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Marques TC, Monteiro HF, Melo DB, Coelho WM, Salman S, Marques LR, Leão KM, Machado VS, Menta P, Dubey D, Sun F, Lima FS. Effect of rumen-protected choline on dairy cow metabolism, immunity, lactation performance, and vaginal discharge microbiome. J Dairy Sci 2024; 107:2864-2882. [PMID: 38101729 DOI: 10.3168/jds.2023-23850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 11/12/2023] [Indexed: 12/17/2023]
Abstract
Rumen-protected choline (RPC) promotes benefits in milk production, immunity, and health in dairy cows by optimizing lipid metabolism during transition period management and early lactation. However, the RPC success in dairy cows depends on choline bioavailability, which is affected by the type of protection used in rumen-protected choline. Therefore, our objectives were to determine the effects of a novel RPC on dry matter intake (DMI), identify markers of metabolism and immunity, and evaluate lactation performance. Dry Holstein (n = 48) cows at 245 ± 3 d of gestation were blocked by parity and assigned to control or RPC treatment within each block. Cows enrolled in the RPC treatment received 15 g/d of CholiGEM (Kemin Industries, Cavriago RE, Italy) from 21 d prepartum and 30 g/d of CholiGEM from calving to 21 d postpartum. During the transition period, DMI was measured daily, and blood was sampled weekly for energy-related metabolites such as β-hydroxybutyrate (BHB), glucose, and nonesterified fatty acids (NEFA), as well as immune function markers such as haptoglobin (Hp) and lipopolysaccharide-binding protein (LPB). Vaginal discharge samples were collected at the calving and 7 d postpartum and stored in microcentrifuge tubes at -80°C until 16S rRNA sequencing. The main responses of body condition score, body weight, DMI, milk yield, milk components, and immune function markers were analyzed using the GLIMMIX procedure of SAS with the effects of treatment, time, parity, and relevant covariates added to the models. The relative abundance of microbiome α-diversity was evaluated by 3 indexes (Chao1, Shannon, and Simpson) and β-diversity by principal coordinate analysis and permutational multivariate ANOVA. We found no differences in DMI in the pre- and postpartum periods. Cows fed RPC increased the yields of energy- and 3.5% fat-corrected milk and fat yield in primiparous and multiparous cows, with an interaction between treatment and parity for these lactation variables. However, we found no differences in milk protein and lactose up to 150 DIM between treatments. Glucose, NEFA, and BHB had no differences between the treatments. However, RPC decreased BHB numerically (control = 1.07 ± 0.13 vs. RPC = 0.63 ± 0.13) in multiparous on the third week postpartum and tended to reduce the incidence of subclinical ketosis (12.7% vs. 4.2%). No effects for Hp and LPB were found in cows fed RPC. Chao1, Shannon, and Simpson indexes were lower at calving in the RPC treatment than in the Control. However, no differences were found 7 d later for Chao1, Shannon, and Simpson indexes. The vaginal discharge microbiome was altered in cows fed RPC at 7 d postpartum. Fusobacterium, a common pathogen associated with metritis, was reduced in cows fed RPC. Rumen-protected choline enhanced lactation performance and health and altered the vaginal discharge microbiome which is a potential proxy for uterine healthy in dairy cows. The current study's findings corroborate that RPC is a tool to support adaptation to lactation and shed light on opportunities for further research in reproductive health.
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Affiliation(s)
- T C Marques
- Department of Population Health and Reproduction, University of California-Davis, Davis, CA 95616; Department of Animal Science, Instituto Federal Goiano, Rio Verde, Goias 75901-970, Brazil
| | - H F Monteiro
- Department of Population Health and Reproduction, University of California-Davis, Davis, CA 95616
| | - D B Melo
- Department of Population Health and Reproduction, University of California-Davis, Davis, CA 95616
| | - W M Coelho
- Department of Population Health and Reproduction, University of California-Davis, Davis, CA 95616
| | - S Salman
- Department of Population Health and Reproduction, University of California-Davis, Davis, CA 95616
| | - L R Marques
- Department of Animal Science, Instituto Federal Goiano, Rio Verde, Goias 75901-970, Brazil
| | - K M Leão
- Department of Animal Science, Instituto Federal Goiano, Rio Verde, Goias 75901-970, Brazil
| | - V S Machado
- Department of Veterinary Sciences, College of Agricultural Sciences and Natural Resources, Texas Tech University, Lubbock, TX 79409
| | - P Menta
- Department of Veterinary Sciences, College of Agricultural Sciences and Natural Resources, Texas Tech University, Lubbock, TX 79409
| | - D Dubey
- Kemin Europa NV, Herentals 2640, Belgium
| | - F Sun
- Kemin Industries Inc., Des Moines, IA 50317
| | - F S Lima
- Department of Population Health and Reproduction, University of California-Davis, Davis, CA 95616.
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Spitzer T, Diamond MP, Wild R, Legro R, Zhang H, Sun F, Ling S, Santoro N. The effect of improved metabolic syndrome parameters on live birth. Fertil Steril 2024:S0015-0282(24)00248-6. [PMID: 38641159 DOI: 10.1016/j.fertnstert.2024.04.020] [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: 11/07/2023] [Revised: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 04/21/2024]
Abstract
OBJECTIVE To determine whether improvements in metabolic syndrome before ovarian stimulation with intrauterine insemination affects live birth among women with obesity and unexplained infertility after fertility treatment. DESIGN Secondary analysis of the randomized controlled clinical trial Improving Reproductive Fitness Through Pretreatment With Lifestyle Modification in Obese Women With Unexplained Infertility (FIT-PLESE). SUBJECTS Three hundred seventy-nine women with obesity and unexplained infertility who underwent standard infertility treatment after a lifestyle intervention. INTERVENTION The FIT-PLESE trial evaluated whether prepregnancy lifestyle interventions (diet with weight loss medication and exercise vs. exercise alone) before ovarian stimulation with intrauterine insemination improved the live birth rate among women with obesity and unexplained infertility. Utilizing FIT-PLESE data, we compared the association between improved Metabolic Syndrome (by diagnostic criteria parameters and Metabolic Syndrome Z-scores) and live birth in a subset of women who have Metabolic Syndrome. MAIN OUTCOME MEASURES Live birth by groups were compared using chi-square and Fisher's exact tests, and continuous variables were compared using Student's t-tests. Logistic regression was used to assess Metabolic Syndrome Z-score difference and live birth. RESULTS 191 study participants were diagnosed with Metabolic Syndrome at baseline. Thirty of these women exhibited a decline in the number of metabolic syndrome parameters and 33 had decline in their Metabolic Syndrome Z-scores during the preconception lifestyle intervention phase. There were no statistically significant differences in live birth among those who exhibited decline in the number of metabolic parameters compared to those who had no decline (33.3% versus 19.9%; p=0.102). Those who improved their Metabolic Syndrome Z-score had a live birth rate of 17.2% compared to 20.8% of those whose Metabolic Syndrome Z-scores were worsened or unchanged (p=0.055). CONCLUSION Analysis of the FIT-PLESE data was unable to demonstrate that women with improvement in Metabolic Syndrome prior to fertility treatment, as shown by decreased number of metabolic parameters and/or improved Metabolic Syndrome Z-scores, benefit with improved fertility and live birth outcomes.
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Affiliation(s)
- Trimble Spitzer
- Department of Gynecologic Surgery and Obstetrics. Uniformed Services University of Health Sciences, Bethesda MD, 20814 USA.
| | - Michael P Diamond
- Department of Obstetrics and Gynecology, Augusta University, Augusta GA 30912, USA
| | - Robert Wild
- Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City OK 73117, USA
| | - Richard Legro
- Department of Obstetrics and Gynecology, Pennsylvania State University, Hershey PA 16802, USA
| | - Heping Zhang
- Department of Biostatistics, Yale University School of Public Health, New Haven CT 06520, USA
| | - Fangbai Sun
- Department of Biostatistics, Yale University School of Public Health, New Haven CT 06520, USA
| | - Shen Ling
- Department of Biostatistics, Yale University School of Public Health, New Haven CT 06520, USA
| | - Nanette Santoro
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora CO 80204, USA
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Liu ZX, Long ZL, Yang ZR, Shi SY, Xu XR, Zhao HY, Yang ZY, Fu Z, Song HB, Lin TF, Zhan SY, Sun F. [Progress in methodological research on bridging the efficacy-effectiveness gap of clinical interventions(2): to improve the extrapolation of efficacy]. Zhonghua Liu Xing Bing Xue Za Zhi 2024; 45:579-584. [PMID: 38678356 DOI: 10.3760/cma.j.cn112338-20230925-00190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2024]
Abstract
Objective: Randomized controlled trials (RCT) usually have strict implementation criteria. The included subjects' characteristics of the conditions for the intervention implementation are quite different from the actual clinical environment, resulting in discrepancies between the risk-benefit of interventions in actual clinical use and the risk-benefit shown in RCT. Therefore, some methods are needed to enhance the extrapolation of RCT results to evaluate the real effects of drugs in real people and clinical practice settings. Methods: Six databases (PubMed, Embase, Web of Science, CNKI, Wanfang Data, and VIP) were searched up to 31st December 2022 with detailed search strategies. A scoping review method was used to integrate and qualitatively describe the included literature inductively. Results: A total of 12 articles were included. Three methods in the included literature focused on: ①improving the design of traditional RCT to increase population representation; ②combining RCT Data with real-world data (RWD) for analysis;③calibrating RCT results according to real-world patient characteristics. Conclusions: Improving the design of RCT to enhance the population representation can improve the extrapolation of the results of RCT. Combining RCT data with RWD can give full play to the advantages of data from different sources; the results of the RCT were calibrated against real-world population characteristics so that the effects of interventions in real-world patient populations can be predicted.
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Affiliation(s)
- Z X Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - Z L Long
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - Z R Yang
- School of Computer Science and Control Engineering, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - S Y Shi
- China Rehabilitation Science Institute, China Disability Control and Prevention Center, China Disable Persons' Federation, Beijing 100068, China
| | - X R Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - H Y Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - Z Y Yang
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hongkong 999077, China
| | - Z Fu
- Administration of Hainan Boao Lecheng International Medical Tourism Pilot Zone, Hainan Institute of Real World Data, Hainan 571437, China
| | - H B Song
- Department of Traditional Chinese Medicine Monitoring and Evaluation, Center for Drug Reevalaution, National Medical Products Administration, Beijing 100076, China Key Laboratory for Research and Evaluation of Pharmacovigilance, National Medical Products Administration, Beijing 100076, China
| | - T F Lin
- Biomedical Information Technology Research Center , Institute of Advanced Computing and Digital Engineering, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - S Y Zhan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China Clinical Epidemiology Research Center, Peking University Third Hospital, Beijing 100191, China
| | - F Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China Administration of Hainan Boao Lecheng International Medical Tourism Pilot Zone, Hainan Institute of Real World Data, Hainan 571437, China
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Sun F, Mishra S, McGuinness PH, Filipiak ZH, Marković I, Sokolov DA, Kikugawa N, Orenstein JW, Hartnoll SA, Mackenzie AP, Sunko V. Response to "Comment on 'A spatially resolved optical method to measure thermal diffusivity'" [Rev. Sci. Instrum. 95, 047101 (2024)]. Rev Sci Instrum 2024; 95:047102. [PMID: 38624366 DOI: 10.1063/5.0195810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 03/03/2024] [Indexed: 04/17/2024]
Affiliation(s)
- F Sun
- Max Planck Institute for Chemical Physics of Solids, 01187 Dresden, Germany
| | - S Mishra
- Max Planck Institute for Chemical Physics of Solids, 01187 Dresden, Germany
| | - P H McGuinness
- Max Planck Institute for Chemical Physics of Solids, 01187 Dresden, Germany
| | - Z H Filipiak
- Max Planck Institute for Chemical Physics of Solids, 01187 Dresden, Germany
| | - I Marković
- Max Planck Institute for Chemical Physics of Solids, 01187 Dresden, Germany
| | - D A Sokolov
- Max Planck Institute for Chemical Physics of Solids, 01187 Dresden, Germany
| | - N Kikugawa
- National Institute for Materials Science, Ibaraki 305-0003, Japan
| | - J W Orenstein
- Department of Physics, University of California, Berkeley, California 94720, USA
- Materials Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - S A Hartnoll
- Department of Applied Mathematics and Theoretical Physics, University of Cambridge, Cambridge CB3 0WA, United Kingdom
| | - A P Mackenzie
- Max Planck Institute for Chemical Physics of Solids, 01187 Dresden, Germany
- School of Physics and Astronomy, University of St Andrews, St Andrews KY16 9SS, United Kingdom
| | - V Sunko
- Max Planck Institute for Chemical Physics of Solids, 01187 Dresden, Germany
- Department of Physics, University of California, Berkeley, California 94720, USA
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Ding CZ, Wang GL, Jiang GQ, Wang HT, Liu YY, Zhang HL, Sun F, Wei L. [circDDX17 targets miR-223-3p / RIP3 to regulate the proliferation and apoptosis of non-small cell lung cancer cells]. Zhonghua Zhong Liu Za Zhi 2024; 46:239-248. [PMID: 38494770 DOI: 10.3760/cma.j.cn112152-20231024-00243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Objective: To explore the molecular mechanism of circDDX17 regulating the proliferation and apoptosis of non-small cell lung cancer cells by targeting the miR-223-3p/RIP3 molecular axis. Methods: The expression levels of circDDX17, miR-223-3p, and RIP3 in human normal lung epithelial cell lines BEAS-2B and non-small cell lung cancer cells H1299, A549, and H446 were detected by reverse transcription-quantitative real-time polymerase chain reaction (RT-qPCR). The plasmids of pcDNA, pcDNA-circDDX17, anti-miR-con, anti-miR-223-3p, pcDNA-circDDX17 and miR-con, pcDNA-circDDX17 and miR-223-3p mimics were transfected into H1299 cells. 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H tetrazolium bromide (MTT) assay was used to detect the cell proliferation. Flow cytometry was used to detect the cell cycle and cell apoptosis. Plate cloning experiment was used to detect cell proliferation ability. The dual luciferase report experiment was applied to verify the targeting relationship between miR-223-3p with circDDX17 and RIP3. Western blot was used to detect the protein expression of cyclinD1, CDK2, cleaved caspase-3 and Bax. Results: The expression levels of circDDX17 and RIP3 mRNA in H1299, A549, and H446 cells were significantly reduced (P<0.05), the expression level of miR-223-3p mRNA was significantly increased (P<0.05) compared with BEAS-2B. The cell viability [(69.46±4.68)%], the number of cell clones (83.49±7.86), the proportion of cells in S phase [(22.52±1.41) %], the protein expression levels of cyclinD1 and CDK2 in PCDNa-CircDDX17 group were lower than those in pcDNA group [(97.54±7.72)%, 205.03±13.37, (28.69±1.49)%, respectively, P<0.05], while the percentage of G0/G1 phase cells [(64.45±3.56)%], apoptosis rate [(18.36±1.63)%], the protein expression levels of cleaved caspase-3 and Bax in pcDNA-circDDX17 group were higher than those of pcDNA group [(51.33±2.76) % and (5.21±0.54) %, respectively, P<0.05]. The viability [(72.64±5.44)%], the number of cell clones (78.16±8.23), the proportion of S-stage cells [(21.34±1.59) %], the protein expression levels of CyclinD1 and CDK2 in anti-miR-223-3p group were lower than those in anti-miR-con group [(103.47±6.25)%, 169.32±14.53, (28.43±1.26)%, respectively, P<0.05]. Percentage of G0/G1 phase cells [(62.86±3.28)%], apoptosis rate [(14.64±1.67)%], the protein expression levels of cleaved caspase-3 and Bax in the anti-miR-223-3p group were higher than those of anti-miR-con group [(51.33±2.71)% and (4.83±0.39)%, respectively, P<0.05]. MiR-223-3p has complementary sites with circDDX17 or RIP3. The viability [(135.45±9.28)%], the number of cell clones (174.64±10.68), the proportion of S-phase cells [(26.39±2.25)%], the protein expression levels of cyclinD1 and CDK2 in pcDNA-circDDX17+miR-223-3p group were higher than those in pcDNA-circDDX17+miR-con group [(101.56±6.68)%, 107.65±7.62, (21.64±1.72)%, P<0.05]. Percentage of G0/G1 phase cells [(56.64±2.76)%], apoptosis rate [(8.34±0.76)%], the protein expression levels of cleaved caspase-3 and Bax in pcDNA-circDDX17+miR-223-3p group were lower than those of pcDNA-circDDX17+miR-con group [(64.03±3.48)% and (15.21±1.18)%, respectively, P<0.05]. Conclusion: circDDX17 could inhibit the proliferation and induce apoptosis of non-small cell lung cancer cells via targeting the miR-223-3p / RIP3 molecular axis.
