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Tang YH, Huang ZN, Chen QY, Li P, Xie JW, Wang JB, Lin JX, Lu J, Cao LL, Lin M, Tu RH, Zheng CH, Huang CM. [Prognostic significance of textbook outcome in advanced gastric patients who underwent neoadjuvant chemotherapy followed by surgical resection]. Zhonghua Wai Ke Za Zhi 2024; 62:379-386. [PMID: 38548605 DOI: 10.3760/cma.j.cn112139-20231209-00261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/09/2024]
Abstract
Objective: To investigate the risk factors and prognostic value of the textbook outcome (TO) in patients with advanced gastric cancer (AGC) who underwent neoadjuvant chemotherapy followed by surgical resection. Methods: This is a retrospective cohort study. A total of 253 patients with AGC who underwent neoadjuvant chemotherapy combined with gastrectomy and D2 lymphadenectomy in the Department of Gastric Surgery, Fujian Medical University Union Hospital from January 2010 to December 2019 were retrospectively included. There were 195 males and 58 females, aged (60.3±10.0) years (range: 27 to 75 years). The patients were then divided into the TO group (n=168) and the non-TO group (n=85). Multivariate Logistic regression was used to analyze the independent predictors of TO. Univariate and multivariate Cox analysis were used to analyze independent prognosis factors for overall survival (OS) and disease-free survival (DFS). Propensity score matching was performed to balance the TO and non-TO groups, and the Kaplan-Meier method was used to calculate survival rates and draw survival curves. Results: Among the 253 patients, 168 patients (66.4%) achieved TO. The Eastern Cooperative Oncology Group score (OR=0.488, 95%CI: 0.278 to 0.856, P=0.012) and ypN stage (OR=0.626, 95%CI:0.488 to 0.805, P<0.01) were independently predictive of TO. Multivariate analysis revealed that TO was an independent risk factor for both OS (HR=0.662, 95%CI: 0.457 to 0.959,P=0.029) and DFS (HR=0.687, 95%CI: 0.483 to 0.976, P=0.036). After matching, the 5-year OS rate (42.2% vs. 27.8%) and the 5-year DFS rate (37.5% vs. 27.8%) were significantly higher in the TO group than in the non-TO group (both P<0.05). Furthermore, patients in the non-TO group benefited significantly from postoperative chemotherapy (both P<0.05), but those in the TO group did not (both P>0.05). Conclusion: TO is an independent prognosis factor in patients undergoing neoadjuvant chemotherapy and surgery for AGC and is associated with postoperative chemotherapy benefits.
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Affiliation(s)
- Y H Tang
- Department of Gastric Surgery, Department of General Surgery, Fujian Province Minimally Invasive Medical Center, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - Z N Huang
- Department of Gastric Surgery, Department of General Surgery, Fujian Province Minimally Invasive Medical Center, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - Q Y Chen
- Department of Gastric Surgery, Department of General Surgery, Fujian Province Minimally Invasive Medical Center, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - P Li
- Department of Gastric Surgery, Department of General Surgery, Fujian Province Minimally Invasive Medical Center, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - J W Xie
- Department of Gastric Surgery, Department of General Surgery, Fujian Province Minimally Invasive Medical Center, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - J B Wang
- Department of Gastric Surgery, Department of General Surgery, Fujian Province Minimally Invasive Medical Center, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - J X Lin
- Department of Gastric Surgery, Department of General Surgery, Fujian Province Minimally Invasive Medical Center, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - J Lu
- Department of Gastric Surgery, Department of General Surgery, Fujian Province Minimally Invasive Medical Center, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - L L Cao
- Department of Gastric Surgery, Department of General Surgery, Fujian Province Minimally Invasive Medical Center, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - M Lin
- Department of Gastric Surgery, Department of General Surgery, Fujian Province Minimally Invasive Medical Center, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - R H Tu
- Department of Gastric Surgery, Department of General Surgery, Fujian Province Minimally Invasive Medical Center, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - C H Zheng
- Department of Gastric Surgery, Department of General Surgery, Fujian Province Minimally Invasive Medical Center, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - C M Huang
- Department of Gastric Surgery, Department of General Surgery, Fujian Province Minimally Invasive Medical Center, Fujian Medical University Union Hospital, Fuzhou 350001, China
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Zheng HL, Wei LH, Lu J, Huang CM. [Quality control of gastric resection range in laparoscopic locally advanced gastric cancer]. Zhonghua Wei Chang Wai Ke Za Zhi 2024; 27:143-147. [PMID: 38413080 DOI: 10.3760/cma.j.cn441530-20231216-00222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
After nearly 30 years of exploration and practice, minimally invasive surgical techniques represented by laparoscopic technology have become an important means for the surgical treatment of gastric cancer. In China, laparoscopic radical resection for locally advanced gastric cancer has been extensively carried out. However, there are still controversies regarding the gastric resection range and methods for advanced gastric cancer. By reviewing relevant domestic and foreign guideline documents and combining team practice experience, this article elaborates on the key points of quality control of laparoscopic gastric resection range for locally advanced gastric cancer from aspects such as tumor localization and gastric resection range for upper, middle and lower gastric tumors. It aims to provide reference for carrying out and promoting laparoscopic radical gastrectomy more safely.
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Affiliation(s)
- H L Zheng
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fu Zhou 350001, China
| | - L H Wei
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fu Zhou 350001, China
| | - J Lu
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fu Zhou 350001, China
| | - C M Huang
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fu Zhou 350001, China
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Jiang YM, Jia J, Zhong Q, Chen QY, Lu J, Wang JB, Xie JW, Li P, Zheng ZH, Huang CM, Li XY, Lin JX. [Establishment of a nomogram prediction model using common preoperative indicators for early weight loss after laparoscopic sleeve gastrectomy]. Zhonghua Wei Chang Wai Ke Za Zhi 2023; 26:1058-1063. [PMID: 37974351 DOI: 10.3760/cma.j.cn441530-20230826-00069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Objectives: To construct a nomogram prediction model using common preoperative indicators for early weight loss (EWL) 1 year after laparoscopic sleeve gastrectomy (LSG). Methods: Relevant data of obese patients who had undergone LSG from January 2015 to May 2022 in Fujian Medical University Union Hospital and Quanzhou First Hospital Affiliated Fujian Medical University were analyzed. Patients with a history of major abdominal surgery, severe gastroesophageal reflux disease, pregnancy within 1 year after surgery, or who were lost to follow-up were excluded, resulting in a total of 200 patients in the study (190 from Fujian Medical University Union Hospital and 10 from Quanzhou First Hospital Affiliated Fujian Medical University). The participants were 51 men and 149 women of a mean age 29.9±8.2 years and a body mass index (BMI) 38.7±6.5 kg/m2. All patients in this group underwent standardized LSG procedure. Achieving ideal weight (BMI≤25 kg/m2) 1 year after LSG was defined as goal of EWL. Logistic regression analyses were performed to identify factors that independently influenced EWL. These factors were incorporated into the nomogram model. Receiver operating characteristic (ROC) curves (the larger the area under the curve [AUC], the better the predictive ability and accuracy of the model), likelihood ratio test (higher likelihood ratio indicates greater model homogeneity), decision curve analysis (higher net benefit indicates a better model), Akaike information criterion (AIC; smaller AIC indicates a better model), and Bayesian information criterion (BIC; smaller BIC indicates a better model) were used to validate the predictive ability of the column line diagram model. Results: In this study of 200 obese patients who underwent LSG surgery, 136 achieved EWL goal, whereas the remaining 64 did not. The rate of EWL goal achievement of the entire group was 68.0%. Compared with patients who did not achieve EWL goal, those who did had lower BMI, alanine transaminase, aspartate transaminase, triglycerides, and higher cholesterol. Additionally, the proportion of female was higher and the proportions of patients with fatty liver and hypertension lower in those who achieved EWL goal (all P<0.05). Univariate and multivariate logistic regression analysis revealed that preoperative BMI (OR=0.852, 95%CI: 0.796-0.912, P<0.001), alanine transaminase (OR=0.992, 95%CI: 0.985-0.999, P=0.024), presence of fatty liver (OR=0.185, 95%CI: 0.038-0.887, P=0.035) and hypertension (OR=0.374, 95%CI: 0.144-0.969, P=0.043) were independently associated with failure to achieve EWL goal. Cholesterol (OR=1.428, 95%CI: 1.052-1.939, P=0.022) was independently associated with achieving EWL goal. We used the above variables to establish an EWL nomogram model. ROC analysis, the likelihood ratio test, decision curve analysis, and AIC all revealed that the predictive value of the model was better than that of BMI alone (nomogram model vs. BMI: area under the curve 0.840 vs. 0.798, P=0.047; likelihood ratio: 58.785 vs. 36.565, AIC: 193.066 vs. 207.063, BIC: 212.856 vs. 213.660). Conclusion: Our predictive model is more accurate in predicting EWL after LSG compared with using BMI.
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Affiliation(s)
- Y M Jiang
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - J Jia
- Department of Gastrointestinal Surgery, Quanzhou First Hospital Affiliated Fujian Medical University, Quanzhou 362000, China
| | - Q Zhong
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - Q Y Chen
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - J Lu
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - J B Wang
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - J W Xie
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - P Li
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - Z H Zheng
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - C M Huang
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - X Y Li
- Department of Gastrointestinal Surgery, Quanzhou First Hospital Affiliated Fujian Medical University, Quanzhou 362000, China
| | - J X Lin
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China
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Huang ZN, Zheng CY, Lu J, Huang CM. [Prevention and management of complications related to laparoscopic spleen-preserving hilar lymph node dissection for gastric cancer]. Zhonghua Wei Chang Wai Ke Za Zhi 2023; 26:132-137. [PMID: 36797558 DOI: 10.3760/cma.j.cn441530-20221102-00449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Hilar splenic lymph node metastasis is one of the risk factors for poor prognosis in patients with proximal gastric cancer. Laparoscopic spleen-preserving splenic hilar lymph node dissection (LSPSHLD) can effectively improve the survival benefits of patients at high risk of splenic hilar lymph node metastasis. However, LSPSHLD is still a challenging surgical difficulty in radical resection of proximal gastric cancer. Moreover, improper operation can easily lead to splenic vascular injury, spleen injury and pancreatic injury and other related complications, due to the deep anatomical location of the splenic hilar region and the intricate blood vessels.Therefore, in the prevention and treatment of LSPSHLD-related complications, we should first focus on prevention, clarify the indication of surgery, and select the benefit group of LSPSHLD individually, so as to avoid the risk caused by over-dissection. Meanwhile, during the perioperative period of LSPSHLD, it is necessary to improve the cognition of related risk factors, conduct standardized and accurate operations in good surgical field exposure and correct anatomical level to avoid surrounding tissues and organs injury, and master the surgical skills and effective measures to deal with related complications, so as to improve the surgical safety of LSPSHLD.
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Affiliation(s)
- Z N Huang
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - C Y Zheng
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China Department of Gastrointestinal Surgery, the Affiliated Hospital of Putian University, Putian 351100, China
| | - J Lu
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - C M Huang
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China
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Zhang X, Gao SH, Han JY, Huang CM, Zhang L. [Influencing factors of Legionella reproduction in secondary water supply operation and management]. Zhonghua Yu Fang Yi Xue Za Zhi 2022; 56:1612-1617. [PMID: 36372752 DOI: 10.3760/cma.j.cn112150-20220614-00604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Objective: To analyze the pollution status and influencing factors of Legionella pneumophila in a secondary water supply facility in a city. Methods: From June to August 2020, a survey on the level of Legionella pneumophila in secondary water supply unit was carried out in a city in northern China, and 304 sets of secondary water supply facilities were included in the study. A total of 760 water samples were collected from the inlet and outlet water of the secondary water supply facilities and some water samples in the water tank were collected for the detection of Legionella pneumophila, standard plate-count bacteria and related physical and chemical indicators. Through questionnaire survey, the basic information of secondary water supply facilities and daily management of water quality were collected. Multivariate logistic regression model was used to analyze the influencing factors of Legionella pneumophila contamination. Results: Among 304 sets of secondary water supply facilities, most of them were located in residential buildings [57.24% (174/304)]. High and low water tank water supply, low water tank variable frequency conversion water supply and non-negative pressure water supply accounted for 26.6% (81/304), 36.8% (112/304) and 36.5% (111/304), respectively. About 25.7% of facilities (78/304) were positive for Legionella pneumophila. Among them, the positive rates of Legionella pneumophila in high and low water tank water supply, low water tank variable frequency conversion water supply and non-negative pressure water supply facilities were 38.3% (31/81), 29.5% (33/112) and 12.6% (14/111), respectively. The results of multivariate logistic regression model analysis showed that the disinfectant residue could reduce the risk of Legionella pneumophila contamination in water samples, and the OR (95%CI) value was 0.083 (0.022-0.317). The increase of the standard plate-count bacteria and conductivity might increase the risk of Legionella pneumophila contamination in water samples. The OR (95%CI) values were 3.160 (1.667-5.99) and 1.004 (1.001-1.006), respectively. Compared with the non-negative pressure water supply, the risk of Legionella pneumophila contamination of secondary water supply facilities was increased by water supply from high and low water tanks and variable frequency conversion water supply from low water tanks, with OR (95%CI) values of 4.296 (2.096-8.803) and 2.894 (1.449-5.782), respectively. Conclusion: The positive rate of Legionella pneumophila in secondary water supply in the study city is high. Disinfectant residue, conductivity and method of water supply are associated with the positive rate of Legionella pneumophila.
