than did ESAS-r, explaining more variance (75.2% vs. 73.5%). As revealed by factor analysis, the three-dimensional factor structure of ESAS-r Cancer outperformed the two-dimensional factor structure of ESAS-r, by allowing for new constructs within measurement. The reliability of ESAS-r Cancer was verified (Cronbach's α = .903, > threshold of 0.8) and slightly higher than ESAS-r (Cronbach's α = .884). CONCLUSION ESAS-r Cancer is now in use with patients throughout Alberta's cancer program. The redesign, testing, and validation process involved patient engagement throughout. Patient testing and perspectives were critical as ESAS-r Cancer is intended for use with ambulatory cancer patients. ESAS-r Cancer can help ensure patients are included in care decisions and that their perspectives are involved in guiding care.
Collapse
Affiliation(s)
- L Watson
- Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada; University of Calgary, Calgary, AB, Canada
| | - C Link
- Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
| | - S Qi
- Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
| | - A DeIure
- Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
| | - L Barbera
- Division of Radiation Oncology, University of Calgary, Tom Baker Cancer Centre, Calgary, AB, Canada
| |
Collapse
|
11
|
Wang J, Liu X, Luo F, Wang X, Liu Y, Hu C, Qi S, Li Y. Association of Overall Survival Benefit Profile of Radiotherapy with Progression-Free Survival after Chemotherapy for Diffuse Large B-Cell Lymphoma. Int J Radiat Oncol Biol Phys 2023; 117:S63-S64. [PMID: 37784543 DOI: 10.1016/j.ijrobp.2023.06.364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Benefit of radiotherapy (RT) after chemotherapy (CT) of diffuse large B-cell lymphoma (DLBCL) remains controversial. It is unknown whether improved progression-free survival (PFS) by RT translate into an overall survival (OS) benefit. To address this question, our research comprehensively evaluated the risk-benefit assessment of RT in DLBCL through an in-depth examination of previously reported data from randomized controlled trials (RCTs) and retrospective comparative studies. MATERIALS/METHODS After screening and quality control, this study included 7 randomized controlled trials and 52 retrospective studies of combined-modality therapy (CMT) versus CT alone. The correlation between PFS and OS was evaluated using the Pearson linear correlation coefficient at trial- and study arm-level. A risk-benefit assessment to describe the OS benefit of RT was performed in meta-analyses of pooled HROS with PFS patterns. RESULTS In RCTs, strong correlations were found between HRPFS and HROS at trial-level (r = 0.876), and PFS and OS at treatment arm-level, regardless of treatments (r = 0.945-0.964 for all, CMT or CT). In retrospective studies, similar correlations between HRPFS and HROS (r = 0.639-0.650), and PFS and OS rates (r = 0.882-0.910) were observed, independent of treatments or rituximab. Adding RT into rituximab-based CT increased the average PFS rate from 63.6 ± 18.9% to 81.5 ± 10.6% (P<0.001), with differential OS benefits of RT between studies. Patients can be stratified into four PFS patterns (>80%, >60-80%, >40-60%, and ≤40%); absolute gain in OS from RT ranged from ≤5% at PFS >80% to ∼21% at PFS ≤40%, with pooled-HROS from 0.70 (95% CI, 0.51-0.97) to 0.48 (95% CI, 0.36-0.63) after rituximab-based CT. Linear analysis revealed an OS advantage of CMT over CT alone in a PFS-dependent manner. CONCLUSION We demonstrate a varied OS benefit profile of RT upon different PFS patterns, and provide valuable evidence for making treatment decisions and designing clinical trials. Future strategies to select the use of RT will need careful tailoring in clinical practice or within RCT to optimize outcome.
Collapse
Affiliation(s)
- J Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China; Department of Oncology, Central hospital affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - X Liu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - F Luo
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - X Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - Y Liu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - C Hu
- Johns Hopkins Medicine Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD
| | - S Qi
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Y Li
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| |
Collapse
|
12
|
Zhao X, Fang H, Jing H, Zhang N, Zhang J, Jin J, Zhong Q, Yang WF, Zhong Y, Dong L, Tie J, Wu HF, Wang XH, Lu Y, Hou X, Zhao L, Qi S, Song Y, Liu Y, Tang Y, Lu N, Chen B, Tang Y, Li Y, Wang S. Lymphocyte Count Kinetics and the Effect of Different Radiotherapy Techniques on Radiation-Induced Lymphopenia in Patients with Breast Cancer Receiving Hypofractionated Postmastectomy Radiotherapy. Int J Radiat Oncol Biol Phys 2023; 117:e216-e217. [PMID: 37784888 DOI: 10.1016/j.ijrobp.2023.06.1112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Radiation-induced lymphopenia (RIL) is associated with poor prognosis in solid tumors. This study aimed to describe the lymphocyte kinetics in patients with breast cancer receiving hypofractionated postmastectomy radiotherapy (RT) and to investigate the association of different RT techniques with RIL. MATERIALS/METHODS We assessed 607 patients who received hypofractionated postmastectomy RT for breast cancer in our prospective clinical database from 8 hospitals. All patients received irradiation to the chest wall and supraclavicular fossa. RT techniques included integrated RT with the photon-based intensity modulated techniques to irradiate all target volumes (integrated RT) and a hybrid approach combining photon irradiation to supraclavicular nodes and electron irradiation to the chest wall (hybrid RT). Peripheral lymphocyte counts (PLC) were tested prior to RT (baseline), weekly during RT, at 1, 2 weeks, 3, 6 months after RT, and then every 6 months. Grade 3+ RIL was defined as PLC nadir during RT of <0.5 ×103/ml. Mean PLC was compared by the t test. Univariate, multivariate, and propensity score matching (PSM) analyses were used to evaluate the effect of different RT techniques on grade 3+ RIL. RESULTS During RT, 121 (19.9%) of patients had grade 3+ RIL. The PLC started to recover at 1 week and reached baseline levels 1 year after RT. A greater proportion of the patients treated with the integrated RT (90/269, 33.5%) developed grade 3+ PLC compared with those receiving hybrid RT (31/338, 9.2%, P < 0.001). After conducting PSM, multivariate analyses showed lower baseline PLC (HR = 0.15, P<0.001) and RT technique (the integrated RT vs. hybrid RT, HR = 4.76, P<0.001) were independent risk factors for grade 3+ RIL. The PLC in patients receiving the integrated RT after RT were higher than that in those receiving hybrid RT (p<0.05). CONCLUSION RT technique affect the risk of and recovery from RIL, which may impact survival. Choosing appropriate RT technique to minimize RIL might be considered to benefit their outcomes.
