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Wu XM, Qian YK, Chen HL, Hu CH, Chen BW. Efficacy and Safety of Anti-HER2 Targeted Therapy for Metastatic HR-Positive and HER2-Positive Breast Cancer: A Bayesian Network Meta-Analysis. Curr Oncol 2023; 30:8444-8463. [PMID: 37754530 PMCID: PMC10528081 DOI: 10.3390/curroncol30090615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 09/09/2023] [Accepted: 09/12/2023] [Indexed: 09/28/2023] Open
Abstract
Despite the development of HER2-targeted drugs, achieving favorable outcomes for patients with HR+/HER2+MBC remains challenging. This study utilized Bayesian Network Meta-analysis to compare the efficacy and safety of anti-HER2 combination regimens. The primary analysis focused on progression-free survival (PFS), while secondary analyses included objective response rate, overall survival (OS) and the incidence rate of grade 3/4 adverse events (AEs). A comprehensive search across seven databases identified 25 randomized controlled trials for inclusion in this meta-analysis. For patients eligible for endocrinotherapy, our findings revealed that dual-target combined endocrine therapy, such as Her2-mAb+Her2-mAb+Endo (HR = 0.38; 95%CrI: 0.16-0.88) and Her2-mAb+Her2-tki+Endo (HR = 0.45; 95%CrI: 0.23-0.89), significantly improved PFS compared to endocrine therapy alone. According to the surface under the cumulative ranking curves (SUCRAs), Her2-mAb+Her2-mAb+Endo and Her2-mAb+Her2-tki+Endo ranked highest in terms of PFS and OS, respectively. For patients unsuitable for endocrine therapy, anti-HER2 dual-target combined chemotherapy, such as Her2-mAb+Her2-mAb+Chem (HR = 0.76; 95%CrI: 0.6-0.96) and Her2-mAb+Her2-tki+Chem (HR = 0.48; 95%CrI: 0.29-0.81), demonstrated significant improvements in PFS compared to Her2-mAb+Chem. The results were the same when compared with Her2-tki+Chem. According to the SUCRAs, Her2-mAb+Her2-tki+Chem and Her2-mAb+Her2-mAb+Chem ranked highest for PFS and OS, respectively. Subgroup analyses consistently supported these overall findings, indicating that dual-target therapy was the optimal approach irrespective of treatment line.
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Affiliation(s)
| | | | | | | | - Bing-Wei Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing 210009, China; (X.-M.W.); (Y.-K.Q.); (H.-L.C.); (C.-H.H.)
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Chen L, Fu G, Hua Q, Zhu HY, Deng Y, Wu W, Zhao YJ, Yang XY, Yang BS, Zhou YB, Liu J, Yu YN, Chen BW, Wang X, Wang Z. Efficacy of add-on Danhong injection in patients with unstable angina pectoris: A double-blind, randomized, placebo-controlled, multicenter clinical trial. J Ethnopharmacol 2022; 284:114794. [PMID: 34732357 DOI: 10.1016/j.jep.2021.114794] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 10/08/2021] [Accepted: 10/28/2021] [Indexed: 06/13/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Danhong injection (DHI),which is extracted from Salviae miltiorrhizae and Flos carthami,has been widely prescribed to patients with unstable angina pectoris (UAP) in China. However, a high quality clinical trial is needed. AIM OF THE STUDY To determine whether DHI can relieve symptoms of transient myocardial ischemia in patients with unstable angina pectoris. MATERIALS AND METHODS A double-blind, placebo-controlled, randomized clinical trial was conducted in nine hospitals in China. Inpatients with UAP with blood stasis syndrome (BSS) were randomized 1:1 to receive DHI or placebo. The primary outcome was improvement rate in the quantification score of angina pectoris. Secondary outcomes included blood stasis syndrome scale, nitrates use, electrocardiogram recordings, PCI procedures, Seattle Angina Questionnaire (SAQ) and biochemical indexes. RESULTS 160 participants were enrolled and 159 were analyzed. There was no significant difference in primary outcome as compared with control group at the end of 7-day treatment, but significant difference at 28-day follow up (70.53% [95% CI, 59.97-81.09%] and 54.34% [95% CI, 42.68-65.99%]; P = 0.0423). The BSS score was significantly lower in the DHI group than that in the control group at day 28 (6.49 [6.96] vs 10.53 [9.07], P = 0.0034). In addition, DHI was significantly superior to placebo in the angina stability score of SAQ (91.10 [17.37] versus 78.21 [22.08], P < 0.001). There were no significant differences in other secondary outcome measures. CONCLUSIONS A small decrease in the total effective rate and an increase in the angina stability score were observed 28 days after implementation of DHI in UAP with a total blood stasis syndrome score decrease, but the efficacy was not observed at day 7. The findings support that DHI may potentially relieve clinical symptoms and can benefit angina stability. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT02007187.
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Affiliation(s)
- Lin Chen
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, No. 16 Nanxiaojie, Dongzhimen Nei, Beijing, 100700, China
| | - Guang Fu
- Department of Cardiology, The First Hospital of Changsha, No.311 Yingpan Road, Changsha, 410005, Hunan, China
| | - Qi Hua
- Department of Cardiology, Xuanwu Hospital of Capital Medical University, No. 45, Changchun Street, Beijing, 100053, China
| | - Hai-Yan Zhu
- Department of Cardiology, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, No. 5 Haiyuncang, Beijing, 100700, China
| | - Yue Deng
- Department of Cardiology, The Affiliated Hospital of Changchun University of Chinese Medicine, No.1478 Gongnong Road, Changchun, 130021, Jilin, China
| | - Wei Wu
- Department of Cardiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, No.16 Airport Road, Guangzhou, 510405, Guangdong, China
| | - Yu-Jie Zhao
- Department of Cardiology, Zhengzhou No.7 People's Hospital, No. 17, Jingnan 5th Road, Henan, 450006, China
| | - Xi-Yan Yang
- Department of Cardiology, First Teaching Hospital of Tianjin University of TCM, No. 314, West Anshan Road, Tianjin, 300193, China
| | - Bai-Song Yang
- Department of Cardiology, Hospital 463 of P. L. A, No. 46 Xiaoheyan Road, Shenyang, 110046, Liaoning, China
| | - Ya-Bin Zhou
- Department of Cardiology, The First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, No. 26 Heping Road, Harbin, 150040, Heilongjiang, China
| | - Jun Liu
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, No. 16 Nanxiaojie, Dongzhimen Nei, Beijing, 100700, China
| | - Ya-Nan Yu
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, No. 16 Nanxiaojie, Dongzhimen Nei, Beijing, 100700, China
| | - Bing-Wei Chen
- School of Public Health, Southeast University, Dijia Qiao 87, Nanjing, 210009, Jiangsu, China
| | - Xian Wang
- Department of Cardiology, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, No. 5 Haiyuncang, Beijing, 100700, China.
| | - Zhong Wang
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, No. 16 Nanxiaojie, Dongzhimen Nei, Beijing, 100700, China.
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3
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Liu J, Li DD, Dong W, Liu YQ, Wu Y, Tang DX, Zhang FC, Qiu M, Hua Q, He JY, Li J, Du B, Du TH, Niu LL, Jiang XJ, Cui B, Chen JB, Wang YG, Wang HR, Yu Q, He J, Mao YL, Bin XF, Deng Y, Tian YD, Han QH, Liu DJ, Duan LQ, Zhao MJ, Zhang CY, Dai HY, Li ZH, Xiao Y, Hu YZ, Huang XY, Xing K, Jiang X, Liu CF, An J, Li FC, Tao T, Jiang JF, Yang Y, Dong YR, Zhang L, Fu G, Li Y, Huang SW, Dou LP, Sun LJ, Zhao YQ, Li J, Xia Y, Liu J, Liu F, He WJ, Li Y, Tan JC, Lin Y, Zhou YB, Yang JF, Ma GQ, Chen HJ, Liu HP, Liu ZW, Liu JX, Luo XJ, Bin XH, Yu YN, Dang HX, Li B, Teng F, Qiao WM, Zhu XL, Chen BW, Chen QG, Shen CT, Wang YY, Chen YD, Wang Z. Detection of an anti-angina therapeutic module in the effective population treated by a multi-target drug Danhong injection: a randomized trial. Signal Transduct Target Ther 2021; 6:329. [PMID: 34471087 PMCID: PMC8410855 DOI: 10.1038/s41392-021-00741-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [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: 03/29/2021] [Revised: 08/11/2021] [Accepted: 08/16/2021] [Indexed: 12/12/2022] Open
Abstract
It’s a challenge for detecting the therapeutic targets of a polypharmacological drug from variations in the responsed networks in the differentiated populations with complex diseases, as stable coronary heart disease. Here, in an adaptive, 31-center, randomized, double-blind trial involving 920 patients with moderate symptomatic stable angina treated by 14-day Danhong injection(DHI), a kind of polypharmacological drug with high quality control, or placebo (0.9% saline), with 76-day following-up, we firstly confirmed that DHI could increase the proportion of patients with clinically significant changes on angina-frequency assessed by Seattle Angina Questionnaire (ΔSAQ-AF ≥ 20) (12.78% at Day 30, 95% confidence interval [CI] 5.86–19.71%, P = 0.0003, 13.82% at Day 60, 95% CI 6.82–20.82%, P = 0.0001 and 8.95% at Day 90, 95% CI 2.06–15.85%, P = 0.01). We also found that there were no significant differences in new-onset major vascular events (P = 0.8502) and serious adverse events (P = 0.9105) between DHI and placebo. After performing the RNA sequencing in 62 selected patients, we developed a systemic modular approach to identify differentially expressed modules (DEMs) of DHI with the Zsummary value less than 0 compared with the control group, calculated by weighted gene co-expression network analysis (WGCNA), and sketched out the basic framework on a modular map with 25 functional modules targeted by DHI. Furthermore, the effective therapeutic module (ETM), defined as the highest correlation value with the phenotype alteration (ΔSAQ-AF, the change in SAQ-AF at Day 30 from baseline) calculated by WGCNA, was identified in the population with the best effect (ΔSAQ-AF ≥ 40), which is related to anticoagulation and regulation of cholesterol metabolism. We assessed the modular flexibility of this ETM using the global topological D value based on Euclidean distance, which is correlated with phenotype alteration (r2: 0.8204, P = 0.019) by linear regression. Our study identified the anti-angina therapeutic module in the effective population treated by the multi-target drug. Modular methods facilitate the discovery of network pharmacological mechanisms and the advancement of precision medicine. (ClinicalTrials.gov identifier: NCT01681316).