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Affiliation(s)
- C Z Ding
- Department of Thoracic Surgery, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou 450003, China
| | - G L Wang
- Department of Thoracic Surgery, Henan Chest Hospital, Zhengzhou 450008, China
| | - G Q Jiang
- Department of Thoracic Surgery, Henan Chest Hospital, Zhengzhou 450008, China
| | - H T Wang
- Department of Thoracic Surgery, Henan Chest Hospital, Zhengzhou 450008, China
| | - Y Y Liu
- Department of Thoracic Surgery, Henan Chest Hospital, Zhengzhou 450008, China
| | - H L Zhang
- Department of Thoracic Surgery, Henan Chest Hospital, Zhengzhou 450008, China
| | - F Sun
- Department of Respiratory, Henan Chest Hospital, Zhengzhou 450008, China
| | - L Wei
- Department of Thoracic Surgery, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou 450003, China
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Liu FQ, Yang ZR, Wu SS, Zhao HY, Zhan SY, Sun F. [Analysis methods and case analysis of effect modification (3): effect modification in individual patient data Meta-analysis]. Zhonghua Liu Xing Bing Xue Za Zhi 2024; 45:447-454. [PMID: 38514323 DOI: 10.3760/cma.j.cn112338-20230824-00095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
This paper briefly introduces the unique advantages, overall analysis ideas and existing analysis methods of individual patient data Meta-analysis in terms of effect modification. In addition to Meta-regression and subgroup analysis, this paper also introduces the analysis methods based on part of individual patient data integrated with aggregated data and summarizes the current reporting of the above mentioned methods. In addition, the application and results interpretation of the above mentioned methods in individual patient data Meta-analysis are presented in this paper by taking "Effects of sodium-glucose cotransporter 2 inhibitors on SBP in patients with type 2 diabetes" as an example and by introducing their advantages and limitations.
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Affiliation(s)
- F Q Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - Z R Yang
- School of Computer Science and Control Engineering, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - S S Wu
- National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - H Y Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - S Y Zhan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - F Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
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7
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Jian T, Yang M, Wu T, Ji X, Xia S, Sun F. Diagnostic value of dynamic contrast enhancement combined with conventional MRI in differentiating benign and malignant lacrimal gland epithelial tumours. Clin Radiol 2024; 79:e345-e352. [PMID: 37953093 DOI: 10.1016/j.crad.2023.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 10/13/2023] [Accepted: 10/16/2023] [Indexed: 11/14/2023]
Abstract
AIM To establish the diagnostic value of the quantitative parameters of dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) combined with conventional MRI in differentiating of benign and malignant lacrimal gland epithelial tumours. MATERIALS AND METHODS A retrospective analysis of primary lacrimal gland epithelial tumours confirmed by histopathology was conducted. Conventional MRI features and DCE-MRI quantitative parameters were collected and subjected to analysis. The diagnostic value was evaluated using receiver operating characteristic (ROC) curve analysis. RESULTS A total of 53 patients were enrolled of which 29 had malignant, whereas 24 had benign tumours. Conventional MRI revealed statistically significant differences between benign and malignant tumours regarding maximum tumour diameter, posterior margin characteristic, bone destruction, and erosion. The Ktrans and Kep values obtained by DCE-MRI were higher in malignant than in benign tumours, with a statistically significant (p<0.001 and p=0.022). A type I time-signal intensity (TIC) curve was more frequent in benign tumours, whereas a type II TIC curve was prevalent in malignant tumours (p=0.001). ROC analysis showed that Ktrans had the best diagnostic value of the DCE-MRI parameters (area under the ROC curve [AUC] of 0.822, 75.9% sensitivity, and 83.3% specificity, p<0.001). The combination of conventional MRI and DCE-MRI factors had the best diagnostic value and balanced sensitivity and specificity (AUC of 0.948, 93.1% sensitivity, and 91.7% specificity, p<0.001). CONCLUSIONS The present findings indicate that the combination of quantitative parameters of DCE-MRI and image characteristics of conventional MRI have a high diagnostic value for the diagnosis of benign and malignant lacrimal gland epithelial tumours.
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Affiliation(s)
- T Jian
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - M Yang
- Department of Ophthalmology, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, China
| | - T Wu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - X Ji
- Department of Radiology, Tianjin First Central Hospital, Tianjin, China
| | - S Xia
- Department of Radiology, Tianjin First Central Hospital, Tianjin, China
| | - F Sun
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China.
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Liu FQ, Yang ZR, Wu SS, Zhao HY, Zhan SY, Sun F. [Analysis methods and case analysis of effect modification (2): effect modification in network Meta-analysis]. Zhonghua Liu Xing Bing Xue Za Zhi 2024; 45:273-278. [PMID: 38413068 DOI: 10.3760/cma.j.cn112338-20230824-00094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
This paper briefly introduces the characteristics, research significance, and global reporting status of effect modification in network Meta-analysis, demonstrates the heterogeneity caused by effect modification in network Meta-analysis, and emphasizes the importance of exploring effect modification in network Meta-analysis. This paper also summarizes the normalized description and analysis strategies of effect modification in network Meta-analysis. Finally, by the case of "comparison of efficacy of three new hypoglycemic drugs in reducing body weight in type 2 diabetes patients", this paper demonstrates the realization of subgroup analysis and network Meta-regression in exploring effect modification, summarizes the advantages and disadvantages of the two methods, to provide references for future researchers.
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Affiliation(s)
- F Q Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - Z R Yang
- School of Computer Science and Control Engineering, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - S S Wu
- National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - H Y Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - S Y Zhan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - F Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
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9
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Liu ZX, Long ZL, Yang ZR, Shi SY, Xu XR, Zhao HY, Yang ZY, Fu Z, Song HB, Lin TF, Zhan SY, Sun F. [Progress in methodological research on bridging the efficacy-effectiveness gap of clinical interventions (1): to improve the validity of real-world evidence]. Zhonghua Liu Xing Bing Xue Za Zhi 2024; 45:286-293. [PMID: 38413070 DOI: 10.3760/cma.j.cn112338-20230925-00189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
Objective: Differences between randomized controlled trial (RCT) results and real world study (RWS) results may not represent a true efficacy-effectiveness gap because efficacy-effectiveness gap estimates may be biased when RWS and RCT differ significantly in study design or when there is bias in RWS result estimation. Secondly, when there is an efficacy- effectiveness gap, it should not treat every patient the same way but assess the real-world factors influencing the intervention's effectiveness and identify the subgroup likely to achieve the desired effect. Methods: Six databases (PubMed, Embase, Web of Science, CNKI, Wanfang Data, and VIP) were searched up to 31st December 2022 with detailed search strategies. A scoping review method was used to integrate and qualitatively describe the included literature inductively. Results: Ten articles were included to discuss how to use the RCT research protocol as a template to develop the corresponding RWS research protocol. Moreover, based on correctly estimating the efficacy-effectiveness gap, evaluate the intervention effect in the patient subgroup to confirm the subgroup that can achieve the expected benefit-risk ratio to bridge the efficacy-effectiveness gap. Conclusion: Using real-world data to simulate key features of randomized controlled clinical trial study design can improve the authenticity and effectiveness of study results and bridge the efficacy-effectiveness gap.
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Affiliation(s)
- Z X Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - Z L Long
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - Z R Yang
- School of Computer Science and Control Engineering, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - S Y Shi
- China Rehabilitation Science Institute, China Disability Control and Prevention Center, China Disable Persons' Federation, Beijing 100068, China
| | - X R Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - H Y Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - Z Y Yang
- School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong 999077, China
| | - Z Fu
- Administration of Hainan Boao Lecheng International Medical Tourism Pilot Zone, Hainan Institute of Real World Data, Haikou 571437, China
| | - H B Song
- Department of Traditional Chinese Medicine Monitoring and Evaluation, Center for Drug Reevalaution, National Medical Products Administration, Beijing 100076, China Key Laboratory for Research and Evaluation of Pharmacovigilance, National Medical Products Administration, Beijing 100076, China
| | - T F Lin
- Biomedical Information Technology Research Center , Institute of Advanced Computing and Digital Engineering, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences,Shenzhen 518055, China
| | - S Y Zhan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China Clinical Epidemiology Research Center, Peking University Third Hospital, Beijing 100191, China
| | - F Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China Administration of Hainan Boao Lecheng International Medical Tourism Pilot Zone, Hainan Institute of Real World Data, Haikou 571437, China
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10
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Zhao YR, Zhao Z, Zhang J, Li KP, Yang JS, Sun F, Liao SM, Zhang JL, Huang F, Zhu J. [Efficacy of rituximab therapy for 10 patients suffering from systemic lupus erythematosus with intestinal involvement]. Zhonghua Nei Ke Za Zhi 2024; 63:198-202. [PMID: 38326047 DOI: 10.3760/cma.j.cn112138-20231016-00220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
We retrospectively analyzed therapy efficacy and the adverse reactions of 10 patients suffering from systemic lupus erythematosus (SLE) with intestinal involvement treated with rituximab (RTX). Patients were hospitalized in the Department of Rheumatology and Immunology of the First Medical Center of PLA General Hospital from January 2015 to January 2023. Among the 10 patients, two were men and eight were women. The age of the cohort was (41.9±8.8) years. The age at disease onset was (28.8±9.2) years. The total course of the SLE diagnosis was(109.6±59.9) months. The course of the diagnosis of SLE with intestinal involvement was (89.3±50.2) months. The time from the appearance of intestinal symptoms to the diagnosis of SLE with intestinal involvement was 1.5 (1.0,8.0) months. The time from the diagnosis of SLE with intestinal involvement to RTX use was 13.0 (1.0,46.3) months. Follow-up duration after application of RTX treatment was (55.3±28.4) months. There were five cases of abdominal pain, four cases of abdominal distension, nine cases of diarrhea, three cases of nervous-system involvement, nine cases of lupus nephritis, and seven cases of serositis. All 10 patients underwent computed tomography and radiology of the abdomen. Eight patients had intestinal-wall edema, seven suffered intestinal dilation, four had target signs, three suffered congestion of mesenteric blood vessels, eight had increased mesenteric-fat density, and six had false intestinal obstruction. All 10 patients showed a low level of complement C3 (250-750 mg/L). Nine cases showed a low level of complement C4 (10-90 mg/L). The SLE disease activity index 2000 (SLEDAI-2K) at baseline in 10 patients was 20.5 (17.8, 30.0). After receiving RTX (0.5 g: day 1, day 14, or 375 mg/m2: day 1, day 14) induction treatment, the intestinal symptoms of 10 cases were relieved completely. Four patients had adverse reactions, of which three received a high-dose glucocorticoid combined with RTX treatment simultaneously. Adverse reactions manifested mainly as a reduced level of IgG and infection with herpes simplex virus in one case, reduced level of IgG and lung infection in one patient, lung infection in one case, and reduced IgG level in one patient. RTX may an efficacious treatment strategy for patients suffering from refractory SLE with intestinal involvement.
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Affiliation(s)
- Y R Zhao
- Department of Rheumatology and Immunology, the First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Z Zhao
- Department of Rheumatology and Immunology, the First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - J Zhang
- Department of Rheumatology and Immunology, the First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - K P Li
- Department of Rheumatology and Immunology, the First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - J S Yang
- Department of Rheumatology and Immunology, the First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - F Sun
- Department of Rheumatology and Immunology, the First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - S M Liao
- Department of Rheumatology and Immunology, the First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - J L Zhang
- Department of Rheumatology and Immunology, the First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - F Huang
- Department of Rheumatology and Immunology, the First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - J Zhu
- Department of Rheumatology and Immunology, the First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
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11
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Liu FQ, Yang ZR, Wu SS, Zhao HY, Zhan SY, Sun F. [Analysis methods and case analysis of effect modification (1): effect modification in epidemiology and traditional Meta-analysis]. Zhonghua Liu Xing Bing Xue Za Zhi 2024; 45:148-154. [PMID: 38228538 DOI: 10.3760/cma.j.cn112338-20230824-00093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
This paper briefly introduces the definition, classification and significance of effect modification in epidemiological studies, summarizes the difference between effect modifier and confounders, and analyze the influence as well as the role of effect modification in epidemiological studies and Meta-analysis. In this paper, the possible scenarios of effect modification and related analysis strategy in Meta-analysis are indicated by graphics, aiming to arouse researchers' attention to effect modification. This paper also demonstrates how to identify and deal with effect modification in Meta-analysis through a study case of "Efficacy of sodium-glucose cotransporter 2 inhibitors in patients with type 2 diabetes", and shows the analysis process and interpretation of results of subgroup analysis and Meta-regression methods respectively. The advantages and disadvantages of these two methods are summarized to provide reference for the method selection of future research.
