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Jiang J, Xia Z, Zheng D, Li Y, Li F, Wang W, Ding S, Zhang J, Su X, Zhai Q, Zuo Y, Zhang Y, Gaisano HY, He Y, Sun J. Factors associated with nocturnal and diurnal glycemic variability in patients with type 2 diabetes: a cross-sectional study. J Endocrinol Invest 2024; 47:245-253. [PMID: 37354249 DOI: 10.1007/s40618-023-02142-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 06/16/2023] [Indexed: 06/26/2023]
Abstract
PURPOSE There is little information on factors that influence the glycemic variability (GV) during the nocturnal and diurnal periods. We aimed to examine the relationship between clinical factors and GV during these two periods. METHODS This cross-sectional study included 134 patients with type 2 diabetes. 24-h changes in blood glucose were recorded by a continuous glucose monitoring system. Nocturnal and diurnal GV were assessed by standard deviation of blood glucose (SDBG), coefficient of variation (CV), and mean amplitude of glycemic excursions (MAGE), respectively. Robust regression analyses were performed to identify the factors associated with GV. Restricted cubic splines were used to determine dose-response relationship. RESULTS During the nocturnal period, age and glycemic level at 12:00 A.M. were positively associated with GV, whereas alanine aminotransferase was negatively associated with GV. During the diurnal period, homeostatic model assessment 2-insulin sensitivity (HOMA2-S) was positively associated with GV, whereas insulin secretion-sensitivity index-2 (ISSI2) was negatively associated with GV. Additionally, we found a J-shape association between the glycemic level at 12:00 A.M. and MAGE, with 9.0 mmol/L blood glucose level as a cutoff point. Similar nonlinear associations were found between ISSI2 and SDBG, and between ISSI2 and MAGE, with ISSI2 value of 175 as a cutoff point. CONCLUSION Factors associated with GV were different between nocturnal and diurnal periods. The cutoff points we found in this study may provide the therapeutic targets for beta-cell function and pre-sleep glycemic level in clinical practice.
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Affiliation(s)
- J Jiang
- Department of Endocrinology, Jining No. 1 People's Hospital, 6 Jiankang Road, Rencheng District, Jining, 272000, Shandong, China
- Postdoctoral of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Z Xia
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 100069, China
| | - D Zheng
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Y Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 100069, China
| | - F Li
- Department of Endocrinology, Jining No. 1 People's Hospital, 6 Jiankang Road, Rencheng District, Jining, 272000, Shandong, China
| | - W Wang
- Department of Endocrinology, Jining No. 1 People's Hospital, 6 Jiankang Road, Rencheng District, Jining, 272000, Shandong, China
| | - S Ding
- Department of Endocrinology, Jining No. 1 People's Hospital, 6 Jiankang Road, Rencheng District, Jining, 272000, Shandong, China
| | - J Zhang
- Department of Endocrinology, Jining No. 1 People's Hospital, 6 Jiankang Road, Rencheng District, Jining, 272000, Shandong, China
| | - X Su
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 100069, China
| | - Q Zhai
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 100069, China
| | - Y Zuo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 100069, China
| | - Y Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 100069, China
| | - H Y Gaisano
- Departments of Medicine and Physiology, University of Toronto, Toronto, ON, Canada
| | - Y He
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 100069, China.
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
| | - J Sun
- Department of Endocrinology, Jining No. 1 People's Hospital, 6 Jiankang Road, Rencheng District, Jining, 272000, Shandong, China.
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Liu Y, Zhang Y, You G, Zheng D, He Z, Guo W, Antonina K, Shukhrat Z, Ding B, Zan J, Zhang Z. Tangeretin attenuates acute lung injury in septic mice by inhibiting ROS-mediated NLRP3 inflammasome activation via regulating PLK1/AMPK/DRP1 signaling axis. Inflamm Res 2024; 73:47-63. [PMID: 38147126 DOI: 10.1007/s00011-023-01819-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/05/2023] [Accepted: 11/06/2023] [Indexed: 12/27/2023] Open
Abstract
OBJECTIVE NLRP3 inflammasome-mediated pyroptosis of macrophage acts essential roles in the progression of sepsis-induced acute lung injury (ALI). Tangeretin (TAN), enriched in citrus fruit peel, presents anti-oxidative and anti-inflammatory effects. Here, we aimed to explore the potentially protective effect of TAN on sepsis-induced ALI, and the underlying mechanism of TAN in regulating NLRP3 inflammasome. MATERIAL AND METHODS The effect of TAN on sepsis-induced ALI and NLRP3 inflammasome-mediated pyroptosis of macrophage were examined in vivo and in vitro using a LPS-treated mice model and LPS-induced murine macrophages, respectively. The mechanism of TAN regulating the activation of NLRP3 inflammasome in sepsis-induced ALI was investigated with HE staining, Masson staining, immunofluorescent staining, ELISA, molecular docking, transmission electron microscope detection, qRT-PCR, and western blot. RESULTS TAN could evidently attenuate sepsis-induced ALI in mice, evidenced by reducing pulmonary edema, pulmonary congestion and lung interstitial fibrosis, and inhibiting macrophage infiltration in the lung tissue. Besides, TAN significantly suppressed inflammatory cytokine IL-1β and IL-18 expression in the serum or bronchoalveolar lavage fluid (BALF) samples of mice with LPS-induced ALI, and inhibited NLRP3 inflammasome-mediated pyroptosis of macrophages. Furthermore, we found TAN inhibited ROS production, preserved mitochondrial morphology, and alleviated excessive mitochondrial fission in LPS-induced ALI in mice. Through bioinformatic analysis and molecular docking, Polo-like kinase 1 (PLK1) was identified as a potential target of TAN for treating sepsis-induced ALI. Moreover, TAN significantly inhibited the reduction of PLK1 expression, AMP-activated protein kinase (AMPK) phosphorylation, and Dynamin related protein 1 (Drp1) phosphorylation (S637) in LPS-induced ALI in mice. In addition, Volasertib, a specific inhibitor of PLK1, abolished the protective effects of TAN against NLRP3 inflammasome-mediated pyroptosis of macrophage and lung injury in the cell and mice septic models. CONCLUSION TAN attenuates sepsis-induced ALI by inhibiting ROS-mediated NLRP3 inflammasome activation via regulating PLK1/AMPK/DRP1 signaling axis, and TAN is a potentially therapeutic candidate against ALI through inhibiting pyroptosis.
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Affiliation(s)
- Yuntao Liu
- State Key Laboratory of Traditional Chinese Medicine Syndrom,The second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
| | - Yuting Zhang
- School of Biomedical and Pharmaceutical Sciences, Guangdong University of Technology, Guangzhou, 510006, China
| | - Guoxing You
- School of Biomedical and Pharmaceutical Sciences, Guangdong University of Technology, Guangzhou, 510006, China
| | - Danwen Zheng
- State Key Laboratory of Traditional Chinese Medicine Syndrom,The second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
| | - Zhipeng He
- State Key Laboratory of Traditional Chinese Medicine Syndrom,The second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
| | - Wenjie Guo
- School of Biomedical and Pharmaceutical Sciences, Guangdong University of Technology, Guangzhou, 510006, China
| | - Kim Antonina
- No. 1 Department of Internal Diseases, Samarkand State Medical University, Samarkand, Uzbekistan
| | - Ziyadullaev Shukhrat
- No. 1 Department of Internal Diseases, Samarkand State Medical University, Samarkand, Uzbekistan
| | - Banghan Ding
- State Key Laboratory of Traditional Chinese Medicine Syndrom,The second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China.
| | - Jie Zan
- School of Biomedical and Pharmaceutical Sciences, Guangdong University of Technology, Guangzhou, 510006, China.
| | - Zhongde Zhang
- State Key Laboratory of Traditional Chinese Medicine Syndrom,The second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China.
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Zhang Y, Ye X, Ge J, Guo D, Zheng D, Yu H, Chen Y, Yao G, Lu Z, Yuille A, Lu L, Jin D, Yan S. Deep Learning-Based Multi-Modality Segmentation of Primary Gross Tumor Volume in CT and MRI for Nasopharyngeal Carcinoma. Int J Radiat Oncol Biol Phys 2023; 117:e498. [PMID: 37785566 DOI: 10.1016/j.ijrobp.2023.06.1739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The delineation of primary gross tumor volume (GTV) of nasopharyngeal carcinoma (NPC) is an essential step for radiotherapy planning. In clinical practice, radiation oncologists manually delineate the GTV in planning CT with the help of diagnostic MRI. This is because NPC tumors are closely adjacent to many important anatomic structures, and CT and MRI provide complementary strength to accurately determine the tumor extension boundary. Manual delineation is time-consuming with the potential registration errors between MRI and CT decreasing the delineation accuracy. In this study, we propose a fully automated GTV segmentation method based on CT and MRI by first aligning MRI to CT, and then, segmenting the GTV using a multi-modality deep learning model. MATERIALS/METHODS We collected 104 nasopharyngeal carcinoma patients with both planning CT and diagnostic MRI scans (T1 & T2 phases). An experienced radiation oncologists manually delineated the GTV, which was further examined by another senior radiation oncologist. Then, a coarse to fine cross-modality registration from MRI to CT was conducted as follows: (1) A rigid transformation was performed on MRI to roughly align MRI to CT with similar anatomic position. (2) Then, the region of interest (RoI) on both CT and rigid-transformed MRI were cropped. (3) A leading cross-modality deformable registration algorithm, named DEEDS, was applied on the cropped MRI and CT RoIs to find an accurate local alignment. Next, using CT and registered MRI as the combined input, a multi-modality deep segmentation network based on nnUNet was trained to generate the GTV prediction. 20% patients were randomly selected as the unseen testing set to quantitatively evaluate the performance. RESULTS The quantitative NPC GTV segmentation performance is summarized in Table 1. The deep segmentation model using CT alone achieved reasonable high performance with 76.6% Dice score and 1.34mm average surface distance (ASD). When both CT and registered MRI were used, the segmentation model further improved the performance by 0.9% Dice score increase and 11% relative ASD error reduction, demonstrating the complementary strength of CT and MRI in determining NPC GTV. Notably, the achieved 77.5% Dice score and 1.19mm ASD by the multimodality model is among the top performing results reported in recent automatic NPC GTV segmentation using either CT or MRI modality. CONCLUSION We developed a fully automated multi-modal deep-learning model for NPC GTV segmentation. The developed model can segment the NPC GTV in high accuracy. With further optimization and validation, this automated model has potential to standardize the NPC GTV segmentation and significantly decrease the workload of radiation oncologists in clinical practice.