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Affiliation(s)
- Jun Liu
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Dan-Dan Li
- Department of Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Wei Dong
- Department of Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Yu-Qi Liu
- Department of Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Yang Wu
- Department of Cardiology, Dongfang Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Da-Xuan Tang
- Department of Cardiology, Dongfang Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Fu-Chun Zhang
- Department of Geratology, Peking University Third Hospital, Beijing, China
| | - Meng Qiu
- Department of Geratology, Peking University Third Hospital, Beijing, China
| | - Qi Hua
- Department of Cardiology, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Jing-Yu He
- Department of Cardiology, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Jun Li
- Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Bai Du
- Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ting-Hai Du
- Department of Cardiology, First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Lin-Lin Niu
- Department of Cardiology, First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Xue-Jun Jiang
- Department of Cardiology, Wuhan University Renmin Hospital, Wuhan, Hubei, China
| | - Bo Cui
- Department of Cardiology, Wuhan University Renmin Hospital, Wuhan, Hubei, China
| | - Jiang-Bin Chen
- Department of Cardiology, Wuhan University Renmin Hospital, Wuhan, Hubei, China
| | - Yang-Gan Wang
- Department of Cardiology, Wuhan University Zhongnan Hospital, Wuhan, Hubei, China
| | - Hai-Rong Wang
- Department of Cardiology, Wuhan University Zhongnan Hospital, Wuhan, Hubei, China
| | - Qin Yu
- Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning, China
| | - Jing He
- Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning, China
| | - Yi-Lin Mao
- Department of Cardiology, Second Affiliated Hospital to Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Xiao-Fang Bin
- Department of Cardiology, Second Affiliated Hospital to Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Yue Deng
- Department of Cardiology, First Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Yu-Dan Tian
- Department of Cardiology, First Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Qing-Hua Han
- Department of Cardiology, First Affiliated Hospital to Shanxi Medical University, Taiyuan, Shanxi, China
| | - Da-Jin Liu
- Department of Cardiology, First Affiliated Hospital to Shanxi Medical University, Taiyuan, Shanxi, China
| | - Li-Qin Duan
- Department of Cardiology, First Affiliated Hospital to Shanxi Medical University, Taiyuan, Shanxi, China
| | - Ming-Jun Zhao
- Department of Cardiology, Affiliated Hospital of Shanxi University of Chinese Medicine, Xianyang, Shanxi, China
| | - Cui-Ying Zhang
- Department of Cardiology, Affiliated Hospital of Shanxi University of Chinese Medicine, Xianyang, Shanxi, China
| | - Hai-Ying Dai
- Department of Cardiology, Changsha Central Hospital, Changsha, Hunan, China
| | - Ze-Hua Li
- Department of Cardiology, Changsha Central Hospital, Changsha, Hunan, China
| | - Ying Xiao
- Department of Cardiology, Changsha Central Hospital, Changsha, Hunan, China
| | - You-Zhi Hu
- Department of Cardiology, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, Hubei, China
| | - Xiao-Yu Huang
- Department of Cardiology, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, Hubei, China
| | - Kun Xing
- Department of Cardiology, Shanxi Provincial People's Hospital, Xi'an, Shanxi, China
| | - Xin Jiang
- Department of Cardiology, Shanxi Provincial People's Hospital, Xi'an, Shanxi, China
| | - Chao-Feng Liu
- Department of Cardiology, Shanxi Province Hospital of Traditional Chinese Medicine, Xi'an, Shanxi, China
| | - Jing An
- Department of Cardiology, Shanxi Province Hospital of Traditional Chinese Medicine, Xi'an, Shanxi, China
| | - Feng-Chun Li
- Department of Cardiology, Xi'an City Hospital of Traditional Chinese Medicine, Xi'an, Shanxi, China
| | - Tao Tao
- Department of Cardiology, Xi'an City Hospital of Traditional Chinese Medicine, Xi'an, Shanxi, China
| | - Jin-Fa Jiang
- Department of Cardiology, Shanghai Tongji Hospital, Shanghai, China
| | - Ying Yang
- Department of Cardiology, Shanghai Tongji Hospital, Shanghai, China
| | - Yao-Rong Dong
- Department of Cardiology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai, China
| | - Lei Zhang
- Department of Cardiology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai, China
| | - Guang Fu
- Department of Cardiology, The First Hospital of Changsha, Changsha, Hunan, China
| | - Ying Li
- Department of Cardiology, The First Hospital of Changsha, Changsha, Hunan, China
| | - Shu-Wei Huang
- Department of Cardiology, Xinhua Hospital of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Li-Ping Dou
- Department of Cardiology, Xinhua Hospital of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Lan-Jun Sun
- Department of Cardiology, Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Zengchan Dao, Tianjin, China
| | - Ying-Qiang Zhao
- Department of Cardiology, Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Zengchan Dao, Tianjin, China
| | - Jie Li
- Department of Cardiology, Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Zengchan Dao, Tianjin, China
| | - Yun Xia
- Department of Chinese medicine, Shanghai Tenth People's Hospital, Shanghai, China
| | - Jun Liu
- Department of Chinese medicine, Shanghai Tenth People's Hospital, Shanghai, China
| | - Fan Liu
- Department of Cardiology, Chongqing City Hospital of Traditional Chinese Medicine, Chongqing, China
| | - Wen-Jin He
- Department of Cardiology, Chongqing City Hospital of Traditional Chinese Medicine, Chongqing, China
| | - Ying Li
- Department of Cardiology, Chongqing City Hospital of Traditional Chinese Medicine, Chongqing, China
| | - Jian-Cong Tan
- Department of Cardiology, Third People's Hospital of Chongqing, Chongqing, China
| | - Yang Lin
- Department of Cardiology, Third People's Hospital of Chongqing, Chongqing, China
| | - Ya-Bin Zhou
- Department of Cardiology, First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin, Heilongjiang, China
| | - Jian-Fei Yang
- Department of Cardiology, First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin, Heilongjiang, China
| | - Guo-Qing Ma
- Department of Cardiology, Second Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin, Heilongjiang, China
| | - Hui-Jun Chen
- Department of Cardiology, Second Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin, Heilongjiang, China
| | - He-Ping Liu
- Department of Cardiology, Jilin Province People's Hospital, Changchun, Jilin, China
| | - Zong-Wu Liu
- Department of Cardiology, Jilin Province People's Hospital, Changchun, Jilin, China
| | - Jian-Xiong Liu
- Department of Cardiology, Chengdu Second People's Hospital, Chengdu, Sichuan, China
| | - Xiao-Jia Luo
- Department of Cardiology, Chengdu Second People's Hospital, Chengdu, Sichuan, China
| | - Xiao-Hong Bin
- Department of Cardiology, Chengdu Second People's Hospital, Chengdu, Sichuan, China
| | - Ya-Nan Yu
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Hai-Xia Dang
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China.,China Academy of Chinese Medical Sciences, Beijing, China
| | - Bing Li
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China.,Institute of Chinese Meteria Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Fei Teng
- Beijing Genomics Institute (Shenzhen), Shenzhen, Guangdong, China
| | - Wang-Min Qiao
- Beijing Genomics Institute (Shenzhen), Shenzhen, Guangdong, China
| | - Xiao-Long Zhu
- Beijing Genomics Institute (Shenzhen), Shenzhen, Guangdong, China
| | - Bing-Wei Chen
- School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Qi-Guang Chen
- School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Chun-Ti Shen
- Changzhou Hospital of Traditional Chinese Medicine, Changzhou, Jiangsu, China
| | - Yong-Yan Wang
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China.
| | - Yun-Dai Chen
- Department of Cardiology, Chinese PLA General Hospital, Beijing, China.
| | - Zhong Wang
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China.
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Liu J, Wang N, Dang HX, Chen BW, Zhang L, Zou C, Zhong CL, Huang JK, Liu Q, Yu YN, Jiang M, Liang WX, Chen QG, Wang YY, Shen CT, Wang Z. Standard Operating Procedures for Chinese Medicine Data Monitoring Committees of Clinical Studies. Chin J Integr Med 2020; 27:483-489. [PMID: 33170939 DOI: 10.1007/s11655-020-3439-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2020] [Indexed: 11/26/2022]
Abstract
Although there is guidance from different regulatory agencies, there are opportunities to bring greater consistency and stronger applicability to address the practical issues of establishing and operating a data monitoring committee (DMC) for clinical studies of Chinese medicine. We names it as a Chinese Medicine Data Monitoring Committee (CMDMC). A panel composed of clinical and statistical experts shared their experience and thoughts on the important aspects of CMDMCs. Subsequently, a community standard on CMDMCs (T/CACM 1323-2019) was issued by the China Association of Chinese Medicine on September 12, 2019. This paper summarizes the key content of this standard to help the sponsors of clinical studies establish and operate CMDMCs, which will further develop the scientific integrity and quality of clinical studies.
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Affiliation(s)
- Jun Liu
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Nian Wang
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Hai-Xia Dang
- China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Bing-Wei Chen
- School of Public Health, Southeast University, Nanjing, 210009, China
| | - Li Zhang
- Dongfang Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, 100078, China
| | - Chong Zou
- Jiangsu Provincial Hospital of Traditional Chinese Medicine (Affiliated Hospital of Nanjing University of Traditional Chinese Medicine), Nanjing, 210029, China
| | - Cheng-Liang Zhong
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300381, China
| | - Ju-Kai Huang
- Dongfang Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, 100078, China
| | - Qiong Liu
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Ya-Nan Yu
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Meng Jiang
- Jiangsu Provincial Hospital of Traditional Chinese Medicine (Affiliated Hospital of Nanjing University of Traditional Chinese Medicine), Nanjing, 210029, China
| | - Wei-Xiong Liang
- Guangdong Hospital of Traditional Chinese Medicine, Guangzhou, 510120, China
| | - Qi-Guang Chen
- School of Public Health, Southeast University, Nanjing, 210009, China
| | - Yong-Yan Wang
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Chun-Ti Shen
- Changzhou Traditional Chinese Medicine Hospital, Changzhou, Jiangsu Province, 213004, China
| | - Zhong Wang
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, 100700, China.
