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Liu M, Li J, Zhang D, Yuan K, Wu F, Yang F, Peng G, Tang B, Orlandini LC. Challenges of Treating Lung Cancer Patients at MR-Linac Using MR-Based Synthetic CT Calculation in the Adaptive Workflow. Int J Radiat Oncol Biol Phys 2023; 117:e684. [PMID: 37786013 DOI: 10.1016/j.ijrobp.2023.06.2149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Magnetic Resonance guided adaptive radiotherapy (MRgART) allows plan adaptation according to the new patient anatomy; the contours of the structures are adjusted based on the patient's daily MRI, and in the adapt to shape (ATS) workflow, the adapted plan is recalculated on the MRI-based synthetic CT (sCT) generated by bulk density assignment. For sites where there is a high electronic density (ED) gradient between the target and surrounding tissues, such as in lung cancer treatments, the assignment of an average ED may not be able to reproduce an accurate dose calculation. This study evaluates the accuracy of the sCT adapted plan calculation for lung cancer patients and assesses whether the assignment of an optimized ED can reduce dosimetric differences should they arise MATERIALS/METHODS: Nine lung cancer patients treated at Unity 1.5 MR-Linac were selected for this retrospective study. The patient's target and organs at risk (OARs) were contoured, and a CT reference plan containing the ED bulk assignment information i.e., the contours to use in the ATS workflow, and their corresponding average ED was generated. To assess the accuracy of the dosimetry of the adapted plan calculated on the sCT, the plan was recalculated on an ideal sCT (sCTref) obtained from the reference CT by forcing the drawn contours to the average ED as defined on the CT reference plan. Targets and OARs dose-volume histogram (DVH) of the CT and sCTref plans and the dose distributions using gamma (γ) analysis with 2%-2mm criteria were compared. In the case of a discrepancy between the DVHs, the average Eds used for the recalculation on the sCTref were adjusted by several attempts to obtain a sCT optimized (sCTopt) for which a superposition of DVHs on CT and sCTopt was achieved. RESULTS For 7 of the 9 patients CT and sCTref target DVHs were not comparable, with a mean dosimetric difference of 5.55% (range 2.35%-7.46%) in the target volume receiving the prescription dose (VDpre), while OARs DVH dose differences remained below 1% for the nine patients. The adjustment of the ED of the homolateral lung in the sCTopt, reduced the mean target VDpre dosimetric difference between CT and sCTopt to 0.66% (range 0.17%-1.64%). In addition, the results of the gamma analysis increased from values ranging between 39.5%-70.3% to 88.5%-93.2%, as shown in the Table. CONCLUSION Dosimetric errors in the use of the sCT calculation for targets in high ED gradient areas may arise; the use of optimized ED for sCT calculation may be a promising strand to investigate in order to proceed with MR-based sCT plan adaptation for lung cancer treatment.
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Lin C, Ni X, Xiao N, Yang F, Guo B, Liao D, Li J. Prognostic Value of Tumor Volume Reduction during Radiotherapy in Patients with Locally Advanced Cervical Cancer in Different Risk Groups. Int J Radiat Oncol Biol Phys 2023; 117:e527. [PMID: 37785639 DOI: 10.1016/j.ijrobp.2023.06.1803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To evaluate the risk factors of patients with locally advanced cervical cancer (LACC) undergoing radical radiotherapy (with or without concurrent chemotherapy) and to assess the prognostic value of tumor volume regression (TVR) based on magnetic resonance imaging (MRI) in different risk groups. MATERIALS/METHODS A retrospective analysis was performed on 176 individuals diagnosed with stage IIA-IVA cervical cancer (CC) who underwent radical intensity-modulated radiotherapy in our center between January 2012 and December 2020. The tumor volume before radiotherapy (TVp) and before brachytherapy (TVmid) were evaluated based on three-dimensional MRI images, TVR = (TVp -TVmid)/TVp × 100%. Kaplan-Meier curves were used to assess patient's overall survival (OS) and progression-free survival (PFS). Prognostic factors were identified using Cox proportional hazards models. RESULTS For the entire cohort, patients with TVR ≥ 94% had better 5-year OS (82.7% vs 49.8%, p<0.001) and 5-year PFS (82.5% vs 51.1%, p<0.001) compared to TVR < 94%. Patients with TVR ≥ 94% were more likely to receive concurrent chemoradiotherapy (CCRT) than those with TVR < 94% (70.1% vs 40.5%, p<0.05). Among patients undergoing CCRT, those with a TVR ≥ 94% had a better prognosis than those with a TVR < 94%. However, among patients who received RT alone, those with TVR ≥ 94% had better PFS but no statistically significant difference in OS. Likewise, among patients with CYFRA21-1 < 7.7 ng/ml, patients with TVR ≥ 94% had a better prognosis. However, TVR was not a prognostic factor in patients with CYFRA21-1 ≥ 7.7 ng/ml. Both CYFRA21-1 (OS, PFS interaction, p<0.001) and FIGO stage (PFS interaction, p = 0.035) were found to significantly impact predictive effects of TVR. CONCLUSION In LACC patients with CRYFA21-1 < 7.7 ng/ml who received CCRT, TVR was an important prognostic factor. However, in patients with CRYFA21-1 ≥ 7.7 ng/ml who received RT alone, the prognostic value of TVR needs to be further explored.
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Cerbon DA, Seldon Taswell CS, Azzam G, Yang F, Carmona R, Abramowitz MC, Samuels MA, Kubicek GJ, Freedman LM, Samuels S. Dosimetric Parameters Correlate with Taste Alterations in Head and Neck Radiotherapy. Int J Radiat Oncol Biol Phys 2023; 117:e220. [PMID: 37784901 DOI: 10.1016/j.ijrobp.2023.06.1121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Dysgeusia is an acute and chronic side effect of head and neck chemoradiation, with persistent taste dysfunction 1-2 years post radiotherapy occurring in 23-50% of patients. Several head and neck clinical trials set oral cavity mean doses between 30 to 40 Gy, however, there are no set guidelines accurately defining the composite structure and anatomic boundaries for the oral cavity or separating the tongue into specific quadrants. In this single institution cross sectional study, we sought to determine the effects of radiation doses to specific regions of the oral cavity and tongue on patient-reported long term dysgeusia. We hypothesize that radiation Dose to specific structures in the oral cavity will correlate with long-term dysgeusia in patients who have received head and neck radiotherapy. MATERIALS/METHODS Patients with primary head and neck cancer receiving definitive intensity modulated radiation therapy (RT) completed quality of life assessments that included patient-reported gustatory function, 1 year post RT. Dosimetric data from RT plans were collected for specific regions and organs at risk within the oral cavity. These structures included the anterior, posterior, superior and inferior tongue (OT), pharyngeal constrictors (as a surrogate for the corda-tympani) and the oral cavity. A forward binary logistic regression model was performed using these data points with scoring from the QLQ-H&N43 questionnaire subsection on taste (Q45) to determine the most predictive values for dysgeusia and the OR for moderate/severe alterations in taste. RESULTS A total of 78 patients were included in this study, of these patients, 63 had dosimetric data for the pharyngeal constrictors. The Oral Cavity Volume percentage receiving 50Gy (OC V50) and Pharyngeal Constrictors Volume percentage receiving 55Gy (PC V55) were the most predictive constraints for dysgeusia. (0.042, p = 0.011 and 0.041, p = 0.033). Holding all other variables constant in a forward binary logistic regression including 78 patients, the odds of having moderate to severe taste alterations increased by 56% (OR 1.045, 95% CI 1.012-1.079) for a 1% increase in OCV50. When analyzing the 68 patients with available pharyngeal constrictors data, taste alteration increased 20% for every 1% increase in PCV55 (OR 1.042, 95% CI 1.003-1.082). There was no correlation with taste alterations in any of the dose parameters tested (Dmax, mean and V50 up to V70) for superior, inferior, anterior or posterior regions of the tongue. CONCLUSION Dosimetric parameters for the oral cavity (OC V50) and pharyngeal constrictors (PC V55) were positively correlated with taste alterations, however, no other specific regions within the oral tongue predicted taste disfunction. Normal tissue complication probability modeling curves to identify OC V50 and PC V55 constraints for dysgeusia are needed.
