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Deng X, Liao Z. A machine-learning model based on dynamic contrast-enhanced MRI for preoperative differentiation between hepatocellular carcinoma and combined hepatocellular-cholangiocarcinoma. Clin Radiol 2024; 79:e817-e825. [PMID: 38413354 DOI: 10.1016/j.crad.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/31/2024] [Accepted: 02/04/2024] [Indexed: 02/29/2024]
Abstract
AIM To establish a machine-learning model based on dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) to differentiate combined hepatocellular-cholangiocarcinoma (cHCC-CC) from hepatocellular carcinoma (HCC) before surgery. MATERIALS AND METHODS Clinical and MRI data of 194 patients with histopathologically diagnosed cHCC-CC (n=52) or HCC (n=142) were analysed retrospectively. ITK-SNAP software was used to delineate three-dimensional (3D) lesions and extract high-throughput features. Feature selection was carried out based on Pearson's correlation coefficient and least absolute shrinkage and selection operator (LASSO) regression analysis. A radiomics model (radiomics features), a clinical model (i.e., clinical-image features), and a fusion model (i.e., radiomics features + clinical-image features) were established using six machine-learning classifiers. The performance of each model in distinguishing between cHCC-CC and HCC was evaluated with the receiver operating characteristic (ROC) curve, the area under the ROC curve (AUC), sensitivity, and specificity. RESULTS Significant differences in liver cirrhosis, tumour number, shape, edge, peritumoural enhancement in the arterial phase, and lipid were identified between cHCC-CC and HCC patients (p<0.05). The AUC of the fusion model based on logistic regression was 0.878 (95% CI: 0.766-0.949) in the arterial phase in the test set, and the sensitivity/specificity was 0.844/0.714; however, the AUC of the clinical and radiomics models was 0.759 (95% CI: 0.663-0.861) and 0.838 (95% CI: 0.719-0.921) in the test set, respectively. CONCLUSION The fusion model based on DCE-MRI in the arterial phase can significantly improve the diagnostic rate of cHCC-CC and HCC as compared with conventional approaches.
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Affiliation(s)
- X Deng
- Medical Imaging Center, Ganzhou People's Hospital, 16th Meiguan Avenue, Ganzhou 341000, China; Ganzhou Institute of Medical Imaging, Ganzhou 341000, China; Ganzhou Key Laboratory of Medical Imaging and Artificial Intelligence, Ganzhou 341000, China
| | - Z Liao
- Medical Imaging Center, Ganzhou People's Hospital, 16th Meiguan Avenue, Ganzhou 341000, China; Ganzhou Institute of Medical Imaging, Ganzhou 341000, China; Ganzhou Key Laboratory of Medical Imaging and Artificial Intelligence, Ganzhou 341000, China.
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2
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Zhong Y, Jia B, Xie C, Hu L, Liao Z, Liu W, Zhang Y, Huang G. Adenylate kinase 4 promotes neuronal energy metabolism and mitophagy in early cerebral ischemia via Parkin/PKM2 pathway. Exp Neurol 2024; 377:114798. [PMID: 38670251 DOI: 10.1016/j.expneurol.2024.114798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 04/15/2024] [Accepted: 04/23/2024] [Indexed: 04/28/2024]
Abstract
Mitochondrial dysfunction is closely related to brain injury and neurological dysfunction in ischemic stroke. Adenylate kinase 4 (AK4) plays a critical role in energy metabolism and mitochondrial homeostasis. However, the underlying mechanisms remain unclear. In the present study, we demonstrated an important role of AK4 in mitochondrial dysfunction in the early cerebral ischemia. Early focal cerebral ischemia induced decrease of AK4 protein expression in ischemic hemispheric brain tissue in mice. Exposure of cultured primary neuron to oxygen-glucose deprivation (OGD) also induced AK4 downregulation. Overexpression of AK4 in neuron using adeno-associated virus (AAV-AK4) in mice promoted neuronal survival reflected by decreased infarction volume and TUNEL staining. AK4 overexpression inhibited mitochondrial decline and downregulation of energy metabolism-associated proteins (p-AMPK and ATP1A3) induced by MCAO. Moreover, AK4 knock-in using lentivirus carried AK4 vector (LV-AK4) induced energy metabolism shift from glycolysis to oxidation in neuron. Using transmission electron microscope and western blot, we revealed that AK4 overexpression promoted mitophagy and mitophagy-associated proteins expression PINK1 and Parkin after MCAO. Mass spectrometry and co-immunoprecipitation revealed an interaction between AK4 and PKM2. Mechanistically, AK4 indirectly decreased PKM2 expression via enhancing its ubiquitination by increasing the interaction between PKM2 and its ubiquitin E3 ligase Parkin, and inhibits Parkin downregulation. In conclusion, our data demonstrate that AK4/ Parkin /PKM axis prevents cerebral ischemia damage via regulation of neuronal energy metabolism model and mitophagy. AK4 was a new target for intervention of early ischemic neuron injury.
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Affiliation(s)
- Yunxue Zhong
- Department of Neurosurgery, Shenzhen Key Laboratory of Neurosurgery, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen 518035, China; Department of Neurosurgery, Graduate Collaborative Training Base of Shenzhen Second People's Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, China
| | - Bingbing Jia
- Department of Neurosurgery, Shenzhen Key Laboratory of Neurosurgery, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen 518035, China; Department of Neurosurgery, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Guangxi University of Chinese Medicine, Shenzhen 518035, China
| | - Cong Xie
- Department of Neurosurgery, Shenzhen Key Laboratory of Neurosurgery, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen 518035, China
| | - Linghui Hu
- Department of Neurosurgery, Shenzhen Key Laboratory of Neurosurgery, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen 518035, China; Department of Neurosurgery, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Graduate School of Guangzhou Medical University, Shenzhen 518035, China
| | - Zijun Liao
- Department of Neurosurgery, Shenzhen Key Laboratory of Neurosurgery, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen 518035, China
| | - Wenlan Liu
- Department of Neurosurgery, Shenzhen Key Laboratory of Neurosurgery, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen 518035, China.
| | - Yuan Zhang
- Department of Neurosurgery, Shenzhen Key Laboratory of Neurosurgery, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen 518035, China.
| | - Guodong Huang
- Department of Neurosurgery, Shenzhen Key Laboratory of Neurosurgery, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen 518035, China.
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Chen M, Li L, Xia Q, Chen X, Liao Z, Wang C, Shen B, Zhou M, Zhang Q, Zhang Y, Qian L, Yuan X, Wang Z, Xue C, An X, Liu B, Gu K, Hou M, Wang X, Wang W, Li E, Zhong J, Cheng J, Shu Y, Yang N, Wang H, Yang R, Liu T, Deng T, Ma F, Liao W, Qiu W, Chen Y, Chen X, Zhang M, Xu R, Li X, Feng J, Ba Y, Shi Y. A real-world observation on thrombopoietic agents for patients with cancer treatment-induced thrombocytopenia in China: A multicenter, cross-sectional study. Cancer 2024; 130:1524-1538. [PMID: 38515388 DOI: 10.1002/cncr.35292] [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: 08/31/2023] [Revised: 12/12/2023] [Accepted: 01/08/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND Studies on various thrombopoietic agents for cancer treatment-induced thrombocytopenia (CTIT) in China are lacking. This study aimed to provide detailed clinical profiles to understand the outcomes and safety of different CTIT treatment regimens. METHODS In this retrospective, cross-sectional study, 1664 questionnaires were collected from 33 hospitals between March 1 and July 1, 2021. Patients aged >18 years were enrolled who were diagnosed with CTIT and treated with recombinant interleukin 11 (rhIL-11), recombinant thrombopoietin (rhTPO), or a thrombopoietin receptor agonist (TPO-RA). The outcomes, compliance, and safety of different treatments were analyzed. RESULTS Among the 1437 analyzable cases, most patients were treated with either rhTPO alone (49.3%) or rhIL-11 alone (27.0%). The most common combination regimen used was rhTPO and rhIL-11 (10.9%). Platelet transfusions were received by 117 cases (8.1%). In multivariate analysis, rhTPO was associated with a significantly lower proportion of platelet recovery, platelet transfusion, and hospitalization due to chemotherapy-induced thrombocytopenia (CIT) than rhIL-11 alone. No significant difference was observed in the time taken to achieve a platelet count of >100 × 109/L and chemotherapy dose reduction due to CIT among the different thrombopoietic agents. The outcomes of thrombocytopenia in 170 patients who received targeted therapy and/or immunotherapy are also summarized. The results show that the proportion of platelet recovery was similar among the different thrombopoietic agents. No new safety signals related to thrombopoietic agents were observed in this study. A higher proportion of physicians preferred to continue treatment with TPO-RA alone than with rhTPO and rhIL-11. CONCLUSIONS This survey provides an overview of CTIT and the application of various thrombopoietic agents throughout China. Comparison of monotherapy with rhIL-11, rhTPO, and TPO-RA requires further randomized clinical trials. The appropriate application for thrombopoietic agents should depend on the pretreatment of platelets, treatment variables, and risk of bleeding. PLAIN LANGUAGE SUMMARY To provide an overview of the outcome of cancer treatment-induced thrombocytopenia in China, our cross-sectional study analyzed 1437 cases treated with different thrombopoietic agents. Most of the patients were treated with recombinant interleukin 11 (rhIL-11) and recombinant thrombopoietin (rhTPO). rhTPO was associated with a significantly lower proportion of platelet recovery and platelet transfusion compared with rhIL-11.
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Affiliation(s)
- Meiting Chen
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Lu Li
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Qing Xia
- Department of Oncology, Renji Hospital, Medical College of Shanghai Jiaotong University, Shanghai, China
| | - Xiaobing Chen
- Departement of Oncology, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Zijun Liao
- Departement of Medical Oncology, Shaanxi Cancer Hospital, Xi'an, China
| | - Chang Wang
- Department of Cancer Center, First Hospital of Jilin University, Changchun, China
| | - Bo Shen
- Department of Oncology, Jiangsu Cancer Institute, Nanjing, China
| | - Min Zhou
- Internal Medicine, Affiliated Cancer Hospital and Institute of Guangzhou Medical University, Guangzhou, China
| | - Qingyuan Zhang
- Department of Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Yanqiao Zhang
- Department of Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Liting Qian
- Division of Life Sciences and Medicine, Department of Radiation Oncology, The First Affiliated Hospital of University of Science and Technology of China, Hefei, China
| | - Xianglin Yuan
- Department of Oncology, Cancer Center of Union Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Zhehai Wang
- Department of Respiratory Medicine, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Cong Xue
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Xin An
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Bin Liu
- Internal Medicine, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Kangsheng Gu
- Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Mei Hou
- Lung Cancer Center, West China Hospital of Sichuan University, Chengdu, China
| | - Xiaojia Wang
- Department of Breast Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, China
| | - Wei Wang
- Internal Medicine, First People's Hospital of Foshan, Foshan, China
| | - Enxiao Li
- Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University Medical College, Xi'an, China
| | - Jincai Zhong
- The First Affiliated Hospital of Guangxi Medicine University, Nanning, China
| | - Jing Cheng
- Cancer Center of Union Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Yongqian Shu
- Department of Oncology, Jiangsu Province Hospital, Nanjing Medical University, Nanjing, China
| | - Nong Yang
- Department of Pharmacy, Hunan Cancer Hospital, Changsha, China
| | - Huaqing Wang
- Department of Medical Oncology, Tianjin People's Hospital, Tianjin, China
| | - Runxiang Yang
- Department of Oncology, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical College, Kunming, China
| | - Tianshu Liu
- Department of Medical Oncology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Ting Deng
- Department of Gastrointestinal Medical Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Clinical Research Center for Cancer, Tianjin, China
| | - Fei Ma
- Internal Medicine, Cancer Hospital of the Chinese Academy of Medical Sciences, Beijing, China
| | - Wangjun Liao
- Internal Medicine-Oncology, Southern Medical University Nanfang Hospital, Guangzhou, China
| | - Wensheng Qiu
- The Second Department of Oncology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yu Chen
- Department of Oncology, Fujian Provincial Cancer Hospital, Fuzhou, China
| | - Xi Chen
- Department of Medical Oncology, Fuzhou General Hospital of Nanjing Military Command, Fuzhou, China
| | - Mingzhi Zhang
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ruilian Xu
- Department of Medical Oncology, Shenzhen People's Hospital, Shenzhen, China
| | - Xiaoling Li
- Department of Thoracic Cancer 1, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China
| | - Jifeng Feng
- Department of Oncology, Jiangsu Cancer Institute, Nanjing, China
| | - Yi Ba
- Department of Gastrointestinal Medical Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Clinical Research Center for Cancer, Tianjin, China
| | - Yanxia Shi
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, China
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Altan M, Soto F, Xu T, Wilson N, Franco-Vega MC, Simbaqueba Clavijo CA, Shannon VR, Faiz SA, Gandhi S, Lin SH, Lopez P, Zhong L, Akhmedzhanov F, Godoy MCB, Shroff GS, Wu J, Khawaja F, Kim ST, Naing A, Heymach JV, Daniel-Macdougall C, Liao Z, Sheshadri A. Pneumonitis After Concurrent Chemoradiation and Immune Checkpoint Inhibition in Patients with Locally Advanced Non-small Cell Lung Cancer. Clin Oncol (R Coll Radiol) 2023; 35:630-639. [PMID: 37507279 DOI: 10.1016/j.clon.2023.07.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 06/20/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023]
Abstract
AIMS Pneumonitis is a common and potentially deadly complication of combined chemoradiation and immune checkpoint inhibition (CRT-ICI) in patients with locally advanced non-small cell lung cancer (LA-NSCLC). In this study we sought to identify the risk factors for pneumonitis with CRT-ICI therapy in LA-NSCLC cases and determine its impact on survival. MATERIALS AND METHODS We conducted a retrospective chart review of 140 patients with LA-NSCLC who underwent curative-intent CRT-ICI with durvalumab between 2018 and 2021. Pneumonitis was diagnosed by a multidisciplinary team of clinical experts. We used multivariable cause-specific hazard models to identify risk factors associated with grade ≥2 pneumonitis. We constructed multivariable Cox proportional hazard models to investigate the impact of pneumonitis on all-cause mortality. RESULTS The median age of the cohort was 67 years; most patients were current or former smokers (86%). The cumulative incidence of grade ≥2 pneumonitis was 23%. Among survivors, 25/28 patients had persistent parenchymal scarring. In multivariable analyses, the mean lung dose (hazard ratio 1.14 per Gy, 95% confidence interval 1.03-1.25) and interstitial lung disease (hazard ratio 3.8, 95% confidence interval 1.3-11.0) increased the risk for pneumonitis. In adjusted models, grade ≥2 pneumonitis (hazard ratio 2.5, 95% confidence interval 1.0-6.2, P = 0.049) and high-grade (≥3) pneumonitis (hazard ratio 8.3, 95% confidence interval 3.0-23.0, P < 0.001) were associated with higher all-cause mortality. CONCLUSIONS Risk factors for pneumonitis in LA-NSCLC patients undergoing CRT-ICI include the mean radiation dose to the lung and pre-treatment interstitial lung disease. Although most cases are not fatal, pneumonitis in this setting is associated with markedly increased mortality.