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Affiliation(s)
- X Zhang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - S H Gao
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - J Y Han
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - C M Huang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - L Zhang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
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Lin JX, Wu D, Jiang YM, Chen JY, Lin GT, Li P, Xie JW, Wang JB, Lu J, Chen QY, Cao LL, Zheng CH, Huang CM. [Effect of splenic hilar lymphadenectomy on locally advanced Siewert type Ⅱ and Ⅲ adenocarcinoma of esophagogastric junction with a tumor diameter ≥4 cm: a five-year survival analysis]. Zhonghua Wai Ke Za Zhi 2022; 60:853-859. [PMID: 36058712 DOI: 10.3760/cma.j.cn112139-20220415-00167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To examine the long term outcome of splenic hilar lymphadenectomy (SHL) for locally advanced Siewert type Ⅱ and Ⅲ adenocarcinoma of esophagogastric junction (AEG) with a tumor diameter ≥4 cm. Methods: A total of 489 locally advanced Siewert type Ⅱ and Ⅲ AEG patients with a tumor diameter ≥4 cm who underwent radical resection from January 2010 to April 2016 were included. There were 383 males and 106 females. There were 225 patients aged≥65 years and 264 patients aged <65 years. SHL was conducted in 270 patients(SHL group). Wilcoxon rank-sum test or χ2 test were conducted for inter-group comparison. Cox proportional hazard regression was used to analyze the long term outcome of SHL and the prognosis factors of overall survival. Kaplan-Meier curve was drawn finally. The results of survival analysis were verified by Log-rank test. Results: Followed-up to April 2021,the median follow-up time was 78.0 months (range: 74.0 to 85.0 months), the follow-up rate was 95.5%(467/489). The splenic hilar lymphnode metastasis rate of the SHL group was 12.6% (34/270). Younger patients (<65 years old), less complications, higher proportion of patients received adjuvant chemotherapy were demonstrated in the SHL group (χ2: 5.644 to 6.744, all P<0.05). Multivariate analysis showed that SHL was the independent prognosis factor of overall survival for patients with Siewert type Ⅱ and Ⅲ AEG and a tumor diameter≥4 cm (HR=0.68, 95%CI: 0.52 to 0.88, P=0.004) along with preoperative CA19-9, pathological T stage, pathological N stage, adjuvant chemotherapy and postoperative complication. Further subgroup analysis demonstrated that the SHL group had better 5-year overall survival than non-SHL group (62.4% vs. 39.2%, χ2=17.983, P=0.006) in Siewert type Ⅲ AEG rather than in Siewert type Ⅱ AEG(57.3% vs. 53.7%, χ2=3.031, P=0.805). Conclusion: In experienced center, splenic hilar lymphadenectomy can improve the prognosis of Siewert type Ⅲ AEG with a tumor diameter ≥4 cm.
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Affiliation(s)
- J X Lin
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Gastrointestinal Cancer, (Ministry of Education), Fuzhou 350001, China
| | - D Wu
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Gastrointestinal Cancer, (Ministry of Education), Fuzhou 350001, China
| | - Y M Jiang
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Gastrointestinal Cancer, (Ministry of Education), Fuzhou 350001, China
| | - J Y Chen
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Gastrointestinal Cancer, (Ministry of Education), Fuzhou 350001, China
| | - G T Lin
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Gastrointestinal Cancer, (Ministry of Education), Fuzhou 350001, China
| | - P Li
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Gastrointestinal Cancer, (Ministry of Education), Fuzhou 350001, China
| | - J W Xie
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Gastrointestinal Cancer, (Ministry of Education), Fuzhou 350001, China
| | - J B Wang
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Gastrointestinal Cancer, (Ministry of Education), Fuzhou 350001, China
| | - J Lu
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Gastrointestinal Cancer, (Ministry of Education), Fuzhou 350001, China
| | - Q Y Chen
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Gastrointestinal Cancer, (Ministry of Education), Fuzhou 350001, China
| | - L L Cao
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Gastrointestinal Cancer, (Ministry of Education), Fuzhou 350001, China
| | - C H Zheng
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Gastrointestinal Cancer, (Ministry of Education), Fuzhou 350001, China
| | - C M Huang
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Gastrointestinal Cancer, (Ministry of Education), Fuzhou 350001, China
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Lin GT, Chen JY, Wu D, Lin JX, Huang CM. [Quality of life after totally laparoscopic versus laparoscopic-assisted total gastrectomy: a retrospective cohort study with propensity score matching]. Zhonghua Wei Chang Wai Ke Za Zhi 2022; 25:699-707. [PMID: 35970804 DOI: 10.3760/cma.j.cn441530-20220301-00074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To evaluate the postoperative quality of life in patients after totally laparoscopic total gastrectomy (TLTG). Methods: A retrospective cohort study based on propensity score matching was performed. Clinical and follow-up data of patients who underwent laparoscopic radical gastrectomy at Union Hospital of Fujian Medical University from January 2014 to May 2015 were collected. Case indusion criteria: (1) primary gastric cancer confirmed by postoperative pathology; (2) receiving TLTG or laparoscopic-assisted total gastrectomy (LATG);(3) R0 resection; (4) completing follow-up for 12 months and complete follow-up data. Exclusion criteria: (1) gastric stump cancer; (2) concurrent tumor; (3) distal metastasis found during operation; (4) history of upper abdominal operation. According to surgical procedures, patients were divided into the LATG group (1076 cases) and the TLTG group (106 cases). To eliminate potential bias in baseline data between the two groups, the propensity score was calculated using a logistic regression model with the following covariates, including age, sex, body mass index, American Society of Anesthesiologists score, tumor location, tumor size, pathology type, and stage. The two groups were matched using a 1:2 propensity assessment ratio and a caliper width of 0.01 standard deviation was specified. The primary outcomes were the quality of life of the two groups at 3, 6 and 12 months after gastrectomy, including physical symptoms and social function. Higher function score indicated better function, and higher symptom score presented worse symptoms. Quality of life score = (100 - somatic symptom scale score + social function scale score) / 2. The secondary outcomes were postoperative nutritional recovery and food tolerance at 3, 6 and 12 months after gastrectomy. The categorical variables were expressed as n(%), and compared using the χ2 test or Fisher exact test. The continuous variables conforming to the normal distribution were represented by Mean ± SD and compared with the paired t-test. Repeated measurement of variance was used to compare nutrition-related indicators within the group among pre-operation, postoperative 1, 3, 6, 12 months. Results: After PSM, there were no significant differences in clinicopathological baseline data between the TLTG group (n=104) and the LATG group (n=208) (all P>0.05). The physical symptoms scores in the TLTG group before operation and 3, 6 and 12 months after operation were 8.6±5.8, 15.5±8.4, 10.1±5.9 and 6.1±2.4 respectively (F=43.493, P<0.001). In the LATG group, the above mentioned scores were 9.7±6.9, 23.7±10.4, 13.3±8.3 and 8.5±4.2 respectively (F=112.588, P<0.001). Compared with the LATG group, the symptom scores in the TLTG group were lower at 3 and 6 months after operation, and the differences were statistically significant (t=-3.653, P<0.001; t=-2.513, P=0.012). At 12 months after operation, although the physical symptom score in the TLTG group was also lower than that in LATG group, the difference was not statistically significant (t=-1.487, P=0.138). The social function scores in the TLTG group before operation and 3, 6 and 12 months after operation were 90.3±8.9, 77.5±14.3, 87.4±10.3 and 91.7±6.7 respectively (F=28.524, P<0.001). In the LATG group, the above mentioned scores were 92.5±6.3, 68.5±16.8, 79.8±14.7 and 84.7±11.1 respectively (F=57.975, P<0.001). Compared with the LATG group, the social function scores of patients in the LATG group were higher at 3, 6 and 12 months after operation (t=3.543, P<0.001; t=3.216, P=0.001; t=2.235, P=0.026). The total scores of quality of life at 3, 6 and 12 months after operation in the TLTG group were 81.0±15.6, 88.3±8.1 and 93.3±9.1 respectively, and the above mentioned scores in the LATG group were 72.4±13.6, 83.3±11.5 and 88.1±7.7 respectively, whose differences at corresponding time point were all significant between the two groups (all P<0.05). The change of total body mass[(-8.4±1.4)% vs. (-13.2±1.6)%, t=2.273, P=0.024], serum albumin[(-5.1±0.7)% vs. (-7.4±0.8)%,t=2.095, P=0.037], meal quantity [(-15.6±4.7)% vs. (-24.1±6.0)%, t=2.885, P=0.004] and meal times [(20.8±7.1)% vs. (30.6±11.5)%, t=3.043, P<0.001] in the TLTG group were significantly lower than those in the LATG group one year after operation (all P<0.05). At 3, 6 and 12 months after operation, the diet proportions of solid and soft food in the TLTG group were higher than those in the LATG group (all P<0.05). Conclusions: Compared with LATG, patients with gastric cancer undergoing TLTG have better health-related quality of life and faster recovery of nutrition.
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Affiliation(s)
- G T Lin
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350004, China
| | - J Y Chen
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350004, China
| | - D Wu
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350004, China
| | - J X Lin
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350004, China
| | - C M Huang
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350004, China
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Tamai H, Ikeda K, Miyamoto T, Taguchi H, Kuo CF, Shin K, Hirata S, Okano Y, Sato S, Yasuoka H, Choi IA, Park SH, Weng MY, Kuwana M, Lee YJ, Ishii T, Kim J, Kameda H, Kojima T, Baek HJ, Hsu PN, Huang CM, Cheng TT, Sung WY, Taninaga T, Mori M, Miyagishi H, Sato Y, Takeuchi T, Kaneko Y. OP0062 EFFICACY AND SAFETY OF ADALIMUMAB WITH LOW AND HIGH DOSE-METHOTREXATE IN PATIENTS WITH RHEUMATOID ARTHRITIS WITH INADEQUATE RESPONSE TO METHOTREXATE: THE RANDOMISED CONTROLLED MIRACLE STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundRheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease that causes not only joint pain but also bone destruction resulting in impairment of quality of life. Tumor necrosis factor inhibitors have improved prognosis of patients with rheumatoid arthritis dramatically, especially in combination with methotrexate, however, the optimal dose of the concomitant methotrexate is unclear.ObjectivesTo evaluate the efficacy and safety of adalimumab in combination with reduced dose of methotrexate in patients with early RA with inadequate response to methotrexate.MethodsThe MIRACLE study was a multinational, randomized, open-label study in patients with RA with inadequate response to methotrexate conducted in Asia. It compared low dose and high dose methotrexate upon starting adalimumab. Methotrexate-naive patients with RA with a disease duration of less than two years started methotrexate at 6 to 8 mg/week and increased it to the maximum tolerable dose by week 12. Patients who have not achieved remission according to simplified disease activity index (SDAI) despite methotrexate ≥ 10 mg/week at week 24 were randomised to the maximum tolerable dose of methotrexate group (10 to 25 mg/week) or the reduced dose group (6 to 8 mg/week) and started to receive subcutaneous adalimumab 40 mg every other week. The primary endpoint was non-inferiority in the achievement of SDAI remission at week 48 in the reduced dose group compared with the maximum tolerable dose group with a non-inferiority margin of -15% based on two-sided 90% confidence interval. (NCT03505008)ResultsA total of 300 patients were enrolled in the study. Among them, 291 started methotrexate and were included in the analysis. The mean age was 57.7±15.2 years, female was 74.6%, and the mean disease duration from the diagnosis of RA was 21.1±56.2 days. Anti-CCP antibody was positive in 211 (73.0%) and the mean SDAI at study enrollment was 26.5±12.4. At week 24, with the mean dose of methotrexate of 12.6±2.9 mg/week, 108 patients (37.1%) achieved remission according to SDAI and continued MTX monotherapy. 134 patients (46.0%) were randomised and started adalimumab with 68 patients in the maximum tolerable dose group and 66 patients in the reduced dose group. At week 48, the remission achievement rates were 38.4 % and 44.8 %, respectively, with the adjusted risk difference of the reduced dose group to the maximum tolerable dose group of 6.4% (-7.0% to 19.8%, 90% CI), which met the criterion for noninferiority. No significant difference was found in health assessment questionnaire disability index ≤0.5 (59.1% vs 62.0%, respectively, p=0.72) and in radiological remission rates (Δmodified total Sharp score ≤0.5, 66.3% vs 62.0 %, respectively, p=0.59). Adverse drug reactions tended to be more frequent in the maximum tolerable dose group than in the reduced dose group (22.1% vs 9.1%, respectively, p=0.06).ConclusionThe MIRACLE randomised study demonstrated that, in patients with inadequate response to methotrexate, the efficacy of adalimumab with reduced dose of concomitant methotrexate was not inferior to that with maximum tolerable dose of methotrexate with better safety profile.Disclosure of InterestsHiroya Tamai Speakers bureau: Eisai, Grant/research support from: Eisai, Kei Ikeda Speakers bureau: AbbVie, Eisai, Eli Lilly, Novartis, Gilead, Asahi-Kasei, Grant/research support from: Mitsubishi-Tanabe, Toshiaki Miyamoto: None declared, Hiroaki Taguchi: None declared, Chang-Fu Kuo: None declared, Kichul Shin: None declared, Shintaro Hirata Speakers bureau: AbbVie, Asahi-Kasei, Astellas, Ayumi, Bristol Myers Squibb, Celgene, Chugai, Eisai, Eli Lilly, Gilead, Glaxo SmithKline, Janssen, Kyorin, Novartis, Pfizer, Sanofi, Tanabe-Mitsubishi, UCB, Paid instructor for: AbbVie, Mitsubishi-Tanabe, Consultant of: AbbVie, Astellas, Bristol Myers Squibb, Eisai, Gilead, Ily Lilly, Grant/research support from: AbbVie, Asahi-Kasei, Eisai, Otsuka, Sanofi, Shionogi, Chugai, Pfizer, Tanabe-Mitsubishi, Eli Lilly, UCB, yutaka okano: None declared, Shinji Sato Speakers bureau: AbbVie, Eisai, Grant/research support from: AbbVie, Eisai, Hidekata Yasuoka Speakers bureau: AbbVie, Asahi Kasei Pharma, Astellas, Daiichi-Sankyo, Eisai, Kissei, Takeda, Mitsubishi-Tanabe, Chugai, Novartis, Eli Lilly, Pfizer, Janssen, Sanofi, Teijin, Boehringer-Ingelheim, Bayer, Glaxo Smith Kline, Paid instructor for: AbbVie, Consultant of: AbbVie, Asahi Kasei, Grant/research support from: Mitsubishi-Tanabe, Takeda, Daiichi-Sankyo, Chugai, Bristol-Myers, MSD, Astellas, In Ah Choi Speakers bureau: Abbvie, Eisai, Sung-Hwan Park: None declared, Meng-Yu Weng Paid instructor for: Novartis, Eli Lilly, ChuGai, Abbvie, Consultant of: Abbvie, Masataka Kuwana Speakers bureau: Astellas, Asahi Kasei Pharma, Boehringer-Ingelheim, Chugai, Eisai, Janssen, Mochida, Nippon Shinyaku, Ono Pharmaceuticals, Pfizer, Mitsubishi-Tanabe, Consultant of: Boehringer-Ingelheim, Kissei, Mochida, Grant/research support from: AbbVie, Asahi Kasei Pharma, Boehringer-Ingelheim, Chugai, Eisai, MBL, Nippon Shinyaku, Ono Pharmaceuticals, Mitsubishi-Tanabe, Yun Jong Lee Grant/research support from: Yuhan, Tomonori Ishii Speakers bureau: Chugai, Mitsubishi-Tanabe, Glaxo Smith Kline, Pfizer, Eli Lilly, Janssen, AbbVie, Eisai, Astellas, Jinhyun Kim: None declared, Hideto Kameda Speakers bureau: AbbVie, Pfizer, Consultant of: AbbVie, Grant/research support from: AbbVie, Eisai, Toshihisa Kojima Speakers bureau: AbbVie, Pfizer, Eisai, Grant/research support from: AbbVie, Han Joo Baek: None declared, Ping-Ning Hsu: None declared, Chun-Ming Huang Paid instructor for: Abbvie, Pfizer, Tien-Tsai Cheng Paid instructor for: Abbvie, Grant/research support from: Abbvie, Wan-Yu Sung: None declared, Takehiro Taninaga Shareholder of: Eisai.co.,Ltd., Employee of: Eisai.co.,Ltd., Masahiko Mori Shareholder of: Eisai.co.,Ltd., Employee of: Eisai.co.,Ltd., Hideaki Miyagishi Shareholder of: Eisai.co.,Ltd., Employee of: Eisai.co.,Ltd., Yasunori Sato Speakers bureau: Eisai Co., Ltd. Kowa Company, Ltd., Consultant of: MOCHIDA PHARMACEUTICAL CO., LTD, Tsutomu Takeuchi Speakers bureau: Astellas, AbbVie, Ayumi, Bristol Myers Squibb, Chugai, Daiichi-Sankyo, Eisai, Eli Lilly, Gilead, Glaxo Smith Kline, Janssen, Mitsubishi-Tanabe, Nippon-kayaku, Novartis, Pfizer, Sanofi, UCB, Grant/research support from: Asahi Kasei, AbbVie, Ayumi, Boehringer-Ingelheim, Chugai, Eisai, Eli Lilly, Mitsubishi-Tanabe, Sanofi, UCB, Yuko Kaneko Speakers bureau: Asahi Kasei, Astellas, Ayumi, Bristol Myers Squibb, Chugai, Eisai, Elli Lilly, Mitsubishi-Tanabe, Novartis, UCB, Grant/research support from: AbbVie, Chugai, Eisai, Mitsubishi-Tanabe, UCB.