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Affiliation(s)
- F Q Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - Z R Yang
- Faculty of Computer Science and Control Engineering, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - S S Wu
- National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - H Y Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - S Y Zhan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
| | - F Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
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12
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Chen P, Liu M, Li GY, Sun F, Li T. Misadjustment of post-trial life-prolonging therapies in the second interim analysis of the MAGNITUDE trial. Ann Oncol 2024; 35:140-141. [PMID: 37871700 DOI: 10.1016/j.annonc.2023.10.128] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 10/10/2023] [Accepted: 10/17/2023] [Indexed: 10/25/2023] Open
Affiliation(s)
- P Chen
- Department of Urology, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - M Liu
- Department of Urology, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - G Y Li
- Department of Urology, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - F Sun
- Department of Urology, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - T Li
- Department of Urology, The Affiliated Hospital of Guizhou Medical University, Guiyang, China.
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Yan ZC, Jiang N, Zhang HX, Zhou Q, Liu XL, Sun F, Yang RM, He HB, Zhao ZG, Zhu ZM. [Efficacy and feasibility of catheter-based adrenal ablation on Cushing's syndrome associated hypertension]. Zhonghua Xin Xue Guan Bing Za Zhi 2023; 51:1152-1159. [PMID: 37963750 DOI: 10.3760/cma.j.cn112148-20230801-00045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
Objective: To explore the value of catheter-based adrenal ablation in treating Cushing's syndrome (CS)-associated hypertension. Methods: A clinical study was conducted in patients with CS, who received catheter-based adrenal ablation between March 2018 and July 2023 in Daping Hospital. Parameters monitored were blood pressure (outpatient and 24-hour ambulatory), body weight, clinical characteristics, serum cortisol and adrenocorticotropic hormone (ACTH) at 8 am, 24-hour urinary free cortisol (24 h UFC), fasting blood glucose and postoperative complications. Procedure effectiveness was defined as blood pressure returning to normal levels (systolic blood pressure<140 mmHg (1 mmHg=0.133 kPa) and diastolic blood pressure<90 mmHg), cortisol and 24 h UFC returning to normal and improvement of clinical characteristics. The parameters were monitored during follow up in the outpatient department at 1, 3, 6, and 12 months after catheter-based adrenal ablation. Results: A total of 12 patients (aged (40.0±13.2) years) were reviewed. There were 5 males, with 5 cases of adenoma and 7 with hyperplasia from imaging studies. Catheter-based adrenal ablation was successful in all without interruption or surgical conversion. No postoperative complication including bleeding, puncture site infection, adrenal artery rupture or adrenal bleeding was observed. The mean follow up was 28 months. Compared to baseline values, body weight declined to (59.48±11.65) kg from (64.81±10.75) kg (P=0.008), fasting blood glucose declined to (4.54±0.83) mmol from (5.53±0.99) mmol (P=0.044), outpatient systolic blood pressure declined to (128±21) mmHg from (140±19) mmHg (P=0.005), diastolic blood pressure declined to (78±10) mmHg from (86±11) mmHg (P=0.041), and the mean ambulatory daytime diastolic blood pressure declined to (79±12) mmHg from (89±8) mmHg (P=0.034). Catheter-based adrenal ablation in 8 patients was defined as effective with their 24 h UFC significantly reduced after the procedure (1 338.41±448.06) mmol/L from (633.66±315.94) mmol/L, P=0.011). The change of 24 h UFC between the effective treatment group and ineffective group was statistically significant (P=0.020). The postoperative systolic blood pressure in the treated adenoma group was significantly lower than those of hyperplasia group (112±13) mmHg vs. (139±20) mmHg, P=0.026). Conclusions: For patients with CS-associated hypertension who are unwilling or unable to undergo surgical treatment, catheter-based adrenal ablation could improve the blood pressure and cortisol level. Catheter-based adrenal ablation could be a safe, effective, and minimally invasive therapy. However, our results still need to be validated in further large-scale studies.
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Affiliation(s)
- Z C Yan
- Department of Hypertension and Endocrinology, Center for Hypertension and Cardiometabolic Diseases, Daping Hospital, Army Medical University, Chongqing Institute of Hypertension, Chongqing 400042, China
| | - N Jiang
- Department of Hypertension and Endocrinology, Center for Hypertension and Cardiometabolic Diseases, Daping Hospital, Army Medical University, Chongqing Institute of Hypertension, Chongqing 400042, China
| | - H X Zhang
- Department of Hypertension and Endocrinology, Center for Hypertension and Cardiometabolic Diseases, Daping Hospital, Army Medical University, Chongqing Institute of Hypertension, Chongqing 400042, China
| | - Q Zhou
- Department of Hypertension and Endocrinology, Center for Hypertension and Cardiometabolic Diseases, Daping Hospital, Army Medical University, Chongqing Institute of Hypertension, Chongqing 400042, China
| | - X L Liu
- Department of Hypertension and Endocrinology, Center for Hypertension and Cardiometabolic Diseases, Daping Hospital, Army Medical University, Chongqing Institute of Hypertension, Chongqing 400042, China
| | - F Sun
- Department of Hypertension and Endocrinology, Center for Hypertension and Cardiometabolic Diseases, Daping Hospital, Army Medical University, Chongqing Institute of Hypertension, Chongqing 400042, China
| | - R M Yang
- Department of Hypertension and Endocrinology, Center for Hypertension and Cardiometabolic Diseases, Daping Hospital, Army Medical University, Chongqing Institute of Hypertension, Chongqing 400042, China
| | - H B He
- Department of Hypertension and Endocrinology, Center for Hypertension and Cardiometabolic Diseases, Daping Hospital, Army Medical University, Chongqing Institute of Hypertension, Chongqing 400042, China
| | - Z G Zhao
- Department of Hypertension and Endocrinology, Center for Hypertension and Cardiometabolic Diseases, Daping Hospital, Army Medical University, Chongqing Institute of Hypertension, Chongqing 400042, China
| | - Z M Zhu
- Department of Hypertension and Endocrinology, Center for Hypertension and Cardiometabolic Diseases, Daping Hospital, Army Medical University, Chongqing Institute of Hypertension, Chongqing 400042, China
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14
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Tse ACY, Lee PH, Sit CHP, Poon ETC, Sun F, Pang CL, Cheng JCH. Comparing the Effectiveness of Physical Exercise Intervention and Melatonin Supplement in Improving Sleep Quality in Children with ASD. J Autism Dev Disord 2023:10.1007/s10803-023-06172-7. [PMID: 37950776 DOI: 10.1007/s10803-023-06172-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2023] [Indexed: 11/13/2023]
Abstract
PURPOSE Previous studies have demonstrated that physical exercise can modulate the endogenous melatonin level in children with autism spectrum disorder (ASD) and improve their sleep quality. However, it remains unclear whether physical exercise or melatonin supplement, or a combination of both, is more effective in improving sleep quality in this population. The purpose of this study is to answer this research question by comparing the effectiveness of three types of interventions (physical exercise vs. melatonin supplement or a combination of both) in improving sleep quality in children with ASD. METHODS Sixty-two (62) children diagnosed with ASD were randomly assigned to one of four groups: cycling (n = 18), melatonin supplement (n = 14), a combination of both (n = 12), and placebo control group (n = 18). Four (4) sleep parameters (sleep efficiency, sleep onset latency, sleep duration, and wake after sleep onset) were assessed. RESULTS The results revealed a significant improvement in sleep efficiency, sleep onset latency, and sleep duration in all of the interventions, but not in the placebo control group. However, no significant group differences were found among the interventions (ps > .05). CONCLUSION Our findings suggest similar effectiveness of physical exercise and melatonin supplementation in improving sleep quality in children with ASD.
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Affiliation(s)
- Andy C Y Tse
- Department of Health and Physical Education, The Education University of Hong Kong, Rm D4-2/F-02, Block D4, 10 Lo Ping Road, Tai Po, N.T, Hong Kong, China.
| | - Paul H Lee
- Clinical Trial Unit, University of Southampton, Southampton, UK
| | - Cindy H P Sit
- Department of Sports Science and Physical Education, Chinese University of Hong Kong, Hong Kong, China
| | - Eric Tsz-Chun Poon
- Department of Sports Science and Physical Education, Chinese University of Hong Kong, Hong Kong, China
| | - F Sun
- Department of Health and Physical Education, The Education University of Hong Kong, Rm D4-2/F-02, Block D4, 10 Lo Ping Road, Tai Po, N.T, Hong Kong, China
| | - Chi-Ling Pang
- School of Education, John Hopkins University, Baltimore, USA
| | - James C H Cheng
- Department of Paediatrics and Adolescent Health, United Christian Hospital, Hong Kong, China
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15
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Lu S, Xie W, Zhang Y, Sun F, Huang J, Wang J, Zhu J, Zhen Z, Zhang Y. Off-target resistance to larotrectinib in two patients with NTRK fusion-positive pediatric solid tumors. Ann Oncol 2023; 34:1065-1067. [PMID: 37666486 DOI: 10.1016/j.annonc.2023.08.015] [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] [Received: 03/24/2023] [Revised: 08/13/2023] [Accepted: 08/21/2023] [Indexed: 09/06/2023] Open
Affiliation(s)
- S Lu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; Department of Pediatric Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - W Xie
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; Department of Pediatric Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Y Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; Department of Pediatric Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - F Sun
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; Department of Pediatric Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - J Huang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; Department of Pediatric Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - J Wang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; Department of Pediatric Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - J Zhu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; Department of Pediatric Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Z Zhen
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; Department of Pediatric Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Y Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; Department of Pediatric Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China.
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16
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Chen L, Wei Y, Sun F, Wang Z, Liu Y, Zhang W, Zhang F, Shi W. An inverse Jiles-Atherton model of nanocrystalline magnetic core for nanoseconds square pulsed magnetization. Rev Sci Instrum 2023; 94:104711. [PMID: 37870442 DOI: 10.1063/5.0165179] [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] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 09/28/2023] [Indexed: 10/24/2023]
Abstract
The magnetic core is a key component of a linear transformer driver (LTD), and the accuracy of the core model affects the calculation of the LTD power flow and the prediction of the output waveform. In this paper, a magnetization model based on the inverse Jiles-Atherton (inverse J-A) model is developed and a particle swarm algorithm is used to identify the parameters and to obtain the variation of the parameters with the excitation characteristic. A nanoseconds square wave LTD magnetic core test platform was built to obtain the magnetization characteristics of nanocrystalline magnetic cores under different excitation characteristic parameters. Under square wave pulses, due to the presence of harmonic components, core loss is more complex. In view of the fitting deviation caused by the traditional J-A model not considering harmonic factors and anisotropy, a dynamic loss correction factor is proposed. Through a comparison of experimental and simulation results, this model can well reflect the magnetization process and has high accuracy in fitting dynamic hysteresis loops and predicting losses, which is important for guiding the design of a square pulse LTD.
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Affiliation(s)
- L Chen
- State Key Laboratory of Electrical Insulation and Power Equipment, Xi'an Jiaotong University, Xi'an, China
| | - Y Wei
- State Key Laboratory of Electrical Insulation and Power Equipment, Xi'an Jiaotong University, Xi'an, China
| | - F Sun
- Northwest Institute of Nuclear Technology, Xi'an, China
| | - Z Wang
- State Key Laboratory of Electrical Insulation and Power Equipment, Xi'an Jiaotong University, Xi'an, China
- Northwest Institute of Nuclear Technology, Xi'an, China
| | - Y Liu
- State Key Laboratory of Electrical Insulation and Power Equipment, Xi'an Jiaotong University, Xi'an, China
| | - W Zhang
- State Key Laboratory of Electrical Insulation and Power Equipment, Xi'an Jiaotong University, Xi'an, China
| | - F Zhang
- State Key Laboratory of Electrical Insulation and Power Equipment, Xi'an Jiaotong University, Xi'an, China
| | - W Shi
- State Key Laboratory of Electrical Insulation and Power Equipment, Xi'an Jiaotong University, Xi'an, China
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17
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Dai L, Huang J, Hu L, Wu J, Wang J, Meng Q, Sun F, Duan Q, Yu J. Efficacy of Nimotuzumab plus Concurrent Chemo-Radiotherapy for Unresectable Esophageal Cancer: A Real-World Study. Int J Radiat Oncol Biol Phys 2023; 117:e354. [PMID: 37785223 DOI: 10.1016/j.ijrobp.2023.06.2432] [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 esophageal cancer ranked 7th in the morbidity of malignant cancer and the 6th contributed to carcinoma deaths. Most patients are diagnosed of advanced stage at first visiting. The 5-year survival rate of unresectable esophageal cancer is about 20% after the standard treatment of concurrent chemo-radiotherapy. Nimotuzumab, a humanized anti-EGFR antibody, has shown good efficacy and low toxicity in epithelial tumors. This two-center, real-world study evaluated the efficacy and safety of nimotuzumab combined with concurrent chemoradiotherapy in unresectable esophageal squamous cell carcinoma (ESCC). MATERIALS/METHODS Totally 503 eligible unresectable ESCC patients from Jan 2014 to Dec 2020 were included. 1:2 nearest neighbor propensity score matching (PSM) was performed to match the Nimo group (nimotuzumab plus concurrent chemo-radiotherapy) and CRT group (concurrent chemo-radiotherapy), and the covariates included age, gender, tumor location, lesion length, TNM stage, clinical stage, and radiotherapy dose. The primary endpoint was overall survival (OS). The secondary endpoints were progression-free survival (PFS), objective response rate (ORR), and disease control rate (DCR). RESULTS A total of 61 patients were in Nimo group which received nimotuzumab (200 mg/w, 4-6 weeks) combined with concurrent chemo-radiotherapy (chemotherapy: S-1/FP/TP/DP for 2-4 cycles; radiotherapy: 2DRT,3D-CRT or IMRT, 50-70 Gy in 25-35 fractions) and 107 patients in CRT group only received concurrent chemo-radiotherapy. The baseline characteristics were well balanced between the two groups. The efficacy of Nimo group was better than that of CRT group. The ORR was 85.2% vs. 71.0%, (P=0.037), the DCR was 98.4% vs. 91.6%, (P>0.05). The median PFS was 28.07 months vs. 19.54 months, and the 1-, 3- and 5-year PFS rates were 78.2% vs. 72.9%, 37.5% vs. 28.3%, and 29.1% vs. 21.3%, respectively (HR: 0.6860, 95% CI: 0.4902-0.9600, P=0.034). The median OS was 34.93 months vs. 24.30 months and the 1-, 3- and 5-year OS rates were 88.5% vs. 81.3%, 46.8% vs. 35.2% and 37.4% vs. 28.0%, respectively (HR: 0.6701, 95% CI: 0.4792-0.9372, P=0.024). The adverse events including radiation esophagitis, radiation pneumonitis, bone marrow suppression, nausea, vomiting, and rash were no significantly different between the two groups (P>0.05). CONCLUSION Nimotuzumab combined with concurrent chemo-radiotherapy improved the ORR, and prolonged PFS and OS in unresectable ESCC patients with a good tolerance.