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Affiliation(s)
- M Altan
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - F Soto
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - T Xu
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - N Wilson
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - M C Franco-Vega
- Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - C A Simbaqueba Clavijo
- Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - V R Shannon
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - S A Faiz
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - S Gandhi
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - S H Lin
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - P Lopez
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - L Zhong
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - F Akhmedzhanov
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - M C B Godoy
- Department of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - G S Shroff
- Department of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - J Wu
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - F Khawaja
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - S T Kim
- Department of Rheumatology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - A Naing
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - J V Heymach
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - C Daniel-Macdougall
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Z Liao
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - A Sheshadri
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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Cavazos A, Iskander GM, Cox V, Cheng H, Ejezie CL, Perez S, Nguyen J, Beddar S, Liao Z, Yeboa DN. Protocol in a Day: An Educational Institutional Workshop for Protocol Development. Int J Radiat Oncol Biol Phys 2023; 117:e557-e558. [PMID: 37785710 DOI: 10.1016/j.ijrobp.2023.06.1871] [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 Protocol-in-a-Day (PIAD) workshop was developed to support junior faculty and residents with clinical trial protocol design, with the main goal of providing initial feedback during development to reduce time for review and approval from institutional oversight committees. Our objectives are to mentor and educate participants and to evaluate the time to institutional approval by oversight committees. MATERIALS/METHODS PIAD provided concurrent educational feedback on 6 key elements of trial design. These included: (1) regulatory aspects; (2) institutional scientific review committee (SRC) and institutional review board (IRB); (3) clinical research and data coordination (including nursing); (4) statistics; (5) correlatives including imaging, biospecimens, and health services research/patient-reported outcomes; and (6) operations. The average number of days from submission to IRB approval or study activation for PIAD protocols was compared to other protocols submitted between January 2018 - January 2022 within the Division of Radiation Oncology. Participants were also given a 15-question survey to assess their perspective of the impact of the workshop. RESULTS A total of 25 protocols went through the PIAD workshop between January 2018-January 2022. Of the 25 protocols, 7 (28%) were excluded from this study due to not being submitted possibly after participants benefited from education on the limitations of their design. Eighteen protocols were included in our final analyses. These protocols included phase II (n = 11), phase 1 (n = 5), and phase III (n = 2). At the time of this report, all protocols (n = 18) have received IRB approval and have been activated. Protocol elements that could impact study activation included protocols requiring investigational new drug (IND) approval (n = 8) and multicenter studies (n = 1). Analyzing the time of submission to request for activation showed a decrease in time for protocols that went through PIAD vs those that did not [PIAD protocols, 254 days vs All other protocols, 262 days]. Likewise, those who attended PIAD had a lower average time from submission to IRB Approval [ PIAD protocols, 40 days vs All other protocols, 59 days]. All participants (100%) of the PIAD workshop responded that the educational program "improved the overall quality of the study design." The most commonly cited changes were protocol language (n = 17), statistics (n = 15), consent language (n = 8), and study design (n = 8). Aspects participants identified as the most educational included mentorship from regulatory, clinical research finance, and IRB review. CONCLUSION PIAD from participant surveys provided high educational value in the areas of improving trial quality, language and statistical design. When analyzing the average time, from 'submission to IRB initial approval' and 'submission to activation', PIAD protocols had a shorter time for approval, and thus suggests PIAD is effective in improving the overall design of protocols.
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Affiliation(s)
- A Cavazos
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - G M Iskander
- MD Anderson Cancer Center, Houston, TX; Tillman J Fertitta Family College of Medicine, Houston, TX
| | - V Cox
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - H Cheng
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX; UT Southwestern Medical Center, Dallas, TX
| | - C L Ejezie
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S Perez
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - J Nguyen
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S Beddar
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Z Liao
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - D N Yeboa
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
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Wang B, Zhong C, Liao Z, Wang H, Cai X, Zhang Y, Wang J, Wang T, Yao H. Effectiveness and safety of human type 5 recombinant adenovirus (H101) in malignant tumor with malignant pleural effusion and ascites: A multicenter, observational, real-world study. Thorac Cancer 2023; 14:3051-3057. [PMID: 37675621 PMCID: PMC10599969 DOI: 10.1111/1759-7714.15101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/24/2023] [Accepted: 08/25/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND The aim of this study was to analyze the effectiveness and safety of H101 in Chinese patients with malignant pleural effusion and ascites (MPE/MA) in the real world. METHODS This multicenter, observational, real-world study recruited patients with MPE/MA caused by malignant tumor receiving H101-containing treatment between January 2020 and June 2022. Effectiveness was evaluated by overall remission rate (ORR), and safety was evaluated based on adverse events (AEs). Subgroup analysis was performed on patients grouped according to tumor type, the volume of MPE and MA, and dosage of H101. RESULTS A total of 643 eligible patients were enrolled, and 467 received H101 monotherapy and 176 received H101 combined with chemotherapy. The ORR of total patients was60.3% with 388 case of PR. In the H101 monotherapy group, the decrease of MPE or MA was achieved in 282 (60.4%, PR) patients, 176 (37.7%, NC) patients showed no change in volume of MPE or MA, and nine (1.9%, PD) patients showed an increase, yielding an ORR of 60.4% (282/467). The ORR for the combination therapy group was 60.2% (106/176), with 106 cases of PR, 69 cases of NC and one case of PD. Subgroup analyses based on tumor type, volume of MPE and MA, and dosage of H101 all showed high ORR, approximately 60%. The main AEs associated with H101-containing regimens were fever, nausea and vomiting. No serious AEs occurred in both groups. CONCLUSION Encouraging clinical benefits and manageable toxicity of H101 against MPE/MA were preliminarily observed in the real-world clinical setting, indicating that the H101-containing regimen is reliable, safe, and feasible, providing a novel and effective option for the treatment of this disease.
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Affiliation(s)
- Baocheng Wang
- Department of OncologyNo. 960 Hospital of PLAJinanPeople's Republic of China
| | - Chen Zhong
- Department of OncologyNo. 960 Hospital of PLAJinanPeople's Republic of China
| | - Zijun Liao
- Department of Medical OncologyShaanxi Provincial Cancer HospitalTaiyuanPeople's Republic of China
| | - Haitao Wang
- Department of OncologyThe Second Hospital of Tianjin Medical UniversityTianjinPeople's Republic of China
| | - Xiuyu Cai
- Department of General Internal MedicineSun Yat‐sen University Cancer CenterGuangzhouPeople's Republic of China
| | - Yanbing Zhang
- Department of Medical OncologyShaanxi Provincial Cancer HospitalTaiyuanPeople's Republic of China
| | - Jun Wang
- Department of OncologyThe First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan HospitalJinanPeople's Republic of China
| | - Tianxiao Wang
- Hepatobiliary Pancreatic Center, Beijing Tsinghua Changgung HospitalSchool of Clinical MedicineBeijingPeople's Republic of China
| | - Hongtao Yao
- Department of Medical AffairsGuangdong Techpool Bio‐pharma Co., Ltd.GuangzhouPeople's Republic of China
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Dudzinski SO, Cabanillas ME, Busaidy NL, Hu MI, Dadu R, Gunn GB, Reddy J, Phan J, Beckham T, Waguespack SG, Sherman S, Ying AK, Gandhi S, Wang C, Liao Z, Chang JY, Ludmir EB, Chen AB, Welsh JW, Ning MS. Definitive Radiotherapy for Oligometastatic and Oligoprogressive Thyroid Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e579. [PMID: 37785759 DOI: 10.1016/j.ijrobp.2023.06.1918] [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) Local consolidative radiotherapy (LCT) for oligometastatic disease is a promising paradigm improving outcomes for various malignancies but has been underexplored for metastatic thyroid cancer. We hypothesize that LCT to distant sites with definitive RT doses can yield favorable outcomes and defer systemic therapy escalation for these patients. MATERIALS/METHODS We reviewed 96 thyroid cancer patients who received 175 LCT courses from 2010-2022 to 228 metastatic sites, including: thorax (45%), bone (40%), brain (6%), head/neck (5%), and abdomen (3%). Common prescriptions were 50-55Gy/4-5fxs or 56-70Gy/8-10fxs for lung; 52.5-60Gy/15fxs for mediastinum; and 18-24Gy/1fx or 27-30Gy/3fxs for bone. RECIST v1.1 and CTCAE v5.0 were used to define progression and toxicities, respectively. Outcomes were evaluated via Kaplan-Meier and associations examined via Cox proportional hazards modeling. RESULTS Median age was 63 years (range: 26-92), with 62 oligometastatic cases (total 1-5 sites) and 34 oligoprogressive (with 1-5 growing sites). Primary disease was controlled in all patients, with 39% receiving post-op RT and 66% prior RAI. Histologies included papillary (40%), anaplastic (25%), follicular (12%), medullary (9%), Hurthle (7%), and poorly-differentiated (7%). Median time from initial diagnosis to LCT was 3 yrs (IQR 1-8), and median follow-up from 1st LCT was 21 mos (IQR 9-51). Patients received an average 2 LCT courses (range 1-8) treating 1-4 sites. Median survival (OS) from 1st LCT was 9 yrs (95% CI = 5-14). On multivariable analysis (MVA), worse OS was associated with anaplastic histology (HR 4.6, p<.01), but longer OS was associated with prior RAI (HR 0.33, p = .02) and oligometastatic disease (HR 0.3, p = .01). For anaplastic histology, median OS was 1.2 years vs. 9.3 years for non-anaplastic; 3-yr OS was 36% vs. 88% (log-rank, p<.01). Five-year OS for oligometastatic cases was 75% vs 53% for oligoprogressive (log-rank, p = .04). Median progression free survival (PFS) from 1st LCT was 15.5 mos (95% C I = 11-20). On MVA for all LCT courses, time to any progression (TTP) was negatively associated with anaplastic histology (HR 1.7, p = .02) and 2nd or higher LCT course (HR 1.45, p = .05), but favorably associated with thoracic site (HR 0.49, p<.01). Following later LCT courses, median TTP was 11 mos vs 17 mos for initial LCT course (log-rank, p = .03). After LCT to lung/chest, TTP was 18.6 mos vs 9.5 mos for non-thoracic sites (log-rank, p<.01). Only 6% of failures occurred at previously treated lesions. Most LCT courses (67%) were without ongoing chemotherapy, while 25% entailed continuing the same regimen and 9% had planned treatment post-RT. There were 2 Grade 3 toxicities (pneumonitis and esophagitis) and no Grade 4-5 events. CONCLUSION With high local control rates and minimal toxicity, LCT can be a feasible strategy to defer systemic therapy escalation for oligometastatic and oligoprogressive thyroid cancer.
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Affiliation(s)
- S O Dudzinski
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - M E Cabanillas
- Department of Endocrine Neoplasia & Hormonal Disorders, University of Texas MD Anderson Cancer Center, Houston, TX
| | - N L Busaidy
- Department of Endocrine Neoplasia & Hormonal Disorders, University of Texas MD Anderson Cancer Center, Houston, TX
| | - M I Hu
- Department of Endocrine Neoplasia & Hormonal Disorders, University of Texas MD Anderson Cancer Center, Houston, TX
| | - R Dadu
- Department of Endocrine Neoplasia & Hormonal Disorders, University of Texas MD Anderson Cancer Center, Houston, TX
| | - G B Gunn
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - J Reddy
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - J Phan
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - T Beckham
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S G Waguespack
- Department of Endocrine Neoplasia & Hormonal Disorders, University of Texas MD Anderson Cancer Center, Houston, TX
| | - S Sherman
- Department of Endocrine Neoplasia & Hormonal Disorders, University of Texas MD Anderson Cancer Center, Houston, TX
| | - A K Ying
- Department of Endocrine Neoplasia & Hormonal Disorders, University of Texas MD Anderson Cancer Center, Houston, TX
| | - S Gandhi
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - C Wang
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Z Liao
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - J Y Chang
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - E B Ludmir
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - A B Chen
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - J W Welsh
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - M S Ning
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
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Abana CO, Carriere PP, Damen P, van Rossum PSN, Bravo PL, Wei X, Pollard JM, Nitsch PL, Murphy MB, Hofstetter W, Liao Z, Lin SH. Long-Term Outcomes and Toxicity in Esophageal Cancer Patients after Neoadjuvant or Definitive Concurrent Chemotherapy with Proton Beam Therapy. Int J Radiat Oncol Biol Phys 2023; 117:e280-e281. [PMID: 37785050 DOI: 10.1016/j.ijrobp.2023.06.1262] [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) Proton-beam therapy (PT) is increasingly utilized over three dimensional-conformal radiation therapy (3D-CRT) and intensity modulated radiation therapy (IMRT) photon irradiation for the treatment of various malignancies due to better toxicity reduction. We investigated the long-term outcomes and toxicity in esophageal cancer (EC) patients treated with PT as part of their neoadjuvant concurrent chemoradiation followed by surgery (nCRT) or definitive concurrent chemoradiation (dCRT) treatment regimen. MATERIALS/METHODS All consecutively treated, American Joint Committee on Cancer 7th edition clinical stage I-IV EC patients from 2006 to 2022 were retrospectively analyzed. Standard RT dose for most patients was 50.4 Gy/28 fractions. nCRT patients had surgery within 4 months post-RT. Kaplan-Meier method was used to determine overall survival (OS), locoregional recurrence-free survival (LRRFS) and distant metastatic-free survival (DMFS). Acute and chronic RT-related toxicities were graded with Common Terminology Criteria for Adverse Events version 4.0. RESULTS There were 510 EC PT patients: 204 (40%) had nCRT and 306 (60%) had dCRT. Most lesions were located in the lower esophagus, of adenocarcinoma histology and treated with passive scatter PT. Overall median follow-up was 72 months. Median, 3- and 5-year OS for all patients were 43 months, 54.1% and 44.9%, respectively. Median LRRFS and DMFS were not reached. Esophagitis was the most common grade ≥3 (G3+) toxicity (59 patients; 28.9%, including a G4 and a G5 toxicity), followed by nausea (29 patients; 14.2%) and esophageal stricture (26 patients, 12.7%). With nCRT, median, 3- and 5-year OS were 80 months, 64.7% and 56.1%, respectively, while the median LRRFS and DMFS were not reached again. Their most common G3+ toxicity was esophagitis in 14 patients (6.9%) followed by nausea (8 patients; 3.9%). An nCRT patient developed G4 RT pneumonitis. Pathological complete response (pCR) was observed in 58 patients (28.4%). Surgery-related pulmonary, cardiac and gastrointestinal complications were reported in 38 (18.6%), 40 (19.6%) and 43 (21.1%) patients, respectively. dCRT patients had a median follow-up of 65 months, and median, 3- and 5-year OS of 32 months, 46.7% and 37.0%, respectively. Although the median LRRFS was not reached, the median DMFS was 74 months. The most observed dCRT G3+ toxicity was esophagitis (45 patients, 22.1%: including both G4 and G5 patients) and then esophageal stricture (23 patients, 11.3%). A dCRT patient developed G4 fistula. CONCLUSION To our knowledge, this is the largest single-institutional study on EC long-term outcomes and toxicity using PT. Our cohort reveals good outcomes and mostly mild CRT-related toxicities. Trimodality nCRT with protons demonstrates excellent outcomes relative to the CROSS trial (49.4 months) with identical pCR rate (29% in CROSS) and similar toxicity profile. nCRT with protons should be studied rigorously in the current randomized phase III trial NRG GI006.