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5
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He L, Wang T, Chen BW, Lu FM, Xu J. Puerarin inhibits apoptosis and inflammation in myocardial cells via PPARα expression in rats with chronic heart failure. Exp Ther Med 2019; 18:3347-3356. [PMID: 31602208 PMCID: PMC6777288 DOI: 10.3892/etm.2019.7984] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 07/12/2019] [Indexed: 12/15/2022] Open
Abstract
Chronic heart failure affects myocardial energy metabolism and cardiac function. Puerarin has been reported to improve cardiac function through regulation of energy metabolism in mice with myocardial infarction. The aim of the current study was to determine whether puerarin can improve body weight and reduce inflammation and apoptosis in rats with chronic heart failure. Rats were divided into three groups: Puerarin, PBS and sham group. Transverse aortic constriction was performed to induce chronic heart failure in the puerarin an PBS groups. Cardiac function, apoptosis and inflammation were evaluated following a 4-week treatment in rats with chronic heart failure. The results demonstrated that puerarin significantly increased the survival rate of rats and improved cardiac function compared with the PBS group. In addition, puerarin decreased lactate dehydrogenase and succinate dehydrogenase activity compared with the PBS group. Puerarin treatment increased the expression levels of glucose transporter type 4 and decreased the expression levels of CD36. Additionally, puerarin decreased the levels inflammatory factors, including tumor necrosis factor α, interleukin (IL)-1β and IL-6 in serum and myocardial tissue compared with the PBS group. Puerarin upregulated peroxisome proliferator-activated receptor α (PPARα) and its downstream target genes nuclear respiratory factor 1, FOS proto-oncogene, YY1 transcription factor, acetyl-coenzyme A carboxylase a, Fas cell surface death receptor, L-type pyruvate kinase and acetyl-coenzyme A dehydrogenase medium chain in myocardial cells from rats with chronic heart failure. These results demonstrated that puerarin inhibited apoptosis and inflammation in myocardial cells via the PPARα pathway. In conclusion, the present study indicated that puerarin may exhibit antiapoptotic and anti-inflammatory activity through the PPARα pathway in rats with chronic heart failure.
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Affiliation(s)
- Le He
- Department of Cardiology, Tianjin Chest Hospital, Tianjin 300222, P.R. China
| | - Tong Wang
- Department of Endocrinology, Tianjin Yellow River Hospital, Tianjin 300110, P.R. China
| | - Bing-Wei Chen
- Department of Cardiology, Tianjin Chest Hospital, Tianjin 300222, P.R. China
| | - Feng-Min Lu
- Department of Cardiology, Tianjin Chest Hospital, Tianjin 300222, P.R. China
| | - Jing Xu
- Department of Cardiology, Tianjin Chest Hospital, Tianjin 300222, P.R. China
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Chen BW, Xiao YF, Li JJ, Liu HL, Qin ZH, Gai Y, Jiang XN. Identification of the CAD gene from Eucalyptus urophylla GLU4 and its functional analysis in transgenic tobacco. Genet Mol Res 2016; 15:gmr-15-04-gmr.15049062. [PMID: 27966751 DOI: 10.4238/gmr15049062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Cinnamyl alcohol dehydrogenase (CAD) catalyzes the final step in lignin biosynthesis. The genus Eucalyptus belongs to the family Myrtaceae, which is the main cultivated species in China. Eucalyptus urophylla GLU4 (GLU4) is widely grown in Guangxi. It is preferred for pulping because of its excellent cellulose content and fiber length. Based on GLU4 and CAD gene expression, a Eucalyptus variety low in lignin content should be obtained using transgenic technology, which could reduce the cost of pulp and improve the pulping rate, and have favorable prospects for application. However, the role and function of CAD in GLU4 is still unclear. In the present study, EuCAD was cloned from GLU4 and identified using bioinformatic tools. Subsequently, in order to evaluate its impact on lignin synthesis, a full-length EuCAD RNAi vector was constructed, and transgenic tobacco was obtained via Agrobacterium-mediated transformation. A significant decrease in CAD expression and lignin content in transgenic tobacco demonstrated a key role for EuCAD in lignin biosynthesis and established a regulatory role for RNAi. In our study, the direct molecular basis of EuCAD expression was determined, and the potential regulatory effects of this RNAi vector on lignin biosynthesis in E. urophylla GLU4 were demonstrated. Our results provide a theoretical basis for the study of lignin biosynthesis in Eucalyptus.
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Affiliation(s)
- B W Chen
- School of Biology Science and Biotechnology, Beijing Forestry University, Beijing, China
- Guangxi Key Laboratory of Superior Timber Trees Resource Cultivation, Guangxi Forestry Research Institute, Nanning, China
| | - Y F Xiao
- Guangxi Key Laboratory of Superior Timber Trees Resource Cultivation, Guangxi Forestry Research Institute, Nanning, China
| | - J J Li
- Guangxi Key Laboratory of Superior Timber Trees Resource Cultivation, Guangxi Forestry Research Institute, Nanning, China
| | - H L Liu
- Guangxi Key Laboratory of Superior Timber Trees Resource Cultivation, Guangxi Forestry Research Institute, Nanning, China
| | - Z H Qin
- Guangxi Key Laboratory of Superior Timber Trees Resource Cultivation, Guangxi Forestry Research Institute, Nanning, China
| | - Y Gai
- School of Biology Science and Biotechnology, Beijing Forestry University, Beijing, China
| | - X N Jiang
- School of Biology Science and Biotechnology, Beijing Forestry University, Beijing, China
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Zhang JX, Dong HZ, Chen BW, Cong HL, Xu J. Characteristics of coronary arterial lesions in patients with coronary heart disease and hypertension. Springerplus 2016; 5:1208. [PMID: 27516946 PMCID: PMC4967058 DOI: 10.1186/s40064-016-2828-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 07/14/2016] [Indexed: 12/21/2022]
Abstract
Objective
The aim of this study was to investigate the correlations between risk factors such as hypertension and the complex degrees of coronary arterial lesions (CAL). Methods We selected 462 patients with coronary heart disease (CHD) with confirmed the stenosis (≥50 %) in at least one major coronary artery on coronary angiography and divided them into the “CHD with hypertension” group (CHD-HT, n = 306) and the CHD group (n = 156). The characteristics of CAL and the occurrence of 2-year postoperative major adverse cardiac cerebrovascular events (MACCE) in the two groups were observed. Results The mean SYNTAX scores (SS) was higher in the CHD-HT group than in the CHD group (P < 0.05). The proportions of complex, calcified, and diffused long lesions in the PCI patients’ target vascular lesions, as well as the total MACCE incidence, were significantly higher in the CHD-HT group than in the CHD group (P < 0.05). Logistic multifactor regression analysis showed that age, male sex, hypertension, diabetes, hyperlipidemia, and previous history of myocardial infarction were positively correlated with the SS (P < 0.05). Conclusions The patients with CHD-HT exhibited complicated and diffused CAL, and arterial hypertension can be considered as a risk factor for the complexity of coronary lesions in patients with ischemic heart disease.
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Affiliation(s)
- Jing-Xia Zhang
- Department of Cardiology, Tianjin Chest Hospital, Jizhao Road, Jinnan District, Tianjin, 300222 China
| | - Hong-Zhi Dong
- Department of Cardiology, Tianjin Chest Hospital, Jizhao Road, Jinnan District, Tianjin, 300222 China
| | - Bing-Wei Chen
- Department of Cardiology, Tianjin Chest Hospital, Jizhao Road, Jinnan District, Tianjin, 300222 China
| | - Hong-Liang Cong
- Department of Cardiology, Tianjin Chest Hospital, Jizhao Road, Jinnan District, Tianjin, 300222 China
| | - Jing Xu
- Department of Cardiology, Tianjin Chest Hospital, Jizhao Road, Jinnan District, Tianjin, 300222 China
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Liu Q, Dang AM, Chen BW, Lv NQ, Wang X, Zheng DY. N-terminal Pro-B-type Natriuretic Peptide is Associated with Arterial Stiffness as Measured According to the Brachial-ankle Pulse Wave Velocity in Patients with Takayasu Arteritis. J Atheroscler Thromb 2014; 22:628-36. [PMID: 25503292 DOI: 10.5551/jat.27672] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM Takayasu arteritis (TA) is associated with increased cardiovascular morbidity and mortality, and the degree of arterial stiffness is an independent predictor of cardiovascular mortality in a variety of diseases. In addition, the levels of N-terminal pro-brain natriuretic peptide (NT-proBNP), a marker of ventricular dysfunction, have been found to be higher in patients with TA than in healthy controls. In this study, we aimed to investigate the relationship between the plasma NT-proBNP levels and arterial stiffness in patients with TA. METHODS Seventy-two patients with TA were recruited in this study. The participants were analyzed with respect to the NT-proBNP levels, cardiovascular risk factors, TA-related variables and arterial stiffness assessed according to the brachial-ankle pulse wave velocity (baPWV). The patients were divided into two groups based on the mean baPWV, and the association between the NT-proBNP and baPWV values was tested using uni- and multivariate analyses. RESULTS Twenty-four patients (33.3%) were classified into the high-baPWV group. The body mass index (p=0.035), systolic blood pressure (p<0.001), diastolic blood pressure (p=0.001), mean blood pressure (p<0.001), plasma NT-proBNP levels (p=0.036) and total cholesterol levels (p=0.030) were significantly higher in the high-baPWV group than in the low-baPWV group. A stepwise multiple linear regression analysis revealed the mean blood pressure (p<0.001), age (p=0.002), and NT-proBNP level (p=0.002) to be independent determinants of the ba-PWV after adjusting for other confounding factors. CONCLUSIONS The plasma NT-proBNP levels are independently associated with the degree of arterial stiffness measured according to the baPWV in patients with TA.