Collapse
Affiliation(s)
- X Zhao
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - H Fang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - H Jing
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - N Zhang
- Department of Radiation Oncology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, China
| | - J Zhang
- Department of Radiation Oncology, Forth Hospital of Hebei Medical University, Shijiazhuang, China
| | - J Jin
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Q Zhong
- Department of Radiation Oncology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - W F Yang
- Department of Radiation Oncology, Affiliated Taizhou hospital of Wenzhou Medical University, Taizhou, China
| | - Y Zhong
- Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - L Dong
- Department of Radiation Oncology, The First Hospital, Jilin University, Changchun, China
| | - J Tie
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, Beijing, China
| | - H F Wu
- Department of Radiation Oncology, Jilin Cancer Hospital, Changchun, China
| | - X H Wang
- Department of Radiochemotherapy, People's Hospital of Tangshan City, Tangshan, China
| | - Y Lu
- Department of Radiation Oncology, Cancer Hospital of Henan Province, Zhengzhou, Henan, China
| | - X Hou
- Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of medical Sciences & Peking Union Medical College, Beijing, China
| | - L Zhao
- Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - S Qi
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Y Song
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Y Liu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Y Tang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - N Lu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - B Chen
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Y Tang
- GCP center/Clinical research center, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Y Li
- Department of Radiation Oncology, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - S Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| |
Collapse
|
13
|
Wu Y, Liu X, Zhong Q, Yang Y, Li YX, Qi S. Association of Treatment Disparities and Primary Sites with the Survival of Non-Gastric Early-Stage MALT Lymphoma. Int J Radiat Oncol Biol Phys 2023; 117:e492-e493. [PMID: 37785554 DOI: 10.1016/j.ijrobp.2023.06.1726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To investigate the association between utilization of radiotherapy and differences in survival among patients with non-gastric early-stage mucosa-associated lymphoid tissue (MALT) lymphoma at different primary sites. MATERIALS/METHODS A total of 5,995 patients with non-gastric early-stage MALT lymphoma in the Surveillance, Epidemiology, and End Results (SEER) database treated between 2000-2015 were extracted and analyzed. Mediation analyses were conducted to quantitatively determine the proportion of the relationship between OS and primary sites mediated by radiotherapy. Inverse probability of treatment weighting (IPTW) was conducted to control confounding factors affecting treatment choice. RESULTS After controlling for confounding factors, pulmonary MALT lymphoma was found to have the highest rate of omitted radiotherapy compared to other primary sites, including ocular adnexa, salivary gland, skin and other sites. Multivariate Cox analyses showed that lung MALT lymphoma patients had the lowest 10-year OS rate of 58.3%, while skin MALT lymphoma patients had the highest 10-year OS rate of 81.6%. After balancing confounding factors that potentially affected the choice of radiotherapy using IPTW, differences in utilization of radiotherapy explained a significant portion of the poor prognosis of lung MALT lymphoma (35.6%, P = 0.002) and the favorable prognosis of skin MALT lymphoma (6.1%, P <0.001). CONCLUSION Differences in survival among patients with non-gastric early-stage MALT lymphoma at different primary sites are associated with disparities in the utilization of radiotherapy.
Collapse
Affiliation(s)
- Y Wu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - X Liu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China
| | - Q Zhong
- Department of Radiation Oncology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Y Yang
- Fujian Medical University Union Hospital, Fujian, China
| | - Y X Li
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - S Qi
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| |
Collapse
|
14
|
Wang X, Qi S, Liu X, Wu Y, Wang J, Luo F, Liu Y, Li Y. Radiotherapy Effect on Long-Term Net Survival Benefit for Early-Stage Diffuse Large B-Cell Lymphoma in the Rituximab Era. Int J Radiat Oncol Biol Phys 2023; 117:e492. [PMID: 37785553 DOI: 10.1016/j.ijrobp.2023.06.1724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) It is controversial whether to add consolidative radiotherapy (RT) after chemoimmunotherapy in the first-line treatment for diffuse large B-cell lymphoma (DLBCL). This study aimed to investigate the long-term net survival benefit of RT for early-stage DLBCL in the rituximab era. MATERIALS/METHODS The data of 10,841 adult patients with early-stage DLBCL from the Surveillance, Epidemiology, and End Results (SEER) database between 2002 and 2015 were extracted and analyzed. The patients had received combined modality treatment (CMT, chemotherapy plus RT) or chemotherapy alone. Linear regression analysis was performed for RT utilization by year of diagnosis. Competing risk analysis was used to evaluate the cumulative incidence of mortality according to the cause of death. Inverse probability of treatment weighting (IPTW) was used to balance the distribution of covariates between treatment arms. Relative survival (RS), standardized mortality ratio (SMR), and transformed Cox regression were performed to estimate the net survival benefit of RT by controlling for background mortality. RESULTS Linear regression revealed that the slope of the best-fit line for RT utilization over time was negative between 2002 and 2015 (m = -0.006, P = 0.003). A total of 4,648 deaths were recorded among 10,841 patients; 55.6% were lymphoma-related death (LRD), and 44.4% were attributed to other causes. Patients initially treated with CMT had a lower cumulative incidence of LRD than chemotherapy alone (HR 0.63, 95% CI: 0.57-0.69; P < 0.001). The 10-year overall survival (OS) rate of 66.1%, RS rate of 85.0%, and SMR of 1.71 achieved with CMT were significantly better than chemotherapy alone (OS, 53.0%; RS, 69.8%; SMR, 2.62; P < 0.001). By IPTW and multivariable analysis, the addition of RT remained associated with better OS (HR 0.67, 95% CI: 0.62-0.71; P < 0.001) and RS (HR 0.69, 95% CI: 0.65-0.74; P < 0.001). CONCLUSION RT was associated with better long-term net survival in patients with early-stage DLBCL in the rituximab era.
Collapse
Affiliation(s)
- X Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - S Qi
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - X Liu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Y Wu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - J Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - F Luo
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Y Liu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Y Li
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| |
Collapse
|
15
|
Zhou H, Zhang Y, Gan C, Fan X, Qi Z, Qi S. [Eriocitrin suppresses proliferation and migration of hepatocellular carcinoma SMMC-7721 cells by promoting ROS production and activating the MAPK pathway]. Nan Fang Yi Ke Da Xue Xue Bao 2023; 43:412-419. [PMID: 37087586 PMCID: PMC10122744 DOI: 10.12122/j.issn.1673-4254.2023.03.11] [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: 04/24/2023]
Abstract
OBJECTIVE To investigate the role of the ROS/MAPK signaling axis in mediating the inhibitory effect of eriocitrin on proliferation and migration of hepatocellular carcinoma SMMC-7721 cells. METHODS SMMC-7721 cells were treated with different concentrations of eriocitrin for 24 h, and the changes in cell viability were detected with CCK-8 assay. The migration and invasion abilities of the treated cells were evaluated using Transwell and scratch healing assays, the cell proliferation was assessed with colony-forming assay, and changes in nuclear morphology were observed with DAPI staining. Western blotting was performed to examine the changes in the expressions of E-cadherin, N-cadherin, MMP-2, MMP-9, PARP, Pro-caspase 3, pJNK, p-P38, and p-ERK. The effect of eriocitrin on PARP cleavage in SMMC-7721 cells pretreated with ERK, JNK and P38 inhibitors (U0126, SB203580 and SP600125, respectively) was detected using Western blotting. The effect of treatment with Nacetyl-cysteine (NAC, 30 μmol/L) and eriocitrin (100, 200, and 300 μg/mL), alone or in combination, on reactive oxygen species (ROS) levels in the cells was examined using a DCFH-DA fluorescent probe. RESULTS Eriocitrin below 50 μg/mL did not produce significant effect on the viability of SMMC-7721 cells (P>0.05). Treatment with eriocitrin significantly inhibited scratch healing, migration, and colony formation of the cells (P < 0.01), reduced the protein expressions of N-cadherin, MMP-2, and MMP-9 (P < 0.01), and up-regulated E-cadherin protein expression (P < 0.05). Eriocitrin-treated SMMC-7721 cells showed obvious apoptotic morphologies with decreased Procaspase 3 expression and increased PARP cleavage (P < 0.01) and phosphorylation levels of JNK, P38, and ERK (P < 0.01); Eriocitrin-induced PAPR cleavage was obviously enhanced by U0126 and SB203580 but attenuated by SP600125. Treatment with 300 μg/mL eriocitrin for 30 min significantly increased ROS level in the cells, and this effect was obviously suppressed by NAC. CONCLUSION Eriocitrin can suppress the proliferation and migration and promote apoptosis of hepatocellular carcinoma SMMC-7721 cells by promoting ROS production and activating the MAPKs signaling pathway.