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Affiliation(s)
- C O Abana
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - P P Carriere
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - P Damen
- Department of Radiation Oncology, The University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - P S N van Rossum
- Department of Radiation Oncology, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - P Lopez Bravo
- Department of Radiation Oncology Clinical Research, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - X Wei
- Department of Radiation Oncology Clinical Research, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - J M Pollard
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - P L Nitsch
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - M Blum Murphy
- Department of Gastrointestinal Medical Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX
| | - W Hofstetter
- Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Z Liao
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S H Lin
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
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Sasaki YM, Xu T, Koutroumpakis S, Sheshadri A, Deswal A, Nguyen QN, Gandhi S, Cascone T, Le X, Altan M, Chen AB, Liao Z. Comorbidities and Their Impact on Treatment Tolerance and Outcome in Elderly NSCLC Patients Treated with Concurrent Chemoradiation Using Proton or Photon Followed by Immunotherapy. Int J Radiat Oncol Biol Phys 2023; 117:e54-e55. [PMID: 37785668 DOI: 10.1016/j.ijrobp.2023.06.767] [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 comorbidities and their impact on treatment tolerance and survival for elderly NSCLC patients treated with concurrent chemoradiation using proton beam therapy (PBT) or intensity modulated radiation therapy (IMRT) followed by immunotherapy (IO). MATERIALS/METHODS This is a retrospective study in senior patients (≥ 65 years) with inoperable locally advanced- NSCLC (LA-NSCLC) who received concurrent chemoradiation (CRT) therapy followed by adjuvant IO. Comorbidities are listed in table 1 and scored according to hazard ratios (HRs) of death. Treatment tolerance and comorbidities were compared between modalities using Fisher's exact test. Association between comorbidities and treatment tolerance was analyzed using logistic regression; association between comorbidities and survival was analyzed by Cox proportional hazards regression. RESULTS Total 218 patients were included with median age of 72 (range 65-86) years. Fifty-three (24.3%) were PBT and 165 (75.7%) were IMRT. Majority patients were white ethnics, had stage III adenocarcinoma disease and good performance score, and received RT dose 60-66 Gy. The median follow-up time for the whole group was 23 months. A 97% of patients had ≥1, and 62% had ≥4 comorbidities. The combined comorbidity scores ranged from 0 to 25. No significant difference in comorbidities between modalities except IMRT had more patients with COPD (36% vs. 51%, p = 0.047). Rates of hospitalization and ER visit during CRT+IO were 28% and 5%, respectively. Rates of IO discontinuation and interruption were 55% and 8%, respectively. Patients received >6 months IO had significantly lower risk of death (HR: 0.25, p<0.001). No significant difference in treatment tolerance between modalities. In multivariable analysis, atrial fibrillation, pulmonary disease, and depression were the comorbidities associated with hospitalization during CRT+IO (p<0.05); dementia was the comorbidity associated with IO interruption (p = 0.042); heart failure, COPD, asthma, osteoporosis and HIV were the comorbidities associated with poor OS (p<0.05). Combined comorbidity score was associated with OS with HR of 1.13 (p<0.001) with adjustment of race, GTV and induction chemotherapy. CONCLUSION Comorbidities were associated with hospitalization and IO interruption during the whole course of CRT and IO therapy, with increased IO discontinuation which negatively impacted survival. Evaluating and scoring comorbidities at diagnosis could be a useful method to predict risk of death before treatment start.
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Affiliation(s)
- Y M Sasaki
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - T Xu
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S Koutroumpakis
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - A Sheshadri
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - A Deswal
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Q N Nguyen
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S Gandhi
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - T Cascone
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - X Le
- Department of Thoracic Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - M Altan
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - A B Chen
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Z Liao
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
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10
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Damen P, van Rossum PSN, Chen Y, Liao Z, Hofstetter W, Hobbs BP, Mohan R, Lin SH. Comparing 90-Day Post-Operative Mortality after Neoadjuvant Proton-Based vs. Photon-Based Chemoradiotherapy for Esophageal Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e346-e347. [PMID: 37785204 DOI: 10.1016/j.ijrobp.2023.06.2415] [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) Standard of treatment for locally advanced esophageal cancer consists of chemoradiotherapy (CRT) followed by surgery. Evidence suggests that proton beam therapy (PBT) results in lower toxicity and fewer post-operative complications compared to photon-based radiotherapy (RT). Mortality in the first 90 days after surgery is a rare event occurring in 2-8% of patients, with higher reported rates (of up to 17%) in older patients. This 90-day mortality (90DM) rate is an important measure of post-operative (non-oncologic) mortality as a proxy of quality of care. We hypothesize that PBT could reduce the incidence of 90DM compared to photon-based RT. MATERIALS/METHODS From a single-center retrospectively acquired database patients with esophageal cancer treated with neoadjuvant CRT and esophagectomy in 1998-2022 were selected. Univariable logistic regression analyses were used to study the associations of RT modality and other patient- and treatment-related characteristics with 90DM. Subsequently, 3 separate methods were applied to adjust for confounding bias. These included multivariable logistic regression, 1:1 nearest-neighbor propensity score matching (PSM), and inverse probability of treatment weighting (IPTW). Finally, stratified analyses for patient groups aged ≥67 vs. <67 years were performed. RESULTS A total of 894 eligible patients were included (PBT, n = 202; photon-based RT, n = 692). PBT patients had a significantly higher age, better performance score, and a higher number of comorbidities. The 90DM rate was 5 (2.5%) in the PBT group and 29 (4.2%) in the photon-based RT group (p = 0.262). Significant univariable predictors of 90DM included higher age and tumor location. After multivariable adjustment, PBT vs. photon therapy was not significantly associated with 90DM (OR 0.49, 95% CI 0.18-1.31). The 90DM rates in the PSM cohort (n = 181 vs. n = 181) were 2.8% for PBT and 3.3% for photon-based RT (p = 0.379). The 90DM rates in the IPTW cohort were 2.8% for PBT and 4.1% for photon-based RT (p = 0.427). In the full cohort, stratified analysis for age groups revealed that in patients aged ≥67 years, PBT was associated with a decreased risk of 90DM compared to photon-based RT (1.3% vs. 8.8%; p = 0.046), which was not the case in patients aged <67 years. In the PSM cohort, a comparable (but non-significant) difference was observed in favor of PBT in patients aged ≥67 years (i.e., 1.5% vs. 7.5%; p = 0.099). Within-group analyses in the original cohort demonstrated that a higher age significantly increased the risk of 90DM within the photon-based RT group (8.8% vs. 2.7% for age ≥67 vs. <67 years; p = 0.001), but not within the PBT group (1.3% vs. 3.2%; p = 0.398). CONCLUSION Post-operative 90DM after esophagectomy for cancer was not significantly different between PBT and photon-based neoadjuvant CRT. However, among older patients we observed a signal that PBT may reduce the risk of 90DM. Higher age increased the risk of 90DM in patients who underwent photon-based RT, but not in patients who underwent PBT.
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Affiliation(s)
- P Damen
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Radiation Oncology, The University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - P S N van Rossum
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Radiation Oncology, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Y Chen
- Department of Biostatistics and Data Science, University of Texas Health Science Center, Houston, TX
| | - Z Liao
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - W Hofstetter
- Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - B P Hobbs
- Department of Population Health, The University of Austin Dell Medical School, Austin, TX
| | - R Mohan
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S H Lin
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
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11
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Liu Y, Hobbs BP, Hofstetter W, Murphy MB, Gandhi S, Nguyen QN, Chang JY, Liao Z, Diehn M, Ma J, Lin SH. Prospective Trial of Using Imaging to Predict Pathologic Response and Clinical Outcomes in Locally Advanced Esophageal Cancer. Int J Radiat Oncol Biol Phys 2023; 117:S12-S13. [PMID: 37784311 DOI: 10.1016/j.ijrobp.2023.06.227] [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) Trimodality therapy with chemoradiation (CRT) followed by esophagectomy is the standard of care for locally advanced esophageal cancer. An unresolved question is whether pathologic complete response (pCR) can be assessed non-invasively for patients post-CRT. In this study, we assessed whether diffusion-weighted imaging (DWI) with MRI or PET can be used as predictors of pCR and other clinical outcomes after CRT. MATERIALS/METHODS Patients were enrolled on a single-arm institutional trial (PA13-0380) assessing the role of imaging in predicting outcomes in potentially resectable esophageal patients undergoing trimodality therapy. All patients received neoadjuvant CRT, and 29 patients had subsequent surgery. DWI MRI and PET scans were obtained at baseline, 2 weeks after the start of CRT (interim) and 4 to 6 weeks after completion of CRT (follow up). Apparent diffusion coefficients (ADCs) were calculated based on DWI images. Circulating tumor DNA was obtained for 27 patients post-radiation using CAPP-Seq. Mann-Whitney tests compared imaging changes associated with pCR. Discrimination of pCR by imaging changes was quantified by received operating characteristics. Youden's index was applied to select optimal thresholds. Kaplan-Meier analysis was performed to assess differences in overall survival (OS) and progression-free survival (PFS) by changes in DWI, PET, and ctDNA parameters. RESULTS Our cohort of 60 patients had a median follow up of 42.7 months, age of 65.4 yrs, and ECOG of 1 at completion of CRT. 90% were male, 58% had a history of smoking, and 85% were white. 83% had adenocarcinoma with the rest squamous cell carcinoma. Stages of the patients ranged from IIA to IIIB. All had moderately (47%) or poorly (53%) differentiated disease. All received 41.4-50.4 Gy in 1.8 Gy fractions with the majority receiving 50.4 Gy (95%). 29 patients underwent surgery after CRT of which 8 (27.6%) had pCR. Mean ΔADC from baseline to mid-treatment was most associated with pCR (AUC = 0.98, p<0.001) for patients undergoing surgery. Max ΔADC from baseline to first follow-up was most associated with OS (p = 0.002) and PFS (p<0.001) for the whole cohort. 27 patients had ctDNA analyzed after RT with the presence of ctDNA significantly associated with worse OS (HR = 0.12, p = 0.05) and PFS (HR = 0.10, p = 0.002). Combining ctDNA and max ΔADC generated a model that was more predictive of OS and PFS than either alone. We found that neither the PET parameters of TLG or SUV max at baseline or changes in these parameters from baseline to mid-treatment or first follow-up were as predictive as DWI. CONCLUSION We show that changes in DWI is associated with pCR, OS, and PFS in resectable esophageal cancer patients undergoing CRT. DWI was more predictive than PET and a model combining DWI and ctDNA was the most predictive of clinical outcomes. This study shows the significant promise of using DWI in potentially guiding treatment decisions in esophageal cancer patients and will require validation in a larger cohort.
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Affiliation(s)
- Y Liu
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - B P Hobbs
- Department of Population Health, The University of Austin Dell Medical School, Austin, TX
| | - W Hofstetter
- Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - M Blum Murphy
- Department of Gastrointestinal Medical Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX
| | - S Gandhi
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Q N Nguyen
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - J Y Chang
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Z Liao
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - M Diehn
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - J Ma
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S H Lin
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
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12
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Chen F, Wu L, Chen Y, Wang J, Liu J, Huang G, Hou D, Liao Z, Zhang T, Xie X, Liu G. A comparison of bioelectrical impedance analysis and air displacement plethysmography to assess body composition in children. Front Public Health 2023; 11:1164556. [PMID: 37469700 PMCID: PMC10352489 DOI: 10.3389/fpubh.2023.1164556] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 06/13/2023] [Indexed: 07/21/2023] Open
Abstract
Background Accurate assessment of body composition (BC) is important to investigate the development of childhood obesity. A bioelectrical impedance analysis (BIA) device is portable and inexpensive compared with air displacement plethysmography (ADP) for the assessment of BC and is widely used in children. However, studies of the effectiveness of BIA are few and present different results, especially in pediatric populations. The aim of this study was to evaluate the agreement between BIA and ADP for estimating BC. Methods The BC of 981 Chinese children (3-5 years) was measured using the BIA device (SeeHigher BAS-H, China) and ADP (BOD POD). Results Our results showed that BIA underestimated fat mass (FM) and overestimated fat-free mass (FFM) in normal weight children (P < 0.05), but the opposite trend was shown in children with obesity (P < 0.05). The agreement between FM and FFM measured by the two methods was strong (CCC > 0.80). The linear regression equation of 5-year-old children was constructed. Conclusion The SeeHigher BAS-H multi-frequency BIA device is a valid device to evaluate BC in Chinese preschool children compared with ADP (BOD POD), especially in 5-year-old children or children with obesity. Further research is needed to standardize the assessment of BC in children.
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Affiliation(s)
- Fangfang Chen
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Lijun Wu
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Yiren Chen
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Jing Wang
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Junting Liu
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Guimin Huang
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Dongqing Hou
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Zijun Liao
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Ting Zhang
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Xianghui Xie
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Gongshu Liu
- Tianjin Women's and Children's Health Center, Tianjin, China
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13
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Liao Z, Xie X, Wang J, Chen Y, Zhang T, Liu G, Chen F. Impact of Early Life Factors on Metabolic Phenotypes of Obesity in Preschool Children. Diabetes Care 2023; 46:1019-1027. [PMID: 36928113 PMCID: PMC10154652 DOI: 10.2337/dc22-1851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 02/04/2023] [Indexed: 03/18/2023]
Abstract
OBJECTIVE To investigate the impact of factors in the first 1,000 days of life on metabolic phenotypes of obesity in preschool children in a cohort study. RESEARCH DESIGN AND METHODS We recruited 3-year-old children for the study. Early life factors included maternal age at delivery, maternal education, prepregnancy BMI, gestational weight gain, gravidity, history of gestational diabetes mellitus, delivery mode, gestational age, family history of metabolic disorders, paternal education, annual family income, child sex, birth weight, and breastfeeding duration. According to BMI and metabolic status, children were classified as metabolically healthy (no metabolic risk factors) with normal weight (MHNW), metabolically unhealthy (one or more metabolic risk factors) with normal weight (MUNW), metabolically healthy with overweight or obesity (MHO), and metabolically unhealthy with overweight or obesity (MUO). RESULTS We recruited 3,822 children for the study, with 3,015 analyzed. Accelerated BMI z score growth rate between 6 and 24 months was associated with MHO (β = 0.022; 95% CI 0.009, 0.036) and MUO (β = 0.037; 95% CI 0.018, 0.056). Maternal overweight (odds ratio [OR] 3.16; 95% CI 1.55, 6.42) and obesity (OR 8.14; 95% CI 3.73, 17.76) before pregnancy and macrosomia (OR 2.47; 95% CI 1.32, 4.59) were associated with MHO, and maternal obesity before pregnancy (OR 6.35; 95% CI 2.17, 18.52) increased the risk of MUO. CONCLUSIONS Early life factors, such as maternal obesity and accelerated BMI growth rate between 6 and 24 months, were related not only to MHO but also to MUO. Children with these early life factors should be given interventions for weight control to prevent metabolic abnormalities.