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Zhang W, Zhang WD, Chen L, Luan XG, Yang F, Li Z, Liu F, Wang DY. [Clinical effects of expanded flaps in reconstructing scar contracture deformities in the face and neck after extensive burns]. ZHONGHUA SHAO SHANG YU CHUANG MIAN XIU FU ZA ZHI 2023; 39:826-834. [PMID: 37805798 DOI: 10.3760/cma.j.cn501225-20230706-00248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/09/2023]
Abstract
Objective: To investigate the clinical effects of expanded flaps in reconstructing scar contracture deformities in the face and neck after extensive burns. Methods: A retrospective observational study was conducted. From May 2016 to September 2022, 17 patients with scar contracture deformities in the face and neck after extensive burns were admitted to Tongren Hospital of Wuhan University & Wuhan Third Hospital, including 13 males and 4 females, aged 23 to 55 years, with 3 patients having degree Ⅱ cervical contracture, 14 patients having degree Ⅲ cervical contracture, and 12 patients having facial scar contracture deformity. In the first stage, 34 rectangular skin and soft tissue expanders (hereinafter referred to as expanders) with rated capacity of 100-600 mL were inserted into the face, chest, shoulder, and abdomen, and then the normal saline was injected for expansion. In the second stage, the scar tissue was removed and the contracture was released to correct the deformity. Two expanded facial flaps were transplanted in local fashion, 17 expanded flaps were transplanted in pedicled fashion, and 15 expanded flaps were freely transplanted to repair the secondary wounds after release, with artery pressurization was performed in 7 flaps. Indocyanine green fluorescence imaging was used to evaluate the arterial blood perfusion and venous return of the flaps during transplantation. The incision area of 32 flaps except 2 facial flaps was 10 cm×8 cm-36 cm×16 cm. The wounds of 31 flap donor sites were closed by direct suture, and the wound of 1 flap donor site was repaired by autologous split-thickness scalp transplantation. The skin condition of inserted place, expansion time, and total amount of normal saline injection of expanders, complications of skin and soft tissue expansion surgery, and survival of flap after the second stage surgery were observed and recorded. The long-term face and neck reconstruction effect and recovery of flap donor area were followed up. At the last follow-up, the 5-level Likert scale was used to evaluate the efficacy satisfaction of patients. Results: Of the 34 expander inserted places in 17 patients, 22 places were superficial scar skin after deep partial-thickness burns, 8 places were superficial scar skin after multiple skin donations, and 4 places were normal skin. After 4 to 15 months of expansion, the total normal saline injection volume was 238 to 2 000 mL, with no complications occurred. After the second stage surgery, the distal part of 2 pedicled flaps was partially necrotic, and the necrotic wounds were healed after flap dressing and free transplantation of contralateral expanded triangular flaps, respectively; the other flaps survived completely. During 6 to 18 months of follow-up, except for 2 expanded paraumbilical flaps and 1 expanded groin flap, which were bloated and improved by flap thinning, the appearance and texture of the other flaps were good, and all the flap donor sites recovered well. At the last follow-up, the face and neck scar contracture deformities were significantly improved in all patients, and the satisfaction of curative effect of patient was very satisfactory in 8 patients and relatively satisfactory in 9 patients. Conclusions: The expanded flaps of chest, abdomen, and other parts, combined with local advance, pedicled, and free transplantation, can effectively reconstruct scar contracture deformities in the face and neck after extensive burns, restore the function of operative area and improve the appearance simultaneously, with high degree of patient satisfaction, which is worthy of promotion in clinic.
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Yang F, Zhang L, Qian LL, Wang RX. [Research progress on the effects and mechanisms of sodium-glucose cotransporter 2 inhibitors for diabetes-associated arrhythmias]. ZHONGHUA XIN XUE GUAN BING ZA ZHI 2023; 51:887-891. [PMID: 37583341 DOI: 10.3760/cma.j.cn112148-20230510-00265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
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Zhang W, Chen L, Yang F, Zhang WD, Liu F, Xie WG. [Treatment methods of upper limbs with destructive electric burns and its clinical efficacy]. ZHONGHUA SHAO SHANG YU CHUANG MIAN XIU FU ZA ZHI 2023; 39:731-737. [PMID: 37805783 DOI: 10.3760/cma.j.cn501225-20230530-00188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/09/2023]
Abstract
Objective: To investigate the treatment methods of upper limbs with destructive electric burns and its clinical efficacy. Methods: A retrospective observational study was conducted. From July 2014 to December 2020, 20 male patients with destructive electric burns in upper limbs who met the inclusion criteria were admitted to Tongren Hospital of Wuhan University & Wuhan Third Hospital, aged from 21 to 57 years, of whom 7 patients underwent emergency surgery, and a total of 20 affected limbs were treated with limb salvage. The necrotic bone was resected in 5 affected limbs, the residual hand and wrist at the distal end of left affected limb was replanted to the residual end of the right forearm in one patient in a cross heterotopic way, and short reduction and replantation after osteotomy were performed for two affected limbs with distal ulnar and radial necrosis. After thorough debridement, the area of wound proposed to be repaired by tissue flap was from 12 cm×7 cm to 58 cm×13 cm. According to the size and distribution of wound, the wounds of 2 affected limbs were repaired by transplantation of pedicled latissimus dorsi myocutaneous flap and free groin flap with vascular anastomosis. The wounds of the remaining 17 affected limbs were repaired with the transplantation of free latissimus dorsi myocutaneous flap, anterolateral thigh flaps, and paraumbilical perforator flap, with 10 affected limbs with larger wounds being jointly transplanted with the groin flap or the paraumbilical perforator flap on the other side. The total grafted tissue flap area was 20 cm×8 cm to 52 cm×20 cm. During tissue flap transplantation, according to the length of blood vessel defect in the affected limb, the distal artery of the affected limb was bridged with the distal part of flap vascular pedicle, undamaged vein on the affected side, superficial vein of abdominal wall, and great saphenous vein, etc., in 14 affected limbs, and the great saphenous vein was grafted in 3 of them with impeded distal return for recanalization of distal limb veins. The wound in the donor area was repaired by direct suture or grafting with split-thickness scalp. After the wound was basically healed, the functional rehabilitation training was started gradually, and the functional reconstruction and scar rectification surgery were started 3 months after tissue flap transplantation. The survival of tissue flaps/skin grafts, wound healing, limb salvage, and follow-up status after surgery were recorded. At the last follow-up, the function of the successfully salvaged limb was evaluated and scored by the disabilities of the arm, shoulder and hand (DASH) scoring scale. Results: After surgery, the