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Affiliation(s)
- Y Zhang
- Johns Hopkins University, Baltimore, MD
| | - X Ye
- Department of Radiation Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - J Ge
- Department of Radiation Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - D Guo
- Alibaba Group (US) Inc., New York, NY
| | - D Zheng
- Department of Radiation Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - H Yu
- Department of Radiation Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Y Chen
- Department of Radiation Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - G Yao
- Department of Radiation Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Z Lu
- Department of Radiation Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - A Yuille
- Johns Hopkins University, Baltimore, MD
| | - L Lu
- Alibaba Group (US) Inc., New York, NY
| | - D Jin
- Alibaba Group (US) Inc., New York, NY
| | - S Yan
- Department of Radiation Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Feng B, Zheng D, Yang L, Su Z, Tang L, Zhu Y, Xu X, Wang Q, Lin Q, Hu J, Lin M, Huang L, Zhou X, Liu H, Li S, Pan W, Shi R, Lu Y, Wu B, Ding B, Wang Z, Guo J, Zhang Z, Zheng G, Liu Y. Post-hospitalization rehabilitation alleviates long-term immune repertoire alteration in COVID-19 convalescent patients. Cell Prolif 2023; 56:e13450. [PMID: 36938980 PMCID: PMC10542649 DOI: 10.1111/cpr.13450] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/27/2023] [Accepted: 03/02/2023] [Indexed: 03/21/2023] Open
Abstract
The global pandemic of Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an once-in-a-lifetime public health crisis. Among hundreds of millions of people who have contracted with or are being infected with COVID-19, the question of whether COVID-19 infection may cause long-term health concern, even being completely recovered from the disease clinically, especially immune system damage, needs to be addressed. Here, we performed seven-chain adaptome immune repertoire analyses on convalescent COVID-19 patients who have been discharged from hospitals for at least 6 months. Surprisingly, we discovered lymphopenia, reduced number of unique CDR3s, and reduced diversity of the TCR/BCR immune repertoire in convalescent COVID-19 patients. In addition, the BCR repertoire appears to be activated, which is consistent with the protective antibody titres, but serological experiments reveal significantly lower IL-4 and IL-7 levels in convalescent patients compared to those in healthy controls. Finally, in comparison with convalescent patients who did not receive post-hospitalization rehabilitation, the convalescent patients who received post-hospitalization rehabilitation had attenuated immune repertoire abnormality, almost back to the level of healthy control, despite no detectable clinic demographic difference. Overall, we report the potential long-term immunological impairment for COVID-19 infection, and correction of this impairment via post-hospitalization rehabilitation may offer a new prospect for COVID-19 recovery strategy.
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Wang P, Ge J, Zheng D, Zhu X, Liu J, Wu Y, Lu L, Yan S, Jin D, Ye X. Anatomy-Guided Deep Learning Model for Accurate and Robust Gross Tumor Volume Segmentation in Lung Cancer Radiation Therapy. Int J Radiat Oncol Biol Phys 2023; 117:e71. [PMID: 37786077 DOI: 10.1016/j.ijrobp.2023.06.803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) In lung cancer radiation therapy, clinicians must outline the gross tumor volume (GTV) precisely on the planning computed tomography (pCT) for accurate radiation dose delivery. However, due to the limited contrast between tumor and normal tissues in lung parenchyma, accurate delineation of tumor boundaries is difficult leading to large inter-observer variation. In this study, we develop an anatomy-guided lung GTV deep segmentation model using a training cohort of multi-center datasets. The quantitative segmentation performance is evaluated on an independent dataset, where the inter-observer delineation variation is also assessed. MATERIALS/METHODS We collected and curated four publicly available lung datasets with GTV annotations (Lung-PET-CT-Dx, LIDC-IDRI, NSCLC-Radiogenomics and RIDER-CT) for deep learning model development. A total of 871 CT scans of patients, who were diagnosed with T1-T4 NSCLC, were available for training after data curation. The GTV annotations of primary tumor were examined and edited by two experienced radiation oncologists following the RTOG 1106 protocol. An anatomy-guided deep learning model was proposed, which consisted two deep networks. The first deep network used CT scan as input and segmented 4 anatomic organs (airway, heart, pulmonary artery and pulmonary vein), while the second deep network took both CT scan and these pre-segmented 4 organs as input and segmented the lung GTV. With the help of anatomic priors from 4 pre-segmented organs, the second deep network could more easily locate the GTV. We used nnUNet as the deep segmentation network. For evaluation, we used NSCLC-Radiomics as the testing dataset, which contains 20 CT scans each annotated by 5 radiation oncologists. The auto-segmented GTV were compared against each of the manual GTV reference. Inter-observer variation was also assessed using the 5 manual GTV references. RESULTS The proposed anatomic-guided lung GTV segmentation model achieved a mean Dice score of 82.4% and 95% Hausdorff distance (HD95) of 6.9mm when averaged cross 20 patients and 5 GTV references (Table 1), which outperformed the basic deep GTV segmentation model by markedly reducing 19.4% HD95 error. The performance of proposed model was also comparable to the inter-observer variation (Dice score: 82.4% vs. 81.9%, HD95 6.9 vs. 6.4mm), indicating that our model had similar reproducibility as human observers. CONCLUSION We developed and tested an anatomy-guided deep learning model for segmenting GTV in NSCLC patients. The model achieves high quantitative segmentation performance, which is comparable to the human observer variation. It can be potentially used in radiotherapy practice to improve GTV delineation consistency and reduce workloads of radiation oncologists.
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Affiliation(s)
- P Wang
- Alibaba DAMO Academy, Hangzhou, Zhejiang, China
| | - J Ge
- Department of Radiation Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - D Zheng
- Department of Radiation Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - X Zhu
- The First Affiliated Hospital, Zhejiang University, Hangzhou, Zhejiang, China
| | - J Liu
- The First Affiliated Hospital, Zhejiang University, Hangzhou, Zhejiang, China
| | - Y Wu
- The First Affiliated Hospital, Zhejiang University, Hangzhou, Zhejiang, China
| | - L Lu
- Alibaba Group (US) Inc., New York, NY
| | - S Yan
- Department of Radiation Oncology, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - D Jin
- Alibaba Group (US) Inc., New York, NY
| | - X Ye
- Department of Radiation Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Zhao Y, Zheng D, Zhang L, Xie X, Liu D, Yu G. Recovery of gland function after endoscopy-assisted removal of impacted hilo-parenchymal stones in the Wharton's duct. Int J Oral Maxillofac Surg 2023; 52:553-559. [PMID: 36210232 DOI: 10.1016/j.ijom.2022.09.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/01/2022] [Accepted: 09/29/2022] [Indexed: 04/09/2023]
Abstract
The aim of this study was to evaluate the gland function of patients following endoscopy-assisted removal of impacted hilo-parenchymal stones in the Wharton's duct. The study cohort comprised 115 patients who had undergone successful endoscopy-assisted lithotomy for hilo-parenchymal stones (mean diameter 7.7 mm). Gland function was evaluated at a mean 12 months after surgery using ultrasonography, sialography, and/or sialometry. Postoperative ultrasonography of 51 affected glands revealed a regular gland size in 58.8%, normal parenchyma density in 51.0%, and ductal ectasia in 80.4%. Postoperative sialograms of 109 affected glands were scored as type I (approximately normal) in 13 cases, type II (saccular ectasia of the hilo-parenchymal duct with/without stenosis, and no contrast retention) in 64, type III (saccular ectasia of the hilo-parenchymal duct with/without stenosis, and mild contrast retention) in 23, and type IV (poor shape of the main duct with evident contrast retention) in nine cases. The existence of ductal ectasia corresponded well to larger stone cases (P = 0.002). In the postoperative sialometry of 35 patients with unilateral stones, differences between the two sides were insignificant (P > 0.05). For patients with hilo-parenchymal submandibular gland stones, endoscopy-assisted surgery and extended postoperative follow-up help preserve the gland with good function.
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Affiliation(s)
- Y Zhao
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Beijing, PR China; Department of Radiology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, Shandong, PR China
| | - D Zheng
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - L Zhang
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - X Xie
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - D Liu
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Beijing, PR China.
| | - G Yu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, PR China
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Cai W, Lin C, Zheng D, Xie H. [Prevalence of Anisakise infections in marine fishes in Eastern Fujian Fishing Ground of Fujian Province]. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi 2023; 35:78-81. [PMID: 36974019 DOI: 10.16250/j.32.1374.2022119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
OBJECTIVE To investigate the prevalence of Anisakis infection in marine fishes in Eastern Fujian Fishing Ground of Fujian Province, so as to provide insights into the development of the anisakiasis control strategy. METHODS Marine fish samples were randomly collected from Jiaocheng District, Fuding City and Xiapu County around Eastern Fujian Fishing Ground in Fujian Province from September to December, 2021. All fishes were dissected, and the abdominal contents were collected. Parasites were sampled under a stereomicroscope and the Anisakis species were identified through morphology. The prevalence and intensity of Anisakis infections were calculated. RESULTS A total of 177 marine fishes belonging to 24 species were dissected, and Anisakis was detected in 73 marine fishes (41.2%) belonging to 16 species (66.7%), with a mean infection intensity of 14.3 parasites per fish. High prevalence of Anisakis infection was found in Ilisha elongata (5/5), Miichthys miiuy (3/3), Plectorhynchus cinctus (2/2), Scomberomorus niphonius (12/13), Trichiurus lepturus (19/23), Pennahia argentata (6/11) and Ditrema temmincki (14/27), with mean infection intensities of 9.2, 2.7, 4.5, 10.9, 39.2, 4.5 parasites per fish and 2.1 parasites per fish. The Anisakis larvae were characterized as Anisakis and Hysterothylacium. CONCLUSIONS High prevalence of Anisakis infection is detected in marine fishes in Eastern Fujian Fishing Ground of Fujian Province. The health education pertaining to food health is required to be reinforced to prevent the development of human anisakiasis.
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Affiliation(s)
- W Cai
- Fujian Center for Disease Control and Prevention, Fujian Key Laboratory of Zoonosis Research, Fuzhou, Fujian 350012, China
| | - C Lin
- Fujian Center for Disease Control and Prevention, Fujian Key Laboratory of Zoonosis Research, Fuzhou, Fujian 350012, China
| | - D Zheng
- Fujian Center for Disease Control and Prevention, Fujian Key Laboratory of Zoonosis Research, Fuzhou, Fujian 350012, China
| | - H Xie
- Fujian Center for Disease Control and Prevention, Fujian Key Laboratory of Zoonosis Research, Fuzhou, Fujian 350012, China
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Zheng D, Zhu MX, Ma L, Li QH, Dong F, Wang J, Jing HM. [Shwachman-Diamond syndrome combined with acute leukemia of ambiguous lineage: a case report]. Zhonghua Nei Ke Za Zhi 2023; 62:196-199. [PMID: 36740411 DOI: 10.3760/cma.j.cn112138-20220615-00449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- D Zheng
- Department of Hematology, Peking University Third Hospital, Beijing 100191, China
| | - M X Zhu
- Department of Hematology, Peking University Third Hospital, Beijing 100191, China
| | - L Ma
- Department of Hematology, Peking University Third Hospital, Beijing 100191, China
| | - Q H Li
- Department of Hematology, Peking University Third Hospital, Beijing 100191, China
| | - F Dong
- Department of Hematology, Peking University Third Hospital, Beijing 100191, China
| | - J Wang
- Department of Hematology, Peking University Third Hospital, Beijing 100191, China
| | - H M Jing
- Department of Hematology, Peking University Third Hospital, Beijing 100191, China
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Liu JR, Gu JL, Huang BH, Kuang LF, Chen ML, Zou WY, Zheng D, Wang HH, Xu DR, Li J. [New agents-based induction chemotherapy followed by autologous stem cell transplantation and maintenance treatment strategy for multiple myeloma: a single center retrospective study of 300 cases]. Zhonghua Xue Ye Xue Za Zhi 2022; 43:1003-1009. [PMID: 36709105 PMCID: PMC9939329 DOI: 10.3760/cma.j.issn.0253-2727.2022.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Indexed: 01/30/2023]
Abstract
Objective: To examine the survival and influential factors of an integrated approach of novel agents, autologous hematopoietic stem cell (auto-HSCT) , and maintenance therapy in patients with multiple myeloma (MM) patients from a single center over the past 15 years. Methods: In our center, 300 MM patients who received an integrated strategy of new agents, auto-HSCT, and maintenance therapy over 15 years were retrospectively and prospectively analyzed. Results: The complete remission rates (CR) and ≥very good partial remission rates (VGPR) following induction therapy, transplantation, and maintenance therapy were respectively 35.3% and 55.2% , 72.4% and 80.0% , 89.2% , and 93.4% . When compared to patients receiving double-drug induction, the ≥VGPR and ORR of patients receiving triple-drug induction were improved. No difference existed in CR, ≥VGPR, and ORR between the PAD (bortezomib + liposome doxorubicin+ dexamethasone) and RAD (lenalidomide + liposome doxorubicin + dexamethasone) regimens, but the benefits speed differed. The negative rate of flow minimal residual disease following induction, transplantation, and maintenance was 18.8% (54 cases) , 41.4% (109 cases) , and 58.7% (142 cases) , respectively. The median time to progress (TTP) was 78.7 months and the median overall survival (OS) was 109 months. The median TTP for RISS-Ⅰ-Ⅲ patients were 111.8 months, 77.4 months, and 30.6 months, and the median OS was 118.8 months, 91.4 months, and 48.5 months, respectively. At various points during treatment, the TTP and OS of patients obtaining CR and MRD negative were longer than those of patients who did not obtain CR and MRD negative. TTP was noticeably shorter in high-risk cytogenetic patients compared to standard-risk patients even when CR was acquired during induction. There was no difference in TTP between patients with high-risk cytogenetics and those with standard-risk cytogenetics if MRD negative was acquired during induction. According to a multivariate analysis, the R-ISS stage was a poor predictor of TTP and OS at various treatment intervals. Therapeutic effectiveness was a newly independent prognostic factor following treatment. Conclusion: A median survival of almost 10 years is possible for MM patients who receive an integrated strategy of induction regimens followed by auto-HSCT and maintenance therapy, which significantly improves prognosis. However, this approach did not significantly benefit high-risk cytogenetic MM patients.
