1
|
Luo YC, Lang ML, Cai WJ, Han ZY, Liu FY, Cheng ZG, Yu XL, Dou JP, Li X, Tan SL, Dong XJ, Liang P, Yu J. [Curative effect of percutaneous microwave ablation therapy on hepatocellular carcinoma survival: a 15-year real-world study]. Zhonghua Gan Zang Bing Za Zhi 2024; 32:332-339. [PMID: 38733188 DOI: 10.3760/cma.j.cn501113-20231124-00223] [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] [Subscribe] [Scholar Register] [Indexed: 05/13/2024]
Abstract
Objective: To evaluate the long-term efficacy of percutaneous microwave ablation (MWA) therapy for hepatocellular carcinoma. Methods: 2054 cases with Barcelona Clinic Liver Cancer (BCLC) stage 0~B at the Fifth Medical Center of the Chinese People's Liberation Army General Hospital from January 2006 to September 2020 were retrospectively collected. All patients were followed up for at least 2 years. The primary endpoint of overall survival and secondary endpoints (tumor-related survival, disease-free survival, and postoperative complications) of patients treated with ultrasound-guided percutaneous MWA were analyzed. Kaplan-Meier method was used for stratified survival rate analysis. Fine-and-Gray competing risk model was used to analyze overall survival. Results: A total of 5 503 HCC nodules [mean tumor diameter (2.6±1.6) cm] underwent 3 908 MWAs between January 2006 and September 2020, with a median follow-up time of 45.6 (24.0 -79.2) months.The technical effectiveness rate of 5 375 tumor nodules was 97.5%. The overall survival rates at 5, 10, and 15-years were 61.6%, 38.8%, and 27.0%, respectively. The tumor-specific survival rates were 67.1%, 47.2%, and 37.7%, respectively. The free tumor survival rates were 25.8%, 15.7%, and 9.9%, respectively. The incidence rate of severe complications was 2.8% (108/3 908). Further analysis showed that the technical effectiveness and survival rate over the passing three time periods from January 2006-2010, 2011-2015, and 2016-September 2020 were significantly increased, with P < 0.001, especially for liver cancer 3.1~5.0 cm (P < 0.001). Conclusion: Microwave ablation therapy is a safe and effective method for BCLC stage 0-B, with significantly enhanced technical efficacy and survival rate over time.
Collapse
Affiliation(s)
- Y C Luo
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijng 100166, China
| | - M L Lang
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijng 100166, China
| | - W J Cai
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijng 100166, China
| | - Z Y Han
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijng 100166, China
| | - F Y Liu
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijng 100166, China
| | - Z G Cheng
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijng 100166, China
| | - X L Yu
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijng 100166, China
| | - J P Dou
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijng 100166, China
| | - X Li
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijng 100166, China
| | - S L Tan
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijng 100166, China
| | - X J Dong
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijng 100166, China
| | - P Liang
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijng 100166, China
| | - J Yu
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijng 100166, China
| |
Collapse
|
2
|
Fan FY, Ding WZ, Liu FY, Cheng ZG, Han ZY, Yu XL, Liang P, Yu J. [Spatial distribution pattern of local tumor progression analysis after microwave ablation of hepatocellular carcinoma based on three-dimensional magnetic resonance imaging]. Zhonghua Gan Zang Bing Za Zhi 2024; 32:208-213. [PMID: 38584101 DOI: 10.3760/cma.j.cn501113-20231123-00219] [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] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
Objective: To investigate the spatial distribution pattern of local tumor progression (LTP) for hepatocellular carcinoma (HCC) ≤5 cm after microwave ablation. Methods: A retrospective analysis was performed on 169 HCCs with matched MRI before and after ablation from December 2009 to December 2019. A tumor MRI was reconstructed using three-dimensional visualization technology. LTP was classified as contact or non-contact, early or late stage, according to whether LTP was in contact with the edge of the ablation zone and the occurrence time (24 months). The tumor-surrounded area was divided into eight quadrants by using the eight-quadrant map method. An analysis was conducted on the spatial correlation between the quadrant where the ablative margin (AM) safety boundary was located and the quadrant where different types of LTP occurred. The t-test, or rank-sum test, was used for the measurement data. 2-test for count data was used to compare the difference between the two groups. Results: The AM quadrant had a distribution of 54.4% LTP, 64.2% early LTP stage, and 69.1% contact LTP, suggesting this quadrant was much more concentrated than the other quadrants (P < 0.001). Additionally, the AM quadrant had only 15.2% of non-contact type LTP and 17.1% of late LTP, which was not significantly different from the average distribution probability of 12.5% (100/8%) among the eight quadrants (P = 0.667, 0.743). 46.6% of early contact type LTP was located at the ablation needle tip, 25.2% at the body, and 28.1% at the caudal, while the location distribution probabilities of non-early contact LTP were 34.8%, 31.8%, and 33.3%, respectively. Conclusion: LTP mostly occurs in areas where the ablation safety boundary is the shortest. However, non-contact LTP and late LTP stages exhibit the feature of uniform distribution. Thus, this type of LPT may result from an inadequate non-ablation safety boundary.
Collapse
Affiliation(s)
- F Y Fan
- Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China Chinese PLA Medical School, Beijing 100853, China
| | - W Z Ding
- Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China
| | - F Y Liu
- Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China Chinese PLA Medical School, Beijing 100853, China
| | - Z G Cheng
- Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China Chinese PLA Medical School, Beijing 100853, China
| | - Z Y Han
- Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China
| | - X L Yu
- Chinese PLA Medical School, Beijing 100853, China
| | - P Liang
- Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China Chinese PLA Medical School, Beijing 100853, China
| | - J Yu
- Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China Chinese PLA Medical School, Beijing 100853, China
| |
Collapse
|
3
|
Wang WJ, Xia B, Dong YM, He PP, Cheng ZW, Ma FQ, Wang CH, Liu FY, Hu WM, Wang FP, Zhao YF, Li HZ, Fu JL. [Correlation analysis between Pirani score and talo-navicular angle,calcaneo-cuboid angle and tibio-calcaneall angle of infant clubfoot under ultrasound]. Zhonghua Wai Ke Za Zhi 2024; 62:210-215. [PMID: 38291636 DOI: 10.3760/cma.j.cn112139-20230712-00005] [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: 02/01/2024]
Abstract
Objective: To explore the evaluation effect of ultrasonography and Pirani score on tarsal deformity, treatment effect and pseudo-correction of congenital clubfoot in infants and young children, and the correlation between the two methods. Methods: This is a retrospective case series study. The clinical data of 26 children (40 feet) with congenital clubfoot who were evaluated by ultrasonography in the Third Affiliated Hospital of Zhengzhou University from January 2020 to January 2023 were retrospectively collected. There were 16 males and 10 females. The age at the first ultrasound examination was (M(IQR)) 9.0 (18.0) days (range: 1 to 46 days). All patients were treated with Ponseti method by the same physician. The Pirani scores before and after treatment and at the last examination, and the talonavicular angle, calcaneocuboid angle and tibiocalcaneal angle measured by ultrasound were collected, and the treatment and follow-up were recorded. Paired sample t test, repeated measures analysis of variance or Kruskal-Wallis test were used for data comparison, and Spearman correlation analysis was used for correlation analysis. The receiver operating characteristic curve was used to calculate the efficacy of ultrasound in evaluating different Pirani scores. Results: The number of plaster fixation in 26 children was 4.0 (1.0) times (range: 2 to 8 times). The medial talonavicular angle and posterior tibiocalcaneal angle were significantly improved after treatment and at the last follow-up compared with those before treatment, and the differences were statistically significant (all P<0.01). There was no difference in lateral calcaneocuboid angle before and after treatment and at the last follow-up (F=1.971, P>0.05). Pseudo-correction occurred in 2 cases (2 feet) during the treatment, with an incidence of 5%. Correlation analysis showed that there was a moderate positive correlation between talonavicular angle and Pirani midfoot score (r=0.480, P<0.01). There was no correlation between calcaneocuboid angle and Pirani midfoot score (r=0.114, P=0.105). There was a moderate negative correlation between tibial heel angle and Pirani hindfoot score (r=-0.566, P<0.01). The cut-off point of Pirani midfoot score of 1.5 was 38.78°, the sensitivity was 0.90, the specificity was 0.56, and the area under the curve was 0.75. The cut-off value of angle was 27.51 °, the sensitivity was 0.16, the specificity was 0.92, and the area under the curve was 0.44.The cut-off points of Pirani midfoot score of 3.0 were 45.08°and 9.96°, the sensitivity was 0.94 and 0.91, the specificity was 0.37 and 0.42, and the area under the curve was 0.59 and 0.62, respectively. The cut-off values of Pirani hindfoot score of 2.0 and 3.0 were 167.46° and 160.15°, respectively. The sensitivity was 0.75 and 0.67, the specificity was 0.81 and 0.83, and the area under the curve was 0.78 and 0.71, respectively. Conclusion: Ultrasound can complement with Pirani score, visually and dynamically observe the morphology and position changes of talonavicular joint, calcaneocuboid joint and tibiotalocalcaneal joint, monitor the recovery and pseudo-correction of tarsal bones, and better evaluate the therapeutic effect.