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Zheng HL, Lin J, Huang CM. [Technical difficulties and countermeasures of digestive tract reconstruction in robotic radical gastrectomy for gastric cancer]. Zhonghua Wei Chang Wai Ke Za Zhi 2022; 25:392-395. [PMID: 35599393 DOI: 10.3760/cma.j.cn441530-20220304-00083] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
There still remain some problemsin digestive tract reconstruction after robotic radical gastrectomy for gastric cancer at present, such as great surgical difficulties and high technical requirements. Based on the surgical experience of the Gastric Surgery Department of Union Hospital, Fujian Medical University and the literatures at home and abroad, relevant issues are discussed in terms of robotic radical distal gastrectomy (Billroth I, Billroth II, and Roux-en-Y gastrojejunostomy), proximal gastrectomy (double-channel and double-muscle flap anastomosis), and total gastrectomy (Roux-en-Y anastomosis, functional end-to-end anastomosis, FEEA, π-anastomosis, Overlap anastomosis, and modified Overlap anastomosis with delayed amputation of jejunum, i.e. later-cut Overlap). This article mainly includes (1) The principles of digestive tract reconstruction after robotic radical gastrectomy for gastric cancer. (2) Digestive tract reconstruction after robotic radical distal gastrectomy: Aiming at the weakness of traditional triangular anastomosis, we introduce the improvement of the technical difficulty, namely "modified triangular anastomosis", and point out that because Billroth II anastomosis is a common anastomosis method in China at present, manual suture under robot is more convenient and safe, and can effectively avoid anastomotic stenosis. (3) Digestive tract reconstruction after robotic proximal gastrectomy: It mainly includes double channel anastomosis and double muscle flap anastomosis, but these reconstruction methods are relatively complicated, and robotic surgery has not been widely carried out at present. (4) Digestive tract reconstruction after robotic total gastrectomy: The most classic one is Roux-en-Y anastomosis, mainly using circular stapler for end-to-side esophagojejunal anastomosis and linear stapler for side-to-side esophagojejunal anastomosis, for which we discuss the solutions to the existing technical difficulties. With the continuous innovation of robotic surgical system and anastomosis instruments, and with the gradual improvement of anastomosis technology, it is believed that digestive tract reconstruction after robotic radical gastrectomy for gastric cancer will have a good application prospect in gastric cancer surgery.
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Affiliation(s)
- H L Zheng
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - J Lin
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - C M Huang
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China
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Lu J, Xu BB, Shen LL, Zheng CH, Li P, Xie JW, Wang JB, Lin JX, Chen QY, Huang CM. [Analysis of characteristics and trends of randomized controlled trials of gastric cancer between 2000 and 2019]. Zhonghua Wai Ke Za Zhi 2022; 60:479-486. [PMID: 35359091 DOI: 10.3760/cma.j.cn112139-20210730-00338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objectives: To analyze the current development status of gastric cancer (GC) randomized controlled trials (RCT) between 2000 and 2019, and to review the basic characteristics of published RCT. Methods: ClinicalTrials.gov was searched for phase 3 or 4 RCT conducted between January 2000 and December 2019 with the keyword "gastric cancer", and the development trend of different types of RCT during different time periods was described. Basic features of registered RCT such as intervention, study area, single-center or multicenter, sample size, and funding were presented. PubMed and Scopus databases were searched to judge the publication status of studies completed until June 2016. The adequacy of the report was estimated by the Consolidated Standards of Reporting Trials (CONSORT) checklist. Design flaws were evaluated by Cochrane tool and/or whether a systematic literature review was cited. The data was analyzed by χ2 test or Fisher exact test. Results: There were 262 RCT including in the present study. The number of GC-RCT registered on ClinicalTrials.gov had been on the rise from 1 case in 2000 to 30 cases in 2015. The proportion of RCT associated with targeted therapy or immunotherapy increased from 0 during 2000-2004 to 37.1% (36/97) during2015-2019. The RCT registered in Asia was 191 cases, while that in non-Asia region was 71 cases. The proportion of multi-center RCT from non-Asia was higher than that from Asia (70.4% (50/71) vs. 50.3% (96/191), χ²=8.527, P=0.003). The proportion of RCT published was 59.1% (81/137). Among the published RCT, 65 (80.2%) studies were reported adequately, but 63 (77.8%) studies had avoidable design limitations. Conclusions: Targeted therapy and immunotherapy have become research hotspots in the treatment of GC. At present, there are inadequate multicenter RCT in Asia, and the publication rate of RCT is low. A considerable number of published RCT are reported inadequately and have avoidable design flaws.
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Affiliation(s)
- J Lu
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fuzhou 350004, China
| | - B B Xu
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fuzhou 350004, China
| | - L L Shen
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fuzhou 350004, China
| | - C H Zheng
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fuzhou 350004, China
| | - P Li
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fuzhou 350004, China
| | - J W Xie
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fuzhou 350004, China
| | - J B Wang
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fuzhou 350004, China
| | - J X Lin
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fuzhou 350004, China
| | - Q Y Chen
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fuzhou 350004, China
| | - C M Huang
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fuzhou 350004, China
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Lu J, Xu BB, Shen LL, Zheng CH, Li P, Xie JW, Wang JB, Lin JX, Chen QY, Huang CM. [Analysis of characteristics and trends of randomized controlled trials of gastric cancer between 2000 and 2019]. Zhonghua Wai Ke Za Zhi 2022; 60:478-485. [PMID: 35417942 DOI: 10.3760/cma.j.cn112139-202100908-00429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objectives: To analyze the current development status of gastric cancer (GC) randomized controlled trials (RCT) between 2000 and 2019, and to review the basic characteristics of published RCT. Methods: ClinicalTrials.gov was searched for phase 3 or 4 RCT conducted between January 2000 and December 2019 with the keyword "gastric cancer", and the development trend of different types of RCT during different time periods was described. Basic features of registered RCT such as intervention, study area, single-center or multicenter, sample size, and funding were presented. PubMed and Scopus databases were searched to judge the publication status of studies completed until June 2016. The adequacy of the report was estimated by the Consolidated Standards of Reporting Trials (CONSORT) checklist. Design flaws were evaluated by Cochrane tool and/or whether a systematic literature review was cited. The data was analyzed by χ2 test or Fisher exact test. Results: There were 262 RCT including in the present study. The number of GC-RCT registered on ClinicalTrials.gov had been on the rise from 1 case in 2000 to 30 cases in 2015. The proportion of RCT associated with targeted therapy or immunotherapy increased from 0 during 2000-2004 to 37.1% (36/97) during 2015-2019. The RCT registered in Asia was 191 cases, while that in non-Asia region was 71 cases. The proportion of multi-center RCT from non-Asia was higher than that from Asia (70.4% (50/71) vs. 50.3% (96/191), χ²=8.527, P=0.003). The proportion of RCT published was 59.1% (81/137). Among the published RCT, 65 (80.2%) studies were reported adequately, but 63 (77.8%) studies had avoidable design limitations. Conclusions: Targeted therapy and immunotherapy have become research hotspots in the treatment of GC. At present, there are inadequate multicenter RCT in Asia, and the publication rate of RCT is low. A considerable number of published RCT are reported inadequately and have avoidable design flaws.
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Affiliation(s)
- J Lu
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fuzhou 350004, China
| | - B B Xu
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fuzhou 350004, China
| | - L L Shen
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fuzhou 350004, China
| | - C H Zheng
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fuzhou 350004, China
| | - P Li
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fuzhou 350004, China
| | - J W Xie
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fuzhou 350004, China
| | - J B Wang
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fuzhou 350004, China
| | - J X Lin
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fuzhou 350004, China
| | - Q Y Chen
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fuzhou 350004, China
| | - C M Huang
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fuzhou 350004, China
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Xue Z, Lu J, Lin J, Huang CM, Li P, Xie JW, Wang JB, Lin JX, Chen QY, Zheng CH. [Establishment of artificial neural network model for predicting lymph node metastasis in patients with stage Ⅱ-Ⅲ gastric cancer]. Zhonghua Wei Chang Wai Ke Za Zhi 2022; 25:327-335. [PMID: 35461201 DOI: 10.3760/cma.j.cn441530-20220105-00010] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To establish a neural network model for predicting lymph node metastasis in patients with stage II-III gastric cancer. Methods: Case inclusion criteria: (1) gastric adenocarcinoma diagnosed by pathology as stage II-III (the 8th edition of AJCC staging); (2) no distant metastasis of liver, lung and abdominal cavity in preoperative chest film, abdominal ultrasound and upper abdominal CT; (3) undergoing R0 resection. Case exclusion criteria: (1) receiving preoperative neoadjuvant chemotherapy or radiotherapy; (2) incomplete clinical data; (3) gastric stump cancer.Clinicopathological data of 1231 patients with stage II-III gastric cancer who underwent radical surgery at the Fujian Medical University Union Hospital from January 2010 to August 2014 were retrospectively analyzed. A total of 1035 patients with lymph node metastasis were confirmed after operation, and 196 patients had no lymph node metastasis. According to the postoperative pathologic staging. 416 patients (33.8%) were stage Ⅱ and 815 patients (66.2%) were stage III. Patients were randomly divided into training group (861/1231, 69.9%) and validation group (370/1231, 30.1%) to establish an artificial neural network model (N+-ANN) for the prediction of lymph node metastasis. Firstly, the Logistic univariate analysis method was used to retrospectively analyze the case samples of the training group, screen the variables affecting lymph node metastasis, determine the variable items of the input point of the artificial neural network, and then the multi-layer perceptron (MLP) to train N+-ANN. The input layer of N+-ANN was composed of the variables screened by Logistic univariate analysis. Artificial intelligence analyzed the status of lymph node metastasis according to the input data and compared it with the real value. The accuracy of the model was evaluated by drawing the receiver operating characteristic (ROC) curve and obtaining the area under the curve (AUC). The ability of N+-ANN was evaluated by sensitivity, specificity, positive predictive values, negative predictive values, and AUC values. Results: There were no significant differences in baseline data between the training group and validation group (all P>0.05). Univariate analysis of the training group showed that preoperative platelet to lymphocyte ratio (PLR), preoperative systemic immune inflammation index (SII), tumor size, clinical N (cN) stage were closely related to postoperative lymph node metastasis. The N+-ANN was constructed based on the above variables as the input layer variables. In the training group, the accuracy of N+-ANN for predicting postoperative lymph node metastasis was 88.4% (761/861), the sensitivity was 98.9% (717/725), the specificity was 32.4% (44/136), the positive predictive value was 88.6% (717/809), the negative predictive value was 84.6% (44/52), and the AUC value was 0.748 (95%CI: 0.717-0.776). In the validation group, N+-ANN had a prediction accuracy of 88.4% (327/370) with a sensitivity of 99.7% (309/310), specificity of 30.0% (18/60), positive predictive value of 88.0% (309/351), negative predictive value of 94.7% (18/19), and an AUC of 0.717 (95%CI:0.668-0.763). According to the individualized lymph node metastasis probability output by N+-ANN, the cut-off values of 0-50%, >50%-75%, >75%-90% and >90%-100% were applied and patients were divided into N0 group, N1 group, N2 group and N3 group. The overall prediction accuracy of N+-ANN for pN staging in the training group and the validation group was 53.7% and 54.1% respectively, while the overall prediction accuracy of cN staging for pN staging in the training group and the validation group was 30.1% and 33.2% respectively, indicating that N+-ANN had a better prediction than cN stage. Conclusions: The N+-ANN constructed in this study can accurately predict postoperative lymph node metastasis in patients with stage Ⅱ-Ⅲ gastric cancer. The N+-ANN based on individualized lymph node metastasis probability has better accurate prediction for pN staging as compared to cN staging.
