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Li YF, Li M, Yang F, Wang HF, Xu F, Chen SY, Sun B, Chen ZH, Huang XS. [Clinical and electrophysiological characteristics and treatment outcomes of anti-neutrophil cytoplasmic antibody ANCA-associated vasculitic neuropathy]. Zhonghua Nei Ke Za Zhi 2024; 63:386-393. [PMID: 38561284 DOI: 10.3760/cma.j.cn112138-20231031-00267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Objective: To investigate the clinical and electrophysiological characteristics of ANCA-associated vasculitic neuropathy (VN) and analyze the predictors of treatment outcomes. Methods: Retrospective case series. In all, 652 consecutive patients with ANCA-associated vasculitis were admitted to the First Medical Center of the Chinese PLA General Hospital between January 2006 and December 2022. Peripheral neuropathy occurred in 91 patients. Patients were excluded if other known causes of neuropathy were present. Sixty-one patients were eventually enrolled, including 17 with eosinophilic granulomatosis with polyangiitis (EGPA), 11 with granulomatosis polyangiitis (GPA), and 33 with microscopic polyangiitis (MPA). Their clinical data were collected and clinical characteristics, VN manifestations, electrophysiological findings (including interside amplitude ratio [IAR]), and treatment outcomes were compared among the three subsets of AAV. Then, factors influencing the treatment outcomes were analyzed using multivariable logistic regression analysis. Results: Peripheral neuropathy occurred in 62.1%(18/29) of EGPA, 8.3%(15/180) of GPA, and 13.1%(58/443) of MPA patients. The age at onset and examination was higher in patients with MPA than those with EGPA or GPA (P<0.01). The occurrence of VN was later in patients with GPA than those with EGPA (P<0.01), and the GPA group had fewer affected nerves than the other two groups (P<0.016). The abnormal IARs of motor nerves in lower limbs were more detected in the EGPA than the MPA group (P<0.01). Logistic regression analysis suggested that higher Birmingham vasculitis activity score-version 3 (BVAS-V3) (OR=6.85, 95%CI 1.33-35.30) was associated with better treatment outcomes of VN. However, central nervous system involvement was a risk factor for poor treatment outcomes (OR=0.13, 95%CI 0.02-0.89). Conclusions: The clinical and electrophysiological characteristics of VN were slightly different among subsets of AAV. Patients with GPA often presented with polyneuropathy and had fewer nerves affected; mononeuritis multiplex was more common in EGPA than GPA and MPA. Higher BVAS-V3 and central nervous system involvement might predict the treatment outcome of VN.
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Affiliation(s)
- Y F Li
- Department of Neurology of the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China Geriatric Neurological Department of the Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing 100853, China
| | - M Li
- Department of Neurology of the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - F Yang
- Department of Neurology of the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - H F Wang
- Department of Neurology of the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - F Xu
- Department of Neurology of the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - S Y Chen
- Geriatric Neurological Department of the Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing 100853, China
| | - B Sun
- Geriatric Neurological Department of the Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing 100853, China
| | - Z H Chen
- Department of Neurology of the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - X S Huang
- Department of Neurology of the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
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Zhang X, Gao Y, Lu L, Cao Y, Zhang W, Sun B, Wu X, Tong A, Chen S, Wang X, Mao J, Nie M. Targeted long-read sequencing for comprehensive detection of CYP21A2 mutations in patients with 21-hydroxylase deficiency. J Endocrinol Invest 2024; 47:833-841. [PMID: 37815751 DOI: 10.1007/s40618-023-02197-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 09/08/2023] [Indexed: 10/11/2023]
Abstract
BACKGROUND 21-Hydroxylase deficiency (21-OHD) is caused by pathogenic CYP21A2 variations. CYP21A2 is arranged in tandem with its highly homologous pseudogene CYP21A1P; therefore, it is prone to mismatch and rearrangement, producing different types of complex variations. There were few reports on using only one method to detect different CYP21A2 variants simultaneously. AIMS Targeted long-read sequencing method was used to detect all types of CYP21A2 variants in a series of patients with 21-OHD. METHODS A total of 59 patients with 21-OHD were enrolled from Peking Union Medical College Hospital. Long-range locus-specific PCR and long-read sequencing (LRS) were performed to detect the pathogenic variants in CYP21A2. RESULTS Copy-number variants of CYP21A2 were found in 25.4% of patients, including 5.1% with 3 copies of CYP21A2, 16.9% with 1 copy of CYP21A2, and 3.4% with 0 copy of CYP21A2. The remaining 74.6% of patients had 2 copies of CYP21A2. Pathogenic variants were identified in all 121 alleles of 59 patients. Specifically, single-nucleotide variants and small insertions/deletions (< 50 bp) were detected in 79 alleles, of which conversed from CYP21A1P were detected in 63 alleles, and rare variants were found in the other 16 alleles. Large gene conversions (> 50 bp) from pseudogene were detected in 10 alleles, and different chimeric genes (CYP21A1P/CYP21A2 or TNXA/TNXB) formed by large deletions were detected in 32 alleles. Of all variants, p.I173N was the most common variant (19.0%). CONCLUSIONS Our study demonstrated that targeted long-read sequencing is a comprehensive method for detecting CYP21A2 variations, which is helpful for genetic diagnosis in 21-OHD patients.
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Affiliation(s)
- X Zhang
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health Commission (NHC), Peking Union Medical College Hospital), Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Y Gao
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health Commission (NHC), Peking Union Medical College Hospital), Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - L Lu
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health Commission (NHC), Peking Union Medical College Hospital), Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Y Cao
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health Commission (NHC), Peking Union Medical College Hospital), Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - W Zhang
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health Commission (NHC), Peking Union Medical College Hospital), Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - B Sun
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health Commission (NHC), Peking Union Medical College Hospital), Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - X Wu
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health Commission (NHC), Peking Union Medical College Hospital), Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - A Tong
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health Commission (NHC), Peking Union Medical College Hospital), Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - S Chen
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health Commission (NHC), Peking Union Medical College Hospital), Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - X Wang
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health Commission (NHC), Peking Union Medical College Hospital), Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - J Mao
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health Commission (NHC), Peking Union Medical College Hospital), Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - M Nie
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health Commission (NHC), Peking Union Medical College Hospital), Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
- State Key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
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Zhang J, Sun B, Tanihata I, Kanungo R, Scheidenberger C, Terashima S, Wang F, Ameil F, Atkinson J, Ayyad Y, Bagchi S, Cortina-Gil D, Dillmann I, Estradé A, Evdokimov A, Farinon F, Geissel H, Guastalla G, Janik R, Kaur S, Knöbel R, Kurcewicz J, Litvinov Y, Marta M, Mostazo M, Mukha I, Nociforo C, Ong HJ, Pietri S, Prochazka A, Sitar B, Strmen P, Takechi M, Tanaka J, Vargas J, Weick H, Winfield JS. A new approach for deducing rms proton radii from charge-changing reactions of neutron-rich nuclei and the reaction-target dependence. Sci Bull (Beijing) 2024:S2095-9273(24)00207-X. [PMID: 38644131 DOI: 10.1016/j.scib.2024.03.051] [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: 01/11/2024] [Revised: 02/25/2024] [Accepted: 03/22/2024] [Indexed: 04/23/2024]
Abstract
We report the charge-changing cross sections (σcc) of 24 p-shell nuclides on both hydrogen and carbon at about 900A MeV, of which 8,9Li, 10-12Be, 10,14,15B, 14,15,17-22N and 16O on hydrogen and 8,9Li on carbon are for the first time. Benefiting from the data set, we found a new and robust relationship between the scaling factor of the Glauber model calculations and the separation energies of the nuclei of interest on both targets. This allows us to deduce proton radii (Rp) for the first time from the cross sections on hydrogen. Nearly identical Rp values are deduced from both target data for the neutron-rich carbon isotopes; however, the Rp from the hydrogen target is systematically smaller in the neutron-rich nitrogen isotopes. This calls for further experimental and theoretical investigations.
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Affiliation(s)
- Jichao Zhang
- School of Physics, Beihang University, Beijing 100191, China
| | - Baohua Sun
- School of Physics, Beihang University, Beijing 100191, China.
| | - Isao Tanihata
- School of Physics, Beihang University, Beijing 100191, China; Research Center for Nuclear Physics (RCNP), Osaka University, Osaka 567-0047, Japan.
| | - Rituparna Kanungo
- Astronomy and Physics Department, Saint Mary's University, Halifax B3H 3C3, Canada; TRIUMF, Vancouver V6T 4A3, Canada
| | - Christoph Scheidenberger
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt D-64291, Germany; Justus-Liebig University, Gießn 35392, Germany; Helmholtz Research Academy Hesse for FAIR (HFHF), GSI Helmholtz Center for Heavy Ion Research, Gießn 35392, Germany
| | | | - Feng Wang
- School of Physics, Beihang University, Beijing 100191, China
| | - Frederic Ameil
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt D-64291, Germany
| | - Joel Atkinson
- Astronomy and Physics Department, Saint Mary's University, Halifax B3H 3C3, Canada
| | - Yassid Ayyad
- Universidad de Santiago de Compostela, Santiago de Compostella E-15706, Spain
| | - Soumya Bagchi
- Department of Physics, Indian Institute of Technology (Indian School of Mines), Dhanbad 826004, India
| | - Dolores Cortina-Gil
- Universidad de Santiago de Compostela, Santiago de Compostella E-15706, Spain
| | - Iris Dillmann
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt D-64291, Germany; Justus-Liebig University, Gießn 35392, Germany
| | - Alfredo Estradé
- Astronomy and Physics Department, Saint Mary's University, Halifax B3H 3C3, Canada; GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt D-64291, Germany
| | - Alexey Evdokimov
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt D-64291, Germany
| | - Fabio Farinon
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt D-64291, Germany
| | - Hans Geissel
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt D-64291, Germany; Justus-Liebig University, Gießn 35392, Germany
| | - Giulia Guastalla
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt D-64291, Germany
| | - Rudolf Janik
- Faculty of Mathematics and Physics, Comenius University, Bratislava 84215, Slovakia
| | - Satbir Kaur
- Astronomy and Physics Department, Saint Mary's University, Halifax B3H 3C3, Canada; Department of Physics and Atmospheric Science, Dalhousie University, Halifax B3H 4R2, Canada
| | - Ronja Knöbel
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt D-64291, Germany
| | - Jan Kurcewicz
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt D-64291, Germany
| | - Yury Litvinov
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt D-64291, Germany
| | - Michele Marta
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt D-64291, Germany
| | - Magdalena Mostazo
- Universidad de Santiago de Compostela, Santiago de Compostella E-15706, Spain
| | - Ivan Mukha
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt D-64291, Germany
| | - Chiara Nociforo
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt D-64291, Germany
| | - Hooi Jin Ong
- Research Center for Nuclear Physics (RCNP), Osaka University, Osaka 567-0047, Japan
| | - Stephane Pietri
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt D-64291, Germany
| | - Andrej Prochazka
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt D-64291, Germany
| | - Branislav Sitar
- Faculty of Mathematics and Physics, Comenius University, Bratislava 84215, Slovakia
| | - Peter Strmen
- Faculty of Mathematics and Physics, Comenius University, Bratislava 84215, Slovakia
| | - Maya Takechi
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt D-64291, Germany
| | - Junki Tanaka
- Research Center for Nuclear Physics (RCNP), Osaka University, Osaka 567-0047, Japan
| | - Jossitt Vargas
- Universidad de Santiago de Compostela, Santiago de Compostella E-15706, Spain
| | - Helmut Weick
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt D-64291, Germany
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Gao H, Sun B, Li X, Bai T, Du L, Song Y, Zheng C, Kan X, Liu F. Risk factors for portal vein system thrombosis after partial splenic embolisation in cirrhotic patients with hypersplenism. Clin Radiol 2023; 78:919-927. [PMID: 37634989 DOI: 10.1016/j.crad.2023.07.022] [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: 03/28/2023] [Revised: 07/18/2023] [Accepted: 07/26/2023] [Indexed: 08/29/2023]
Abstract
AIM To determine risk factors for portal venous system thrombosis (PVST) after partial splenic artery embolisation (PSAE) in cirrhotic patients with hypersplenism. MATERIALS AND METHODS Between March 2014 and February 2022, 428 cirrhotic patients with hypersplenism underwent partial splenic artery embolisation and from these patients 208 were enrolled and 220 were excluded. Medical records of enrolled patients were collected. Computed tomography (CT) images were reviewed by two blinded, independent radiologists. Statistical analyses were performed by using SPSS. RESULTS Progressive PVST was observed in 18.75% (39/208) of cirrhotic patients after PSAE. No significant differences in peripheral blood counts, liver function biomarkers, and renal function were observed between the patients with progressive PVST and the patients without progressive PVST. The imaging data showed significant differences in PVST, the diameters of the portal, splenic, and superior mesenteric veins between the progressive PVST group and non-progressive PVST group. Univariate and multivariate analysis demonstrated portal vein thrombosis, spleen infarction percentage, and the diameter of the splenic vein were independent risk factors for progressive PVST. Seventeen of 173 (9.83%) patients showed new PVST; the growth of PVST was observed in 62.86% (22/35) of the patients with pre-existing PVST. Spleen infarction percentage and the diameter of the splenic vein were independent risk factors for new PVST after PSAE. CONCLUSION The present study demonstrated portal vein thrombosis, spleen infarction percentage, and the diameter of the splenic vein were independent risk factors for PVST after PSAE in cirrhotic patients with hypersplenism.