Collapse
Affiliation(s)
- W J Wang
- Orthopaedic Department, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - B Xia
- Orthopaedic Department, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Y M Dong
- Emergency Department, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - P P He
- Department of Ultrasound,the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Z W Cheng
- Medical Record Department, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - F Q Ma
- Orthopaedic Department, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - C H Wang
- Department of Ultrasound,the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - F Y Liu
- Orthopaedic Department, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - W M Hu
- Orthopaedic Department, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - F P Wang
- Orthopaedic Department, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Y F Zhao
- Orthopaedic Department, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - H Z Li
- Department of Ultrasound,the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - J L Fu
- Orthopaedic Department, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| |
Collapse
|
4
|
Zhang W, Li S, Yun HJ, Yu W, Shi W, Gao C, Xu J, Yang Y, Qin L, Ding Y, Jin K, Liu F, Ji X, Ren C. Hypoxic postconditioning drives protective microglial responses and ameliorates white matter injury after ischemic stroke. CNS Neurosci Ther 2024; 30:e14346. [PMID: 37435771 PMCID: PMC10848070 DOI: 10.1111/cns.14346] [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: 02/05/2023] [Revised: 06/05/2023] [Accepted: 06/19/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND Ischemic stroke (IS) is a cerebrovascular disease with high incidence and mortality. White matter repair plays an important role in the long-term recovery of neurological function after cerebral ischemia. Neuroprotective microglial responses can promote white matter repair and protect ischemic brain tissue. AIMS The aim of this study was to investigate whether hypoxic postconditioning (HPC) can promote white matter repair after IS, and the role and mechanism of microglial polarization in white matter repair after HPC treatment. MATERIALS & METHODS Adult male C57/BL6 mice were randomly divided into three groups: Sham group (Sham), MCAO group (MCAO), and hypoxic postconditioning group (HPC). HPC group were subjected to 45 min of transient middle cerebral artery occlusion (MCAO) immediately followed by 40 min of HPC. RESULTS The results showed that HPC reduced the proinflammatory level of immune cells. Furthermore, HPC promoted the transformation of microglia to anti-inflammatory phenotype on the third day after the procedure. HPC promoted the proliferation of oligodendrocyte progenitors and increased the expression of myelination-related proteins on the 14th day. On the 28th day, HPC increased the expression of mature oligodendrocytes, which enhanced myelination. At the same time, the motor neurological function of mice was restored. DISCUSSION During the acute phase of cerebral ischemia, the function of proinflammatory immune cells was enhanced, long-term white matter damage was aggravated, and motor sensory function was decreased. CONCLUSION HPC promotes protective microglial responses and white matter repair after MCAO, which may be related to the proliferation and differentiation of oligodendrocytes.
Collapse
Affiliation(s)
- Wei Zhang
- Beijing Key Laboratory of Hypoxia Translational Medicine, Xuanwu HospitalCapital Medical UniversityBeijingChina
| | - Sijie Li
- Beijing Key Laboratory of Hypoxia Translational Medicine, Xuanwu HospitalCapital Medical UniversityBeijingChina
| | - Ho Jun Yun
- Department of NeurosurgeryWayne State University School of MedicineDetroitMichiganUSA
| | - Wantong Yu
- Beijing Key Laboratory of Hypoxia Translational Medicine, Xuanwu HospitalCapital Medical UniversityBeijingChina
- Department of Neurology, Xuanwu HospitalCapital Medical UniversityBeijingChina
| | - Wenjie Shi
- Beijing Key Laboratory of Hypoxia Translational Medicine, Xuanwu HospitalCapital Medical UniversityBeijingChina
| | - Chen Gao
- Beijing Key Laboratory of Hypoxia Translational Medicine, Xuanwu HospitalCapital Medical UniversityBeijingChina
| | - Jun Xu
- Beijing Key Laboratory of Hypoxia Translational Medicine, Xuanwu HospitalCapital Medical UniversityBeijingChina
- Center of Stroke, Beijing Institute for Brain DisorderCapital Medical UniversityBeijingChina
| | - Yu Yang
- Beijing Key Laboratory of Hypoxia Translational Medicine, Xuanwu HospitalCapital Medical UniversityBeijingChina
- School of Chinese MedicineBeijing University of Chinese MedicineBeijingChina
| | - Linhui Qin
- Beijing Key Laboratory of Hypoxia Translational Medicine, Xuanwu HospitalCapital Medical UniversityBeijingChina
| | - Yuchuan Ding
- Department of NeurosurgeryWayne State University School of MedicineDetroitMichiganUSA
| | - Kunlin Jin
- Department of Pharmacology and NeuroscienceUniversity of North Texas Health Science CenterFort WorthTexasUSA
| | - Fengyong Liu
- Department of Interventional Radiology, Senior Department of OncologyFifth Medical Center of PLA General HospitalBeijingChina
| | - Xunming Ji
- Beijing Key Laboratory of Hypoxia Translational Medicine, Xuanwu HospitalCapital Medical UniversityBeijingChina
- Center of Stroke, Beijing Institute for Brain DisorderCapital Medical UniversityBeijingChina
| | - Changhong Ren
- Beijing Key Laboratory of Hypoxia Translational Medicine, Xuanwu HospitalCapital Medical UniversityBeijingChina
- Center of Stroke, Beijing Institute for Brain DisorderCapital Medical UniversityBeijingChina
| |
Collapse
|
5
|
Ren C, Li N, Xu J, Yang Y, Qin L, Jia L, Wang X, Huang S, Jin K, Liu F, Ji X, Li S. Hypoxic Conditioning: A Potential Perioperative Strategy to Reduce Abdominal Aortic Occlusion-Related Injury in Mouse Proximal and Distal Organs. Aging Dis 2024:AD.2024.0121. [PMID: 38300647 DOI: 10.14336/ad.2024.0121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 01/21/2024] [Indexed: 02/02/2024] Open
Abstract
This study aimed to investigate the impact of abdominal aortic occlusion (AAO)- induced injury on the kidney, lower limb muscles, heart, and brain in mice, and the potential protective effects of hypoxic postconditioning (HyC). The experimental design employed an abdominal aortic occlusion (AAO) model, and involved three groups of mice: sham, AAO, and AAO+HyC. Ten minutes after the AAO model, mice were subjected to hypoxic treatment lowering oxygen concentration to 5% within 45 minutes, and then returned to a normal oxygen environment. Hematoxylin- eosin (HE) stain was used for Histopathological examinations, and Quantibody Mouse Array was used for detecting apoptosis and inflammation-related protein expression. Histopathological examinations showed that HyC mitigated pathological damage to proximal organs (kidneys and lower limb muscles), distal organs (heart and brain), and reduced inflammatory cell infiltration. Expression of apoptosis- and inflammation-related proteins in brain and heart tissues were also evaluated. HyC significantly increased cellular inhibitor of apoptosis 2 (cIAP2) in the brain and Bcl-2 and insulin-like growth factor 2 (IGF-2) in the heart. Additionally, HyC regulated the expression of several inflammation-related factors in both brain and heart tissues. Although further investigation is needed, particularly in human subjects, this study highlights the potential of HyC as a promising therapeutic strategy for reducing AAO-associated organ damage.