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Affiliation(s)
- L Dai
- Department of Radiotherapy, Changzhou Second People's Hospital, Nanjing Medical University, Changzhou, China
| | - J Huang
- Department of Radiation Oncology, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - L Hu
- Department of Radiotherapy, Changzhou Second People's Hospital, Nanjing Medical University, Changzhou, China
| | - J Wu
- Department of Radiation Oncology, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - J Wang
- Department of Radiotherapy, Changzhou Second People's Hospital, Nanjing Medical University, Changzhou, China
| | - Q Meng
- Department of Radiotherapy, Changzhou Second People's Hospital, Nanjing Medical University, Changzhou, China
| | - F Sun
- Department of Radiotherapy, Changzhou Second People's Hospital, Nanjing Medical University, Changzhou, China
| | - Q Duan
- Department of Radiotherapy, Changzhou Second People's Hospital, Nanjing Medical University, Changzhou, China
| | - J Yu
- Department of Radiation Oncology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Vitek WS, Sun F, Cardozo E, Hoeger KM, Hansen KR, Santoro N, Zhang H, Legro RS. Moderate and increased physical activity is not detrimental to live birth rates among women with unexplained infertility and obesity. F S Rep 2023; 4:308-312. [PMID: 37719091 PMCID: PMC10504528 DOI: 10.1016/j.xfre.2023.06.004] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 06/20/2023] [Accepted: 06/20/2023] [Indexed: 09/19/2023] Open
Abstract
Objective To determine if moderate physical activity is associated with live birth rates in women with unexplained infertility and obesity. Design Secondary analysis of the Improving Reproductive Fitness through Pretreatment with Lifestyle Modification in Obese Women with Unexplained Infertility trial. Setting US fertility centers, 2015-2019. Patients A total of 379 women participated in Improving Reproductive Fitness through Pretreatment with Lifestyle Modification in Obese Women with Unexplained Infertility trial, a lifestyle modification program with increased physical activity (phase I, 16 weeks) and up to three cycles of clomiphene citrate treatment and intrauterine insemination (phase II). Interventions Participants were instructed to add 500 steps/day weekly until a maximum of 10,000 steps/day was reached and maintained. Participants were stratified as active (top third, N = 125) and less active (lower third, N = 125) on the basis of the average number of steps per day recorded using a FitBit activity tracker. Main Outcome Measures Live birth rate. Results Active participants were more physically active at the time of enrollment than less active participants (average baseline steps per day, 8,708 [7,079-10,000] vs. 4,695 [3,844-5,811]; P ≤ 0.001) and were more likely to reach 10,000 steps/day than less active participants (average steps per day, 10,526 [9,481-11,810] vs. 6,442 [4,644-7,747]; P ≤ 0.001), although both groups increased their average steps per day by a similar amount (1,818 vs.1,747; P = 0.57). There was no difference in live birth rates (24/125 [19.2%] vs. 25/125 [20%]; P = 0.87) between active and less active participants nor were there differences in clinical pregnancy rates (P = 0.45) or miscarriage rates (P = 0.49) between the two groups. Conclusions Active participants were more likely to achieve the physical activity goal, although this was not associated with benefit or harm with respect to live birth. Clinical Trial Registration Number ClinicalTrials.gov (NCT02432209), first posted: May 4, 2015.
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Affiliation(s)
- Wendy S. Vitek
- Department of Obstetrics and Gynceology, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Fangbai Sun
- Yale School of Public Health, New Haven, Connecticut
| | | | - Kathleen M. Hoeger
- Department of Obstetrics and Gynceology, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Karl R. Hansen
- Department of Obstetrics and Gynceology, University of Oklahoma College of Medicine, Oklahoma City, Oklahoma
| | - Nanette Santoro
- Department of Obstetrics and Gynceology, University of Colorado School of Medicine, Denver, Colorado
| | - Heping Zhang
- Yale School of Public Health, New Haven, Connecticut
| | - Richard S. Legro
- Department of Obstetrics and Gynceology, Penn State College of Medicine, Hershey, Pennsylvania
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Zhang CX, Tan H, Ding JM, Xu H, Sun F. [Landmark vessel in membrane anatomy-based colorectal surgery]. Zhonghua Wei Chang Wai Ke Za Zhi 2023; 26:650-655. [PMID: 37583023 DOI: 10.3760/cma.j.cn441530-20230323-00091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
Abstract
The theory of membrane anatomy has been widely used in the field of colorectal surgery. The key point to perform high quality total mesorectal excision (TME) and complete mesocolic excision (CME) is to identify the correct anatomical plane. Intraoperative identification of the various fasciae and fascial spaces is the key to accessing the correct surgical plane and surgical success. The landmark vessels refer to the small vessels that originate from the original peritoneum on the surface of the abdominal viscera during embryonic development and are produced by the fusion of the fascial space. From the point of view of embryonic development, the abdominopelvic fascial structure is a continuous unit, and the landmark vessels on its surface do not change morphologically with the fusion of fasciae and have a specific pattern. Drawing on previous literature and clinical surgical observations, we believe that tiny vessels could be used to identify various fused fasciae and anatomical planes. This is a specific example of membrane anatomical surgery.
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Affiliation(s)
- C X Zhang
- First Clinical School of Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510405, China Department of Proctology, Yubei Hospital of Traditional Chinese Medicine, Chongqing Yubei District, Chongqing 401120, China
| | - H Tan
- First Clinical School of Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510405, China
| | - J M Ding
- First Clinical School of Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510405, China
| | - H Xu
- First Clinical School of Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510405, China
| | - F Sun
- Department of Colorectal Surgery, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, China
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20
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Li P, Liu ZK, Zhao HY, Liu XY, Shen P, Lin HB, Zhan SY, Sun F. [A risk prediction model of cervical cancer developed based on nested case-control design]. Zhonghua Liu Xing Bing Xue Za Zhi 2023; 44:1139-1145. [PMID: 37482719 DOI: 10.3760/cma.j.cn112338-20221223-01079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Objective: To construct a cervical cancer risk prediction model based on nested case-control study design and Yinzhou Health Information Platform in Ningbo, and provide reliable reference for self-risk assessment of cervical cancer in local women. Methods: In local women aged 25-75 years old who had no history of cervical cancer registered in Yinzhou before October 31, 2018, a follow up was conducted for at least three years, the patients who developed cervical cancer during the follow up period were selected as the case group and matched with a control group at a ratio of 1∶10. The prediction indicators before the onset was used in model construction. Variables were selected by Lasso-logistic regression, the variables with non-zero β were selected to fit the logistic regression model and Bootstrap was used for internal validation. The discrimination of the model was evaluated by area under the receiver operating characteristic curve(AUROC), and the calibration was evaluated by calibration curve and Hosmer-Lemeshow test. Results: The prediction indicators included in the final model were age, smoking status, history of cervicitis, history of adenomyosis, HPV testing, and thinprep cytologic test. The AUROC calculated in the internal validation was 0.740 (95%CI:0.739-0.740), and the calibration curve was almost identical with the ideal curve, P=0.991 in Hosmer-Lemeshow test, indicating that the model discrimination and calibration were good. Conclusions: In this study, a simple and practical cervical cancer risk prediction model was developed. The model can be used in general population with strong interpretability, good discrimination and calibration in internal validation, which can provide a reference for women to assess their risk of cervical cancer.
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Affiliation(s)
- P Li
- Key Laboratory of Epidemiology of Major Diseases, Ministry of Education/Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Z K Liu
- Key Laboratory of Epidemiology of Major Diseases, Ministry of Education/Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - H Y Zhao
- Key Laboratory of Epidemiology of Major Diseases, Ministry of Education/Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - X Y Liu
- National Engineering Research Center for Software Engineering, Peking University, Beijing 100871, China
| | - P Shen
- Yinzhou District Center for Disease Control and Prevention of Ningbo, Ningbo 315100, China
| | - H B Lin
- National Engineering Research Center for Software Engineering, Peking University, Beijing 100871, China
| | - S Y Zhan
- Key Laboratory of Epidemiology of Major Diseases, Ministry of Education/Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - F Sun
- Key Laboratory of Epidemiology of Major Diseases, Ministry of Education/Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
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21
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Cheng F, Su YQ, Wang XR, Wu FY, Sun F, Fang Y, Zhang RJ, Zhao SX, Song HD. [Genetic mutation profiles for children with congenital hypothyroidism in Fujian province]. Zhonghua Yi Xue Za Zhi 2023; 103:336-343. [PMID: 36740391 DOI: 10.3760/cma.j.cn112137-20220705-01490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Objective: To explore the mutation characteristics of pathogenic genes in children with congenital hypothyroidism (CH) in Fujian. Methods: The clinical data of 116 unrelated CH children diagnosed in Fujian Provincial Maternal and Child Health Hospital from January 2019 to September 2020 were retrospectively analyzed, including 50 females and 66 males, with an average age of (20±10) days at diagnosis. Targeted exome sequencing technology was used to detect the mutation frequency, type and distribution characteristics of 29 genes related to thyroxine synthesis or thyroid development. Results: Three hundred and fifty-one potential functional mutations were detected in 105 of 116 CH patients, with a detection rate of 90.5% (105/116). DUOX2 (66.4%, 77/116) was the most frequent mutated gene, followed by TG (23.3%, 27/116), DUOXA1 (23.3%, 27/116), and TPO (12.1%, 14/116), which were all involved in thyroid hormone synthesis. Among the 105 children with CH, 70 cases carried double allele mutation. Except for 3 cases of thyroid dysplasia related genes (2 cases of TSHR and 1 case of GLIS3), the rest were also related to thyroid hormone synthesis. The gene with the highest carrier rate was DUOX2 (68.8%, 59/70), followed by TG (8.6%, 6/70), TPO (4.3%, 3/70), DUOXA2 (1.4%, 1/70) and DUOXA1 (1.4%, 1/70). Conclusion: The main mutated genes in CH children in Fujian are the key genes involved in thyroid hormone synthesis, such as DUOX2, TG and TPO.
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Affiliation(s)
- F Cheng
- College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Department of Clinical Laboratory, Fujian Children's Hospital, Fuzhou 350001, China
| | - Y Q Su
- College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Department of Clinical Laboratory, Fujian Maternity and Child Health Hospital, Fuzhou 350001, China
| | - X R Wang
- College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Medical Reaseach Center, Fujian Maternity and Child Health Hospital, Fuzhou 350001, China
| | - F Y Wu
- Department of Molecular Diagnostics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai 200011, China
| | - F Sun
- Department of Molecular Diagnostics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai 200011, China
| | - Y Fang
- Department of Molecular Diagnostics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai 200011, China
| | - R J Zhang
- Department of Molecular Diagnostics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai 200011, China
| | - S X Zhao
- Department of Molecular Diagnostics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai 200011, China
| | - H D Song
- Department of Molecular Diagnostics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai 200011, China
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22
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Santoro N, Flyckt R, Davis A, Finkelstein J, Crawford S, Sun F, Derby C, Morrison A, Sluss P, Zhang H. Anti-Müllerian Hormone Level Decline in Patients Undergoing Hysterectomy With and Without Oophorectomy Compared With Natural Menopause. Obstet Gynecol 2023; 141:331-340. [PMID: 36649324 PMCID: PMC9858351 DOI: 10.1097/aog.0000000000005049] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 08/09/2022] [Accepted: 10/07/2022] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To evaluate the relationship between hysterectomy with and without ovarian conservation and the onset of ovarian failure using anti-müllerian hormone (AMH) levels and imputed final menstrual period (FMP). METHODS A total of 1,428 women with an observed FMP and 232 women who underwent hysterectomy (159 with bilateral salpingo-oophorectomy [BSO], 13 with one ovary conserved, and 60 with both ovaries conserved) and who had serial AMH measurements were included from SWAN (The Study of Women's Health Across the Nation), a multi-ethnic, multi-site, community-based study. Anti-müllerian hormone levels were sampled annually with at least one presurgery or pre-FMP measurement at least one postsurgery or post-FMP measurement. Surgery-related differences in patterns of AMH levels with respect to surgery date or FMP were estimated using piecewise linear mixed modeling; differences in age at first undetectable AMH level were estimated using survival analyses. RESULTS Patients with conservation of one or both ovaries or natural menopause demonstrated similar patterns of decline in AMH levels when anchored to surgery or FMP. Patients with hysterectomy (all types) had a later counterfactual FMP (52.9±0.2 SEM) compared with the observed FMP in those with natural menopause (52.1±0.1 years, P =.002). Those undergoing BSO had an immediate reduction in AMH level to undetectable after surgery. CONCLUSION Hysterectomy does not lead to a more rapid decline in AMH levels postoperatively compared with natural menopause. Patients undergoing BSO have a rapid loss of AMH, consistent with complete removal of the ovaries. These data suggest that hysterectomy as currently performed does not compromise ovarian reserve.
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Affiliation(s)
- Nanette Santoro
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, Colorado 80045
| | - Rebecca Flyckt
- Division of Reproductive Endocrinology, Case Western Reserve University, Cleveland, Ohio 44106
| | - Anne Davis
- current address: IVI RMA Global, San Diego, California 92121
| | - Joel Finkelstein
- Endocrine Unit, Massachusetts General Hospital, Boston, Massachusetts 02114
| | - Sybil Crawford
- Department of Medicine, UMass Chan Medical School, Worcester, Massachusetts 01605
| | - Fangbai Sun
- Department of Statistics and Data Science, Yale University School of Medicine, New Haven Connecticut 06511
| | - Carol Derby
- Departments of Neurology and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York 10461
| | | | - Patrick Sluss
- Department of Clinical Pathology, Massachusetts General Hospital, Boston, Massachusetts 01224
| | - Heping Zhang
- Department of Statistics and Data Science, Yale University School of Medicine, New Haven Connecticut 06511
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23
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Lucas-Cava V, Bote J, Moreno-Lobato B, Picado-Román N, Sun F, Sánchez-Margallo FM. PILOT STUDY FOR THE CREATION OF A STROKE MODEL IN RABBITS USING ENDOVASCULAR TECHNIQUES. Br J Surg 2023. [DOI: 10.1093/bjs/znac443.045] [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: 01/09/2023]
Abstract
Abstract
Introduction
Due to the clinical implications of stroke in patients, the “2IQBIONEURO” project promoted by the Interreg VA Spain-Portugal programme (POCTEP) aims to study the treatment of neurological diseases associated with ageing. The aim was to evaluate the feasibility of the technique of selective cerebral artery (CA) embolisation for the creation of a stroke model in rabbits.