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Affiliation(s)
- Zijun Liao
- Capital Institute of Pediatrics, Beijing, China
| | | | - Jing Wang
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Yiren Chen
- Capital Institute of Pediatrics, Beijing, China
| | - Ting Zhang
- Capital Institute of Pediatrics, Beijing, China
| | - Gongshu Liu
- Tianjin Women's and Children's Health Center, Tianjin, China
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14
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Abstract
Hepatocyte nuclear factor 4γ (HNF4G) is considered to be a transcription factor and functions as an oncogene in certain types of human cancer. However, the precise functions and the potential molecular mechanisms of HNF4G in glioma remain unclear. Therefore, the present study aimed to elucidate the role of HNF4G in glioma and the underlying mechanism. Western blotting and reverse transcription-quantitative PCR (RT-qPCR) demonstrated that HNF4G was highly expressed in glioma tissues and cell lines. The overexpression of HNF4G in LN229 and U251 glioma cells promoted cell proliferation and cell cycle progression, and inhibited apoptosis, while the knockdown of HNF4G suppressed cell proliferation, cell cycle progression and tumor growth, and induced apoptosis. A significant positive association was detected between HNF4G and neuropilin-1 (NRP1) mRNA expression in glioma tissues. Bioinformatics analysis, chromatin immunoprecipitation-RT-qPCR and promoter reporter assays confirmed that HNF4G promoted NRP1 transcription in glioma by binding to its promoter. NRP1 overexpression facilitated glioma cell proliferation and cell cycle progression, and suppressed apoptosis in vitro, while the knockdown of NRP1 inhibited cell proliferation and cell cycle progression, and facilitated apoptosis. NRP1 overexpression reversed the effects induced by HNF4G knockdown on glioma cell proliferation, cell cycle progression and apoptosis. In summary, the present study demonstrated that HNF4G promotes glioma cell proliferation and suppresses apoptosis by activating NRP1 transcription. These findings indicate that HNF4G acts as an oncogene in glioma and may thus be an effective therapeutic target for glioma.
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Affiliation(s)
- Hongmin Che
- Department of Neurosurgery, Xi'an Gaoxin Hospital, Xi'an, Shaanxi 710075, P.R. China,Correspondence to: Professor Hongmin Che, Department of Neurosurgery, Xi'an Gaoxin Hospital, 16 Tuanjie South Road, Xi'an, Shaanxi 710075, P.R. China, E-mail:
| | - Qi Zheng
- Department of Medical Oncology, Affiliated Shaanxi Provincial Cancer Hospital, College of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China
| | - Zijun Liao
- Department of Medical Oncology, Affiliated Shaanxi Provincial Cancer Hospital, College of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China
| | - Lu Zhang
- Department of Foreign Languages, Xi'an Mingde Institute of Technology, Xi'an, Shaanxi 710124, P.R. China,Professor Lu Zhang, Department of Foreign Languages, Xi'an Mingde Institute of Technology, 11 Fengye Road, Xi'an, Shaanxi 710124, P.R. China, E-mail:
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15
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Zhao Y, Zhao B, Chen G, Chen Y, Liao Z, Zhang H, Feng W, Li Y, Weng H, Li W, Zhou Y, Ren B, Lu Y, Chen J, Liu Z, Su Z, Wang W, Zhang L. Validation of different personalized risk models of chemotherapy-induced nausea and vomiting: results of a randomized, double-blind, phase III trial of fosaprepitant for cancer patients treated with high-dose cisplatin. Cancer Commun (Lond) 2022; 43:246-256. [PMID: 36545810 PMCID: PMC9926955 DOI: 10.1002/cac2.12397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 11/18/2022] [Accepted: 12/09/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Highly emetogenic chemotherapy induces emesis in cancer patients without prophylaxis. The purpose of this study was to evaluate the efficacy and safety of a fosaprepitant-based triple antiemetic regimen for the prevention of chemotherapy-induced nausea and vomiting (CINV) in patients with solid malignant tumors, determine risk factors and externally validate different personalized risk models for CINV. METHODS This phase III trial was designed to test the non-inferiority of fosaprepitant toward aprepitant in cancer patients who were to receive the first cycle of single-day cisplatin chemotherapy. The primary endpoint was complete response (CR) during the overall phase (OP) with a non-inferiority margin of 10.0%. Logistic regression models were used to assess the risk factors of CR and no nausea. To validate the personalized risk models, the accuracy of the risk scoring systems was determined by measuring the specificity, sensitivity and area under the receiver operating characteristic (ROC) curve (AUC), while the predictive accuracy of the nomogram was measured using concordance index (C-index). RESULTS A total of 720 patients were randomly assigned. CR during the OP in the fosaprepitant group was not inferior to that in the aprepitant group (78.1% vs. 77.7%, P = 0.765) with a between-group difference of 0.4% (95% CI, -5.7% to 6.6%). Female sex, higher cisplatin dose (≥ 70 mg/m2 ), no history of drinking and larger body surface area (BSA) were significantly associated with nausea. The AUC for the acute and delayed CINV risk indexes was 0.68 (95% CI: 0.66-0.71) and 0.66 (95% CI: 0.61-0.70), respectively, and the C-index for nomogram CINV prediction was 0.59 (95% CI, 0.54-0.64). Using appropriate cutoff points, the three models could stratify patients with high- or low-risk CINV. No nausea and CR rate were significantly higher in the low-risk group than in the high-risk group (P < 0.001). CONCLUSIONS Fosaprepitant-based triple prophylaxis demonstrated non-inferior control for preventing CINV in patients treated with cisplatin-base chemotherapy. Female cancer patients without a history of alcohol consumption, with larger BSA and received high-dose cisplatin might be more vulnerable to CINV. Three personalized prediction models were well-validated and could be used to optimize antiemetic therapy for individual patients.
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Affiliation(s)
- Yuanyuan Zhao
- Department of Medical OncologySun Yat‐sen University Cancer CenterState Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineGuangzhouGuangdongP. R. China
| | - Bing Zhao
- Department of Day WardFirst Affiliated Hospital of Xinjiang Medical UniversityUrumqiXinjiangP. R. China
| | - Gang Chen
- Department of Medical OncologySun Yat‐sen University Cancer CenterState Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineGuangzhouGuangdongP. R. China
| | - Yinlan Chen
- Department of Medical OncologyJiangxi Cancer HospitalNanchangJiangxiP. R. China
| | - Zijun Liao
- Department of Medical OncologyShaanxi Provincial Cancer HospitalXi'anShaanxiP. R. China
| | - Haiming Zhang
- Department of Medical OncologyThe First People Hospital of XiangtanXiangtanHunanP. R. China
| | - Weineng Feng
- Department of Medical OncologyThe First People Hospital of FoshanFoshanGuangdongP. R. China
| | - Yinyin Li
- Department of Medical OncologyShenyang Tenth People's HospitalShenyangLiaoningP. R. China
| | - Heng Weng
- Respiratory MedicineFuzhou Pulmonary Hospital of FujianFuzhouFujianP. R. China
| | - Weidong Li
- Department of Medical OncologyAffiliated Cancer Hospital & Institute of Guangzhou Medical UniversityGuangzhouGuangdongP. R. China
| | - Yuefen Zhou
- Department of Medical OncologyThe Central Hospital of LishuiLishuiZhejiangP. R. China
| | - Biyong Ren
- Department of Medical OncologyChongqing Three Gorges Central HospitalChongqingP. R. China
| | - Yanda Lu
- Department of Medical OncologyThe First Affiliated Hospital of Hainan Medical UniversityHaikouHainanP. R. China
| | - Jianhua Chen
- Department of Medical OncologyHunan Province Tumor HospitalChangshaHunanP. R. China
| | - Zhenteng Liu
- Institute of Materia MedicaLuoxin Pharmaceutical Group Co., LtdShanghaiP. R. China
| | - Zhenzhong Su
- Institute of Materia MedicaLuoxin Pharmaceutical Group Co., LtdShanghaiP. R. China
| | - Wenliang Wang
- Institute of Materia MedicaLuoxin Pharmaceutical Group Co., LtdShanghaiP. R. China
| | - Li Zhang
- Department of Medical OncologySun Yat‐sen University Cancer CenterState Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineGuangzhouGuangdongP. R. China
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16
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Weng J, Dabaja B, Das P, Gunn G, Chronowski G, Bloom E, Lee P, Koong A, Ning M, Semien K, Sanders C, Ritchey R, Nguyen K, Hoffman K, Robinson I, Kerr A, Brokaw J, Liao Z, Nguyen Q. Radiation Therapy Decision Making Process and Operations for COVID-19 Positive Patients. Int J Radiat Oncol Biol Phys 2022. [PMCID: PMC9595469 DOI: 10.1016/j.ijrobp.2022.07.1722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Purpose/Objective(s) A challenging clinical dilemma during the COVID-19 pandemic is management of cancer patients who test positive for COVID. Given the need to balance the risk of disease progression with the risk of transmission to other patients and staff, radiation therapy for these patients requires careful consideration and modification of standard workflows. It is also critical to develop processes to mitigate radiation treatment interruption, which can affect patient outcomes. The objective of this study was to report the clinical operations and outcomes for COVID positive patients receiving radiation therapy during the pandemic at a tertiary cancer center including 2 network locations. Materials/Methods During March 2020 to March 2022, the Radiation Oncology COVID committee (RO COVID) developed an integrated process to triage patients, provide treatment recommendations, and implement infection control procedures to safely deliver radiation therapy to COVID positive patients. Policies were created for each center with multidisciplinary input from infectious disease, radiation oncology, radiation therapy, and nursing. All COVID positive patients were presented to the RO COVID group and evaluated for clinical urgency, benefit with radiation, and life expectancy. If deemed necessary, a limited planned break or hypofractionated regimen was recommended to minimize staff exposure. We conducted a retrospective review of COVID positive patients with different primary malignancies treated through the COVID positive pathway. Results A total of 68 COVID positive patients were treated with the COVID positive pathway (HN 15, Breast 9, CNS 8, GU 8, GYN, 7, Thoracic 6, GI 5, HEME 5, PED 3, SARC 2). The median age was 57.1 years (IQR 45.8-63.4) and 47% were female. There were 39 patients (57%) who were asymptomatic and were tested for routine pre-radiation screening or due to concerns of COVID exposure. Twenty-three (34%) patients were treated with palliative intent and 8 (12%) were treated for an emergent indication (i.e., spinal cord compression, bleeding). Thirteen (19%) patients were receiving radiation treatment, had a treatment break (7-21 days), and then resumed their radiation course. All treatments were successfully completed without known nosocomial spread of COVID to staff or other patients. Among this heterogenous group of patients, 58 (85%) were alive with a median follow up of 2 months (IQR 0.5-7.5). COVID infection may have contributed to 3 out of 10 deaths (4% of total cohort). The remaining deaths were due to progression of disease or other non-COVID causes. Conclusion In this study, COVID positive patients were safely treated with radiation therapy through a comprehensive decision making and clinical operations pathway taking into account evolving COVID guidelines for three different variant surges. Although limited in follow up, patient outcomes are promising with few COVID-related deaths and low overall mortality rates, even with hypofractionated regimens.
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Affiliation(s)
- J. Weng
- MD Anderson Cancer Center, Houston, TX,Corresponding author:
| | - B. Dabaja
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - P. Das
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - G.B. Gunn
- MD Anderson Cancer Center, Houston, TX
| | - G.M. Chronowski
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - P. Lee
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - A.C. Koong
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - M.S. Ning
- MD Anderson Cancer Center, Houston, TX
| | - K. Semien
- MD Anderson Cancer Center, Houston, TX
| | | | | | - K. Nguyen
- MD Anderson Cancer Center, Houston, TX
| | - K.E. Hoffman
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - I. Robinson
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - A. Kerr
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - J. Brokaw
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Z. Liao
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Q.N. Nguyen
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
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Moore Z, Huang X, Lobaugh S, Geyer A, Gelblum D, Shepherd A, Shaverdian N, Wu A, Chaft J, Zauderer M, Rudin C, Chawla M, Jones D, Sopka D, Mak R, Liao Z, Gomez D, Zhang Z, Paik P, Rimner A. Biomarkers Associated with Pulmonary Exacerbations in a Prospective, Placebo-Controlled, Randomized Trial of Nintedanib for the Treatment of Radiation Pneumonitis. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.2128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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18
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Odwuor A, Lee P, Chang J, Liao Z, Gandhi S, Jeter M, Lin S, Chen A, Welsh J, Nguyen Q, O'Reilly M, Chun S, Ning M. Outcomes and Toxicity Following Three or More Definitive Courses of Thoracic Radiation Therapy. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Odwuor A, Lee P, Chang J, Liao Z, Gandhi S, Jeter M, Lin S, Chen A, Welsh J, Nguyen Q, O'Reilly M, Chun S, Ning M. Salvage Re-Irradiation with Proton Beam Therapy for New or Locoregionally Recurrent Non-Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1537] [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]
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20
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He Y, Adair A, Cazoulat G, Yepes P, Titt U, Wu C, Mirkovic D, Balter P, Pollard J, Cardenas C, Liao Z, Mohan R, Brock K. Modeling Variable Proton Relative Biological Effectiveness (RBE) Using Voxel-Level Image Density Change for Non-Small Cell Lung Cancer (NSCLC) Patients Treated with Passive Scattering Proton Therapy (PSPT) or Intensity Modulated Photon Therapy (IMRT). Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1848] [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]
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21
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Dorraki M, Liao Z, Abbott D, Psaltis PJ, Baker E, Bidargaddi N, Van Den Hengel A, Narula J, Verjans JW. Cardiovascular disease risk prediction via machine learning using mental health data. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Robust and accurate risk prediction models are much needed in cardiovascular disease. It is well-known that mental health is associated with the risk of developing cardiovascular disease. It is unknown whether mental health markers can enhance existing risk prediction models for cardiovascular disease.
Purpose
The main purpose of this study was to assess capability of mental health factors along with traditional risk factors to be used in cardiovascular predictive machine learning models, and to develop a combined machine learning approach using both traditional risk and psychological factors in 375,145 participants of the UK Biobank.