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Affiliation(s)
- H Gao
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - B Sun
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - X Li
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - T Bai
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - L Du
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Y Song
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - C Zheng
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - X Kan
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
| | - F Liu
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
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Ixquiac M, Reynoso FJ, Schmidt M, Mazur TR, Zhao T, Gay HA, Hugo GD, Henke LE, Michalski JM, Velarde A, De Falla V, Reyes FE, Montenegro E, Ruiz Furlan EA, Sun B. Bridging the Gap of Radiotherapy Treatment Planning Quality between High-Income, and Low- and Middle-Income Countries Using Knowledge-Based Planning. Int J Radiat Oncol Biol Phys 2023; 117:e591. [PMID: 37785788 DOI: 10.1016/j.ijrobp.2023.06.1941] [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) Radiotherapy departments in low- and middle-income countries (LMICs) like Guatemala have recently introduced intensity-modulated radiotherapy (IMRT). IMRT has become the standard of care in high-income countries (HIC) due to reduced toxicity and improved outcomes in some cancers. The purpose of this work is to show the feasibility of adapting knowledge-based (KB) models established in a HIC to a LMIC lacking experience in IMRT to improve plan quality and planning efficiency. MATERIALS/METHODS A Halcyon Linac was installed at our clinic in Guatemala in 2019 and has been used to treat approximately 90 patients daily with IMRT. A model developed on a cohort of head and neck cancer patients at a US academic radiotherapy center were applied at our center to create 20head and neck VMAT plans with different prescriptions, including simultaneous-integrated and sequential boosts. RESULTS The plans created using the KB models achieved similar coverage of the planning target volume for each plan KB plans showed better 1) Parotid sparing with a mean dose reduction between 5%-25% and spinal cord maximum dose reduction between 3%-15%. The time efficiency to create VMAT plans using KB model versus manual planning improved four-fold, on average one hour versus more than 4 hours, respectively. CONCLUSION Despite different prescriptions, guidelines and demographics of cancer patients between two institutions in a HIC and LMIC, this work demonstrates that KB planning can be used to generate better and more consistent VMAT plans versus manually created plans. In addition, KB planning has the potential to greatly increase planning efficiency higher efficiency and help address the shortage of medical physicists and dosimetrists in LMICs.
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Affiliation(s)
- M Ixquiac
- Liga Nacional Contra el Cáncer e Instituto de Cancerología LIGA-INCAN, Guatemala City, Guatemala
| | - F J Reynoso
- Washington University School of Medicine in St. Louis, Department of Radiation Oncology, St. Louis, MO
| | - M Schmidt
- Washington University in St. Louis, St. Louis, MO
| | - T R Mazur
- Washington University School of Medicine in St. Louis, Department of Radiation Oncology, St. Louis, MO
| | - T Zhao
- Washington University in St. Louis, St. Louis, MO
| | - H A Gay
- Washington University School of Medicine in St. Louis, Department of Radiation Oncology, St. Louis, MO
| | - G D Hugo
- Washington University School of Medicine in St. Louis, St. Louis, MO
| | - L E Henke
- University Hospitals, Department of Radiation Oncology, Case Western Reserve University, Cleveland, OH
| | - J M Michalski
- Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO
| | - A Velarde
- Liga Nacional Contra el Cáncer e Instituto de Cancerología LIGA-INCAN, Guatemala City, Guatemala
| | - V De Falla
- Liga Nacional Contra el Cáncer e Instituto de Cancerología LIGA-INCAN, Guatemala City, Guatemala
| | - F E Reyes
- Liga Nacional Contra el Cáncer e Instituto de Cancerología LIGA-INCAN, Guatemala City, Guatemala
| | - E Montenegro
- Liga Nacional Contra el Cáncer / INCAN, Guatemala, Guatemala
| | - E A Ruiz Furlan
- Liga Nacional Contra el Cáncer e Instituto de Cancerología LIGA-INCAN, Guatemala City, Guatemala
| | - B Sun
- Baylor College of Medicine, Department of Radiation Oncology, Houston, TX
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Liu C, Zou W, Huang R, Yu J, Sun B. Dissecting Systemic T Cell Responses after Stereotactic Ablative Radiotherapy in NSCLC by Single-Cell RNA and T Cell Receptor Sequencing. Int J Radiat Oncol Biol Phys 2023; 117:e246. [PMID: 37784964 DOI: 10.1016/j.ijrobp.2023.06.1182] [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) There is accumulating evidence that stereotactic ablative radiotherapy (SABR) modulates immune responses to cancer; combining SABR and immunotherapy could promote the abscopal effect, but the precise effects of SABR on patients' systemic T cells is unclear. Here, we investigated SABR-induced systemic T cell response in early-stage non-small cell lung cancer (NSCLC) by single-cell RNA and T cell receptor sequencing. MATERIALS/METHODS We performed single-cell RNA and T cell receptor sequencing on 29,439 T cells from four pairs of peripheral blood before and after SABR in early-stage NSCLC patients. Cell clustering and dimensionality reduction, SingleR, feature genes score, and TCR profiling analyses were used to investigate the heterogeneity of T cells and their changes following SABR. RESULTS We identified fourteen T cell subtypes using unsupervised graph-based clustering of uniform manifold approximation and projection. By comparing the gene set scores of CD8_TE and CD8_EM pre- and post-SABR, we found both cytotoxic and inhibitory scores were significantly elevated in CD8_TE (both P < 0.001), while cytotoxic score was significantly increased in CD8_EM (P < 0.001) after SABR. We also found that CD4_TE showed increased cytotoxic scores and decreased Treg scores (P < 0.001 and < 0.05, respectively), while Treg cells showed decreased inhibitory and Treg scores (P < 0.001 and <0.01, respectively) after SABR. The proportion of large TCR clones was higher after SABR, which was accompanied by a decrease in proportion of single clones. When we compared the transcriptomes of CD8_TE cells between the single, small and large clones post-SABR, we found high expression of GZMB and KLRC3 in cells with large clones, and GZMK, IL7R, and SELL in small and single clones. This suggested that T cells after SABR with large clones may have higher cytotoxicity than those with small and single clones. CONCLUSION Our study identified systemic T cell activation after SABR at single-cell resolution, providing unprecedented insight into the immune-modulatory role of SABR in early-stage NSCLC.
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Affiliation(s)
- C Liu
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - W Zou
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - R Huang
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - J Yu
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - B Sun
- Department of Radiation Oncology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
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7
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Ixquiac M, Montenegro E, Reynoso FJ, Schmidt M, Mazur TR, Zhao T, Gay HA, Hugo GD, Henke LE, Michalski JM, Velarde A, De Falla V, Reyes FE, Furlan EAR, Sun B. Standardizing LT Chest Wall Radiotherapy Treatment Planning in a Low- or Middle- Income Country Radiotherapy Clinic Using Knowledge Based Planning. Int J Radiat Oncol Biol Phys 2023; 117:e675-e676. [PMID: 37785990 DOI: 10.1016/j.ijrobp.2023.06.2129] [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) Radiotherapy departments in low- or middle-income countries (LMICs) tend to lag behind introducing emerging technologies like intensity-modulated radiotherapy (IMRT). IMRT has become the standard of care in high-income countries (HIC) due to reduced toxicity and improved outcomes in a wide variety of cancers. The purpose of this work is showing the results of left Chest-Wall knowledge-based planning (KBP) standardization and implementation in a LMIC setting. MATERIALS/METHODS A Halcyon Linac was installed at our clinic in Guatemala in 2019 and currently used to treat ∼90 IMRT patients daily. The standardization of IMRT procedures has been difficult for complex sites like chest-wall. The steps for standardization included: AAPM TG-263 nomenclature implementation, and planning workflows within the TPS, creation of optimization structures, and plan quality evaluation following RTOG1005 protocol hypofractionation arm. 25 plans were created manually achieving all RTOG1005 protocol constraints. The statistics were analyzed trough the model analytics tool provided by KPB manufacturer. RESULTS The results show that more plans are needed to improve the KBP model. This initial model was used to create a standardized clinical protocol in the TPS in order to continue adding plans to the KBP model database. This approach ensures that we obtain consistent plan quality and standardize our planning. The manual planning objectives achieved: CONCLUSION: The experience using the TPS to standardize our treatment planning process achieved good consistency in our planning objectives. This approach will help create KBP models according to our own clinic-specific requirements. Future work will be made to compare our LMIC KBP models with those made at a HIC academic radiotherapy center.
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Affiliation(s)
- M Ixquiac
- Liga Nacional Contra el Cáncer e Instituto de Cancerología LIGA-INCAN, Guatemala City, Guatemala
| | - E Montenegro
- Liga Nacional Contra el Cáncer / INCAN, Guatemala, Guatemala
| | - F J Reynoso
- Washington University School of Medicine in St. Louis, Department of Radiation Oncology, St. Louis, MO
| | - M Schmidt
- Washington University in St. Louis, St. Louis, MO
| | - T R Mazur
- Washington University School of Medicine in St. Louis, Department of Radiation Oncology, St. Louis, MO
| | - T Zhao
- Washington University in St. Louis, St. Louis, MO
| | - H A Gay
- Washington University School of Medicine in St. Louis, Department of Radiation Oncology, St. Louis, MO
| | - G D Hugo
- Washington University School of Medicine in St. Louis, St. Louis, MO
| | - L E Henke
- University Hospitals, Department of Radiation Oncology, Case Western Reserve University, Cleveland, OH
| | - J M Michalski
- Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO
| | - A Velarde
- Liga Nacional Contra el Cáncer e Instituto de Cancerología LIGA-INCAN, Guatemala City, Guatemala
| | - V De Falla
- Liga Nacional Contra el Cáncer e Instituto de Cancerología LIGA-INCAN, Guatemala City, Guatemala
| | - F E Reyes
- Liga Nacional Contra el Cáncer e Instituto de Cancerología LIGA-INCAN, Guatemala City, Guatemala
| | - E A Ruiz Furlan
- Liga Nacional Contra el Cáncer e Instituto de Cancerología LIGA-INCAN, Guatemala City, Guatemala
| | - B Sun
- Baylor College of Medicine, Department of Radiation Oncology, Houston, TX
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8
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Kibudde S, Kavuma A, van Rheenen J, Zhao T, Gay HA, Jhaveri PM, Sun B. Impact of AI-Based Auto-Segmentation on Radiotherapy Processes in Low and Middle-Income Countries. Int J Radiat Oncol Biol Phys 2023; 117:S80. [PMID: 37784580 DOI: 10.1016/j.ijrobp.2023.06.398] [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) Radiotherapy processes require significant human resources and expertise, creating a barrier for rapid deployment in low and middle-income countries (LMICs). Optimal radiotherapy (RT) relies on accurate segmentation of tumor targets and organs-at-risk (OARs) during the RT planning process. This study reports the impact of AI-based auto-segmentation on RT processes in an LMIC. MATERIALS/METHODS Ten patients including five head and neck (HN), and five prostate cancer patients were randomly selected. Their planning CT images were subjected to auto- segmentation using an FDA-approved AI software tool, and manual segmentation by an experienced radiation oncologist from a Sub-Saharan African RT clinic. The control data consisted of contours from an experienced radiation oncologist and dosimetrists at a large academic institution in the US. For prostate cases, the contours included the prostate, seminal vesicles, bladder, rectum, penile bulb, and both femoral heads. For HN cases, the contours included the brain, brainstem, bilateral eyes, lens, optic nerves, cochlea, parotids, optic chiasm, spinal cord, oral cavity, and mandible. The time to complete the segmentation was recorded for both auto-segmentation and manual contours from the LMIC. The DICE similarity coefficients were used for comparative evaluation. RESULTS The average time for contouring per patient was 2 minutes for AI compared to 57 minutes for manual contouring in the LMIC. When comparing the control data, AI pelvic contours provide a slightly better agreement than LMIC manual contours for all the OARs, with the following mean DICE coefficients for AI vs LMIC manual contours: bladder (0.971 vs 0.958), left femoral head (0.960 vs 0.949), right femoral head (0.959 vs 0.941), rectum (0.880 vs 0.867), prostate (0.836 vs 0.824), seminal vesicles (0.696 vs 0.580), and penile bulb (0.536 vs 0.528). For HN contours, AI provide a better agreement for 7 of 11 OARs than the LMIC manual contours, with the following mean DICE coefficients: brain (0.972 vs 0.982), mandible (0.877 vs 0.925), right parotid (0.847 vs 0.800), left parotid (0.798 vs 0.792), spinal cord (0.837 vs 0.821), left eye (0.875 vs 0.832), right eye (0.867 vs 0.836), brainstem (0.866 vs 852), oral cavity (0.796 vs 0.787), left lens (0.650 vs 0.729) and right lens (0.671 vs 0.682). Neither AI contours nor LMIC manual contours had good agreement with the control data (<0.600) for optic nerves, chiasm, and cochlea due to their small volumes. CONCLUSION AI-based auto-segmentation tools are capable of producing contours of comparable quality to those generated by manual segmentation for both pelvic and HN cancer patients in LMICs, while also resulting in substantial time savings. AI-based auto-segmentation holds tremendous potential for improving radiotherapy care in LMICs with limited sources.