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Affiliation(s)
- Z Xue
- Department of Gastric Surgery, Key Laboratory of Gastrointestinal Cancer (Ministry of Education), Fujian Medical University Union Hospital, Fuzhou 350004, China
| | - J Lu
- Department of Gastric Surgery, Key Laboratory of Gastrointestinal Cancer (Ministry of Education), Fujian Medical University Union Hospital, Fuzhou 350004, China
| | - J Lin
- Department of Gastric Surgery, Key Laboratory of Gastrointestinal Cancer (Ministry of Education), Fujian Medical University Union Hospital, Fuzhou 350004, China
| | - C M Huang
- Department of Gastric Surgery, Key Laboratory of Gastrointestinal Cancer (Ministry of Education), Fujian Medical University Union Hospital, Fuzhou 350004, China
| | - P Li
- Department of Gastric Surgery, Key Laboratory of Gastrointestinal Cancer (Ministry of Education), Fujian Medical University Union Hospital, Fuzhou 350004, China
| | - J W Xie
- Department of Gastric Surgery, Key Laboratory of Gastrointestinal Cancer (Ministry of Education), Fujian Medical University Union Hospital, Fuzhou 350004, China
| | - J B Wang
- Department of Gastric Surgery, Key Laboratory of Gastrointestinal Cancer (Ministry of Education), Fujian Medical University Union Hospital, Fuzhou 350004, China
| | - J X Lin
- Department of Gastric Surgery, Key Laboratory of Gastrointestinal Cancer (Ministry of Education), Fujian Medical University Union Hospital, Fuzhou 350004, China
| | - Q Y Chen
- Department of Gastric Surgery, Key Laboratory of Gastrointestinal Cancer (Ministry of Education), Fujian Medical University Union Hospital, Fuzhou 350004, China
| | - C H Zheng
- Department of Gastric Surgery, Key Laboratory of Gastrointestinal Cancer (Ministry of Education), Fujian Medical University Union Hospital, Fuzhou 350004, China
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Tamai H, Kaneko Y, Kameda H, Kuwana M, Okano Y, Ishii T, Ikeda K, Taguchi H, Sato S, Miyamoto T, Hirata S, Yasuoka H, Kojima T, Park SH, Shin K, Baek HJ, Lee YJ, Choi IA, Kim J, Hsu PN, Kuo CF, Huang CM, Weng MY, Sung WY, Tsai WC, Cheng TT, Taninaga T, Mori M, Miyagishi H, Sato Y, Takeuchi T. AB0253 COMPARISON OF PHARMACODYNAMICS OF METHOTREXATE AS METHOTREXATE-POLYGLUTAMATES CONCENTRATIONS IN RHEUMATOID ARTHRITIS; INTERIM DATA EVALUATION OF MIRACLE STUDY CONDUCTED IN JAPAN, KOREA AND TAIWAN. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Methotrexate (MTX) is the first-line therapy for rheumatoid arthritis (RA). The concentrations of MTX-polyglutamates (PG) in erythrocytes, an active form of MTX, are useful markers for the optimal usage of MTX in patients with RA. The concentrations of MTX-PG have been reported to be different between Japanese and Caucasians. However, the difference among Asian ethnicity remains unclear.Objectives:To examine MTX-PG concentrations in association with MTX dose during the first 24 weeks after the initiation of MTX for newly diagnosed RA patients in Japan, Korea and Taiwan.Methods:MIRACLE study is a multicenter, open-label, randomized, 48 weeks interventional study conducted in Japan, Korea and Taiwan to evaluate non-inferiority of low dose to high dose of MTX as an add-on therapy to adalimumab in 300 patients with RA who do not achieve remission after 24 weeks MTX monotherapy in stipulated dosage. In the first 24 weeks, MTX was started at 6 to 8 mg/week for newly diagnosed RA patients, and promptly escalated to the maximum tolerable dose in 12 weeks in principle. This interim data evaluation was intended to investigate the differences among countries in the relationship between MTX dose, safety and MTX-PG concentrations in erythrocytes during the first 24 weeks. The efficacy of the treatment is not included at this point.Results:A total of 166 patients (106 in Japan, 35 in Korea, 25 in Taiwan) were included in this interim data. The age at treatment initiation was 57.2 years old on average and female was 79.5%. The time course changes in total and individual MTX-PG levels differed in the three countries. At 24 weeks, whereas the mean total MTX-PG concentrations were comparable (112.9 nmol/L in Japan, 104.4 nmol/L in Korea, and 115.7 nmol/L in Taiwan) with a dose of MTX of 12.3 mg/week, 14.1 mg/week, and 12.2 mg/week, respectively, the individual MTX-PG concentrations were different. The MTX-PG1 and MTX-PG2 concentrations were lower in Korea than Japan and Taiwan whereas MTX-PG3, MTX-PG4 and MTX-PG5 concentrations were the highest in Korea.Conclusion:The distribution of short-chain and long-chain MTX-PG concentrations were various among Asian countries despite similar dose of MTX administration: NCT03505008.Disclosure of Interests:Hiroya Tamai: None declared, Yuko Kaneko Speakers bureau: AbbVie, Astellas, Ayumi, Bristol–Myers Squibb, Chugai, Eisai, Eli Lilly, Hisamitsu, Jansen, Kissei, Kirin, Pfizer, Sanofi, Takeda, Tanabe-Mitsubishi, and UCB., Grant/research support from: Sanofi, Hideto Kameda Speakers bureau: AbbVie, Pfizer, Consultant of: AbbVie, Grant/research support from: AbbVie, Eisai, Masataka Kuwana Speakers bureau: Astellas, Asahi Kasei Pharma, Boehringer- Ingelheim, Chugai, Eisai, Janssen, Mochida, Nippon Shinyaku, Ono Pharmaceuticals, Pfizer, Mitsubishi-Tanabe, Consultant of: Corbus, Grant/research support from: AbbVie, Asahi Kasei Pharma, Boehringer- Ingelheim, Chugai, Eisai, MBL, Nippon Shinyaku, Ono Pharmaceuticals, Mitsubishi-Tanabe, Yutaka Okano: None declared, Tomonori Ishii Speakers bureau: Chugai, Mitsubishi- Tanabe, Glaxo Smith Kline, Pfizer, Eli Lilly, Janssen, AbbVie, Eisai, Astellas, Kei Ikeda Speakers bureau: AbbVie, Eli Lilly, Novartis, Mitsubishi-Tanabe, Eisai, BMS, Grant/research support from: Mitsubishi-Tanabe, Hiroaki Taguchi: None declared, Shinji Sato: None declared, Toshiaki Miyamoto: None declared, Shintaro Hirata Speakers bureau: AbbVie, Asahi Kasei Pharma, Astellas, Ayumi, Bristol Myers Squibb, Chugai, Eisai, Eli Lilly, Janssen, Glaxo Smith Kline, Kissei, Pfizer, Sanofi, Mitsubishi- Tanabe, UCB, Paid instructor for: AbbVie, Mitsubishi- Tanabe, Consultant of: AbbVie, Eisai, Gilead, Grant/research support from: AbbVie, Chugai, Mitsubishi-Tanabe, UCB, Hidekata Yasuoka Speakers bureau: AbbVie, Asahi Kasei Pharma, Astellas, Daiichi- Sankyo, Eisai, Kissei, Takeda, Mitsubishi- Tanabe, Chugai, Novartis, Eli Lilly, Pfizer, Janssen, Sanofi, Teijin, Boehringer- Ingelheim, Bayer, Glaxo Smith Kline, Paid instructor for: AbbVie, Consultant of: AbbVie, Asahi Kasei, Grant/research support from: Mitsubishi-Tanabe, Takeda, Daiichi-Sankyo, Chugai, Bristol-Myers, MSD, Astellas, Toshihisa Kojima Speakers bureau: AbbVie, Pfizer, Eisai, Grant/research support from: AbbVie, Sung-Hwan Park: None declared, Kichul Shin: None declared, Han Joo Baek: None declared, Yun Jong Lee Grant/research support from: research fund, In Ah Choi Speakers bureau: Abbvie, Eizai, Grant/research support from: Abbvie, Eizai, Jinhyun Kim: None declared, Ping-Ning Hsu: None declared, Chang-Fu Kuo: None declared, Chun-Ming Huang Paid instructor for: AbbVie, Pfizer, Meng-Yu Weng Consultant of: AbbVie, Wan-Yu Sung: None declared, Wen-Chan Tsai: None declared, Tien-Tsai Cheng Paid instructor for: AbbVie, Grant/research support from: AbbVie, Takehiro Taninaga Shareholder of: Eisai Co., Ltd., Employee of: Eisai Co., Ltd., Masahiko Mori Shareholder of: Eisai Co., Ltd., Employee of: Eisai Co., Ltd., Hideaki Miyagishi Employee of: Eisai Co., Ltd., Yasunori Sato: None declared, Tsutomu Takeuchi Speakers bureau: Astellas, Abbvie, Daiichi Sankyo, Ayumi, Eisai, GlaxoSmithKline, Mitsubishi Tanabe, Chugai, Novartis, Eli Lilly, Pfizer, Bristol Myers Squibb, Janssen, UCB, TaishoToyama, Sanofi–Aventis, Nipponkayaku, Taiho, Gilead, Boehringer Ingelheim, Grant/research support from: Asahikasei, Astellas, Abbvie, Daiichi Sankyo, Ayumi, Eisai, Takeda, Mitsubishi Tanabe, Chugai, Eli Lilly, UCB, Sanofi–Aventis, Nipponkayaku, Boehringer Ingelheim
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Ding XW, Zheng ZC, Zhao Q, Zhai G, Liang H, Wu X, Zhu ZG, Wang HJ, He QS, He XL, Du YA, Chen LC, Hua YW, Huang CM, Xue YW, Zhou Y, Zhou YB, Wu D, Fang XD, Dai YG, Zhang HW, Cao JQ, Li LP, Chai J, Tao KX, Li GL, Jie ZG, Ge J, Xu ZF, Zhang WB, Li QY, Zhao P, Ma ZQ, Yan ZL, Zheng GL, Yan Y, Tang XL, Zhou X. [A multi-center retrospective study of perioperative chemotherapy for gastric cancer based on real-world data]. Zhonghua Wei Chang Wai Ke Za Zhi 2021; 24:403-412. [PMID: 34000769 DOI: 10.3760/cma.j.cn.441530-20200111-00014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the effect of perioperative chemotherapy on the prognosis of gastric cancer patients under real-world condition. Methods: A retrospective cohort study was carried out. Real world data of gastric cancer patients receiving perioperative chemotherapy and surgery + adjuvant chemotherapy in 33 domestic hospitals from January 1, 2014 to January 31, 2016 were collected. Inclusion criteria: (1) gastric adenocarcinoma was confirmed by histopathology, and clinical stage was cT2-4aN0-3M0 (AJCC 8th edition); (2) D2 radical gastric cancer surgery was performed; (3) at least one cycle of neoadjuvant chemotherapy (NAC) was completed; (4) at least 4 cycles of adjuvant chemotherapy (AC) [SOX (S-1+oxaliplatin) or CapeOX (capecitabine + oxaliplatin)] were completed. Exclusion criteria: (1) complicated with other malignant tumors; (2) radiotherapy received; (3) patients with incomplete data. The enrolled patients who received neoadjuvant chemotherapy and adjuvant chemotherapy were included in the perioperative chemotherapy group, and those who received only postoperative adjuvant chemotherapy were included in the surgery + adjuvant chemotherapy group. Propensity score matching (PSM) method was used to control selection bias. The primary outcome were overall survival (OS) and progression-free survival (PFS) after PSM. OS was defined as the time from the first neoadjuvant chemotherapy (operation + adjuvant chemotherapy group: from the date of operation) to the last effective follow-up or death. PFS was defined as the time from the first neoadjuvant chemotherapy (operation + adjuvant chemotherapy group: from the date of operation) to the first imaging diagnosis of tumor progression or death. The Kaplan-Meier method was used to estimate the survival rate, and the Cox proportional hazards model was used to evaluate the independent effect of perioperative chemo therapy on OS and PFS. Results: 2 045 cases were included, including 1 293 cases in the surgery+adjuvant chemotherapy group and 752 cases in the perioperative chemotherapy group. After PSM, 492 pairs were included in the analysis. There were no statistically significant differences in gender, age, body mass index, tumor stage before treatment, and tumor location between the two groups (all P>0.05). Compared with the surgery + adjuvant chemotherapy group, patients in the perioperative chemotherapy group had higher proportion of total gastrectomy (χ(2)=40.526, P<0.001), smaller maximum tumor diameter (t=3.969, P<0.001), less number of metastatic lymph nodes (t=1.343, P<0.001), lower ratio of vessel invasion (χ(2)=11.897, P=0.001) and nerve invasion (χ(2)=12.338, P<0.001). In the perioperative chemotherapy group and surgery + adjuvant chemotherapy group, 24 cases (4.9%) and 17 cases (3.4%) developed postoperative complications, respectively, and no significant difference was found between two groups (χ(2)=0.815, P=0.367). The median OS of the perioperative chemotherapy group was longer than that of the surgery + adjuvant chemotherapy group (65 months vs. 45 months, HR: 0.74, 95% CI: 0.62-0.89, P=0.001); the median PFS of the perioperative chemotherapy group was also longer than that of the surgery+adjuvant chemotherapy group (56 months vs. 36 months, HR=0.72, 95% CI:0.61-0.85, P<0.001). The forest plot results of subgroup analysis showed that both men and women could benefit from perioperative chemotherapy (all P<0.05); patients over 45 years of age (P<0.05) and with normal body mass (P<0.01) could benefit significantly; patients with cTNM stage II and III presented a trend of benefit or could benefit significantly (P<0.05); patients with signet ring cell carcinoma benefited little (P>0.05); tumors in the gastric body and gastric antrum benefited more significantly (P<0.05). Conclusion: Perioperative chemotherapy can improve the prognosis of gastric cancer patients.