Collapse
Affiliation(s)
- H Zhou
- Key Laboratory of Biologically Active Biomacromolecules, Wannan Medical College, Wuhu 241002, China
| | - Y Zhang
- Key Laboratory of Biologically Active Biomacromolecules, Wannan Medical College, Wuhu 241002, China
| | - C Gan
- Key Laboratory of Biologically Active Biomacromolecules, Wannan Medical College, Wuhu 241002, China
| | - X Fan
- Key Laboratory of Biologically Active Biomacromolecules, Wannan Medical College, Wuhu 241002, China
- Department of Biochemistry and Molecular Biology, Wannan Medical College, Wuhu 241002, China
| | - Z Qi
- Key Laboratory of Biologically Active Biomacromolecules, Wannan Medical College, Wuhu 241002, China
- Department of Biochemistry and Molecular Biology, Wannan Medical College, Wuhu 241002, China
| | - S Qi
- Key Laboratory of Biologically Active Biomacromolecules, Wannan Medical College, Wuhu 241002, China
- Department of Biochemistry and Molecular Biology, Wannan Medical College, Wuhu 241002, China
| |
Collapse
|
16
|
Li M, Qi S, Li S, Du L. Realizing Scalable Nano-SiO 2-Aerogel-Reinforced Composite Polymer Electrolytes with High Ionic Conductivity via Rheology-Tuning UV Polymerization. Molecules 2023; 28:molecules28020756. [PMID: 36677814 PMCID: PMC9861509 DOI: 10.3390/molecules28020756] [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] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 12/31/2022] [Accepted: 01/10/2023] [Indexed: 01/14/2023]
Abstract
Polymer electrolytes for lithium metal batteries have aroused widespread interest because of their flexibility and excellent processability. However, the low ambient ionic conductivity and conventional fabrication process hinder their large-scale application. Herein, a novel polyethylene-oxide-based composite polymer electrolyte is designed and fabricated by introducing nano-SiO2 aerogel as an inorganic filler. The Lewis acid-base interaction between SiO2 and anions from Li salts facilitates the dissociation of Li+. Moreover, the SiO2 interacts with ether oxygen (EO) groups, which weakens the interaction between Li+ and EO groups. This synergistic effect produces more free Li+ in the electrolyte. Additionally, the facile rheology-tuning UV polymerization method achieves continuous coating and has potential for scalable fabrication. The composite polymer electrolyte exhibits high ambient ionic conductivity (0.68 mS cm-1) and mechanical properties (e.g., the elastic modulus of 150 MPa). Stable lithium plating/stripping for 1400 h in Li//Li symmetrical cells at 0.1 mA cm-2 is achieved. Furthermore, LiFePO4//Li full cells deliver superior discharge capacity (153 mAh g-1 at 0.5 C) and cycling stability (with a retention rate of 92.3% at 0.5 C after 250 cycles) at ambient temperature. This work provides a promising strategy for polymer-based lithium metal batteries.
Collapse
|
17
|
Song Y, Huang Z, Fang H, Tang Y, Jing H, Song Y, Jin J, Liu Y, Chen B, Tang Y, Qi S, Lu N, Li N, LI Y, Wang S. Comparison of Breast-Conserving Surgery vs. Mastectomy for Patients with Breast Cancer after Neoadjuvant Chemotherapy. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
18
|
Sun G, Wen G, Zhang Y, Tang Y, Jing H, Zhao X, Chen S, Jin J, Song Y, Liu Y, Fang H, Tang Y, Qi S, Li N, Chen B, Lu N, LI Y, Wang S. Development and External Validation of a Nomogram to Predict the Benefit of Regional Node Irradiation in Patients with pT1-2N1M0 Breast Cancer. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
|
19
|
Zhong Q, Liu Y, Wu Y, Liu X, Li G, Xu Y, Qi S, LI Y. Impact of Age on Long-Term Mortality and Net Survival Benefit of Radiotherapy for Early-Stage Follicular Lymphoma from the SEER Database (2000-2015). Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
|
20
|
Strohschein F, Qi S, Link C, Davidson S, Watson L. Using real-world evidence to understand the symptom experience and concerns of older adults with cancer: Age-analysis of patient-reported outcome measures routinely collected in Alberta, Canada. J Geriatr Oncol 2022. [DOI: 10.1016/s1879-4068(22)00323-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
21
|
Qi S, Li S, Zou W, Zhang W, Wang X, Du L, Liu S, Zhao J. Enabling Scalable Polymer Electrolyte with Synergetic Ion Conductive Channels via a Two Stage Rheology Tuning UV Polymerization Strategy. Small 2022; 18:e2202013. [PMID: 35587735 DOI: 10.1002/smll.202202013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/28/2022] [Indexed: 06/15/2023]
Abstract
Lithium metal batteries with polyethylene oxide (PEO) electrolytes are considered as one of the ideal candidates for next generation power sources. However, the low ambient operation capability and conventional solvent-based fabrication process of PEO limit their large-scale application. In this work, a comb-like quasi-solid polymer electrolyte (QPE) reinforced with polyethylene glycol terephthalate nonwoven is fabricated. Combining the density functional theory calculation analysis and polymer structure design, optimized and synergized ion conductive channels are established by copolymerization of tetrahydrofurfuryl acrylate and introduction of plasticizer tetramethyl urea. Additionally, a unique two-stage solventless UV polymerization strategy is utilized for rheology tuning and electrolyte fabrication. Compared with the conventional one-step UV process, this strategy is ideally suited for the roll-to-roll continuous coating fabrication process with environmental friendliness. The fabricated QPE exhibits high ionic conductivity of 0.40 mS cm-1 and Li+ transference number (t = 0.77) at room temperature. LiFePO4 //Li batteries are assembled to evaluate battery performance, which deliver excellent discharge capacity (144.9 mAh g-1 at 0.5 C) and cycling stability (with the retention rate 94.5% at 0.5 C after 200 cycles) at room temperature. The results demonstrate that it has high potential for solid-state lithium metal batteries.
Collapse
Affiliation(s)
- Shengguang Qi
- Guangdong Provincial Key Laboratory of Fuel Cell Technology, School of Chemistry and Chemical Engineering, South China University of Technology, Guangzhou, 510641, China
- School of Materials Science and Engineering, South China University of Technology, Guangzhou, 510641, China
| | - Shulian Li
- Guangdong Provincial Key Laboratory of Fuel Cell Technology, School of Chemistry and Chemical Engineering, South China University of Technology, Guangzhou, 510641, China
| | - Wenwu Zou
- Guangdong Provincial Key Laboratory of Fuel Cell Technology, School of Chemistry and Chemical Engineering, South China University of Technology, Guangzhou, 510641, China
| | - Weifeng Zhang
- Guangdong Provincial Key Laboratory of Fuel Cell Technology, School of Chemistry and Chemical Engineering, South China University of Technology, Guangzhou, 510641, China
| | - Xiujun Wang
- Guangdong Provincial Key Laboratory of Fuel Cell Technology, School of Chemistry and Chemical Engineering, South China University of Technology, Guangzhou, 510641, China
| | - Li Du
- Guangdong Provincial Key Laboratory of Fuel Cell Technology, School of Chemistry and Chemical Engineering, South China University of Technology, Guangzhou, 510641, China
| | - Shumei Liu
- School of Materials Science and Engineering, South China University of Technology, Guangzhou, 510641, China
| | - Jianqing Zhao
- School of Materials Science and Engineering, South China University of Technology, Guangzhou, 510641, China
| |
Collapse
|
22
|
DeRamus TP, Wu L, Qi S, Iraji A, Silva R, Du Y, Pearlson G, Mayer A, Bustillo JR, Stromberg SF, Calhoun VD. Multimodal data fusion of cortical-subcortical morphology and functional network connectivity in psychotic spectrum disorder. Neuroimage Clin 2022; 35:103056. [PMID: 35709557 PMCID: PMC9207350 DOI: 10.1016/j.nicl.2022.103056] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 04/18/2022] [Accepted: 05/21/2022] [Indexed: 11/20/2022]
Abstract
Overlap has been noted disorders which fall on the psychotic spectrum. Univariate studies may miss joint brain features across diagnostic categories. mCCA with jICA is paired with features across the psychotic spectrum to produce joint components. One joint component displayed a significant relationship with cognitive scores. The replicate trends of cortical-subcortical irregularity in psychotic spectrum disorders.