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Affiliation(s)
- J R Liu
- Department of Hematology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - J L Gu
- Department of Hematology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - B H Huang
- Department of Hematology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - L F Kuang
- Department of Hematology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - M L Chen
- Department of Hematology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - W Y Zou
- Department of Hematology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - D Zheng
- Department of Hematology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - H H Wang
- Department of Hematology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - D R Xu
- Department of Hematology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - J Li
- Department of Hematology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
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Tong C, Li Q, Kong L, Ni X, Halengbieke A, Zhang S, Wu Z, Tao L, Han Y, Zheng D, Guo X, Yang X. Sex-specific metabolic risk factors and their trajectories towards the non-alcoholic fatty liver disease incidence. J Endocrinol Invest 2022; 45:2233-2245. [PMID: 35896944 DOI: 10.1007/s40618-022-01848-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 06/21/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE Non-alcoholic fatty liver disease (NAFLD) is a common chronic liver disease. This study examined sex-specific associations between NAFLD and metabolic factors and investigated the trajectory of risk factors. METHODS We retrospectively investigated 16,140 individuals from Beijing Health Management Cohort. Univariate and multivariate time-dependent Cox regression analyses were performed to identify independent risk factors for new-onset NAFLD. The trajectory of risk factors was investigated using the latent growth curve model and growth mixture model. RESULTS Over a median follow-up of 3.15 years, 2,450 (15.18%) participants developed NAFLD. The risk factors for NAFLD in men were increased body mass index (BMI); waist circumference (WC); triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), haemoglobin (Hb), and serum uric acid (SUA) levels; and platelet (PLT) count and decreased serum creatinine-to-body weight (sCr/bw) and high-density lipoprotein cholesterol (HDL-C) levels. In women, the risk factors were increased BMI, WC, and fasting plasma glucose (FPG), TG, LDL-C, SUA, white blood cell (WBC), and PLT and decreased sCr/bw and HDL-C levels. In addition, BMI, LDL-C, sCr/bw and PLT changing trajectories were associated with NAFLD in men; BMI, WC, TG, LDL-C, SUA and sCr/bw trends was associated with NAFLD risk in women. CONCLUSIONS Development of NAFLD is associated with BMI, LDL-C, sCr/bw and PLT changing trajectories in men; BMI, WC, TG, LDL-C, SUA and sCr/bw trends are associated an increased risk of NAFLD in women. Deterioration of metabolic risk factors status can be a predictor of NAFLD many years before its occurrence.
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Affiliation(s)
- C Tong
- School of Public Health, Capital Medical University, 10 Xitoutiao, Youanmen, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, No. 10 Xitoutiao, Youanmen, Fengtai District, Beijing, 100069, China
| | - Q Li
- Science and Education Section, Beijing Physical Examination Center, No. 59, Beiwei Road, Xicheng district, Beijing, China
| | - L Kong
- Information Center, Beijing Physical Examination Center, No. 59, Beiwei Road, Xicheng district, Beijing, China
| | - X Ni
- School of Public Health, Capital Medical University, 10 Xitoutiao, Youanmen, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, No. 10 Xitoutiao, Youanmen, Fengtai District, Beijing, 100069, China
| | - A Halengbieke
- School of Public Health, Capital Medical University, 10 Xitoutiao, Youanmen, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, No. 10 Xitoutiao, Youanmen, Fengtai District, Beijing, 100069, China
| | - S Zhang
- Medical Records Statistics Office, Peking University First Hospital, Beijing, 100034, China
| | - Z Wu
- School of Public Health, Capital Medical University, 10 Xitoutiao, Youanmen, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, No. 10 Xitoutiao, Youanmen, Fengtai District, Beijing, 100069, China
| | - L Tao
- School of Public Health, Capital Medical University, 10 Xitoutiao, Youanmen, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, No. 10 Xitoutiao, Youanmen, Fengtai District, Beijing, 100069, China
| | - Y Han
- Science and Education Section, Beijing Physical Examination Center, No. 59, Beiwei Road, Xicheng district, Beijing, China
| | - D Zheng
- School of Public Health, Capital Medical University, 10 Xitoutiao, Youanmen, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, No. 10 Xitoutiao, Youanmen, Fengtai District, Beijing, 100069, China
| | - X Guo
- School of Public Health, Capital Medical University, 10 Xitoutiao, Youanmen, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, No. 10 Xitoutiao, Youanmen, Fengtai District, Beijing, 100069, China
| | - X Yang
- School of Public Health, Capital Medical University, 10 Xitoutiao, Youanmen, Fengtai District, Beijing, 100069, China.
- Beijing Municipal Key Laboratory of Clinical Epidemiology, No. 10 Xitoutiao, Youanmen, Fengtai District, Beijing, 100069, China.
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Tanny S, Sperling N, Zheng D, Lemus OD, Joyce N, Jr HQ, Cummings M. Tracking OAR Volume and DVH Variability in the Initial Cohort of Pelvic Patients Treated with CBCT-Guided, Online Adaptive Therapy. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.2290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Type 1 diabetes most commonly presents in adulthood, contrary to the widely held view that it is a disease of childhood. Furthermore, a substantial proportion of cases of adult-onset type 1 diabetes does not require insulin therapy at clinical onset. Recent studies have emphasised the evidence that adult-onset type 1 diabetes is prevalent but often misclassified initially as type 2 diabetes (1, 2). In this review, we discuss that recent literature, highlighting the similarities and differences between adult-onset and childhood-onset type 1 diabetes, exploring recent debates surrounding its epidemiology and genetics, as well as expanding on important issues of diagnostic criteria for individuals presenting with adult-onset diabetes and the subsequent management once identified as having an autoimmune basis. In addition, this review looks at the psychosocial challenges faced by T1D patients and their possible management.
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Affiliation(s)
- J Burahmah
- Blizard Institute, Queen Mary, London, UK
| | - D Zheng
- Blizard Institute, Queen Mary, London, UK
| | - R D Leslie
- Blizard Institute, Queen Mary, London, UK.
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13
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Zheng D, Chiang C, Lam TC, Chan S, Lee A, Kong F. 666P Circulating CX3CR1+CD8 T and Th17 cells and immunotherapy response in recurrent or metastatic NPC. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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14
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Zeng H, Zheng D, Witlox W, Levy A, Traverso A, Kong FM, Houben R, De Ruysscher D, Hendriks L. EP14.01-014 Risk Factors for Brain Metastasis in Patients with Small Cell Lung Cancer: A Systematic Review and Meta-analysis. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Zhang X, Zheng D, Huang Q. Regarding "Brain Perfusion Alterations on 3D Pseudocontinuous Arterial Spin-Labeling MR Imaging in Patients with Autoimmune Encephalitis: A Case Series and Literature Review". AJNR Am J Neuroradiol 2022; 43:E36-E37. [PMID: 36007948 PMCID: PMC9451636 DOI: 10.3174/ajnr.a7563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- X Zhang
- Department of RadiologyNanjing Brain Hospital, Nanjing Medical UniversityJiangning District, Nanjing, China
| | - D Zheng
- Department of RadiologyNanjing Brain Hospital, Nanjing Medical UniversityJiangning District, Nanjing, China
| | - Q Huang
- Department of RadiologyNanjing Brain Hospital, Nanjing Medical UniversityJiangning District, Nanjing, China
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Flora P, Li M, Zheng D, Ezhkova E. 722 Repressive epigenetic mechanisms mediated by PRC1 safeguards adult hair follicle stem cell quiescence. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Li M, Flora P, Pu H, Bar C, Silva J, Cohen I, Galbo P, Liu H, Yu X, Jin J, Koseki H, D’Orazio J, Zheng D, Ezhkova E. 712 UV-induced reduction in polycomb repression promotes epidermal pigmentation. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Ma J, Zhang J, Yang Y, Zheng D, Wang X, Liang H, Zhang L, Xin Y, Ling X, Fang C, Jiang H, Meng H, Zheng W. 65P Camrelizumab combined with paclitaxel and nedaplatin as neoadjuvant therapy for locally advanced esophageal squamous cell carcinoma (ESPRIT): A phase II, single-arm, exploratory research. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.10.083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Zhou S, Yan Y, Zheng D, Wang S, Wisnoskie S, Umstadter D. A Modified Lethal and Potentially Lethal Model With Explicit Oxygen Tension Dependence for FLASH RT. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Zeng H, De Ruysscher D, Hu X, Zheng D, Yang L, Kong F, Hendriks L. P63.12 Radiotherapy for Small Cell Lung Cancer in Current Clinical Practice Guidelines. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.668] [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: 11/24/2022]
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21
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Yue JC, Wu QP, Zhou N, Zhang K, Zheng D, Lü GL, Cheng JD. Correlation between Abdominal Wall Subcutaneous Fat Thickness and Heart Weight in Southern Chinese Population. Fa Yi Xue Za Zhi 2021; 37:351-357. [PMID: 34379904 DOI: 10.12116/j.issn.1004-5619.2021.410204] [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] [Received: 02/20/2021] [Indexed: 11/30/2022]
Abstract
Abstract Objective To study the correlation between the abdominal wall subcutaneous fat thickness and heart weight, so as to provide reference for prediction methods of normal range of heart weight that is suitable for autopsy in China. Methods The forensic pathology autopsy cases accepted by Center for Medicolegal Expertise of Sun Yat-sen University from 1998 to 2017 were collected. Then the exclusion criteria were determined, and according to them the total case group was selected, and the 6 disease groups and the normal group were further selected from the total case group. The rank sum test was used to compare the heart weight of the normal group and the disease groups to determine the influence of diseases on heart weight. Then the Spearman rank correlation analysis of abdominal wall subcutaneous fat thickness and heart weight in different genders and different ages in the total case group and the normal group was conducted to get the correlation coefficient (rs). Results In the total case group, correlation between abdominal wall subcutaneous fat thickness and heart weight was shown in males of all ages (P<0.05); while in females, the correlation had no statistical significance (P>0.05) in 15-<20 age and 50-<60 age, but was statistically significant (P<0.05) in other age groups. For the males in the normal group, rs was respectively 0.411, 0.541 and 0.683 in the 15-<40 age, the 40-<60 age, and the ≥60 age. For the females, rs was respectively 0.249 and 0.317 in the 15-<40 age and the 40-<60 age. The correlation in the ≥60 age had no statistical significance(P>0.05). Conclusion In the general population and the normal population, abdominal wall subcutaneous fat thickness is correlated with the heart weight of males. It is of significance to include the abdominal wall subcutaneous fat thickness in the prediction of normal range of heart weight for males in China.