Collapse
Affiliation(s)
- Changhong Ren
- Beijing Key Laboratory of Hypoxia Conditioning Translational Medicine, Xuanwu Hospital, Capital Medical University, Center of Stroke, Beijing Institute of Brain Disorder, Capital Medical University, Beijing, China
| | - Ning Li
- Beijing Key Laboratory of Hypoxia Conditioning Translational Medicine, Xuanwu Hospital, Capital Medical University, Center of Stroke, Beijing Institute of Brain Disorder, Capital Medical University, Beijing, China
| | - Jun Xu
- Beijing Key Laboratory of Hypoxia Conditioning Translational Medicine, Xuanwu Hospital, Capital Medical University, Center of Stroke, Beijing Institute of Brain Disorder, Capital Medical University, Beijing, China
| | - Yong Yang
- School of Chinese Medicine, Beijing University of Chines Medicine, Beijing, China
| | - Linhui Qin
- Beijing Key Laboratory of Hypoxia Conditioning Translational Medicine, Xuanwu Hospital, Capital Medical University, Center of Stroke, Beijing Institute of Brain Disorder, Capital Medical University, Beijing, China
| | - Linpei Jia
- Department of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xian Wang
- Beijing Key Laboratory of Hypoxia Conditioning Translational Medicine, Xuanwu Hospital, Capital Medical University, Center of Stroke, Beijing Institute of Brain Disorder, Capital Medical University, Beijing, China
| | - Shuangfeng Huang
- Beijing Key Laboratory of Hypoxia Conditioning Translational Medicine, Xuanwu Hospital, Capital Medical University, Center of Stroke, Beijing Institute of Brain Disorder, Capital Medical University, Beijing, China
| | - Kunlin Jin
- Department of Pharmacology & Neuroscience, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | - Fengyong Liu
- Department of Interventional Radiology, Senior Department of Oncology, Fifth Medical Center of PLA General Hospital, Beijing, China
| | - Xunming Ji
- Beijing Key Laboratory of Hypoxia Conditioning Translational Medicine, Xuanwu Hospital, Capital Medical University, Center of Stroke, Beijing Institute of Brain Disorder, Capital Medical University, Beijing, China
| | - Sijie Li
- Beijing Key Laboratory of Hypoxia Conditioning Translational Medicine, Xuanwu Hospital, Capital Medical University, Center of Stroke, Beijing Institute of Brain Disorder, Capital Medical University, Beijing, China
| |
Collapse
|
6
|
Liu FY, Ji Q, Wang YL, Chen JM, Dong LL, Ding WJ, Lai H, Wang CS. [Surgical treatment for obstructive hypertrophic cardiomyopathy: a five-year single-center experience of 421 cases]. Zhonghua Wai Ke Za Zhi 2023; 61:201-208. [PMID: 36650965 DOI: 10.3760/cma.j.cn112139-20221129-00505] [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: 01/19/2023]
Abstract
Objectives: To examine the short-term and mid-term effects of surgical treatment of obstructive hypertrophic cardiomyopathy (HCM) in one center. Methods: The perioperative data and short-term follow-up outcomes of 421 patients with obstructive HCM who received surgical treatment at Department of Cardiac Surgery, Zhongshan Hospital, Fudan University from January 2017 to December 2021 were analyzed retrospectively. There were 207 males and 214 females, aged (56.5±11.7) years (range: 19 to 78 years). Preoperative New York Heart Association (NYHA) classification included 45 cases of class Ⅱ, 328 cases in class Ⅲ, and 48 cases in class Ⅳ. Fifty-eight patients were diagnosed with latent obstructive HCM and 257 patients had moderate or more mitral regurgitation with 56 patients suffering from intrinsic mitral valve diseases. All procedures were completed by a multidisciplinary team, including professional echocardiologists involving in preoperative planning for proper mitral valve management strategies and intraoperative monitoring. A total of 338 patients underwent septal myectomy alone, and 59 patients underwent mitral valve surgery along with myectomy. A single transaortic approach was used in 355 patients, and a right atrial-atrial septal/atrial sulcus approach was used in 51 other patients. Long-handled minimally invasive surgical instruments were used for the procedures. Student t test, Wilcoxon rank sum test, χ2 test or Fisher exact test were used to compare the data before and after surgery. Results: The aortic cross-clamping time of septal myectomy alone was (34.3±8.5) minutes (range: 21 to 94 minutes). Eighteen patients had intraoperative adverse events and underwent immediate reoperation, including residual obstruction (10 patients), left ventricular free wall rupture (4 patients), ventricular septal perforation (3 patients), and aortic valve perforation (1 patient). Four patients died during hospitalization, and 11 patients developed complete atrioventricular block requiring permanent pacemaker implantation. After discharge, 384 (92.1%) patients received a follow-up visit with a median duration of 9 months. All follow-up patients survived with significantly improved NYHA classifications: 216 patients in class Ⅰ and 168 patients in class Ⅱ (χ2=662.73, P<0.01 as compared to baseline). At 6 months after surgery, follow-up echocardiography showed that the thickness of the ventricular septum ((13.6±2.5) mm vs. (18.2±3.0) mm, t=23.51, P<0.01) and the peak left ventricular outflow tract gradient ((12.0±6.3) mmHg vs. (93.4±19.8) mmHg, 1 mmHg=0.133 kPa, t=78.29, P<0.01) were both significantly lower than baseline values. Conclusion: The construction of the surgical team (including echocardiography experts), proper mitral valve management strategies, identification and management of sub-mitral-valve abnormalities, and application of long-handled minimally invasive surgical instruments are important for the successful implementation of septal myectomy with satisfactory short-and medium-term outcomes.