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Affiliation(s)
- X W Ding
- Department of Gastric surgery, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer Prevention and Therapy, Tianjin 300060, China
| | - Z C Zheng
- Department of Gastric Surgery, Cancer Hospital of China Medical University (Liaoning Cancer Hospital and Institute), Shenyang 110042, China
| | - Q Zhao
- The Third Department of Surgery, The Fourth Hospital, Hebei Medical University, Shijiazhuang 050011, China
| | - G Zhai
- Department of General Surgery, Shanxi Provincial Tumor Hospital, Taiyuan 030013, China
| | - H Liang
- Department of Gastric surgery, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer Prevention and Therapy, Tianjin 300060, China
| | - X Wu
- Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Z G Zhu
- Department of Surgery, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai Institute of Digestive Surgery, Shanghai Key Laboratory of Gastric Neoplasms, Shanghai 200025, China
| | - H J Wang
- Department of Gastrointestinal Surgery, Affiliated Tumor Hospital, Xinjiang Medical University, Urumqi 830011, China
| | - Q S He
- Department of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, China
| | - X L He
- Department of General Surgery, Tangdu Hospital, The Air Force Medical University, Xi'an 710038, China
| | - Y A Du
- Department of Gastric Surgery, Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - L C Chen
- Department of Gastrointestinal Surgery, Fujian Provincial Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou 350014, China
| | - Y W Hua
- Department of General Surgery, The Affiliated Tumor Hospital of Zhengzhou University, Zhengzhou 450008, China
| | - C M Huang
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350004, China
| | - Y W Xue
- Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin 150081, China
| | - Y Zhou
- Department of Gastic Surgery, Afiliated CancerHospital, Fudan University, Shanghai 200030, China
| | - Y B Zhou
- Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - D Wu
- Department of Gastrointestinal Surgery, Second Affiliated Hospital, Zhejiang University, Hangzhou 310009, China
| | - X D Fang
- Department of Gastrointestinal Colorectal And Anal Surgery, China-Japan Union Hospital of Jilin University, Changchun 130033, China
| | - Y G Dai
- Department of Gastrointestinal Surgery, Yunnan Cancer Hospital, Kunming 650118, China
| | - H W Zhang
- Diagnosis and Treatment Center of Digestive Disease, Wuxi Mingci cardiovascular Hospital, Wuxi 214101, China
| | - J Q Cao
- Department of Gastrointestinal Surgery, Second Affiliated Hospital, Nanchang University, Nanchang 330006, China
| | - L P Li
- Department of Gastrointestinal Surgery, The Affiliated Provincial Hospital, Shandong First Medical University, Jinan 250021, China
| | - J Chai
- Department of Gastric Surgery, The Affiliated Shandong Tumor Hospital, Shandong University, Jinan 250117, China
| | - K X Tao
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - G L Li
- Department of General Surgery, Jinling Hospital/General Hospital of Eastern Theater Command, School of Medicine, Nanjing University, Nanjing 210002, China
| | - Z G Jie
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - J Ge
- Department of Gastrointestinal Surgery Xiangya Hospital of Central South University, Changsha 410008, China
| | - Z F Xu
- Department of General Surgery, The Affiliated Hospital, Shandong Academy of Medical Sciences, Jinan 250031, China
| | - W B Zhang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China
| | - Q Y Li
- Departerment of Abdominal Surgery, Jiangxi Cancer Hospital, Nanchang 330029, China
| | - P Zhao
- Departerment of Gastrointestinal Surgery, Sichuan Tumor Hospital, Chengdu 610041, China
| | - Z Q Ma
- Department of General Surgery, Peking Uninon Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences (CAMS) and PUMC, Beijing 100730, China
| | - Z L Yan
- Department of Gastrointestinal Surgery, Ningbo First Hospital, Ningbo 315000, China
| | - G L Zheng
- Department of Gastric surgery, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer Prevention and Therapy, Tianjin 300060, China
| | - Y Yan
- Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - X L Tang
- Department of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, China
| | - X Zhou
- The Third Department of Surgery, The Fourth Hospital, Hebei Medical University, Shijiazhuang 050011, China
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15
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Lu J, Huang CM. [Exploration and development of indocyanine green fluorescence applied in laparoscopic splenic hilum lymph node dissection for gastric cancer]. Zhonghua Zhong Liu Za Zhi 2019; 41:900-903. [PMID: 31874546 DOI: 10.3760/cma.j.issn.0253-3766.2019.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
With the continuous development of laparoscopic techniques and the concept of individualized treatment, laparoscopic surgery is also moving from "minimally invasive" to "minimally invasive plus precision" . Lymph node metastasis is one of the most important risk factors affecting the prognosis of gastric cancer (GC). Reasonable lymph node dissection has always been an important exploration direction in the field of GC surgery. In recent years, domestic and foreign studies have found that the new tracer, indocyanine green (ICG), can detect the lymphatic vasculature non-invasively, and more accurately display the perigastric lymph nodes, providing a new perspective in laparoscopic lymph node dissection for GC. Alternatively, since the application of ICG in laparoscopic gastrointestinal tumor surgery, especially in gastric cancer surgery is still in the early stage of exploration and experience accumulation, more high-level medical evidences are needed to evaluate its clinical value.
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Affiliation(s)
- J Lu
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350004, China
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Lin JX, Yoon C, Desiderio J, Yi BC, Li P, Zheng CH, Parisi A, Huang CM, Strong VE, Yoon SS. Development and validation of a staging system for gastric adenocarcinoma after neoadjuvant chemotherapy and gastrectomy with D2 lymphadenectomy. Br J Surg 2019; 106:1187-1196. [PMID: 31197829 DOI: 10.1002/bjs.11181] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 01/21/2019] [Accepted: 02/25/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Neoadjuvant chemotherapy followed by gastrectomy with D2 lymphadenectomy is commonly used for patients with locally advanced gastric adenocarcinoma. The eighth AJCC ypTNM staging system was validated based on patients undergoing more limited lymphadenectomy (less than D2). The aim of this study was to develop a system for accurate staging of patients with locally advanced gastric adenocarcinoma who receive neoadjuvant chemotherapy followed by gastrectomy with D2 lymphadenectomy. METHODS A modified system of ypTNM was developed, based on overall survival (OS) of patients receiving neoadjuvant chemotherapy followed by gastrectomy with D2 lymphadenectomy at Memorial Sloan Kettering Cancer Center, and validated using data from an international cohort of patients who had similar treatment. RESULTS Of 325 patients in the derivation cohort, 33 (10·2 per cent) had ypT0 N0/+ tumours, which are not classifiable under the AJCC system. The 5-year OS rate for modified ypTNM stages I, II, IIIA and IIIB was 89, 71, 42·3 and 10 per cent respectively, compared with 82, 65·2 and 24·1 for AJCC stages I, II and III respectively. The concordance index (0·730 versus 0·709), estimated area under the curve (0·765 versus 0·740) and time-dependent receiver operating characteristic (ROC) curve throughout the observation period were all superior for modified ypTNM staging. For the validation cohort of 186 patients, the modified system was again better at separating patients into prognostic groups for OS. CONCLUSION The modified ypTNM staging system improves the accuracy of OS prediction for patients treated with neoadjuvant chemotherapy followed by gastrectomy with D2 lymphadenectomy.
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Affiliation(s)
- J X Lin
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, China.,Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, USA
| | - C Yoon
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, USA
| | - J Desiderio
- Department of Digestive Surgery, St. Mary's Hospital, University of Perugia, Terni, Italy
| | - B C Yi
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, USA
| | - P Li
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - C H Zheng
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - A Parisi
- Department of Digestive Surgery, St. Mary's Hospital, University of Perugia, Terni, Italy
| | - C M Huang
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - V E Strong
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, USA
| | - S S Yoon
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, USA
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17
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Zhu CC, Fang QJ, Zhou QY, Huang CM, Hu MJ, Yuan KM, Li J. [Nested case-control study on risk factors of postoperative hyperactive-type delirium in geriatric orthopedic patients]. Zhonghua Yi Xue Za Zhi 2019; 98:3230-3234. [PMID: 30392286 DOI: 10.3760/cma.j.issn.0376-2491.2018.40.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the risk factors of postoperative hyperactive-type delirium(PHTD) in geriatric orthopedic patients using nested case-control study. Methods: Seventy-four patients who underwent orthopedic surgeries in the Second Affiliated Hospital of Wenzhou Medical University from January 2008 to December 2013, aged 65 or above, American Society of Anesthesiologists (ASA) physical status Ⅰ-Ⅳ, with complete medical records and confirmed diagnosis of PHTD were selected as case group. A control group of 444 patients, on the basis of 1∶6 versus nested case group, from the same cohort but without PHTD was established. Data patterns such as patient age, gender, ASA classification, status of preoperative/postoperative electrolytes, preoperative blood glucose, preoperative/postoperative plasma albumin and preoperative/postoperative hematocrit(Hct), uses of non-steroidal analgesics, anticholinergic drugs and benzodiazepines drugs, type of anesthesia, anesthesia duration, difference in postoperative analgesia were collected and analyzed. Results: Univariate Logistic regression analysis showed that gender, age, ASA grade, preoperative electrolytes, anesthesia duration, operative duration, intraoperative hypotension and the difference of postoperative analgesia were risk factors for PHTD. Multiple Logistic regression analysis showed that gender (OR=2.562, 95%CI: 1.438-4.564, P=0.001), age (OR=3.929, 95%CI: 1.788-8.633, P=0.001), preoperative electrolytes(OR=3.714, 95%CI: 2.068-6.670, P<0.001)were the independent risk factors for PHTD. Conclusion: Male, elderly patients and abnormalities of preoperative electrolyte are the independent risk factors for PHTD in geriatric orthopedic patients.
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Affiliation(s)
- C C Zhu
- Department of Anesthesiology and Perioperative Medicine, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China
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Huang CM, Lee TT. Immunomodulatory effects of phytogenics in chickens and pigs - A review. Asian-Australas J Anim Sci 2018; 31:617-627. [PMID: 29268586 PMCID: PMC5930271 DOI: 10.5713/ajas.17.0657] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [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: 09/04/2017] [Revised: 10/17/2017] [Accepted: 11/17/2017] [Indexed: 12/12/2022]
Abstract
Environmental stressors like pathogens and toxins may depress the animal immune system through invasion of the gastrointestinal tract (GIT) tract, where they may impair performance and production, as well as lead to increased mortality rates. Therefore, protection of the GIT tract and improving animal health are top priorities in animal production. Being natural-sourced materials, phytochemicals are potential feed additives possessing multiple functions, including: anti-inflammatory, anti-fungal, anti-viral and antioxidative properties. This paper focuses on immunity-related physiological parameters regulated by phytochemicals, such as carvacrol, cinnamaldehyde, curcumin, and thymol; many studies have proven that these phytochemicals can improve animal performance and production. On the molecular level, the impact of inflammatory gene expression on underlying mechanisms was also examined, as were the effects of environmental stimuli and phytochemicals in initiating nuclear factor kappa B and mitogen-activated protein kinases signaling pathways and improving health conditions.
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Affiliation(s)
- C. M. Huang
- Department of Animal Science, National Chung Hsing University, Taichung 402,
Taiwan
| | - T. T. Lee
- Department of Animal Science, National Chung Hsing University, Taichung 402,
Taiwan
- The iEGG and Animal Biotechnology Center, National Chung Hsing University, Taichung 402,
Taiwan
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19
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He X, Wang SP, Zhou YF, Huang CM, Ning SB, LvQ SJ. A novel method to detect circulating antigens of Schistosoma japonicum using a gold nanorod optical sensor. Trop Biomed 2017; 34:180-190. [PMID: 33592997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Diagnostic method of Schistosoma japonicum (S.japonicum) is the key of schistosomiasis prevention and control. In China, schistosomiasis reached the stage of transmission control, and almost of the epidemic areas tend to have low infection rate and intensity, but it is difficult for the existing detection methods to achieve accurate monitoring. In this study, a novel method to detect the circulating antigens of S.japonicum using gold nanorods optical sensor was developed. Gold nanorods were prepared by seed-mediated growth followed by deposition onto Indium-Tin-Oxide (ITO) glass to fabricate a solid phase biosensor. In order to assembly between the ITO glass and gold nanorod, hydroxylation and sulfhydrylation were carried out to modify the ITO glass. Surface of gold nanorods was conjugated with an SIEA26-28kDaSjscFv antibody against S.japonicum circulating antigens, and the sensor optical changed upon antigen-antibody recognition. The sensor was used to detect S.japonicum infection in rabbits by testing the serum once a week for 8 weeks. Results revealed different displacement of localized surface plasmon resonance (LSPR) of the gold nanorod optical sensor each week while the control group showed no such change in LSPR. Simultaneously, Indirect Hemagglutination Assay(IHA) and Fast Enzyme-Linked Immuno Sorbent Assay (F-ELISA) method were used to test these samples. Ten human serum samples from S.japonicum infected patients were analyzed using the gold nanorods optical sensor, which revealed that health human serum did not show any spectrum displacement. We developed a specificity gold nanorod optical sensor by combining the SIEA26-28kDaSjscFv, which was used to detect circulating antigens of S.japonicum. This method is expected to overcome the issues pertaining to the testing of circulating antigens of S.japonicum.
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Affiliation(s)
- X He
- Department of Parasitology, Xiangya School of Medicine, Central South University, Changsha, 410078, PR China
| | - S P Wang
- Department of Parasitology, Xiangya School of Medicine, Central South University, Changsha, 410078, PR China
| | - Y F Zhou
- Department of Parasitology, Xiangya School of Medicine, Central South University, Changsha, 410078, PR China
| | - C M Huang
- Department of Parasitology, Xiangya School of Medicine, Central South University, Changsha, 410078, PR China
| | - S B Ning
- Department of Parasitology, Xiangya School of Medicine, Central South University, Changsha, 410078, PR China
| | - S J LvQ
- Department of Parasitology, Xiangya School of Medicine, Central South University, Changsha, 410078, PR China
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Hu MX, Guo Q, Li JN, Huang CM, Ren GR. Reduction of methylene blue with Ag nanoparticle-modified microporous polypropylene membranes in a flow-through reactor. NEW J CHEM 2017. [DOI: 10.1039/c7nj01068k] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Methylene blue was reduced by the flow-through catalytic membrane reactor in real time with the flow rate larger than 210 L m−2 h−1.
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Affiliation(s)
- M. X. Hu
- Department of Applied Chemistry
- School of Food Science and Biotechnology
- Zhejiang Gongshang University
- Hangzhou
- China
| | - Q. Guo
- Department of Applied Chemistry
- School of Food Science and Biotechnology
- Zhejiang Gongshang University
- Hangzhou
- China
| | - J. N. Li
- Department of Applied Chemistry
- School of Food Science and Biotechnology
- Zhejiang Gongshang University
- Hangzhou
- China
| | - C. M. Huang
- Department of Applied Chemistry
- School of Food Science and Biotechnology
- Zhejiang Gongshang University
- Hangzhou
- China
| | - G. R. Ren
- Department of Applied Chemistry
- School of Food Science and Biotechnology
- Zhejiang Gongshang University
- Hangzhou
- China
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Lin JX, Huang CM, Zheng CH, Li P, Xie JW, Wang JB, Lu J, Chen QY, Cao LL, Lin M. [Surgical outcomes after laparoscopy-assisted distal gastrectomy and open distal gastrectomy for patients with advanced gastric cancer: a case-control study using a propensity score method]. Zhonghua Wai Ke Za Zhi 2016; 54:755-760. [PMID: 27686639 DOI: 10.3760/cma.j.issn.0529-5815.2016.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the surgical outcomes after the laparoscopy-assisted distal gastrectomy (LADG) for patients with advanced gastric cancer. Methods: The data of 213 patients who underwent LADG and 213 treated by open distal gastrectomy (ODG) were selected using the propensity score matching method from a prospectively constructed database of 641 patients who underwent radical distal gastrectomy between January 2005 and June 2012 in Department of Gastric Surgery, Fujian Medical University Union Hospital. The baseline characteristics and surgical outcomes were compared using a paired t-test or the Wilcoxon signed ranks test for continuous variables. The cumulative survival rates were compared using the Kaplan-Meier method and log-rank test. Results: Among all patients, there were significant differences in tumor location, digestive tract reconstruction, histologic type, pT stage, and pTNM stage between LADG and ODG group (P<0.05). After propensity score matching, patient distributions were closely balanced. There was no significant difference in clinicopathologic characteristics between the two groups (P>0.05). Regarding perioperative characteristics, the time to first flatus, and time to resumption of diet, did not differ between the two groups (P>0.05), while there were significant differences in the operation time (t=-11.28, P=0.000), blood loss (t=-5.674, P=0.000), number of dissected lymph nodes (t=4.727, P=0.000), and post-operative hospital stay (t=-2.193, P=0.038). LADG group has less morbidity than ODG group (χ2=4.777, P=0.029). Multivariate analysis revealed that the laparoscopic surgery (RR=0.392, P=0.009) was the protected factor for determining postoperative complications. There was no significant difference in the cumulative survival rate at total and each UICC stage between the two groups, either (P>0.05). Conclusion: LADG is an oncological safe minimally invasive procedure for advanced gastric cancer yields comparable oncological outcomes with ODG.