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Affiliation(s)
- S Kibudde
- Uganda Cancer Institute, Kampala, Uganda
| | - A Kavuma
- Uganda Cancer Institute, Kampala, Uganda
| | - J van Rheenen
- Global Health Center, Institute for Public Health, Washington University in St. Louis, St. Louis, MO
| | - T Zhao
- Washington University in St. Louis, St. Louis, MO
| | - H A Gay
- Washington University School of Medicine in St. Louis, Department of Radiation Oncology, St. Louis, MO
| | | | - B Sun
- Baylor College of Medicine, Department of Radiation Oncology, Houston, TX
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9
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Yang YC, Shen Y, Wang XD, Jiang Y, Qiu QH, Li J, Yu SQ, Ke X, Liu F, Xu YT, Lou HF, Wang HT, Yu GD, Xu R, Meng J, Meng CD, Sun N, Chen JJ, Zeng M, Xie ZH, Sun YQ, Tang J, Zhao KQ, Zhang WT, Shi ZH, Xu CL, Yang YL, Lu MP, Ye HP, Wei X, Sun B, An YF, Sun YN, Gu YR, Zhang TH, Ba L, Yang QT, Ye J, Xu Y, Li HB. [Expert consensus on the prevention and treatment of adverse reactions in subcutaneous immunotherapy(2023, Chongqing)]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2023; 58:643-656. [PMID: 37455109 DOI: 10.3760/cma.j.cn115330-20221111-00679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Affiliation(s)
- Y C Yang
- Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Y Shen
- Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - X D Wang
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Y Jiang
- Department of Otolaryngology Head and Neck Surgery, the Affiliated Hospital of Qingdao University, Qingdao 266000, China
| | - Q H Qiu
- Department of Otolaryngology Head and Neck Surgery, Guangdong Provincial People's Hospital, Guangzhou 510080, China
| | - J Li
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, China, Guangxi Hospital Division of The First Affiliated Hospital, Sun Yat-sen University, Nanning 530029, China
| | - S Q Yu
- Department of Otolaryngology Head and Neck Surgery, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China
| | - X Ke
- Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - F Liu
- Department of Otolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Y T Xu
- Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350004, China
| | - H F Lou
- Department of Otorhinolaryngology Head and Neck Surgery, Eye, Ear, Nose and Throat Hospital, Shanghai Medical College, Fudan University, Shanghai 200031, China
| | - H T Wang
- Department of Allergy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - G D Yu
- Department of Otorhinolaryngology, Affiliated Hospital of Guizhou Medical University, Guiyang 550001, China
| | - R Xu
- Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, China, Guangxi Hospital Division of The First Affiliated Hospital, Sun Yat-sen University, Nanning 530029, China
| | - J Meng
- Department of Otolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - C D Meng
- Department of Otolaryngology Head and Neck Surgery, China Japan Union Hospital of Jilin University, Changchun 130033, China
| | - N Sun
- Department of Otolaryngology, Huadong Hospital, Fudan University, Shanghai 200040, China
| | - J J Chen
- Department of Otolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - M Zeng
- Department of Otolaryngology, Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Z H Xie
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Y Q Sun
- Department of Otolaryngology, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen 518170, China
| | - J Tang
- Department of Otorhinolaryngology, Affiliated First People's Hospital of Foshan City, Sun Yat-sen University, Foshan 528000, China
| | - K Q Zhao
- Department of Otorhinolaryngology Head and Neck Surgery, Eye, Ear, Nose and Throat Hospital, Shanghai Medical College, Fudan University, Shanghai 200031, China
| | - W T Zhang
- Department of Otolaryngology Head and Neck Surgery, the Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
| | - Z H Shi
- Department of Otolaryngology Head and Neck Surgery and Department of Allergy, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - C L Xu
- Department of Otolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Guangxi Medical University, Nanning 530007, China
| | - Y L Yang
- Department of 1st Otolaryngology, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - M P Lu
- Department of Otolaryngology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - H P Ye
- Department of Otolaryngology, Guizhou Province Hospital, Guiyang 550002, China
| | - X Wei
- Department of Otorhinolaryngology Head and Neck Surgery, Hainan General Hospital, Haikou 570311, China
| | - B Sun
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - Y F An
- Department of Otorhinolaryngology Head and Neck Surgery, Shanxi Medical University Affiliated Second Hospital, Taiyuan 030001, China
| | - Y N Sun
- Department of Otolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Harbin Medical University, Harbin 150001, China
| | - Y R Gu
- Department of Otorhinolaryngology Head and Neck Surgery, Eye, Ear, Nose and Throat Hospital, Shanghai Medical College, Fudan University, Shanghai 200031, China
| | - T H Zhang
- Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Harbin Medical University, Harbin 150001, China
| | - L Ba
- Department of Otolaryngology Head and Neck Surgery, People's Hospital of Tibet Autonomous Region, Lasa 850000, China
| | - Q T Yang
- Department of Otolaryngology Head and Neck Surgery and Department of Allergy, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - J Ye
- Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - Y Xu
- Department of Otolaryngology, Head and Neck Surgery, Renmin Hospital, Wuhan University, Wuhan 430060, China
| | - H B Li
- Department of Otorhinolaryngology Head and Neck Surgery, Eye, Ear, Nose and Throat Hospital, Shanghai Medical College, Fudan University, Shanghai 200031, China
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Bai R, Lu TQ, Sun B. [Evolution and progress of surgical intervention strategies for acute pancreatitis]. Zhonghua Wai Ke Za Zhi 2023; 61:556-561. [PMID: 37402683 DOI: 10.3760/cma.j.cn112139-20221209-00520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 07/06/2023]
Abstract
Acute pancreatitis is one of the common surgical acute abdominal diseases. Since people first recognized acute pancreatitis in the middle of the nineteenth century, a diversified minimally invasive treatment model with standardization has been formed today. According to the main line of surgical intervention of acute pancreatitis treatment,this period can be roughly divided into five stages:exploration stage, conservative treatment stage, pancreatectomy stage, debridement and drainage of the pancreatic necrotic tissue stage, and minimally invasive treatment as the first choice led by the multidisciplinary team mode stage. Throughout history, the evolution and progress of surgical intervention strategies for acute pancreatitis cannot be separated from the progress of science and technology, the update of treatment concepts and the further understanding of the pathogenesis. This article will summarize the surgical characteristics of acute pancreatitis treatment at each stage to explain the development of surgical treatment of acute pancreatitis,to help investigate the development of surgical treatment of acute pancreatitis in the future.
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Affiliation(s)
- R Bai
- Department of Pancreatic and Biliary Surgery,the First Affiliated Hospital of Harbin Medical University & Key Laboratory of Hepatosplenic Surgery,Ministry of Education,Harbin 150001,China
| | - T Q Lu
- Department of Pancreatic and Biliary Surgery,the First Affiliated Hospital of Harbin Medical University & Key Laboratory of Hepatosplenic Surgery,Ministry of Education,Harbin 150001,China
| | - B Sun
- Department of Pancreatic and Biliary Surgery,the First Affiliated Hospital of Harbin Medical University & Key Laboratory of Hepatosplenic Surgery,Ministry of Education,Harbin 150001,China
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Halsey TM, Thomas AS, Hayase T, Ma W, Abu-Sbeih H, Sun B, Parra ER, Jiang ZD, DuPont HL, Sanchez C, El-Himri R, Brown A, Flores I, McDaniel L, Turrubiates MO, Hensel M, Pham D, Watowich SS, Hayase E, Chang CC, Jenq RR, Wang Y. Microbiome alteration via fecal microbiota transplantation is effective for refractory immune checkpoint inhibitor-induced colitis. Sci Transl Med 2023; 15:eabq4006. [PMID: 37315113 PMCID: PMC10759507 DOI: 10.1126/scitranslmed.abq4006] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 05/19/2023] [Indexed: 06/16/2023]
Abstract
Immune checkpoint inhibitors (ICIs) target advanced malignancies with high efficacy but also predispose patients to immune-related adverse events like immune-mediated colitis (IMC). Given the association between gut bacteria with response to ICI therapy and subsequent IMC, fecal microbiota transplantation (FMT) represents a feasible way to manipulate microbial composition in patients, with a potential benefit for IMC. Here, we present a large case series of 12 patients with refractory IMC who underwent FMT from healthy donors as salvage therapy. All 12 patients had grade 3 or 4 ICI-related diarrhea or colitis that failed to respond to standard first-line (corticosteroids) and second-line immunosuppression (infliximab or vedolizumab). Ten patients (83%) achieved symptom improvement after FMT, and three patients (25%) required repeat FMT, two of whom had no subsequent response. At the end of the study, 92% achieved IMC clinical remission. 16S rRNA sequencing of patient stool samples revealed that compositional differences between FMT donors and patients with IMC before FMT were associated with a complete response after FMT. Comparison of pre- and post-FMT stool samples in patients with complete responses showed significant increases in alpha diversity and increases in the abundances of Collinsella and Bifidobacterium, which were depleted in FMT responders before FMT. Histologically evaluable complete response patients also had decreases in select immune cells , including CD8+ T cells, in the colon after FMT when compared with non-complete response patients (n = 4). This study validates FMT as an effective treatment strategy for IMC and gives insights into the microbial signatures that may play a critical role in FMT response.