Collapse
Affiliation(s)
- F Y Liu
- Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai Municipal Institute for Cardiovascular Diseases, Shanghai 200032, China
| | - Q Ji
- Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai Municipal Institute for Cardiovascular Diseases, Shanghai 200032, China
| | - Y L Wang
- Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai Municipal Institute for Cardiovascular Diseases, Shanghai 200032, China
| | - J M Chen
- Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai Municipal Institute for Cardiovascular Diseases, Shanghai 200032, China
| | - L L Dong
- Department of Cardiac Ultrasound Diagnosis, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - W J Ding
- Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai Municipal Institute for Cardiovascular Diseases, Shanghai 200032, China
| | - H Lai
- Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai Municipal Institute for Cardiovascular Diseases, Shanghai 200032, China
| | - C S Wang
- Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai Municipal Institute for Cardiovascular Diseases, Shanghai 200032, China
| |
Collapse
|
7
|
Zhang L, Zhang X, Li Q, Makamure J, Liu Z, Zhao D, Li X, Shi H, Zheng C, Liu F, Liang B. Transarterial chemoembolization failure in patients with hepatocellular carcinoma: Incidence, manifestation and risk factors. Clin Res Hepatol Gastroenterol 2023; 47:102071. [PMID: 36539181 DOI: 10.1016/j.clinre.2022.102071] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 11/16/2022] [Accepted: 12/16/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND To identify the incidence, manifestation and risk factors of transarterial chemoembolization (TACE) failure defined as untreatable progression (UP) in patients with hepatocellular carcinoma (HCC) on short-term observation. METHODS Patients from two hospitals with HCC treated with TACE were considered. According to the definition of UP, TACE failure was considered to be present in at least one of the following situations: situation I, failure to achieve objective response in the targeted tumor after at least two initial TACE treatments; situation II, failure to achieve objective response in local tumor progression or new intrahepatic tumor after another TACE session; situation III, presence of major progression; and situation IV, presence of impaired liver function or performance status that contraindicates TACE treatment. Patients were assessed for TACE failure on follow-up visits after two or three TACE sessions. Risk factors for TACE failure were evaluated with logistic regression analysis. RESULTS A total of 206 patients were included. TACE failure occurred in 42 (42/206, 20.4%) patients, of whom 21, 1, 4, 0 and 16 patients manifested as situation I, II, III, IV alone, and combination of situation I with the others, respectively. Multivariate analysis showed that tumor without complete capsule (P < .001) and non-smooth margin (P = .004) were independent predictors of the presence of TACE failure. CONCLUSIONS TACE failure was uncommon in patients with HCC, which manifested predominantly as failure of treatment response of the initial intrahepatic tumor. Non-smooth tumor margin and tumors without complete capsule were associated with the presence of TACE failure.
Collapse
Affiliation(s)
- Lijie Zhang
- Department of Radiology, Hubei Key Laboratory of Molecular Imaging, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, Wuhan 430022, China; Department of Interventional Radiology, The Fifth Medical Center of Chinese, PLA General Hospital, Beijing 100039, PR China
| | - Xin Zhang
- Department of Radiology, Hubei Key Laboratory of Molecular Imaging, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, Wuhan 430022, China
| | - Qing Li
- Department of Radiology, Hubei Key Laboratory of Molecular Imaging, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, Wuhan 430022, China
| | - Joyman Makamure
- Department of Radiology, Hubei Key Laboratory of Molecular Imaging, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, Wuhan 430022, China
| | - Ziyi Liu
- Department of Radiology, Hubei Key Laboratory of Molecular Imaging, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, Wuhan 430022, China
| | - Dan Zhao
- Department of Radiology, Hubei Key Laboratory of Molecular Imaging, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, Wuhan 430022, China
| | - Xin Li
- Department of Radiology, Hubei Key Laboratory of Molecular Imaging, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, Wuhan 430022, China
| | - Heshui Shi
- Department of Radiology, Hubei Key Laboratory of Molecular Imaging, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, Wuhan 430022, China
| | - Chuansheng Zheng
- Department of Radiology, Hubei Key Laboratory of Molecular Imaging, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, Wuhan 430022, China
| | - Fengyong Liu
- Department of Interventional Radiology, The Fifth Medical Center of Chinese, PLA General Hospital, Beijing 100039, PR China.
| | - Bin Liang
- Department of Radiology, Hubei Key Laboratory of Molecular Imaging, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, Wuhan 430022, China.
| |
Collapse
|
8
|
Liu FY, Feng XM, Ji XL, Su XL. [Cluster classification and clinical prognostic modeling based on m6A RNA methylation regulators in liver cancer]. Zhonghua Gan Zang Bing Za Zhi 2022; 30:962-969. [PMID: 36299190 DOI: 10.3760/cma.j.cn501113-20200727-00428] [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: Cluster classification based on m6A methylation regulators and construct prognostic evaluation model. Methods: Utilizing consensus cluster to classify the liver cancer samples form TCGA based on the expression of 13 m6A methylation regulators, and verify the function and prognostic significance of the clustered subtypes. Marker genes were further screened to construct a risk prediction model for evaluating the prognosis of liver cancer patients. Results: The two clustered subtypes based on m6A methylation regulators showed significant differences in the prognosis value of liver cancer patients (P=0.048), and 38 prognostic markers related to m6A methylation in liver cancer were screened from the subgroup with poor prognosis. Two m6A regulatory genes, YTHDF1 and YTHDF2, are proved with adverse prognosis by univariate cox analysis (P<0.05, Hazard ratio>1). We used Lasso regression method to build risk assessment model and effectively predicted the prognosis status of liver cancer patients within 4 years (4-year AUC=0.685, 3-year AUC=0.669). Moreover, the assessment model was validated in another dataset of Asia liver cancer patients. Conclusion: The study provided ideas for studying m6A methylation in liver cancer, and the risk prediction model can be used to evaluate the short-term prognosis of liver cancer patients.
Collapse
Affiliation(s)
- F Y Liu
- Clinical Medical Research Center, the Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010010, China College of Life Sciences, Inner Mongolia University, Hohhot 010010, China Inner Mongolia Key Laboratory of Medical Cell Biology, Hohhot 010010, China
| | - X M Feng
- Clinical Medical Research Center, the Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010010, China
| | - X L Ji
- Infectious Disease, the Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010010, China
| | - X L Su
- Clinical Medical Research Center, the Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010010, China Inner Mongolia Key Laboratory of Medical Cell Biology, Hohhot 010010, China
| |
Collapse
|
9
|
Sun B, Zhang L, Sun T, Ren Y, Cao Y, Zhang W, Zhu L, Guo Y, Gui Y, Liu F, Chen L, Xiong F, Zheng C. Safety and efficacy of lenvatinib combined with camrelizumab plus transcatheter arterial chemoembolization for unresectable hepatocellular carcinoma: A two-center retrospective study. Front Oncol 2022; 12:982948. [PMID: 36172158 PMCID: PMC9511022 DOI: 10.3389/fonc.2022.982948] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 08/17/2022] [Indexed: 12/03/2022] Open
Abstract
Objectives To compare the safety and efficacy of lenvatinib (LEN) combined with camrelizumab plus transcatheter arterial chemoembolization (TACE-LEN-C) and TACE combined with LEN (TACE-LEN) in patients with unresectable hepatocellular carcinoma (uHCC). Methods Eighty-three patients with uHCC treated with TACE-LEN-C or TACE-LEN from September 2018 to May 2021 were enrolled in this retrospective study. Overall survival (OS), progression-free survival (PFS), local tumor response, and adverse events (AEs) were evaluated. Univariate and multivariate analyses were used to determine the factors affecting survival. Results There were 31 patients in the TACE-LEN-C group and 52 patients in the TACE-LEN group. The median follow-up period was 14.2 months (range 7.2–25.2 months) in the whole study. The combination of triple therapy was found to significantly prolong the PFS (12.5 months vs. 6.6 months, P<0.001) and OS (18.9 months vs. 13.9 months, P<0.001. In terms of tumor response, the combination demonstrated a higher objective response rate (71% vs. 42.3% by the modified Response Evaluation Criteria in Solid Tumors, P=0.023) without a statistically significant difference in the disease control rate (93.5% in TACE-LEN-C, 80.8% in TACE-LEN, P=0.195). In the multivariate analysis, two independent factors affecting PFS were identified: number of tumors and treatment. Three independent factors affected OS: number of tumors, Barcelona Clinic Liver Cancer (BCLC) stage, and treatment. All the AEs were tolerable. Conclusion TACE-LEN-C is a safe and effective treatment for patients with uHCC, and could be a potential treatment option.