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Affiliation(s)
- J C Yue
- Faculty of Forensic Medicine, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China
| | - Q P Wu
- Department of Toxicology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - N Zhou
- Faculty of Forensic Medicine, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China
| | - K Zhang
- Faculty of Forensic Medicine, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China
| | - D Zheng
- Faculty of Forensic Medicine, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China
| | - G L Lü
- Guangzhou Forensic Science Institute, Guangzhou 510030, China
| | - J D Cheng
- Faculty of Forensic Medicine, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China
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22
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Liu S, Han W, Shen C, Zhu C, Wang Q, Liang X, He X, Xie Q, Wei J, Wu M, Zhao X, Liu H, Liu D, Guo X, Nie S, Cao L, Lu L, Fang Y, Lu Z, Wu Y, Zhao M, Han J, Zhang X, Chang J, Xu S, Ma W, Si J, Qi S, Peng P, Chai Y, Cao Y, Jiang Y, Yin W, Wang Y, Zhan H, Huang Y, Deng Y, Song J, Yang L, Wu J, Ding B, Zheng D, Qian C, Huang R, Lin J, Xu Z, Zhang G, Hu Y, Dou Q, Zhang X, Tian Y, Yao D, Walline JH, Zhu H, Xu J, Li Y, Yu X. Depressive State in the Emergency Department During COVID-19: A National Cross-Sectional Survey in China. Front Psychiatry 2021; 12:566990. [PMID: 34194341 PMCID: PMC8236535 DOI: 10.3389/fpsyt.2021.566990] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 05/10/2021] [Indexed: 02/05/2023] Open
Abstract
Chinese emergency department (ED) staff encountered significant mental stress while fighting the coronavirus disease 2019 (COVID-19) pandemic. We sought to investigate the prevalence and associated factors for depressive symptoms among ED staff (including physicians, nurses, allied health, and auxiliary ED staff). A cross-sectional national survey of ED staff who were on duty and participated in combating the COVID-19 pandemic was conducted March 1-15, 2020. A total of 6,588 emergency medical personnel from 1,060 hospitals responded to this survey. A majority of respondents scored above 10 points on the PHQ-9 standardized test, which is associated with depressive symptoms. Those aged 31-45, those working in the COVID-19 isolation unit, and those with relatives ≤ 16 or ≥70 years old at home all had statistically significant associations with scoring >10 points. Depressive symptoms among Chinese emergency medical staff were likely quite common during the response to the COVID-19 pandemic and reinforce the importance of targeted ED staff support during future outbreaks.
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Affiliation(s)
- Shuang Liu
- Department of Emergency Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Wei Han
- Institute of Basic Medical Sciences, School of Basic Medicine, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Chenyu Shen
- Department of Psychiatric, Yuquan Hospital Tsinghua University, Beijing, China
| | - Changju Zhu
- Department of Emergency Medicine, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Qiaofang Wang
- Department of Emergency Medicine, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xianquan Liang
- Department of Emergency Medicine, The Second People's Hospital of Guiyang, Guiyang, China
| | - Xiangxi He
- Department of Emergency Medicine, The Second People's Hospital of Guiyang, Guiyang, China
| | - Qin Xie
- Department of Intensive Care, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Jie Wei
- Department of Emergency Medicine, Renmin Hospital of Wuhan University, Wuhan, China
| | - Miao Wu
- Department of Emergency Medicine, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xiaodong Zhao
- Department of Emergency Medicine, Fourth Medical Center of PLA General Hospital, Beijing, China
| | - Hongsheng Liu
- Department of Emergency Medicine, Fourth Medical Center of PLA General Hospital, Beijing, China
| | - Danping Liu
- Department of Emergency Medicine, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Xiaowang Guo
- Department of Emergency Medicine, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Shinan Nie
- Department of Emergency Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Liping Cao
- Department of Emergency Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Linxin Lu
- Department of Emergency Medicine, Shanxi Bethune Hospital, Taiyuan, China
| | - Yaqin Fang
- Department of Emergency Medicine, Shanxi Bethune Hospital, Taiyuan, China
| | - Zhongqiu Lu
- Department of Emergency Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yixu Wu
- Department of Emergency Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Min Zhao
- Department of Emergency Medicine, China Medical University of Shengjing Hospital, Shenyang, China
| | - Jun Han
- Department of Emergency Medicine, China Medical University of Shengjing Hospital, Shenyang, China
| | - Xinchao Zhang
- Department of Emergency Medicine, Beijing Hospital, Beijing, China
| | - Jie Chang
- Department of Emergency Medicine, Beijing Hospital, Beijing, China
| | - Shuogui Xu
- Department of Emergency Medicine, Changhai Hospital, Shanghai, China
| | - Wenjie Ma
- Department of Emergency Medicine, Changhai Hospital, Shanghai, China
| | - Junli Si
- Department of Emergency Medicine, Qingdao Municipal Hospital, Qingdao, China
| | - Suxia Qi
- Department of Emergency Medicine, Qingdao Municipal Hospital, Qingdao, China
| | - Peng Peng
- Department of Emergency Medicine, The First Affiliate Hospital of Xinjiang Medical University, Wulumuqi, China
| | - Yage Chai
- Department of Emergency Medicine, The First Affiliate Hospital of Xinjiang Medical University, Wulumuqi, China
| | - Yu Cao
- Department of Emergency Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Yaowen Jiang
- Department of Emergency Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Wen Yin
- Department of Emergency Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Yanjun Wang
- Department of Emergency Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Hong Zhan
- Department of Emergency Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yingxiong Huang
- Department of Emergency Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ying Deng
- Department of Emergency Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Juanjuan Song
- Department of Emergency Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Lishan Yang
- Department of Emergency Medicine, General Hospital of Ningxia Medical University, Nanjing, China
| | - Jiali Wu
- Department of Emergency Medicine, General Hospital of Ningxia Medical University, Nanjing, China
| | - Banghan Ding
- Department of Emergency Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Danwen Zheng
- Department of Emergency Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Chuanyun Qian
- Department of Emergency Medicine, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Rui Huang
- Department of Emergency Medicine, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jiyan Lin
- Department of Emergency Medicine, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Zhihong Xu
- Department of Emergency Medicine, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Guoxiu Zhang
- Department of Emergency Medicine, The First Affiliated Hospital and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Yingying Hu
- Department of Emergency Medicine, The First Affiliated Hospital and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China
| | - Qingli Dou
- Department of Emergency Medicine, People's Hospital of Shenzhen, Shenzhen, China
| | - Xiaoming Zhang
- Department of Emergency Medicine, People's Hospital of Shenzhen, Shenzhen, China
| | - Yingping Tian
- Department of Emergency Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Dongqi Yao
- Department of Emergency Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Joseph Harold Walline
- Accident and Emergency Medicine Academic Unit, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Huadong Zhu
- Department of Emergency Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Jun Xu
- Department of Emergency Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yi Li
- Department of Emergency Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Xuezhong Yu
- Department of Emergency Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
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Zhang LY, Zheng D, Jing SS, Zhang XK, Chang PC, Yang J, Pei JQ, Du HG, Song JY, Qin MX, Dang ZJ, Wang ZA, Chai KQ. [A comparative study of transperitoneal transmesenteric approach versus paracolic sulci approach laparoscopic adrenal tumorectomy for treatment of primary hyperaldosteronism on left side]. Zhonghua Yi Xue Za Zhi 2021; 101:1513-1517. [PMID: 34044519 DOI: 10.3760/cma.j.cn112137-20210208-00385] [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 compare the therapeutic effect of transperitoneal transmesenteric approach versus paracolic sulci approach laparoscopic adrenal tumorectomy for treatment of left-sided primary hyperaldosteronism. Methods: From January 2017 to July 2019, the clinical data of 70 patients with left-sided primary hyperaldosteronism (PHA) who underwent surgery in the First Hospital of Lanzhou University and five other hospitals in Gansu Province were retrospectively analyzed. There are 43 male and 27 female patients. Among them,28 patients were performed transperitoneal transmesenteric approach laparoscopic adrenal tumorectomy and 42 patients were performed transperitoneal paracolic sulci approach laparoscopic adrenal tumorectomy. The general information and perioperative data of the two groups were compared. Results: All 70 cases of surgery were successfully completed. As compared with the paracolic sulci approach group, the operation time was significantly shorter in the transmesenteric approach group[(26.7±8.8)vs (38.9±7.1)min,P<0.001)], and the estimated blood loss was less in the transmesenteric approach group[45(30,50) vs 50(40,60)ml,P=0.042]. There was no statistically significant difference in the postoperative hospitalization days between the two groups[(4.4±1.0)vs(4.5±1.0)d, P=0.669)]. The electrolytes and aldosterone to renin ratio returned to a healthy level in the postoperative one month, and the blood pressure also returned to a healthy level in 53 (75.7%) patients. Conclusion: Transperitoneal transmesenteric approach laparoscopic adrenal tumorectomy is safe and feasible, with a short operation time and relatively less estimated blood loss.