Multiple authors have noted overlapping symptoms and alterations across clinical, anatomical, and functional brain features in schizophrenia (SZ), schizoaffective disorder (SZA), and bipolar disorder (BPI). However, regarding brain features, few studies have approached this line of inquiry using analytical techniques optimally designed to extract the shared features across anatomical and functional information in a simultaneous manner. Univariate studies of anatomical or functional alterations across these disorders can be limited and run the risk of omitting small but potentially crucial overlapping or joint neuroanatomical (e.g., structural images) and functional features (e.g., fMRI-based features) which may serve as informative clinical indicators of across multiple diagnostic categories. To address this limitation, we paired an unsupervised multimodal canonical correlation analysis (mCCA) together with joint independent component analysis (jICA) to identify linked spatial gray matter (GM), resting-state functional network connectivity (FNC), and white matter fractional anisotropy (FA) features across these diagnostic categories. We then calculated associations between the identified linked features and trans-diagnostic behavioral measures (MATRICs Consensus Cognitive Battery, MCCB). Component number 4 of the 13 identified displayed a statistically significant relationship with overall MCCB scores across GM, resting-state FNC, and FA. These linked modalities of component 4 consisted primarily of positive correlations within subcortical structures including the caudate and putamen in the GM maps with overall MCCB, sparse negative correlations within subcortical and cortical connection tracts (e.g., corticospinal tract, superior longitudinal fasciculus) in the FA maps with overall MCCB, and negative relationships with MCCB values and loading parameters with FNC matrices displaying increased FNC in subcortical-cortical regions with auditory, somatomotor, and visual regions.
Collapse
Affiliation(s)
- T P DeRamus
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS) - Georgia State University, Georgia Institute of Technology, and Emory University, Atlanta, GA, USA.
| | - L Wu
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS) - Georgia State University, Georgia Institute of Technology, and Emory University, Atlanta, GA, USA
| | - S Qi
- College of Computer Science and Technology, Nanjing University of Aeronautics and Astronautics, Nanjing, China
| | - A Iraji
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS) - Georgia State University, Georgia Institute of Technology, and Emory University, Atlanta, GA, USA
| | - R Silva
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS) - Georgia State University, Georgia Institute of Technology, and Emory University, Atlanta, GA, USA
| | - Y Du
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS) - Georgia State University, Georgia Institute of Technology, and Emory University, Atlanta, GA, USA; School of Computer and Information Technology, Shanxi University, Taiyuan, China
| | - G Pearlson
- Olin Neuropsychiatry Research Center, Institute of Living at Hartford Hospital, Hartford, CT, USA; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Department of Neuroscience, Yale University School of Medicine, New Haven, CT, USA
| | - A Mayer
- The Mind Research Network, Lovelace Biomedical and Environmental Research Institute, Albuquerque, USA
| | - J R Bustillo
- Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - S F Stromberg
- Psychiatry and Behavioral Health Clinical Program, Presbyterian Healthcare System, Albuquerque, NM, USA
| | - V D Calhoun
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS) - Georgia State University, Georgia Institute of Technology, and Emory University, Atlanta, GA, USA; The Mind Research Network, Lovelace Biomedical and Environmental Research Institute, Albuquerque, USA; Department of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, USA; Department of Computer Science, Georgia State University, Atlanta, USA; Department of Psychology, Georgia State University, Atlanta, USA
| |
Collapse
|
23
|
Zhao Y, Tang Y, Liu W, Li N, Song Y, Wang S, Liu Y, Fang H, Lu N, Tang Y, Qi S, Yang Y, Chen B, LI Y, Jin J. Four-Dimensional Computed Tomography Scan Analysis of Liver Tumor Motion Treated With Abdominal Compression During Stereotactic Treatment of Liver. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
24
|
Gunther J, Yang J, Hajj C, Ng A, Brady J, Cheng S, Levis M, Qi S, Mikhaeel G, Ricardi U, Illidge T, Turin A, Knafl M, Specht L, Dabaja B, Yahalom J. Efficacy and Toxicity of Alternative Radiation Treatment Schemes for Patients With Hematologic Malignancies: A Collaborative ILROG COVID Era Report. Int J Radiat Oncol Biol Phys 2021. [PMCID: PMC8536223 DOI: 10.1016/j.ijrobp.2021.07.961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose/Objective(s) The COVID19 pandemic required radiation oncologists (ROs) to consider shorter treatment courses to minimize patient and staff exposure and conserve healthcare resources. Hematologic ROs adopted hypofractionated radiation therapy (hRT) regimens according to guidelines published by the International Lymphoma Radiation Oncology Group (ILROG). We report for the first time the preliminary efficacy and toxicity of these novel hypofractionated regimens in the treatment of hematologic malignancies. Materials/Methods We conducted a multicenter, multinational retrospective study under the direction of the ILROG. All patients receiving hRT according to ILROG guidelines from 1/1/2020 to 8/31/2020 were included. Patient and treatment details were abstracted from separate institutional databases. Toxicity was graded using CTCAE v5.0. Results Ninety-three patients from 4 institutions treated with 114 RT courses were included. Patient and treatment details are displayed in Table 1. Median follow up for the cohort was 179 days, and 77 patients (82%) were alive at last follow up. Maximal toxicity experienced by patients included Grade 1 (n = 16), Grade 2 (n = 1) and Grade 3 (n = 1) toxicities. Of 80 sites with response assessment within the RT field, 69% of patients achieved a complete response (n = 55), 20% partial response (n = 16), 9% stable disease (n = 7), and 2% progressive disease (n = 2). No COVID19 infections during or after RT have been documented in this patient cohort. Conclusion HRT according to ILROG guidelines resulted in low rates of acute toxicity and reasonable short-term treatment efficacy. Longer follow up and comparison with control groups is needed to draw more definitive conclusions and will be presented at the Annual Meeting.