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Affiliation(s)
- Taylor M. Halsey
- Graduate School of Biomedical Sciences, Microbiology and Infectious Diseases, The University of Texas MD Anderson Cancer Center UTHealth Houston; Houston, Texas, USA
| | - Anusha S. Thomas
- Department of Gastroenterology, Hepatology & Nutrition, The University of Texas MD Anderson Cancer Center; Houston, Texas, USA
| | - Tomo Hayase
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center; Houston, Texas, USA
| | - Weijie Ma
- Department of Gastroenterology, Hepatology & Nutrition, The University of Texas MD Anderson Cancer Center; Houston, Texas, USA
- Department of Hepatobiliary and Pancreatic Surgery, Zhongnan Hospital of Wuhan University; Wuhan, Hubei Province, People’s Republic of China
| | - Hamzah Abu-Sbeih
- Department of Gastroenterology, Hepatology & Nutrition, The University of Texas MD Anderson Cancer Center; Houston, Texas, USA
- Department of Internal Medicine, University of Missouri; Kansas City, Missouri, USA
| | - Baohua Sun
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center; Houston, Texas, USA
| | - Edwin Roger Parra
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center; Houston, Texas, USA
| | - Zhi-Dong Jiang
- Center for Infectious Diseases, School of Public Health, The University of Texas; Houston, Texas, USA
| | - Herbert L. DuPont
- Center for Infectious Diseases, School of Public Health, The University of Texas; Houston, Texas, USA
- Kelsey Research Foundation; Houston, Texas, USA
| | - Christopher Sanchez
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center; Houston, Texas, USA
| | - Rawan El-Himri
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center; Houston, Texas, USA
| | - Alexandria Brown
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center; Houston, Texas, USA
| | - Ivonne Flores
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center; Houston, Texas, USA
| | - Lauren McDaniel
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center; Houston, Texas, USA
| | - Miriam Ortega Turrubiates
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center; Houston, Texas, USA
| | | | - Dung Pham
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center; Houston, Texas, USA
| | - Stephanie S. Watowich
- Department of Immunology, The University of Texas MD Anderson Cancer Center; Houston, Texas, USA
| | - Eiko Hayase
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center; Houston, Texas, USA
| | - Chia-Chi Chang
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center; Houston, Texas, USA
| | - Robert R. Jenq
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center; Houston, Texas, USA
- Department of Stem Cell Transplantation, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center; Houston, Texas, USA
| | - Yinghong Wang
- Department of Gastroenterology, Hepatology & Nutrition, The University of Texas MD Anderson Cancer Center; Houston, Texas, USA
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Li Y, Li XY, Tang X, Wang R, Zhang CY, Wang SQ, Yuan X, Wang L, Tong ZH, Sun B. [Application of veno-arterio-venous extracorporeal membrane oxygenation in patients with critical respiratory failure combined with refractory shock]. Zhonghua Jie He He Hu Xi Za Zhi 2023; 46:565-571. [PMID: 37278170 DOI: 10.3760/cma.j.cn112147-20221008-00803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Objective: To preliminarily analyze the application experience of veno-arterio-venous extracorporeal membrane oxygenation (VAV-ECMO).The VAV-ECMO is a rescue strategy for patients with extremely critical respiratory failure combined with refractory shock. Methods: From February 2016 to February 2022, the characteristics and outcomes of patients who were started on either veno-venous or veno-arterial ECMO due to respiratory or hemodynamic failure, and then converted to VAV-ECMO in respiratory intensive care unit (ICU) of Beijing Chaoyang Hospital were analyzed. Results: A total of 15 patients underwent VAV-ECMO, aged 53 (40, 65) years, and 11 of whom were male. Within the group, VV-ECMO was initially used in 12 patients due to respiratory failure, but then VAV-ECMO was used due to cardiogenic shock (7/12) and septic shock (4/12), while VAV-ECMO was established in two patients due to lung transplantation. One patient was diagnosed with pneumonia complicated by septic shock, which was initially determined to be VA-ECMO, but then switched to VAV-ECMO because it was difficult to maintain oxygenation. The time from the establishment of VV or VA-ECMO to the switch to VAV-ECMO was 3 (1, 5) days and the VAV-ECMO support time was 5 (2, 8) days. ECMO-related complications were bleeding, mostly in the digestive tract (n=4) and airway hemorrhage (n=4), without intracranial hemorrhage, and poor arterial perfusion of the lower limbs (n=2). Among these 15 patients, the overall ICU mortality was 53.3%. The mortality of patients who received VAV-ECMO due to septic shock and cardiogenic shock was 100% (4/4) and 42.8% (3/7), respectively. Two patients who received VAV-ECMO due to lung transplantation all survived. Conclusion: VAV-ECMO may be a safe and effective treatment for carefully selected patients with critical respiratory failure associated with cardiogenic shock or end-stage lung disease lung transplantation transition, however, patients with septic shock may benefit the least.
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Affiliation(s)
- Y Li
- Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing Engineering Research Centre for Diagnosis and Treatment of Respiratory and Critical Care Medicine (Beijing Chaoyang Hospital), Beijing 100020,China
| | - X Y Li
- Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing Engineering Research Centre for Diagnosis and Treatment of Respiratory and Critical Care Medicine (Beijing Chaoyang Hospital), Beijing 100020,China
| | - X Tang
- Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing Engineering Research Centre for Diagnosis and Treatment of Respiratory and Critical Care Medicine (Beijing Chaoyang Hospital), Beijing 100020,China
| | - R Wang
- Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing Engineering Research Centre for Diagnosis and Treatment of Respiratory and Critical Care Medicine (Beijing Chaoyang Hospital), Beijing 100020,China
| | - C Y Zhang
- Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing Engineering Research Centre for Diagnosis and Treatment of Respiratory and Critical Care Medicine (Beijing Chaoyang Hospital), Beijing 100020,China
| | - S Q Wang
- Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing Engineering Research Centre for Diagnosis and Treatment of Respiratory and Critical Care Medicine (Beijing Chaoyang Hospital), Beijing 100020,China
| | - X Yuan
- Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing Engineering Research Centre for Diagnosis and Treatment of Respiratory and Critical Care Medicine (Beijing Chaoyang Hospital), Beijing 100020,China
| | - L Wang
- Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing Engineering Research Centre for Diagnosis and Treatment of Respiratory and Critical Care Medicine (Beijing Chaoyang Hospital), Beijing 100020,China
| | - Z H Tong
- Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing Engineering Research Centre for Diagnosis and Treatment of Respiratory and Critical Care Medicine (Beijing Chaoyang Hospital), Beijing 100020,China
| | - B Sun
- Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing Engineering Research Centre for Diagnosis and Treatment of Respiratory and Critical Care Medicine (Beijing Chaoyang Hospital), Beijing 100020,China
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Rodriguez S, Sun B, McAllen S, Jiang M, Parra ER. Multiplexed Barcoding Image Analysis for Immunoprofiling and Spatial Mapping Characterization in the Single-Cell Analysis of Paraffin Tissue Samples. J Vis Exp 2023. [PMID: 37092851 DOI: 10.3791/64758] [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: 04/25/2023] Open
Abstract
Multiplexed imaging technology using antibody barcoding with oligonucleotides, which sequentially detects multiple epitopes in the same tissue section, is an effective methodology for tumor evaluation that improves the understanding of the tumor microenvironment. The visualization of protein expression in formalin-fixed, paraffin-embedded tissues is achieved when a specific fluorophore is annealed to an antibody-bound barcode via complementary oligonucleotides and then sample imaging is performed; indeed, this method allows for the use of customizable panels of more than 40 antibodies in a single tissue staining reaction. This method is compatible with fresh frozen tissue, formalin-fixed, paraffin-embedded tissue, cultured cells, and peripheral blood mononuclear cells, meaning that researchers can use this technology to view a variety of sample types at single-cell resolution. This method starts with a manual staining and fixing protocol, and all the antibody barcodes are applied using an antibody cocktail. The staining fluidics instrument is fully automated and performs iterative cycles of labeling, imaging, and removing spectrally distinct fluorophores until all the biomarkers have been imaged using a standard fluorescence microscope. The images are then collected and compiled across all the imaging cycles to achieve single-cell resolution for all the markers. The single-step staining and gentle fluorophore removal not only allow for highly multiplexed biomarker analysis but also preserve the sample for additional downstream analysis if desired (e.g., hematoxylin and eosin staining). Furthermore, the image analysis software enables image processing-drift compensation, background subtraction, cell segmentation, and clustering-as well as the visualization and analysis of the images and cell phenotypes for the generation of spatial network maps. In summary, this technology employs a computerized microfluidics system and fluorescence microscope to iteratively hybridize, image, and strip fluorescently labeled DNA probes that are complementary to tissue-bound, oligonucleotide-conjugated antibodies.
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Affiliation(s)
- Saxon Rodriguez
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center
| | - Baohua Sun
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center
| | - Salome McAllen
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center
| | - Mei Jiang
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center
| | - Edwin Roger Parra
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center;
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Patel S, Knierim J, Goldstein D, Lamba H, Sun B, Schmitto J, Lowes B, Shah P, Kanwar M, Wald J, Ravichandran A, MacGowan G, Ton V, Silvestry S, Sera F, Farooq M, Jorde U, Stehlik J, Selzman C, Potapov E, Drakos S. Long-Term Clinical Trajectory after Durable Lvad Weaning: An International Registry Report. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1518] [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: 04/05/2023] Open
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Stehlik J, Schroder J, Pinney S, Patel C, D'Alessandro D, Goldstein D, Jorde U, Patel S, Mani D, Esmailian F, Kobashigawa J, Takeda K, Uriel N, Pham S, Patel P, Kai M, Sun B, Shah A, Ono M, Couper G, DeNofrio D, Vest A, Joyce D, DeVore A, Mallidi H, Itoh A, Mehra M, Givertz M, Milano C, Farr M. First Report of the Transmedics Organ Care System Heart Perfusion Registry. A Multi-Institutional Outcomes Analysis. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.634] [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: 04/05/2023] Open
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Crespo R, Khan N, Mudy K, Bae A, Samara M, Eckman P, Sun B, Hryniewicz K. Proactive Right Ventricular Assist Device Placement in Patients Undergoing Left Ventricular Assist Device Implantation Leads to Improved Short and Long Term Survival. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.851] [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: 04/05/2023] Open
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Crespo R, Weaver C, Bennett M, Sun B, Eckman P, Samara M, Hryniewicz K. Myocardial Recovery Profile in Patients Following Left Ventricular Assist Device Explantation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1236] [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: 04/05/2023] Open
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Milano C, Schroder J, Farr M, DeVore A, D'Alessandro D, Goldstein D, Jorde U, Patel S, Daneshmand M, Pinney S, Esmailian F, Kobashigawa J, Takeda K, Uriel N, Pham S, Patel P, Kai M, Sun B, Shah A, Ono M, Couper G, DeNofrio D, Vest A, Joyce D, Mallidi H, Itoh A, Mehra M, Givertz M, Patel C, Stehlik J. Demographics and Outcomes of Clinical Trial vs Initial Post-Approval Use of Transmedics Organ Care System Heart. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.135] [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: 04/05/2023] Open
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19
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Sun B, Li M. [The mechanism, inducement and long-term effects of acquired weakness in intensive care units]. Zhonghua Yi Xue Za Zhi 2023; 103:1-5. [PMID: 36977562 DOI: 10.3760/cma.j.cn112137-20221117-02413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
With the development of critical care medicine, the case fatality rate in intensive care units (ICU) patients has decreased significantly, but most patients still suffer from the long-term problems of related complications after discharge, which seriously affects the quality of life and social integration after discharge. Complications such as ICU acquired weakness (ICU-AW) and Post-ICU Syndrome (PICS) are not uncommon throughout the treatment of severe patients. The treatment of critically ill patients should not only focus on the treatment of the disease, but also gradually extend to the whole-process physiological-psychological-social medical intervention mode in the ICU, during the stay in the general ward and after discharge. On the basis of ensuring patient safety, patients' physical and psychological status assessment in the early stage of ICU admission, and disease prevention as soon as possible, which can reduce the long-term impact on the quality of life and social work after discharge.
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Affiliation(s)
- B Sun
- Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University/Beijing Institute of Respiratory Medicine/Beijing Key laboratory of Respiratory and Pulmonary Circulation Disorders/Beijing Engineering Research Center for Diagnosis and Treatment of China, Beijing 100020, China
| | - M Li
- Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University/Beijing Institute of Respiratory Medicine/Beijing Key laboratory of Respiratory and Pulmonary Circulation Disorders/Beijing Engineering Research Center for Diagnosis and Treatment of China, Beijing 100020, China
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20
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Lim B, Alexander A, Willey JS, Sun H, Liu S, Patel AB, Parra ER, Haymaker C, Soto LS, Serrano A, Sun B, Lima CFP, Tamegnon A, Pandurengan RK, Douse D, Lan J, Raja L, Chu R, Knafl M, Woodman SE, Zhu H, Shulze K, Fedenko K, Darbonne W, Ueno NT, Valero V. Abstract P4-08-19: Biomarker analysis: Multi-omics elucidation of Cohort 1 from a phase II study of a triple combination of Atezolizumab + cobimetinib + eribulin in patients with metastatic inflammatory breast cancer. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-p4-08-19] [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: 03/06/2023]
Abstract
Abstract
Background: Inflammatory breast cancer (IBC) is a rare but aggressive tumor type accounting for up to 10% of breast cancer deaths. One-third of IBCs express high PD-L1 that can be targeted by atezolizumab (Az). MEK inhibitor cobimetinib (Co) not only inhibits the RAS-MAPK pathway but can further enhance immune-mediated killing. Thus, we hypothesize that Az+Co may enhance the efficacy of chemotherapy in metastatic IBC (mIBC). We opened a trial to test this hypothesis with a comprehensive multi-omics biomarker assessment. Patients and Methods: In a single-center, open-label phase II study, cohort 1 received one cycle of Az+ Co, followed by four cycles of Az+Co+eribulin (E) to induce a maximum clinical response, followed by Az+Co maintenance. Pre and Post one cycle of Az+Co tumors were collected for immunohistochemistry (IHC), multiplex immunofluorescence (mIF), whole-exome sequencing (WES), and RNA sequencing (RNAseq). Blood was collected for circulating tumor DNA (ctDNA). Results: Seventeen patients were enrolled in cohort 1. Seven had PR, and three had SD as the best responses. Fourteen had pre, and six had pre/post tumors. The levels of PD-L1 expression at pre/post were not associated with responses. WES revealed the median tumor mutation burden at pre- was 9mt/Mb. More than 50% had TP53 and PI3K pathway mutations at pre. RTK-RAS and Notch pathways were altered in 4/9 cases. PRDM9 and DPY19L2 single-gene mutations were commonly noted in pre. No cancer-associated gene aberration, including potential biomarkers of anti-PDL1 agent response was associated with clinical outcomes. Transcriptomic gene set enrichment analysis demonstrated a greater degree of TNFa and TGFb signaling, Oxphos, angiogenesis, and epithelial-to-mesenchymal transition (EMT) processes in tumors from patients with poor response. Immune profiling by RNAseq revealed two responders to have elevated effector memory T cells, NK T cells, myeloid dendritic cells, and M1 macrophage signatures in pre-samples, but post-samples were not available. mIF confirmed a higher frequency of NK-T cells. The ctDNA analysis from serially collected blood samples is ongoing. Discussion: In this comprehensive multi-omics analysis of pre-and-post-Az+Co, we observed several novel findings, while conventional biomarkers for Az and Co did not correlate with clinical responses. EMT, Oxphos, Notch, and chronic inflammation pathways, which are not previously well reported, were observed in this IBC cohort. These markers warrant further validation to see if they carry significance as therapeutic targets in IBC.