grafted tissue flap in the affected limb and the skin grafts transplanted on the wound at flap donor site survived, and wounds at the recipient and donor sites healed well. Two affected limbs had distal necrosis within 10 days after tissue flap transplantation, and the middle and upper forearms were amputated. The remaining 18 affected limbs were successfully salvaged (including shortened replantation and cross heterotopic replantation). During 6-48 months of follow-up, 5 affected limbs that were successfully salvaged developed aseptic dissolution of residual tendon and bone tissue 3 to 18 months after tissue flap transplantation, which gradually healed after surgical debridement combined with vacuum sealing drainage treatment. At the last follow-up, the stump of two affected limbs healed well after amputation; 18 affected limbs that were successfully salvaged all survived well, of which 8 affected limbs had good recovery of finger flexion and extension function and thumb opponensplasty and could complete daily activities independently, 9 affected limbs regained partial mobility and could complete daily activities such as dressing and eating with the assistance of the opposite upper limb or auxiliary devices, and one affected limb had no function. At the last follow-up, the functional scores of DASH scoring scale of the 18 affected limbs that were successfully salvaged ranged from 30.0 to 100. Conclusions: Timely surgical debridement, proper treatment of the injured bone tissue, effective vascular bridging for reconstruction of the distal artery of the affected limb, and the use of blood-rich tissue flap to repair the wound, combined with early rehabilitation and functional restoration treatment, are beneficial to salvage the upper limb with destructive electric burns and improve the function of the affected limb.
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Chen L, Yu XD, Yang F, Mao M, Zhao ZY, Li TY, Jiang F. [Summary to the Sixth Special Summit on Child Health and Early Prevention of Adult Diseases]. ZHONGHUA ER KE ZA ZHI = CHINESE JOURNAL OF PEDIATRICS 2023; 61:764-765. [PMID: 37528026 DOI: 10.3760/cma.j.cn112140-20230605-00378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
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Proskuryakova AA, Ivanova ES, Makunin AI, Larkin DM, Ferguson-Smith MA, Yang F, Uphyrkina OV, Perelman PL, Graphodatsky AS. Comparative studies of X chromosomes in Cervidae family. Sci Rep 2023; 13:11992. [PMID: 37491593 PMCID: PMC10368622 DOI: 10.1038/s41598-023-39088-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 07/20/2023] [Indexed: 07/27/2023] Open
Abstract
The family Cervidae is the second most diverse in the infraorder Pecora and is characterized by variability in the diploid chromosome numbers among species. X chromosomes in Cervidae evolved through complex chromosomal rearrangements of conserved segments within the chromosome, changes in centromere position, heterochromatic variation, and X-autosomal translocations. The family Cervidae consists of two subfamilies: Cervinae and Capreolinae. Here we build a detailed X chromosome map with 29 cattle bacterial artificial chromosomes of representatives of both subfamilies: reindeer (Rangifer tarandus), gray brocket deer (Mazama gouazoubira), Chinese water deer (Hydropotes inermis) (Capreolinae); black muntjac (Muntiacus crinifrons), tufted deer (Elaphodus cephalophus), sika deer (Cervus nippon) and red deer (Cervus elaphus) (Cervinae). To track chromosomal rearrangements during Cervidae evolution, we summarized new data, and compared them with available X chromosomal maps and chromosome level assemblies of other species. We demonstrate the types of rearrangements that may have underlined the variability of Cervidae X chromosomes. We detected two types of cervine X chromosome-acrocentric and submetacentric. The acrocentric type is found in three independent deer lineages (subfamily Cervinae and in two Capreolinae tribes-Odocoileini and Capreolini). We show that chromosomal rearrangements on the X-chromosome in Cervidae occur at a higher frequency than in the entire Ruminantia lineage: the rate of rearrangements is 2 per 10 million years.
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Feng ZZ, Yang F, Cheng ST, Hu XY, Sun Y, Yang M. [Quantification of brain developmental trajectories based on histogram parameters at slice of the anterior and posterior horns of the lateral ventricles on routine brain MRI in normal children aged 0 to 5 years]. ZHONGHUA YI XUE ZA ZHI 2023; 103:2112-2118. [PMID: 37455130 DOI: 10.3760/cma.j.cn112137-20230414-00614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
Objective: To investigate the value of histogram parameters in quantifying brain development trajectory at slice of anterior and posterior horns of lateral ventricles on conventional brain MRI in normal children aged 0-5 years. Methods: Routine brain MRI data [apparent diffusion coefficient (ADC) map, T1-weighted imaging (T1WI), and T2-weighted imaging (T2WI)] were retrospectively collected from 300 children aged 0-5 years who underwent MRI at Children 's Hospital of Nanjing Medical University from April 2014 to November 2021, 154 males and 146 females, aged [M (Q1, Q3) ] 35.57(17.98,50.66)months. According to the random sampling method, they were divided into training set (n=240) and validation set (n=60) in a ratio of 8∶2. The training set was divided into 6 groups according to age:≤0.5 years, 24 persons; >0.5-≤1 years,21 persons; >1-≤2 years,31 persons; >2-≤3 years,44 persons; >3-≤4 years,42 persons; >4-≤5 years,78 persons. MRIcron software was used to delineate the whole brain at the level of the anterior and posterior horns of the lateral ventricles of the three MRI data as the region of interest. Then gray histograms and their parameters [including mean, maximum, minimum, skewness, kurtosis, mode, variance, and percentiles at 5% intervals from 10% to 95%(10th-95th) ]were obtained. Intra-class correlation coefficients (ICC) were used to assess consistency of intra-observer and inter-observer measurement. Representative parameters were selected by Spearman correlation analysis and curve fitting. The linear regression coefficient β represented development rates at different ages. The selected curve regression models were applied to the validation set, and the reliability of the model was evaluated with accuracy. Results: Intra-observer and inter-observer histogram measurement parameters were generally in good consistency (ICC>0.800, all P<0.001). Histogram parameters ADC 10th-65th, T1WI 55th-80th and T2WI 10th-45th were highly correlated with age (∣r∣≥0.700, 0.600 and 0.600 respectively; all P<0.001). ADC 30th and T2WI 10th had the greatest goodness of fit (R²=0.871, 0.873; both P<0.001). Map of brain development trends showed that ADC 30th and T2WI 10th decreased with age. ADC 30th changed rapidly before the age of 2 years, most significantly within 6 months, and the rate of decrease slowed down after 2 years old. T2WI 10th decreased rapidly within 1 year, and moderately after 1 year old. The curve regression models of ADC 30th and T2WI 10th had higher accuracy in validation set [93% (56/60) and 95% (57/60), respectively]. Conclusion: Histogram parameters can quantify brain developmental trajectories at slice of anterior and posterior horns of lateral ventricles on conventional MRI in normal children aged 0-5 years, and obtain the brain development curves reflecting this slice of this age group.