Methods
In 3 rabbits, through a 4Fr introducer in the femoral artery, a 4Fr Cobra catheter and 0.035″ guide was placed in the aortic arch to perform angiography of the brachiocephalic trunk. Under road-mapping, the right common carotid artery was catheterised, and its bifurcation into its external and internal branches was visualised with angiography in an oblique position (90°). With a 1.5Fr microcatheter and 0.008″ microguidewire inserted coaxially, the internal carotid artery was catheterised to perform superselective angiography of the cerebral vasculature. The microcatheter was positioned in the CA for embolisation by injection of PVA (100–200 µm) until stasis was reached as an end point or when reflux occurred. MRI monitoring was performed before and after embolisation (2, 5 and 24 hours). After 24 hours, neurological evaluation and macroscopic postmortem study with tetrazolium were performed.
Results
Successful occlusion of the CA was achieved in all animals whose lesion was observed on MRI.
Conclusions
The development of a stroke model in rabbits by selective embolisation of the CA is feasible, and can be used for the preclinical study of stroke.
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Affiliation(s)
| | - J Bote
- Centro de Cirugía de Mínima Invasión Jesús Usón
| | | | | | - F Sun
- Centro de Cirugía de Mínima Invasión Jesús Usón
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24
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Zhao X, Sun F, Li HX, Li YP. Tuberculosis complicated by spinal cord cryptococcosis: a case report and literature review. Eur Rev Med Pharmacol Sci 2023; 27:411-416. [PMID: 36647890 DOI: 10.26355/eurrev_202301_30896] [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: 01/18/2023]
Abstract
BACKGROUND Spinal cord involvement by Cryptococcus neoformans infection is extremely rare, with most cases occurring in immunosuppressed patients. CASE PRESENTATION A young male patient presented with a 10-day history of progressive lower limb weakness culminating in paralysis, urinary incontinence, and constipation. The patient had no known immunodeficiency induced by the human immunodeficiency virus (HIV), malignancy, or organ transplantation. Laboratory investigations showed elevated C-reactive protein (CRP) levels; however, all other immune indicators were normal. Magnetic resonance imaging (MRI) revealed oval-shaped extradural masses (1.3-3.5 cm) with isointense T1-weighted signal and heterogeneous T2-weighted signal in the spinal canal at the level of the 9th thoracic vertebra. The lesions spread along the intervertebral foramen and involved both sides, showing significant enhancement in contrast-enhanced MRI. The patient was managed surgically, in combination with antifungal and anti-tuberculous therapy and could walk independently 3 months after the treatment. Cryptococcosis was confirmed by histopathology and fungal culture. CONCLUSIONS The results suggest that for lesions that affect spinal stability or cause severe nerve damage, surgical treatment should be considered along with medical management.
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Affiliation(s)
- X Zhao
- Shenyang Tenth People's Hospital, Shenyang Chest Hospital, Shenyang, China.
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25
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Ding JM, Tan H, Xu H, Chen XQ, Wu XS, Sun F. [Cognition and reflection on the "lateral ligament of rectum"]. Zhonghua Wei Chang Wai Ke Za Zhi 2022; 25:1126-1131. [PMID: 36562239 DOI: 10.3760/cma.j.cn441530-20220419-00163] [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: 12/24/2022]
Abstract
As total mesorectal excision (TME) for rectal cancer is widely carried out in China, lateral ligament of rectum, as an important anatomical structure of the lateral rectum with certain anatomical value and clinical significance, has been the focus of attention. In this paper, by comparing and analyzing the characteristics about ligaments of the abdomen and pelvis, reviewing the membrane anatomy and the theory of primitive gut rotation, and combining clinical observations and histological studies, the author came to a conclusion that lateral ligament of rectum does not exist, but is only a relatively dense space on the rectal side accompanied by numerous tiny nerve plexuses and small blood vessels penetrating through it.
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Affiliation(s)
- J M Ding
- Major of Traditional Chinese Medicine Surgery, First Clinical School of Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong, China
| | - H Tan
- Major of Traditional Chinese Medicine Surgery, First Clinical School of Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong, China
| | - H Xu
- Major of Traditional Chinese Medicine Surgery, First Clinical School of Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong, China
| | - X Q Chen
- Major of Traditional Chinese Medicine Surgery, First Clinical School of Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong, China
| | - X S Wu
- Department of Colorectal Surgery, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, China
| | - F Sun
- Department of Colorectal Surgery, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, China
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Ma FF, Wei T, Sun F, Ma Y. [Accuracy of two different registration methods of dynamic navigation system for dental implant placement]. Zhonghua Kou Qiang Yi Xue Za Zhi 2022; 57:1225-1229. [PMID: 36509522 DOI: 10.3760/cma.j.cn112144-20220506-00240] [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: 12/15/2022]
Abstract
Objective: To compare cusp and U-tube registration methods of dynamic navigation system in dental implant placement. Methods: Twenty resin mandible models and 40 implants were utilized, with implants being placed by a single researcher using one of the two registration methods selected at random. Accuracy was measured through the superimposition of the final and planned implant positions. Angular deviation, three-dimensional (3D) entry deviation, and 3D apex deviation were analyzed. Results: The 3D entry deviation, and 3D apex deviation and angular deviation of cusp group and U-tube group were (1.07±0.46) and (0.93±0.54) mm, (1.16±0.55) and (1.03±0.53) mm, 2.06°±0.98°and 1.62°±0.97°. No significant differences (t=0.91, P=0.368; t=0.79, P=0.436; t=1.42, P=0.164) were observed when comparing these two registration methods. Conclusions: Both the cusp and U-tube registration methods are highly accurate when implemented in vitro. The cusp registration technique can also overcome several of the limitations of the U-tube approach, and it is convenient for clinic.
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Affiliation(s)
- F F Ma
- First Clinical Division, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing 100034, China
| | - T Wei
- First Clinical Division, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing 100034, China
| | - F Sun
- First Clinical Division, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing 100034, China
| | - Y Ma
- First Clinical Division, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing 100034, China
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Lakhani N, Hamid O, Braña I, Reguera Puertas P, Lopez Criado M, Swiecicki P, De Miguel Luken M, Gil Martín M, Khong H, Moreno Garcia V, Lostes Bardaji M, Sun F, Sandigursky S, Zambrano M, Cristea M, Fury M. 196TiP A phase I study of REGN6569, a GITR monoclonal antibody (mAb), in combination with cemiplimab in patients with advanced solid tumour malignancies. Immuno-Oncology and Technology 2022. [DOI: 10.1016/j.iotech.2022.100308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Hurley EG, Sun F, Zhang H, Polotsky AJ, Rios JS. Minimal Stimulation Using Gonadotropin-Releasing Hormone Antagonist is Associated with Higher Live Birth Rates: A National Study of 13,050 Cycles. Womens Health Rep (New Rochelle) 2022; 3:957-963. [PMID: 36479370 PMCID: PMC9712044 DOI: 10.1089/whr.2022.0080] [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] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/07/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND The optimal protocol for minimal stimulation in vitro fertilization (IVF) has yet to be established. This study aims to determine if the use of gonadotropin-releasing hormone (GnRH) antagonist during minimal stimulation improves outcomes. MATERIALS AND METHODS All cycles designated as minimal stimulation from 2014 to 2016 from the Society for Assisted Reproductive Technology Clinic Online Reporting System were identified. Cycles in which GnRH antagonist was administered (n = 5984) were compared to those that did not receive it (n = 7066). Wilcoxon's rank-sum test and chi-square test were used to analyze continuous and categorical variables. RESULTS A total of 6750 patients undergoing 13,050 cycles were included. GnRH antagonist use was associated with a significantly higher total gonadotropin dosage (median 975.0 [interquartile range, IQR, 600.0, 1575.0] vs. median 660.0 [IQR 375.0, 975.0], p < 0.001), lower cycle cancelation rate (11.3% vs. 13.6%, p < 0.001; OR 1.24, 95% CI 1.12-1.38, p < 0.001), and higher live birth rate (4.3% vs. 2.1%, p < 0.001; OR 0.47, 95% CI 0.39-0.58, p < 0.001). GnRH antagonist use was associated with a significantly higher live birth rate in women ≥35 years of age (2.7% vs. 0.9%, p < 0.001; OR 0.34, 95% CI 0.25-0.47, p < 0.001) and antimullerian hormone <1 (4.9% vs. 2.6%, p = 0.004; OR 0.52, 95% CI 0.33-0.81, p = 0.004). CONCLUSION The use of GnRH antagonist suppression during minimal stimulation IVF is associated with an improved live birth rate, especially in older women and in women with diminished ovarian reserve. Although GnRH antagonist use may increase costs, it significantly decreases cancelation rate, increases number of embryos cryopreserved, and should be encouraged for minimal stimulation IVF.
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Affiliation(s)
- Emily G. Hurley
- Department of Reproductive Endocrinology and Infertility, University of Cincinnati, West Chester, Ohio, USA
| | - Fangbai Sun
- Department of Biostatistics, Yale University School of Public Health, New Haven, Connecticut, USA
| | - Heping Zhang
- Department of Biostatistics, Yale University School of Public Health, New Haven, Connecticut, USA
| | - Alex J. Polotsky
- Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Julie Sroga Rios
- Department of Reproductive Endocrinology and Infertility, University of Cincinnati, West Chester, Ohio, USA
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Zang BY, Qu JH, Zhou JW, Wang WQ, Liu MZ, Li MR, Zhao HY, Zhang R, Liu YN, Wang LJ, Wan X, Sun F, Wu J. [Progress in research of determinants of healthy life expectancy]. Zhonghua Liu Xing Bing Xue Za Zhi 2022; 43:1811-1820. [PMID: 36444467 DOI: 10.3760/cma.j.cn112338-20220629-00575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Objective: To analyze the influencing factors of healthy life expectancy (HLE). Methods: Seven Chinese and English databases were used for the retrieval of related literatures published by May 7, 2022 to identify influencing factors of HLE, including diseases and injuries and their risk factors. Based on the ecological model of health determinants, this study classifies the risk factors of diseases and injuries into five levels: personal characteristics, individual behavior and lifestyle, social network, living and working conditions, and macroscopic socio-economic, cultural and environmental conditions. Contents of research area, HLE indicators, research population, influencing factors, data sources and results were extracted. The frequencies of reported documents of different HLE indicators and influencing factors of different dimensions were visualized by using evidence map, and the empirical studies of four authoritative English medical journals and Chinese core medical journals were further compared and described. Results: A total of 90 studies were selected, in which 26 were conducted in China (28.9%). Fifty-three studies are about diseases and injuries in the first dimension, and all of them have studied non-communicable diseases, accounting for the highest proportion (58.9%). There were 77 studies about the analysis on the determinants of health at five levels by an ecological model, all the studies reported multi-level results. Among them, 53 studies reported personal characteristics (58.9%), 47 studies reported individual behavior and lifestyle (52.2%), 10 studies reported social networks (11.1%), 35 studies reported living and working environment (38.9%), 8 studies reported social economy, culture status and environment condition (8.9%). The literatures about HLE published by 4 authoritative English medical journals and 21 Chinese core medical journals in recent three years were selected. Non-communicable diseases and personal characteristics were the top two most commonly studied factors of HLE, and 11 (52.3%) and 12 (57.1%) studies reported these two kinds of factors respectively. The most important factor contributing to the global disability-adjusted life years of non-communicable diseases was individual behavior and lifestyle, which was the most changeable factor. Conclusions: In recent three years, studies involving influencing factors of HLE were mainly non-communicable diseases and personal characteristics. In the future, individual behavior, lifestyle and working environment should be strengthened.
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Affiliation(s)
- B Y Zang
- School of Public Health, Peking University, Beijing 100191, China
| | - J H Qu
- School of Public Health, Peking University, Beijing 100191, China Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - J W Zhou
- School of Public Health, Peking University, Beijing 100191, China
| | - W Q Wang
- School of Public Health, Peking University, Beijing 100191, China
| | - M Z Liu
- School of Public Health, Peking University, Beijing 100191, China
| | - M R Li
- School of Public Health, Peking University, Beijing 100191, China
| | - H Y Zhao
- School of Public Health, Peking University, Beijing 100191, China
| | - R Zhang
- National Center for Chronic and Non-communicable Disease Prevention and Control, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Y N Liu
- National Center for Chronic and Non-communicable Disease Prevention and Control, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - L J Wang
- National Center for Chronic and Non-communicable Disease Prevention and Control, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - X Wan
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Beijing 100005, China
| | - F Sun
- School of Public Health, Peking University, Beijing 100191, China
| | - Jing Wu
- National Center for Chronic and Non-communicable Disease Prevention and Control, Chinese Center for Disease Control and Prevention, Beijing 100050, China
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Shi SY, Liu ZX, Zhao HY, Nie XL, Fu Z, Song HB, Yao C, Zhan SY, Sun F. [Real-world evidence and randomized controlled trials: the initiation, implementation, progress interpretation and revelation of RCT DUPLICATE (part 1)]. Zhonghua Liu Xing Bing Xue Za Zhi 2022; 43:1828-1834. [PMID: 36444469 DOI: 10.3760/cma.j.cn112338-20220513-00408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
In recent years, researchers, pharmaceutical companies, and political makers gradually using more real-world data (RWD) to produce real-world evidence (RWE) for policy-making. A research team of Harvard University launched the RCT DUPLICATE project in 2018, aiming to replicate 30 randomized controlled trials using the medical claims database in order to explore methods for quantifying the efficacy-effectiveness gap and explain its potential sources, to enhance the credibility of the RWE. This paper reviews the background of RCT DUPLICATE Initiative, highlights the research purposes, research design and implementation process of the RCT DUPLICATE Initiative, to help domestic scholars better understand the scope and application value of RWE.