Citation Format: Bora Lim, Angela Alexander, Jie S. Willey, Huiming Sun, Suyu Liu, Anisha B. Patel, Edwin Roger Parra, Cara Haymaker, Luisa Solis Soto, Alejandra Serrano, Baohua Sun, Cibelle Freitas Pinto Lima, Auriole Tamegnon, Renganayaki K. Pandurengan, Dzifa Douse, Jessica Lan, Luthra Raja, Randy Chu, Mark Knafl, Scott E. Woodman, Haifeng Zhu, Katja Shulze, Katherine Fedenko, Walter Darbonne, Naoto T. Ueno, Vicente Valero. Biomarker analysis: Multi-omics elucidation of Cohort 1 from a phase II study of a triple combination of Atezolizumab + cobimetinib + eribulin in patients with metastatic inflammatory breast cancer. [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P4-08-19.
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Affiliation(s)
- Bora Lim
- 1Baylor College of Medicine, Houston, TX
| | | | | | - Huiming Sun
- 4The University of Texas MD Anderson Cancer Center
| | - Suyu Liu
- 5The University of Texas MD Anderson Cancer Center, Texas
| | | | | | | | | | | | - Baohua Sun
- 11The University of Texas MD Anderson Cancer Center
| | | | | | | | - Dzifa Douse
- 15The University of Texas MD Anderson Cancer Center
| | - Jessica Lan
- 16The University of Texas MD Anderson Cancer Center
| | - Luthra Raja
- 17The University of Texas MD Anderson Cancer Center
| | - Randy Chu
- 18The University of Texas MD Anderson Cancer Center
| | - Mark Knafl
- 19The University of Texas MD Anderson Cancer Center
| | | | - Haifeng Zhu
- 21The University of Texas MD Anderson Cancer Center
| | | | | | | | - Naoto T. Ueno
- 25The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Vicente Valero
- 26Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
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21
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Sun B, Liu Z, Tchetgen Tchetgen E. Semiparametric Efficient G-estimation with Invalid Instrumental Variables. Biometrika 2023. [DOI: 10.1093/biomet/asad011] [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: 02/17/2023] Open
Abstract
Summary
The instrumental variable method is widely used in the health and social sciences for identification and estimation of causal effects in the presence of potential unmeasured confounding. In order to improve efficiency, multiple instruments are routinely used, leading to concerns about bias due to possible violation of the instrumental variable assumptions. To address this concern, we introduce a new class of G-estimators that are guaranteed to remain consistent and asymptotically normal for the causal effect of interest provided that a set of at least γ out of K candidate instruments are valid, for γ≤K set by the analyst ex ante, without necessarily knowing the identity of the valid and invalid instruments. We provide formal semiparametric efficiency theory supporting our results. Both simulation studies and applications to the UK Biobank data demonstrate the superior empirical performance of our estimators compared to competing methods.
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Affiliation(s)
- B Sun
- National University of Singapore Department of Statistics and Data Science, , 6 Science Drive 2, 117546 Singapore
| | - Z Liu
- Columbia University Department of Biostatistics, , 722 West 168th St., New York, New York 10032, U.S.A
| | - E Tchetgen Tchetgen
- University of Pennsylvania Department of Statistics and Data Science, The Wharton School, , 265 South 37th Street, Philadelphia, Pennsylvania 19104, U.S.A
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22
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Otten A, van der Meer F, Gibbs S, Sun B, Boon R. 198 Novel, functional long noncoding RNAs with skin-ageing-associated expression changes control epidermal homeostasis. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.209] [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: 11/19/2022]
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23
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De Falla V, Figueroa F, Michalski J, van Rheenen J, Gay H, Ruiz Furlan E, Kihn A, Hugo G, Sobrevilla L, Garcia M, Davila S, Powderly W, Velarde A, Sun B, Lee K, Huang Y, Ma K, Najera K, García C, Reyes F, Ixquiac M, Henke L. Quality of Life of Patients Treated with Radiotherapy in an Upper Middle-Income Country. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1698] [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: 12/01/2022]
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24
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Kavuma A, Kibudde S, Schmidt M, Zhao T, Gay H, Michalski J, Hugo G, Li B, van Rheenen J, Vanchinbazar E, Minjgee M, N E, Ssewamala F, Velarde A, Furlan EAR, De Falla V, Ixquiac M, Reyes F, Henke L, Sun B. Lessons Learned from Remote Global Radiation Oncology Education and Training on IMRT for Low- and Middle-Income Countries. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1417] [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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25
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Zhao ZL, Tang X, He CW, Liu YL, Li XY, Wang R, Li Y, Cao SY, Sun B, Tong ZH. [Clinical characteristics and outcomes of acute respiratory distress syndrome caused by severe Chlamydia psittaci pneumonia]. Zhonghua Jie He He Hu Xi Za Zhi 2022; 45:1015-1021. [PMID: 36207958 DOI: 10.3760/cma.j.cn112147-20220221-00139] [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] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Objective: To investigate the clinical characteristics and outcomes of acute respiratory distress syndrome (ARDS) caused by Chlamydia psittaci pneumonia. Methods: From June 2016 to January 2021, 10 cases were diagnosed as severe Chlamydia psittaci pneumonia induced ARDS in Intensive Care Unit of Respiratory and Critical Care Medicine Department (RICU) of Beijing Chao-Yang Hospital Affiliated to Capital Medical University. We collected the clinical data including clinical features, laboratory tests, imaging and outcomes of the patients. Results: The pathogenic diagnosis was confirmed by metagenomic Next-generation Sequencing (mNGS) in these 10 patients, with a median age of 59 (46, 67) years. In addition to high fever, cough and dyspnea, the patients also had multiple organ involvement. Six patients had elevated peripheral leukocyte count, 10 cases had increased type B natriuretic peptide, 7 cases had increased aspartate aminotransferase/alanine aminotransferase, 9 cases had hyponatremia and 3 cases had elevated creatinine. The imaging findings were bilateral consolidation with air bronchogram and infiltrates, and pleural effusion were found in 5 cases. All cases were combined with respiratory failure. Six patients received invasive mechanical ventilation. Nine patients received moxifloxacin and one patient was administrated with Azithromycin. All the patients were improved and discharged after the treatment, and the mean duration of RICU stay was 13.5 (11, 16.7) days. One month follow-up of nine patients showed significant improvement in lung lesions. Conclusions: Severe Chlamydia psittiaci pneumonia may be complicated with respiratory failure and/or multiple organ involvement. For severe pneumonia with an exposure history of sick birds, the possibility of Chlamydia psittaci infection should be considered. mNGS may help etiological diagnosis. All patients in this study had a good prognosis after targeted treatment.
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Affiliation(s)
- Z L Zhao
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - X Tang
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - C W He
- Department of Respiratory and Critical Care Medicine, Beijing Prevention and Treatment Hospital of Occupational Disease for Chemical Industry, Beijing 100093, China
| | - Y L Liu
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - X Y Li
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - R Wang
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - Y Li
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - S Y Cao
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - B Sun
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - Z H Tong
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
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26
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Chen S, Sun B. 778 Regulation of human cutaneous wound healing by the FAAHP1 pseudogene. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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27
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Patel J, McGain F, Bhatelia T, Wang S, Sun B, Monty J, Pareek V. Vented Individual Patient (VIP) Hoods for the Control of Infectious Airborne Diseases in Healthcare Facilities. Engineering (Beijing) 2022; 15:126-132. [PMID: 35721872 PMCID: PMC9197795 DOI: 10.1016/j.eng.2020.12.024] [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] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 10/28/2020] [Accepted: 12/17/2020] [Indexed: 05/13/2023]
Abstract
By providing a means of separating the airborne emissions of patients from the air breathed by healthcare workers (HCWs), vented individual patient (VIP) hoods, a form of local exhaust ventilation (LEV), offer a new approach to reduce hospital-acquired infection (HAI). Results from recent studies have demonstrated that, for typical patient-emitted aerosols, VIP hoods provide protection at least equivalent to that of an N95 mask. Unlike a mask, hood performance can be easily monitored and HCWs can be alerted to failure by alarms. The appropriate use of these relatively simple devices could both reduce the reliance on personal protective equipment (PPE) for infection control and provide a low-cost and energy-efficient form of protection for hospitals and clinics. Although the development and deployment of VIP hoods has been accelerated by the coronavirus disease 2019 (COVID-19) pandemic, these devices are currently an immature technology. In this review, we describe the state of the art of VIP hoods and identify aspects in need of further development, both in terms of device design and the protocols associated with their use. The broader concept of individual patient hoods has the potential to be expanded beyond ventilation to the provision of clean conditions for individual patients and personalized control over other environmental factors such as temperature and humidity.
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Affiliation(s)
- J Patel
- CSIRO Energy, Melbourne, VIC 3169, Australia
| | - F McGain
- Western Health, Melbourne, VIC 3021, Australia
- School of Public Health, The University of Sydney, Sydney, NSW 2006, Australia
- Centre for Integrated Critical Care, The University of Melbourne, Melbourne, VIC 3010, Australia
| | - T Bhatelia
- The Western Australian School of Mines: Minerals, Energy and Chemical Engineering, Curtin University, Perth, WA 6102, Australia
| | - S Wang
- Department of Mechanical Engineering, City University of Hong Kong, Hong Kong 999077, China
| | - B Sun
- The Western Australian School of Mines: Minerals, Energy and Chemical Engineering, Curtin University, Perth, WA 6102, Australia
| | - J Monty
- Department of Mechanical Engineering, The University of Melbourne, Melbourne, VIC 3010, Australia
| | - V Pareek
- The Western Australian School of Mines: Minerals, Energy and Chemical Engineering, Curtin University, Perth, WA 6102, Australia
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28
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Sun B, He ZQ, Wang HF, Li YR, Yang F, Cui F, Chen ZH, Huang XS. [Novel MFN2, BSCL2 and LRSAM1 variants in a cohort of Chinese patients with Charcot-Marie-Tooth disease]. Zhonghua Nei Ke Za Zhi 2022; 61:901-907. [PMID: 35922214 DOI: 10.3760/cma.j.cn112138-20211010-00686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: Charcot-Marie-Tooth disease (CMT) comprises a group of clinically and genetically heterogeneous inherited neuropathies with an estimated prevalence of 1 in 2500. This study aimed to analyze the clinical and mutational characteristics of Chinese CMT patients with MFN2, BSCL2 and LRSAM1 variants. Methods: In this study, genetic analysis was performed in 206 Chinese patients at Chinese PLA General Hospital from December 2012 to March 2020 with clinical diagnosis of CMT, and reported variants of MFN2, BSCL2 and LRSAM1 related to CMT2. Results: We reported ten MFN2 mutations in ten unrelated patients (7 male, 3 female), two of whom had positive family history. Three novel mutations were detected including c.475-2A>G (splicing); c.687dupA (p.E230Rfs*16) and c.558dupT (p.S186fs). We reported three BSCL2 mutations of four unrelated patients, including c.461C>G (p.S154W), c.461C>T(p.S154L), and novel variants of c.1309G>C (p.A437P) and c.845C>T (p.A282V). Furthermore, two novel variants of LRSAM1, including c.1930G>T (p.G644C) and c.1178T>A (p.L393Q) were detected in two unrelated patients. Conclusion: Mutational spectrum of MFN2-, BSCL2-and LRSAM1-related CMT disease is expanded with the identification of novel variants in Chinese patients.