Collapse
Affiliation(s)
- Bo Sun
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Key Laboratory of Molecular Imaging of Hubei Province, Wuhan, China
- Department of Interventional Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lijie Zhang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Key Laboratory of Molecular Imaging of Hubei Province, Wuhan, China
- Department of Interventional Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tao Sun
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Key Laboratory of Molecular Imaging of Hubei Province, Wuhan, China
- Department of Interventional Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yanqiao Ren
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Key Laboratory of Molecular Imaging of Hubei Province, Wuhan, China
- Department of Interventional Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yanyan Cao
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Key Laboratory of Molecular Imaging of Hubei Province, Wuhan, China
- Department of Interventional Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Weihua Zhang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Key Laboratory of Molecular Imaging of Hubei Province, Wuhan, China
- Department of Interventional Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Licheng Zhu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Key Laboratory of Molecular Imaging of Hubei Province, Wuhan, China
- Department of Interventional Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yusheng Guo
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Key Laboratory of Molecular Imaging of Hubei Province, Wuhan, China
- Department of Interventional Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuxi Gui
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Key Laboratory of Molecular Imaging of Hubei Province, Wuhan, China
- Department of Interventional Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fengyong Liu
- Department of Interventional Radiology, The Fifth Medical Center of Chinese, People’s Liberation Army (PLA) General Hospital, Beijing, China
| | - Lei Chen
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Key Laboratory of Molecular Imaging of Hubei Province, Wuhan, China
- Department of Interventional Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Chuansheng Zheng, ; Fu Xiong, ; Lei Chen,
| | - Fu Xiong
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Key Laboratory of Molecular Imaging of Hubei Province, Wuhan, China
- Department of Interventional Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Chuansheng Zheng, ; Fu Xiong, ; Lei Chen,
| | - Chuansheng Zheng
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Key Laboratory of Molecular Imaging of Hubei Province, Wuhan, China
- Department of Interventional Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Chuansheng Zheng, ; Fu Xiong, ; Lei Chen,
| |
Collapse
|
10
|
Kouli O, Murray V, Bhatia S, Cambridge WA, Kawka M, Shafi S, Knight SR, Kamarajah SK, McLean KA, Glasbey JC, Khaw RA, Ahmed W, Akhbari M, Baker D, Borakati A, Mills E, Thavayogan R, Yasin I, Raubenheimer K, Ridley W, Sarrami M, Zhang G, Egoroff N, Pockney P, Richards T, Bhangu A, Creagh-Brown B, Edwards M, Harrison EM, Lee M, Nepogodiev D, Pinkney T, Pearse R, Smart N, Vohra R, Sohrabi C, Jamieson A, Nguyen M, Rahman A, English C, Tincknell L, Kakodkar P, Kwek I, Punjabi N, Burns J, Varghese S, Erotocritou M, McGuckin S, Vayalapra S, Dominguez E, Moneim J, Salehi M, Tan HL, Yoong A, Zhu L, Seale B, Nowinka Z, Patel N, Chrisp B, Harris J, Maleyko I, Muneeb F, Gough M, James CE, Skan O, Chowdhury A, Rebuffa N, Khan H, Down B, Fatimah Hussain Q, Adams M, Bailey A, Cullen G, Fu YXJ, McClement B, Taylor A, Aitken S, Bachelet B, Brousse de Gersigny J, Chang C, Khehra B, Lahoud N, Lee Solano M, Louca M, Rozenbroek P, Rozitis E, Agbinya N, Anderson E, Arwi G, Barry I, Batchelor C, Chong T, Choo LY, Clark L, Daniels M, Goh J, Handa A, Hanna J, Huynh L, Jeon A, Kanbour A, Lee A, Lee J, Lee T, Leigh J, Ly D, McGregor F, Moss J, Nejatian M, O'Loughlin E, Ramos I, Sanchez B, Shrivathsa A, Sincari A, Sobhi S, Swart R, Trimboli J, Wignall P, Bourke E, Chong A, Clayton S, Dawson A, Hardy E, Iqbal R, Le L, Mao S, Marinelli I, Metcalfe H, Panicker D, R HH, Ridgway S, Tan HH, Thong S, Van M, Woon S, Woon-Shoo-Tong XS, Yu S, Ali K, Chee J, Chiu C, Chow YW, Duller A, Nagappan P, Ng S, Selvanathan M, Sheridan C, Temple M, Do JE, Dudi-Venkata NN, Humphries E, Li L, Mansour LT, Massy-Westropp C, Fang B, Farbood K, Hong H, Huang Y, Joan M, Koh C, Liu YHA, Mahajan T, Muller E, Park R, Tanudisastro M, Wu JJG, Chopra P, Giang S, Radcliffe S, Thach P, Wallace D, Wilkes A, Chinta SH, Li J, Phan J, Rahman F, Segaran A, Shannon J, Zhang M, Adams N, Bonte A, Choudhry A, Colterjohn N, Croyle JA, Donohue J, Feighery A, Keane A, McNamara D, Munir K, Roche D, Sabnani R, Seligman D, Sharma S, Stickney Z, Suchy H, Tan R, Yordi S, Ahmed I, Aranha M, El Sabawy D, Garwood P, Harnett M, Holohan R, Howard R, Kayyal Y, Krakoski N, Lupo M, McGilberry W, Nepon H, Scoleri Y, Urbina C, Ahmad Fuad MF, Ahmed O, Jaswantlal D, Kelly E, Khan