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Hao X, Li CL, Xie HX, Yang F, Jiang CJ, Du ZT, Wang XM, Wang H, Hei FL, Hou XT. [Risk factors associated with in-hospital mortality in patients requiring extracorporeal membrane oxygenation in the perioperative period of heart transplantation]. ZHONGHUA YI XUE ZA ZHI 2023; 103:1986-1992. [PMID: 37438080 DOI: 10.3760/cma.j.cn112137-20230330-00516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
Abstract
Objective: To explore risk factors associated with in-hospital mortality in patients requiring extracorporeal membrane oxygenation (ECMO) in the perioperative period of heart transplantation. Methods: The data of ECMO cases in the perioperative period of heart transplantation from the Chinese Society of Extracorporeal Life Support (CSECLS) between January 2017 and December 2021 were retrospectively analyzed. These patients were divided into the survival group and non-survival group according to their outcomes at discharge. The demographics, indications and complications of ECMO between the two groups were compared, and the related risk factors of poor prognosis were analyzed. Results: A total of 77 patients were included in the study, including 67 males and 10 females, with a median age [M(Q1, Q3)] of 48 (36, 59) years. Sixty-three patients (81.8%) were successfully withdrawn from the ECMO and 46 patients (59.7%) survived to discharge. The median ECMO time was 139 (92, 253) hours. Compared with the survival group, the non-survival group (n=31) had more patients with chronic kidney disease before surgery [22.6% (7/31) vs 4.3% (2/46), P=0.034], and a higher proportion of continuous renal replacement therapy (CRRT) during ECMO [74.2% (23/31) vs 50.0% (23/46), P=0.034]. Moreover, the non-survival group had longer duration of extracorporeal circulation [262 (195, 312) vs 201 (155, 261) min, P=0.056] and higher lactate value in the first 24 hours of ECMO support [2.7 (2.1, 4.7) vs 2.3 (1.4, 3.8) mmol/L, P=0.060], but the differences were not statistically significant. Multivariate logistic regression analysis showed that perioperative application of CRRT was an independent risk factor for poor prognosis in ECMO patients during heart transplantation (OR=19.345, 95%CI: 1.209-309.440, P=0.036). Conclusion: CRRT treatment during ECMO is a risk factor for in-hospital mortality in patients undergoing heart transplantation.
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Zhao YQ, Song YZ, Li ZH, Yang F, Xu T, Li FF, Yang DF, Wu T. [Second allogeneic hematopoietic stem cell transplantation with reduced-intensity conditioning and donor changes in relapsed hematological malignancies after the first allogeneic transplant]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2023; 44:465-471. [PMID: 37550201 PMCID: PMC10450545 DOI: 10.3760/cma.j.issn.0253-2727.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Indexed: 08/09/2023]
Abstract
Objective: The purpose of this study was to assess the safety and efficacy of a second allogeneic hematopoietic stem cell transplantation (allo-HSCT) with reduced-intensity conditioning (RIC) in patients with hematological malignancies who had relapsed after the first allo-HSCT. Methods: Between April 2018 and June 2021, 44 patients with hematological malignancies (B-ALL 23, T-ALL/T-LBL 4, AML15, and MDS 2) were enrolled and retrospectively examined. Unrelated donors (n=12) or haploidentical donors (n=32) were used. Donors were replaced in all patients for the second allo-HSCT. Hematological and immunological germline predisposition genes and hematopoietic and immune function tests were used to select the best-related donor. Total body irradiation (TBI) /fludarabine (FLU) -based (n=38), busulfan (BU) /FLU-based (n=4), total marrow irradiation (TMI) /FLU-based (n=1), and BU/cladribine-based (n=1) were the RIC regimens used. For graft versus host disease (GVHD) prevention, cyclosporine, mycophenolate mofetil, short-term methotrexate, and ATG were used. Eighteen (40.9%) of 44 patients with gene variations for which targeted medications are available underwent post-transplant maintenance therapy. Results: The median age was 25 years old (range: 7-55). The median interval between the first and second HSCT was 19.5 months (range: 6-77). Before the second allo-HSCT, 33 (75%) of the patients were in complete remission (CR), whereas 11 (25%) were not. All patients had long-term engraftment. The grade Ⅱ-Ⅳ GVHD and severe acute GVHD rates were 20.5% and 9.1%, respectively. Chronic GVHD was found in 20.5% of limited patterns and 22.7% of severe patterns. CMV and EBV reactivation rates were 29.5% and 6.8%, respectively. Hemorrhage cystitis occurred in 15.9% of cases, grade Ⅰ or Ⅱ. The 1-yr disease-free survival (DFS), overall survival (OS), and cumulative recurrence incidence (RI) rates of all patients were 72.5% (95% CI, 54.5%-84.3%), 80.6% (95% CI, 63.4%-90.3%), and 25.1% (95% CI, 13.7%-43.2%), respectively, with a median follow-up of 14 (2-39) months. There were eight deaths (seven relapses and one infection). The rate of non-relapse mortality (NRM) was only 2.3%. The CR patients' 1-yr RI rate was significantly lower than the NR patients (16.8% vs 48.1%, P=0.026). The DFS rate in CR patients was greater than in NR patients, although there was no statistical difference (79.9% vs 51.9%, P=0.072). Univariate analysis revealed that CR before the second allo-HSCT was an important prognostic factor. Conclusion: With our RIC regimens, donor change, and post-transplant maintenance therapy, the second allo-HSCT in relapsed hematological malignancies after the first allo-HSCT is a safe and effective treatment with high OS and DFS and low NRM and relapse rate. The most important factor influencing the prognosis of the second allo-HSCT is the patient's illness condition before the transplant.