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Affiliation(s)
- B Sun
- Neurological Department of the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China Geriatric Neurological Department of the Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing 100853, China
| | - Z Q He
- Neurological Department of the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - H F Wang
- Neurological Department of the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Y R Li
- Neurological Department of the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - F Yang
- Neurological Department of the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - F Cui
- Neurological Department of the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Z H Chen
- Neurological Department of the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - X S Huang
- Neurological Department of the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
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29
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Takashima S, Cai P, Sun W, Bui J, Otten A, Qu K, Sun B. 459 Regulation of the keratinocyte progenitor to differentiation switch by alternative mRNA splicing. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.468] [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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30
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Su JF, Wang X, Shi YZ, Sun B, Zhao Y, Zhao YY, Zheng JD, Shu X, Li M. [Analysis of China's influenza vaccine application policy based on the macro model of the health system]. Zhonghua Yu Fang Yi Xue Za Zhi 2022; 56:1023-1026. [PMID: 35899359 DOI: 10.3760/cma.j.cn112150-20220510-00463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This article uses the analysis framework of the macro model of the health system to analyze the influenza vaccine policy documents issued by the state and governments at all levels from three perspectives: structure, process and results, and provides a scientific basis for improving the application strategy of influenza vaccine. It is suggested that on the basis of continuing to strengthen publicity, mobilization and organizational guarantee, measures to promote the application of influenza vaccine in China by exploring multi-channel financing mechanisms, combining the experience of new crown vaccination to improve the convenience of influenza vaccination, and scientifically setting vaccination rate targets, improve preparedness for an influenza pandemic.
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Affiliation(s)
- J F Su
- China National Biotec Group Company Limited,Beijing 100024, China
| | - X Wang
- China National Biotec Group Company Limited,Beijing 100024, China
| | - Y Z Shi
- China National Biotec Group Company Limited,Beijing 100024, China
| | - B Sun
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing 100191, China
| | - Y Zhao
- China National Biotec Group Company Limited,Beijing 100024, China
| | - Y Y Zhao
- China National Biotec Group Company Limited,Beijing 100024, China
| | - J D Zheng
- Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - X Shu
- China National Biotec Group Company Limited,Beijing 100024, China
| | - M Li
- China National Biotec Group Company Limited,Beijing 100024, China
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31
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Wang R, Sun B. [Weaning of veno-venous extracorporeal membrane oxygenation: when to use the "resting lung"]. Zhonghua Yi Xue Za Zhi 2022; 102:1891-1894. [PMID: 35768386 DOI: 10.3760/cma.j.cn112137-20220224-00389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Differences in weaning strategies for veno-venous extracorporeal membrane oxygenation (VV-ECMO) are based on expert opinions rather than clinical evidence. Therefore, each center has its own "unique skills". The timing of VV-ECMO weaning has not received due attention. It is difficult to find research on the choice of VV-ECMO weaning timing in the database. There are few studies involving VV-ECMO that describe the weaning process in detail. At present, the weaning process of VV-ECMO is mainly based on expert opinions. This article classified the current VV-ECMO weaning strategies, appealed to a unified VV-ECMO weaning protocol in China as soon as possible, and further improved the prognosis of patients with extracorporeal life support.
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Affiliation(s)
- R Wang
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - B Sun
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
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32
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Sui YH, Lu TQ, Sun B. [Treatment choices for infected pancreatic necrosis:surgery debridement or endoscopy drainage?]. Zhonghua Wai Ke Za Zhi 2022; 60:660-665. [PMID: 35775258 DOI: 10.3760/cma.j.cn112139-20220326-00126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Infected pancreatic necrosis (IPN) is a crucial reason for the poor prognosis of patients with acute pancreatitis,which is complicated and difficult to predict the outcomes. Surgery is an important way to cure IPN,and "step-up approach" is the mainstream mode of IPN treatment. In the era of minimally invasive surgery,the full course endoscopic treatment of IPN has been gradually hot and achieved good outcomes as endoscopic technology' improvement. However,it is controversial that whether technique is better for IPN by surgery debridement or endoscopy drainage,and there is no consensus on the scope of applicability and the timing of intervention. The paper aims to explore the intervention methods,indications and timing of endoscopic and surgical treatment of IPN and elaborate the selection strategies of them in clinical practice,so as to develop individualized treatment options,accurately implement minimally invasive intervention and improve the prognosis.
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Affiliation(s)
- Y H Sui
- Department of Pancreatic and Biliary Surgery,the First Affiliated Hospital of Harbin Medical University,Key Laboratory of Hepatosplenic Surgery,Ministry of Education,Harbin 150001,China
| | - T Q Lu
- Department of Pancreatic and Biliary Surgery,the First Affiliated Hospital of Harbin Medical University,Key Laboratory of Hepatosplenic Surgery,Ministry of Education,Harbin 150001,China
| | - B Sun
- Department of Pancreatic and Biliary Surgery,the First Affiliated Hospital of Harbin Medical University,Key Laboratory of Hepatosplenic Surgery,Ministry of Education,Harbin 150001,China
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Almekinders MM, Bismeijer T, Kumar T, Yang F, Thijssen B, van der Linden R, van Rooijen C, Vonk S, Sun B, Parra Cuentas ER, Wistuba II, Krishnamurthy S, Visser LL, Seignette IM, Hofland I, Sanders J, Broeks A, Love JK, Menegaz B, Wessels L, Thompson AM, de Visser KE, Hooijberg E, Lips E, Futreal A, Wesseling J. Comprehensive multiplexed immune profiling of the ductal carcinoma in situ immune microenvironment regarding subsequent ipsilateral invasive breast cancer risk. Br J Cancer 2022; 127:1201-1213. [PMID: 35768550 PMCID: PMC9519539 DOI: 10.1038/s41416-022-01888-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 05/17/2022] [Accepted: 06/07/2022] [Indexed: 12/25/2022] Open
Abstract
Background Ductal carcinoma in situ (DCIS) is treated to prevent subsequent ipsilateral invasive breast cancer (iIBC). However, many DCIS lesions will never become invasive. To prevent overtreatment, we need to distinguish harmless from potentially hazardous DCIS. We investigated whether the immune microenvironment (IME) in DCIS correlates with transition to iIBC. Methods Patients were derived from a Dutch population-based cohort of 10,090 women with pure DCIS with a median follow-up time of 12 years. Density, composition and proximity to the closest DCIS cell of CD20+ B-cells, CD3+CD8+ T-cells, CD3+CD8− T-cells, CD3+FOXP3+ regulatory T-cells, CD68+ cells, and CD8+Ki67+ T-cells was assessed with multiplex immunofluorescence (mIF) with digital whole-slide analysis and compared between primary DCIS lesions of 77 women with subsequent iIBC (cases) and 64 without (controls). Results Higher stromal density of analysed immune cell subsets was significantly associated with higher grade, ER negativity, HER-2 positivity, Ki67 ≥ 14%, periductal fibrosis and comedonecrosis (P < 0.05). Density, composition and proximity to the closest DCIS cell of all analysed immune cell subsets did not differ between cases and controls. Conclusion IME features analysed by mIF in 141 patients from a well-annotated cohort of pure DCIS with long-term follow-up are no predictors of subsequent iIBC, but do correlate with other factors (grade, ER, HER2 status, Ki-67) known to be associated with invasive recurrences. ![]()
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Affiliation(s)
- Mathilde M Almekinders
- Division of Molecular Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands.,Department of Pathology, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.,Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - Tycho Bismeijer
- Division of Molecular Carcinogenesis, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Tapsi Kumar
- Department of Genomic Medicine, MD Anderson Cancer Center, Houston, TX, USA.,Department of Genetics, MD Anderson Cancer Center, Houston, TX, USA.,MD Anderson Cancer Center UT Health Graduate School of Biomedical Sciences, Houston, TX, USA
| | - Fei Yang
- Department of Translational Molecular Pathology, MD Anderson Cancer Center, Houston, TX, USA
| | - Bram Thijssen
- Division of Molecular Carcinogenesis, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Rianne van der Linden
- Department of Pathology, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Charlotte van Rooijen
- Department of Pathology, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Shiva Vonk
- Department of Pathology, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.,Core Facility Molecular Pathology and Biobanking, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Baohua Sun
- Department of Translational Molecular Pathology, MD Anderson Cancer Center, Houston, TX, USA
| | - Edwin R Parra Cuentas
- Department of Translational Molecular Pathology, MD Anderson Cancer Center, Houston, TX, USA
| | - Ignacio I Wistuba
- Department of Translational Molecular Pathology, MD Anderson Cancer Center, Houston, TX, USA
| | | | - Lindy L Visser
- Division of Molecular Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Iris M Seignette
- Department of Pathology, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Ingrid Hofland
- Core Facility Molecular Pathology and Biobanking, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Joyce Sanders
- Department of Pathology, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Annegien Broeks
- Core Facility Molecular Pathology and Biobanking, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Jason K Love
- Breast Surgical Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Brian Menegaz
- Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Lodewyk Wessels
- Division of Molecular Carcinogenesis, Netherlands Cancer Institute, Amsterdam, The Netherlands.,Oncode Institute, Utrecht, The Netherlands
| | | | - Karin E de Visser
- Oncode Institute, Utrecht, The Netherlands.,Division of Tumour Biology & Immunology, Netherlands Cancer Institute, Amsterdam, The Netherlands.,Department of Immunology, Leiden University Medical Center, Leiden, The Netherlands
| | - Erik Hooijberg
- Department of Pathology, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Esther Lips
- Division of Molecular Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Andrew Futreal
- Department of Genomic Medicine, MD Anderson Cancer Center, Houston, TX, USA
| | - Jelle Wesseling
- Division of Molecular Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands. .,Department of Pathology, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. .,Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands.
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Sun B, Zheng JD, Zhang SY, Lu MX, Yuan H, Wang JR, Li JC, Su JF, Li M, Wang Z. [SWOT analysis of influenza vaccination promotion of primary care staff based on the perspective of the supplier, customer, and management]. Zhonghua Liu Xing Bing Xue Za Zhi 2022; 43:953-959. [PMID: 35725355 DOI: 10.3760/cma.j.cn112338-20220108-00014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To analyze the situation of influenza vaccination among primary healthcare workers, find out the problems, and explore the strategies and measures to promote influenza vaccination among grass-roots medical staff. Methods: From April to May 2021, key insider interviews and literature research were carried out based on the perspectives of influenza vaccine suppliers (influenza vaccine manufacturers), consumers (primary medical institutions and primary healthcare workers), and managers (governments at all levels, health administrative departments and disease prevention and control departments). The SWOT (strengths, weaknesses, opportunities, and threats) analysis technique was used to comprehensively evaluate the current situation of influenza vaccination among grass-roots healthcare workers, and a SWOT analysis matrix was established. Results: Influenza vaccination of grass-roots healthcare workers have advantages and opportunities, including primary medical and health institutions' vital influenza vaccination accessibility, influenza vaccine safety is higher, COVID-19 outbreak improves the public awareness of respiratory infectious diseases and vaccine production enthusiasm, coronavirus vaccination has strengthened the capacity of the vaccine distribution system. There are also disadvantages and threats such as the high price of influenza vaccine, insufficient supply, low awareness of influenza vaccine vaccination among grass-roots healthcare workers, lack of demand assessment mechanism on influenza vaccine, poor vaccine deployment, structural imbalance in vaccine supply in different areas, and severe vaccine waste. SWOT analysis matrix of the influenza vaccination status of grass-roots healthcare workers was established, forming dominant opportunity (SO) strategy, dominant threat (ST) strategy, inferior opportunity (WO) strategy, and inferior threat (WT) strategy. Conclusion: Measures should be taken by the supplier, the demand-side, and the management side to improve the influenza vaccine coverage rate of primary healthcare workers, but the emphasis should be on the coordination and management of the management side.