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Affiliation(s)
- L Y Zhang
- Department of Urology No.2, the First Hospital of Lanzhou University, Lanzhou 730030, China
| | - D Zheng
- Department of Urology No.2, the First Hospital of Lanzhou University, Lanzhou 730030, China
| | - S S Jing
- Department of Urology No.2, the First Hospital of Lanzhou University, Lanzhou 730030, China
| | - X K Zhang
- Department of Urology No.2, the First Hospital of Lanzhou University, Lanzhou 730030, China
| | - P C Chang
- Department of Urology No.2, the First Hospital of Lanzhou University, Lanzhou 730030, China
| | - J Yang
- Department of Urology No.2, the First Hospital of Lanzhou University, Lanzhou 730030, China
| | - J Q Pei
- Department of Urology, Jiu Gang Hospital, Jiayuguan 735100, China
| | - H G Du
- Department of Urology, Jiu Gang Hospital, Jiayuguan 735100, China
| | - J Y Song
- Department of Urology, Jinchuan Group Staff Hospital, Jinchang 737100, China
| | - M X Qin
- Department of Urology, Jinchuan Group Staff Hospital, Jinchang 737100, China
| | - Z J Dang
- Department of Urology, Yumen First People's Hospital, Yumen 735211, China
| | - Z A Wang
- Department of Urology, Jiuquan Second People's Hospital, Jiuquan 735000, China
| | - K Q Chai
- Department of Urology, Baiyin First People's Hospital, Baiyin 730900, China
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Liang C, Van Laar Veth AJ, Li Q, Zheng D, Hackett ML. Effect of mood on long-term disability in younger stroke survivors: results from the Psychosocial Outcomes In StrokE (POISE) study. Top Stroke Rehabil 2021; 29:286-294. [PMID: 34018471 DOI: 10.1080/10749357.2021.1922802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background & Purpose: Anxiety and depression are common among stroke survivors, and their effect on long-term outcome remains unknown in those under 65 years of age. We investigated the association between early anxiety/depression after stroke and 12-month disability, and whether this is modified by sex.Methods: The Psychosocial Outcomes In StrokE (POISE) study was a prospective observational cohort study that recruited 441 younger (< 65 years) stroke survivors ≤28 days of acute stroke. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale, and disability using the World Health Organization Disability Assessment Scale version II (WHODAS-II). Associations between baseline anxiety/depression, and disability at 12-months was tested using analysis of covariance. Subgroup analysis was conducted using interaction term.Results: 92 (25%) had anxiety and 53 (14%) depression at baseline. Multivariable models showed significant association between baseline anxiety and 12-month disability (WHODAS-II score 15.24 vs. 11.49, p < .05). Those with anxiety had more impairment in 'cognition' (WHODAS-II score 18.26 vs. 8.71, p < .001), 'getting along' (WHODAS-II score 11.87 vs. 7.42, p < .05) and 'participation' (WHODAS-II score 22.37 vs. 15.92, p < .005) WHODAS-II. No significant relationship was found between baseline depression and long-term disability. There was no differential effect of anxiety by sex found in this study.Conclusions: Post-stroke anxiety has an adverse effect on disability at one year among young stroke survivors.
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Affiliation(s)
- C Liang
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - A J Van Laar Veth
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Q Li
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - D Zheng
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia.,Translational Australian Clinical Toxicology program, Biomedical Informatics in Digital Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - M L Hackett
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia.,Faculty of Health and Wellbeing, University of Central Lancashire, Preston, Lancashire, UK
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Wang J, Shu J, Wu F, Song ZT, Gan HY, Yu J, Zheng D. [A case of congenital hepatic fibrosis diagnosed and treated by transjugular intrahepatic portosystemic shunt]. Zhonghua Gan Zang Bing Za Zhi 2021; 29:373-376. [PMID: 33979966 DOI: 10.3760/cma.j.cn501113-20190527-00190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- J Wang
- Department of Gastroenterology, the Central Hospital of Wuhan, Tongji Medical College of Huazhong University of Science & Technology, Wuhan 430000, China
| | - J Shu
- Department of Gastroenterology, the Central Hospital of Wuhan, Tongji Medical College of Huazhong University of Science & Technology, Wuhan 430000, China
| | - F Wu
- Department of Gastroenterology, the Central Hospital of Wuhan, Tongji Medical College of Huazhong University of Science & Technology, Wuhan 430000, China
| | - Z T Song
- Department of Gastroenterology, the Central Hospital of Wuhan, Tongji Medical College of Huazhong University of Science & Technology, Wuhan 430000, China
| | - H Y Gan
- Department of Gastroenterology, the Central Hospital of Wuhan, Tongji Medical College of Huazhong University of Science & Technology, Wuhan 430000, China
| | - J Yu
- Department of Gastroenterology, the Central Hospital of Wuhan, Tongji Medical College of Huazhong University of Science & Technology, Wuhan 430000, China
| | - D Zheng
- Department of Gastroenterology, the Central Hospital of Wuhan, Tongji Medical College of Huazhong University of Science & Technology, Wuhan 430000, China
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Pang S, Bhuvan T, Zheng D, Mendonca S, D’Rozario J, Powell D, Heng T. Immunometabolic changes in resident macrophages underlie msc therapeutic effects. Cytotherapy 2021. [DOI: 10.1016/s1465324921003613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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27
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Wang Y, Liu Y, Lv Q, Zheng D, Zhou L, Ouyang W, Ding B, Zou X, Yan F, Liu B, Chen J, Liu T, Fu C, Fang Q, Wang Y, Li F, Chen A, Lundborg CS, Guo J, Wen Z, Zhang Z. Effect and safety of Chinese herbal medicine granules in patients with severe coronavirus disease 2019 in Wuhan, China: a retrospective, single-center study with propensity score matching. Phytomedicine 2021; 85:153404. [PMID: 33637412 PMCID: PMC7642753 DOI: 10.1016/j.phymed.2020.153404] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 10/15/2020] [Accepted: 11/01/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Chinese herbal medicine (CHM) has been used for severe illness caused by coronavirus disease 2019 (COVID-19), but its treatment effects and safety are unclear. PURPOSE This study reviews the effect and safety of CHM granules in the treatment of patients with severe COVID-19. METHODS We conducteda single-center, retrospective study on patients with severe COVID-19 in a designated hospital in Wuhan from January 15, 2020 to March 30, 2020. The propensity score matching (PSM) was used to assess the effect and safety of the treatment using CHM granules. The ratio of patients who received treatment with CHM granules combined with usual care and those who received usual care alone was 1:1. The primary outcome was the time to clinical improvement within 28 days, defined as the time taken for the patients' health to show improvement by decline of two categories (from the baseline) on a modified six-category ordinal scale, or to be dischargedfrom the hospital before Day 28. RESULTS Using PSM, 43 patients (45% male) aged 65.6 (57-70) yearsfrom each group were exactly matched. No significant difference was observed in clinical improvement of patients treated with CHM granules compared with those who received usual (p = 0.851). However, the use of CHM granules reduced the 28-day mortality (p = 0.049) and shortened the duration of fever (4 days vs. 7 days, p = 0.002). The differences in the duration of cough and dyspnea and the difference in lung lesion ratio on computerized tomography scans were not significant.Commonly,patients in the CHM group had an increased D-dimer level (p = 0.036). CONCLUSION Forpatients with severe COVID-19, CHM granules, combined with usual care, showed no improvement beyond usual care alone. However, the use of CHM granules reduced the 28-day mortality rate and the time to fever alleviation. Nevertheless, CHM granules may be associated with high risk of fibrinolysis.
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Affiliation(s)
- Yuanyuan Wang
- Department of Emergency, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China; Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Yuntao Liu
- Department of Emergency, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China; Guangdong Provincial Key Laboratory of Research on Emergency in TCM, Guangzhou, China
| | - Qingquan Lv
- Department of Medical Administration, Wuhan Hankou Hospital, Wuhan, China
| | - Danwen Zheng
- Department of Emergency, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Li Zhou
- Key Unit of Methodology in Clinical Research, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wenwei Ouyang
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden; Key Unit of Methodology in Clinical Research, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Banghan Ding
- Department of Emergency, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xu Zou
- Intensive Care Unit, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Fang Yan
- Department of Internal Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Bo Liu
- Department of Radiology, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jun Chen
- Department of Radiology, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Zhuhai, China
| | - Tianzhu Liu
- Department of Radiology, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Zhuhai, China
| | - Chicheng Fu
- Shanghai Aitrox Technology Corporation Limited, Shanghai, China
| | - Qu Fang
- Shanghai Aitrox Technology Corporation Limited, Shanghai, China
| | - Yi Wang
- Shanghai Aitrox Technology Corporation Limited, Shanghai, China
| | - Fang Li
- Department of Emergency, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ailan Chen
- Department of Cardiology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | | | - Jianwen Guo
- Department of Neurology, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
| | - Zehuai Wen
- Key Unit of Methodology in Clinical Research, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
| | - Zhongde Zhang
- Department of Emergency, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China; Guangdong Provincial Key Laboratory of Research on Emergency in TCM, Guangzhou, China; State Key Laboratory of Dampness Syndrome of Chinese Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
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Wang YY, Zhou N, Yue JC, Zhang K, Zhao QH, Zheng D, Hu BJ, Cheng JD. Review and Prospects of Pathogen Detection Related to Autopsy of Coronavirus Infectious Diseases. Fa Yi Xue Za Zhi 2021; 37:69-76. [PMID: 33780188 DOI: 10.12116/j.issn.1004-5619.2020.400328] [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] [Received: 03/31/2020] [Indexed: 11/30/2022]
Abstract
Abstract In the past, coronavirus caused two serious human-to-human pandemics in the world, including severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). In late 2019, coronavirus disease 2019 (COVID-19) caused another major global public health event. Due to the strong infectivity of novel coronavirus, it is difficult to carry out the autopsy of related death cases widely. This paper reviews the previous status of the pathogen detection related to the autopsy of coronavirus infection diseases, and introduces the ongoing detection methods of novel coronavirus in clinical practice, in order to provide reference for the pathogen detection and study related to autopsy of COVID-19.
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Affiliation(s)
- Y Y Wang
- Faculty of Forensic Medicine, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China
| | - N Zhou
- Faculty of Forensic Medicine, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China
| | - J C Yue
- Faculty of Forensic Medicine, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China
| | - K Zhang
- Faculty of Forensic Medicine, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China
| | - Q H Zhao
- Faculty of Forensic Medicine, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China
| | - D Zheng
- Faculty of Forensic Medicine, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China
| | - B J Hu
- Department of Pathology, Guangzhou Medical University, Guangzhou 511436, China
| | - J D Cheng
- Faculty of Forensic Medicine, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China
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Lu C, Zhou Z, Zheng D, He Y, Li Y, Wang Z, Zhong W, Zhang X, Wu Y, Zhou Q. P76.19 Clinical Outcomes of Lung Cancer Patients Who Acquired EGFR T790M/in trans-C797S Mutations After Resistance to Osimertinib. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.1076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Huang L, Xu X, Zhang L, Zheng D, Liu Y, Feng B, Hu J, Lin Q, Xi X, Wang Q, Lin M, Zhou X, He Z, Weng H, Deng Q, Ding B, Guo J, Zhang Z. Post-traumatic Stress Disorder Symptoms and Quality of Life of COVID-19 Survivors at 6-Month Follow-Up: A Cross-Sectional Observational Study. Front Psychiatry 2021; 12:782478. [PMID: 35082700 PMCID: PMC8784850 DOI: 10.3389/fpsyt.2021.782478] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 12/02/2021] [Indexed: 12/31/2022] Open
Abstract
Background: Post-traumatic stress disorder (PTSD) is the most common psychiatric sequelae among novel coronavirus disease (COVID-19) patients. The aim of this study was to determine the prevalence of PTSD symptoms, PTSD-related factors, and its relationship with quality of life at long-term follow-up in hospitalized COVID-19 survivors. Methods: A cross-sectional study was undertaken to evaluate the health consequences of hospitalized COVID-19 survivors. All participants were interviewed face-to-face through a series of questionnaires: a researcher-developed symptom questionnaire, the Post-traumatic Stress Disorder Checklist-Civilian Version, the Generalized Anxiety Disorder 7-item, and the 36-item Short Form. Results: A total of 574 participants were enrolled with an average age of 57 years. The median follow-up time post-discharge was 193.9 days (SD = 15.32). Among the participants, 77.9% of survivors presented with at least one symptom, where fatigue or muscle weakness (47.9%) was reported the most frequently, followed by chest distress (29.4%) and sleep difficulty (29.4%). The prevalence of PTSD was 11.15% [95% confidence interval (CI): 8.56, 13.73] with a cut-off score of 44. Factors such as respiratory symptoms [odds ratio (OR): 3.53; 95% CI: 1.68-7.42], anxiety (OR: 14.64; 95% CI: 7.09-30.21), and sleep difficulty (OR: 2.17; 95% CI: 1.14-4.16) were positively related to PTSD. Those COVID-19 survivors with potential PTSD had significantly lower quality of life than those without (P < 0.05). Conclusion: Our study illustrated that a significant number of COVID-19 survivors were suffering from physical or mental distress to varying degrees at 6 months post-discharge. People with PTSD were more likely to experience persistent respiratory symptoms and sleep difficulty, as well as anxiety and a decreased quality of life. Such survivors require greater attention to their mental health, particularly the PTSD symptoms at the early phase, which may play an important role in the recovery of both the physical and psychological health of COVID-19 survivors.