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Zhang L, He J, Yang F, Dang H, Li Y, Guo S, Li S, Cao C, Xu J, Li S, Zhou X. [Progress of schistosomiasis control in People's Republic of China in 2022]. ZHONGGUO XUE XI CHONG BING FANG ZHI ZA ZHI = CHINESE JOURNAL OF SCHISTOSOMIASIS CONTROL 2023; 35:217-224. [PMID: 37455091 DOI: 10.16250/j.32.1374.2023073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
This report presented the endemic status of schistosomiasis and analyzed the data collected from the national schistosomiasis prevention and control system and national schistosomiasis surveillance program in the People's Republic of China in 2022. Among the 12 provinces (municipality and autonomous region) endemic for schistosomiasis, Shanghai Municipality, Zhejiang Province, Fujian Province, Guangdong Province and Guangxi Zhuang Autonomous Region continued to maintain the achievements of schistosomiasis elimination, and Sichuan and Jiangsu provinces maintained the criteria of transmission interruption, while Yunnan, Hubei, Anhui, Jiangxi and Hunan provinces maintained the criteria of transmission control by the end of 2022. A total of 452 counties (cites, districts) were found to be endemic for schistosomiasis in China in 2022, with 27 434 endemic villages covering 73 424 400 people at risk of infections. Among the 452 endemic counties (cities, districts), 75.89% (343/452), 23.45% (106/452) and 0.66% (3/452) achieved the criteria of elimination, transmission interruption and transmission control of schistosomiasis, respectively. In 2022, 4 317 356 individuals received serological tests for schistosomiasis, and 62 228 were sero-positive. A total of 208 646 individuals received stool examinations for schistosomiasis, with one positive and another two cases positive for urine microscopy, and these three 3 cases were imported schistosomiasis patients from Africa. There were 28 565 cases with advanced schistosomiasis documented in China by the end of 2022. Oncomelania hupensis snail survey was performed in 18 891 endemic villages in China in 2022 and O. hupensis snails were found in 6 917 villages (36.62% of all surveyed villages), with 8 villages identified with emerging snail habitats. Snail survey was performed at an area of 655 703.01 hm2 and 183 888.60 hm2 snail habitats were found, including 110.58 hm2 emerging snail habitats and 844.35 hm2 re-emerging snail habitats. There were 477 200 bovines raised in the schistosomiasis endemic areas of China in 2022, and 113 946 bovines received serological examinations for schistosomiasis, with 204 sero-positives detected. Among the 131 715 bovines received stool examinations, no positives were identified. In 2022, there were 19 726 schistosomiasis patients receiving praziquantel chemotherapy, and expanded chemotherapy was performed in 714 465 person-time for humans and 234 737 herd-time for bovines in China. In 2022, snail control with chemical treatment was performed at an area of 119 134.07 hm2, and the actual area of chemical treatment was 65 825.27 hm2, while environmental improvements were performed at an area of 1 163.96 hm2. Data from the national schistosomiasis surveillance program of China showed that the mean prevalence of Schistosoma japonicum infections was both zero in humans and bovines in 2022, and no S. japonicum infection was detected in O. hupensis snails. These data demonstrated that the endemic status of schistosomiasis continued to decline in China in 2022, with 3 confirmed schistosomiasis patients that had a foreign nationality and all imported from Africa, and the areas of snail habitats remained high. Further improvements in the construction of the schistosomaisis surveillance and forecast system, and reinforcement of O. hupensis survey and control are required to prevent the re-emerging schistosomiasis.
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Cao Z, Aharonian F, An Q, Bai LX, Bai YX, Bao YW, Bastieri D, Bi XJ, Bi YJ, Cai JT, Cao Q, Cao WY, Cao Z, Chang J, Chang JF, Chen ES, Chen L, Chen L, Chen L, Chen MJ, Chen ML, Chen QH, Chen SH, Chen SZ, Chen TL, Chen Y, Cheng HL, Cheng N, Cheng YD, Cui SW, Cui XH, Cui YD, Dai BZ, Dai HL, Dai ZG, Della Volpe D, Dong XQ, Duan KK, Fan JH, Fan YZ, Fang J, Fang K, Feng CF, Feng L, Feng SH, Feng XT, Feng YL, Gao B, Gao CD, Gao LQ, Gao Q, Gao W, Gao WK, Ge MM, Geng LS, Gong GH, Gou QB, Gu MH, Guo FL, Guo XL, Guo YQ, Guo YY, Han YA, He HH, He HN, He JY, He XB, He Y, Heller M, Hor YK, Hou BW, Hou C, Hou X, Hu HB, Hu Q, Hu SC, Huang DH, Huang TQ, Huang WJ, Huang XT, Huang XY, Huang Y, Huang ZC, Ji XL, Jia HY, Jia K, Jiang K, Jiang XW, Jiang ZJ, Jin M, Kang MM, Ke T, Kuleshov D, Kurinov K, Li BB, Li C, Li C, Li D, Li F, Li HB, Li HC, Li HY, Li J, Li J, Li J, Li K, Li WL, Li WL, Li XR, Li X, Li YZ, Li Z, Li Z, Liang EW, Liang YF, Lin SJ, Liu B, Liu C, Liu D, Liu H, Liu HD, Liu J, Liu JL, Liu JL, Liu JS, Liu JY, Liu MY, Liu RY, Liu SM, Liu W, Liu Y, Liu YN, Long WJ, Lu R, Luo Q, Lv HK, Ma BQ, Ma LL, Ma XH, Mao JR, Min Z, Mitthumsiri W, Nan YC, Ou ZW, Pang BY, Pattarakijwanich P, Pei ZY, Qi MY, Qi YQ, Qiao BQ, Qin JJ, Ruffolo D, Sáiz A, Shao CY, Shao L, Shchegolev O, Sheng XD, Song HC, Stenkin YV, Stepanov V, Su Y, Sun QN, Sun XN, Sun ZB, Tam PHT, Tang ZB, Tian WW, Wang C, Wang CB, Wang GW, Wang HG, Wang HH, Wang JC, Wang JS, Wang K, Wang LP, Wang LY, Wang PH, Wang R, Wang W, Wang XG, Wang XY, Wang Y, Wang YD, Wang YJ, Wang ZH, Wang ZX, Wang Z, Wang Z, Wei DM, Wei JJ, Wei YJ, Wen T, Wu CY, Wu HR, Wu S, Wu XF, Wu YS, Xi SQ, Xia J, Xia JJ, Xiang GM, Xiao DX, Xiao G, Xin GG, Xin YL, Xing Y, Xiong Z, Xu DL, Xu RF, Xu RX, Xue L, Yan DH, Yan JZ, Yan T, Yang CW, Yang F, Yang FF, Yang HW, Yang JY, Yang LL, Yang MJ, Yang RZ, Yang SB, Yao YH, Yao ZG, Ye YM, Yin LQ, Yin N, You XH, You ZY, Yu YH, Yuan Q, Yue H, Zeng HD, Zeng TX, Zeng W, Zeng ZK, Zha M, Zhang B, Zhang BB, Zhang F, Zhang HM, Zhang HY, Zhang JL, Zhang LX, Zhang L, Zhang PF, Zhang PP, Zhang R, Zhang SB, Zhang SR, Zhang SS, Zhang X, Zhang XP, Zhang YF, Zhang Y, Zhang Y, Zhao B, Zhao J, Zhao L, Zhao LZ, Zhao SP, Zheng F, Zheng JH, Zhou B, Zhou H, Zhou JN, Zhou P, Zhou R, Zhou XX, Zhu CG, Zhu FR, Zhu H, Zhu KJ, Zuo X. A tera-electron volt afterglow from a narrow jet in an extremely bright gamma-ray burst. Science 2023:eadg9328. [PMID: 37289911 DOI: 10.1126/science.adg9328] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 05/25/2023] [Indexed: 06/10/2023]
Abstract
Some gamma-ray bursts (GRBs) have a tera-electron volt (TeV) afterglow, but the early onset of this has not been observed. We report observations with the Large High Altitude Air Shower Observatory of the bright GRB 221009A, which serendipitously occurred within the instrument field of view. More than 64,000 photons >0.2 TeV were detected within the first 3000 seconds. The TeV flux began several minutes after the GRB trigger, then rose to a peak about 10 seconds later. This was followed by a decay phase, which became more rapid ~650 seconds after the peak. We interpret the emission using a model of a relativistic jet with half-opening angle ~0.8°. This is consistent with the core of a structured jet and could explain the high isotropic energy of this GRB.