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Affiliation(s)
- B Sun
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing 100191, China
| | - J D Zheng
- Division of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - S Y Zhang
- Business Management Department, Shandong Provincial Center for Disease Control and Prevention, Ji'nan 250014, China
| | - M X Lu
- Immunization Planning Institute, Henan Provincial Center for Disease Control and Prevention, Zhengzhou 450016, China
| | - H Yuan
- Institute of Acute Communicable Disease Prevention and Control, Sichuan Provincial Center for Disease Control and Prevention, Chengdu 610041, China
| | - J R Wang
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing 100191, China
| | - J C Li
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing 100191, China
| | - J F Su
- China National Biotech Group Company Limited, Beijing 100029, China
| | - M Li
- China National Biotech Group Company Limited, Beijing 100029, China
| | - Zhifeng Wang
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing 100191, China Center for Health Policy and Technology Evaluation, Peking University Health Science Center, Beijing 100191, China
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Duan Z, Gao Y, Liu B, Sun B, Li S, Wang C, Liu D, Wang K, Zhang Y, Lou Z, Xie L, Xie F. The Application Value of Metagenomic and Whole-Genome Capture Next-Generation Sequencing in the Diagnosis and Epidemiological Analysis of Psittacosis. Front Cell Infect Microbiol 2022; 12:872899. [PMID: 35734579 PMCID: PMC9207344 DOI: 10.3389/fcimb.2022.872899] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 05/10/2022] [Indexed: 01/16/2023] Open
Abstract
BackgroundTo evaluate the value of metagenomic next-generation sequencing (mNGS) for the early diagnosis of psittacosis, and to investigate its epidemiology by whole-genome capture.MethodsTwenty-one bronchoalveolar lavage fluid (BALF) and blood samples of 16 psittacosis patients from multiple centers during August 2019 to September 2021 were analyzed retrospectively. mNGS with normal datasets (10 M 75-bp single-end reads after sequencing) and larger datasets (30 M 150-bp paired-end reads after sequencing) as well as quantitative real-time polymerase chain reaction (qPCR) were used to detect the pathogen. Also, whole-genome capture of Chlamydophila psittaci was applied to draw the phylogenetic tree.ResultsmNGS successfully detected the pathogen in all 16 cases (100%), while qPCR was positive only in 5 out of 10 cases (50%), indicating a significantly higher sensitivity of mNGS than qPCR (p < 0.01). BALF-mNGS performed better than blood-mNGS (16/16 versus 3/5, p < 0.05). In addition, larger datasets (the read counts have tripled, and the base number was 12-fold larger compared to clinical mNGS with a normal dataset) of mNGS showed significantly increased contents of human DNA (p < 0.05) and decreased reads per million of the pathogen, suggesting no improvement. Whole-genome capture results of five samples (>60% coverage and >1 depth) were used to construct the phylogenetic tree.ConclusionSignificant advantages of mNGS with normal datasets were demonstrated in early diagnosing psittacosis. It is the first study to use whole-genome capture to analyze C. psittaci epidemiological information.
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Affiliation(s)
- Zhimei Duan
- College of Pulmonary and Critical Care Medicine, Chinese People’s Liberation Army (PLA) General Hospital, Beijing, China
| | - Yanqiu Gao
- Respiratory Intensive Care Unit, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Bin Liu
- Characteristic Medical Center, the Chinese People’s Armed Police Forces, Tianjin, China
| | - Baohua Sun
- Department of the Respiratory and Critical Care Medicine, Cangzhou Central Hospital, Cangzhou, China
| | - Shuangfeng Li
- Respiratory Intensive Care Unit, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Chenlei Wang
- Department of the Respiratory and Critical Care Medicine, Cangzhou Central Hospital, Cangzhou, China
| | - Dongli Liu
- Department of the Respiratory and Critical Care Medicine, Yan’an University Affiliated Hospital, Yan’an, China
| | - Kaifei Wang
- College of Pulmonary and Critical Care Medicine, Chinese People’s Liberation Army (PLA) General Hospital, Beijing, China
| | - Ye Zhang
- Department of Scientific Affairs, Hugobiotech Co., Ltd., Beijing, China
| | - Zheng Lou
- Department of Scientific Affairs, Hugobiotech Co., Ltd., Beijing, China
- *Correspondence: Fei Xie, ; Lixin Xie, ; Zheng Lou,
| | - Lixin Xie
- College of Pulmonary and Critical Care Medicine, Chinese People’s Liberation Army (PLA) General Hospital, Beijing, China
- *Correspondence: Fei Xie, ; Lixin Xie, ; Zheng Lou,
| | - Fei Xie
- College of Pulmonary and Critical Care Medicine, Chinese People’s Liberation Army (PLA) General Hospital, Beijing, China
- *Correspondence: Fei Xie, ; Lixin Xie, ; Zheng Lou,
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Sun B, Laberiano-Fernández C, Salazar -Alejo R, Zhang J, Rendon JLS, Lee J, Soto LMS, Wistuba II, Parra ER. Impact of Region-of-Interest Size on Immune Profiling Using Multiplex Immunofluorescence Tyramide Signal Amplification for Paraffin-Embedded Tumor Tissues. Pathobiology 2022; 90:1-12. [PMID: 35609532 PMCID: PMC9684353 DOI: 10.1159/000523751] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 02/21/2022] [Indexed: 01/29/2023] Open
Abstract
INTRODUCTION Representative regions of interest (ROIs) analysis from the whole slide images (WSI) are currently being used to study immune markers by multiplex immunofluorescence (mIF) and single immunohistochemistry (IHC). However, the amount of area needed to be analyzed to be representative of the entire tumor in a WSI has not been defined. METHODS We labeled tumor-associated immune cells by mIF and single IHC in separate cohorts of non-small cell lung cancer (NSCLC) samples and we analyzed them as whole tumor area as well as using different number of ROIs to know how much area will be need to represent the entire tumor area. RESULTS For mIF using the InForm software and ROI of 0.33 mm2 each, we observed that the cell density data from five randomly selected ROIs is enough to achieve, in 90% of our samples, more than 0.9 of Spearman correlation coefficient and for single IHC using ScanScope tool box from Aperio and ROIs of 1 mm2 each, we found that the correlation value of more than 0.9 was achieved using 5 ROIs in a similar cohort. Additionally, we also observed that each cell phenotype in mIF influence differently the correlation between the areas analyzed by the ROIs and the WSI. Tumor tissue with high intratumor epithelial and immune cells phenotype, quality, and spatial distribution heterogeneity need more area analyzed to represent better the whole tumor area. CONCLUSION We found that at minimum 1.65 mm2 area is enough to represent the entire tumor areas in most of our NSCLC samples using mIF.
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Affiliation(s)
- Baohua Sun
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Caddie Laberiano-Fernández
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Ruth Salazar -Alejo
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Jiexin Zhang
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Jose Luis Solorzano Rendon
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Jack Lee
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Luisa Maren Solis Soto
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Ignacio Ivan Wistuba
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Edwin Roger Parra
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Douvaras P, Lepack A, Buenaventura D, Sun B, Sira E, Ibourk M, Kosmyna B, Pereira E, Ebel M, Srinivas M, Simpson L, LoSchiavo D, Dilworth D, Wilkinson D, Keightley A, Domian I, Soh C, Wang J, Fisher S, Tomishima M, Paladini C, Patsch C, Irion S. iPSC: Late Breaking Abstract: A UNIVERSAL APPROACH TO TREAT CNS MANIFESTATIONS IN LYSOSOMAL STORAGE DISEASES USING IPSC-DERIVED MICROGLIA. Cytotherapy 2022. [DOI: 10.1016/s1465-3249(22)00398-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Sun B, Zhao J, Shao ZY. MiR-572 promotes the development of non-small cell lung cancer by targeting KLF2. Eur Rev Med Pharmacol Sci 2022; 26:3083-3090. [PMID: 35587058 DOI: 10.26355/eurrev_202205_28725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The aim of this study was to uncover the role of miR-572 in regulating proliferative and migratory abilities in non-small cell lung cancer (NSCLC) and the possible mechanism. PATIENTS AND METHODS Expression levels of miR-572 in 46 matched NSCLC and paracancerous samples were detected. The relationship between miR-572 level and clinical features of NSCLC was analyzed. Subsequently, the regulatory effects of miR-572 on proliferative and migratory abilities in lung cancer cells were assessed by functional experiments. Finally, the downstream genes of miR-572 were tested by luciferase assay, and their functions in the development of NSCLC were finally explored by rescue experiments. RESULTS It was found that miR-572 was upregulated in NSCLC samples. High level of miR-572 predicted high rates of lymphatic and distant metastases, as well as poor prognosis in NSCLC. Besides, the knockdown of miR-572 suppressed proliferative and migratory abilities in A549 and SPC-A1 cells. KLF2 was identified to be the downstream gene of miR-572, which was involved in the regulation of NSCLC phenotypes influenced by miR-572. CONCLUSIONS MiR-572 is closely linked to metastasis and prognosis in NSCLC patients, and it promotes the malignant development of NSCLC via targeting KLF2.
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Affiliation(s)
- B Sun
- Department of Thoracic Surgery, Jining No. 1 People's Hospital, Jining, China.
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Hollunder B, Li N, Ostrem J, Polosan M, Akram H, Vissani M, Zhang C, Sun B, Finke C, Kühn A, Mazzoni A, Romito L, Zrinzo L, Joyce E, Chabardes S, Starr P, Horn A. FV 1 Segregating the prefrontal cortex by means of deep brain stimulation. Clin Neurophysiol 2022. [DOI: 10.1016/j.clinph.2022.01.009] [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: 12/01/2022]
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Fan PH, Liang D, Jia LJ, Gong YB, Sun B, Fu LL, Liu QY. [Clinicopathological features of verrucous hemangioma]. Zhonghua Bing Li Xue Za Zhi 2021; 50:1341-1345. [PMID: 34865421 DOI: 10.3760/cma.j.cn112151-20210602-00402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Objective: To investigate the clinicopathological features, and differential diagnosis of verrucous hemangioma (VH). Methods: Twenty-eight VH cases diagnosed from 2005 to 2020 in Henan Provincial People's Hospital, Zhengzhou, China were analyzed retrospectively. Immunohistochemical studies were used to detect diagnostic markers. The mutation status of PIK3CA (exons 9 and 20) was detected using fluorescence PCR. Results: There were 13 males and 15 females in 28 cases, with the male to female ratio of 1.0∶1.2. There were 25 patients under the age of 18 years. The age range was from 10 months to 56 years (mean, 9.7 years; median, 4.5 years). There were 17 cases occurred in the lower extremities, 7 in the upper extremities and 4 in the trunk. All 28 cases were irregular red patches on the skin, which grew slowly. Some of them were thickened with uneven surface, which was light pink or red-white. Skin lesions of the 7 cases ranged from dark red and reddish brown, with a rough and hard surface. Satellite foci were present. Microscopically, 28 cases had a wide range of pathological features. Dilated, malformed vessels were observed from dermal papilla to deep soft tissue. Among them, the dermal papillary layer was mainly composed of many proliferating and expanding thin-walled capillaries and cavernous blood vessels. Thin-walled small vessels were found in the dermal reticular layer and subcutaneous fascia layer, with no obvious endothelial cell proliferation, occasional papillary hyperplasia, and lobular distribution of the malformed vessels in the fascia layer mixed with the fibroadipose tissue. There was epidermal papillary hyperplasia with hyperkeratosis and parakeratosis, lengthening and mutual fusion of epithelial horns. Immunohistochemistry showed that CD31, CD34, ERG and WT-1 were diffusely and strongly positive. The expression of GLUT-1 was present in superficial dermal vascular endothelial cells, but undetectable in the deep layer. The PIK3CA tests of 13 cases showed that no somatic mutations were found in exons 9 and 20. Twenty-five patients were followed up for 5 months to 10 years. Seven patients underwent multiple surgical resections and plastic surgeries due to the large size, and 8 patients had recurrence. Conclusions: VH is a rare congenital vascular malformation and more commonly occurs in infants and children. It tends to appear in limbs, especially lower limbs and distal limbs. Its morphology and immunophenotype are characteristic and should be distinguished from other vascular malformations and the resolution phase of infant hemangiomas. In about one third of the cases, postoperative recurrence may occur and long-term follow-up is often required.