MHT, Naidu D, Neo WX, O'Neill R, Sugrue M, Abbas JD, Abdul-Fattah S, Azlan A, Barry K, Idris NS, Kaka N, Mc Dermott D, Mohammad Nasir MN, Mozo M, Rehal A, Shaikh Yousef M, Wong RH, Curran E, Gardner M, Hogan A, Julka R, Lasser G, Ní Chorráin N, Ting J, Browne R, George S, Janjua Z, Leung Shing V, Megally M, Murphy S, Ravenscroft L, Vedadi A, Vyas V, Bryan A, Sheikh A, Ubhi J, Vannelli K, Vawda A, Adeusi L, Doherty C, Fitzgerald C, Gallagher H, Gill P, Hamza H, Hogan M, Kelly S, Larry J, Lynch P, Mazeni NA, O'Connell R, O'Loghlin R, Singh K, Abbas Syed R, Ali A, Alkandari B, Arnold A, Arora E, Azam R, Breathnach C, Cheema J, Compton M, Curran S, Elliott JA, Jayasamraj O, Mohammed N, Noone A, Pal A, Pandey S, Quinn P, Sheridan R, Siew L, Tan EP, Tio SW, Toh VTR, Walsh M, Yap C, Yassa J, Young T, Agarwal N, Almoosawy SA, Bowen K, Bruce D, Connachan R, Cook A, Daniell A, Elliott M, Fung HKF, Irving A, Laurie S, Lee YJ, Lim ZX, Maddineni S, McClenaghan RE, Muthuganesan V, Ravichandran P, Roberts N, Shaji S, Solt S, Toshney E, Arnold C, Baker O, Belais F, Bojanic C, Byrne M, Chau CYC, De Soysa S, Eldridge M, Fairey M, Fearnhead N, Guéroult A, Ho JSY, Joshi K, Kadiyala N, Khalid S, Khan F, Kumar K, Lewis E, Magee J, Manetta-Jones D, Mann S, McKeown L, Mitrofan C, Mohamed T, Monnickendam A, Ng AYKC, Ortu A, Patel M, Pope T, Pressling S, Purohit K, Saji S, Shah Foridi J, Shah R, Siddiqui SS, Surman K, Utukuri M, Varghese A, Williams CYK, Yang JJ, Billson E, Cheah E, Holmes P, Hussain S, Murdock D, Nicholls A, Patel P, Ramana G, Saleki M, Spence H, Thomas D, Yu C, Abousamra M, Brown C, Conti I, Donnelly A, Durand M, French N, Goan R, O'Kane E, Rubinchik P, Gardiner H, Kempf B, Lai YL, Matthews H, Minford E, Rafferty C, Reid C, Sheridan N, Al Bahri T, Bhoombla N, Rao BM, Titu L, Chatha S, Field C, Gandhi T, Gulati R, Jha R, Jones Sam MT, Karim S, Patel R, Saunders M, Sharma K, Abid S, Heath E, Kurup D, Patel A, Ali M, Cresswell B, Felstead D, Jennings K, Kaluarachchi T, Lazzereschi L, Mayson H, Miah JE, Reinders B, Rosser A, Thomas C, Williams H, Al-Hamid Z, Alsadoun L, Chlubek M, Fernando P, Gaunt E, Gercek Y, Maniar R, Ma R, Matson M, Moore S, Morris A, Nagappan PG, Ratnayake M, Rockall L, Shallcross O, Sinha A, Tan KE, Virdee S, Wenlock R, Donnelly HA, Ghazal R, Hughes I, Liu X, McFadden M, Misbert E, Mogey P, O'Hara A, Peace C, Rainey C, Raja P, Salem M, Salmon J, Tan CH, Alves D, Bahl S, Baker C, Coulthurst J, Koysombat K, Linn T, Rai P, Sharma A, Shergill A, Ahmed M, Ahmed S, Belk LH, Choudhry H, Cummings D, Dixon Y, Dobinson C, Edwards J, Flint J, Franco Da Silva C, Gallie R, Gardener M, Glover T, Greasley M, Hatab A, Howells R, Hussey T, Khan A, Mann A, Morrison H, Ng A, Osmond R, Padmakumar N, Pervaiz F, Prince R, Qureshi A, Sawhney R, Sigurdson B, Stephenson L, Vora K, Zacken A, Cope P, Di Traglia R, Ferarrio I, Hackett N, Healicon R, Horseman L, Lam LI, Meerdink M, Menham D, Murphy R, Nimmo I, Ramaesh A, Rees J, Soame R, Dilaver N, Adebambo D, Brown E, Burt J, Foster K, Kaliyappan L, Knight P, Politis A, Richardson E, Townsend J, Abdi M, Ball M, Easby S, Gill N, Ho E, Iqbal H, Matthews M, Nubi S, Nwokocha JO, Okafor I, Perry G, Sinartio B, Vanukuru N, Walkley D, Welch T, Yates J, Yeshitila N, Bryans K, Campbell B, Gray C, Keys R, Macartney M, Chamberlain G, Khatri A, Kucheria A, Lee STP, Reese G, Roy choudhury J, Tan WYR, Teh JJ, Ting A, Kazi S, Kontovounisios C, Vutipongsatorn K, Amarnath T, Balasubramanian N, Bassett E, Gurung P, Lim J, Panjikkaran A, Sanalla A, Alkoot M, Bacigalupo V, Eardley N, Horton M, Hurry A, Isti C, Maskell P, Nursiah K, Punn G, Salih H, Epanomeritakis E, Foulkes A, Henderson R, Johnston E, McCullough H, McLarnon M, Morrison E, Cheung A, Cho SH, Eriksson F, Hedges J, Low Z, May C, Musto L, Nagi S, Nur S, Salau E, Shabbir S, Thomas MC, Uthayanan L, Vig S, Zaheer M, Zeng G, Ashcroft-Quinn S, Brown R, Hayes J, McConville R, French R, Gilliam A, Sheetal S, Shehzad MU, Bani W, Christie I, Franklyn J, Khan M, Russell J, Smolarek S, Varadarassou R, Ahmed SK, Narayanaswamy S, Sealy J, Shah M, Dodhia V, Manukyan A, O'Hare R, Orbell J, Chung I, Forenc K, Gupta A, Agarwal A, Al Dabbagh A, Bennewith R, Bottomley J, Chu TSM, Chu YYA, Doherty W, Evans B, Hainsworth P, Hosfield T, Li CH, McCullagh I, Mehta A, Thaker A, Thompson B, Virdi A, Walker H, Wilkins E, Dixon C, Hassan MR, Lotca N, Tong KS, Batchelor-Parry H, Chaudhari S, Harris T, Hooper J, Johnson C, Mulvihill C, Nayler J, Olutobi O, Piramanayagam B, Stones K, Sussman M, Weaver C, Alam F, Al Rawi M, Andrew F, Arrayeh A, Azizan N, Hassan A, Iqbal Z, John I, Jones M, Kalake O, Keast M, Nicholas J, Patil A, Powell K, Roberts P, Sabri A, Segue AK, Shah A, Shaik Mohamed SA, Shehadeh A, Shenoy S, Tong A, Upcott M, Vijayasingam D, Anarfi S, Dauncey J, Devindaran A, Havalda P, Komninos G, Mwendwa E, Norman C, Richards J, Urquhart A, Allan J, Cahya E, Hunt H, McWhirter C, Norton R, Roxburgh C, Tan JY, Ali Butt S, Hansdot S, Haq I, Mootien A, Sanchez I, Vainas T, Deliyannis E, Tan M, Vipond M, Chittoor Satish NN, Dattani A, De Carvalho L, Gaston-Grubb M, Karunanithy L, Lowe B, Pace C, Raju K, Roope