Methods
A comprehensive Pearson correlation analysis is carried out on UK Biobank data. Subsequently, an ensemble model containing decision tree, random forest, XGBoost, support vector machine (SVM), and deep neural network (DNN) classification approaches was built to predict cardiovascular diseases (CVD) in UK Biobank participants. The model was first trained using traditional cardiovascular risk factors, and subsequently trained using a combination of cardiovascular risk and psychological factors.
Results
The correlation analysis revealed that there is a correlation between CVD and mental health factors suggesting the potential of mental health application for machine learning models. Our ensemble machine learning model was able to predict CVD with an accuracy of 73.49% using CVD risk factors alone. However, by combining psychological factors with CVD risk factors in the training data, an improved accuracy of 95.70% was achieved. The accuracy and robustness of ensemble machine learning model outperformed any of five constituent learning algorithms alone.
Conclusions
Our results suggest that mental health assessment data along with traditional risk factors provides a powerful, safe and affordable machine learning model enrichment that can be used for state-of-the-art prediction of CVD.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Dorraki
- South Australian Health and Medical Research Institute , Adelaide , Australia
| | - Z Liao
- University of Adelaide, Australian Institute for Machine Learning , Adelaide , Australia
| | - D Abbott
- University of Adelaide, School of Electrical and Electronic Engineering , Adelaide , Australia
| | - P J Psaltis
- South Australian Health and Medical Research Institute , Adelaide , Australia
| | - E Baker
- University of Adelaide, Australian Institute for Machine Learning , Adelaide , Australia
| | - N Bidargaddi
- Flinders University, College of Medicine and Public Health , Adelaide , Australia
| | - A Van Den Hengel
- University of Adelaide, Australian Institute for Machine Learning , Adelaide , Australia
| | - J Narula
- Mount Sinai Medical Center , New York , United States of America
| | - J W Verjans
- South Australian Health and Medical Research Institute , Adelaide , Australia
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22
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de Baere T, Shen C, Ducassou A, Bonvalot S, Chajon E, Farber L, Vivar O, Tyan P, Koay E, Lin S, Liao Z, Dicker A, Hoffmann C, Le Tourneau C. 489P Analysis of 3-dimensional volumetric distribution and dispersion of the radioenhancer NBTXR3 in various solid malignancies. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.617] [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] Open
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23
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Chen F, Wang P, Wang J, Liao Z, Zong X, Chen Y, Lai J, Zhang T, Liu G, Xie X. Analysis and Comparison of Early Childhood Nutritional Outcomes Among Offspring of Chinese Women Under the Chinese 2021 and US 2009 Gestational Weight Gain Guidelines. JAMA Netw Open 2022; 5:e2233250. [PMID: 36149650 PMCID: PMC9508653 DOI: 10.1001/jamanetworkopen.2022.33250] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
IMPORTANCE In 2009, the US National Academy of Medicine (NAM) released revised gestational weight gain (GWG) guidelines, which were established primarily for White North American women and may be unsuitable for Asian women. In 2021, the Chinese Nutrition Society (CNS) released its GWG guidelines, but their applicability requires re-examination. OBJECTIVE To compare the differences between the CNS and NAM recommendations for GWG in association with health outcomes in the offspring of Chinese women. DESIGN, SETTING, AND PARTICIPANTS In this bidirectional cohort study, children in China were recruited at age 3 years from 2017 to 2018, with 2 follow-up visits over the next 2 years (between September 2017 and September 2020). Information during pregnancy was retrieved from medical records. Data analysis was performed from October 2021 to January 2022. MAIN OUTCOMES AND MEASURES GWG was classified as insufficient, appropriate, or excessive according to the CNS and NAM guidelines separately. Children's height, weight, fat mass, fat-free mass, and percentage of body fat were measured at each visit. Body mass index, fat mass index, fat-free mass index, weighted κ score, risk ratio values, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. RESULTS A total of 3822 children (1996 boys and 1826 girls; mean [SD] age, 3.79 [0.30] years) were enrolled; after exclusions, 3170 term singleton children were recruited and were followed at 4 and 5 years of age. According to the CNS guidelines, the prevalence rates were 14.1% for insufficient GWG, 48.1% for appropriate GWG, and 37.9% for excessive GWG, whereas the rates according to NAM guidelines were 39.7% for insufficient GWG, 37.2% for appropriate GWG, and 23.1% for excessive GWG. The weighted κ value for the classification agreement between the 2 guidelines was 0.530 (95% CI, 0.510-0.550). For the appropriate GWG group, the rates for low nutritional levels did not differ between the 2 guidelines, but the rates for high nutritional levels were significantly lower under CNS guidelines than under NAM guidelines. When the sensitivity, specificity, PPV, and NPV with respect to the mothers who maintained appropriate GWG were used to estimate the nonhigh nutritional status of their offspring, generally higher values based on the CNS guidelines were found compared with those based on the NAM recommendations. CONCLUSIONS AND RELEVANCE These findings suggest that the GWG recommendations promulgated by the NAM are higher than the CNS guidelines, with the latter more suitable for Chinese women.
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Affiliation(s)
| | - Peng Wang
- Tianjin Women’s and Children’s Health Center, Tianjin, China
| | - Jing Wang
- Tianjin Women’s and Children’s Health Center, Tianjin, China
| | - Zijun Liao
- Capital Institute of Pediatrics, Beijing, China
| | - Xinnan Zong
- Capital Institute of Pediatrics, Beijing, China
| | - Yiren Chen
- Capital Institute of Pediatrics, Beijing, China
| | - Jianqiang Lai
- National Institute of Nutrition and Health, Chinese Centre for Disease Control and Prevention, Beijing, China
| | - Ting Zhang
- Capital Institute of Pediatrics, Beijing, China
| | - Gongshu Liu
- Tianjin Women’s and Children’s Health Center, Tianjin, China
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Chen F, Wang J, Liao Z, Zong X, Zhang T, Xie X, Liu G. Body Composition in Preschool Children and the Association With Prepregnancy Weight and Gestational Weight Gain: An Ambispective Cohort Study. Front Nutr 2022; 9:881452. [PMID: 35685884 PMCID: PMC9173682 DOI: 10.3389/fnut.2022.881452] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 02/22/2022] [Accepted: 03/28/2022] [Indexed: 11/29/2022] Open
Abstract
Objective To describe the body composition in preschool children and to evaluate the association with prepregnancy BMI and gestational weight gain (GWG). Methods Children were recruited in their first year in kindergarten (3 years old) and followed up for the next 2 years. Information during pregnancy and birth was retrieved from medical records. Height, weight, fat mass, fat-free mass, and percentage of body fat (FM%) were measured through a bioelectrical impedance analysis for each child visit, and BMI, fat mass index (FMI), and fat-free mass index (FFMI) were calculated. Generalized linear mixed models (GLMMs) were used to evaluate the associations between prepregnancy weight, GWG, and adiposity indicators. Results A total of 3,329 single-birth 3-year-old children were recruited as the baseline population and were followed at 4 and 5 years old. During the 3 years of follow-up, the mean (±SD) values of BMI, FMI, FFMI, and FM% of the children were 15.6 (±1.6) kg/m2, 2.8 (±1.3) kg/m2, 12.8 (±0.7) kg/m2, and 17.2% (±5.8%), respectively. The prevalence rates of overweight and obesity in mothers before pregnancy were 16.6 and 3.2%, respectively. Mothers were divided into three groups based on GWG: appropriate (1,233, 37.0%), excessive (767, 23.0%), and insufficient (1,329, 39.9%). GLMMs analyses showed that the preschool children’s BMI, FMI, FFMI, and FM% were all significantly positively related to maternal prepregnancy BMI and GWG (all P < 0.001); the children of mothers who were overweight/obese before pregnancy were more likely to be overweight/obese, high FMI, high FFMI, and high FM% at preschool age (all P < 0.001); although maternal excessive GWG was not correlated with offspring’s overweight/obese (P = 0.156), the children of mothers with excessive GWG are more likely to have higher FMI, but not to be with a higher FFMI status than the children of mothers with appropriate GWG. For prepregnancy overweight/obese women, compared with the GWG-appropriate group, maternal excessive GWG was related to the risk of high FMI (coefficient = 0.388, 95% CI: 0.129–0.647) and high FM% (coefficient = 0.352, 95% CI: 0.097–0.607), but was not related to the risk of overweight/obese or high FFMI of the offspring at preschool age. Conclusion Fat mass index decreased with age, while FFMI increased with age among 3- to 5-year-old children. It is necessary to optimize maternal weight prior to conception and GWG management to improve the health outcomes of the offspring.
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Affiliation(s)
| | - Jing Wang
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Zijun Liao
- Capital Institute of Pediatrics, Beijing, China
| | - Xinnan Zong
- Capital Institute of Pediatrics, Beijing, China
| | - Ting Zhang
- Capital Institute of Pediatrics, Beijing, China
| | | | - Gongshu Liu
- Tianjin Women's and Children's Health Center, Tianjin, China
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25
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Chen F, Wang J, Liu J, Huang G, Hou D, Liao Z, Zhang T, Liu G, Xie X, Tai J. Characteristics of Body Composition Estimated by Air-Displacement Plethysmography in Chinese Preschool Children. Front Public Health 2022; 10:926819. [PMID: 35719642 PMCID: PMC9204163 DOI: 10.3389/fpubh.2022.926819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 05/18/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveTo describe the characteristics of body composition by air-displacement plethysmography (ADP) among Chinese preschool children.MethodsPreschool children were recruited from three kindergartens. Adiposity indices were evaluated using the ADP method. BMI, fat mass index (FMI), fat-free mass index (FFMI) and waist-to-height ratio (WHtR) were calculated. Overweight and obesity were diagnosed using the WHO reference. Analyses were executed by SPSS and MedCalc software. Smoothed curves were constructed using the lambda-mu-sigma (LMS) method.ResultsThis study evaluated the growth trend for body composition of ADP-based body fat indices based on a relatively large sample of preschool children, the first ever reported in China. A total of 1,011 children aged 3–5 years comprised our study population. BMI and FFMI increased with age, but the slope (P = 0.710) and y intercept (P = 0.132) in the BMI trend analysis demonstrated no differences between boys and girls. For the FFMI trend lines, the slope was significantly higher for boys than for girls (P = 0.013). The percentage of fat mass (FM%), FMI, and WHtR were negatively correlated with age for both sexes, except for FMI in girls (P = 0.094). The 95% CI regression lines for FM% according to different weight statuses intersected.ConclusionsADP is applicable to estimating body composition among Chinese preschool children. Misclassifications might occur when overweight/obese status is defined based on surrogate indices.
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Affiliation(s)
- Fangfang Chen
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
- *Correspondence: Fangfang Chen
| | - Jing Wang
- Research Project Group, Tianjin Women's and Children's Health Center, Tianjin, China
| | - Junting Liu
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Guimin Huang
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Dongqing Hou
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Zijun Liao
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Ting Zhang
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Gongshu Liu
- Research Project Group, Tianjin Women's and Children's Health Center, Tianjin, China
| | - Xianghui Xie
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
- Xianghui Xie
| | - Jun Tai
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
- Jun Tai
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Jiang Y, Wu X, Liao Z, Qi J, Gu J. AB1043 IDENTIFICATION OF UNUSUAL TOPHI ANTERIOR TO THE THYROID CARTILAGE USING DIFFERENT IMAGING METHODS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundInadequately treated gout patients could develop tophi. However, tophi could appear as atypical mass, leading to difficulty in differential diagnosis.ObjectivesThe objectives of the study were to describe an unusual case with tophi anterior to the Thyroid Cartilage using different imaging methods.MethodsClinical information of the case was presented. Ultrasound, dual energy Computed Tomography (DECT) and CT scan were compared to describe the tophi.ResultsA 66-year-old man with a 30-year history of gout was admitted. He had received urate-lowering drugs intermittently over the past few years. Physical examination revealed multiple tophi on the hands, feet, and other auricular surfaces. Moreover, there was a subcutaneous mass above the thyroid cartilage (Figure 1A). Ultrasound revealed hyperechoic nodule anterior to the thyroid cartilage, 11*7cm in size, with uneven internal echo, no blood flow signal inside, and a close relationship between the barrier of the nodule and the thyroid cartilage (Figure 1B). DECT of the neck confirmed that the mass anterior to the thyroid cartilage were tophi (Figure 1C-D). A plain radiographic evaluation demonstrated soft-tissue swellings and para-articular erosions involving hands (Figure 1E-F). The serum creatinine and uric acid levels were elevated as follows, creatinine, 562 μmol per liter (normal range, 31.8 to 116); and uric acid, 621 μmol per liter (normal range, 90 to 420).Figure 1.Tophi detected by different imaging methods. A.A picture of the mass anterior to the thyroid cartilage; B. A mass anterior to the thyroid cartilage detected by ultrasound; C. The mass anterior to the thyroid cartilage detected by dual energy CT; D. The mass anterior to the thyroid cartilage detected by CT scan; E. a picture of tophi in the hands; F. a plain radiograph of tophi in the hands.ConclusionDECT has more advantages over ultrasound and CT for detection of atypical tophi in gout patients.Disclosure of InterestsYutong Jiang Grant/research support from: Scientific and Technological Planning Project of Guangzhou City [grant number 202102020150], Xinyu Wu: None declared, Zetao Liao: None declared, Jun Qi: None declared, Jieruo Gu: None declared