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Affiliation(s)
- S Y Shi
- Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China China Institute of Rehabilitation Sciences, Center for Prevention and Control of Disability of China Disabled Persons Federation, Beijing 100068, China
| | - Z X Liu
- Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
| | - H Y Zhao
- Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
| | - X L Nie
- Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China Center for Clinical Epidemiology and Evidence-based Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Z Fu
- Hainan Institute of Real World Data, the Admonistration of Boao Lecheng International Medical Tourism Pilot Zone, Lecheng 571437, China
| | - H B Song
- Center for Drug Reevaluation, National Medical Products Administration, Beijing 100022, China Key Laboratory for Research and Evaluation of Pharmacovigilance, National Medical Products Administration, Beijing 100022, China
| | - C Yao
- Hainan Institute of Real World Data, the Admonistration of Boao Lecheng International Medical Tourism Pilot Zone, Lecheng 571437, China Peking University Clinical Research Institute, Beijing 100191, China
| | - S Y Zhan
- Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China Clinical Epidemiology Research Center, Peking University Third Hospital, Beijing 100191, China
| | - F Sun
- Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China Hainan Institute of Real World Data, the Admonistration of Boao Lecheng International Medical Tourism Pilot Zone, Lecheng 571437, China
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Shi SY, Liu ZX, Zhao HY, Nie XL, Han S, Fu Z, Song HB, Yao C, Zhan SY, Sun F. [Real-world evidence and randomized controlled trials: the initiation, implementation, progress interpretation and revelation of RCT DUPLICATE (part 2)]. Zhonghua Liu Xing Bing Xue Za Zhi 2022; 43:1835-1841. [PMID: 36444470 DOI: 10.3760/cma.j.cn112338-20220513-00409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
With the promotion and application of big medical data, non-interventional real-world evidence (RWE) has been used by regulators to assess the effectiveness of medical products. This paper briefly introduces the latest progress and research results of the RCT DUPLICATE Initiative launched by the research team of Harvard University in 2018 and summarizes relevant research experience based on the characteristics of China's medical service to provide inspiration and reference for domestic scholars to conduct related RWE research in the future.
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Affiliation(s)
- S Y Shi
- Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China China Institute of Rehabilitation Sciences, Center for Prevention and Control of Disability of China Disabled Persons Federation, Beijing 100068, China
| | - Z X Liu
- Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
| | - H Y Zhao
- Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
| | - X L Nie
- Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China Center for Clinical Epidemiology and Evidence-based Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - S Han
- Department of Pharmacy Management and Clinical Pharmacy, Peking University School of Pharmacy, Beijing 100191, China
| | - Z Fu
- Hainan Institute of Real World Data, the Admonistration of Boao Lecheng International Medical Tourism Pilot Zone, Lecheng 571437, China
| | - H B Song
- Center for Drug Reevaluation, National Medical Products Administration, Beijing 100022, China Key Laboratory for Research and Evaluation of Pharmacovigilance, National Medical Products Administration, Beijing 100022, China
| | - C Yao
- Hainan Institute of Real World Data, the Admonistration of Boao Lecheng International Medical Tourism Pilot Zone, Lecheng 571437, China Peking University Clinical Research Institute, Beijing 100191, China
| | - S Y Zhan
- Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China Clinical Epidemiology Research Center, Peking University Third Hospital, Beijing 100191, China
| | - F Sun
- Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China Hainan Institute of Real World Data, the Admonistration of Boao Lecheng International Medical Tourism Pilot Zone, Lecheng 571437, China
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Seungdamrong AM, Pal L, Kuokkanen S, Lieman H, Wild RA, Sun F, Zhang H, Diamond MP, Legro RS, Santoro N. RELATIONSHIP OF ANTITHYROID ANTIBODIES AND TSH TO INFERTILITY PHENOTYPES AND OUTCOMES. Fertil Steril 2022. [DOI: 10.1016/j.fertnstert.2022.08.311] [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: 11/27/2022]
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Cai S, Miao K, Tan XY, Cheng S, Li DT, Zeng XY, Yang Y, Meng RR, Liu ZK, Li Y, Li KL, Sun F, Zhan SY. [Clinical research progress and implications of therapeutic vaccines for cervical cancer and precancerous lesions: a qualitative systematic review]. Zhonghua Zhong Liu Za Zhi 2022; 44:743-760. [PMID: 35880341 DOI: 10.3760/cma.j.cn112152-20210824-00638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To systematically summarize and analyze the clinical research progress of therapeutic vaccines for cervical cancer or precancerous lesions. Methods: English databases (PubMed, Embase, Web of Science, Cochrane library, Proquest, and ClinicalTrails.gov) and Chinese databases (SinoMed, CNKI, WanFang, and VIP Database) were systematically searched to collect literature on therapeutic vaccines for cervical cancer or precancerous lesions from inception to February 18, 2021. After screening, we evaluated the risk of bias of included studies, and combed the basic information of the literature, research designs, information of vaccines, study patients, outcome indicators and so on, qualitatively summarized the clinical research progress. Results: A total of 71 studies were included in this systematic review, including 14 random controlled trials, 15 quasi-random controlled trials, 4 cohort studies, 1 case-control study, 34 case series studies and 3 case reports. The study patients included women aged 15~79 with cervical cancer or precancerous lesions in 18 countries from 1989 to 2021. On the one hand, there were 40 studies on therapeutic vaccines for cervical precancerous lesions (22 867 participants), involving 21 kinds of vaccines in 6 categories. Results showed 3 marketed vaccines (Cervarix, Gardasil, Gardasil 9) as adjuvant immunotherapies were significant effective in preventing the recurrence of precancerous lesions compared with the conization only. In addition, MVA E2 vaccine had been in phase Ⅲ clinical trials as a specific therapeutic vaccine, with relative literature showing it could eliminate most high-grade precancerous lesions. Therapeutic vaccines for precancerous lesions all showed good safety. On the other hand, there were 31 studies on therapeutic vaccines for cervical cancer (781 participants), involving 19 kinds of vaccines in 7categories, with none had been marketed. 25 studies were with no control group, showing the vaccines could effectively eliminate solid tumors, prevent recurrence, and prolong the median survival time. However, the vaccines effectiveness couldn't be statistically calculated due to the lack of a control group. As for the safety of therapeutic vaccines for cervical cancer, 9 studies showed that patients experienced serious adverse events after treatments, where 7 studies reported that serious adverse events occurred in patients couldn't be ruled out as the results of therapeutic vaccines. Conclusions: The literature review shows that the literature evidence for the therapeutic vaccines for cervical precancerous lesions is relatively mature compared with the therapeutic vaccines for cervical cancer. The four kinds of vaccines on the market are all therapeutic vaccines for precancerous lesions, but they are generally used as vaginal infection treatments or adjuvant immunotherapies for cervical precancerous lesions, not used for the specific treatments of cervical precancerous lesions. Other specific therapeutic vaccines are in the early stage of clinical trials, mainly phase Ⅰ/Ⅱ clinical trials with small sample size. The effectiveness and safety data are limited, and further research is still needed.
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Affiliation(s)
- S Cai
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China
| | - K Miao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - X Y Tan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - S Cheng
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - D T Li
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, China
| | - X Y Zeng
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Y Yang
- National Institute of Health Data Science, Peking University, Beijing 100191, China
| | - R R Meng
- National Institute of Health Data Science, Peking University, Beijing 100191, China
| | - Z K Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Y Li
- National Center for Disease Control and Prevention, Beijing 100050, China
| | - K L Li
- National Center for Disease Control and Prevention, Beijing 100050, China
| | - F Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - S Y Zhan
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing 100191, China
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Baker KC, Steiner AZ, Hansen KR, Barnhart KT, Cedars MI, Legro RS, Diamond MP, Krawetz SA, Usadi R, Baker VL, Coward RM, Sun F, Wild R, Masson P, Smith JF, Santoro N, Zhang H. Poor reproducibility of percentage of normally shaped sperm using the World Health Organization Fifth Edition strict grading criteria. F S Rep 2022; 3:110-115. [PMID: 35789726 PMCID: PMC9250115 DOI: 10.1016/j.xfre.2022.03.003] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/22/2022] [Accepted: 03/13/2022] [Indexed: 12/03/2022] Open
Abstract
Objective To determine the reproducibility of the World Health Organization Fifth Edition (WHO5) strict grading methodology by comparing the percentage of morphologically normal sperm (PNS) recorded by the core laboratory with results obtained at the fertility centers participating in a multisite clinical trial. Design Secondary cohort analysis of data from the Males, Antioxidants, and Infertility trial. Setting Fertility centers. Patients Semen values of 171 men participating in a multicenter, double-blind, randomized, placebo-controlled trial evaluating the effect of antioxidants on male fertility. Interventions Not applicable. Main Outcome Measures Strict morphology expressed as PNS as determined at each fertility center and the core central laboratory for the same semen sample. Results No correlation was found in the PNS values for the same semen sample between the core laboratory and fertility center laboratories either as a group or by individual site. Interobserver agreement was similarly low (κ = 0.05 and 0.15) between the core and fertility laboratories as a group for strict morphology, categorized by the WHO5 lower reference limits of 4% and 0, respectively. Moderate agreement was found between the core and 2 individual fertility laboratories for the cutoff value of 0 (κ = 0.42 and 0.57). The remainder of the comparisons demonstrated poor to fair agreement. Conclusions Strict morphology grading using the WHO5 methodology demonstrated overall poor reproducibility among a cohort of experienced fertility laboratories. This lack of correlation and agreement in the PNS values calls into question the reproducibility, and thereby the potential applicability, of sperm strict morphology testing.
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Affiliation(s)
- Karen C Baker
- Division of Urology, Duke University, Durham, North Carolina
| | - Anne Z Steiner
- Department of Obstetrics and Gynecology, Duke University, Durham, North Carolina
| | - Karl R Hansen
- Department of Obstetrics and Gynecology, Health Sciences Center, University of Oklahoma, Oklahoma City, Oklahoma
| | - Kurt T Barnhart
- Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Marcelle I Cedars
- Department of Obstetrics and Gynecology, University of California-San Francisco, San Francisco, California
| | - Richard S Legro
- Department of Obstetrics and Gynecology, Pennsylvania State University, Hershey, Pennsylvania
| | - Michael P Diamond
- Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Stephen A Krawetz
- Department of Obstetrics and Gynecology & Center for Molecular Medicine and Genetics, Wayne State University, Detroit, Michigan
| | - Rebecca Usadi
- Department of Reproductive Endocrinology and Infertility, Atrium Health, Charlotte, North Carolina
| | - Valerie L Baker
- Department of Gynecology and Obstetrics, Johns Hopkins University, Lutherville, Maryland
| | - R Matthew Coward
- Department of Urology, University of North Carolina, Chapel Hill, North Carolina
| | - Fangbai Sun
- Department of Biostatistics, Yale School of Public Health, New Haven Connecticut
| | - Robert Wild
- Department of Obstetrics and Gynecology, Biostatistics and Epidemiology University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Puneet Masson
- Department of Urology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - James F Smith
- Department of Urology, University of California-San Francisco, San Francisco, California
| | - Nanette Santoro
- Department of Obstetrics and Gynecology, University of Colorado, Aurora, Colorado
| | - Heping Zhang
- Collaborative Center for Statistics in Science, Yale School of Public Health, New Haven, Connecticut
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Lu XR, Lai XF, Sun F, Zhan SY, Wang S. [Strengthening the Reporting of Pharmacogenetic Studies (STROPS) guideline]. Zhonghua Liu Xing Bing Xue Za Zhi 2022; 43:747-754. [PMID: 35589583 DOI: 10.3760/cma.j.cn112338-20210402-00276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Pharmacogenetic studies are designed to investigate the associations between genetic variation and treatment response for a particular drug in terms of both efficacy and adverse events and have high sample size requirements. To improve the quality of pharmacogenetic studies and facilitate the Meta-analyses to investigate statistically significant associations, Strengthening the Reporting of Pharmacogenetic Studies (STROPS) guideline was developed in 2020 based on the Strengthening the Reporting of Genetic Association Studies (STREGA) statement. The objective of this article is to present a brief introduction to the STROPS guideline and an interpretation of the key points in some items with examples for the better understanding and application.
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Affiliation(s)
- X R Lu
- Department of Epidemiology and Biostatistics School of Public Health, Peking University, Beijing 100191, China
| | - X F Lai
- Department of Epidemiology and Biostatistics School of Public Health, Peking University, Beijing 100191, China
| | - F Sun
- Department of Epidemiology and Biostatistics School of Public Health, Peking University, Beijing 100191, China
| | - S Y Zhan
- Department of Epidemiology and Biostatistics School of Public Health, Peking University, Beijing 100191, China Center for Clinical Epidemiology, Peking University Third Hospital, Beijing 100191, China
| | - Shengfeng Wang
- Department of Epidemiology and Biostatistics School of Public Health, Peking University, Beijing 100191, China
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Sun F, Fan Y, Zhang C, Wang Y, Wang Y, Peng B. Vitrification by transient vacuum flashing spray cooling of liquid nitrogen. Cryo Letters 2022; 43:167-174. [PMID: 36626141] [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: 01/11/2023]
Abstract
BACKGROUND The transient vacuum flashing spray cooling of liquid nitrogen (LN2) on a microstructured surface can provide ultra-fast cooling rate and may improve cell survival rates. OBJECTIVE To utilize flashing spray cooling of LN2 instead of film boiling to improve further cell vitrification. METHOD This study analyzed the effects of the three key parameters (flow rate of liquid nitrogen, ambient pressure, and spray distance) on the cooling process by experimentation. RESULTS The experimental results showed that the vacuum flashing spray cooling of LN2 can gain higher cooling rates than that achieved by film boiling in conventional vitrification methods. The three parameters all affected the vacuum flash evaporation spray cooling of LN2, and their effect trends were not monotonous but followed a parabolic trend that increased and then decreased. That is, the three parameters all have optimum values to the cooling process. CONCLUSION Vacuum flash evaporation spray cooling can develop the ultra-fast cooling rates needed to enhance cell vitrification. doi.org/10.54680/fr22310110212.