Collapse
|
25
|
Sun G, Zhang J, Wang S, Tang Y, Jing H, Zhang J, Wang J, Song Y, Jin J, Fang H, Liu Y, Chen B, Tang Y, Li N, Lu N, Qi S, Yang Y, Ying J, LI Y. Tumor-Infiltrating Lymphocytes and Prognosis in Stage I-III Triple-Negative Breast Cancer: A Retrospective Analysis of 258 Patients Treated Without Neoadjuvant Therapy. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
26
|
Chen S, Sun G, Wang S, Fang H, Song Y, Jin J, Liu Y, Tang Y, Jing H, Lu N, Qi S, Chen B, Tang Y, Zhao X, Song Y, Li Y. Delay in Initiating Postmastectomy Radiotherapy is Associated With Inferior Clinical Oncologic Outcomes for High-Risk Breast Cancer. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
27
|
Song Y, Sun G, Wang S, Zhang J, Fang H, Tang Y, Wang J, Song Y, Qi S, Chen B, Yang Y, Jing H, Tang Y, Jin J, Liu Y, Hu C, Lu N, Li N, LI Y. Quality of Life After Partial or Whole Breast Irradiation After Breast-Conserving Surgery for Low-Risk Breast Cancer: 1-Year Results of a Phase 2 Randomized Controlled Trial. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
28
|
Chen S, Li N, Tang Y, Chen B, Fang H, Qi S, Lu N, Yang Y, Wang S, Song Y, Liu Y, LI Y, Jin J. Radiomics Analysis of Fat Saturated T2-Weighted MRI Sequences for Prognostic Prediction to Soft-Tissue Sarcoma of the Extremities and Trunk Treated With Neoadjuvant Radiotherapy. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
29
|
Sun G, Wen G, Zhang Y, Tang Y, Jing H, Fang H, Wang J, Zhang J, Zhao X, Chen S, Song Y, Jin J, Liu Y, Tang Y, Qi S, Li N, Chen B, Lu N, Yang Y, Wang S, LI Y. Risk Factors to Identify the Indication for Regional Nodal Irradiation in T1-2N1M0 Breast Cancer: A Joint Analysis of 4243 Real-World Cases From Two Institutions. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
30
|
Zhao Y, Tang Y, Liu W, Li N, Song Y, Wang S, Liu Y, Fang H, Lu N, Tang Y, Qi S, Yang Y, Chen B, LI Y, Jin J. Long-Term Outcomes of Watch & Wait (W&W) after Neoadjuvant Treatment in Patients With Rectal Cancer. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
31
|
Cai S, Li Q, Zhou H, Xu Y, Song J, Gan C, Qi Z, Qi S. [Mechanism of PI3K/AKT/mTOR signaling pathway for mediating anti-inflammatory and anti-oxidant effects of chrysin: a protein microarray-based study]. Nan Fang Yi Ke Da Xue Xue Bao 2021; 41:1554-1561. [PMID: 34755672 DOI: 10.12122/j.issn.1673-4254.2021.10.15] [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: 11/24/2022]
Abstract
OBJECTIVE To investigate the mechanism of PI3K/AKT/mTOR signaling pathway for mediating the anti-inflammatory and anti-oxidant effects of chrysin. METHODS RAW264.7 cells were treated with different concentrations of chrysin for 24 h, and the changes in cell viability were detected using CCK-8 method. The cells with or without chrysin pretreatment for 2 h were stimulated with lipopolysaccharide (LPS) for different lengths of time, and the related signal molecules were screened using protein chip technique. In cells pretreated with chrysin for 2 h followed by LPS stimulation for 18 h, the release of IL-6, MCP-1 and TNF-α by the cells was detected with ELISA, and NO production was examined using Griess method, and ROS level was determined using DCFH-DA. The effects of chrysin, LPS, and their combination on the mRNA expressions of iNOS and COX-2 were detected using RT-PCR; Western blotting was performed to examine the changes in cellular expressions of p-AKT, p-PRAS40, p-mTOR, mTOR, p-P70S6k, p-S6RP and S6RP following the treatments with LPS, N-Acetyl-L-cysteine, and chrysin, alone or in combinations. RESULTS Chrysin below 60 μg/mL did not significantly affect the viability of RAW264.7 cells (P>0.05). Chrysin treatment significantly reduced the release of IL-6, MCP-1, and TNF-α and the level of NO (P < 0.01), and inhibited the mRNA and protein expressions of iNOS and COX-2 (P < 0.01) in the cells. The results of protein chip screening suggested that LPS could activate the AKT/mTOR pathway, which was significantly inhibited by chrysin pretreatment, and the results were verified by Western blotting (P < 0.01). Chrysin treatment significantly reduced the generation of endogenous ROS, and treatment with N-Acetyl-L-cysteine to eliminate intracellular ROS obviously reduced the expressions of iNOS and COX-2 (P < 0.05) and blocked the AKT/mTOR pathway (P < 0.05). CONCLUSION Chrysin can inhibit the synthesis of the upstream signaling molecule ROS to inhibit the activation of AKT/mTOR signaling pathway, regulate the translation process of ribosomes, down-regulate the synthesis and release of pro-inflammatory cytokines and inflammatory mediators, and thus produce anti-inflammatory effects.
Collapse
Affiliation(s)
- S Cai
- Key Laboratory of Active Macromolecules, Wannan Medical College, Wuhu 241002, China
| | - Q Li
- Key Laboratory of Active Macromolecules, Wannan Medical College, Wuhu 241002, China.,Department of Human Anatomy, Wannan Medical College, Wuhu 241002, China
| | - H Zhou
- Key Laboratory of Active Macromolecules, Wannan Medical College, Wuhu 241002, China
| | - Y Xu
- Key Laboratory of Active Macromolecules, Wannan Medical College, Wuhu 241002, China
| | - J Song
- Key Laboratory of Active Macromolecules, Wannan Medical College, Wuhu 241002, China
| | - C Gan
- Key Laboratory of Active Macromolecules, Wannan Medical College, Wuhu 241002, China
| | - Z Qi
- Department of Biochemistry and Molecular Biology, Wannan Medical College, Wuhu 241002, China.,Key Laboratory of Active Macromolecules, Wannan Medical College, Wuhu 241002, China
| | - S Qi
- Department of Biochemistry and Molecular Biology, Wannan Medical College, Wuhu 241002, China.,Key Laboratory of Active Macromolecules, Wannan Medical College, Wuhu 241002, China
| |
Collapse
|
32
|
Janne P, Wang M, Mitchell P, Fang J, Nian W, Chiu C, Zhou J, Zhao Y, Su W, Camidge D, Yang T, Zhu V, Millward M, Fan Y, Huang W, Cheng Y, Jiang L, Brungs D, Bazhenova L, Lee C, Gao B, Qi S, Yu X, Deng C, Chen K, Ye X, Zheng L, Yang Z, Yang J. OA15.02 Phase 1 Studies of DZD9008, an Oral Selective EGFR/HER2 Inhibitor in Advanced NSCLC with EGFR Exon20 Insertion Mutations. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
33
|
Zhang R, Qi S, Dai W, Chen S, Zhang Y, Tian W, Yan W, Kong M, Tian J, Su D. Publication trends and hotspots in enhanced recovery after surgery: 20-year bibliometric analysis. Br J Surg 2021; 108:e62-e64. [PMID: 33711108 DOI: 10.1093/bjs/znaa076] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Indexed: 12/20/2022]
Abstract
We evaluated enhanced recovery after surgery (ERAS) research and used bibliometric analysis to quantitatively and qualitatively predict research hotspots through extracting relevant publications from the core collection of the Web of Science database.