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Chen Z, Tan J, Cheng T, Wu X, Gu J, Liao Z. POS0014 EFFICACY AND SAFETY OF JAK INHIBITORS IN REFRACTORY OR INITIAL TREATMENT OF ADULT ONSET STILL’S DISEASE. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundInappropriate activation of pro-inflammatory cytokines such as interleukin (IL)-1, IL-6 or IL-18, is a pathogenic cornerstone in adult onset Still’s disease (AOSD). Beyond therapies targeting IL-1 and IL-6, Janus kinases (JAK) inhibitors have been suggested to be efficient in refractory AOSD patients [1].ObjectivesTo assess the efficacy and safety of JAK inhibitors in the treatment of AOSD patient refractory to, or with initial treatment.MethodsThis retrospective study was based on our single center of the department of rheumatology and immunology. The data was collected from the patients’ medical records using a standardized questionnaire and analyzed at different time points. The response to JAK inhibitors was categorized as complete remission (CR), partial remission (PR) or failure (F) [2].Results7 patients were recruited (Table 1), including 4 refractory patients and 3 initial patients. Mean age at JAK inhibitor treatment start was 27.5 years for refractory patients and 35 years for initial patients; and mean disease duration was 66.5 months and 1 month respectively. All patients had fever and polyarthritis, 5 patents had rash. In addition, pulmonary hypertension, abnormal liver function tests, abdominal pain, and heart failure were also observed in our patients. Response to corticosteroids, conventional synthetic or biological Disease Modifying Anti-Rheumatic Drugs (DMARDs) had been considered inadequate in 4 refractory patients. Tofacitinib was added in the initial treatment for 3 patients for high disease activity. In total, baricitinib was used in 2 patients and tofacitinib in 5 patients. Steroids were concurrently used in 6 patients, MTX in three, SASP and NSAIDs in one. At a mean follow up of 3.8 months, complete remission was observed in one patient (with tofacitinib), partial remission was in 5 patients (4 patients with tofacitinib and one with baricitinib), and failure in one (patients with baricitinib). At the last visit, steroids could be decreased but not stopped in those 6 patients. Tolerance of JAK inhibitors was excellent, none infectious disease or other severe side effect were observed.Table 1.Characteristics of the AOSD patientsNo.SexAge (year)Disease Duration (Month)Main symptomsTreatments before JAKionsetJAKiSteroids at onsetConconmitant treatmentSteroids at the end of F-UF-U(month)Outcome1M2629Fever, polyarthritisPred+MTXTofacitinib0MTX04PR2M259Fever, polyarthritis, rash, pulmonary hypertensionPred+MTXBaricitinib16MTX+Pred124F3M3812Fever, polyarthritis, rashPred+MTX+CsA+NSAIDsTofacitinib24Pred123PR4M21216Fever, polyarthritisPred+MTX+SASP+NSAIDs+TNFiBaricitinib4Pred+MTX+SASP+NSAIDs43PR5F331Fever, polyarthritis, rash, abnormal liver function testsPredTofacitinib40Pred25CR6F471Fever, polyarthritis, rash, abdominal painPredTofacitinib36Pred45PR7F251Fever, polyarthritis, rash, heart failurePredTofacitinib40Pred123PRPred: prednisone; MTX: Methotrexate; SASP: salicylazosulfapyridine; CsA: ciclosporin A; NSAIDs: Non-Steroidal Antiinflammatory Drugs; TNFi: Tumor necrosis factor inhibitor. CR: complete remission; PR: partial remission; F: failure.ConclusionJAK inhibitors treatment may be helpful for some patients with refractory AOSD, or patients with severe disease activity at initial treatment. Different treatment responses were observed in these short series of cases, which might be due to the phenotype of patients. However, the scale of patients in our study was too low to draw a conclusion. Further study and additional information are needed to evaluate more precisely the risk-benefit ratio of this treatment, and a possible difference in efficacy among the different groups of patients or JAK inhibitors.References[1]Aosd T, Table E. Ann Rheum Dis 2020;79:842–4.[2]Vercruysse F, Barnetche T, Lazaro E, et al. Arthritis Res Ther 2019;21:1–11. doi:10.1186/s13075-019-1838-6.Figure 1.Changes in laboratory test (A) WBC; (B) CRP; (C) ESR;(D) Ferritin. M0: baseline; M1: month 1; M3: month 3; M5: month 5.AcknowledgementsNoneDisclosure of InterestsNone declared
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Abstract
BackgroundPro-inflammatory cytokines such as interleukin 6 (IL-6) are involved in the pathogenesis of adult-onset Still’s disease (AOSD). Anti-IL-6 agents such as tocilizumab have been tried to treat AOSD successfully.ObjectivesTo access the efficacy of tocilizumab in the treatment of AOSD patient refractory to,or with initial treatment.MethodsWe reviewed three cases with refractory AOSD treated with tocilizumab. All patients fulfill the Cush criteria for AOSD. All patients performed blood culture, auto-antibodies test and bone marrow test to exclude infectious diseases, other rheumatic diseases and tumors. All patients received broad-spectrum antibiotics and had no response. All patients received glucocorticoid therapy and at least one kind of anti-cytokine therapies but didn’t have full response. Then the three patients received intravenous tocilizumab treatment of 8mg/kg every 2 weeks or 4 weeks.ResultsThe first patient, a 21-year-old woman, performed positron emission tomography (PET-CT) and lymphoglandula pathology in addition to routine tests. She received high dose methylprednisolone (500mg per day for 3 days and followed by 80mg per day), gamma globulin injection (20g per day for 3 days) and baricitinib 4mg per day for 12 days, but had no response to the treatment. Then she received tocilizumab of 8mg/kg every 2 weeks and stopped baricitinib. And the symptoms and blood tests improved gradually, and the methylprednisolone dose reduced to 16mg per day at the last follow-up.The second patient is a 52-year-old man, and performed bone marrow cytology and PET-CT to excluded hematological diseases. He received methylprednisolone 80mg per day, adalimumab and tofacitinib treatment. But the patients still got recurrent fever, high ESR, CRP and serum ferritin. Then he stopped adalimumab and tofacitinib, and received tocilizumab of 8mg/kg every 2 weeks and reduced to 8mg/kg every 4 weeks because of economic factors. The patient did not develop fever and the inflammatory indexes such as ESR/CRP gradually decreased to normal range. And methylprednisolone dose reduced to 32mg nowadays.The third patient is a 30-year-old woman and has recurrent AOSD for 15 years. She had tried glucocorticoids, methotrexate, iguratimod, baritinib and entanercept successively. Yet she still had recurrent arthritis on hand and knee, and elevated ESR/CRP/serum ferritin. Additionally she suffered femoral head necrosis because of excessive doses of glucocorticoid. The patient received tocilizumab 8mg/kg every 4 weeks, then joint symptoms and inflammatory indicators improved significantly. The methylprednisolone dose was also successfully reduced to 4mg/d.The Figure 1 showed the main course of disease evolution.Figure 1.ConclusionTocilizumab may be an effective candidate in refractory AOSD despite no response to other treatments.Disclosure of InterestsNone declared
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Chen F, Liu J, Hou D, Li T, Chen Y, Liao Z, Wu L. The Relationship between Fat Mass Percentage and Glucose Metabolism in Children and Adolescents: A Systematic Review and Meta-Analysis. Nutrients 2022; 14:nu14112272. [PMID: 35684072 PMCID: PMC9183098 DOI: 10.3390/nu14112272] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/26/2022] [Accepted: 05/26/2022] [Indexed: 12/04/2022] Open
Abstract
To assess the relationship between fat mass percentage (FMP) and glucose metabolism in children aged 0−18 years we performed a systematic review of the literature on Medline/PubMed, SinoMed, Embase and Cochrane Library using the PRISMA 2020 guidelines up to 12 October 2021 for observational studies that assessed the relationship of FMP and glucose metabolism. Twenty studies with 18,576 individuals were included in the meta-analysis. The results showed that FMP was significantly associated with fasting plasma glucose (FPG) (r = 0.08, 95% confidence interval (CI): 0.04−0.13, p < 0.001), fasting plasma insulin (INS) (r = 0.48, 95% CI: 0.37−0.57, p < 0.001), and homeostasis model assessment (HOMA)- insulin resistance (IR) (r = 0.44, 95% CI: 0.33−0.53, p < 0.001). The subgroup analysis according to country or overweight and obesity indicated that these associations remained significant between FMP and INS or HOMA-IR. Our results demonstrated that there is a positive relationship between FMP and FPG. Moreover, subgroup analysis according to country or overweight and obesity indicated that FMP is significantly associated with INS and HOMA-IR. This is the first known systematic review and meta-analysis to determine the associations of FMP with glucose metabolism in children and adolescents.
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Affiliation(s)
- Fangfang Chen
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing 100020, China; (F.C.); (Y.C.)
| | - Junting Liu
- Child Health Big Data Research Center, Capital Institute of Pediatrics, Beijing 100020, China; (J.L.); (D.H.); (T.L.)
| | - Dongqing Hou
- Child Health Big Data Research Center, Capital Institute of Pediatrics, Beijing 100020, China; (J.L.); (D.H.); (T.L.)
| | - Tao Li
- Child Health Big Data Research Center, Capital Institute of Pediatrics, Beijing 100020, China; (J.L.); (D.H.); (T.L.)
| | - Yiren Chen
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing 100020, China; (F.C.); (Y.C.)
| | - Zijun Liao
- Department of Integrated Early Childhood Development, Capital Institute of Pediatrics, Beijing 100020, China;
| | - Lijun Wu
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing 100020, China; (F.C.); (Y.C.)
- Correspondence: ; Tel.: +86-10-85695537
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Monti S, Cella L, Xu T, Mohan R, Liao Z, Palma G. MO-0875 Thoracic regions contributing to radiation induced lymphocyte depletion in lung cancer patients. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02441-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Palma G, Monti S, Xu T, Mohan R, Liao Z, Cella L. MO-0881 Dose patterns associated to radiation induced esophagitis in locally advanced NSCLC patients. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02447-1] [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: 10/18/2022]
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Weiß A, Löck S, Xu T, Liao Z, Troost E. PD-0663 Do structural parameters of the dose distribution improve the prediction of RP in NSCLC patients? Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02910-3] [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: 10/18/2022]
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TANG J, Liao Z, Luo L, Deng S, Hu X, Li X. POS-400 CD16+ MONOCYTES RECRUITED BY GLOMERULAR ENDOTHELIAL CELLS VIA THE CX3CL1-CX3CR1 AXIS CONTROBUTE TO RENAL DAMAGE IN MPO-AAV. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.01.422] [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: 10/19/2022] Open
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Abstract
Protein subcellular localization prediction (PSLP), which plays an important role in the field of computational biology, identifies the position and function of proteins in cells without expensive cost and laborious effort. In the past few decades, various methods with different algorithms have been proposed in solving the problem of subcellular localization prediction; machine learning and deep learning constitute a large portion among those proposed methods. In order to provide an overview about those methods, the first part of this article will be a brief review of several state-of-the-art machine learning methods on subcellular localization prediction; then the materials used by subcellular localization prediction is described and a simple prediction method, that takes protein sequences as input and utilizes a convolutional neural network as the classifier, is introduced. At last, a list of notes is provided to indicate the major problems that may occur with this method.
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Affiliation(s)
- Gaofeng Pan
- Department of Computer Science and Engineering, University of South Carolina, Columbia, SC, USA
| | - Chao Sun
- Department of Computer Science and Engineering, University of South Carolina, Columbia, SC, USA
| | - Zijun Liao
- Department of Computer Science and Engineering, University of South Carolina, Columbia, SC, USA.,Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fujian Medical University, Fujian, China
| | - Jijun Tang
- Department of Computer Science and Engineering, University of South Carolina, Columbia, SC, USA. .,School of Computer Science and Technology, College of Intelligence and Computing, Tianjin University, Tianjin, China.
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Khan E, Lambrakis K, Liao Z, Gerlach J, Verjans J, Dykes L, Chew D. Developing a Machine Learning (ML) Model for Digital Phenotyping of Myocardial Infarction (MI) and Injury Amongst Patients Presenting With Suspected Acute Coronary Syndrome (ACS). Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.526] [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: 10/16/2022]
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Wu L, Chen F, Liu J, Hou D, Li T, Chen Y, Liao Z. The Relationship Between Fat-Free Mass and Glucose Metabolism in Children and Adolescents: A Systematic Review and Meta-Analysis. Front Pediatr 2022; 10:864904. [PMID: 35558370 PMCID: PMC9087035 DOI: 10.3389/fped.2022.864904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 03/31/2022] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To assess the relationship between fat-free mass (FFM) and glucose metabolism in children 0-18 years of age. METHODS We performed a systematic review of the literature on Medline/PubMed, SinoMed, Embase, and the Cochrane Library using the PRISMA 2020 guidelines to 12 October 2021; this encompassed observational studies in which the relationship between FFM and glucose metabolism was assessed. Correlation coefficient (r), regression coefficient (β), and odds ratio (OR) values in the studies were extracted and recorded as the primary data. "Agency for Healthcare Research and Quality" quality-assessment forms recommended for cross-sectional/prevalence studies were applied to evaluate the quality of the selected studies, and we executed R software to combine the pooled data. RESULTS We included eight studies comprising 13,282 individuals, five of which involved the assessment of the relationship between FFM and blood glucose, and four on the relationship between FFM and insulin resistance (IR). Our results showed that FFM was significantly associated with fasting plasma insulin levels (r = 0.34, 95% CI: 0.30-0.39, P < 0.001). Due to high heterogeneity or insufficient quantity of data, the studies of the relationship between FFM and fasting plasma glucose, HOMA-IR, or HbA1c were not congruent, and were therefore not suitable for meta-analysis. CONCLUSION Our results indicated that FFM was significantly associated with fasting plasma insulin levels. As far as we have determined, this is the first-ever systematic review and meta-analysis of the associations between FFM and glucose metabolism in children and adolescents; and our results thus provide novel information to fill a gap in the literature in this area. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020150320, PROSPERO CRD42020150320.
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Affiliation(s)
- Lijun Wu
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Fangfang Chen
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Junting Liu
- Child Health Big Data Research Center, Capital Institute of Pediatrics, Beijing, China
| | - Dongqing Hou
- Child Health Big Data Research Center, Capital Institute of Pediatrics, Beijing, China
| | - Tao Li
- Child Health Big Data Research Center, Capital Institute of Pediatrics, Beijing, China
| | - Yiren Chen
- Child Health Big Data Research Center, Capital Institute of Pediatrics, Beijing, China
| | - Zijun Liao
- Department of Integrated Early Childhood Development, Capital Institute of Pediatrics, Beijing, China
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Cella L, Monti S, Xu T, Durante M, Liuzzi R, Mohan R, Liao Z, Palma G. Spatial dose patterns associated to cardiac toxicity and survival in patients treated with photons and protons for lung cancer. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00130-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Lin S, Augustyn A, He J, Qiao Y, Xu T, Liao Z, Gardner K, Moran J, Tang C, Adams D. Sequential Monitoring of PD-L1 on Circulating Tumor Stromal Cells Predicts Survival Outcomes for Unresectable Stage 3 NSCLC Treated With Immunotherapies After Definitive Chemoradiation. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.058] [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: 11/25/2022]
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Liao Z, Allott K, Anderson JFI, Killackey E, Cotton SM. Quality of life in first episode psychosis: a cluster analytic approach. Qual Life Res 2021; 31:1807-1817. [PMID: 34661805 DOI: 10.1007/s11136-021-03014-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2021] [Indexed: 12/01/2022]
Abstract
PURPOSE Quality of life is increasingly recognised as an important outcome for young people with first episode psychosis (FEP). The first aim was to determine whether distinct homogenous subgroups of young people with FEP could be delineated based on profiles on quality of life domains (Physical Health, Psychological, Social relationships and Environmental). The second aim was to examine the discriminant validity of these subgroups with respect to demographic, functioning and clinical features of FEP. METHOD Quality of life, demographic characteristics, clinical characteristics, cognition and functioning were assessed in 145 people with FEP. Cluster analysis using Ward's methods and Squared Euclidean Distance with a k-means verification were employed to identify subgroups with homogenous quality of life profiles. The clusters were externally validated using multinomial logistic regressions. RESULTS Three distinct quality of life profiles were identified: one with good quality of life across all domains (30%), one with poor quality of life particularly in Psychological and Social relationships domains (28%), and one 'intermediate' group with comparatively low Psychological quality of life (42%). Depression, semantic verbal fluency, social inclusion and social/occupational functioning showed associations with group membership. CONCLUSION Our results suggest the potential of maintaining relatively good quality of life despite the experience of FEP. Future research on interventions to improve quality of life may consider the potential of addressing depression, social inclusion and social/occupational functioning.