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Affiliation(s)
- Qing Liu
- Department of Special Care Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College
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Cai LN, Zhu SW, Zhou C, Wang YB, Jiang NZ, Chen H, Tang XY, Wang JH, Chen X, Hu WJ, Chen BW, Chen BA. [Infection status of HBV, HCV and HIV in voluntary blood donors of Chinese Nanjing area during 2010-2013]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2014; 22:1089-93. [PMID: 25130834 DOI: 10.7534/j.issn.1009-2137.2014.04.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study was purposed to understand the infection of HBV, HCV, HIV among the voluntary blood donors and the epidemic trend in infectious population in Chinese Nanjing area, and to guide the mobilization and recruitment of blood donors. A total of 199777 whole blood samples of voluntary blood donors were tested by ELISA, the nucleic acid technology (NAT) combined detection (HBV-DNA, HCV-RNA, HIV-RNA) was added for detection of the samples with HBsAg,anti-HCV, anti-HIV at least unilateral negative donors from June 10, 2010 to June 9, 2013 years, and these statistic data were analyzed. Every HIV reactive sample(HIV-antibody and/or HIV-RNA) was sent to be confirmed in the Centers for Disease Control and Prevention in Nanjing. The results showed that the voluntary donors' infection rate of HBsAg, anti-HCV, anti-HIV were 0.45%, 0.28%, 0.11% respectively; NAT positive rate was 0.07%, 32 cases were confirmed with anti-HIV positive, in which 30 cases were male (6 cases were repeated blood donors) and 2 cases were female, 3 cases were unconfirmed, in which 2 cases were males and 1 case was female. The statistical analysis demonstrated that the difference of unqualitative rate of HBsAg, anti-HCV, anti-HIV was statistically significant between the first-time and repeated blood donors.It is concluded that the positive rate of anti-HCV and anti-HIV displayed a declining trend year by year in Nanjing voluntary blood donation population from June 10,2010 to June 9, 2013 years. The unqualitative rate of HBsAg and NAT increased with the age increasing, while that of anti-HCV, anti-HIV decreased with age increasing. The unqualitative rate of the repeated blood donors is far lower than that of the first-time blood donors. The ELISA positive rate of anti-HIV testing in females is higher than that in males, but the confirmed positive rate of male is significantly higher than that of female. Therefore the consulting skills before donating should be improved, concerning the link of recruiting donors, focusing on strengthening the first-time donors' consultation, evaluating and developing the fixed voluntary blood donors, and vigorously popularizing NAT technology in blood screening to improve the blood safety effectively.
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Affiliation(s)
- Li-Na Cai
- Department of Hematology, Zhongda Hospital,Southeast University Medical School, Nanjing 210009, Jiangsu Province, China. Quality Management Division, Jiangsu Province Blood Center, Nanjing 210042, Jiangsu Province, China
| | - Shao-Wen Zhu
- Department of Clinical Laboratorial Examination, Nanjing 210042, Jiangsu Province, China
| | - Chun Zhou
- Office of Administration, Jiangsu Province Blood Center, Nanjing 210042, Jiangsu Province, China
| | - Yue-Bang Wang
- Department of Clinical Laboratorial Examination, Nanjing 210042, Jiangsu Province, China
| | - Ni-Zhen Jiang
- Department of Clinical Laboratorial Examination, Nanjing 210042, Jiangsu Province, China
| | - Hui Chen
- Department of Clinical Laboratorial Examination, Nanjing 210042, Jiangsu Province, China
| | - Xin-Yi Tang
- Department of Clinical Laboratorial Examination, Nanjing 210042, Jiangsu Province, China
| | - Jin-Hua Wang
- Department of Clinical Laboratorial Examination, Nanjing 210042, Jiangsu Province, China
| | - Xian Chen
- Department of Clinical Laboratorial Examination, Nanjing 210042, Jiangsu Province, China
| | - Wen-Jia Hu
- Department of Clinical Laboratorial Examination, Nanjing 210042, Jiangsu Province, China
| | - Bing-Wei Chen
- Public Health School of Southeast University, Nanjing 210009, Jiangsu Province, China
| | - Bao-An Chen
- Department of Hematology, Zhongda Hospital,Southeast University Medical School, Nanjing 210009, Jiangsu Province, China. E-mail:
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Chen BW, Wang ZG, Lv NQ, Cheng YM, Dang AM. The role of cardiac pacing in carotid sinus syndrome: a meta-analysis. Clin Auton Res 2014; 24:127-34. [PMID: 24682799 DOI: 10.1007/s10286-014-0238-x] [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] [Received: 07/30/2013] [Accepted: 03/05/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE Cardiac pacing can be used to treat carotid sinus syndrome (CSS), but clinical studies have shown conflicting results. We conducted a systematic review and meta-analysis to evaluate the role of pacing for CSS. METHODS A systematic search of publications in PubMed, Embase, and the Cochrane Library without language restriction was performed. Prospective randomized studies that compared cardiac pacing with standard therapy or pacing with different algorithms were included if the recurrence of syncope or the number of falls was observed. RESULTS Eight studies enrolling 540 patients were identified. In open-label studies, the recurrence of syncope was reduced significantly by cardiac pacing compared with standard therapy. The recurrence of syncope was not different between single- and dual-chamber pacing, but a lower rate of patients with pre-syncope was observed in the group with dual-chamber pacing. Double-blind clinical studies failed to observe the role of cardiac pacing for preventing falls in patients with CSS. CONCLUSION The results of meta-analysis supported the use of cardiac pacing for patients with dominant cardioinhibitory CSS.
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Affiliation(s)
- Bing-Wei Chen
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishilu, Beijing, 100037, People's Republic of China
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Chen BW, Liu Q, Wang X, Dang AM. Are dual-chamber implantable cardioverter-defibrillators really better than single-chamber ones? A systematic review and meta-analysis. J Interv Card Electrophysiol 2014; 39:273-80. [DOI: 10.1007/s10840-014-9873-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2013] [Accepted: 01/21/2014] [Indexed: 11/28/2022]
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12
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Chen BW, Dang AM. Sleep duration and hypertension: flawed methods call the conclusions into question. Sleep Med 2013; 14:1432-3. [DOI: 10.1016/j.sleep.2013.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Accepted: 09/13/2013] [Indexed: 11/28/2022]
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Yeh CH, Chow CW, Chen HY, Chen BW. Using adaptive four-band OFDM modulation with 40 Gb/s downstream and 10 Gb/s upstream signals for next generation long-reach PON. Opt Express 2011; 19:26150-26160. [PMID: 22274202 DOI: 10.1364/oe.19.026150] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
In this demonstration, we propose and demonstrate an adaptive long-reach passive optical network (LR-PON) using four-band orthogonal frequency division multiplexed (OFDM) channels. The downstream traffic rates from 6.25 to 40 Gb/s (using fixed quadrature amplitude modulation (QAM) level in the four OFDM bands) and from 9.37 to 40.3 Gb/s (using variable QAM levels in the four OFDM bands) can be achieved adaptively in the optical network units (ONUs) depending on different fiber transmission lengths from 0 to 100 km. For the upstream transmission, a 10 Gb/s 16-QAM OFDM signal with pre-emphasis is experimentally performed by using a 2.5 GHz directly modulated laser (DML). Based on the simulation and experimental results, the proposed adaptive four-band OFDM system could be a promising candidate for the future LR-PON.
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Affiliation(s)
- C H Yeh
- Information and Communications Research Laboratories, Industrial Technology Research Institute (ITRI), Hsinchu, Taiwan.
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Abstract
Abstract
The effects of zinc l-carnosine on the damaging actions of ethanol were examined in rabbit isolated gastric glands. Ethanol (8%, v/v) incubation produced a 50% viability of the gland populations and released a significant amount (38%) of the total lactate dehydrogenase (an index of membrane injury) of the glands. Zinc l-carnosine pre-incubation for 15 min markedly prevented these actions of ethanol; however, l-carnosine by itself did not have these effects. These findings indicate that zinc ion but not carnosine in the zinc l-carnosine molecule possesses cytoprotective action against ethanol-induced gastric gland damage in rabbits.
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Affiliation(s)
- C H Cho
- Department of Pharmacology, Faculty of Medicine, University of Hong Kong
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Yang CP, Hung JJ, Jaing TH, Lin KH, Lin DT, Lu MY, Liang DC, Chen SH, Liu HC, Hsiao CC, Shu SG, Chen JS, Chang TT, Chiou SS, Hsieh YL, Lin MT, Lee MT, Peng CT, Cheng SN, Chen RL, Chen BW, Lin KS. Treatment results of the TPOG-NHL92 protocols for childhood non-Hodgkin's lymphomas in Taiwan: a report from the Taiwan Pediatric Oncology Group (TPOG). Acta Paediatr Taiwan 2000; 41:193-204. [PMID: 11021005] [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: 09/28/2022]
Abstract
A nation-wide chemotherapeutic trial for childhood non-Hodgkin's lymphoma (NHL) was conducted by the Taiwan Pediatric Oncology Group (TPOG). Four TPOG-NHL92 protocols based on stage and histology were activated in 1992: TPOG-92LD (treatment duration: 8 months) was used for localized (stages I/II) NHL with any histology, 92LB (2 years), 92SNC (5 months), and 92LC (1 year) for advanced (stages III/IV) lymphoblastic (LB), small non-cleaved cell (SNC), and large cell (LC) lymphoma, respectively. From January 1992 through June 1998, 200 children with newly diagnosed NHL from 13 member hospitals of TPOG were enrolled. There were 140 boys and 60 girls. Their ages at diagnosis ranged from 2.4 months to 18.3 years with a median of 8.2 years. There were 54 (27.3%) patients with LB, 94 (47.5%) with SNC including B-cell acute lymphoblastic leukemia (B-ALL), and 50 (25.2%) with LC. Stages I, II, III, and IV (including B-ALL) of the disease comprised 5%, 10%, 43%, and 42% of cases, respectively. There were 176 patients eligible for evaluation of treatment results. The remission rate of induction was 82.4%, induction failed in 22 (12.5%) patients, and nine patients died during induction. As of August 31, 1999, 26 patients relapsed, six died during remission, one patient developed secondary acute myelomonocytic leukemia, and 105 patients remained in continuous remission with a median remission duration of 49 months. The event-free survival (EFS) at 7 years was 63.5%, 61.5% and 65% for LB, SNC, and LC groups (P = 0.8298). The 7-year EFS for stages I/II, III, and IV of the disease was 73%, 68.9%, and 50.3% (P = 0.0212), respectively. We concluded that following the strategy of stratification of therapy, only disease stages had prognostic significance in this study. More efforts are needed to improve our treatment results.
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Affiliation(s)
- C P Yang
- Division of Hemotology/Oncology, Chang-Gung Children's Hospital-Linkou, Taipei, Taiwan
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Abstract
BACKGROUND It has been reported that zinc sulphate contributes an anti-inflammatory action in many animal models; however, the impact of zinc in colitis remains unclear. The aim of the present study was to examine the role of zinc sulphate in experimental colitis. METHODS Colitis was induced by 2,4,6-trinitrobenzenesulphonic acid (TNB) in rats. Beginning at the first day of TNB colitis, the rats were treated with a zinc sulphate enema once daily for 6 days. The rats were examined 8 days later. RESULTS The TNB induced severe colitis as evidenced by increased mucosal lesion area, mucosal myeloperoxidase (MPO) activity and prostaglandin E2 (PGE2) and leukotriene B4 (LTB4) levels. Six days after the application of the zinc sulphate enema, the mucosal lesion area, MPO activity, PGE2 and LTB4 levels all decreased significantly. Mucosal superoxide dismutase activity remained unchanged after zinc treatments. CONCLUSIONS Our data suggest that zinc sulphate enemas have an anti-inflammatory action on experimental colitis.