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Affiliation(s)
- P H Fan
- Department of Pathology, Henan Provincial People's Hospital, Zhengzhou 450003, China
| | - D Liang
- Department of Breast Surgery, Henan Provincial People's Hospital, Zhengzhou 450003, China
| | - L J Jia
- Department of Breast Surgery, Henan Provincial People's Hospital, Zhengzhou 450003, China
| | - Y B Gong
- Department of Hemangioma, Henan Provincial People's Hospital, Zhengzhou 450003, China
| | - B Sun
- Department of Hemangioma, Henan Provincial People's Hospital, Zhengzhou 450003, China
| | - L L Fu
- Department of Radiology, Henan Provincial People's Hospital, Zhengzhou 450003, China
| | - Q Y Liu
- Department of Pathology, Henan Provincial People's Hospital, Zhengzhou 450003, China
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Lv H, Tian Y, Huang C, Sun B, Gai C, Li Z, Tian Z. 110P Neoadjuvant PD-1 blockade combined with chemotherapy for patients with resectable locally advanced esophageal squamous cell carcinoma (ESCC): A real world data analysis. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.10.128] [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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Wan S, Liu Z, Chen Y, Mai Z, Jiang M, Di Q, Sun B. MicroRNA-140-3p represses the proliferation, migration, invasion and angiogenesis of lung adenocarcinoma cells via targeting TYMS (thymidylate synthetase). Bioengineered 2021; 12:11959-11977. [PMID: 34818974 PMCID: PMC8810165 DOI: 10.1080/21655979.2021.2009422] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
MicroRNA (miR)-140-3p has been proved to repress lung adenocarcinoma (LUAD), and our study aims to further evaluate the mechanism. Bioinformatic analyses were performed. The viability, proliferation, migration, invasion and angiogenesis of transfected LUAD cells were all determined via Cell Counting Kit-8, colony formation, Scratch, Transwell, and tube formation assays. The targeting relationship between miR-140-3p and thymidylate synthetase (TYMS) was confirmed by dual-luciferase reporter assay. Relative expressions of miR-140-3p, TYMS, epithelial-to-mesenchymal transition- (E-cadherin, N-cadherin, vimentin), angiogenesis- (vascular endothelial growth factor (VEGF)), and apoptosis-related factors (cleaved caspase-3, B-cell lymphoma-2 (Bcl-2), Bcl-2-associated X protein (Bax)) were quantified by quantitative real-time polymerase chain reaction or Western blot. TYMS was high-expressed yet miR-140-3p was low-expressed in LUAD cells. Upregulation of miR-140-3p inhibited TYMS expression, viability, colony formation, migration, invasion, and tube length within LUAD cells, while downregulation of miR-140-3p did oppositely. Silenced TYMS, the downstream target gene of miR-140-3p, reversed the effects of miR-140-3p downregulation on TYMS expression, cell viability, colony formation, migration, invasion, and tube length as well as the metastasis-, apoptosis- and angiogenesis-related proteins in LUAD cells. Upregulation of miR-140-3p inhibited the proliferation, migration, invasion and angiogenesis of LUAD cells via targeting TYMS.
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Affiliation(s)
- Shanzhi Wan
- No.1 Department of Respiratory and Critical Care Medicine, Cangzhou Central Hospital, No. 16, Xinhua West Road, Yunhe District, Cangzhou City, Hebei Province, China
| | - Zhimin Liu
- Department of No. 1 Pediatrics, Cangzhou Hospital of Integrated TCM-WM, Cangzhou City, Hebei Province, China
| | - Yang Chen
- No.1 Department of Respiratory and Critical Care Medicine, Cangzhou Central Hospital, No. 16, Xinhua West Road, Yunhe District, Cangzhou City, Hebei Province, China
| | - Zhitao Mai
- No.1 Department of Respiratory and Critical Care Medicine, Cangzhou Central Hospital, No. 16, Xinhua West Road, Yunhe District, Cangzhou City, Hebei Province, China
| | - Mingming Jiang
- No.1 Department of Respiratory and Critical Care Medicine, Cangzhou Central Hospital, No. 16, Xinhua West Road, Yunhe District, Cangzhou City, Hebei Province, China
| | - Qingguo Di
- No.1 Department of Respiratory and Critical Care Medicine, Cangzhou Central Hospital, No. 16, Xinhua West Road, Yunhe District, Cangzhou City, Hebei Province, China
| | - Baohua Sun
- No.1 Department of Respiratory and Critical Care Medicine, Cangzhou Central Hospital, No. 16, Xinhua West Road, Yunhe District, Cangzhou City, Hebei Province, China
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Zhao X, Xuan L, Yin J, Tang Y, Sun H, Wu S, Jing H, Fang H, Song Y, Jin J, Liu Y, Chen B, Qi S, Li N, Tang Y, Lu N, Yang Y, Li Y, Sun B, Wang S. Radiotherapy in Breast Cancer Patients With Isolated Regional Recurrence After Mastectomy: A Joint Analysis of 144 Cases From Two Institutions. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.714] [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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Zhao T, Schiff J, Spraker M, Huang Y, Sun B, Hugo G, Abraham C. Dosimetric Verification of Simulation-Free Palliative Radiotherapy: A Retrospective Study on Delivered Dose Reconstructed on CBCT Setup Images. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1357] [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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Yang Y, Fan X, Xu C, Wu J, Sun B. State consensus cooperative control for a class of nonlinear multi-agent systems with output constraints via ADP approach. Neurocomputing 2021. [DOI: 10.1016/j.neucom.2021.05.046] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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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Zeng M, Zhu Y, Lin Z, Long H, Lu B, Sun B, Cheng L, Zhao S, Zhao R. Modified anterior midline approach to treat hyperextension bicondylar tibial plateau fractures: Surgical technique and clinical experience with 18 cases. Knee 2021; 32:1-8. [PMID: 34298335 DOI: 10.1016/j.knee.2021.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 07/01/2021] [Accepted: 07/05/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND We evaluated the modified anterior midline approach and its efficacy for hyperextension bicondylar tibial plateau (HEBTP) fractures. METHODS From 2015 to 2019, 18 patients with HEBTP fractures with just little posterior cortical displacement were treated using the modified anterior midline approach. The operative protocols are fully described in this article, and the following parameters: articular step-off height (ASH), posterior tibial slope angle (pTSA), and medial tibial plateau angle (mTPA) were measured perioperatively and at the final follow-up. We also recorded the Rasmussen score and range of motion (ROM) to assess knee joint function at the final follow-up. RESULTS No complications, such as percutaneous nerve damage, infection, skin necrosis, and internal fixation breakage or loosening occurred perioperatively. The mean time for bony union was 13.7 weeks, and the mean preoperative ASH of the anterior cortex was 4.49 mm; this was restored to its normal height after surgery. The mean preoperative pTSA and mTPA were - 5.89° and 81.69°, respectively, compared with 3.89° and 87.91°, respectively, postoperatively. Comparing the postoperative and final follow-up radiographs, there were no significant differences in ASH, pTSA, and mTPA (P < 0.05). The average Rasmussen score was 27.2 (range, 23-29) at the final follow-up. Excellent results were achieved in 14 (77.8%) patients and good in 4 (22.2%) patients. The mean ROM in flexion was 123.2° and 2.9° in extension at the final follow-up. CONCLUSIONS This study suggested that the modified anterior midline approach is a reasonable alternative for HEBTP fracture repair.
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Affiliation(s)
- M Zeng
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Y Zhu
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Z Lin
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - H Long
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - B Lu
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - B Sun
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - L Cheng
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - S Zhao
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - R Zhao
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China.
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hou Q, Sun B, Yao N, Wei L, Xu S, Cao J. PO-1185 Development of a nomogram for predicting brain metastasis of small cell lung cancer. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07636-2] [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] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Li X, Li L, Liu T, Hai X, Sun B. Leukocytosis induced by tigecycline in two patients with severe acute pancreatitis. Br J Biomed Sci 2021; 78:225-228. [PMID: 33599194 DOI: 10.1080/09674845.2021.1885865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- X Li
- Department of Pharmacy, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - L Li
- Department of Pancreatic and Biliary Surgery, The First Affiliated Hospital of Harbin Medical University; Key Laboratory of Hepatosplenic Surgery, Ministry of Education, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - T Liu
- Department of Pharmacy, Harbin Medical University Cancer Hospital, Harbin, China
| | - X Hai
- Department of Pharmacy, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - B Sun
- Department of Pancreatic and Biliary Surgery, The First Affiliated Hospital of Harbin Medical University; Key Laboratory of Hepatosplenic Surgery, Ministry of Education, The First Affiliated Hospital of Harbin Medical University, Harbin, China
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Sui YH, Sun B. [Rethinking on the classification of infected pancreatic necrosis and its surgical intervention strategy]. Zhonghua Wai Ke Za Zhi 2021; 59:601-607. [PMID: 34256461 DOI: 10.3760/cma.j.cn112139-20210127-00054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Infected pancreatic necrosis is a complex disease which is difficult to deal with.Timely and effective removal of the infection is the core of surgical treatment.Accurate determination and location of the infected area as well as targeted drainage and debridement are the key to further enhance the overall cure rate of necrotizing pancreatitis.Combining the clinical practice and relevant literatures,the classification of infected pancreatic necrosis is tentatively proposed based on the site of infection and necrosis or treatment in this paper.Meanwhile, the diversified intervention methods in the new era and the issues that need attention in the concept of step-up approach are rediscussed, aiming at scientific planning of treatment strategies and targeted intervention methods to reduce patients' mortality and improve prognosis.
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Affiliation(s)
- Y H Sui
- Department of Pancreatic and Biliary Surgery,the First Affiliated Hospital of Harbin Medical University,Key Laboratory of Hepatosplenic Surgery,Ministry of Education,Harbin 150001,China
| | - B Sun
- Department of Pancreatic and Biliary Surgery,the First Affiliated Hospital of Harbin Medical University,Key Laboratory of Hepatosplenic Surgery,Ministry of Education,Harbin 150001,China
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50
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Yam C, Yen EY, Chang JT, Bassett RL, Alatrash G, Garber H, Huo L, Yang F, Philips AV, Ding QQ, Lim B, Ueno NT, Kannan K, Sun X, Sun B, Parra Cuentas ER, Symmans WF, White JB, Ravenberg E, Seth S, Guerriero JL, Rauch GM, Damodaran S, Litton JK, Wargo JA, Hortobagyi GN, Futreal A, Wistuba II, Sun R, Moulder SL, Mittendorf EA. Immune Phenotype and Response to Neoadjuvant Therapy in Triple-Negative Breast Cancer. Clin Cancer Res 2021; 27:5365-5375. [PMID: 34253579 DOI: 10.1158/1078-0432.ccr-21-0144] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 05/10/2021] [Accepted: 07/07/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE Increasing tumor-infiltrating lymphocytes (TIL) is associated with higher rates of pathologic complete response (pCR) to neoadjuvant therapy (NAT) in patients with triple-negative breast cancer (TNBC). However, the presence of TILs does not consistently predict pCR, therefore, the current study was undertaken to more fully characterize the immune cell response and its association with pCR. EXPERIMENTAL DESIGN We obtained pretreatment core-needle biopsies from 105 patients with stage I-III TNBC enrolled in ARTEMIS (NCT02276443) who received NAT from Oct 22, 2015 through July 24, 2018. The tumor-immune microenvironment was comprehensively profiled by performing T-cell receptor (TCR) sequencing, programmed death-ligand 1 (PD-L1) IHC, multiplex immunofluorescence, and RNA sequencing on pretreatment tumor samples. The primary endpoint was pathologic response to NAT. RESULTS The pCR rate was 40% (42/105). Higher TCR clonality (median = 0.2 vs. 0.1, P = 0.03), PD-L1 positivity (OR: 2.91, P = 0.020), higher CD3+:CD68+ ratio (median = 14.70 vs. 8.20, P = 0.0128), and closer spatial proximity of T cells to tumor cells (median = 19.26 vs. 21.94 μm, P = 0.0169) were associated with pCR. In a multivariable model, closer spatial proximity of T cells to tumor cells and PD-L1 expression enhanced prediction of pCR when considered in conjunction with clinical stage. CONCLUSIONS In patients receiving NAT for TNBC, deep immune profiling through detailed phenotypic characterization and spatial analysis can improve prediction of pCR in patients receiving NAT for TNBC when considered with traditional clinical parameters.
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Affiliation(s)
- Clinton Yam
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Er-Yen Yen
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jeffrey T Chang
- Department of Integrative Biology and Pharmacology, The University of Texas Health Science Center at Houston, Houston, Texas
| | - Roland L Bassett
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Gheath Alatrash
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Haven Garber
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Lei Huo
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Fei Yang
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Anne V Philips
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Qing-Qing Ding
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Bora Lim
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Naoto T Ueno
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Kasthuri Kannan
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Xiangjie Sun
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Baohua Sun
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Edwin Roger Parra Cuentas
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - William Fraser Symmans
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jason B White
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Elizabeth Ravenberg
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sahil Seth
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jennifer L Guerriero
- Division of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts.,Breast Oncology Program, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts
| | - Gaiane M Rauch
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Senthil Damodaran
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jennifer K Litton
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jennifer A Wargo
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Gabriel N Hortobagyi
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Andrew Futreal
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ignacio I Wistuba
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ryan Sun
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Stacy L Moulder
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Elizabeth A Mittendorf
- Division of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts. .,Breast Oncology Program, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts.,Ludwig Center at Harvard, Boston, Massachusetts
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