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Affiliation(s)
- J X Lin
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China
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Wu ZY, Wang SM, Chen ZH, Huv SX, Huang K, Huang BJ, Du JL, Huang CM, Peng L, Jian ZX, Zhao G. MiR-204 regulates HMGA2 expression and inhibits cell proliferation in human thyroid cancer. Cancer Biomark 2016; 15:535-42. [PMID: 26406941 DOI: 10.3233/cbm-150492] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Analysis using publicly available algorithms has found that high mobility group AT-hook 2 (HMGA2), a key transcriptional regulatory factor, is a potential target of microRNA-204 (miR-204). Some studies have shown that both miR-204 and HMGA2 are associated with cancer development. OBJECTIVE We examined the possible relationship between miR-204 and HMGA2 in the development of thyroid cancer. METHODS We assessed miR-204 expression in thyroid cancer specimens and cell lines using real-time polymerase chain reaction (PCR). Luciferase reporter assay was used to confirm the target associations. The effect of miR-204 on cell proliferation was confirmed with tetrazolium and colony formation assays. Gene and protein expression were examined using real-time PCR and western blotting, respectively. RESULTS MiR-204 was downregulated in the thyroid cancer specimens and cell lines, and targeted the 3^\prime untranslated region of HMGA2 directly. MiR-204 overexpression decreased cyclin D1 and Ki67 expression and increased P21 expression, which subsequently inhibited thyroid cancer cell proliferation. CONCLUSIONS Our findings suggest that miR-204 plays a protective role by inhibiting thyroid cancer cell proliferation, and may identify new targets for anti-cancer treatment.
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Affiliation(s)
- Z Y Wu
- Department of General Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - S M Wang
- Department of General Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Z H Chen
- Department of General Surgery, Hospital of Traditional Chinese Medicine of Zhongshan, Zhongshan, Guangdong, China
| | - S X Huv
- Department of General Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - K Huang
- Department of General Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - B J Huang
- Department of General Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - J L Du
- Department of General Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - C M Huang
- Department of General Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - L Peng
- Department of General Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Z X Jian
- Department of General Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - G Zhao
- Department of General Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
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Lin F, Huang CM, Cao J, Pei ZH, Gu WL, Fan SF, Li KP, Lin CM. Segment-specific targeting via RNA interference mediates down-regulation of OPN expression in hepatocellular carcinoma cells. Genet Mol Res 2015; 14:14440-7. [PMID: 26600502 DOI: 10.4238/2015.november.18.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Osteopontin (OPN) plays an important role in the metastasis and recurrence of tumors after resection of hepatocellular carcinoma (HCC). In this study, the down-regulation effect on OPN expression in HCC cells of RNA interference (RNAi) molecules designed to target different segments of OPN was investigated to identify a more effective site for OPN knockdown. Specific small interfering RNAs (siRNAs A, B, and C) of OPN were synthesized and transfected into an HCC cell line (HEP-G2; representing the OPNi-A, OPNi-B, and OPNi-C groups). Fluorescent quantitative polymerase chain reaction and immunohistochemical methods were used to detect the mRNA and protein expression of OPN before and after RNAi. Results showed that after transfection, the fluorescence intensity of the OPNi-A group was greater than those of the OPNi-B and OPNi-C groups. After 48 h of transfection, the ΔCT values of OPN mRNA expression in the OPNi-A-C groups increased from 8.31 ± 1.58, 8.78 ± 1.49, and 8.25 ± 1.51 to 12.14 ± 1.43, 10.22 ± 1.97, and 10.48 ± 1.88, respectively (P < 0.05), and the OPN protein levels (immunohistochemistry scores) decreased from 6.44 ± 1.67, 5.43 ± 2.05, and 5.45 ± 2.52 to 2.84 ± 1.52, 4.43 ± 1.65, and 3.95 ± 1.43 points, respectively. These results indicated that RNAi based on different segments of the OPN gene had different down-regulatory effects on OPN expression. Synthesis of targeted siRNA aimed at specific OPN segments might have important significance for dealing with the invasiveness and metastasis of HCC cells.
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Affiliation(s)
- F Lin
- Department of General Surgery, Guangzhou First People's Hospital Affiliated to Guangzhou Medical University, Guangzhou, Guangdong, China
| | - C M Huang
- Department of General Surgery, People's Hospital of Guangdong Province, Guangzhou, Guangdong, China
| | - J Cao
- Department of General Surgery, Guangzhou First People's Hospital Affiliated to Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Z H Pei
- Department of General Surgery, Guangzhou First People's Hospital Affiliated to Guangzhou Medical University, Guangzhou, Guangdong, China
| | - W L Gu
- Department of General Surgery, Guangzhou First People's Hospital Affiliated to Guangzhou Medical University, Guangzhou, Guangdong, China
| | - S F Fan
- Department of General Surgery, Guangzhou First People's Hospital Affiliated to Guangzhou Medical University, Guangzhou, Guangdong, China
| | - K P Li
- Department of General Surgery, Guangzhou First People's Hospital Affiliated to Guangzhou Medical University, Guangzhou, Guangdong, China
| | - C M Lin
- Department of General Surgery, Guangzhou First People's Hospital Affiliated to Guangzhou Medical University, Guangzhou, Guangdong, China
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Guo JL, Liao JY, Chang LC, Wu HL, Huang CM. The effectiveness of an integrated multicomponent program for adolescent smoking cessation in Taiwan. Addict Behav 2014; 39:1491-9. [PMID: 24949950 DOI: 10.1016/j.addbeh.2014.05.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [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: 10/21/2013] [Revised: 04/24/2014] [Accepted: 05/21/2014] [Indexed: 11/16/2022]
Abstract
If adolescents do not receive appropriate assistance in quitting smoking, they are highly likely to become regular smokers when they enter adulthood. Thus, an effective smoking-cessation program is required. A program was designed based on both the smoking-cessation barriers reported by students and effective strategies derived from the literature. We assigned 143 student smokers from 6 vocational high schools to intervention (n=78) and comparison groups (n=65). Data were collected at the baseline, the end of the program, and 1- and 4-month follow-up time points. For the intervention group, the smoking-abstinence rates confirmed using the urine cotinine test were 22.73% at the end of the program and 20.75% at the 4-month follow-up point. Days smoked in the past month, number of cigarettes smoked per day, and the Fagerström Test for Nicotine Dependence score of the intervention group decreased at all of the time points. The group differences in these variables were statistically significant; the magnitude of effect sizes ranged from 0.44 to 0.95. Multicomponent programs addressing smoking-cessation barriers that students encounter can help adolescents quit smoking.
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Affiliation(s)
- J L Guo
- Department of Health Promotion and Health Education, University of National Taiwan Normal University, Taipei, Taiwan.
| | - J Y Liao
- Department of Health Promotion and Health Education, University of National Taiwan Normal University, Taipei, Taiwan.
| | - L C Chang
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan.
| | - H L Wu
- Department of Internal Medicine Cardiopulmonary, Taiwan Adventist Hospital, Taipei, Taiwan.
| | - C M Huang
- Department of Nursing, National Yang-Ming University, Taipei, Taiwan.
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25
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Xiu H, Bai HW, Huang CM, Xu CL, Li XY, Fu Q. Selective localization of titanium dioxide nanoparticles at the interface and its effect on the impact toughness of poly(L-lactide)/poly(ether)urethane blends. EXPRESS POLYM LETT 2013. [DOI: 10.3144/expresspolymlett.2013.24] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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26
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Paillot R, Prowse L, Montesso F, Huang CM, Barnes H, Escala J. Whole inactivated equine influenza vaccine: Efficacy against a representative clade 2 equine influenza virus, IFNgamma synthesis and duration of humoral immunity. Vet Microbiol 2012; 162:396-407. [PMID: 23146168 DOI: 10.1016/j.vetmic.2012.10.019] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Revised: 10/15/2012] [Accepted: 10/17/2012] [Indexed: 11/19/2022]
Abstract
Equine influenza (EI) is a serious respiratory disease of horses induced by the equine influenza virus (EIV). Surveillance, quarantine procedures and vaccination are widely used to prevent or to contain the disease. This study aimed to further characterise the immune response induced by a non-updated inactivated EI and tetanus vaccine, including protection against a representative EIV isolate of the Florida clade 2 sublineage. Seven ponies were vaccinated twice with Duvaxyn IE-T Plus at an interval of four weeks. Five ponies remained unvaccinated. All ponies were experimentally infected with the EIV strain A/eq/Richmond/1/07 two weeks after the second vaccination. Clinical signs of disease were recorded and virus shedding was measured after experimental infection. Antibody response and EIV-specific IFNgamma synthesis, a marker of cell-mediated immunity, were measured at different time points of the study. Vaccination resulted in significant protection against clinical signs of disease induced by A/eq/Richmond/1/07 and reduced virus shedding when challenged at the peak of immunity. Antigenic drift has been shown to reduce protection against EIV infection. Inclusion of a more recent and representative EIV vaccine strain, as recommended by the OIE expert surveillance panel on equine influenza vaccine, may maximise field protection. In addition, significant levels of EIV-specific IFNgamma synthesis by peripheral blood lymphocytes were detected in immunised ponies, which provided a first evidence of CMI stimulation after vaccination with a whole inactivated EIV. Duration of humoral response was also retrospectively investigated in 14 horses vaccinated under field condition and following the appropriate immunisation schedule, up to 599 days after first immunisation. This study revealed that most immunised horses maintained significant levels of cross-reactive SRH antibody for a prolonged period of time, but individual monitoring may be beneficial to identify poor vaccine responders.
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Affiliation(s)
- R Paillot
- Animal Health Trust, Centre for Preventive Medicine, Lanwades Park, Newmarket, Suffolk CB8 7UU, UK.
| | - L Prowse
- Animal Health Trust, Centre for Preventive Medicine, Lanwades Park, Newmarket, Suffolk CB8 7UU, UK
| | - F Montesso
- Animal Health Trust, Centre for Preventive Medicine, Lanwades Park, Newmarket, Suffolk CB8 7UU, UK
| | - C M Huang
- Eli Lilly and Company, 1301 South White River Parkway East, Indianapolis, IN 46225, USA
| | - H Barnes
- Elanco Animal Health, European Biological R&D Eli Lilly and Company Limited, Lilly House, Priestley Road, Basingstoke, Hampshire RG24 9NL, UK
| | - J Escala
- Elanco Animal Health, European Biological R&D Eli Lilly and Company Limited, Lilly House, Priestley Road, Basingstoke, Hampshire RG24 9NL, UK
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Huang RM, He JY, Zhao J, Luo Q, Huang CM. Fenton-biological treatment of reverse osmosis membrane concentrate from a metal plating wastewater recycle system. Environ Technol 2011; 32:515-522. [PMID: 21877532 DOI: 10.1080/09593330.2010.504747] [Citation(s) in RCA: 4] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Although reverse osmosis (RO) has been widely used in the recycling of metal plating wastewater, organic compounds and heavy metals in the RO concentrate are difficult to remove by conventional treatment. A combination process including Fenton oxidation and a biological aerated filter was used to treat RO concentrate containing complex Cu and Ni from metal plating. During the Fenton treatment, Cu and Ni ions were released due to degradation of organic compounds and then removed by pH adjustment and coagulation. The concentrate was further treated using by a biological aerated filter. Optimum conditions were as follows: initial pH of influent of 4.0; dosage of H2O2 of 5.0 mmol l(-1); ratio of n(Fe2+)/n(H2O2) of 0.8; precipitation pH of Cu and Ni ions of 8.0; and a hydraulic retention time of the biological aerated filter of 2.5 h. The results showed that concentrations of effluent COD, Cu and Ni ions were less than 40 mg l(-1), 0.5 mg l(-1) and 0.3 mg l(-1), respectively; this means the treated effluent meets the emission standards for pollutants from electroplating set by China's Environmental Protection Agency.
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Affiliation(s)
- R M Huang
- School of Environmental Science and Engineering, South China University of Technology, Guangzhou, People's Republic of China.
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Chen SY, Wan L, Huang CM, Huang YC, Sheu JJC, Lin YJ, Liu SP, Lan YC, Lai CH, Lin CW, Tsai CH, Tsai FJ. Genetic polymorphisms of the DNA repair gene MPG may be associated with susceptibility to rheumatoid arthritis. J Appl Genet 2011; 51:519-21. [PMID: 21063071 DOI: 10.1007/bf03208883] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Rheumatoid arthritis (RA) is a chronic autoimmune disease and can lead to deformities and severe disabilities, due to irreversible damage of tendons, joints, and bones. A previous study indicated that a DNA repair system was involved in the development of RA. In this study, we investigated the association of four N-methylpurine-DNA glycosylase (MPG) gene polymorphisms (rs3176364, rs710079, rs2858056, and rs2541632) with susceptibility to RA in 384 Taiwanese individuals (192 RA patients and 192 control subjects). Our data show a statistically significant difference in genotype frequency distributions at rs710079 and rs2858056 SNPs between RA patients and control groups (P = 0.040 and 0.029, respectively). Our data also indicated that individuals with the GG genotype at rs2858056 SNP may have a higher risk of developing RA. In addition, compared with the haplotype frequencies between case and control groups, individuals with the GCGC haplotype appeared to be at a greater risk of RA progression (P = 0.003, OR = 1.75; 95% CI = 1.20-1.55). Our results suggest that rs710079 and rs2858056 polymorphisms and the GCGC haplotype in the MPG gene are associated with the risk of RA progression, and thus may be used as molecular markers of RA if they are confirmed by further research.