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Affiliation(s)
- B W Chen
- Department of Gastroenterology, First Teaching Hospital of Beijing Medical University, China
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17
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Wong BC, Lam SK, Ching CK, Hu WH, Ong LY, Chen BW, Gao Z, Chen JS, Jiang XW, Hou XH, Lu JY, Wang WH, Ho J, Yuen ST, Lai KC, Kwok E, Hui WM, Covacci A. Seroprevalence of cytotoxin-associated gene A positive Helicobacter pylori strains in Changle, an area with very high prevalence of gastric cancer in south China. Aliment Pharmacol Ther 1999; 13:1295-302. [PMID: 10540043 DOI: 10.1046/j.1365-2036.1999.00619.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
Abstract
BACKGROUND Helicobacter pylori, especially the CagA-positive strains, are closely associated with peptic ulcers and gastric cancers. We performed a large scale gastric cancer screening project and examined the prevalence of H. pylori and CagA-positive strains in Changle, China, an area with one of the World's highest gastric cancer mortality. We also compared the prevalence with that in Hong Kong which has one-tenth of the gastric cancer mortality of that in Changle. METHODS A total of 2424 subjects in Changle and 523 subjects in Hong Kong had endoscopic examination and venesection. Sera were tested for anti-H. pylori antibody and anti-CagA antibody and correlated with endoscopic findings. RESULTS In Changle, 80. 9% of the subjects were H. pylori carriers. Out of 551 carriers, 408 (74%) were positive for anti-CagA antibody. A total of 76% and 87% of the asymptomatic and gastric cancer patients were positive for anti-CagA antibody, respectively (P > 0.05). Compared to Hong Kong, there was a significantly (P < 0.0001) higher prevalence of CagA-positive strains in asymptomatic subjects in Changle (76%) than in Hong Kong (28%), but not in peptic ulcers or gastric cancers. CONCLUSIONS Subjects in Changle had a high prevalence of H. pylori infection and a high prevalence of the CagA-positive strains. The contrast in the prevalence of CagA-positive strains, in asymptomatic subjects in two areas with differing gastric cancer mortality, supports the pathogenic role of CagA-positive strains in gastric carcinogenesis.
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Affiliation(s)
- B C Wong
- Department of Medicine and Pathology, University of Hong Kong, Hong Kong
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Wong BC, Lam SK, Ching CK, Hu WH, Kwok E, Ho J, Yuen ST, Gao Z, Chen JS, Lai KC, Ong LY, Chen BW, Wang WH, Jiang XW, Hou XH, Lu JY. Differential Helicobacter pylori infection rates in two contrasting gastric cancer risk regions of South China. China Gastric Cancer Study Group. J Gastroenterol Hepatol 1999; 14:120-5. [PMID: 10029291 DOI: 10.1046/j.1440-1746.1999.01823.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Carriers of Helicobacter pylori are believed to have a three- to six-fold increased risk of developing gastric cancer. We have recently conducted a simultaneous cross-sectional population study on the prevalence of H. pylori infection in a cohort of asymptomatic adult volunteers in two contrasting gastric cancer risk regions of South China, Hong Kong and Changle of Fujian. Their mean annual gastric cancer mortality has been approximately 7.5 and 75/100 000 population, respectively, since the beginning of the last decade. The aim of this study was to evaluate if H. pylori prevalence bears any relationship to gastric cancer mortality rates in these two southern regions of China. METHODS Sera were obtained from 397 volunteers in Hong Kong. They were tested for anti-H.pylori immunoglobulin (Ig) G antibody by using a commercial enzyme-linked immunosorbent assay (ELISA) kit. Volunteers of Changle (1456) had upper endoscopy examination and were also tested for anti-H. pylori IgG antibody by the same ELISA method. RESULTS The overall H. pylori infection prevalence was significantly higher in Changle (80.4%) than in Hong Kong (58.4%; P< 0.01). The high prevalence is associated with more atrophic gastritis. The overall risk of gastric cancer in people of Changle is approximately five-fold that of Hong Kong (adjusted odds ratio 4.9, 95% CI 2.5-9.8). CONCLUSIONS It is concluded that the prevalence of H. pylori infection rates bear a direct relationship to gastric cancer mortality rates in these two southern regions of China. Thus, H. pylori most likely plays a significant aetiopathogenetic role in gastric carcinogenesis in subjects living in Changle.
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Affiliation(s)
- B C Wong
- University Department of Medicine, The University of Hong Kong, China
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Wong BC, Ching CK, Lam SK, Li ZL, Chen BW, Li YN, Liu HJ, Liu JB, Wang BE, Yuan SZ, Xu CP, Hou XH, Zhang AT, Zheng ZT. Differential north to south gastric cancer-duodenal ulcer gradient in China. China Ulcer Study Group. J Gastroenterol Hepatol 1998; 13:1050-7. [PMID: 9835323 DOI: 10.1111/j.1440-1746.1998.tb00569.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
There are suggestions that duodenal ulcer protects individuals from gastric cancer and that rice is ulcerogenic while wheat is gastro-protective. We aimed to examine the relationship of gastric cancer, duodenal and gastric ulcers in different geographical regions in China and identified dietary risk factors for duodenal ulcer and gastric cancer. The prevalence of peptic ulcer and gastric cancer among symptomatic patients in eight major cities, four each from the north and the south representing all the six defined regions of China were studied. Endoscopy and case records over a 10 year period were reviewed and cases of confirmed duodenal and gastric ulcer and gastric cancer, together with the total number of endoscopies performed per year, were recorded. Rates were expressed as cases/1000 endoscopies. Results were compared to another epidemiological study on diet and mortality in the same regions in China conducted at the same time. Duodenal ulcer rates were 2.4-fold higher in southern China than northern China, whereas gastric cancer rates were 1.6-fold higher in the north than in the south. Correlation studies showed for the first time an inverse linear relationship between the gastric cancer rates and the duodenal ulcer rates (r=-0.8076, P=0.015), as well as the duodenal ulcer: gastric ulcer ratios (r=-0.9133, P=0.002). Gastric ulcer rates were higher in southern China but did not correlate with the gastric cancer rates (r=0.1455, P=0.731). Duodenal ulcer rates were found to be related to daily rice intake (r=0.8554, P=0.029) and inversely related to daily wheat flour intake (r=-0.8472, P=0.033). Gastric cancer rates were not related to any dietary risk factors tested. We concluded there was an inverse relationship between gastric cancer rates and duodenal ulcer rates. Although duodenal ulceration and gastric cancer are both linked to Helicobacter pylori infection, the findings of this study indicate independent additional aetiological factors for the pathogenesis of these conditions. Dietary factors such as rice or wheat intake may play a role.
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Affiliation(s)
- B C Wong
- Department of Medicine, Queen Mary Hospital, University of Hong Kong, China
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Hui WM, Ho J, Chen BW, Cho CH, Branicki FJ, Lam SK. Can misoprostol and omeprazole reduce nicotine and ethanol induced gastric mucosal injury? A quantitative macroscopic and microscopic analysis in rats. J Gastroenterol Hepatol 1997; 12:7-12. [PMID: 9076615 DOI: 10.1111/j.1440-1746.1997.tb00337.x] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
We compared the effects of misoprostol, omeprazole and methylcellulose (control) on gastric mucosal injury induced by nicotine and/or ethanol. The results demonstrate that misoprostol and omeprazole each significantly reduce macroscopic injury and deep injury at a microscopic level (P < 0.05) induced by nicotine alone, ethanol alone or a combination of ethanol and nicotine. Misoprostol and omeprazole each reduced the leakage of fluorescein isothiocyanate-albumin into the interstitium in the gastric mucosa. Misoprostol and omeprazole are each effective in preventing injury induced by nicotine and ethanol and vascular factors are involved.
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Affiliation(s)
- W M Hui
- Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong
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Chuu WM, Lin DT, Lin KH, Chen BW, Chen RL, Lin KS. Can severe neonatal jaundice be prevented by neonatal screening for glucose-6-phosphate dehydrogenase deficiency?--a review of evidence. Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi 1996; 37:333-41. [PMID: 8942026] [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: 02/03/2023]
Abstract
An evidence-based approach is used to evaluate the neonatal screening program for glucose-6-phosphate dehydrogenase (G-6-PD) deficiency. The primary consideration to include G-6-PD deficiency (G-6-PDD) in neonatal screening program was the public health burden of G-6-PDD-associated neonatal jaundice (G-6-PDDANJ) in the target population. However, the prevalence of G-6-PDD per se cannot be the sole index of the public health burden of G-6-PDDANJ. In more developed areas, G-6-PDDANJ is no longer a major public health problem. Further, most cases with G-6-PDDANJ in more developed areas are not precipitated by any identifiable icterogenic agents, and therefore not preventable by avoidance education. In less developed areas, however, G-6-PDDANJ is still a big public health burden and requires intervention. In this study, the effectiveness of neonatal screening programs for G-6-PDD to prevent severe neonatal jaundice(NJ) has been shown based on historical comparison, but the results may be confounded by other temporal factors. G-6-PDDANJ usually occurs in the first week after birth. Prompt need for G-6-PD screening results precludes it from incorporation into other existent neonatal screening programs (i.e., for PKU), and from centralization of laboratory work. The efficacy, adverse effects and cost-effectiveness of this mass screening program need further study.
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Affiliation(s)
- W M Chuu
- Department of Pediatrics, National Taiwan University Hospital, Taipei, R.O.C
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Cho CH, Chen BW, Luk CT, Lai KH, Lam SK. The gastric cytoprotective action of adenosine and prostaglandin E2 in rabbits. Agents Actions 1994; 42:146-8. [PMID: 7879700 DOI: 10.1007/bf01983481] [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] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The direct protective action of adenosine and prostaglandin E2 (PGE2) was examined in an isolated gastric gland preparation in rabbits. Ethanol (8%, v/v) incubation markedly increased the release of lactate dehydrogenase (LDH) and number of non-viable glands in the preparation. Both effects were prevented by PGE2 preincubation in a concentration (10(-6), 1.4 x 10(-5) or 2.8 x 10(-5) M)-dependent manner. The protective action was smaller in adenosine-treated groups, and yet the highest concentration (10(-4) M) of the compound also significantly inhibited the cytotoxic effects of ethanol. These findings indicate that both adenosine and PGE2 possess cytoprotective action on gastric glands in rabbits, but the former compound exerts its action beyond physiological concentrations. It is concluded that endogenous PGE2, but not adenosine may act as an ulcer modulator in the stomach.