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Affiliation(s)
- F Sun
- Institute of Marine Engineering and Thermal Science, Dalian Maritime University, Dalian, China.
| | - Y Fan
- Institute of Marine Engineering and Thermal Science, Dalian Maritime University, Dalian, China
| | - C Zhang
- Institute of Marine Engineering and Thermal Science, Dalian Maritime University, Dalian, China
| | - Y Wang
- Institute of Marine Engineering and Thermal Science, Dalian Maritime University, Dalian, China
| | - Y Wang
- Institute of Marine Engineering and Thermal Science, Dalian Maritime University, Dalian, China
| | - B Peng
- Institute of Marine Engineering and Thermal Science, Dalian Maritime University, Dalian, China
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Spitzer TL, Trussell JC, Coward RM, Hansen KR, Barnhart KT, Cedars MI, Diamond MP, Krawetz SA, Sun F, Zhang H, Santoro N, Steiner AZ. Biomarkers of Stress and Male Fertility. Reprod Sci 2022; 29:1262-1270. [PMID: 35106743 PMCID: PMC9078052 DOI: 10.1007/s43032-022-00853-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 01/08/2022] [Indexed: 11/25/2022]
Abstract
To study if stress, as measured by salivary alpha-amylase and cortisol, negatively impacts male fertility, as measured by semen parameters, pregnancy, and live birth rates. Prospective, cohort study of men enrolled in the Males, Antioxidants, and Infertility (MOXI) trial. One-hundred twelve infertile men provided first-morning salivary and semen samples at baseline. Salivary samples were analyzed for alpha-amylase and cortisol. Couples attempted to conceive naturally (months 1-3) and with clomiphene citrate/intrauterine insemination (months 4-6). The association between stress-related biomarkers and semen parameters including DNA fragmentation was assessed using linear regression models adjusting for male age. Salivary levels were dichotomized at the 80th percentile. Pregnancy/live birth rates in couples in the upper quintile were compared to remaining subjects using chi-square testing. Salivary levels of alpha-amylase were not associated with semen parameters or DNA fragmentation. Salivary cortisol levels were not correlated with DNA fragmentation or normal morphology. For every 1-unit increase in salivary cortisol, total sperm count increased by 13.9 million (95% CI: 2.5, 25.3) and total motile sperm count increased by 9.9 million (95% CI: 3.2-16.6). Couple pregnancy rates and live birth rates did not differ for males in the highest quintile of alpha-amylase (27% and 28%, p = 0.96; 23% and 21%, p = 0.87) or cortisol (40% and 26%, p = 0.22; 35% and 19%, p = 0.12), compared to males with lower values. Physiologic measures of high stress may not harm but actually improve semen parameters among men with male-factor infertility.
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Affiliation(s)
- Trimble L Spitzer
- Department of Obstetrics and Gynecology, Naval Medical Center Portsmouth, 620 John Paul Jones Cir, Portsmouth, VA, 23708, USA.
| | - J C Trussell
- Department of Urology, State University of New York Upstate Medical University, 750 E Adams St, Syracuse, NY, 13210, USA
| | - R Matthew Coward
- Department of Urology, UNC School of Medicine, 2113 Physicians Office Building CB#7235, Chapel Hill, NC, 27599-7235, USA
- UNC Fertility, 7920 ACC Blvd #300, Raleigh, NC, 27617, USA
| | - Karl R Hansen
- Department of Obstetrics and Gynecology, University of Oklahoma College of Medicine, Oklahoma City, OK, 73104, USA
| | - Kurt T Barnhart
- Division of Reproductive Endocrinology and Infertility, University of Pennsylvania Medical Center, Philadelphia, PA, USA
| | - Marcelle I Cedars
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco School of Medicine, San Francisco, CA, 94143, USA
| | - Michael P Diamond
- Department of Obstetrics and Gynecology, Augusta University, Augusta, GA, 30912, USA
| | - Stephen A Krawetz
- Department of Obstetrics and Gynecology, Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI, 48202, USA
| | - Fangbai Sun
- Department of Biostatistics, Yale University School of Public Health, New Haven, CT, USA
| | - Heping Zhang
- Department of Biostatistics, Yale University School of Public Health, New Haven, CT, USA
| | - Nanette Santoro
- Department of Obstetrics and Gynecology, University of Colorado, Denver, CO, 80204, USA
| | - Anne Z Steiner
- Department of Obstetrics and Gynecology, Duke University, Durham, NC, 27713, USA
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Zhou HZW, Lai XF, Sun F, Dimairo DIMAIRO, Zhan SY, Wang SF. [How to report adaptive design randomized trials-A interpretation of international reporting guideline ACE]. Zhonghua Liu Xing Bing Xue Za Zhi 2022; 43:409-417. [PMID: 35345299 DOI: 10.3760/cma.j.cn112338-20210319-00230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Concerns has been raised in improving the quality of adaptive design randomized trials reports. Based on the CONSORT 2010 (Consolidated Standards of Reporting Trials), The Adaptive designs CONSORT Extension (ACE) has developed items and reporting specifications for adaptive design trials. This paper presents a brief explanation of the extension and new items of ACE and introduces the applications of ACE checklist with examples.
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Affiliation(s)
- H Z W Zhou
- School of Public Health/Department of Epidemiology and Biostatistics, School of Public Health/Key Laboratory for Research and Evaluation of Pharmacovigilance, National Medical Products Administration/Clinical Epidemiology Research Center, Peking University, Beijing 100191, China
| | - X F Lai
- School of Public Health/Department of Epidemiology and Biostatistics, School of Public Health/Key Laboratory for Research and Evaluation of Pharmacovigilance, National Medical Products Administration/Clinical Epidemiology Research Center, Peking University, Beijing 100191, China
| | - F Sun
- School of Public Health/Department of Epidemiology and Biostatistics, School of Public Health/Key Laboratory for Research and Evaluation of Pharmacovigilance, National Medical Products Administration/Clinical Epidemiology Research Center, Peking University, Beijing 100191, China
| | - D I M A I R O Dimairo
- School of Health and Related Research, The University of Sheffield, Sheffield S1 4DP, UK
| | - S Y Zhan
- School of Public Health/Department of Epidemiology and Biostatistics, School of Public Health/Key Laboratory for Research and Evaluation of Pharmacovigilance, National Medical Products Administration/Clinical Epidemiology Research Center, Peking University, Beijing 100191, China
| | - S F Wang
- School of Public Health/Department of Epidemiology and Biostatistics, School of Public Health/Key Laboratory for Research and Evaluation of Pharmacovigilance, National Medical Products Administration/Clinical Epidemiology Research Center, Peking University, Beijing 100191, China
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Yang Y, Zeng XY, Liu ZK, Li ZX, Zhao HY, Liu ZX, Li P, Yao XY, He BJ, Li KL, Li Y, Sun F, Zhan S. [Artificial intelligence-based literature data warehouse for vaccine safety]. Zhonghua Liu Xing Bing Xue Za Zhi 2022; 43:431-435. [PMID: 35345302 DOI: 10.3760/cma.j.cn112338-20210407-00288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To establish a sustainable updated literature data warehouse for global vaccine safety assessment, and provide data support for evidence-based vaccine safety assessment. Methods: Semi-automated construction and updating of a literature data warehouse were achieved through the continuous integration of standard operating steps of evidence-based reviews with artificial intelligence technologies. Following the standard procedure of a systematic literature review, the literatures about vaccine safety assessment published before November 29, 2020 were retrieved from 9 databases including OVID, Scopus, Web of Science, Cochrane Library, and ClinicalTrails.org in English and Wanfang, CNKI, VIP, and SinoMed in Chinese. Literatures were screened for two rounds in a semi-automatic manner (by artificial intelligence literature processing system and manual work) according to the inclusion/exclusion criteria. Furthermore, the literatures were classified according to the types of vaccines and adverse events. The updating strategy was established, and the literature data warehouse was updated regularly. Experts were organized to select specific vaccine safety topics and carry out special demonstration studies. Results: More than 0.41 million articles were retrieved. According to the inclusion/exclusion criteria, 23 304 articles were included after two rounds of screening. At present, we have selected and completed three prior topics as demonstration studies, including the systematic review of "DPT (diphtheria, pertussis and tetanus) vaccine and encephalopathy/encephalitis", and the classified management of literatures about allergic purpura and brachial plexus neuritis. Conclusions: The sustainable updated literature data warehouse of vaccine safety can provide high-quality research data for vaccine safety research, including evidence support for immunization related policy-making and adjustment and vaccine safety-related methodological research or clinical tool development; and further demonstration studies can provide references for building a new methodological framework system for timely and efficient completion of the evidence-based assessment of vaccine safety.
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Affiliation(s)
- Y Yang
- National Institute of Health Data Science, Peking University, Beijing 100191, China
| | - X Y Zeng
- School of Public Health, Peking University, Beijing 100191, China
| | - Z K Liu
- School of Public Health, Peking University, Beijing 100191, China
| | - Z X Li
- Department of Education, Peking University Health Science Center, Beijing 100191, China
| | - H Y Zhao
- School of Public Health, Peking University, Beijing 100191, China
| | - Z X Liu
- School of Public Health, Peking University, Beijing 100191, China
| | - P Li
- School of Public Health, Peking University, Beijing 100191, China
| | - X Y Yao
- School of Public Health, Peking University, Beijing 100191, China
| | - B J He
- School of Public Health, Peking University, Beijing 100191, China
| | - K L Li
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Y Li
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - F Sun
- School of Public Health, Peking University, Beijing 100191, China
| | - Siyan Zhan
- School of Public Health, Peking University, Beijing 100191, China Research Center of Clinical Epidemiololgy, Peking University Third Hospital, Beijing 100191, China
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Zynda H, Copelin J, Weiss W, Sun F, Lee C. Effects of reducing dietary cation-anion difference on lactation performance and nutrient digestibility of lactating cows and ammonia emissions from manure. J Dairy Sci 2022; 105:4016-4031. [DOI: 10.3168/jds.2021-21195] [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] [Received: 08/23/2021] [Accepted: 01/20/2022] [Indexed: 11/19/2022]
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Kuang L, Zhang B, Sun F, Zhang JB. [The characteristics of vaginal microbiota and its correlation with cervical cancer]. Zhonghua Fu Chan Ke Za Zhi 2022; 57:156-160. [PMID: 35184476 DOI: 10.3760/cma.j.cn112141-20211112-00664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
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Faridmoayer JRE, Lapkus M, Pastewski J, Sun F, Elassar H, Studzinski D, Czako P, Nagar S, Chen H. VASCULAR INVASION PREDICTS ADVANCED TUMOR CHARACTERISTICS IN PAPILLARY THYROID CARCINOMA. Am J Surg 2022; 223:492. [DOI: 10.1016/j.amjsurg.2022.02.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Souter I, Sun F, Zhang H, Diamond MP, Legro RS, Wild RA, Hansen KR, Santoro N. A personalized medicine approach to ovulation induction/ovarian stimulation: development of a predictive model and online calculator from level-I evidence. Fertil Steril 2022; 117:408-418. [PMID: 35125179 PMCID: PMC8985501 DOI: 10.1016/j.fertnstert.2021.10.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 05/06/2021] [Revised: 10/28/2021] [Accepted: 10/28/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To estimate the probability of clinical or multiple pregnancy during ovulation induction (OI)/ovarian stimulation (OS). DESIGN Secondary analysis of two multicenter randomized clinical trials (combined). SETTING Multicenter. PATIENTS A total of 750 women with polycystic ovary syndrome and 900 women with unexplained infertility. INTERVENTIONS Ovulation induction/OS with either timed intercourse (polycystic ovary syndrome) or intrauterine insemination. MAIN OUTCOME MEASURES Clinical and multiple pregnancy rates/cycle, cumulative pregnancy rates. Age, body mass index, parity, diagnosis, medication, markers of ovarian reserve, and ovarian response were considered in multivariable regression models for clinical, multiple, and cumulative pregnancy rates. Receiver operating characteristic curves were created for clinical and multiple pregnancy rates. RESULTS Younger patient and partner age, treatment type, lower body mass index, and medication dose were all associated with clinical pregnancy. Variables associated with multiple pregnancy included the abovementioned variables (except age), in addition to diagnosis, parity, higher antral follicle count, antimüllerian hormone levels, and ovarian response. Gonadotropin use was associated with multiple pregnancy, with progressively increasing odds ratios (cycles 1-4). Receiver operating characteristic curves indicated the model's predictive power to be fair for clinical pregnancy (areas under the curve [95% confidence interval {CI}]: 0.78 [0.75-0.81] for cycle 1 and 0.70 [0.64-0.75] for cycle 4) and good-to-excellent for multiple pregnancy (areas under the curve [95% CI]: 0.78 [0.72-0.84] for cycle 1 and 0.86 [0.78-0.93] for cycle 4). Partner age, lower medication dose, parity, antimüllerian hormone levels, and diagnosis were associated with cumulative pregnancy rates. CONCLUSIONS Using the majority of the factors known to predict the outcome of OI/OS cycles, we constructed an easy-to-use formula that may predict individualized chances of clinical and multiple pregnancy for commonly used fertility treatments (https://pregnancyprediction.medicine.yale.edu/CalDirect.html). CLINICAL TRIAL REGISTRATION NUMBERS Assessing Multiple Intrauterine Gestations after Ovulation Stimulation NCT01044862; PPCOSII NCT00719186.
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Affiliation(s)
- Irene Souter
- Department of Obstetrics/Gynecology and Reproductive Biology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
| | - Fangbai Sun
- Collaborative Center for Statistics, Department of Biostatistics, Yale University School of Public Health, New Haven, Connecticut
| | - Heping Zhang
- Collaborative Center for Statistics, Department of Biostatistics, Yale University School of Public Health, New Haven, Connecticut
| | - Michael P Diamond
- Department of Obstetrics and Gynecology, Augusta University, Augusta, Georgia
| | - Richard S Legro
- Department of Obstetrics and Gynecology, Pennsylvania State University, Hershey, Pennsylvania
| | - Robert A Wild
- Department of Obstetrics and Gynecology, University of Oklahoma Health Schiences Center, Oklahoma City, Oklahoma
| | - Karl R Hansen
- Department of Obstetrics and Gynecology, University of Oklahoma Health Schiences Center, Oklahoma City, Oklahoma
| | - Nanette Santoro
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, Colorado
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Wang WW, Zhou QX, Ma L, Feng SH, Yang ZR, Sun F, Zhan S. [Introduction of a tool to assess Risk of Bias in Non-randomized Studies-of Environmental Exposure (ROBINS-E)]. Zhonghua Liu Xing Bing Xue Za Zhi 2022; 43:98-104. [PMID: 35130659 DOI: 10.3760/cma.j.cn112338-20201112-01324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This paper summaries the Risk of Bias in Non-randomized Studies-of Environmental Exposure (ROBINS-E), a tool for evaluating risk of bias about non-randomized studies of exposures (NRSE), and introduces the application of ROBINS-E in a published NRSE. According to the characteristics of NRSE, evaluation fields and signaling questions were designed in ROBINS-E to provide essential information about risk of bias for NRSE included in systematic reviews and GRADE. ROBINS-E is the tool in assessment of risk of bias in observational studies and quasi-randomized studies. Although the tool has been used in practice to some extent, but it still needs further improvement. Attention should be paid to its update and progress.