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Affiliation(s)
- S Y Chen
- Genetic Center, Department of Medical Research, Taichung, Taiwan
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Miao L, Tanemura S, Huang R, Liu CY, Huang CM, Xu G. Large Seebeck coefficients of protonated titanate nanotubes for high-temperature thermoelectric conversion. ACS Appl Mater Interfaces 2010; 2:2355-2359. [PMID: 20735107 DOI: 10.1021/am100365y] [Citation(s) in RCA: 7] [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: 05/29/2023]
Abstract
Titanate nanotubes Na(2-x)H(x)Ti(3)O(7) produced by alkali hydrothermally treated ground TiO(2) aerogels are investigated as possible materials for high-temperature thermoelectric conversion by measuring their thermoelectric properties. Strikingly, the Seebeck coefficients increased sharply in the temperature range 745 to 1032 K, reaching a maximum of 302 muV/K. The electrical resistivity of the TNNTs ranged from 325 to 525 Omegam, which is lower than that of bulk TiO(2), and thermal conductivities at room temperature were also very low, ranging from 0.55 to 0.75 Wm(-1) K(-1). The hollow structure of the titanate nanotubes, with small, uniform diameters, is thought to be responsible for the ultralow thermal conductivity. The large thermoelectric power and ultralow thermal conductivity suggest that titanate nanotubes represent a new kind of p-type oxide thermoelectric material.
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Affiliation(s)
- L Miao
- Key Laboratory for Renewable Energy and Gas Hydrates, Guangzhou Institute of Energy Conversion, Chinese Academy of Sciences, No. 2 Nengyuan Road, Tianhe District, Guangzhou, 510640 P.R. China.
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Huang CM, Tsai CH, Tsai JJP, Kung PT, Chen CL, Tsai FJ. The relationship between insulin‐like growth factor‐II geneApaI polymorphism and rheumatoid arthritis. Scand J Rheumatol 2009; 33:126-7. [PMID: 15163116 DOI: 10.1080/03009740410006079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- C M Huang
- Division of Immunology and Rheumatology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
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Wan L, Lin YJ, Sheu JJ, Huang CM, Tsai Y, Tsai CH, Wong W, Tsai FJ. Analysis of ERCC2/XPD functional polymorphisms in systemic lupus erythematosus. Int J Immunogenet 2008; 36:33-7. [PMID: 19055600 DOI: 10.1111/j.1744-313x.2008.00817.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Sunlight/ultraviolet (UV) irradiation has been recognized as an important risk factor for developing systemic lupus erythematosus (SLE). However, the interpretation of genetic variations involved in UV-light sensitivity is largely unknown. Recent studies indicated that two genetic variations of ERCC2/XPD gene (rs1799793 in exon 10 and rs13181 in exon 23) have been found to exert negative influences on nucleotide excision repair system. To analyse the possible contribution of the ERCC2/XPD functional single nucleotide polymorphisms in genetic susceptibility to SLE, the rs13181 and rs1799793 SNPs in ERCC2/XPD were genotyped by polymerase chain reaction followed by restriction fragment length polymorphism analysis. Association was studied by case-control analyses using samples from 172 SLE patients and 160 healthy controls. Haplotype analysis was performed to detect the association with genetic predisposition to SLE and the clinical features. Although these two functional genetic variations are linked to several immune dysfunction-induced diseases, no statistically significant differences in allele or genotype frequencies were observed between SLE patients and controls. Haplotype analysis showed that none of ERCC2/XPD haplotypes was associated with the incidence of SLE disease, nor the preference of clinical features. In conclusion, the ERCC2/XPD functional polymorphisms analysed in this study showed no association in genetic susceptibility to SLE.
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Affiliation(s)
- L Wan
- Human Genetic Center, China Medical University Hospital, Taichung, Taiwan
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Kuo TT, Lin YH, Huang CM, Chang SF, Dai H, Feng TY. The lysogenic cycle of the filamentous phage Cflt from Xanthomonas campestris pv. citri. Virology 2008; 156:305-12. [PMID: 18644553 DOI: 10.1016/0042-6822(87)90410-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/1986] [Accepted: 10/13/1986] [Indexed: 10/26/2022]
Abstract
A phage, Cflt, forming turbid plaques, was isolated from Xanthomonas campestris pv. citri. After infection, infected sensitive cells become immune to Cflt and produce very few phages. These properties were genetically rather stable. The phage was purified and shown to be filamentous with a size of 1157 +/- 73 nm. The genome size is about 7.62 kb. The phage does not affect the growth of host bacteria. Under natural cultivation conditions Cflt-lysogenized cells could be induced spontaneously to give high phage yields, or cured to give phage-free cells. The integration of Cflt DNA into host DNA was proved by Southern blot hybridization. The lysogenic phage was genetically stable in log phase cells and persisted in stationary phase cells through many cell generations in the absence of extracellular phage reinfection.
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Affiliation(s)
- T T Kuo
- Institute of Botany, Academia Sinica, Taipei, Republic of China
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Liu HL, Huang CM, Lim SN, Kuan WC, Chen HM, Wu T, Hsu YY. SU-FF-I-68: False Positive Analysis of Functional MRI During Simulated Deep Brain Stimulation. Med Phys 2006. [DOI: 10.1118/1.2240748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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34
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Lee KC, Chang CY, Chuang YC, Young MS, Huang CM, Yin WH, Tung DY, Lee WC, Lee SL, Sue SH, Wei J. Heart transplant coronary artery disease in Chinese recipients. Transplant Proc 2005; 36:2380-3. [PMID: 15561255 DOI: 10.1016/j.transproceed.2004.06.044] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Transplant coronary artery disease is the principle limiting factor for long-term survival of heart transplantation (HTx) recipients. We reviewed our data to assess the incidence of this disorder among Chinese HTx recipients and to compare it with the results of Western studies. MATERIAL AND METHODS From July 1988 to May 2002, 182 patients received 184 orthotopic HTx. One hundred sixty-three recipients survived for at least 1 year with available SPECT scans or coronary angiogram studies. The data set included donor characteristics, recipient characteristics, active cytomegalovirus (CMV) infection rate, rejection episodes, immunosuppressants, and human leukocyte antigen (HLA) mismatches. RESULTS Surgical mortality in our program was 4.3% and the actuarial freedom from coronary artery disease at 1, 3, and 5 years was 99%, 95%, and 92%, respectively. Angiogram results were stratified into coronary artery disease (n = 15) or absence of the disorder (n = 148) groups. Only older donor age showed statistical significance between the groups. Compared with the Western series, the present data show higher actuarial survival rates and freedom from coronary artery disease. There were statistically significant differences in regard to graft ischemia time, proportion of male recipients, ischemic heart disease, rejection episodes during the first year, and incidence of CMV infection. CONCLUSIONS SPECT scan can detect coronary artery disease before there is significant stenosis of the coronary artery with acceptable survival rates. Chinese HTx recipients show a lower incidence of the disorder, lower rates of ischemia heart disease, lower proportion of male gender, lower incidence of CMV infection, fewer rejection episodes during the first year, and less ischemic time than Western recipients, which maybe the contributing factors to their better survival.
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Affiliation(s)
- K C Lee
- Heart Center, Cheng Hsin General Hospital, Taipei, Taiwan.
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Lo SF, Huang CM, Tsai CH, Chen ML, Tsai FJ. Interleukin-1 receptor antagonist gene polymorphism in Taiwanese patients with gout. Clin Exp Rheumatol 2005; 23:85-8. [PMID: 15789892] [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: 05/02/2023]
Abstract
OBJECTIVE The purpose of this study was to examine whether interleukin-1 receptor antagonist (IL-1Ra) gene polymorphism is a marker of susceptibility to or of the clinical characteristics of gout in Taiwanese patients. METHODS 196 Taiwanese patients with gout and 103 unrelated normal healthy control subjects living in central Taiwan were studied. Polymorphism of the gene for IL-1Ra was typed from genomic DNA. Allelic frequencies and carriage rates were compared between gout patients and control subjects. The relationship between IL-1Ra genotypes and the clinical characteristics of gout was also evaluated. RESULTS No significant differences were observed in genetic and allelic frequencies of the IL-1Ra gene polymorphism between patients with gout and healthy control subjects. Furthermore, we did not detect any association of IL-1Ra genotype with the clinical and laboratory profiles in patients with gout. CONCLUSION The results from the present study suggest that the interleukin-1 receptor antagonist gene polymorphism is not a genetic marker of susceptibility to gout for Taiwanese. Furthermore, our study also suggests that the IL-1Ra gene polymorphism is unrelated to the clinical characteristics of gout.
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Affiliation(s)
- S F Lo
- Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taiwan
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Yang YH, Lai HJ, Huang CM, Wang LC, Lin YT, Chiang BL. Sera from children with active Henoch-Schönlein purpura can enhance the production of interleukin 8 by human umbilical venous endothelial cells. Ann Rheum Dis 2004; 63:1511-3. [PMID: 15479906 PMCID: PMC1754792 DOI: 10.1136/ard.2003.016196] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To investigate the ability of sera from children with active Henoch-Schonlein purpura (HSP) to enhance endothelial interleukin (IL) 8 production and intercellular adhesion molecule (ICAM)-1 expression. METHODS Nine children with active HSP and nine normal healthy children were enrolled. IL8 serum levels of patients and controls at different stages were analysed. Production of IL8 and expression of ICAM-1 by human umbilical venous endothelial cells were detected (ELISA for IL8, flow cytometry for ICAM-1) and compared under various stimuli, including sera of patients at different stages, sera of controls, and medium alone. RESULTS Serum levels of IL8 were increased at the acute stage. Levels of IL8 in supernatants from human umbilical venous endothelial cells (HUVEC) co-cultured with sera from children with active HSP were significantly higher than those from HUVEC without any treatment (p = 0.001), HUVEC treated with inactive sera (p = 0.004), and HUVEC treated with sera from healthy controls (p = 0.004). Sera from patients and from controls did not enhance the expression of ICAM-1 on HUVEC. CONCLUSIONS Some factors may be present in sera from children with active HSP that could activate endothelial cells to produce IL8. This process may account, in part, for the mechanisms of perivascular neutrophil infiltration and leucocytosis in HSP.
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Affiliation(s)
- Y H Yang
- Department of Paediatrics, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei, Taiwan
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Wei J, Chang CY, Chuang YC, Young MS, Huang CM, Yin WH, Tung DY, Lee WC, Lee SL, Chu CH. Heart transplantation at Cheng Hsin General Hospital in Taiwan: 15-year experience. Transplant Proc 2004; 36:2374-6. [PMID: 15561253 DOI: 10.1016/j.transproceed.2004.08.102] [Citation(s) in RCA: 4] [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: 10/26/2022]
Abstract
Heart transplantation (HTx) in Taiwan, which started in 1987, now includes more than 500 cases. From July 1988 to September 2003, we performed 215 cases of orthotopic HTx in 164 male and 51 female recipients of mean age of 47.3 +/- 14.3 years, (range 2.7 to 74.9 years). The leading etiologies were dilated cardiomyopathy (CMP), 68.5%; ischemic CMP, 20.2%; and valvular CMP, 4.2%. The actuarial survival rates at 1, 5, and 10 years are 88.3%, 77.1%, and 57.2%, respectively. We performed the first case of HTx in Asia after bridging for 14 days with an indigenous total artificial heart (TAH; the Phoenix-7 model); we performed the first case of infant HTx without blood transfusion and also the first case of autotransplantation of heart for repair of a left ventricular rupture after a mitral valve replacement. These cases were all successful with the longest surviving HTx recipient in Asia. We have used the biatrial anastomosis technique in all cases. We discovered familial CMP due to mitochondrial defects in two pediatric cases. Because of the scarcity of donor hearts, we have used size-mismatched hearts as well as suboptimal and hepatitis-positive donor hearts, all with satisfactory outcomes. Our experience has shown comparable results to Western programs, with efficacy and cost-effectiveness. We find the technique of biatrial anastomosis for orthotopic HTx to result in a low incidence of tricuspid regurgitation and conduction anomalies. The use of suboptimal and size-mismatched donor hearts is also promising.
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Affiliation(s)
- J Wei
- Heart Centre, Cheng Hsin General Hospital, Taipei, Taiwan, R.O.C.
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Huang CM, Chen CL, Tsai JJP, Tsai CH, Tsai FJ. Association between urokinase gene 3'-UTR T/C polymorphism and Chinese patients with rheumatoid arthritis in Taiwan. Clin Exp Rheumatol 2004; 22:219-22. [PMID: 15083890] [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: 04/29/2023]
Abstract
OBJECTIVES The purpose of this study was to investigate whether the urokinase gene 3'-UTR C/T polymorphism is a marker of susceptibility to or severity of rheumatoid arthritis (RA) in Chinese patients. METHODS A total of 145 RA patients and 134 healthy control subjects were enrolled in this study. We identified the C/T polymorphism of the urokinase gene, which is mapped on the 3'-untranslated region (3'-UTR) on chromosome 10 by polymerase chain reaction (PCR). RESULTS There were significant differences in the distribution of the urokinase gene 3'-UTR C/T polymorphism frequency between RA patients and subjects in the control group. However, we did not detect an, association between the urokinase gene 3'-UTR C/T polymorphism and rheumatoid factor (RF), extraarticular involvement or bone erosion in RA patients. CONCLUSION The urokinase gene 3'-UTR "T" allele was associated with RA in Chinese patients in Taiwan.
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Affiliation(s)
- C M Huang
- Division of Immunology and Rheumatology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
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Abstract
We aimed to evaluate the relationship between two polymorphisms of the IL4 gene (-590T/C and intron 3) and systemic lupus erythematosus in Chinese patients in Taiwan. This study included 91 patients with systemic lupus erythematosus (SLE) and 163 unrelated, age matched healthy controls living in the same area. The typing of -590T/C and intron 3 VNTR (variable number of tandem repeats) polymorphisms were performed by PCR-RFLP and PCR, respectively. Allelic frequencies and carriage rates between SLE patients and controls were compared, and the relationship between allelic frequencies and clinical manifestations of SLE was evaluated. The genotype frequencies of IL-4 intron 3 were found to differ significantly between SLE patients with and without discoid rash (chi-square test, P = 0.03 5). The allelic frequency of intron 3 RP1 was significant different in the patients with discoid rash when compared to patients without this clinical feature (OR = 3.70, 95% CI 2.04-6.72, chi2 test, P = 0.029). The RP1/RP1 homozygous carriage was significantly associated with patients with discoid rash when compared to patients without this clinical feature (OR = 6.04, 95% CI 2.81-12.95, P = 0.01). The allelic frequency of -590T was significant different in the patients with discoid rash when compared to patients without this clinical feature (OR = 3.44, 95% CI 1.88-6.31, chi-square test, P=0.04). The T/T homozygous carriage was significantly associated with patients with discoid rash when compared to patients without this clinical feature (OR = 5.41, 95% CI 2.50-11.68, P = 0.02). We describe a novel association between RPI/RPI and T/T homozygous carriage and patients with discoid rash. The role of the intron 3 polymorphism of the IL4 gene in SLE remains unclear and further substantiation based on larger patient samples is needed.