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Brekke TD, Papadopulos AST, Julià E, Fornas O, Fu B, Yang F, de la Fuente R, Page J, Baril T, Hayward A, Mulley JF. A new chromosome-assigned Mongolian gerbil genome allows characterization of complete centromeres and a fully heterochromatic chromosome. Mol Biol Evol 2023:7162499. [PMID: 37183864 DOI: 10.1093/molbev/msad115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 04/23/2023] [Accepted: 05/11/2023] [Indexed: 05/16/2023] Open
Abstract
Chromosome-scale genome assemblies based on ultra-long read sequencing technologies are able to illuminate previously intractable aspects of genome biology such as fine-scale centromere structure and large-scale variation in genome features such as heterochromatin, GC content, recombination rate, and gene content. We present here a new chromosome-scale genome of the Mongolian gerbil (Meriones unguiculatus) which includes the complete sequence of all centromeres. Gerbils are thus the one of the first vertebrates to have their centromeres completely sequenced. Gerbil centromeres are composed of four different repeats of length 6pb, 37 bp, 127 bp, or 1747bp which occur in simple alternating arrays and span 1-6Mb. Gerbil genomes have both an extensive set of GC-rich genes and chromosomes strikingly enriched for constitutive heterochromatin. We sought to determine if there was a link between these two phenomena and found that the two heterochromatic chromosomes of the Mongolian gerbil have distinct underpinnings: Chromosome 5 has a large block of intra-arm heterochromatin as the result of a massive expansion of centromeric repeats, while chromosome 13 is comprised of extremely large (>150 kb) repeated sequences. In addition to characterizing centromeres, our results demonstrate the importance of including karyotypic features such as chromosome number and the locations of centromeres in the interpretation of genome sequence data, and highlight novel patterns involved in the evolution of chromosomes.
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Ye K, Liu X, Li D, Gao L, Zheng K, Qu J, Xing N, Yang F, Liu B, Li A, Pang Q. Extracellular matrix-regulator MMPA is required for the orderly proliferation of neoblasts and differentiation of ectodermal progenitor cells in the planarian Dugesia japonica. Biochem Biophys Res Commun 2023; 659:1-9. [PMID: 37030019 DOI: 10.1016/j.bbrc.2023.03.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/09/2023] [Accepted: 03/14/2023] [Indexed: 04/05/2023]
Abstract
Matrix metalloproteinases (MMPs) are members of a family of zinc-dependent metallopeptidase proteins that are widely found in plants, animals, and microorganisms. As the regulators of the extracellular matrix and basement membrane, MMPs play an important role in embryogenesis, development, innate immunity, and regeneration. However, the function of MMP family in planarian, a model for regeneration research, is still ambiguous. Here, we cloned 5 MMPs genes from Dugesia japonica and found that DjMMPA was associated with the process of regeneration, neoblasts cell maintenance confusion and destruction. Loss of DjMMPA led to homeostasis confusion and eventually death, owing to neoblasts proliferation disorder. Additionally, DjMMPA RNAi-treated animals had impaired regeneration after amputation. Furthermore, knockdown of DjMMPA had noticeable defects in cell differentiation of ectoderm, especially in eyes and neural progenitor cells, possibly by inhibiting Wnt signaling. Our results suggest that extracellular matrix-regulator MMPA is required for the orderly proliferation of neoblasts and differentiation of ectodermal progenitor cells in the planarian, which provide valuable information for further explorations into the molecular mechanism of MMPS, stem cells, and regeneration.
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Huang C, Sanaei F, Verdurmen WPR, Yang F, Ji W, Walboomers XF. The Application of Organs-on-a-Chip in Dental, Oral, and Craniofacial Research. J Dent Res 2023; 102:364-375. [PMID: 36726271 PMCID: PMC10031637 DOI: 10.1177/00220345221145555] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
The current development of microfluidics-based microphysiological systems (MPSs) will rapidly lead to a paradigm shift from traditional static 2-dimensional cell cultivation towards organized tissue culture within a dynamic cellular milieu. Especially organs-on-a-chip (OoCs) can very precisely re-create the mechanical and unique anatomical structures of the oral environment. This review provides an introduction to such technology, from commonly used chip materials and fabrication methods to the application of OoC in in vitro culture. OoCs are advantageous because of their small-scaled culture environment, the highly controlled dynamic experimental conditions, and the likeness to the in vivo structure. We specifically focus on current chip designs in dental, oral, and craniofacial (DOC) research. Also, future perspectives are discussed, like model standardization and the development of integrated platforms with advanced read-out functionality. By doing so, it will be possible for OoCs to serve as an alternative for animal testing and to develop highly predictive human models for clinical experiments and even personalized medicine.
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Ren N, Dai S, Ma S, Yang F. Strategies for activity analysis of single nucleotide polymorphisms associated with human diseases. Clin Genet 2023; 103:392-400. [PMID: 36527336 DOI: 10.1111/cge.14282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 12/10/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022]
Abstract
Genome-wide association studies (GWAS) have identified a large number of single nucleotide polymorphism (SNP) sites associated with human diseases. In the annotation of human diseases, especially cancers, SNPs, as an important component of genetic factors, have gained increasing attention. Given that most of the SNPs are located in non-coding regions, the functional verification of these SNPs is a great challenge. The key to functional annotation for risk SNPs is to screen SNPs with regulatory activity from thousands of disease associated-SNPs. In this review, we systematically recapitulate the characteristics and functional roles of SNP sites, discuss three parallel reporter screening strategies in detail based on barcode tag classification, and recommend the common in silico strategies to help supplement the annotation of SNP sites with epigenetic activity analysis, prediction of target genes and trans-acting factors. We hope that this review will contribute to this exuberant research field by providing robust activity analysis strategies that can facilitate the translation of GWAS results into personalized diagnosis and prevention measures for human diseases.