J, Taylor C, Youssef H, Munro T, Thorn C, Wong KHF, Yunus A, Chawla S, Datta A, Dinesh AA, Field D, Georgi T, Gwozdz A, Hamstead E, Howard N, Isleyen N, Jackson N, Kingdon J, Sagoo KS, Schizas A, Yin L, Aung E, Aung YY, Franklin S, Han SM, Kim WC, Martin Segura A, Rossi M, Ross T, Tirimanna R, Wang B, Zakieh O, Ben-Arzi H, Flach A, Jackson E, Magers S, Olu abara C, Rogers E, Sugden K, Tan H, Veliah S, Walton U, Asif A, Bharwada Y, Bowley D, Broekhuizen A, Cooper L, Evans N, Girdlestone H, Ling C, Mann H, Mehmood N, Mulvenna CL, Rainer N, Trout I, Gujjuri R, Jeyaraman D, Leong E, Singh D, Smith E, Anderton J, Barabas M, Goyal S, Howard D, Joshi A, Mitchell D, Weatherby T, Badminton R, Bird R, Burtle D, Choi NY, Devalia K, Farr E, Fischer F, Fish J, Gunn F, Jacobs D, Johnston P, Kalakoutas A, Lau E, Loo YNAF, Louden H, Makariou N, Mohammadi K, Nayab Y, Ruhomaun S, Ryliskyte R, Saeed M, Shinde P, Sudul M, Theodoropoulou K, Valadao-Spoorenberg J, Vlachou F, Arshad SR, Janmohamed AM, Noor M, Oyerinde O, Saha A, Syed Y, Watkinson W, Ahmadi H, Akintunde A, Alsaady A, Bradley J, Brothwood D, Burton M, Higgs M, Hoyle C, Katsura C, Lathan R, Louani A, Mandalia R, Prihartadi AS, Qaddoura B, Sandland-Taylor L, Thadani S, Thompson A, Walshaw J, Teo S, Ali S, Bawa JH, Fox S, Gargan K, Haider SA, Hanna N, Hatoum A, Khan Z, Krzak AM, Li T, Pitt J, Tan GJS, Ullah Z, Wilson E, Cleaver J, Colman J, Copeland L, Coulson A, Davis P, Faisal H, Hassan F, Hughes JT, Jabr Y, Mahmoud Ali F, Nahaboo Solim ZN, Sangheli A, Shaya S, Thompson R, Cornwall H, De Andres Crespo M, Fay E, Findlay J, Groves E, Jones O, Killen A, Millo J, Thomas S, Ward J, Wilkins M, Zaki F, Zilber E, Bhavra K, Bilolikar A, Charalambous M, Elawad A, Eleni A, Fawdon R, Gibbins A, Livingstone D, Mala D, Oke SE, Padmakumar D, Patsalides MA, Payne D, Ralphs C, Roney A, Sardar N, Stefanova K, Surti F, Timms R, Tosney G, Bannister J, Clement NS, Cullimore V, Kamal F, Lendor J, McKay J, Mcswiggan J, Minhas N, Seneviratne K, Simeen S, Valverde J, Watson N, Bloom I, Dinh TH, Hirniak J, Joseph R, Kansagra M, Lai CKN, Melamed N, Patel J, Randev J, Sedighi T, Shurovi B, Sodhi J, Vadgama N, Abdulla S, Adabavazeh B, Champion A, Chennupati R, Chu K, Devi S, Haji A, Schulz J, Testa F, Davies P, Gurung B, Howell S, Modi P, Pervaiz A, Zahid M, Abdolrazaghi S, Abi Aoun R, Anjum Z, Bawa G, Bhardwaj R, Brown S, Enver M, Gill D, Gopikrishna D, Gurung D, Kanwal A, Kaushal P, Khanna A, Lovell E, McEvoy C, Mirza M, Nabeel S, Naseem S, Pandya K, Perkins R, Pulakal R, Ray M, Reay C, Reilly S, Round A, Seehra J, Shakeel NM, Singh B, Vijay Sukhnani M, Brown L, Desai B, Elzanati H, Godhaniya J, Kavanagh E, Kent J, Kishor A, Liu A, Norwood M, Shaari N, Wood C, Wood M, Brown A, Chellapuri A, Ferriman A, Ghosh I, Kulkarni N, Noton T, Pinto A, Rajesh S, Varghese B, Wenban C, Aly R, Barciela C, Brookes T, Corrin E, Goldsworthy M, Mohamed Azhar MS, Moore J, Nakhuda S, Ng D, Pillay S, Port S, Abdullah M, Akinyemi J, Islam S, Kale A, Lewis A, Manjunath T, McCabe H, Misra S, Stubley T, Tam JP, Waraich N, Chaora T, Ford C, Osinkolu I, Pong G, Rai J, Risquet R, Ainsworth J, Ayandokun P, Barham E, Barrett G, Barry J, Bisson E, Bridges I, Burke D, Cann J, Cloney M, Coates S, Cripps P, Davies C, Francis N, Green S, Handley G, Hathaway D, Hurt L, Jenkins S, Johnston C, Khadka A, McGee U, Morris D, Murray R, Norbury C, Pierrepont Z, Richards C, Ross O, Ruddy A, Salmon C, Shield M, Soanes K, Spencer N, Taverner S, Williams C, Wills-Wood W, Woodward S, Chow J, Fan J, Guest O, Hunter I, Moon WY, Arthur-Quarm S, Edwards P, Hamlyn V, McEneaney L, N D G, Pranoy S, Ting M, Abada S, Alawattegama LH, Ashok A, Carey C, Gogna A, Haglund C, Hurley P, Leelo N, Liu B, Mannan F, Paramjothy K, Ramlogan K, Raymond-Hayling O, Shanmugarajah A, Solichan D, Wilkinson B, Ahmad NA, Allan D, Amin A, Bakina C, Burns F, Cameron F, Campbell A, Cavanagh S, Chan SMZ, Chapman S, Chong V, Edelsten E, Ekpete O, El Sheikh M, Ghose R, Hassane A, Henderson C, Hilton-Christie S, Husain M, Hussain H, Javid Z, Johnson-Ogbuneke J, Johnston A, Khalil M, Leung TCC, Makin I, Muralidharan V, Naeem M, Patil P, Ravichandran S, Saraeva D, Shankey-Smith W, Sharma N, Swan R, Waudby-West R, Wilkinson A, Wright K, Balasubramanian A, Bhatti S, Chalkley M, Chou WK, Dixon M, Evans L, Fisher K, Gandhi P, Ho S, Lau YB, Lowe S, Meechan C, Murali N, Musonda C, Njoku P, Ochieng L, Pervez MU, Seebah K, Shaikh I, Sikder MA, Vanker R, Alom J, Bajaj V, Coleman O, Finch G, Goss J, Jenkins C, Kontothanassis A, Liew MS, Ng K, Outram M, Shakeel MM, Tawn J, Zuhairy S, Chapple K, Cinnamond A, Coleman S, George HA, Goulder L, Hare N, Hawksley J, Kret A, Luesley A, Mecia L, Porter H, Puddy E, Richardson G, Sohail B, Srikaran V, Tadross D, Tobin J, Tokidis E, Young L, Ashdown T, Bratsos S, Koomson A, Kufuor A, Lim MQ, Shah S, Thorne EPC, Warusavitarne J, Xu S, Abigail S, Ahmed A, Ahmed J, Akmal A, Al-Khafaji M, Amini B, Arshad M, Bogie E, Brazkiewicz M, Carroll M, Chandegra A, Cirelli C, Deng A, Fairclough S, Fung YJ, Gornell C, Green RL, Green SV, Gulamhussein AHM, Isaac AG, Jan R, Jegatheeswaran L, Knee M, Kotecha J, Kotecha