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Affiliation(s)
- W W Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China
| | - Q X Zhou
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Center of Evidence-based Medicine and Clinical Research, Peking University, Beijing 100191, China
| | - L Ma
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, China
| | - S H Feng
- School of Basic Medical Sciences, Capital Medical University, Beijing 100069, China
| | - Z R Yang
- Primary Care Unit, School of Clinical Medicine, University of Cambridge, Cambridge CB1 8RN, UK
| | - F Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Center of Evidence-based Medicine and Clinical Research, Peking University, Beijing 100191, China
| | - Siyan Zhan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Center of Evidence-based Medicine and Clinical Research, Peking University, Beijing 100191, China Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing 100191, China
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Knudtson JF, Sun F, Coward RM, Hansen KR, Barnhart KT, Smith J, Legro RS, Diamond MP, Krawetz SA, Zhang H, Usadi R, Baker VL, Santoro N, Steiner AZ. The relationship of plasma antioxidant levels to semen parameters: the Males, Antioxidants, and Infertility (MOXI) randomized clinical trial. J Assist Reprod Genet 2021; 38:3005-3013. [PMID: 34455507 PMCID: PMC8609082 DOI: 10.1007/s10815-021-02301-2] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 08/12/2021] [Indexed: 11/24/2022] Open
Abstract
PURPOSE The understanding of the role of plasma antioxidant levels in male fertility in the USA is limited. In a secondary analysis of the Males, Antioxidants, and Infertility (MOXI) randomized clinical trial, we sought to determine whether serum levels of vitamin E (α-tocopherol), zinc, and selenium were correlated with semen parameters and couple fertility outcomes. METHODS This study is a secondary analysis of the MOXI clinical trial. The primary endpoints in this secondary analysis include semen parameters, and DNA fragmentation and clinical outcomes including pregnancy and live birth. Analyses were completed using Wilcoxon's rank-sum test and linear regression models. RESULTS At baseline, the analysis included plasma labs for vitamin E (n = 131), selenium (n = 124), and zinc (n = 128). All baseline plasma values were in the normal ranges. There was no association between selenium, zinc, or vitamin E levels and semen parameters or DNA fragmentation. Baseline antioxidant levels in the male partners did not predict pregnancy or live birth among all couples. Among those randomized to placebo, baseline male antioxidant levels did not differ between those couples with live birth and those that did not conceive or have a live birth. CONCLUSIONS Among men attending fertility centers in the USA, who have sufficient plasma antioxidant levels of zinc, selenium, or vitamin E, no association was observed between vitamins and semen parameters or clinical outcomes in couples with male infertility. Higher levels of antioxidants among men with circulating antioxidants in the normal range do not appear to confer benefit on semen parameters or male fertility.
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Affiliation(s)
- Jennifer F Knudtson
- Department of Obstetrics and Gynecology, University of Texas Health Science Center San Antonio, San Antonio, Texas; and Aspire Fertility, San Antonio, TX, USA.
| | - Fangbai Sun
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | - R Matthew Coward
- Department of Urology, University of North Carolina, Chapel Hill, NC, USA
| | - Karl R Hansen
- Department of Obstetrics and Gynecology, Health Sciences Center, University of Oklahoma, Oklahoma City, OK, USA
| | - Kurt T Barnhart
- Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA, USA
| | - James Smith
- Department of Urology, University of California- San Francisco, San Francisco, CA, USA
| | - Richard S Legro
- Department of Obstetrics and Gynecology, Pennsylvania State University, Hershey, PA, USA
| | - Michael P Diamond
- Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Stephen A Krawetz
- Department of Obstetrics and Gynecology & Molecular Medicine and Genetics, Wayne State University, Detroit, MI, USA
| | - Heping Zhang
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | - Rebecca Usadi
- Department of Reproductive Endocrinology and Infertility, Atrium Health, Charlotte, NC, USA
| | - Valerie L Baker
- Department of Gynecology and Obstetrics, Division of Reproductive Endocrinology and Infertility, Johns Hopkins University, Lutherville, MD, USA
| | - Nanette Santoro
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Anne Z Steiner
- Department of Reproductive Endocrinology and Infertility, Duke University School of Medicine, Durham, NC, USA
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Wang S, Diao QY, Hu FM, Bi YL, Piao MY, Jiang LS, Sun F, Li H, Tu Y. Development of ruminating behavior in Holstein calves between birth and 30 days of age. J Dairy Sci 2021; 105:572-584. [PMID: 34656354 DOI: 10.3168/jds.2021-20405] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 08/16/2021] [Indexed: 11/19/2022]
Abstract
Ruminating behavior accompanies the development of the rumen and the intake of solid feed in calves. However, few studies have reported on the emergence and development of rumination. In this study, we observed ruminating behavior changes of 56 Holstein calves (body weight at birth = 40.1 ± 3.96 kg; mean ± standard deviation) from birth to 30 d of age under the feeding management of suckling calves that were only fed pelleted concentrate feed and milk. All calves were housed in individual pens equipped with infrared cameras. We explored feed intake within 30 d of age, body weight on 61 d of age, and other apparent indicators, including the age of first eating the bedding, duration of non-nutritive oral behavior at 25 and 30 d of age, total starter feed intake within 30 d of age, average daily starter feed intake within 30 d of age, and duration of ruminating behavior at 25 and 30 d of age for all calves, to further explore the effects of the age of first ruminating behavior (AFR). The AFR fitted the normal distribution and ranged from 15 to 20 d of age for 50% of the experimental population. The AFR was positively correlated with the age of first eating the bedding and duration of non-nutritive oral behavior at 30 d of age. Total starter feed intake within 30 d of age, average daily starter feed intake within 30 d of age, duration of ruminating behavior at 25 and 30 d of age, and duration of eating the bedding at 25 and 30 d of age were negatively correlated with AFR. Overall, to the best of our knowledge, this is the first study that has analyzed the correlation between AFR and other indicators. We found that earlier AFR was associated with shorter duration of non-nutritive oral behavior, longer durations of rumination and eating the bedding, and higher feed intake by 30 d of age.
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Affiliation(s)
- S Wang
- Key Laboratory of Feed Biotechnology of the Ministry of Agriculture, Institute of Feed Research of Chinese Academy of Agricultural Sciences, Beijing 100081, China; Beijing Key Laboratory for Dairy Cow Nutrition, Beijing University of Agriculture, Beijing 102206, China
| | - Q Y Diao
- Key Laboratory of Feed Biotechnology of the Ministry of Agriculture, Institute of Feed Research of Chinese Academy of Agricultural Sciences, Beijing 100081, China; Beijing Key Laboratory for Dairy Cow Nutrition, Beijing University of Agriculture, Beijing 102206, China
| | - F M Hu
- Key Laboratory of Feed Biotechnology of the Ministry of Agriculture, Institute of Feed Research of Chinese Academy of Agricultural Sciences, Beijing 100081, China; Beijing Key Laboratory for Dairy Cow Nutrition, Beijing University of Agriculture, Beijing 102206, China
| | - Y L Bi
- Key Laboratory of Feed Biotechnology of the Ministry of Agriculture, Institute of Feed Research of Chinese Academy of Agricultural Sciences, Beijing 100081, China; Beijing Key Laboratory for Dairy Cow Nutrition, Beijing University of Agriculture, Beijing 102206, China
| | - M Y Piao
- Key Laboratory of Feed Biotechnology of the Ministry of Agriculture, Institute of Feed Research of Chinese Academy of Agricultural Sciences, Beijing 100081, China; Beijing Key Laboratory for Dairy Cow Nutrition, Beijing University of Agriculture, Beijing 102206, China
| | - L S Jiang
- Beijing Key Laboratory for Dairy Cow Nutrition, Beijing University of Agriculture, Beijing 102206, China
| | - F Sun
- Institution of Animal Husbandry Research, Heilongjiang Academy of Agricultural Sciences, Harbin 150086, China
| | - H Li
- JiuXing Dairy Farm, Beijing 101500, China
| | - Y Tu
- Key Laboratory of Feed Biotechnology of the Ministry of Agriculture, Institute of Feed Research of Chinese Academy of Agricultural Sciences, Beijing 100081, China; Beijing Key Laboratory for Dairy Cow Nutrition, Beijing University of Agriculture, Beijing 102206, China.
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Pei XY, Su H, Weng JL, Sun F. [Combination of periodontal, endodontic, orthodontic and implant therapy in a severe periodontitis: a case report]. Zhonghua Kou Qiang Yi Xue Za Zhi 2021; 56:1020-1024. [PMID: 34619897 DOI: 10.3760/cma.j.cn112144-20201108-00559] [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: 11/05/2022]
Affiliation(s)
- X Y Pei
- First Clinical Division, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100034, China
| | - H Su
- First Clinical Division, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100034, China
| | - J L Weng
- First Clinical Division, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100034, China
| | - F Sun
- First Clinical Division, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100034, China
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Yan C, Wang M, Sun F, Cao L, Jia B, Xia Y. Macrophage M1/M2 ratio as a predictor of pleural thickening in patients with tuberculous pleurisy. Infect Dis Now 2021; 51:590-595. [PMID: 34581278 DOI: 10.1016/j.idnow.2020.11.013] [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: 11/17/2020] [Revised: 11/23/2020] [Accepted: 11/27/2020] [Indexed: 10/22/2022]
Abstract
We evaluated the association between macrophage polarization and the development of pleural thickening in patients with tuberculous pleurisy. Patients with tuberculous pleurisy admitted to our hospital between October 2018 and March 2019 were prospectively recruited. Pleural fluid samples were obtained before treatment for detection of adenosine deaminase (ADA) and macrophage phenotype (M1: CD14+ CD86+; M2: CD14+ CD163+). Peripheral blood samples were subjected to interferon gamma release assay (IGRA). All subjects were administered standard anti-tuberculosis regimen (2HREZ/4HR); high-resolution CT was performed to determine pleural thickening (thickness>2mm) after completion of treatment. Pleural effusion in patients with thickened pleura had significantly more M1 but fewer M2 macrophages, and higher ADA level, as compared to those with normal pleura (P<0.05). No significant between-group difference was observed with respect to IGRA. In receiver operating characteristic (ROC) curve analysis, the optimal cut-off level of M1/M2 ratio for predicting pleural thickening was 1.149 (area under the curve: 0.842; sensitivity: 88.6%; specificity: 69.2%; positive predictive value: 86.3%; negative predictive value: 81.7%). M1/M2 ratio in the pleural fluid is a promising marker for predicting the development of pleural thickening in patients with tuberculous pleurisy. Macrophage-mediated immune response may play an important role in the pathogenesis of tuberculous pleurisy.
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Affiliation(s)
- C Yan
- Department of Respiratory Diseases, the First Affiliated Hospital of Xinjiang Medical University, 830054 Urumqi, Xinjiang, China
| | - M Wang
- Xinjiang Medical University, 830054 Urumqi, Xinjiang, China
| | - F Sun
- Department of Respiratory Diseases, the First Affiliated Hospital of Xinjiang Medical University, 830054 Urumqi, Xinjiang, China.
| | - L Cao
- Department of Clinical Laboratory, the First Affiliated Hospital of Xinjiang Medical University, 830054 Urumqi, Xinjiang, China
| | - B Jia
- Department of Respiratory Diseases, the First Affiliated Hospital of Xinjiang Medical University, 830054 Urumqi, Xinjiang, China
| | - Y Xia
- Department of Respiratory Diseases, the First Affiliated Hospital of Xinjiang Medical University, 830054 Urumqi, Xinjiang, China
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Rios JS, Coward RM, Hansen KR, Barnhart KT, Cedars MI, Legro RS, Diamond MP, Krawetz SA, Usadi R, Baker VL, Sun F, Wild R, Smith JF, Santoro N, Zhang H, Steiner AZ. Sperm deoxyribonucleic acid fragmentation: predictors, fertility outcomes, and assays among infertile males. F S Rep 2021; 2:282-288. [PMID: 34553152 PMCID: PMC8441563 DOI: 10.1016/j.xfre.2021.06.003] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 06/09/2021] [Accepted: 06/11/2021] [Indexed: 11/25/2022] Open
Abstract
Objective To examine the factors associated with increased deoxyribonucleic acid fragmentation index (DFI), evaluate the pregnancy outcomes of men with increased DFI, and compare three independent DFI assays. Design Secondary analysis. Setting Nine US-based fertility centers. Patient(s) Infertile men (N = 147) with sperm concentration ≤15 × 106/mL, motility ≤40%, or normal morphology ≤4% were enrolled. The female partners were ovulatory, ≤40 years old, and had documented tubal patency. Intervention(s) At a baseline visit, the men provided a semen sample. The couples attempted conception without assistance for 3 months and with ovarian stimulation and intrauterine insemination in the subsequent 3 months. Main Outcome Measure(s) The DFI was analyzed using the sperm chromatin structure assay (SCSA) with increased DFI defined as >30%. The predictors of increased DFI were determined by a multivariable linear regression model. The pregnancy outcomes were compared using the χ2 test. The independent DFI assays (SCSA, deoxynucleotidyl transferase-mediated dUTP nick end labeling, and Comet) were compared with Pearson and Spearman correlations. Result(s) The 19% of men with increased DFI were older (36.0 vs. 33.0 years) and had lower total sperm motility (38.2% ± 20.5% vs. 45.2% ± 15.6%). Increased male age was found to be a significant predictor of DFI (0.75, 95% confidence interval [0.06, 1.45]). Increased DFI was not associated with conception or live birth. There was a modest correlation of the deoxynucleotidyl transferase-mediated dUTP nick end labeling assay with the SCSA (r = 0.34) and Comet assay (r = 0.19). Conclusion(s) Older age was associated with increased DFI among infertile men. The DFI assays were only weakly correlated, indicating a standard definition of DFI is needed to truly interrogate how sperm deoxyribonucleic acid fragmentation impacts male fertility.
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Affiliation(s)
- Julie S Rios
- University of Cincinnati College of Medicine, Cincinnati, Ohio
| | | | - Karl R Hansen
- University of Oklahoma College of Medicine, Oklahoma City, Oklahoma
| | - Kurt T Barnhart
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Marcelle I Cedars
- University of California San Francisco School of Medicine, San Francisco, California
| | - Richard S Legro
- Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | | | | | | | | | - Fangbai Sun
- Yale School of Public Health, New Haven, Connecticut
| | - Robert Wild
- University of North Carolina, Chapel Hill, North Carolina
| | - James F Smith
- University of California San Francisco School of Medicine, San Francisco, California
| | | | - Heping Zhang
- Yale School of Public Health, New Haven, Connecticut
| | - Anne Z Steiner
- Duke University School of Medicine, Durham, North Carolina
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50
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Vitek W, Sun F, Cardozo E, Noel M, Hoeger K, Santoro NF, Zhang H, Legro RS. INCREASED PHYSICAL ACTIVITY IS NOT DETRIMENTAL TO LIVE BIRTH IN WOMEN WITH OBESITY AND INFERTILITY. Fertil Steril 2021. [DOI: 10.1016/j.fertnstert.2021.07.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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