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Affiliation(s)
- Z Liao
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, 3010, Australia
| | - K Allott
- Orygen, Parkville, Melbourne, VIC, 3052, Australia.,Centre for Youth Mental Health, The University of Melbourne, Locked Bag 10 (35 Poplar Road), Parkville, Melbourne, VIC, 3052, Australia
| | - J F I Anderson
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, 3010, Australia
| | - E Killackey
- Orygen, Parkville, Melbourne, VIC, 3052, Australia.,Centre for Youth Mental Health, The University of Melbourne, Locked Bag 10 (35 Poplar Road), Parkville, Melbourne, VIC, 3052, Australia
| | - S M Cotton
- Orygen, Parkville, Melbourne, VIC, 3052, Australia. .,Centre for Youth Mental Health, The University of Melbourne, Locked Bag 10 (35 Poplar Road), Parkville, Melbourne, VIC, 3052, Australia.
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Chen N, Wu H, Deng Z, Liao Z, Feng S, Luo Z, Chu Y, Qiu G, Li X, Jin Y, Rong S, Wang F, Gan L, Chen R, Zhao L. [An optimized protocol of meniscus cell extraction for single-cell RNA sequencing]. Nan Fang Yi Ke Da Xue Xue Bao 2021; 41:1310-1318. [PMID: 34658344 DOI: 10.12122/j.issn.1673-4254.2021.09.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To optimize the protocol of meniscus cell extraction to enhance the efficiency of cell suspension preparation and maintain a high cell viability for single-cell RNA sequencing. METHODS We compared the efficiency of the routine cell extraction methods (short-time digestion and long-time digestion) and the optimized protocol for obtaining meniscus cell suspensions by evaluating the cell number obtained and the cell viability. Single-cell RNA sequencing datasets were analyzed to evaluate the stability of the cell suspension prepared using the optimized protocol. The reliability of the optimized protocol was assessed by comparing the single-cell RNA sequencing dataset obtained by the optimized protocol with published single-cell RNA sequencing datasets of the meniscus. RESULTS The optimized protocol harvested a greater number of cells (over 1×105) than the routine protocols. The cell suspension prepared with the optimized protocol showed a cell viability higher than 80%, the highest among the 3 methods. Analysis of single-cell RNA sequencing datasets showed that the ratio of the mitochondrial genes was below 20% in over 80% of the cells. CD34+ cells, MCAM+ cells and COL1A1+ cells were identified in the datasets. Comparison with the publish datasets showed that the optimized protocol was capable of harvesting COL3A1+, COL1A1+, MYLK+, BMP2+, CD93+ and CDK1+ cells. CONCLUSION Single-cell suspension prepared from the meniscus can be stably obtained using the optimized protocol for single-cell RNA sequencing using the 10× Genomics platform.
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Affiliation(s)
- N Chen
- Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - H Wu
- Zhujiang Hospital, Southern Medical University, Guangzhou 510080, China
| | - Z Deng
- Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Z Liao
- Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - S Feng
- Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Z Luo
- Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Y Chu
- Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - G Qiu
- Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - X Li
- Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Y Jin
- Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - S Rong
- Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - F Wang
- Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - L Gan
- Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - R Chen
- Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - L Zhao
- Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
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Yang D, Li Z, Gao G, Li X, Liao Z, Wang Y, Li W, Zhang Y, Liu W. Combined Analysis of Surface Protein Profile and microRNA Expression Profile of Exosomes Derived from Brain Microvascular Endothelial Cells in Early Cerebral Ischemia. ACS Omega 2021; 6:22410-22421. [PMID: 34497930 PMCID: PMC8412952 DOI: 10.1021/acsomega.1c03248] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 08/05/2021] [Indexed: 05/12/2023]
Abstract
Endothelial cell damage is an important pathological basis for the deterioration of acute ischemia stroke. Our previous studies have been exploring the mechanism of blood-brain barrier (BBB) endothelial cell injury in the early stage of cerebral ischemia. Exosomes act as an important intercellular player in neurovascular communication. However, the characteristic of exosomes derived from BBB endothelial cells in early ischemic stroke is poorly understood. We exposed cultured brain microvascular endothelial cells (bEnd.3) to 3 h oxygen glucose deprivation (OGD) to mimic early cerebral ischemia in vitro and compared miRome and surface protein contents of exosomes derived from bEnd.3 cells by miRNA sequencing and the proximity barcoding assay (PBA). A total of 346 differentially miRNA (159 upregulated and 187 downregulated) were identified via miRNA-Seq in bEnd.3 cells after exposure to OGD for 3 h. Moreover, Gene Ontology (GO) and KEGG pathway analyses showed that cell proliferation- and angiogenesis-associated miRNAs were significantly affected. The abnormal changes in top eight miRNAs were further verified by a quantitative polymerase chain reaction (qPCR). PBA experiments showed that the numbers of exosomes carrying the following proteins increased significantly under ischemia, including bFGF, CD146, EPHA2, ABCB5, and ITGB2. These proteins were related to angiogenesis, cell proliferation, and cell inflammation. The network analysis combining PBA data with miRNA-Seq data showed that 79 miRNAs were related to 24 membrane proteins and predicted that there were surface proteins associated with a variety of miRNA molecules, such as ITGA9, XIAP, ADAM1, ITGA2, ITGA3, PDPN, and ITGB1. Meanwhile, there were miRNAs related to various surface proteins including miR-410-3p, miR-378b, and miR-1960. Taken together, our data demonstrated for the first time the changes of exosomal miRNAs and surface protein profiles derived from ischemic microvascular endothelial cells, which may provide new therapeutic targets for BBB protection in ischemic stroke.
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Affiliation(s)
- Dexin Yang
- Department
of Neurosurgery, Shenzhen Key Laboratory of Neurosurgery, Shenzhen Second People’s Hospital/The First
Affiliated Hospital of Shenzhen University, Shenzhen 518035, China
- The
Central Laboratory, Shenzhen Second People’s
Hospital/The First Affiliated Hospital of Shenzhen University, Shenzhen 518035, China
| | - Zongyang Li
- Department
of Neurosurgery, Shenzhen Key Laboratory of Neurosurgery, Shenzhen Second People’s Hospital/The First
Affiliated Hospital of Shenzhen University, Shenzhen 518035, China
- The
Central Laboratory, Shenzhen Second People’s
Hospital/The First Affiliated Hospital of Shenzhen University, Shenzhen 518035, China
| | - Guoqing Gao
- Department
of General Medicine, The Central Hospital
of Wulanchabu City, Wulanchabu 012000, China
| | - Xiaofeng Li
- Department
of Neurosurgery, Shenzhen Key Laboratory of Neurosurgery, Shenzhen Second People’s Hospital/The First
Affiliated Hospital of Shenzhen University, Shenzhen 518035, China
- The
Central Laboratory, Shenzhen Second People’s
Hospital/The First Affiliated Hospital of Shenzhen University, Shenzhen 518035, China
| | - Zijun Liao
- Department
of Neurosurgery, Shenzhen Key Laboratory of Neurosurgery, Shenzhen Second People’s Hospital/The First
Affiliated Hospital of Shenzhen University, Shenzhen 518035, China
- The
Central Laboratory, Shenzhen Second People’s
Hospital/The First Affiliated Hospital of Shenzhen University, Shenzhen 518035, China
| | - Yachao Wang
- Department
of Neurosurgery, Shenzhen Key Laboratory of Neurosurgery, Shenzhen Second People’s Hospital/The First
Affiliated Hospital of Shenzhen University, Shenzhen 518035, China
- The
Central Laboratory, Shenzhen Second People’s
Hospital/The First Affiliated Hospital of Shenzhen University, Shenzhen 518035, China
| | - Weiping Li
- Department
of Neurosurgery, Shenzhen Key Laboratory of Neurosurgery, Shenzhen Second People’s Hospital/The First
Affiliated Hospital of Shenzhen University, Shenzhen 518035, China
| | - Yuan Zhang
- Department
of Neurosurgery, Shenzhen Key Laboratory of Neurosurgery, Shenzhen Second People’s Hospital/The First
Affiliated Hospital of Shenzhen University, Shenzhen 518035, China
- The
Central Laboratory, Shenzhen Second People’s
Hospital/The First Affiliated Hospital of Shenzhen University, Shenzhen 518035, China
- Department
of Pathophysiology, Baotou Medical College, Baotou 014060, China
| | - Wenlan Liu
- Department
of Neurosurgery, Shenzhen Key Laboratory of Neurosurgery, Shenzhen Second People’s Hospital/The First
Affiliated Hospital of Shenzhen University, Shenzhen 518035, China
- The
Central Laboratory, Shenzhen Second People’s
Hospital/The First Affiliated Hospital of Shenzhen University, Shenzhen 518035, China
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Palma G, Monti S, Pacelli R, Liao Z, Deasy J, Mohan R, Cella L. OC-0641 Radiation pneumonitis in thoracic cancer patients: multi-center voxel-based analysis. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06997-8] [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]
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Monti S, Cella L, Xu T, Mohan R, Liao Z, Palma G. OC-0637 Thoracic dose patterns associated with radiation induced lymphopenia in patients treated for NSCLC. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06993-0] [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: 11/17/2022]
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Yu C, Gu J, Liao Z, Feng S. Prediction of spinal anesthesia-induced hypotension during elective cesarean section: a systematic review of prospective observational studies. Int J Obstet Anesth 2021; 47:103175. [PMID: 34034957 DOI: 10.1016/j.ijoa.2021.103175] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 04/15/2021] [Accepted: 04/25/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Spinal anesthesia is the standard for elective cesarean section but spinal anesthesia-induced hypotension remains an important problem. Accurate prediction of hypotension could enhance clinical decision-making, alter management, and facilitate early intervention. We performed a systematic review of predictors of spinal anesthesia-induced hypotension and their predictive value during cesarean section. METHODS PubMed, Embase, Cochrane Library, Google Scholar and Web of Science databases were searched for prospective observational studies assessing the diagnostic accuracy of predictors of spinal anesthesia-induced hypotension in elective cesarean section. The quality of studies was assessed and predictors were grouped in domains based on the type of predictor. RESULTS Thirty-eight studies (n=3086 patients) were included. In most studies, patients received 500-1000 mL crystalloid preload or 500-2000 mL crystalloid coload. Vasopressors for post-spinal hypotension were boluses of ephedrine 5-15 mg and/or phenylephrine 25-100 µg in most studies. The hypotension rate varied from 29% to 80% based on the definition. For analysis, >30 predictors were classified into seven domains: demographic characteristics, baseline hemodynamic variables, baseline sympathovagal balance, postural stress testing, peripheral perfusion indices, blood volume and fluid responsiveness indices, and genetic polymorphism. CONCLUSIONS Environmental and individual factors increased outcome variability, which restricted the value of the autonomic nervous system and peripheral perfusion indices for prediction of spinal anesthesia-induced hypotension. Supine stress tests may reflect parturients' cardiovascular tolerance during hemodynamic fluctuations and may optimize the predictive value of static state predictors. Future research for predicting spinal anesthesia-induced hypotension should focus on composite and dynamic parameters during the supine stress tests.
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Affiliation(s)
- C Yu
- Department of Anesthesiology and Key Laboratory of Birth Defects and Related Diseases of Women and Children Sichuan University, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - J Gu
- Department of Anesthesiology and Key Laboratory of Birth Defects and Related Diseases of Women and Children Sichuan University, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Z Liao
- Department of Anesthesiology and Key Laboratory of Birth Defects and Related Diseases of Women and Children Sichuan University, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - S Feng
- Department of Anesthesiology and Key Laboratory of Birth Defects and Related Diseases of Women and Children Sichuan University, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China.
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Zhai Y, Zhao B, Wang Y, Li L, Li J, Li X, Chang L, Chen Q, Liao Z. Construction of the optimization prognostic model based on differentially expressed immune genes of lung adenocarcinoma. BMC Cancer 2021; 21:213. [PMID: 33648465 PMCID: PMC7923649 DOI: 10.1186/s12885-021-07911-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 02/11/2021] [Indexed: 02/07/2023] Open
Abstract
Background Lung adenocarcinoma (LUAD) is the most common pathology subtype of lung cancer. In recent years, immunotherapy, targeted therapy and chemotherapeutics conferred a certain curative effects. However, the effect and prognosis of LUAD patients are different, and the efficacy of existing LUAD risk prediction models is unsatisfactory. Methods The Cancer Genome Atlas (TCGA) LUAD dataset was downloaded. The differentially expressed immune genes (DEIGs) were analyzed with edgeR and DESeq2. The prognostic DEIGs were identified by COX regression. Protein-protein interaction (PPI) network was inferred by STRING using prognostic DEIGs with p value< 0.05. The prognostic model based on DEIGs was established using Lasso regression. Immunohistochemistry was used to assess the expression of FERMT2, FKBP3, SMAD9, GATA2, and ITIH4 in 30 cases of LUAD tissues. Results In total,1654 DEIGs were identified, of which 436 genes were prognostic. Gene functional enrichment analysis indicated that the DEIGs were involved in inflammatory pathways. We constructed 4 models using DEIGs. Finally, model 4, which was constructed using the 436 DEIGs performed the best in prognostic predictions, the receiver operating characteristic curve (ROC) was 0.824 for 3 years, 0.838 for 5 years, 0.834 for 10 years. High levels of FERMT2, FKBP3 and low levels of SMAD9, GATA2, ITIH4 expression are related to the poor overall survival in LUAD (p < 0.05). The prognostic model based on DEIGs reflected infiltration by immune cells. Conclusions In our study, we built an optimal prognostic signature for LUAD using DEIGs and verified the expression of selected genes in LUAD. Our result suggests immune signature can be harnessed to obtain prognostic insights. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-07911-8.
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Affiliation(s)
- Yang Zhai
- Department of Oncology, Tumor Hospital of Shaanxi Province, Xi'an, 710061, People's Republic of China.,Bioinspired Engineering and Biomechanics Center (BEBC), Xi'an Jiaotong University, Xi'an, 710049, PR China
| | - Bin Zhao
- Department of Epidemiology, Shaanxi Provincial Tumor Hospital, Xi'an, 710061, China.,The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Yuzhen Wang
- Department of Oncology, Tumor Hospital of Shaanxi Province, Xi'an, 710061, People's Republic of China
| | - Lina Li
- Department of Oncology, Tumor Hospital of Shaanxi Province, Xi'an, 710061, People's Republic of China
| | - Jingjin Li
- Department of Vasculocardiology, First Affiliated Hospital, Xi'an Jiaotong University Medical College, Xi'an, 710061, PR China
| | - Xu Li
- Department of Oncology, Tumor Hospital of Shaanxi Province, Xi'an, 710061, People's Republic of China
| | - Linhan Chang
- Xi'an Medical University, Xi'an, 710061, PR China
| | - Qian Chen
- Department of Reproduction, First Affiliated Hospital, Xi'an Jiaotong University Medical College, Xi'an, Shaanxi, 710061, PR China.
| | - Zijun Liao
- Department of Oncology, Tumor Hospital of Shaanxi Province, Xi'an, 710061, People's Republic of China.