Collapse
Affiliation(s)
- R Zhang
- Department of Anaesthesiology, Renji Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - S Qi
- Department of Anaesthesiology, Renji Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - W Dai
- Department of Anaesthesiology, Renji Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - S Chen
- Department of Anaesthesiology, Renji Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Y Zhang
- Department of Anaesthesiology, Renji Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - W Tian
- Department of Anaesthesiology, Renji Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - W Yan
- Department of Anaesthesiology, Renji Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - M Kong
- Department of Anaesthesiology, Renji Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - J Tian
- Department of Anaesthesiology, Renji Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - D Su
- Department of Anaesthesiology, Renji Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| |
Collapse
|
34
|
Li Z, Zhou T, Chen N, Shahzad MA, Zhang B, Qi S. Flow and heat transfer characteristics in rough micro-channels. KERNTECHNIK 2021. [DOI: 10.3139/124.190001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
35
|
Zhai Y, Fang H, Zhao X, Yang Z, Chen B, Wang S, Tang Y, Qi S, Liu Y, LI Y. Radiation Induced Pneumonitis after Whole Breast Radiation: A Cross-Sectional Study. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
36
|
Tang Y, Wang S, Li Y, Fang H, Jing H, Liu Y, Jin J, Song Y, Chen B, Tang Y, Lu N, Yang Y, Qi S, Li N. A Phase II Study of Hypofractionated Whole-Breast Radiation With Simultaneous Tumor Bed Boost after Breast Conserving Surgery. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
37
|
Romero-Ruiz A, Skorupskaite K, Gaytan F, Torres E, Perdices-Lopez C, Mannaerts BM, Qi S, Leon S, Manfredi-Lozano M, Lopez-Rodriguez C, Avendaño MS, Sanchez-Garrido MA, Vazquez MJ, Pinilla L, van Duin M, Kohout TA, Anderson RA, Tena-Sempere M. Kisspeptin treatment induces gonadotropic responses and rescues ovulation in a subset of preclinical models and women with polycystic ovary syndrome. Hum Reprod 2020; 34:2495-2512. [PMID: 31820802 PMCID: PMC6936723 DOI: 10.1093/humrep/dez205] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 08/25/2019] [Indexed: 12/14/2022] Open
Abstract
STUDY QUESTION Can kisspeptin treatment induce gonadotrophin responses and ovulation in preclinical models and anovulatory women with polycystic ovary syndrome (PCOS)? SUMMARY ANSWER Kisspeptin administration in some anovulatory preclinical models and women with PCOS can stimulate reproductive hormone secretion and ovulation, albeit with incomplete efficacy. WHAT IS KNOWN ALREADY PCOS is a prevalent, heterogeneous endocrine disorder, characterized by ovulatory dysfunction, hyperandrogenism and deregulated gonadotrophin secretion, in need of improved therapeutic options. Kisspeptins (encoded by Kiss1) are master regulators of the reproductive axis, acting mainly at GnRH neurons, with kisspeptins being an essential drive for gonadotrophin-driven ovarian follicular maturation and ovulation. Altered Kiss1 expression has been found in rodent models of PCOS, although the eventual pathophysiological role of kisspeptins in PCOS remains unknown. STUDY DESIGN, SIZE, DURATION Gonadotrophin and ovarian/ovulatory responses to kisspeptin-54 (KP-54) were evaluated in three preclinical models of PCOS, generated by androgen exposures at different developmental windows, and a pilot exploratory cohort of anovulatory women with PCOS. PARTICIPANTS/MATERIALS, SETTING, METHODS Three models of PCOS were generated by exposure of female rats to androgens at different periods of development: PNA (prenatal androgenization; N = 20), NeNA (neonatal androgenization; N = 20) and PWA (post-weaning androgenization; N = 20). At adulthood (postnatal day 100), rats were subjected to daily treatments with a bolus of KP-54 (100 μg/kg, s.c.) or vehicle for 11 days (N = 10 per model and treatment). On Days 1, 4, 7 and 11, LH and FSH responses were assessed at different time-points within 4 h after KP-54 injection, while ovarian responses, in terms of follicular maturation and ovulation, were measured at the end of the treatment. In addition, hormonal (gonadotrophin, estrogen and inhibin B) and ovulatory responses to repeated KP-54 administration, at doses of 6.4-12.8 nmol/kg, s.c. bd for 21 days, were evaluated in a pilot cohort of anovulatory women (N = 12) diagnosed with PCOS, according to the Rotterdam criteria. MAIN RESULTS AND THE ROLE OF CHANCE Deregulated reproductive indices were detected in all PCOS models: PNA, NeNA and PWA. Yet, anovulation was observed only in NeNA and PWA rats. However, while anovulatory NeNA rats displayed significant LH and FSH responses to KP-54 (P < 0.05), which rescued ovulation, PWA rats showed blunted LH secretion after repeated KP-54 injection and failed to ovulate. In women with PCOS, KP-54 resulted in a small rise in LH (P < 0.05), with an equivalent elevation in serum estradiol levels (P < 0.05). Two women showed growth of a dominant follicle with subsequent ovulation, one woman displayed follicle growth but not ovulation and desensitization was observed in another patient. No follicular response was detected in the other women. LIMITATIONS, REASONS FOR CAUTION While three different preclinical PCOS models were used in order to capture the heterogeneity of clinical presentations of the syndrome, it must be noted that rat models recapitulate many but not all the features of this condition. Additionally, our pilot study was intended as proof of principle, and the number of participants is low, but the convergent findings in preclinical and clinical studies reinforce the validity of our conclusions. WIDER IMPLICATIONS OF THE FINDINGS Our first-in-rodent and -human studies demonstrate that KP-54 administration in anovulatory preclinical models and women with PCOS can stimulate reproductive hormone secretion and ovulation, albeit with incomplete efficacy. As our rat models likely reflect the diversity of PCOS phenotypes, our results argue for the need of personalized management of anovulatory dysfunction in women with PCOS, some of whom may benefit from kisspeptin-based treatments. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by research agreements between Ferring Research Institute and the Universities of Cordoba and Edinburgh. K.S. was supported by the Wellcome Trust Scottish Translational Medicine and Therapeutics Initiative (STMTI). Some of this work was undertaken in the MRC Centre for Reproductive Health which is funded by the MRC Centre grant MR/N022556/1. M.T.-S. is a member of CIBER Fisiopatología de la Obesidad y Nutrición, which is an initiative of Instituto de Salud Carlos III. Dr Mannaerts is an employee of Ferring International PharmaScience Center (Copenhagen, Denmark), and Drs Qi, van Duin and Kohout are employees of the Ferring Research Institute (San Diego, USA). Dr Anderson and Dr Tena-Sempere were recipients of a grant support from the Ferring Research Institute, and Dr Anderson has undertaken consultancy work and received speaker fees outside this study from Merck, IBSA, Roche Diagnostics, NeRRe Therapeutics and Sojournix Inc. Dr Skorupskaite was supported by the Wellcome Trust through the Scottish Translational Medicine and Therapeutics Initiative 102419/Z/13/A. The other authors have no competing interest.