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Affiliation(s)
- Liqun Huang
- The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiaohua Xu
- The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Lingjie Zhang
- Department of Medical Administration, Hubei Provincial Hospital of Traditional Chinese and Western Medicine, Wuhan, China
| | - Danwen Zheng
- Department of Emergency, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yuntao Liu
- Department of Emergency, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Bing Feng
- Department of Pharmacology of Traditional Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jiajun Hu
- Department of Medical Administration, Hubei Provincial Hospital of Traditional Chinese and Western Medicine, Wuhan, China
| | - Qiaoli Lin
- Department of Geriatrics, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiaotu Xi
- Department of Emergency, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Qian Wang
- The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Meixuan Lin
- The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xin Zhou
- The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zehui He
- Department of Clinical Epidemiology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Heng Weng
- Department of Clinical Epidemiology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Qiuying Deng
- Department of Emergency, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Banghan Ding
- Department of Emergency, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jianwen Guo
- Department of Medical Administration, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhongde Zhang
- Department of Emergency, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.,Guangdong Provincial Key Laboratory of Research on Emergency in Traditional Chinese Medicine, Guangzhou, China
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Wong J, Lin C, Baine M, Bennion N, Yu L, Zheng D, Vipin D, Hollingsworth M, Zhou S, Zheng D. Effect Of Interobserver And Interdisciplinary Segmentation Variability On Radiomic Features For Pancreatic Cancer. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Parr E, Du Q, Zhang C, Lin C, Kamal A, McAlister J, Liang X, Bavitz K, Rux G, Hollingsworth M, Baine M, Zheng D. Radiomics-Based Survival and Recurrence Prediction for Pancreatic Cancer Following Stereotactic Body Radiotherapy. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.680] [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: 11/16/2022]
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Li J, Lin C, Zheng D. CT and Pathological Control Study on Small Cluster Lymph Nodes Metastases of Esophageal Cancer and Construction of Nomogram Prediction Model. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Su Z, Wen J, Zeng Y, Zhao H, Lv S, van der Velde R, Zheng D, Wang X, Wang Z, Schwank M, Kerr Y, Yueh S, Colliander A, Qian H, Drusch M, Mecklenburg S. Multiyear in-situ L-band microwave radiometry of land surface processes on the Tibetan Plateau. Sci Data 2020; 7:317. [PMID: 32999274 PMCID: PMC7527448 DOI: 10.1038/s41597-020-00657-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 08/21/2020] [Indexed: 11/26/2022] Open
Abstract
We report a unique multiyear L-band microwave radiometry dataset collected at the Maqu site on the eastern Tibetan Plateau and demonstrate its utilities in advancing our understandings of microwave observations of land surface processes. The presented dataset contains measurements of L-band brightness temperature by an ELBARA-III microwave radiometer in horizontal and vertical polarization, profile soil moisture and soil temperature, turbulent heat fluxes, and meteorological data from the beginning of 2016 till August 2019, while the experiment is still continuing. Auxiliary vegetation and soil texture information collected in dedicated campaigns are also reported. This dataset can be used to validate the Soil Moisture and Ocean Salinity (SMOS) and Soil Moisture Active Passive (SMAP) satellite based observations and retrievals, verify radiative transfer model assumptions and validate land surface model and reanalysis outputs, retrieve soil properties, as well as to quantify land-atmosphere exchanges of energy, water and carbon and help to reduce discrepancies and uncertainties in current Earth System Models (ESM) parameterizations. Measurement cases in winter, pre-monsoon, monsoon and post-monsoon periods are presented.
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Affiliation(s)
- Z Su
- Faculty of Geo-information Science and Earth Observation (ITC), University of Twente, Enschede, The Netherlands.
- Key Laboratory of Subsurface Hydrology and Ecological Effect in Arid Region of Ministry of Education, School of Water and Environment, Chang'an University, Xi'an, 710054, China.
| | - J Wen
- College of Atmospheric Sciences, Plateau Atmosphere and Environment Key Laboratory of Sichuan Province, Chengdu University of Information Technology, Chengdu, China.
| | - Y Zeng
- Faculty of Geo-information Science and Earth Observation (ITC), University of Twente, Enschede, The Netherlands
| | - H Zhao
- Faculty of Geo-information Science and Earth Observation (ITC), University of Twente, Enschede, The Netherlands
| | - S Lv
- College of Atmospheric Sciences, Plateau Atmosphere and Environment Key Laboratory of Sichuan Province, Chengdu University of Information Technology, Chengdu, China
| | - R van der Velde
- Faculty of Geo-information Science and Earth Observation (ITC), University of Twente, Enschede, The Netherlands
| | - D Zheng
- Institute of Tibetan Plateau Research, Chinese Academy of Sciences, Beijing, China
| | - X Wang
- Key Laboratory of Land Surface Process and Climate Change in Cold and Arid Regions, Northwest Institute of Eco-Environment and Resources, Chinese Academy of Sciences, Lanzhou, China
| | - Z Wang
- Key Laboratory of Land Surface Process and Climate Change in Cold and Arid Regions, Northwest Institute of Eco-Environment and Resources, Chinese Academy of Sciences, Lanzhou, China
| | - M Schwank
- Swiss Federal Research Institute WSL, Birmensdorf, Switzerland
- Gamma Remote Sensing AG, Gümligen, Switzerland
| | - Y Kerr
- CESBIO (CNES/CNRS/UPS/IRD), Toulouse, France
| | - S Yueh
- Jet Propulsion Laboratory, Pasadena, USA
| | | | - H Qian
- Key Laboratory of Subsurface Hydrology and Ecological Effect in Arid Region of Ministry of Education, School of Water and Environment, Chang'an University, Xi'an, 710054, China
| | - M Drusch
- European Space Agency, ESTEC, Earth Observation Programmes, Noordwijk, The Netherlands
| | - S Mecklenburg
- European Space Agency, ESA Climate Office, Harwell Campus, Oxfordshire, UK
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Chen D, Li H, Zhao Y, Qiu Y, Xiao L, He H, Zheng D, Li X, Huang L, Yu X, Xu N, Hu X, Chen Y, Chen F. Characterization of carbapenem-resistant Klebsiella pneumoniae in a tertiary hospital in Fuzhou, China. J Appl Microbiol 2020; 129:1220-1226. [PMID: 32396222 PMCID: PMC7687251 DOI: 10.1111/jam.14700] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 04/07/2020] [Accepted: 05/05/2020] [Indexed: 02/06/2023]
Abstract
Aims The emergence of carbapenem‐resistant Klebsiella pneumoniae (CRKP) strains has led to increased mortality and morbidity rates. Tigecycline, a new class of broad‐spectrum glycyl‐tetracycline antibiotics, has been used to target multi‐ and pan‐drug‐resistant bacterial infections. This study aimed to assess the molecular characteristics of CRKP in a tertiary hospital, and its susceptibility to tigecycline, to create a reference for hospital infection control and clinical drug use. Methods and Results We retrieved patient clinical information and CRKP characterization from medical records and detected the MIC of tigecycline using the micro‐broth dilution method. Multi‐locus sequence typing was performed, and antibiotic resistance genes associated with CRKP were detected by qPCR. A total of 166 CRKP strains were detected in the sputum, urine and blood among intensive care unit patients (average age, 69·6 years). The most infrequently observed resistance genes were amikacin resistance genes, followed by tobramycin resistance genes. KPC‐2, CTX‐M9 and CTX‐M1 were the most frequently detected resistance genes. Conclusions No strain was resistant to tigecycline (MIC ≥ 8 µg ml−1). Twenty‐four sequence types were identified, with ST11 being the most common type. Significance and Impact of the Study Clinicians and infection control experts should be aware of CRKP prevalence to facilitate clinical treatment and improve nosocomial infection control.