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Affiliation(s)
- C H Cho
- Department of Pharmacology, Faculty of Medicine, University of Hong Kong
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23
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Abstract
Amoxycillin in combination with anti-ulcer agents has been shown to prolong duodenal ulcer remission. While this effect can be related to the eradication of Helicobacter pylori, it is not known if amoxycillin might possess cytoprotective properties. Protection against ethanol-induced gastric mucosal damage by intragastric instillation of amoxycillin suspension (prepared from capsule form) and solution (from injection form, 100% pure amoxycillin), and by intraperitoneal injection of amoxycillin solution was studied using an ex vivo gastric chamber in the rat. Intragastric and intraperitoneal administration of amoxycillin dose-dependently protected the rat gastric mucosa from damage by absolute ethanol. This protection was lost when the rats were pretreated with indomethacin. Gastric mucosal blood flow as measured by laser Doppler flowmetry and gastric acid output were unaffected by amoxycillin. Amoxycillin imparts gastric cytoprotection, and one possible mechanism is by the release of prostaglandins.
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Affiliation(s)
- S K Lam
- Department of Medicine, Queen Mary Hospital, University of Hong Kong
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24
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Teng RJ, Chen BW, Ho MM. Transient leukemoid reaction in an extremely premature neonate. Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi 1994; 35:225-8. [PMID: 8042507] [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: 01/28/2023]
Abstract
A female newborn was delivered prematurely at gestational age of 26 weeks with birth weight of 1,000 grams. Her initial white blood cell count was 68,900/mm3, which increased to 207,000/mm3 on the fifth day of life with a remarkable shift-to-left pattern. The most immature myeloid series in the peripheral blood smear was promyelocyte; and the promyelocyte, myelocyte and meta-myelocyte accounted for 38% of the peripheral white blood cells. Neither hepatosplenomegaly nor skin rash was noted, but the platelet count dropped to 86,000/mm3 transiently on Day 8. Cytogenetic study for the bone marrow aspiration revealed normal results. The leukemoid reaction recovered within three weeks without specific treatment. Antenatal usage of steroid to promote lung maturation was considered to be one possible cause of the transient leukemoid reaction.
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Affiliation(s)
- R J Teng
- Department of Pediatrics, National Taiwan University Hospital, Taipei. R.O.C
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25
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Lin KH, Su IJ, Chen RL, Lin DT, Tien HF, Chen BW, Lin KS. Peripheral T-cell lymphoma in childhood: a report of five cases in Taiwan. Med Pediatr Oncol 1994; 23:26-35. [PMID: 8177142 DOI: 10.1002/mpo.2950230106] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
We encountered five children with peripheral T-cell lymphoma (PTL) at National Taiwan University Hospital (NTUH) from 1985-1989. The patients were four boys and one girl, aged between 5 and 13 years. The duration of prediagnostic symptoms varied from 1 month to 5 years. All had pyrexia and lymphadenopathy; one had a prolonged history of granulomatosis with repeated infection. Four had hepatosplenomegaly. One patient presented with diffuse pulmonary infiltration and impending respiratory failure. All patients were negative for human T-cell leukemia virus (HTLV)-I antibody, and positive for HBsAg. Four patients who had EBV-viral capsid antigen (VCA) IgG and who were IgM tested were positive for EBV-VCA IgG, but only two had evidence of active EBV infection. Tumor cell markers were examined and showed the following phenotypes: all patients were CD2, CD3, and CD7 positive but CD19 and CD20 negative; three patients were CD4 positive and CD8 negative; the other two patients were CD4 negative and CD8 positive. Four patients died 2-7 months after diagnosis. The remaining patient received allogeneic bone marrow transplantation and has survived free of disease for more than 22 months after transplant. Our five cases reconfirm the high frequency of diagnostic delay, the heterogenous immunophenotypes, high mortality, and poor responsiveness to conventional therapy for PTL. Bone marrow transplantation in the early stage might be a possible cure of this disease.
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Affiliation(s)
- K H Lin
- Department of Pediatrics, National Taiwan University Hospital, Taipei, Republic of China
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26
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Cho CH, Chen BW, Ho CS, Ko JK, Lam SK. Assessment of hemodynamic changes in rat stomachs by laser Doppler velocimetry and reflectance spectrophotometry. Effects of ethanol and prostaglandin E2 under ischemic and congestive conditions. Digestion 1994; 55:389-94. [PMID: 7705551 DOI: 10.1159/000201170] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
One of the ulcerogenic mechanisms by which ethanol induces mucosal lesions in the stomach is the depression of gastric mucosal blood flow (GMBF). The goal of this study was to determine whether lesion formation is the result of vascular ischemia alone or ischemia combined with congestion. The aims of this study were to answer this question by evaluating the relationship between GMBF, oxygen saturation (ISO2) and hemoglobin volume (IHb) in the gastric mucosa under the influences of ethanol and prostaglandin E2 (PGE2) in the ischemic and congestive states, using a laser Doppler flowmeter and tissue spectrum analyzer. Ligation of the gastric celiac artery or vein markedly decreased the GMBF and the ISO2 level. The former procedure also reduced but the latter increased the IHb level. Ethanol administration produced effects similar to venous ligation, i.e. vascular stasis with ischemia. There was a negative correlation between GMBF and severity of lesion formation after ethanol administration. However, at the lesion site all the hemodynamic parameters were significantly reduced, indicating that a necrotic condition had occurred. PGE2 preincubation (25 micrograms) elevated GMBF, ISO2 and IHb levels. It also alleviated the reduction of blood flow induced by ethanol and increased the recovery rate of GMBF and ISO2 after the release of arterial or venous ligation. It is concluded that the decrease in blood flow due to ethanol is probably caused by constriction of venules rather than arterioles inside the mucosa, and this effect could lead to vascular congestion. PGE2 probably dilates both arterioles and venules in the gastric mucosa and thereby increases the blood flow in the gastric mucosa.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- C H Cho
- Department of Pharmacology, Faculty of Medicine, University of Hong Kong
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27
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Abstract
BACKGROUND The mechanism by which epidermal growth factor (EGF) protects the gastric mucosa against injury is unclear. Whether EGF has any effect on gastric blood flow has not been reported. METHODS Using an ex vivo gastric chamber preparation, the effect of EGF on gastric blood flow in rats was studied by laser Doppler flowmetry. Measurements of blood flow and mucosal damage were made in both intact and sialoadenectomized rats with graded doses of EGF at basal condition and after topical application of absolute ethanol. RESULTS Sialoadenectomy alone increased ethanol-induced gastric mucosal lesions (P < 0.05) but had no significant effect on blood flow. EGF pretreatment resulted in both a reduction in ethanol-induced gastric mucosal injury as well as a significant increase in blood flow compared with controls (both P < 0.05). Graded doses of EGF (3.12-25 micrograms) resulted in an dose-dependent increase in gastric blood flow (r = 0.68; P < 0.001), which correlated inversely with the degree of mucosal damage (r = -0.72; P < 0.001). CONCLUSIONS Mucosal protection by EGF is accompanied by an increase in gastric blood flow; this action may contribute to its mucosal protective effect.
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Affiliation(s)
- W M Hui
- Department of Medicine, University of Hong Kong, Queen Mary Hospital
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28
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Chen RL, Lin KH, Chen BW, Su S, Lin DT, Chuu WM, Lin KS, Huang LM, Lee CY. Long-term observation of pediatric aplastic anemia. J Formos Med Assoc 1992; 91:390-5. [PMID: 1358306] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2022]
Abstract
Fifty-nine verified cases of acquired aplastic anemia (AA), diagnosed at the Pediatric Department of the National Taiwan University Hospital from 1977 to 1987, were reviewed and analyzed. The demographic features showed a high relative incidence (acute myelogenous leukemia/AA ratio, 2.2/1), a high percentage of non-severe AA (39%) and a high association with hepatitis (20.8%). No evidence of hepatitis A, B or C virus infection was found in five cases of hepatitis-associated AA. No sex preponderance was noted in this pediatric series. The 10-year projected survival rate of the total series approached 55%. The crude two-year-survival and two-year-transfusion-free-survival rates were 59% and 44%, respectively, in the conservative therapy group treated with androgens and steroids; 36% and 32%, respectively, in patients with severe AA in the conservative therapy group; and 73% and 64%, respectively, in the aggressive therapy group treated with cyclosporin, anti-lymphocyte globulin or bone marrow transplant. The major causes of death were hemorrhage (44%) and infection (56%) in the conservative therapy group; but in the aggressive therapy group, two out of three deaths were related to therapeutic complications. Multivariate analysis of prognostic factors revealed that severity and treatment modality were independent risk factors. Only two out of 31 patients who survived more than two years (long-term survivors) experienced late mortalities. At two, five, seven and 10 years after diagnosis, 61%, 55%, 41% and 40% of the long-term survivors had inadequate hematopoietic recovery.
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Affiliation(s)
- R L Chen
- Department of Pediatrics, National Taiwan University Hospital, Taipei, R.O.C
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Cho CH, Chen BW, Hui WM, Lam SK, Ogle CW. The role of the vagus nerve in the protective action of acid inhibitors on ethanol-induced gastric mucosal damage in rats. J Gastroenterol Hepatol 1992; 7:178-83. [PMID: 1571501 DOI: 10.1111/j.1440-1746.1992.tb00958.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The role of vagus in the actions of different acid inhibitors on ethanol-induced gastric damage and mucosal blood flow (GMBF) changes was studied in anaesthetized rats, using an ex vivo stomach chamber preparation. Subdiaphragmatic bilateral vagotomy decreased the basal gastric acid secretion and GMBF; it also intensified ethanol-evoked lesions in the glandular mucosa. Misoprostol, omeprazole and cimetidine produced a similar degree of reduction in acid output. Misoprostol given subcutaneously (s.c.) (50 micrograms/kg), or added to the incubation solution (12.5 micrograms) for 15 min, markedly prevented ethanol-induced lesion formation and reduction in GMBF. The reversing effect of s.c. injection of misoprostol on either lesion formation or on GMBF reduction was attenuated by vagotomy. Omeprazole protected against lesion formation only when present in the incubation solution (12.5 mg) of ex vivo chamber preparations of both vagus-intact and vagotomized animals, but the effect was significantly less in the latter group. The drug also prevented the depressive action of ethanol in vagus-intact animals. Cimetidine pretreatment (50 mg s.c. or 12.5 mg in incubation solution), however, did not modify the effects of ethanol on lesion formation and the GMBF. The findings indicate that the three different types of acid inhibitors exert different actions on ethanol-induced gastric mucosal damage, although they produced similar inhibition of acid output. Vagotomy lowers the GMBF and attenuates the antiulcer action of misoprostol and omeprazole, especially when the drugs are given by the parenteral route.