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Affiliation(s)
- M C Wu
- Department of Medical Genetics, Division of Immunology and Rheumatology, China Medical College Hospital, Taichung, Taiwan
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Huang CM, Wu MC, Wu JY, Tsai FJ. No association of interleukin-4 gene polymorphisms in Chinese patients with rheumatoid arthritis in Taiwan. Clin Exp Rheumatol 2002; 20:871-2. [PMID: 12508786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
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Abstract
The purpose of this study was to evaluate whether vitamin D receptor (VDR) genes BsmI polymorphisms were markers for susceptibility to or severity of systemic lupus erythematosus (SLE) in Chinese patients in Taiwan. The study included 47 Chinese patients with SLE. In addition, 90 unrelated, healthy individuals living in central Taiwan served as control subjects. Each polymorphism was detected as a result of polymerase chain reaction (PCR)-based restriction analysis. A PCR product length was determined to be 580bp (BB) whereas two fragments of 405 and 175bp were determined to be excisable lengths (bb) by BsmI endonuclease. The relationship between Bsm polymorphisms and clinical manifestations of SLE was evaluated. We found that BB was significantly more common and bb less common in SLE than in control group (chi2 = 54.2, P < 0.0001). In addition, the frequency of B allele was also significantly more common in patients with SLE than in the healthy control subjects (chi2 = 38.7, P < 0.0001), giving an odds ratio of 7.14 (95% confidence interval 3.53-14.4). In the SLE patients, we did not detect any associations of VDR genotype with the clinical, laboratory profiles, or lupus nephritis (chi2 = 2.34, P = 0.3). This study indicated an increased distribution of VDR BB genotype and B allelic frequencies in the Chinese SLE patients in Taiwan. However, there were no associations between the frequency of VDR allelic variations and clinical manifestations, laboratory profiles, or lupus nephritis.
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Affiliation(s)
- C M Huang
- Division of Immunology and Rheumatology, Department of Internal Medicine, China Medical College Hospital, Taiwan
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Chang AY, Huang CM, Chan JY, Chan SH. Involvement of noradrenergic innervation from locus coeruleus to hippocampal formation in negative feedback regulation of penile erection in the rat. Hippocampus 2002; 11:783-92. [PMID: 11811673 DOI: 10.1002/hipo.1094] [Citation(s) in RCA: 12] [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] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We demonstrated previously that a novel negative feed back mechanism for the regulation of penile erection, which is triggered by ascending sensory inputs initiated by tumescence of the penis, exists in the hippocampal formation (HF). This study further elucidated the role of the locus coeruleus (LC), which is the largest aggregate of norepinephrine-containing neurons in the brain and provides the major noradrenergic innervation to the HF, in this process. Adult male Sprague-Dawley rats that were anesthetized and maintained with chloral hydrate were used. The intracavernous pressure (ICP) recorded from the corpus cavernosum of the penis was used as the experimental index for penile erection. Electrical activation of the LC elicited a significant reduction in baseline ICP. Similar observations were obtained on microinjection bilaterally into the hippocampal CA1 or CA3 subfield or dentate gyrus of equimolar doses (5 nmol) of norepinephrine (alpha1-, alpha2-agonist), phenylephrine (alpha1-agonist), or BHT 933 (alpha2-agonist). Bilateral electrolytic lesions of the LC discernibly enhanced the magnitude and/or duration of the elevation in ICP induced by intracavernous administration of papaverine (400 microgram). A potentiation of the papaverine-evoked ICP increase was also observed following pretreatment with bilateral hippocampal application of equimolar doses (250 pmol) of either prazosin (alpha1-, alpha2B-, alpha2C-antagonist), naftopidil (alpha1A/D-antagonist), yohimbine (alpha2-antagonst), or rauwolscine (alpha2B-, alpha2C-antagonist). None of these antagonists, however, affected baseline ICP. These results suggest that noradrenergic innervation of the HF that originates from the LC may play an active role in negative feedback regulation of penile erection, engaging at least alpha1A/D-, alpha2B-, and alpha2C-adrenoceptors in the HF.
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Affiliation(s)
- A Y Chang
- Center for Neuroscience, National Sun Yat-sen University, Kaohsiung, Taiwan, Republic of China.
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Chang AY, Chan JY, Kao FJ, Huang CM, Chan SH. Engagement of inducible nitric oxide synthase at the rostral ventrolateral medulla during mevinphos intoxication in the rat. J Biomed Sci 2001; 8:475-83. [PMID: 11702011 DOI: 10.1007/bf02256610] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
We evaluated the relationship between the toxicity induced by the organophosphate mevinphos (Mev) and inducible nitric oxide synthase (iNOS) in the rostral ventrolateral medulla (RVLM), the medullary origin of sympathetic neurogenic vasomotor tone. Adult Sprague-Dawley rats that were anesthetized and maintained with propofol were used. Laser scanning confocal microscopic analysis revealed colocalization of the M2 subtype of muscarinic receptors (M(2)R) and iNOS immunoreactivity in RVLM neurons. Comicroinjection bilaterally of Mev (10 nmol) and artificial cerebrospinal fluid (aCSF) into the RVLM elicited a progressive decline in systemic arterial pressure (SAP) and heart rate. This was accompanied during phase 1 Mev intoxication by an increase in the power density of the very high-frequency (VHF; 5-9 Hz), high-frequency (HF; 0.8-2.4 Hz), low-frequency (LF; 0.25- 0.8 Hz) and very low-frequency (VLF; 0-0.25 Hz) components of SAP signals. Phase 2 exhibited a reversal of the VHF and VLF power to control levels and a further reduction in the power density of both HF and LF components to below baseline. Hypotension and bradycardia promoted by Mev were significantly blunted on coadministration into the RVLM of the selective iNOS inhibitors S-methylisothiourea (250 pmol) or aminoguanidine (250 pmol). Not only was the augmented power density of HF and LF components during phase 1 Mev intoxication further enhanced, the reduced power of these two spectral components during phase 2 was appreciably antagonized. On the other hand, the temporal changes in VHF and VLF power were essentially the same as with coadministration of Mev and aCSF. We conclude that, as a cholinesterase inhibitor, Mev may induce toxicity via nitric oxide produced by iNOS on activation of the M(2)R by the accumulated acetylcholine in the RVLM.
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Affiliation(s)
- A Y Chang
- Center for Neuroscience, Department of Biological Science, National Sun Yat-sen University, Kaohsiung, Taiwan, ROC.
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Abstract
The purpose of this study was to evaluate if IL-1beta (IL-1beta promoter and IL-1beta exon 5) and IL-1receptor antagonist (IL-1Ra) gene polymorphisms act as markers of susceptibility to or severity of RA. The study included 104 RA patients and 103 normal controls. No significant difference was observed in the cytokine allelic frequencies of IL-1beta promoter and IL-1beta exon 5 between patients with RA and healthy controls. In addition, there was no significant association in the cytokine carriage rates of I and II allele of IL-1Ra between RA patients and healthy controls. In contrast, the IV allele of IL-1Ra was significantly increased in RA patients with low inflammatory activity (P=0.03). This study indicated that allelic frequency and carriage rate of IL-1beta (IL-1beta promoter and IL-1beta exon 5) and IL-1Ra (I and II allele) do not differ significantly between normal controls and RA patients in Taiwan. However, the carriage rate of IV allele of IL-1Ra was high in the RA patients with low inflammatory activity.
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Affiliation(s)
- C M Huang
- Department of Internal Medicine, China Medical College Hospital, Taichung, Taiwan
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Huang CM, Shui HA, Wu YT, Chu PW, Lin KG, Kao LS, Chen ST. Proteomic analysis of proteins in PC12 cells before and after treatment with nerve growth factor: increased levels of a 43-kDa chromogranin B-derived fragment during neuronal differentiation. Brain Res Mol Brain Res 2001; 92:181-92. [PMID: 11483256 DOI: 10.1016/s0169-328x(01)00118-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Proteomic analysis is an important approach to characterizing the proteome and studying protein function in the post-genomic era. It is also a powerful screening method for detecting unexpected alterations in protein expression that may be missed by conventional biochemical techniques. The aim of this study was to perform a preliminary proteomic analysis of PC12 cells in order to investigate the effect of nerve growth factor (NGF) on protein expression in PC12 cells during neurite outgrowth. PC12 cell proteins were separated by two-dimensional electrophoresis (2DE) and visualized by silver staining, then certain proteins were identified by N-terminal amino acid microsequencing and a homology search of a protein sequence database. Over 400 proteins were detected, 10% of which showed a significant (greater than 30%) increase or decrease in expression during NGF-induced neuronal differentiation. Seven proteins in the 2DE map were identified; the levels of five of these were unaffected by NGF treatment, whereas the levels of the other two, beta-tubulin and a novel 43-kDa chromogranin B-derived fragment, were significantly increased by more than 30 and 200%, respectively. Our results suggest that chromogranin B processing is enhanced in PC12 cells during NGF-induced neuronal differentiation. In addition, since this increase in the levels of the chromogranin B-derived fragment was specifically blocked by PD98059, we suggest that the increased processing can be ascribed to activation of the MAP kinase pathway, and that the 43-kDa chromogranin B-derived fragment can serve as a new marker of neuronal differentiation for proteomic studies.
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Affiliation(s)
- C M Huang
- Institute of Biological Chemistry, Academia Sinica, No. 128, Sec. 2 Yan-Chiu-Yuan Road, Taipei 11529, Taiwan
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Abstract
[reaction: see text] A general approach to the synthesis of aza bicyclic enones was developed via a simple two-step annulation involving a Mitsunobu protocol and anionic cyclization. According to this strategy the total synthesis of (-)-brunsvigine was accomplished with 12% overall yield.
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Affiliation(s)
- C K Sha
- Department of Chemistry, National Tsing Hua University, Hsinchu 300, Taiwan, ROC.
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47
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Pan TL, Goto S, Lord R, Huang YC, Huang CM, Wang PW, Lin YC, Kawamoto S, Ono K, Liao PC, Lin CL, Lai CY, Chang HL, Lan CH, Lee TH, Wang YC, Wu ML, Jawan B, Cheng YF, Chen ST, Chen CL. Proteome analysis in liver transplantation. Transplant Proc 2001; 33:156. [PMID: 11266756 DOI: 10.1016/s0041-1345(00)01952-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- T L Pan
- Department of Surgery and Liver Transplant Program, Chang Gung Memorial Hospital Kaohsiung, Niao Sung, Kaohsiung, Taiwan
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Abstract
BACKGROUND The binding of somatostatin (SST) to endogenous G-protein-coupled receptors (SST receptors or SSTRs) is followed by internalization of SST, and, several reports have shown that a high density of SSTRs is present on most hormone-secreting tissue tumors. Facile synthesis of the long-acting SST analog, octreotide, has previously been described. Octreotide might be of practical value in developing tumor tracers and in serving as a carrier of cytotoxic antitumor drugs. RESULTS Fluorescein-labeled octreotide was internalized into the cytosol of human breast MCF-7 carcinoma cells via binding to SSTRs. Octreotide-conjugated paclitaxel (taxol) was created by coupling taxol-succinate to the amino-terminal end of octreotide. This conjugate retains the biological activity of taxol in inducing formation of tubulin bundles, eventually causing apoptosis of MCF-7 cells. Cytotoxicity of octreotide-conjugated taxol is mainly mediated by SSTR, as shown by the observation that octreotide pretreatment can rescue the induced cell death. In comparison with free taxol, this conjugate shows much less toxicity in Chinese hamster ovary cells. CONCLUSIONS Octreotide-conjugated taxol exerts the same antitumor effect of free taxol on stabilizing microtubule formation and inducing cell death. This conjugate triggers tumor cell apoptosis mediated by SSTRs and is exclusively toxic to SSTR-expressing cells. Octreotide-conjugated taxol is less toxic to low-SSTR-expressing cells compared with free taxol. Our results strongly indicated that octreotide-conjugated taxol demonstrates cell selectivity and may be used as a targeting agent for cancer therapy.
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Affiliation(s)
- C M Huang
- Institute of Biological Chemistry, Academia Sinica, Taipei 115, Taiwan
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Abstract
Telomeres are specialized structures at the ends of eukaryotic chromosomes which are composed of simple repetitive G-rich hexameric sequences. Activation of telomerase, a ribonucleoprotein that synthesizes telomeric DNA, is found in most malignant tumors. However, little data is available concerning the correlation between telomerase activity and NPC (nasopharyngeal carcinoma). In this study, telomerase activation was determined using the TRAP (telomerase repeat amplification protocol) assay in 62 nasopharyngeal biopsies (25 NPC, 25 non-malignant nasopharyngeal lymphoid tissues, 12 post-irradiated nasopharyngeal tissues). The results showed that strong telomerase activity was present in both NPC and non-malignant nasopharyngeal biopsies. Post-irradiated nasopharyngeal samples had a significantly lower telomerase activity than NPC and non-malignant nasopharyngeal lymphoid tissues. It is well known that nasopharyngeal tissue is infiltrated by numerous lymphocytes, which might retain telomerase activity. Therefore, the finding that the telomerase activation was lowest in post-irradiated nasopharyngeal tissues is reasonable because of the destruction of activated lymphocytes and NPC by radiation. NPC biopsies with positive lymph node involvement exhibited higher levels of telomerase compared to those without lymph node involvement. Our data indicate a positive association between telomerase activity and tumor potential for lymphatic spreading in limited local tumors. In addition, telomerase activity may be useful as a diagnostic marker in the detection of tumor cells in recurrent NPC, but not in primary NPC.
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Affiliation(s)
- C F Hwang
- Department of Otolaryngology, Chang-Gung Memorial Hospital, Kaohsiung, Taiwan
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Abstract
Gout with systemic lupus erythematosus (SLE) or progressive systemic sclerosis (PSS) has rarely been reported, whereas mixed connective tissue disease (MCTD) with the demonstration of intra-articular monosodium urate crystals has never been reported. We describe an unusual case of MCTD (SLE-PSS) in a 37-year-old woman who developed acute gouty arthritis. Arthrocentesis and synovianalysis may be necessary to differentiate gout from the arthropathy of MCTD.
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Affiliation(s)
- C M Huang
- Department of Internal Medicine, China Medical College Hospital, Taichung, Taiwan, ROC
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