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Leng S, Xu W, Wu L, Liu L, Du J, Yang F, Huang D, Zhang L. NLRP3 Disturbs Treg/Th17 Cell Balance to Aggravate Apical Periodontitis. J Dent Res 2023; 102:656-666. [PMID: 36883625 DOI: 10.1177/00220345231151692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Apical periodontitis is an inflammatory condition that is considered an immunological reaction of the periapical tissue to invading bacteria and their pathogenic components. Recent research has revealed that NLR family pyrin domain containing 3 (NLRP3) is crucial to the pathogenesis of apical periodontitis and serves as a link between innate and adaptive immunity. The balance between regulatory T-cell (Treg) and T helper cell 17 (Th17 cell) determines the direction of the inflammatory response. Therefore, this study aimed to investigate whether NLRP3 exacerbated periapical inflammation by disturbing Treg/Th17 balance and the underlying regulatory mechanisms. In the present study, NLRP3 was raised in apical periodontitis tissues as opposed to healthy pulp tissues. Low NLRP3 expression in dendritic cells (DCs) increased transforming growth factor β secretion while decreasing interleukin (IL)-1β and IL-6 production. The Treg ratio and IL-10 secretion rose when CD4+ T cells were cocultured with DCs primed with IL-1β neutralizing antibody (anti-IL-1β) and specific small interfering RNA (siRNA) targeting NLRP3 (siRNA NLRP3), but the proportion of Th17 cells and IL-17 release dropped. Furthermore, siRNA NLRP3-mediated suppression of NLRP3 expression aided Treg differentiation and elevated Foxp3 expression as well as IL-10 production in CD4+ T cells. Inhibition of NLRP3 activity by MCC950 boosted the percentage of Tregs while decreasing the ratio of Th17 cells, leading to reduced periapical inflammation and bone resorption. Nigericin administration, however, exacerbated periapical inflammation and bone destruction with an unbalanced Treg/Th17 response. These findings demonstrate that NLRP3 is a pivotal regulator by regulating the release of inflammatory cytokines from DCs or directly suppressing Foxp3 expression to disturb Treg/Th17 balance, thus exacerbating apical periodontitis.
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Liu H, Chen R, Li H, Lin J, Wang Y, Han M, Wang T, Wang H, Chen Q, Chen F, Chu P, Liang C, Ren C, Zhang Y, Yang F, Sheng Y, Wei J, Wu X, Yu G. Genome-wide identification and expression analysis of SlRR genes in response to abiotic stress in tomato. PLANT BIOLOGY (STUTTGART, GERMANY) 2023; 25:322-333. [PMID: 36457231 DOI: 10.1111/plb.13494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 11/15/2022] [Indexed: 06/17/2023]
Abstract
The cytokinin two-component signal transduction system (TCS) is involved in many biological processes, including hormone signal transduction and plant growth regulation. Although cytokinin TCS has been well characterized in Arabidopsis thaliana, its role in tomato remains elusive. In this study, we characterized the diversity and function of response regulator (RR) genes, a critical component of TCS, in tomato. In total, we identified 31 RR genes in the tomato genome. These SlRR genes were classified into three subgroups (type-A, type-B and type-C). Various stress-responsive cis-elements were present in the tomato RR gene promoters. Their expression responses under pesticide treatment were evaluated by transcriptome analysis. Their expression under heat, cold, ABA, salinity and NaHCO3 treatments was further investigated by qRT-PCR and complemented with the available transcription data under these treatments. Specifically, SlRR13 expression was significantly upregulated under salinity, drought, cold and pesticide stress and was downregulated under ABA treatment. SlRR23 expression was induced under salt treatment, while the transcription level of SlRR1 was increased under cold and decreased under salt stress. We also found that GATA transcription factors played a significant role in the regulation of SlRR genes. Based on our results, tomato SlRR genes are involved in responses to abiotic stress in tomato and could be implemented in molecular breeding approaches to increase resistance of tomato to environmental stresses.
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Lin P, You YK, Liu JY, Yang F, Cai QC, Jiang Y, Shen JJ. [Clinical efficacy and prognostic risk factors of salvage liver transplantation, rehepatectomy, and local ablation in the treatment of postoperative recurrence of hepatocellular carcinoma]. ZHONGHUA GAN ZANG BING ZA ZHI = ZHONGHUA GANZANGBING ZAZHI = CHINESE JOURNAL OF HEPATOLOGY 2023; 31:155-160. [PMID: 37137830 DOI: 10.3760/cma.j.cn501113-20210727-00364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Objective: To investigate and analyze the clinical efficacy of salvage liver transplantation (SLT), rehepatectomy (RH), local ablation (LA), and prognostic risk factors in patients with postoperative recurrence of hepatocellular carcinoma. Methods: Clinical data of 145 patients with recurrent liver cancer in the 900th Hospital of the Joint Logistics Support Force of the People's Liberation Army from January 2005 to June 2018 were retrospectively collected. SLT group, RH group, and LA group included 25, 44, and 76 cases, respectively. Follow-up and statistics were recorded on the overall survival rate, relapse-free survival rate, and complications of the three groups of patients at 1, 2, and 3 years after surgery. Univariate and multivariate COX analyses were used to analyze the prognostic risk factors in patients with recurrent HCC. Results: The overall survival rates of 1, 2, and 3 years following surgery in the SLT, RH, and LA groups were 100.0%, 84.0%, 72.0%, 95.5%, 77.3%, 65.9%, 90.8%, 76.3%, and 63.2%, respectively, when the recurrence of liver cancer met the Milan criteria. The overall survival rate did not differ statistically between SLT and RH (P = 0.303) or between RH and LA (P = 0.152). There were statistically significant differences in recurrence-free survival between SLT and RH or RH and LA (P = 0.046). There was no statistically significant difference in the incidence of complications between SLT and RH or RH and LA (P > 0.017). Age > 65 years was an independent risk factor affecting the overall survival rate in patients with recurrent HCC. Age > 65 years and recurrence time < 24 months were independent risk factors affecting the recurrence-free survival rate in patients with recurrent HCC. Conclusion: SLT is the best treatment option when the recurrence of HCC meets Milan's criteria. RH and LA are the appropriate treatment plans for recurrent HCC when the liver source is limited.