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Affiliation(s)
- C H Cho
- Department of Pharmacology, Faculty of Medicine, University of Hong Kong
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30
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Hui WM, Joana H, Chen BW, Cho CH, Luk CT, Lam SK. Nicotine induced gastric injury. A quantitative macroscopic and microscopic analysis of the protective effects of sucralfate and feeding. Gut 1991; 32:372-6. [PMID: 2026336 PMCID: PMC1379073 DOI: 10.1136/gut.32.4.372] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Nicotine, while an important component of cigarettes, does not cause gross gastric mucosal damage, although its microscopic effect remains unknown. We have evaluated the histology and the microvascular permeability of (a) the effect of nicotine alone or in combination with ethanol on the gastric mucosa of rats and (b) the effect of feeding and sucralfate on the mucosa of rats treated with nicotine and ethanol. Mucosal injury was assessed histologically by the depth of injury and microvascular permeability by the leakage of fluorescein isothiocyanate-labelled albumin. Our results show that nicotine induced microscopic mucosal damage and accentuated the damage induced by alcohol. The damaging effects on mucosa of nicotine and ethanol, alone or in combination, were reduced by pretreatment with sucralfate. Similarly, feeding reduced the degree of mucosal injury. Nicotine and ethanol increased leakage of albumin into the interstitium and the leakage was reduced after sucralfate pretreatment. This study substantiates the adverse effect of smoking on mucosal damage. Vascular factors are probably involved in the pathogenesis.
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Affiliation(s)
- W M Hui
- Department of Medicine, University of Hong Kong, Queen Mary Hospital
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31
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Abstract
We compared the effects of graded doses of misoprostol (50-200 mg), omeprazole (12.5-50 mg), cimetidine (6.25-50 mg) and sucralfate (50-200 mg) on gastric mucosal blood flow as measured by laser Doppler flowmetry and gastric mucosal injury induced by ethanol. The results demonstrated that sucralfate, misoprostol and omeprazole, but not cimetidine, increased gastric mucosal blood flow in a dose-dependent manner and protected the mucosa against ethanol damage. The peak and summation blood flow were significantly greater with sucralfate than with misoprostol and omeprazole, but the degree of mucosal protection was similar. These results indicate that the increase in gastric mucosal blood flow, an action which is common to the three drugs, plays an important role in gastric mucosal protection, but other factors are also involved.
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Affiliation(s)
- W M Hui
- Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong
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32
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Hui WM, Chen BW, Cho CH, Lam SK, Luk CT. The effect of misoprostol, omeprazole and sucralfate on nicotine- and ethanol-induced gastric injury and gastric mucosal blood flow: a comparative study. J Gastroenterol Hepatol 1990; 5:653-8. [PMID: 2129835 DOI: 10.1111/j.1440-1746.1990.tb01120.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Nicotine, which is thought to be responsible for part of the pharmacological effect of smoking, exacerbates gastric mucosal injury in rats. The effects of misoprostol (12.5 micrograms to 100 micrograms), omeprazole (12.5 mg to 100 mg) and sucralfate (50 to 400 mg) on gastric mucosal blood flow and mucosal injury induced by nicotine were studied in an ex vivo gastric chamber preparation in rats. Rats were pretreated with nicotine (25 micrograms/mL orally) for 10 days and ethanol was added to the gastric chamber preparation. Laser Doppler flowmetry was used to measure the gastric mucosal blood flow and mucosal damage (ulcer index) was assessed by the area of haemorrhagic lesions. The ulcer index was significantly higher in rats pretreated with nicotine. Treatment with misoprostol and omeprazole lowered the ulcer index significantly compared with controls. The peak and summation blood flows were lower in nicotine-treated rats but failed to reach statistical significance. The peak blood flow (blood flow at 45 min) and the summation blood flow were significantly higher with all doses of sucralfate, misoprostol and omeprazole than in controls (P less than 0.05). The increase in gastric mucosal blood flow was significantly higher with sucralfate and misoprostol than with omeprazole. We conclude that sucralfate, misoprostol and omeprazole prevent nicotine- and ethanol-induced gastric mucosal damage and are accompanied by an increase in gastric mucosal blood flow. This indicates that smoking exacerbates gastric mucosal injury and that cytoprotective and site-protective agents can reduce injury by these noxious agents.
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Affiliation(s)
- W M Hui
- Department of Medicine and Pharmacology, University of Hong Kong, Queen Mary Hospital
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33
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Cho CH, Chen BW, Hui WM, Luk CT, Lam SK. Endogenous prostaglandins: its role in gastric mucosal blood flow and ethanol ulceration in rats. Prostaglandins 1990; 40:397-403. [PMID: 2126386 DOI: 10.1016/0090-6980(90)90104-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The involvement of endogenous prostaglandins (PGs) in modulating gastric mucosal blood flow (GMBF) is still unclear. The present study was designed to demonstrate the role of this autacoid in the basal GMBF and the restoration of blood flow after restriction of blood supply to the stomach. The ex-vivo gastric chamber was prepared and the GMBF was measured by a laser Doppler technique. 20% ethanol incubation for 10 min in the chamber increased the basal GMBF and lessened the reduction of blood flow induced by absolute ethanol. It also decreased lesion formation caused by ethanol. Indomethacin 5 mg/kg, given s.c 60 min before experimentation had the opposite effects. Ligation of the gastric artery for 20 min which reduced the GMBF by 60%, worsened ethanol ulceration. There was a marked rebound of the GMBF after the ligation was released. Indomethacin totally abolished the blood flow rebound and aggravated ethanol ulceration. However, 20% ethanol incubation significantly potentiated such a rebound in blood flow and reduced lesion formation. Indomethacin pretreatment reversed these actions, whereas misoprostol administration produced the similar effects as 20% ethanol. It is concluded that GMBF plays an important role in ethanol ulceration and both basal and rebound GMBF is probably modulated by endogenous PGs.
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Affiliation(s)
- C H Cho
- Department of Pharmacology, Faculty of Medicine, University of Hong Kong
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34
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Abstract
A study was made of the cellular and molecular characteristics of nine Chinese infants, consecutively presenting with acute leukemia. Five cases were acute lymphoblastic leukemia (ALL); four were acute nonlymphoblastic leukemia (ANLL). Hyperleukocytosis, hepatosplenomegaly, and poor response to conventional therapy were common features, and CNS involvement was detected at diagnosis in three cases. The blast cells from all five cases with ALL expressed early B-cell markers, i.e., HLA-DR+, CD19+, but CD10-. Terminal deoxynucleotidyl transferase (TdT) was present in blasts from four of the five cases and periodic acid-Schiff staining in blasts from two patients only. The leukemic cells of one patient also showed positive nonspecific esterase activity and expressed myeloid-associated antigens CD33 (My9), CD11 (OkM1), and CD14 (My4 and Mo2). Molecular analysis of leukemic cell DNA from this and two other patients showed rearrangement of the immunoglobulin (Ig) heavy-chain genes, but without any evidence of kappa light-chain gene rearrangement. T-cell receptor (TCR) genes remained in the germline configuration in these cases. Cytogenetic analysis showed translocation t(4;11) (q21;q23) in all four cases studied. In the group of ANLL, three cases belonged to the M4 and one to the M2 subtype. Chromosomal abnormality involving 11q23 was also detected in two patients: t(11;17)(q23;q11) and del(11)(q14q23) in each case respectively. Neither Ig nor TCR gene rearrangement was present in blast cells from patients with ANLL. The data indicate that chromosomal rearrangement of band 11q23 was quite common in Chinese infants with either form of leukemia, a finding that may have pathogenetic implications.
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Affiliation(s)
- W M Chuu
- Department of Pediatrics, National Taiwan University Hospital, Taipei, Republic of China
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35
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Hwang KC, Hsieh KH, Chen BW, Lin KH. Immunologic and virologic status of multitransfused thalassemic patients. Zhonghua Min Guo Wei Sheng Wu Ji Mian Yi Xue Za Zhi 1990; 23:19-26. [PMID: 2168312] [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: 12/30/2022]
Abstract
Viral markers of hepatitis B virus (HBV), cytomegalovirus (CMV) and human immunodeficiency virus (HIV), immunoglobulins and complements, T-cell subpopulation antibodies (OKT series) and mitogen responses have been investigated in 68 multitransfused thalassemic patients and in 46 age-matched children. Results showed (1) 56 patients (82.4%) had been exposed to HBV; 29 patients (42.6%) had been exposed to CMV and none were HIV infection. (2) Increased IgG, IgA, OKIal, and decreased C3, OKT3, OKT4, OKT4/OTK8 ratio showed in patients as compared to controls. (3) An apparent increase in lymphocyte proliferation was seen in patients' cultures with or without mitogen (PHA and ConA) stimulation. (4) No definite factors such as sex, age at first transfusion, number of transfusions or HBsAg carrier status correlated with the abnormal change of immunological tests. (5) Immunological investigation, done on 2 occasions six months apart, revealed no significant modifications except that 13 patients (19%) who were initially seronegative for CMV converted to seropositive. These investigations suggest that, although saline-washed RBC was used for the transfused patients, there was high prevalence of HBV and CMV infection. Further studies of lymphocyte function (i.e. lymphokines) are needed to understand the increased spontaneous proliferation in culture and PHA, ConA mitogen responses.
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Affiliation(s)
- K C Hwang
- Department of Pediatrics, Provincial Tao-Yuan General Hospital
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36
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Abstract
The influences of acute or chronic nicotine pretreatment on ethanol-induced changes on gastric secretion, mucosal blood flow (GMBF), and glandular mucosal damage were studied in anesthetized rats. Ethanol administration decreased gastric acid secretion and GMBF, which were accompanied by a marked increase in gastric mucosal damage. Acute nicotine incubation 2 or 4 mg dose-dependently elevated both the titratable acid in the luminal solution and the gastric secretory volume; it also prevented the depressive action on GMBF and gastric mucosal damage in ethanol-treated animals. Chronic nicotine treatment for 10 days reduced the inhibitory action of ethanol on gastric acid secretion; the higher dose (25 micrograms/ml drinking water) potentiated the decrease of GMBF and the ulcerogenic property of ethanol. However, chronic treatment with the lower dose (5 micrograms/ml drinking water) had the opposite effects; it also markedly increased the gastric secretory volume. It is concluded that acute nicotine pretreatment elevates, whereas chronic nicotine pretreatment differentially affects GMBF. These effects could account for their protective or preventive actions on ethanol ulceration. The increase in nonacid gastric secretory volume by nicotine could partially explain its antiulcer effect. Furthermore, the acid secretory state of the stomach appears unrelated to the ulcerogenic property of ethanol.