Collapse
Affiliation(s)
- A Romero-Ruiz
- Department of Cell Biology, Physiology & Immunology, University of Córdoba, 14004 Córdoba, Spain.,Maimónides Institute of Biomedical Research of Córdoba (IMIBIC)/Reina Sofia University Hospital, 14004 Córdoba, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 14004 Córdoba, Spain
| | - K Skorupskaite
- MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK
| | - F Gaytan
- Department of Cell Biology, Physiology & Immunology, University of Córdoba, 14004 Córdoba, Spain.,Maimónides Institute of Biomedical Research of Córdoba (IMIBIC)/Reina Sofia University Hospital, 14004 Córdoba, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 14004 Córdoba, Spain
| | - E Torres
- Department of Cell Biology, Physiology & Immunology, University of Córdoba, 14004 Córdoba, Spain.,Maimónides Institute of Biomedical Research of Córdoba (IMIBIC)/Reina Sofia University Hospital, 14004 Córdoba, Spain
| | - C Perdices-Lopez
- Department of Cell Biology, Physiology & Immunology, University of Córdoba, 14004 Córdoba, Spain.,Maimónides Institute of Biomedical Research of Córdoba (IMIBIC)/Reina Sofia University Hospital, 14004 Córdoba, Spain
| | - B M Mannaerts
- Ferring International PharmaScience Center, Copenhagen, Denmark
| | - S Qi
- Ferring Research Institute, San Diego, CA 92121, USA
| | - S Leon
- Department of Cell Biology, Physiology & Immunology, University of Córdoba, 14004 Córdoba, Spain.,Maimónides Institute of Biomedical Research of Córdoba (IMIBIC)/Reina Sofia University Hospital, 14004 Córdoba, Spain
| | - M Manfredi-Lozano
- Department of Cell Biology, Physiology & Immunology, University of Córdoba, 14004 Córdoba, Spain.,Maimónides Institute of Biomedical Research of Córdoba (IMIBIC)/Reina Sofia University Hospital, 14004 Córdoba, Spain
| | - C Lopez-Rodriguez
- Department of Cell Biology, Physiology & Immunology, University of Córdoba, 14004 Córdoba, Spain.,Maimónides Institute of Biomedical Research of Córdoba (IMIBIC)/Reina Sofia University Hospital, 14004 Córdoba, Spain
| | - M S Avendaño
- Department of Cell Biology, Physiology & Immunology, University of Córdoba, 14004 Córdoba, Spain.,Maimónides Institute of Biomedical Research of Córdoba (IMIBIC)/Reina Sofia University Hospital, 14004 Córdoba, Spain
| | - M A Sanchez-Garrido
- Department of Cell Biology, Physiology & Immunology, University of Córdoba, 14004 Córdoba, Spain.,Maimónides Institute of Biomedical Research of Córdoba (IMIBIC)/Reina Sofia University Hospital, 14004 Córdoba, Spain
| | - M J Vazquez
- Department of Cell Biology, Physiology & Immunology, University of Córdoba, 14004 Córdoba, Spain.,Maimónides Institute of Biomedical Research of Córdoba (IMIBIC)/Reina Sofia University Hospital, 14004 Córdoba, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 14004 Córdoba, Spain
| | - L Pinilla
- Department of Cell Biology, Physiology & Immunology, University of Córdoba, 14004 Córdoba, Spain.,Maimónides Institute of Biomedical Research of Córdoba (IMIBIC)/Reina Sofia University Hospital, 14004 Córdoba, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 14004 Córdoba, Spain
| | - M van Duin
- Ferring Research Institute, San Diego, CA 92121, USA
| | - T A Kohout
- Ferring Research Institute, San Diego, CA 92121, USA
| | - R A Anderson
- MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK
| | - M Tena-Sempere
- Department of Cell Biology, Physiology & Immunology, University of Córdoba, 14004 Córdoba, Spain.,Maimónides Institute of Biomedical Research of Córdoba (IMIBIC)/Reina Sofia University Hospital, 14004 Córdoba, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 14004 Córdoba, Spain.,FiDiPro Program, Institute of Biomedicine, University of Turku, Kiinamyllynkatu 10, FIN-20520 Turku, Finland
| |
Collapse
|
38
|
Qi S, Yan B, Liu C, Wang C, Zhang L. Predictive significance of Charcot-Leyden Crystal mRNA levels in nasal brushing for nasal polyp recurrence. Rhinology 2020; 58:166-174. [PMID: 31884512 DOI: 10.4193/rhin19.296] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Tissue eosinophils have been shown to be associated with polyp recurrence in chronic rhinosinusitis with nasal polyps (CRSwNP). We addressed whether the mRNA levels of Charcot-Leyden Crystal (CLC) in nasal brushing samples, a molecule mainly released from activated eosinophils, could serve as an effective non-invasive biomarker to predict polyp recurrence. METHODS A total of 51 patients with CRSwNP completing the postoperative follow-up over a period of 12-18 months were enrolled. Baseline CLC mRNA levels of the nasal brushings collected prior to endoscopic sinus surgery were quantified by quantitative real-time polymerase chain reaction (qRT-PCR). Polyp specimens were collected during surgery and were evaluated for inflammatory cells by histopathologic staining. The patients' baseline characteristics were reviewed and analyzed for associations with recurrence. Logistic regression analysis was performed to determine the predictive factors for polyp recurrence, and receiver operating characteristic (ROC) curves were performed to determine their predictive values. RESULTS Overall, 25/51(49.02%) patients experienced polyp recurrence during the 12-18 months follow-up. The baseline relative CLC mRNA level in nasal brushing samples was significantly increased in patients with recurrence compared to those without recurrence (p.
Collapse
Affiliation(s)
- S Qi
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, P.R. China; Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, P.R. China
| | - B Yan
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, P.R. China; Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, P.R. China
| | - C Liu
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, P.R. China; Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, P.R. China
| | - C Wang
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, P.R. China; Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, P.R. China
| | - L Zhang
- Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, P.R. China; Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, P.R. China; Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing, P.R. China
| |
Collapse
|
39
|
Yu T, Yao H, Qi S, Wang J. GC-MS analysis of volatiles in cinnamon essential oil extracted by different methods. Grasas y Aceites 2020. [DOI: 10.3989/gya.0462191] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Cinnamon essential oil (CEO) was extracted by three different methods: steam distillation (SD), ultrasound-assisted steam distillation (UASD) and microwave-assisted steam distillation (MASD). The volatiles in CEO were separated and identified by gas chromatography–mass spectrometry (GC-MS), and the differences in volatiles among the three different methods were further analyzed through principal component analysis. The results showed that 36 individual volatile components were present in the CEO from the three different methods. In general, the numbers of aldehydes, esters, alcohols, terpenes, aromatics and ketones were 6, 3, 7, 17, 2, and 1, respectively. The most abundant volatile component was determined to be cinnamic aldehyde. The content of total cinnamic aldehydes, which determines the price of CEO, was the highest among the three methods in the UASD sample (85.633%). Moreover, the highest yield (8.33‰) of essential oil was extracted by the UASD method. Therefore, UASD was the best way for CEO extraction in this research and was recommended for future industrial applications.