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Wong SL, Alshaikhi J, Grimes H, Amos RA, Poynter A, Rompokos V, Gulliford S, Royle G, Liao Z, Sharma RA, Mendes R. Retrospective Planning Study of Patients with Superior Sulcus Tumours Comparing Pencil Beam Scanning Protons to Volumetric-Modulated Arc Therapy. Clin Oncol (R Coll Radiol) 2021; 33:e118-e131. [PMID: 32798157 PMCID: PMC7883303 DOI: 10.1016/j.clon.2020.07.016] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 05/30/2020] [Accepted: 07/22/2020] [Indexed: 12/25/2022]
Abstract
AIMS Twenty per cent of patients with non-small cell lung cancer present with stage III locally advanced disease. Precision radiotherapy with pencil beam scanning (PBS) protons may improve outcomes. However, stage III is a heterogeneous group and accounting for complex tumour motion is challenging. As yet, it remains unclear as to whom will benefit. In our retrospective planning study, we explored if patients with superior sulcus tumours (SSTs) are a select cohort who might benefit from this treatment. MATERIALS AND METHODS Patients with SSTs treated with radical radiotherapy using four-dimensional planning computed tomography between 2010 and 2015 were identified. Tumour motion was assessed and excluded if greater than 5 mm. Photon volumetric-modulated arc therapy (VMAT) and PBS proton single-field optimisation plans, with and without inhomogeneity corrections, were generated retrospectively. Robustness analysis was assessed for VMAT and PBS plans involving: (i) 5 mm geometric uncertainty, with an additional 3.5% range uncertainty for proton plans; (ii) verification plans at maximal inhalation and exhalation. Comparative dosimetric and robustness analyses were carried out. RESULTS Ten patients were suitable. The mean clinical target volume D95 was 98.1% ± 0.4 (97.5-98.8) and 98.4% ± 0.2 (98.1-98.9) for PBS and VMAT plans, respectively. All normal tissue tolerances were achieved. The same four PBS and VMAT plans failed robustness assessment. Inhomogeneity corrections minimally impacted proton plan robustness and made it worse in one case. The most important factor affecting target coverage and robustness was the clinical target volume entering the spinal canal. Proton plans significantly reduced the mean lung dose (by 21.9%), lung V5, V10, V20 (by 47.9%, 36.4%, 12.1%, respectively), mean heart dose (by 21.4%) and thoracic vertebra dose (by 29.2%) (P < 0.05). CONCLUSIONS In this planning study, robust PBS plans were achievable in carefully selected patients. Considerable dose reductions to the lung, heart and thoracic vertebra were possible without compromising target coverage. Sparing these lymphopenia-related organs may be particularly important in this era of immunotherapy.
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Affiliation(s)
- S-L Wong
- University College London Cancer Institute, London, UK; Department of Clinical Oncology, University College London Hospitals NHS Foundation Trust, London, UK.
| | - J Alshaikhi
- Department of Medical Physics and Biomedical Engineering, University College London, London, UK; Department of Radiotherapy Physics, University College London Hospitals NHS Foundation Trust, London, UK; Saudi Particle Therapy Centre, Riyadh, Saudi Arabia
| | - H Grimes
- Department of Radiotherapy Physics, University College London Hospitals NHS Foundation Trust, London, UK
| | - R A Amos
- Department of Clinical Oncology, University College London Hospitals NHS Foundation Trust, London, UK; Department of Radiotherapy Physics, University College London Hospitals NHS Foundation Trust, London, UK; Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - A Poynter
- Department of Radiotherapy Physics, University College London Hospitals NHS Foundation Trust, London, UK
| | - V Rompokos
- Department of Radiotherapy Physics, University College London Hospitals NHS Foundation Trust, London, UK
| | - S Gulliford
- Department of Medical Physics and Biomedical Engineering, University College London, London, UK; Department of Radiotherapy Physics, University College London Hospitals NHS Foundation Trust, London, UK
| | - G Royle
- Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| | - Z Liao
- Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - R A Sharma
- University College London Cancer Institute, London, UK; Department of Clinical Oncology, University College London Hospitals NHS Foundation Trust, London, UK; NIHR University College London Hospitals Biomedical Research Centre, London, UK
| | - R Mendes
- Department of Clinical Oncology, University College London Hospitals NHS Foundation Trust, London, UK
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Liao Z, Zhou Y, Liu A, Li H, Peters RL, Liu J. Association of cesarean delivery on maternal request with neonatal iron stores at birth. Eur J Clin Nutr 2021; 75:1637-1644. [PMID: 33637973 DOI: 10.1038/s41430-021-00874-w] [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: 03/18/2020] [Revised: 01/17/2021] [Accepted: 01/28/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Cesarean has been suggested to decrease neonatal iron stores at birth. However, few studies have differentiated the effect induced by cesarean operation from that related to medical indications. OBJECTIVES We aimed to estimate the association of cesarean delivery on maternal request (CDMR), a subtype of cesarean without any medical indications, with a spectrum of indicators reflecting iron stores at birth. METHODS This prospective cohort study involved 288 term singleton neonates born to women without any complications by CDMR or spontaneous vaginal delivery (SVD). Measured hematological iron-related indicators in cord blood included serum ferritin (SF), hemoglobin (Hb), red blood cell (RBC), and hematocrit (Hct). Blood flow volume (BFV) of cord vein when clamping was measured to reflect placental transfusion status during birth. Quantile regression was used to assess the association between delivery mode and the iron store indicators. RESULTS CDMR (n = 154) versus SVD group (n = 134) had lower conditional median cord blood SF (-34.80; 95% CI -64.70, -4.90 μg/L; P = 0.02), Hb (-10.67; 95% CI -18.87, -2.47 g/L; P = 0.01), RBC (-0.30; 95% CI -0.48, -0.12 ×1012/L; P = 0.002), and Hct (-3.06; 95% CI -6.08, -0.04 %; P = 0.047). The BFV was higher in CDMR than SVD group at the 25th centile (0.51; 95% CI 0.19, 0.82 ml/cm3; P = 0.002), median (0.49; 95% CI 0.04, 0.95 ml/cm3; P = 0.03) and the 75th centile (0.54; 95% CI 0.06, 1.03 ml/cm3; P = 0.03). CONCLUSIONS The cesarean operation per se likely hampered placental transfusion from mother to neonate and decreased iron stores at birth.
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Affiliation(s)
- Zijun Liao
- Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health, Peking University Health Science Center, Beijing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China.,Department of Integrated Early Childhood Development, Capital Institute of Pediatrics, Beijing, China
| | - Yubo Zhou
- Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health, Peking University Health Science Center, Beijing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Aiju Liu
- Inner Mongolia Maternal and Child Health Care Hospital, Hohhot, Inner Mongolia, China
| | - Hongtian Li
- Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health, Peking University Health Science Center, Beijing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Rachel L Peters
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Jianmeng Liu
- Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health, Peking University Health Science Center, Beijing, China. .,Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China.
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Chen X, Liao Z, Shen Y, Dong B, Hou L, Hao Q. The Relationship between Pre-Admission Waiting Time and the Surgical Outcomes after Hip Fracture Operation in the Elderly. J Nutr Health Aging 2021; 25:951-955. [PMID: 34545913 DOI: 10.1007/s12603-021-1656-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVES To investigate the association between pre-admission waiting time and postoperative complications, length of stay (LOS), and costs during hospitalization. METHOD This was a single-center, observational study. The subjects of this study were elderly hip fracture patients who were admitted to the Department of Orthopedics, West China Hospital, Sichuan University, from December 2010 to June 14, 2017, and that underwent internal fixation or joint replacement surgery. The pre-admission waiting time was treated as a categorical variable according to median and first quartile values. Outcomes included postoperative complications (pneumonia and other complications [urinary tract infection, heart failure, non-A-grade healing]), LOS, and costs during hospitalization. LOS and costs during hospitalization were converted into binary outcomes based upon median values. Binary logistic regression analyses were used to analyze correlations between pre-admission waiting time and patient outcomes. RESULTS A total of 889 patients 60 years of age and older were enrolled in this study, of whom 65.47% were females and 34.53% were males. The proportion of patients with pre-admission waiting times less than 8 h, 8 - 24 h, and ≥ 24 h were 24.3%, 17.32%, and 58.38%, respectively. Postoperative pneumonia and other complications affected 12.04% and 6.30% of patients, respectively. Relative to patients with the pre-admission waiting times of less than 8 h, those with longer pre-admission waiting times exhibited a higher risk of postoperative pneumonia (8 - 24 h: OR = 2.72,95% CI: 1.29-5.74, p = 0.009; ≥ 24 h: OR = 2.76,95% CI: 1.48-5.14, p = 0.001). Patients with the pre-admission waiting time ≥ 24 h also exhibited a higher risk of the other complications (OR = 2.55, 95% CI: 1.53-4.26, p <0.001), a longer LOS (OR = 1.43, 95% CI:1.02-2.01, p = 0.036), and higher costs during hospitalization (OR = 1.51, 95% CI:1.05 - 2.17, p = 0.026) relative to patients with a waiting time less than 8 hours. CONCLUSION Pre-admission waiting time was associated with postoperative complications, LOS, and hospitalization costs among older Chinese patients undergoing surgery to treat hip fractures.
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Affiliation(s)
- X Chen
- Qiukui Hao, MD, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China; ; Telephone: ++86-28-85422321
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Wu Q, Huang Y, Liao Z, van Velthoven MH, Wang W, Zhang Y. Effectiveness of WeChat for Improving Exclusive Breastfeeding in Huzhu County China: Randomized Controlled Trial. J Med Internet Res 2020; 22:e23273. [PMID: 33270026 PMCID: PMC7746496 DOI: 10.2196/23273] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 09/06/2020] [Accepted: 11/02/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The benefits of breastfeeding for both infants and mothers have been well recognized. However, the exclusive breastfeeding rate in China is low and decreasing. Mobile technologies have rapidly developed; communication apps such as WeChat (one of the largest social networking platforms in China) are widely used and have the potential to conveniently improve health behaviors. OBJECTIVE This study aimed to assess the effectiveness of using WeChat to improve breastfeeding practices. METHODS This 2-arm randomized controlled trial was conducted among pregnant women from May 2019 to April 2020 in Huzhu County, Qinghai Province, China. Pregnant women were eligible to participate if they were aged 18 years or older, were 11 to 37 weeks pregnant with a singleton fetus, had no known illness that could limit breastfeeding after childbirth, used WeChat through their smartphone, and had access to the internet. A total of 344 pregnant women were recruited at baseline, with 170 in the intervention group and 174 in the control group. Women in the intervention group received breastfeeding knowledge and promotion information weekly through a WeChat official account from their third month of pregnancy to 6 months postpartum. The primary outcome of exclusive and predominant breastfeeding rate was measured 0-1 month, 2-3 months, and 4-5 months postpartum. RESULTS At 0-1 month postpartum, the exclusive breastfeeding rate was significantly higher in the intervention group than that in the control group (81.1% vs 63.3%; odds ratio [OR] 2.75, 95% CI 1.58-4.78; P<.001). Similarly, mothers in the intervention group were more likely to provide predominantly breast milk (OR 2.77, 95% CI 1.55-4.96; P<.001) and less likely to give dairy products to their children (OR 0.40, 95% CI 0.21-0.75; P=.005). There was no statistically significant difference for exclusive breastfeeding rate 2-3 months (P=.09) and 4-5 months postpartum (P=.27), though more children in the intervention group were exclusively breastfed than those in the control group 2-3 months postpartum (intervention: 111/152, 73.0%; control: 96/152, 63.2%) and 4-5 months postpartum(intervention: 50/108, 46.3%; control: 46/109, 42.2%). CONCLUSIONS This study is the first effort to promote exclusive breastfeeding through WeChat in China, which proved to be an effective method of promoting exclusive breastfeeding in early life. WeChat health education can be used in addition to local breastfeeding promotion programs. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR1800017364; http://www.chictr.org.cn/showproj.aspx?proj=29325. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/s12889-019-7676-2.
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Affiliation(s)
- Qiong Wu
- Capital Institute of Pediatrics, Beijing, China
| | - Yiwen Huang
- Capital Institute of Pediatrics, Beijing, China
| | - Zijun Liao
- Capital Institute of Pediatrics, Beijing, China
| | | | - Wei Wang
- Capital Institute of Pediatrics, Beijing, China
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50
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Sparks FT, Liao Z, Li W, Grosmark A, Soltesz I, Losonczy A. Hippocampal adult-born granule cells drive network activity in a mouse model of chronic temporal lobe epilepsy. Nat Commun 2020; 11:6138. [PMID: 33262339 PMCID: PMC7708476 DOI: 10.1038/s41467-020-19969-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 11/10/2020] [Indexed: 02/06/2023] Open
Abstract
Temporal lobe epilepsy (TLE) is characterized by recurrent seizures driven by synchronous neuronal activity. The reorganization of the dentate gyrus (DG) in TLE may create pathological conduction pathways for synchronous discharges in the temporal lobe, though critical microcircuit-level detail is missing from this pathophysiological intuition. In particular, the relative contribution of adult-born (abGC) and mature (mGC) granule cells to epileptiform network events remains unknown. We assess dynamics of abGCs and mGCs during interictal epileptiform discharges (IEDs) in mice with TLE as well as sharp-wave ripples (SPW-Rs) in healthy mice, and find that abGCs and mGCs are desynchronized and differentially recruited by IEDs compared to SPW-Rs. We introduce a neural topic model to explain these observations, and find that epileptic DG networks organize into disjoint, cell-type specific pathological ensembles in which abGCs play an outsized role. Our results characterize identified GC subpopulation dynamics in TLE, and reveal a specific contribution of abGCs to IEDs.
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Affiliation(s)
- F T Sparks
- Department of Neuroscience, Columbia University, New York, NY, USA
- Mortimer B. Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY, USA
- The Kavli Institute for Brain Science, Columbia University, New York, NY, USA
| | - Z Liao
- Department of Neuroscience, Columbia University, New York, NY, USA
- Mortimer B. Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY, USA
- The Kavli Institute for Brain Science, Columbia University, New York, NY, USA
| | - W Li
- Department of Neuroscience, Columbia University, New York, NY, USA
- Mortimer B. Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY, USA
- The Kavli Institute for Brain Science, Columbia University, New York, NY, USA
| | - A Grosmark
- Department of Neuroscience, Columbia University, New York, NY, USA
- Mortimer B. Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY, USA
- The Kavli Institute for Brain Science, Columbia University, New York, NY, USA
| | - I Soltesz
- Department of Neurosurgery, Stanford University, Stanford, CA, USA
| | - A Losonczy
- Department of Neuroscience, Columbia University, New York, NY, USA.
- Mortimer B. Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY, USA.
- The Kavli Institute for Brain Science, Columbia University, New York, NY, USA.
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