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Affiliation(s)
- C H Cho
- Department of Pharmacology, Faculty of Medicine, University of Hong Kong
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37
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Abstract
Sucralfate possesses site protective and cytoprotective actions and heals ulcers effectively, but its effect on gastric mucosal blood flow is unknown. Using an ex vivo gastric chamber preparation, we studied the effect of sucralfate on gastric mucosal blood flow in rats by laser doppler flowmetry. Under both fasting and fed states, measurements of gastric mucosal blood flow and damage were made in rats after topical application of absolute ethanol alone or after pretreatment with sucralfate. Gastric mucosal damage was assessed by measuring the total area of haemorrhagic mucosal lesions. Ethanol induced gastric mucosal lesions were significantly less with sucralfate pretreatment than without (p less than 0.008). Mucosal blood flow significantly fell after ethanol application (p less than 0.001). The fall was significantly less in fed than in fasted rats (p less than 0.05), and after pretreatment with sucralfate 100 mg or 200 mg than without in both fasted (p less than 0.0008 and 0.00001, respectively) and fed (p less than 0.002 and 0.001, respectively) rats. Graded doses of sucralfate (25-400 mg) resulted in an increase in gastric mucosal blood flow in a dose dependent manner (r = 0.731, p less than 0.001). In conclusion that sucralfate increases gastric mucosal blood flow in rats and lessens the fall in blood flow in rats treated with ethanol, and this action may contribute to its protection against the vascular damage of mucosa by ethanol.
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Affiliation(s)
- B W Chen
- University Department of Medicine, University of Hong Kong, Queen Mary Hospital
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38
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Cho CH, Chen BW, Poon YK, Ng MM, Hui WM, Lam SK, Ogle CW. Dual effects of zinc sulphate on ethanol-induced gastric injury in rats: possibly mediated by an action on mucosal blood flow. J Pharm Pharmacol 1989; 41:685-9. [PMID: 2575145 DOI: 10.1111/j.2042-7158.1989.tb06341.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The present study examines the protective effect of zinc sulphate against ethanol-induced gastric mucosal ulcers in rats. Absolute ethanol decreased the gastric mucosal blood flow and produced haemorrhagic lesions in the glandular mucosa. Zinc sulphate preincubation in an ex-vivo stomach chamber preparation prevented the formation of ethanol-induced lesions and attenuated the decrease of blood flow produced by ethanol. Subcutaneous injection of the same doses of the drug at 15 and 30 min before ethanol exposure, markedly reduced the blood flow and also aggravated ethanol-induced gastric injury; however, when injected at 23 and 24 h before ethanol administration, zinc sulphate protected against lesion formation but had no effect on the vascular changes induced by ethanol in the gastric glandular mucosa. These findings show that the antiulcer effect of zinc sulphate occurs only when the drug is given orally, or injected s.c. 23 and 24 h before ethanol challenge. Furthermore, this protective action is probably not entirely mediated by preservation of the gastric mucosal blood flow.
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Affiliation(s)
- C H Cho
- Department of Pharmacology, Faculty of Medicine, University of Hong Kong
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39
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Chen BW, Lin DT, Lin KH, Chuu WM, Su S, Lin KS. An analysis of risk factor and survival in childhood acute lymphoblastic leukemia. Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi 1989; 30:299-308. [PMID: 2637611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
To study the survival and prognostic factor of childhood acute lymphoblastic leukemia, 78 newly-diagnosed cases between January 1982 and June 1987 in National Taiwan University Hospital were reviewed and analyzed. They were stratified into two groups, i.e. standard-risk (SR) and high-risk (HR), according to their pre-treatment leukocyte count and age. Following induction therapy, 97% of the SR patients and 80% of the HR patients attained complete remission. In the SR group, the 2- and 3-year failure-free survival rates were 37% and 24%, with a median survival of 16 months. In the HR group, failure-free survival at the second and third year were 11% and 4%, respectively, with a median survival of 5.3 months. Three factors are strongly related to induction failure, i.e. high leukocyte counts (greater than 50*10(9)/1), massive hepatomegaly and large lymph nodes. Univariate analysis of failure-free survival showed six variables with significant detrimental effects on eventual outcomes, i.e. high leukocyte counts (greater than 50*10(9)/1), meningeal leukemia, marked lymphadenopathy, age younger than 2 years and older than 10 years, massive hepatomegaly (greater than 6 cm), and high LDH level (greater than 800 u/1). However, statistical survival models should also determine the joint effects of the prognostic factors so that the relative importance of each factor can be assessed. High initial leukocyte count, disclosed by multivariate analysis, was the single most important factor detrimental to the continuance of complete remission (P = 0.0004). Preliminary results also revealed poor compliance and early relapse in this study. Possible causes of early failure are discussed. Conceptual education for family members, as well as management with effective cytoreductive therapies are urgently needed.
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Kuo CY, Lin DT, Tuu WM, Chen BW, Lin KH, Lin KS. Dyskeratosis congenita preceded by severe aplastic anemia: report of one case. Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi 1989; 30:337-41. [PMID: 2637616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Dyskeratosis congenita is a rare hereditary disease which usually manifests with skin hyperpigmentation, nail dystrophy, and leukoplakia of the mucous membrane (triad). This report describes a six-year-old boy with severe aplastic anemia who was later diagnosed to have dyskeratosis congenita. His unusual presentation was pancytopenia followed by leukoplakia of the tongue, hyperpigmentation of the skin and dystrophy of the nails. Treatment with horse anti-human lymphocyte immunoglobulin (ALG) for his aplastic anemia was not effective.
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Chen BW, Chang MH, Lin DT, Lin KH, Chuu WM, Lin KS. Extrahepatic biliary obstruction caused by cancer of non-liver origin in children: report of 5 cases. Taiwan Yi Xue Hui Za Zhi 1989; 88:819-23. [PMID: 2592945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Obstructive jaundice secondary to external compression of the extrahepatic bile duct caused by tumor of non-liver origin was found in 5 of 199 consecutive children with cancer between 1986 and 1988 at the Department of Pediatrics, National Taiwan University Hospital. Of the 5 patients, 2 had non-Hodgkin's lymphoma and the other 3 had acute promyelocytic leukemia, histiocytosis X and neuroblastoma, respectively. Extrahepatic biliary obstruction occurred as part of the initial presentation of malignancy in 3 cases, and later in the course of disease in the other 2 cases. In each instance, abdominal ultrasonography and computed tomography revealed dilatation of intrahepatic biliary trees due to mass compressing effects. A huge multilobulated tumor and multiple enlarged lymph nodes near the porta hepatis were found in all 3 patients who underwent an exploratory laparotomy. Wedge biopsy of the liver showed no cancer cell invasion. One case died before chemotherapy had commenced. The other 4 patients received chemotherapy and 3 of them received additional radiotherapy. Although jaundice and tumor regressed dramatically with this mode of treatments, subsequent recurrence of tumor without jaundice rapidly ensued in 3 patients. They all died, except 1 case, within 18 months from the occurrence of jaundice. This suggests that these patients were in an advanced stage of disease and should be diagnosed early and treated vigorously. Accordingly, cancer of non-liver origin, although rare, should be considered in the differential diagnosis of obstructive jaundice if survival is to be improved in these cancer children.
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Shieh CC, Chen BW, Lin KH. Late onset hemorrhagic cystitis after allogeneic bone marrow transplantation. Taiwan Yi Xue Hui Za Zhi 1989; 88:508-11. [PMID: 2551995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Three patients with acute myeloblastic leukemia, thalassemia major and aplastic anemia experienced hemorrhagic cystitis on the 23rd, 35th and 36th day respectively after allogeneic bone marrow transplantation. The conditioning regimens before transplantation comprised cyclophosphamide with or without busulfan and total lymphoid irradiation. The hematuria lasted from 5 to 45 days and then subsided after treatment. Multiple factors including the toxicity of chemotherapeutic agents, viral infection and graft-versus-host reactions may contribute to late onset hemorrhagic cystitis after allogeneic bone marrow transplantation. Adequate treatment to minimize urothelial damage from chemotherapy, screening for viral infection and controlling graft-versus-host disease are mandatory in decreasing the complication of late-onset hemorrhagic cystitis after bone marrow transplantation.
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Cho CH, Pang SF, Chen BW, Pfeiffer CJ. Modulating action of melatonin on serotonin-induced aggravation of ethanol ulceration and changes of mucosal blood flow in rat stomachs. J Pineal Res 1989; 6:89-97. [PMID: 2921717 DOI: 10.1111/j.1600-079x.1989.tb00406.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Effects of melatonin and serotonin on ethanol ulceration and mucosal blood flow in the rat stomach were investigated. Melatonin and serotonin (5-HT) administration did not produce observable gastric injury in the ex vivo stomach, but the 5-HT dose dependently reduced glandular mucosal blood flow (GMBF) in this organ. Ethanol depressed GMBF and induced visible glandular mucosal injury. The latter effect was prevented by melatonin preincubation. Serotonin pretreatment aggravated the gastric mucosal injury and GMBF changes induced by ethanol; these actions were partially reversed by melatonin. The findings indicate that the GMBF and gastric injury are related; the reduction in FMBF, however, may not be the sole factor responsible for ulceration. The antagonistic effects of melatonin on 5-HT action on the stomach suggest that melatonin may act as a modulator for 5-HT action on the gastrointestinal tract.
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Affiliation(s)
- C H Cho
- Department of Pharmacology, Faculty of Medicine, University of Hong Kong
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Hu FL, Jia BQ, Chen BW. [Ranitidine and cimetidine in short-term treatment of duodenal ulcer and their acid inhibitory effect in patients with duodenal ulcer]. Zhonghua Nei Ke Za Zhi 1987; 26:468-70, 510. [PMID: 3428033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Ding XC, Chen BW, Shen JF, Gu WH, Cao WJ. [Pharmacokinetics of fluorocarbon blood substitute]. Zhongguo Yao Li Xue Bao 1983; 4:262-4. [PMID: 6230872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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