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Yang L, Liu H, Han J, Xu S, Zhang G, Wang Q, Du Y, Yang F, Zhao X, Shi G. Ultra-low-dose CT lung screening with artificial intelligence iterative reconstruction: evaluation via automatic nodule-detection software. Clin Radiol 2023:S0009-9260(23)00031-4. [PMID: 36948944 DOI: 10.1016/j.crad.2023.01.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 01/04/2023] [Accepted: 01/15/2023] [Indexed: 02/05/2023]
Abstract
AIM To test the feasibility of ultra-low-dose (ULD) computed tomography (CT) combined with an artificial intelligence iterative reconstruction (AIIR) algorithm for screening pulmonary nodules using computer-assisted diagnosis (CAD). MATERIALS AND METHODS A chest phantom with artificial pulmonary nodules was first scanned using the routine protocol and the ULD protocol (3.28 versus 0.18 mSv) to compare the image quality and to test the acceptability of the ULD CT protocol. Next, 147 lung-screening patients were enrolled prospectively, undergoing an additional ULD CT immediately after their routine CT examination for clinical validation. Images were reconstructed with filtered back-projection (FBP), hybrid iterative reconstruction (HIR), the AIIR, and were imported to the CAD software for preliminary nodule detection. Subjective image quality on the phantom was scored using a five-point scale and compared using the Mann-Whitney U-test. Nodule detection using CAD was evaluated for ULD HIR and AIIR images using the routine dose image as reference. RESULTS Higher image quality was scored for AIIR than for FBP and HIR at ULD (p<0.001). As reported by CAD, 107 patients were presented with more than five nodules on routine dose images and were chosen to represent the challenging cases at an early stage of pulmonary disease. Among such, the performance of nodule detection by CAD on ULD HIR and AIIR images was 75.2% and 92.2% of the routine dose image, respectively. CONCLUSION Combined with AIIR, it was feasible to use an ULD CT protocol with 95% dose reduction for CAD-based screening of pulmonary nodules.
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Yang Y, Deng S, Wang C, Wang Y, Shi Y, Lin J, Wang N, Su L, Yang F, Wang H, Zhu S. Association of Dental Caries with Muscle Mass, Muscle Strength, and Sarcopenia: A Community-Based Study. J Nutr Health Aging 2023; 27:10-20. [PMID: 36651482 DOI: 10.1007/s12603-022-1875-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Changes in the oral cavity can reflect other changes throughout the body. This study aimed to investigate the association of dental caries with muscle mass, muscle strength, and sarcopenia, and also to describe the microbial diversity, composition, and community structure of severe dental caries and sarcopenia. DESIGN Cross-sectional study based on a Chinese population aged from 50 to 85 years. SETTING Communities from Lanxi City, Zhejiang Province, China. PARTICIPANTS A total of 1,442 participants aged from 50 to 85 years from a general community (62.8% women; median age 61.0 [interquartile range: 55.0, 68.0]). MEASUREMENTS Dental caries was assessed by the decayed, missing, and filled teeth (DMFT) index. Sarcopenia was defined as the presence of both low muscle mass (assessed by dual-energy X-ray absorptiometry scanning) and low muscle strength (assessed by handgrip strength). Multivariate logistic regression models were used to analyze the association of dental caries with muscle mass, muscle strength, and sarcopenia. Fecal samples underwent 16S rRNA profiling to evaluate the diversity and composition of the gut microbiota in patients with severe dental caries and/or sarcopenia. RESULTS In the fully adjusted logistic models, dental caries was positively associated with low muscle strength (DMFT ≥ 7: OR, 1.61; 95% CI, 1.25-2.06), and sarcopenia (DMFT ≥ 7: OR, 1.51; 95% CI, 1.01-2.26), but not low muscle mass. Severe dental caries was positively associated with higher alpha-diversity indices (richness, chao1, and ACE, all p < 0.05) and associated with beta-diversity based on Bray-Curtis distance (p = 0.006). The severe dental caries group and the sarcopenia group overlapped with 11 depleted and 13 enriched genera. CONCLUSION Dental caries was positively associated with low muscle strength and sarcopenia but not muscle mass, and this association was more pronounced in male individuals. Significant differences were observed in gut microbiota composition both in severe dental caries and sarcopenia, and there was an overlap of the genera features. Future longitudinal studies are needed to clarify causal relationships.
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Zhang Z, Wang F, Xiao B, Ma J, Yang F. A new remote web-based MDSplus data visualization system for EAST. FUSION ENGINEERING AND DESIGN 2023. [DOI: 10.1016/j.fusengdes.2022.113337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Liu L, Yang Y, Yang F, Lin Y, Liu K, Wang X, Zhang Y. A mechanistic investigation about hepatoxic effects of borneol using zebrafish. Hum Exp Toxicol 2023; 42:9603271221149011. [PMID: 36594174 DOI: 10.1177/09603271221149011] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Except for clinical value, borneol is routinely used in food and cosmetics with seldom safety evaluation. To investigate its hepatoxicity, we exposed 3 dpf (days post fertilization) larval zebrafish to borneol at a gradient of concentrations (200-500 μM) for 3 days. Herein, our results revealed that high doses of borneol (300-500 μM) caused liver size decrease or lateral lobe absence. Borneol also seriously disturbed the hepatic protein metabolism presented with the increased activity of alanine aminotransferase (ALT) and lipid metabolism shown with the increased level of triglycerides (TG) and total cholesterol (TC). The lipid accumulation (oil red staining) was detected as well. Additionally, significant upregulation of genes was detected that related to oxidative stress, lipid anabolism, endoplasmic reticulum stress (ERS), and autophagy. Conversely, the lipid metabolism-related genes were markedly downregulated. Moreover, the changes in the superoxide dismutase activity and the level of glutathione and malondialdehyde raised the likelihood of lipid peroxidation. The outcomes indicated the involvement of oxidative stress, ERS, lipid metabolism, and autophagy in borneol-induced lipid metabolic disorder and hepatic injury. This study will provide a more comprehensive understanding of borneol hepatoxicity and the theoretical basis for the safe use of this compound.
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Zhu X, Zhang X, Ding L, Tang Y, Xu A, Yang F, Qiao G, Gao X, Zhou J. Associations of Pain and Sarcopenia with Successful Aging among Older People in China: Evidence from CHARLS. J Nutr Health Aging 2023; 27:196-201. [PMID: 36973927 DOI: 10.1007/s12603-023-1892-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
OBJECTIVES Sarcopenia and chronic pain are geriatric syndromes that negatively impact the lives of older people. The aim of this study was to explore the relationship among sarcopenia, pain, and successful aging among older persons participating in the China Health and Retirement Longitudinal Study (CHARLS). DESIGN Cohort study with a 2-year follow-up. SETTING AND PARTICIPANTS Data were derived from 2 waves of the CHARLS, and 4280 community-dwelling participants aged ≥ 60 years were included in the study. METHODS Sarcopenia status was defined according to the Asian Working Group for Sarcopenia 2019 (AWGS 2019) criteria. Successful aging was defined following Rowe and Kahn's multidimensional model. Pain was assessed by a self-reported questionnaire. A generalized estimating equation (GEE) was used to examine the associations. RESULTS Longitudinal results demonstrated that compared with no sarcopenia, possible sarcopenia [OR (95%CI): 0.600 (0.304~1.188)] was not significantly associated with successful aging. Pain only was strongly associated with successful aging [0.388 (0.251~0.600)], whereas the association between sarcopenia only and successful aging was weaker [0.509 (0.287~0.905)]. The likelihood of being successful aging was substantially lower in the presence of coexisting sarcopenia and pain [0.268 (0.108~0.759)]. CONCLUSIONS Both pain and sarcopenia are significant predictors for achieving successful aging among community-dwelling older adults. Early identification of sarcopenia and pain permits the implementation of treatment strategies and presents an opportunity to mitigate the risk of being unsuccessful aging.
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