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Affiliation(s)
- D Chen
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China.,Clinical Microbiology Laboratory, Fujian Provincial Hospital, Fuzhou, China
| | - H Li
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China.,Department of Pulmonary and Critical Care Medicine, Fujian Provincial Hospital, Fuzhou, China
| | - Y Zhao
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Y Qiu
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - L Xiao
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - H He
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - D Zheng
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - X Li
- Department of Pulmonary and Critical Care Medicine, Fujian Provincial Hospital, Fuzhou, China
| | - L Huang
- Department of Pulmonary and Critical Care Medicine, Fujian Provincial Hospital, Fuzhou, China
| | - X Yu
- Department of Pulmonary and Critical Care Medicine, Fujian Provincial Hospital, Fuzhou, China
| | - N Xu
- Department of Pulmonary and Critical Care Medicine, Fujian Provincial Hospital, Fuzhou, China
| | - X Hu
- Clinical Microbiology Laboratory, Fujian Provincial Hospital, Fuzhou, China
| | - Y Chen
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China.,Department of Pulmonary and Critical Care Medicine, Fujian Provincial Hospital, Fuzhou, China
| | - F Chen
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
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Zhang X, Ma JD, Jing J, Wang J, Wu T, Zheng D, Dai L. AB0054 SYNOVIAL CD163+ MACROPHAGES ARE ASSOCIATED WITH RADIOGRAPHIC JOINT DESTRUCTION IN RHEUMATOID ARTHRITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1141] [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:CD163, a hemoglobin scavenger receptor, has been identified as a marker of M2 macrophages, it can promote the release of IL-10 and carbon oxide. Researches on inflammatory diseases and tumors have suggested that CD163 plays anti-inflammatory effect and promotes tumor growth and metastasis. Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by chronic synovitis with inflammatory cells infiltration including considerable macrophages. However, little is known about the role of CD163+ macrophages in RA synovium.Objectives:To investigate the expression and clinical significance of synovial CD163+ macrophages in RA.Methods:Seventy-five RA patients were recruited and clinical data including disease activity, HAQ and Sharp/van der Heijde-modified Sharp score of bilateral hands and wrists were collected. Synovial tissues were obtained by needle biopsies or arthroscopy of knee joints. Eighteen osteoarthritis (OA) and seventeen orthopedic arthropathies (orth.A) patients were included as controls. All synovium were stained with H&E and immunohistochemically for CD163, CD3, CD20, CD38, CD68, and CD15. Histologic changes of synovitis in H&E stained sections were graded with Krenn’s synovitis score.Results:Positive CD163 expression were found in both lining synoviocytes and sublining inflammatory cells. Both densities of lining and sublining CD163+ macrophages in RA synovium were significantly higher than that in OA or Orth.A synovium (140.47±66.93 vs. 17.85±7.70 vs. 19.76±5.26 and 417.92±249.62 vs. 27.58±14.19 vs. 29.87±9.33, allP<0.001, Figure 1).According to Krenn’s synovitis score, there were 68% RA patients showing high synovitis (score>4). Both lining and sublining synovial CD163+ macrophages were significantly higher than those showing low synovitis (lining: 158.40±62.91 vs. 122.06±66.74, sublining: 462.96±62.91 vs. 371.65±271.54, bothP<0.05). Meanwhile, the densities of lining and sublining CD163+ macrophages were both positively correlated with Krenn’s synovitis score (r=0.238 and 0.343, bothP<0.05).For clinical relationship in RA, the density of sublining CD163+ macrophages was positively correlated with total Sharp score (mTSS) (r=0.399,P<0.001), joint space narrowing subscore (r=0.248,P=0.032) and joint erosion subscore (r=0.457,P<0.001). While the density of lining CD163+ macrophages was positively correlated with mTSS (r=0.319,P=0.005) and joint erosion subscore (r=0.358,P=0.002). Meanwhile, the densities of sublining and lining CD68+ macrophages were also positively correlated with mTSS (r=0.253 and 0.242, bothP<0.05), of which the correlation was weaker than that of CD163+ macrophages (Figure 2). There were no significant correlation between the density of CD163+ macrophages and disease activity or HAQ (allP>0.05).Conclusion:Synovial CD163+ macrophages are associated with radiographic joint destruction, which imply that CD163+ macrophages may play role in the pathogenisis of joint destruction in RA.Figure 1.Representative immunohistochemical findings of synovial CD163 expression. (A) Synovial CD163 expression in an Orth.A patient, an OA patient and a RA patient. (B) Densities of lining and sublining CD163+ macrophages in Orth.A, OA and RA patients.Figure 2.Spearman’s rank correlation analysis for synovial macrophages and mTSS in RA. (A) Correlation between sublining CD163+ macrophages and mTSS, joint space narrowing subscore, joint erosion subscore. (B) Correlation between lining CD163+ macrophages and mTSS, joint space narrowing subscore, joint erosion subscore.Funding: :This work was supported by National Natural Science Foundation of China (no. 81801606 and 81971527), Guangdong Natural Science Foundation (no. 2017A030313576, 2018A030313541 and 2019A1515011928).Figures:Disclosure of Interests:None declared
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Mao DM, Zhou N, Zheng D, Yue JC, Zhao QH, Luo B, Guan DW, Zhou YW, Hu BJ, Cheng JD. Guide to the Forensic Pathology Practice on Death Cases Related to Corona Virus Disease 2019 (COVID-19) (Trial Draft). Fa Yi Xue Za Zhi 2020; 36:6-5. [PMID: 32198985 DOI: 10.12116/j.issn.1004-5619.2020.01.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Indexed: 11/30/2022]
Abstract
Abstract Autopsy is of great significance to the elucidation of the pathological changes, pathogeneses and causes of death of corona virus disease 2019 (COVID-19) and can provide theoretical basis for more scientific and accurate prevention and control of the outbreak. Based on related laws and regulations, such as the Law of the People's Republic of China on Prevention and Control of Infectious Diseases, the clinical manifestations and epidemiological characteristics of COVID-19, and the related guidelines on the prevention and control of the outbreak, combined with the practical work of forensic pathology examination, the Guide to the Forensic Pathology Practice on Death Cases Related to Corona Virus Disease 2019 (COVID-19) (Trial Draft) has been developed. This guide includes information on the background investigation of the cases, autopsy room requirements, personal prevention and protections, external examinations, autopsy, auxiliary examinations, and so on. This guide can be used as a reference by forensic and pathological examination institutions, as well as examination staff.
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Affiliation(s)
- D M Mao
- Faculty of Forensic Medicine, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China
| | - N Zhou
- Faculty of Forensic Medicine, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China
| | - D Zheng
- Faculty of Forensic Medicine, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China
| | - J C Yue
- Faculty of Forensic Medicine, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China
| | - Q H Zhao
- Faculty of Forensic Medicine, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China
| | - B Luo
- Faculty of Forensic Medicine, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China
| | - D W Guan
- School of Forensic Medicine, China Medical University, Shenyang 110122, China
| | - Y W Zhou
- Department of Forensic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - B J Hu
- Guangzhou Medical University, Guangzhou 511436, China
| | - J D Cheng
- Faculty of Forensic Medicine, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China
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Liu H, Wang L, Chan K, Xiong L, Leng L, Shi L, Leung TW, Chen F, Zheng D. The Application of Non-linear Flow Resistance in Cerebral Artery: Compared with Windkessel Model based on Genetic Algorithm. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2019:2285-2288. [PMID: 31946356 DOI: 10.1109/embc.2019.8857963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Continuous blood pressure is measured from various extracranial body sites, with difference in amplitude and phase with intracranial blood pressure. Consequent influences on the accuracy of Windkessel model need further investigation. Between blood pressure and intracranial flow rate, a model with non-linear flow resistance (R-DT) was proposed and compared with the 3-element Windkessel (RCR) model. From the measured blood flow velocity in middle cerebral artery, the blood pressure was estimated by R-DT and RCR models respectively. The parameters in the models were optimized by genetic algorithm. The accuracies of R-DT and RCR models were compared based on their estimation errors to the measured blood pressure. The capacitance element in RCR model indicated limited ability to take the time shift into account. Compared with RCR model, R-DT model had less error (averaged relative error: 5.19% and 2.49% for RCR and RDT models). The non-linear flow resistance was applicable in simulating cerebral arteries.
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Zhang X, Wang A, Zhang J, Singh M, Liu D, Zuo Y, Wu L, Song M, Wang W, Feigin V, Wang Y, Zheng D. Association of plasma C-reactive protein with ischaemic stroke: a Mendelian randomization study. Eur J Neurol 2019; 27:565-571. [PMID: 31692152 DOI: 10.1111/ene.14113] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 11/04/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND PURPOSE Elevated C-reactive protein (CRP) is associated with an increased risk of ischaemic stroke (IS). However, the causality of this association is uncertain. The aim is to investigate whether genetically raised plasma CRP concentration levels are associated with IS on the basis of the Mendelian randomization method. METHODS Based on the National Center for Biotechnology Information single nucleotide polymorphism (SNP) database, the Chinese online genetic database as well as previously published studies, four CRP-associated SNP alleles (rs1130864, rs1205, rs876537 and rs3093059) with minor allele frequency ≥0.15 were selected and the concentration levels of CRP were measured in 378 first-ever IS patients and 613 healthy controls. RESULTS Three SNPs were chosen and used as instrumental variables. The adjusted odds ratios (ORs) [95% confidence interval (95% CI)] of IS per addition of the modelled allele were 1.07 (0.79-1.45) for rs876537, 0.99 (0.73-1.35) for rs1205 and 1.08 (0.71-1.65) for rs3093059. The OR (95% CI) of IS for plasma CRP ≥2.0 mg/l was 2.19 (1.06-4.53) compared with <2.0 mg/l. The adjusted OR (95% CI) of IS per genetically predicted 10% higher CRP concentration, based on the three SNPs as the instruments, was 1.02 (0.94-1.11). Furthermore, similar results were obtained with adjusted ORs (95% CI) of 1.00 (0.88-1.13) and 1.04 (0.93-1.16), respectively, for large-artery atherosclerosis and small-artery occlusion per genetically predicted 10% higher CRP concentration. CONCLUSIONS This Mendelian randomization study provides no clear support that elevated CRP concentration is causally associated with the risk of IS.
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Affiliation(s)
- X Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - A Wang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - J Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - M Singh
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - D Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Y Zuo
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - L Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - M Song
- Department of Epidemiology and Health Statistics, School of Public Health, Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - W Wang
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - V Feigin
- National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, Auckland, New Zealand
| | - Y Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - D Zheng
- Department of Epidemiology and Health Statistics, School of Public Health, Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
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Gu JL, Li J, Liu JR, Zou WY, Huang BH, Zheng D, Wang HH. [High dose melphalan (HDM) is superior to cyclophosphamide plus etoposide and busulfan (CVB) as the conditioning regimen in autologous stem cell transplantation for multiple myeloma]. Zhonghua Xue Ye Xue Za Zhi 2019; 40:732-737. [PMID: 31648473 PMCID: PMC7342454 DOI: 10.3760/cma.j.issn.0253-2727.2019.09.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
目的 比较大剂量美法仑(HDM)和环磷酰胺、依托泊苷联合白消安(CVB)预处理方案应用于新诊断多发性骨髓瘤(NDMM)患者自体造血干细胞移植(ASCT)的安全性、近期及远期疗效。 方法 回顾性分析2011年1月至2017年8月期间接受PAD(硼替佐米+脂质体阿霉素+地塞米松)方案诱导治疗序贯ASCT的NDMM患者共123例,按接受预处理方案分为CVB组(82例)和HDM组(41例)。 结果 ①非血液学不良反应方面两者无显著区别。②CVB组中性粒细胞植入和血小板植入较HDM组快,中性粒细胞植入时间为第10(9~35)天对第11(9~12)天(z=−3.433,P=0.001);血小板植入时间为11(7~55)d对HDM组13(10~35)d(z=−3.506,P<0.001);但CVB组也更早进入粒细胞缺乏(粒缺)及显著血小板减少,最终粒缺及显著血小板减少持续时间两组间尚未显示出差别;但CVB组的发热持续时间以及相应抗生素使用时间显著延长。③CVB组经过移植后获得传统疗效进步的患者比例显著低于HDM组(9/46对14/28,P=0.021);而且移植后3个月CVB组的微小残留病(MRD)阴性率有低于HDM组的趋势(31.7%对48.8%,P=0.065)。④无论单因素还是多因素分析均显示两种预处理方案并不影响接受PAD诱导序贯ASCT及维持治疗的NDMM患者的至进展时间(TTP)(P= 0.619)及总生存(OS)时间(P=0.295)。 结论 HDM预处理方案血液学不良反应、减低MM肿瘤负荷以及使用方便性方面较CVB方案具有优势,但采用两种预处理方案的ASCT治疗MM的TTP和OS未见明显差异。
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Affiliation(s)
- J L Gu
- The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
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Zheng D, Yang Y, Wu C, Wang H, Liu S, Xu X, Zhang D, Li F, Ni J, Xu J, Jiang G. P2.11-11 Exosomal miRNAs as Diagnosis Biomarkers for Distinguishing Benign and Malignant Nodules in Non-Small Cell Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Padilla O, Schrank B, Chin C, Zheng D, Connolly E. Predictors of Breast Reconstruction Failure and Morbidity in Patients Undergoing Postmastectomy Radiotherapy in the Era of Neoadjuvant Chemotherapy. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Wu Q, Liu JR, Huang BH, Zou WY, Gu JL, Chen ML, Kuang LF, Zheng D, Xu DR, Zhou ZH, Wang HH, Su C, Tong XZ, Li J. [Bortezomib-based induction chemotherapy followed by autologous hematopoietic stem cell transplantation and maintenance in 200 patients with multiple myeloma: long-term follow-up results from single center]. Zhonghua Xue Ye Xue Za Zhi 2019; 40:453-459. [PMID: 31340616 PMCID: PMC7342406 DOI: 10.3760/cma.j.issn.0253-2727.2019.06.002] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To study the efficacy, safety and long-term outcomes of integrated strategy of bortezomib-based induction regimens followed by autologous hematopoietic stem cell (ASCT) and maintenance therapy in Chinese multiple myeloma (MM) patients. Methods: 200 MM patients receiving integrated strategy of bortezomib--based induction regimens followed by ASCT and maintenance therapy were retrospectively and prospectively analyzed from December 1. 2006 to April 30. 2018. Results: The complete remission rates (CR) and better than very good partial remission rates (VGPR) after induction therapy, transplantation and maintenance therapy were respectively 31% and 75.5%, 51.8% and 87.7%,73.6% and 93.4%. There was no difference between 4 cycles and more than 5 cycles induction chemotherapy. The negative rate of MRD detection by flow cytometry was 17.6% and 38.2% respectively after induction and 3 months after transplantation. The negative rate of MRD gradually increased during the maintenance therapy. The success rate of high dose CTX combined with G-CSF mobilization was 95.5% and transplantation related mortality (TRM) was zero. The median time to progress (TTP) was 75.3 months and the median overall survival (OS) was 99.5 months. TTP of patients obtaining CR and negative MRD after induction were longer that those of no CR and positive MRD. TTP and OS of patients receiving triple-drug induction and ASCT in early stage were longer than those of double-drug induction and ASCT in late stage. LDH≥240 U/L, high risk cytogenetics, ISS II+III stage and HBsAg positive were prognostic factors at diagnosis. However, only MRD and high risk cytogenetics were independent prognostic factors after transplantation and maintenance therapy. The clinical characteristics of patients of TTP ≥6 years were listed below: light-chain type M protein, ISS I stage, normal level of hemoglobin and platelet, normal LDH, HBsAg negative, chromosome 17p-negative, good response and sustained good response. Conclusions: Integrated strategy of bortezomib-based induction regimens followed by ASCT and maintenance therapy can significantly improve the short-term and long-term efficacy. The prognostic factors of TTP in different disease stages were different. Response to treatment, especially MRD, played a more important role in prognostic factors.