Collapse
|
40
|
Aggarwal R, Jackson S, Qi S, Lemke N, Kelly R, Huddleston S. Functional Status and Time Since Primary Lung Transplant Predict Survival after Redo Lung Transplant. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
41
|
Overbeck N, Nagvajara GM, Ferzoco S, May BCH, Beierschmitt A, Qi S. In-vivo evaluation of a reinforced ovine biologic: a comparative study to available hernia mesh repair materials. Hernia 2020; 24:1293-1306. [PMID: 32006122 PMCID: PMC7701079 DOI: 10.1007/s10029-019-02119-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 12/30/2019] [Indexed: 12/11/2022]
Abstract
Purpose Two innovative reinforced biologic materials were studied in a non-human primate hernia repair model. The test articles, which combine layers of ovine decellularized extracellular matrix with minimal amounts of synthetic polymer, were evaluated for their biologic performance as measured by inflammatory response, healing kinetics, integration, and remodeling into functional host tissue. For comparison, seven clinically used biologic and synthetic meshes were also studied. Methods Animals were implanted with test articles in surgically created full-thickness midline abdominal wall defects, and evaluated macroscopically and histologically at 4, 12, and 24 weeks. Results Macroscopically, biologics resorbed and remodeled into naturally appearing tissue; the reinforced biologics appeared similar, but remodeled earlier and were less prone to stretch. Synthetics developed a layer of reactive tissue above and separate from the contracted mesh structure. At early time points, the collagen networks of biologics and reinforced biologics were infiltrated by host cells primarily as a peripheral layer on the biologics. As early as 12 weeks, the collagen networks associated with the reinforced biologics remodeled into organized host collagen. By 24 weeks, both reinforced biologics and biologics had low levels of inflammation. In contrast, a foreign body response persisted at 24 weeks with the synthetics, which had developed less organized collagen, separate in space from the actual mesh. Conclusions The current study shows a favorable response to reinforced biologics, which were associated with an initial inflammatory response, resolving by later time points, followed by active remodeling, and the formation of new morphologically functional collagen. Electronic supplementary material The online version of this article (10.1007/s10029-019-02119-z) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
| | | | - S Ferzoco
- Department of Surgery, Atrius Health, Dedham, MA, USA
| | - B C H May
- Aroa Biosurgery Limited, Auckland, New Zealand
| | - A Beierschmitt
- Behavioural Science Foundation, Basseterre, Saint Kitts and Nevis
| | - S Qi
- University of Montreal, Montreal, QC, Canada
| |
Collapse
|
42
|
Chen R, Tang S, Lu Q, Zhang X, Zhang W, Chen Z, Qi S. A 9-year experience study of single-port micro-laparoscopic repair of pediatric inguinal hernia using a simple needle. Hernia 2019; 24:639-644. [PMID: 31893317 PMCID: PMC7210235 DOI: 10.1007/s10029-019-02079-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 11/03/2019] [Indexed: 11/11/2022]
Abstract
Purpose As laparoscopic techniques and equipments improve, laparoscopic inguinal hernia repair has been gaining popularity. The objective of the study was to summarize 9 years of experience using a single-port micro-laparoscopic approach to repair pediatric inguinal hernias with a simple hernia needle. Methods 1880 children with inguinal hernias were enrolled using micro-laparoscopic surgery between June 2009 and 2018. All patients underwent high ligation surgery using a single-port micro-laparoscopic technique. The clinical data were retrospectively analyzed. Results All micro-laparoscopic surgeries were successfully performed in the 1880 patients, who ranged in age from 2 months to 14 years (3.66 ± 2.96 years) including 1622 males and 258 females. Among them, 1299 cases were unilateral hernias and 581 cases were bilateral hernias. The average operating time was 12.5 ± 3.5 min for a unilateral hernia and 20.5 ± 4.5 min for bilateral hernias. All patients were discharged 1–2 days after surgery, and the average length of their hospital stay was 2–4 days. Complications of knot reaction and pneumoscrotum occurred in 5 cases (0.27%) and 54 cases (2.87%), respectively, but these cases were properly managed, with no major impact on the operational outcomes. All patients were followed up for 3–65 months; there were 13 recurrent cases (0.69%). Conclusions Single-port micro-laparoscopic herniorrhaphy in children using a simple hernia needle is a reliable and minimally invasive procedure.
Collapse
Affiliation(s)
- R Chen
- Department of General Surgery, Tungwah Hospital Affiliated With Sun Yat-Sen University, Dongguan, 523110, Guangdong, China
| | - S Tang
- Department of General Surgery, Tungwah Hospital Affiliated With Sun Yat-Sen University, Dongguan, 523110, Guangdong, China.
| | - Q Lu
- Department of General Surgery, Tungwah Hospital Affiliated With Sun Yat-Sen University, Dongguan, 523110, Guangdong, China
| | - X Zhang
- Department of General Surgery, Tungwah Hospital Affiliated With Sun Yat-Sen University, Dongguan, 523110, Guangdong, China
| | - W Zhang
- Department of General Surgery, Tungwah Hospital Affiliated With Sun Yat-Sen University, Dongguan, 523110, Guangdong, China
| | - Z Chen
- Department of General Surgery, Tungwah Hospital Affiliated With Sun Yat-Sen University, Dongguan, 523110, Guangdong, China
| | - S Qi
- Department of General Surgery, Tungwah Hospital Affiliated With Sun Yat-Sen University, Dongguan, 523110, Guangdong, China
| |
Collapse
|
43
|
Wang WN, Qi S, Wang YN. [Blastic plasmacytoid dendritic cell neoplasm in testicle: report of a case]. Zhonghua Bing Li Xue Za Zhi 2019; 48:730-732. [PMID: 31495099 DOI: 10.3760/cma.j.issn.0529-5807.2019.09.016] [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)
- W N Wang
- Department of Pathology, Affiliated Hospital of Hebei University, Baoding 071000, China
| | - S Qi
- Department of Pathology, Gaoyang Hospital, Hebei Province, Gaoyang 071500, China
| | - Y N Wang
- Department of Pathology, Affiliated Hospital of Hebei University, Baoding 071000, China
| |
Collapse
|
44
|
Yang Y, Qi S, Liu W, Su H, Wang Y, He X, Zhang L, Wu G, Qu B, Qian L, Xiaorong H, Zhang F, Qiao X, WANG H, Li G, Zhang Y, Zhu Y, Cao J, Lan S, Wu J, Wu T, Zhu S, Shi M, Li-ming X, Yuan Z, Liu X, Song Y, Li Y. Treatment Benefit Associating with Non-Anthracycline Chemotherapy in Extranodal NK/T-Cell Lymphoma, Nasal Type: A Multicenter Study from the China Lymphoma Collaborative Group (CLCG). Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
45
|
Yang Z, Huang Z, Wang S, Tang Y, Jing H, Wang J, Zhang J, Yang Y, Song Y, Fang H, Jin J, Liu Y, Qi S, Li N, Tang Y, Lu N, Chen B, LI Y. Modeling and Validation of a Nomogram to Predict N2 or N3 Disease in Breast Cancer Patients with One to Three Sentinel Lymph Nodes. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
46
|
Wang S, Wen G, Tang Y, Yang Y, Peng R, Jing H, Wang J, Zhang J, Zhao X, Sun G, Jin J, Liu Y, Song Y, Fang H, Ren H, Tang Y, Qi S, Li N, Chen B, Lu N, Yu Z, Zhang Y, LI Y. Recurrence Score Helps in Selecting T1-2N1 Breast Cancer Patients for Individualized Postmastectomy Radiotherapy – Joint Analysis of 2793 Patients from Two Institutions. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
47
|
Chen B, Li Y, Wang W, Tan Y, Wang S, Zheng X, Chen S, Zhao Y, Jin J, Fang H, Qi S, Li N, Liu Y, Tang Y, Yu T, Song Y. Efficacy and Prognosis of Radiotherapy for Hepatocellular Carcinoma with Tumor Thrombosis in Main Portal Vein or/and Vena Cava. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.2061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
48
|
Ma M, Wang S, Tang Y, Miao J, Zhao B, Qin S, Zhang J, Qi S, Ma Y, Liu X, LI Y. Use of Isocenter Bilateral Tangential Fields Combined with Intensity-Modulated Radiation Therapy for Synchronous Bilateral Whole-Breast Irradiation: A Dosimetric Study. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.2391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
49
|
Yu S, Chen S, Wang S, Tang Y, Li M, Song Y, Jin J, Liu Y, Fang H, Chen B, Qi S, Li N, Tang Y, Lu N, LI Y. Deep Inspiration Breath Hold Provides Fewer Set-up Errors Compared with Free Breathing for Whole-Breast Radiation. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
50
|
Abulimiti M, Jin J, Liu W, Li S, Tang Y, Li N, Tang Y, Wang S, Song Y, Liu Y, Fang H, Lu N, Qi S, Chen B, LI Y. Long Term Efficacy of Preoperative Chemotherapy or Chemoradiotherapy Combined with Total Mesorectal Excision for Locally Advanced Rectal Cancer: Retrospective Analysis of 305 Patients. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.2075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|