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Affiliation(s)
- Q Wu
- Department of Hematology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
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Liu H, Leung T, Wong A, Chen F, Zheng D. The Geometric Effects on the Stress of Arterial Atherosclerotic Plaques: a Computational Study. Annu Int Conf IEEE Eng Med Biol Soc 2019; 2019:6948-6951. [PMID: 31947437 DOI: 10.1109/embc.2019.8857885] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND The rupture of atherosclerotic plaques could cause serious clinical events. The wall shear stress (WSS) and axial plaque stress (APS) could reflect the risk of plaque rupture. This study aimed to quantitatively investigate the geometric effects on WSS and APS using computational fluid dynamics (CFD). METHODS 63 plaque models were developed from three severities (75%, 82%, and 89% in area), three eccentricities (the deviation of plaque throat from the arterial centerline: 0, 0.375 and 0.75mm), and 7 different length combinations of the proximal and distal stenotic segments (2mm-5mm, 3mm-5mm, 4mm-5mm, 5mm-5mm, 5mm-4mm, 5mm-3mm, 5mm-2mm). For each model, CFD simulation was performed to calculate the maximum and area-averaged WSS and APS on the proximal and distal stenotic segments. The multivariate analysis of variance and linear regression analysis were performed to quantitatively investigate the geometry-stress relationship.The results showed that, the severity and eccentricity of a plaque were linearly related to its WSS and APS. APS value on a segment (proximal or distal) of the plaque depended on the segmental length It was also shown that the difference of APS between proximal and distal segments depended exclusively on the difference of length between segments (all p<; 0.05). CONCLUSION The geometry of a plaque influences its WSS and APS. APS and its proximal/distal difference depend on the segmental lengths.
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Zheng D, Tang SB, Ye WQ, Liu SP, Li ZH, Liu XS, Quan L, Luo B, Cheng JD. Strategy of the Causes of Death of Dependents. Fa Yi Xue Za Zhi 2019; 35:285-288. [PMID: 31282621 DOI: 10.12116/j.issn.1004-5619.2019.03.004] [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] [Received: 08/27/2018] [Indexed: 11/30/2022]
Abstract
Abstract Objective To discuss the methods and strategies to identify the causes of dependents' deaths, as well as provide the experiences that can be used for reference and scientific basis for the forensic identification of the potentially growing deaths of the same kind in the future. Methods The 13 cases concerning death of dependents accepted by Sun Yat-sen University Forensic Center were collected, and the basic information of the dependents were statistically described. The nutritional status, environmental condition and medical care condition were evaluated according to dietary energy, living space, environment and medical treatment condition. Results Among the 13 dependents, there were 11 males and 2 females, with the oldest 74 and the youngest 9 and dwelling time was from 0.4 to 5.6 years. Forensic pathological examination showed that 13 dependents had infectious diseases and 11 were severely dystrophic. There were no fatal mechanical injuries or poisoning in dependents. Molecular pathological screening of 4 cases revealed no pathogenic variants of sudden death susceptible genes. The poor status of the diet, nutrition, living environment and medical care of these dependents were discovered. The direct cause of death of all 13 dependents was identified to be disease. The lack of nutrition, poor living environment and lack of medical care were thought to play a dominant role in causing the deaths of 12 dependants. Conclusion The death identification should follow the judicial procedure. In identification of the causes of death and analysis of the proportion of the affecting factors resulting in death, all factors, including nutrition,environment, medical care, injury and diseases, need to be considered.
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Affiliation(s)
- D Zheng
- Department of Forensic Pathology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China.,Guangdong Province Translational Forensic Medicine Engineering Technology Research Center, Sun Yat-Sen University, Guangzhou 510080, China
| | - S B Tang
- Department of Forensic Pathology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China.,Guangdong Province Translational Forensic Medicine Engineering Technology Research Center, Sun Yat-Sen University, Guangzhou 510080, China
| | - W Q Ye
- Department of Forensic Pathology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China.,Guangdong Province Translational Forensic Medicine Engineering Technology Research Center, Sun Yat-Sen University, Guangzhou 510080, China
| | - S P Liu
- Department of Forensic Pathology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China.,Guangdong Province Translational Forensic Medicine Engineering Technology Research Center, Sun Yat-Sen University, Guangzhou 510080, China
| | - Z H Li
- Department of Forensic Pathology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China.,Guangdong Province Translational Forensic Medicine Engineering Technology Research Center, Sun Yat-Sen University, Guangzhou 510080, China
| | - X S Liu
- Department of Forensic Pathology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China.,Guangdong Province Translational Forensic Medicine Engineering Technology Research Center, Sun Yat-Sen University, Guangzhou 510080, China
| | - L Quan
- Department of Forensic Pathology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China.,Guangdong Province Translational Forensic Medicine Engineering Technology Research Center, Sun Yat-Sen University, Guangzhou 510080, China
| | - B Luo
- Department of Forensic Pathology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China.,Guangdong Province Translational Forensic Medicine Engineering Technology Research Center, Sun Yat-Sen University, Guangzhou 510080, China
| | - J D Cheng
- Department of Forensic Pathology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China.,Guangdong Province Translational Forensic Medicine Engineering Technology Research Center, Sun Yat-Sen University, Guangzhou 510080, China
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Qin X, Guo Q, Liu Y, Zhu D, Li J, Zheng D, Tong J. [Prognostic value of procalcitonin and C-reactive protein combined with sequential organ failure assessment score in elderly patients with sepsis induced by pulmonary infection]. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2019; 31:562-565. [PMID: 31198140 DOI: 10.3760/cma.j.issn.2095-4352.2019.05.008] [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 prognostic value of procalcitonin (PCT) and C-reactive protein (CRP) combined with sequential organ failure assessment (SOFA) score in elderly patients with sepsis induced by pulmonary infection. METHODS A retrospective study was conducted. The elderly patients aged over 60 years old with sepsis induced by pulmonary infection admitted to Guangdong Provincial Hospital of Chinese Medicine from October 2015 to December 2018 were enrolled. The PCT, CRP and SOFA scores of patients within 24 hours after admission and 28-day prognosis were recorded. The patients were divided into groups according to the severity of the disease and 28-day prognosis. The differences in above parameters among all the groups were compared. Receiver operator characteristic (ROC) curve was drawn to analyze the prognostic value of the above indicators in elderly patients with sepsis induced by pulmonary infection alone or in combination. RESULTS A total of 265 patients were enrolled in the study. According to the severity of the disease, the patients were divided into sepsis group (n = 194) and septic shock group (n = 71). According to the 28-day prognosis, the patients were divided into survival group (n = 186) and non-survival group (n = 79). Compared with the sepsis group, the PCT, CRP and SOFA scores of patients in the septic shock group were significantly increased [PCT (μg/L): 6.16 (1.94, 19.60) vs. 1.56 (0.34, 7.32), CRP (mg/L): 128.90 (54.93, 198.70) vs. 91.45 (30.15, 175.30), SOFA score: 9.0 (7.0, 12.0) vs. 4.0 (3.0, 5.0)] with significant differences (all P < 0.05). Compared with the survival group, the PCT, CRP and SOFA scores of sepsis patients in the non-survival group were significantly increased [PCT (μg/L): 4.80 (1.06, 19.60) vs. 1.82 (0.34, 7.24), CRP (mg/L): 135.20 (58.10, 225.50) vs. 91.45 (31.50, 172.53), SOFA score: 7.0 (4.0, 11.0) vs. 4.0 (3.0, 6.0)] with significant differences (all P < 0.01). ROC curve analysis showed that the area under the ROC curve (AUC) of PCT, CRP, SOFA score and CRP+PCT+SOFA score was 0.641, 0.607, 0.697, and 0.712, indicating that above parameters had certain predictive value for 28-day prognosis of elderly patients with sepsis induced by pulmonary infection, and the combined predictive value of them was the greatest with the sensitivity of 55.1% and the specificity of 80.1%. CONCLUSIONS PCT, CRP and SOFA score are commonly used to evaluate the prognosis of the elderly patients with sepsis induced by pulmonary infection, and the combination of them has higher evaluation value.
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Affiliation(s)
- Xiaolan Qin
- Department of Emergency, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, Guangdong, China
| | - Quanlai Guo
- Department of Emergency, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, Guangdong, China
| | - Yuntao Liu
- Department of Emergency, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, Guangdong, China.,Guangdong Provincial Key Laboratory of Research on Emergency in Traditional Chinese Medicine, Guangzhou 510120, Guangdong, China
| | - Decai Zhu
- Department of Emergency, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, Guangdong, China
| | - Jun Li
- Department of Emergency, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, Guangdong, China.,Guangdong Provincial Key Laboratory of Research on Emergency in Traditional Chinese Medicine, Guangzhou 510120, Guangdong, China
| | - Danwen Zheng
- Department of Emergency, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, Guangdong, China
| | - Junsheng Tong
- Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong, China. Corresponding author: Guo Quanlai,
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López-Sánchez G, Smith L, Zheng D, Sapkota R, Yang L, Chen Z, Pardhan S. Physical activity behaviour in people with diabetes residing in China: A cross-sectional analysis. Sci Sports 2019. [DOI: 10.1016/j.scispo.2018.11.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Nguyen M, Cohen I, Valdes J, Xu Z, Bar C, Dauber K, Tsai P, Zhao D, Zheng D, Hsu Y, Chen T, Ezhkova E. 869 The specification of Merkel cell in the back skin and glabrous paw skin is controlled by FGFR2-meditated signaling. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Cohen I, Zhao D, Menon G, Nakayama M, Koseki H, Zheng D, Ezhkova E. 287 Polycomb repressive complex 1 (PRC1) preserves epidermal tissue integrity independently of PRC2. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.363] [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: 11/16/2022]
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Yao H, Zheng D, Xie M, Wang Z. 268 A New Look at Reconstruction Strategy: Classification and Management for Extramammary Paget's Disease. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.01.274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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