S, Maxwell-Armstrong C, McIntyre C, Mendis N, Naing TKP, Oberman J, Ong ZX, Ramalingam A, Saeed Adam A, Tan LL, Towell S, Yadav J, Anandampillai R, Chung S, Hounat A, Ibrahim B, Jeyakumar G, Khalil A, Khan UA, Nair G, Owusu-Ayim M, Wilson M, Kanani A, Kilkelly B, Ogunmwonyi I, Ong L, Samra B, Schomerus L, Shea J, Turner O, Yang Y, Amin M, Blott N, Clark A, Feather A, Forrest M, Hague S, Hamilton K, Higginbotham G, Hope E, Karimian S, Loveday K, Malik H, McKenna O, Noor A, Onsiong C, Patel B, Radcliffe N, Shah P, Tye L, Verma K, Walford R, Yusufi U, Zachariah M, Casey A, Doré C, Fludder V, Fortescue L, Kalapu SS, Karel E, Khera G, Smith C, Appleton B, Ashaye A, Boggon E, Evans A, Faris Mahmood H, Hinchcliffe Z, Marei O, Silva I, Spooner C, Thomas G, Timlin M, Wellington J, Yao SL, Abdelrazek M, Abdelrazik Y, Bee F, Joseph A, Mounce A, Parry G, Vignarajah N, Biddles D, Creissen A, Kolhe S, K T, Lea A, Ledda V, O'Loughlin P, Scanlon J, Shetty N, Weller C, Abdalla M, Adeoye A, Bhatti M, Chadda KR, Chu J, Elhakim H, Foster-Davies H, Rabie M, Tailor B, Webb S, Abdelrahim ASA, Choo SY, Jiwa A, Mangam S, Murray S, Shandramohan A, Aghanenu O, Budd W, Hayre J, Khanom S, Liew ZY, McKinney R, Moody N, Muhammad-Kamal H, Odogwu J, Patel D, Roy C, Sattar Z, Shahrokhi N, Sinha I, Thomson E, Wonga L, Bain J, Khan J, Ricardo D, Bevis R, Cherry C, Darkwa S, Drew W, Griffiths E, Konda N, Madani D, Mak JKC, Meda B, Odunukwe U, Preest G, Raheel F, Rajaseharan A, Ramgopal A, Risbrooke C, Selvaratnam K, Sethunath G, Tabassum R, Taylor J, Thakker A, Wijesingha N, Wybrew R, Yasin T, Ahmed Osman A, Alfadhel S, Carberry E, Chen JY, Drake I, Glen P, Jayasuriya N, Kawar L, Myatt R, Sinan LOH, Siu SSY, Tjen V, Adeboyejo O, Bacon H, Barnes R, Birnie C, D'Cunha Kamath A, Hughes E, Middleton S, Owen R, Schofield E, Short C, Smith R, Wang H, Willett M, Zimmerman M, Balfour J, Chadwick T, Coombe-Jones M, Do Le HP, Faulkner G, Hobson K, Shehata Z, Beattie M, Chmielewski G, Chong C, Donnelly B, Drusch B, Ellis J, Farrelly C, Feyi-Waboso J, Hibell I, Hoade L, Ho C, Jones H, Kodiatt B, Lidder P, Ni Cheallaigh L, Norman R, Patabendi I, Penfold H, Playfair M, Pomeroy S, Ralph C, Rottenburg H, Sebastian J, Sheehan M, Stanley V, Welchman J, Ajdarpasic D, Antypas A, Azouaghe O, Basi S, Bettoli G, Bhattarai S, Bommireddy L, Bourne K, Budding J, Cookey-Bresi R, Cummins T, Davies G, Fabelurin C, Gwilliam R, Hanley J, Hird A, Kruczynska A, Langhorne B, Lund J, Lutchman I, McGuinness R, Neary M, Pampapathi S, Pang E, Podbicanin S, Rai N, Redhouse White G, Sujith J, Thomas P, Walker I, Winterton R, Anderson P, Barrington M, Bhadra K, Clark G, Fowler G, Gibson C, Hudson S, Kaminskaite V, Lawday S, Longshaw A, MacKrill E, McLachlan F, Murdeshwar A, Nieuwoudt R, Parker P, Randall R, Rawlins E, Reeves SA, Rye D, Sirkis T, Sykes B, Ventress N, Wosinska N, Akram B, Burton L, Coombs A, Long R, Magowan D, Ong C, Sethi M, Williams G, Chan C, Chan LH, Fernando D, Gaba F, Khor Z, Les JW, Mak R, Moin S, Ng Kee Kwong KC, Paterson-Brown S, Tew YY, Bardon A, Burrell K, Coldwell C, Costa I, Dexter E, Hardy A, Khojani M, Mazurek J, Raymond T, Reddy V, Reynolds J, Soma A, Agiotakis S, Alsusa H, Desai N, Peristerakis I, Adcock A, Ayub H, Bennett T, Bibi F, Brenac S, Chapman T, Clarke G, Clark F, Galvin C, Gwyn-Jones A, Henry-Blake C, Kerner S, Kiandee M, Lovett A, Pilecka A, Ravindran R, Siddique H, Sikand T, Treadwell K, Akmal K, Apata A, Barton O, Broad G, Darling H, Dhuga Y, Emms L, Habib S, Jain R, Jeater J, Kan CYP, Kathiravelupillai A, Khatkar H, Kirmani S, Kulasabanathan K, Lacey H, Lal K, Manafa C, Mansoor M, McDonald S, Mittal A, Mustoe S, Nottrodt L, Oliver P, Papapetrou I, Pattinson F, Raja M, Reyhani H, Shahmiri A, Small O, Soni U, Aguirrezabala Armbruster B, Bunni J, Hakim MA, Hawkins-Hooker L, Howell KA, Hullait R, Jaskowska A, Ottewell L, Thomas-Jones I, Vasudev A, Clements B, Fenton J, Gill M, Haider S, Lim AJM, Maguire H, McMullan J, Nicoletti J, Samuel S, Unais MA, White N, Yao PC, Yow L, Boyle C, Brady R, Cheekoty P, Cheong J, Chew SJHL, Chow R, Ganewatta Kankanamge D, Mamer L, Mohammed B, Ng Chieng Hin J, Renji Chungath R, Royston A, Sharrad E, Sinclair R, Tingle S, Treherne K, Wyatt F, Maniarasu VS, Moug S, Appanna T, Bucknall T, Hussain F, Owen A, Parry M, Parry R, Sagua N, Spofforth K, Yuen ECT, Bosley N, Hardie W, Moore T, Regas C, Abdel-Khaleq S, Ali N, Bashiti H, Buxton-Hopley R, Constantinides M, D'Afflitto M, Deshpande A, Duque Golding J, Frisira E, Germani Batacchi M, Gomaa A, Hay D, Hutchison R, Iakovou A, Iakovou D, Ismail E, Jefferson S, Jones L, Khouli Y, Knowles C, Mason J, McCaughan R, Moffatt J, Morawala A, Nadir H, Neyroud F, Nikookam Y, Parmar A, Pinto L, Ramamoorthy R, Richards E, Thomson S, Trainer C, Valetopoulou A, Vassiliou A, Wantman A, Wilde S, Dickinson M, Rockall T, Senn D, Wcislo K, Zalmay P, Adelekan K, Allen K, Bajaj M, Gatumbu P, Hang S, Hashmi Y, Kaur T, Kawesha A, Kisiel A, Woodmass M, Adelowo T, Ahari D, Alhwaishel K, Atherton R, Clayton B, Cockroft A, Curtis Lopez C, Hilton M, Ismail N, Kouadria M, Lee L, MacConnachie A, Monks F, Mungroo S, Nikoletopoulou C, Pearce L, Sara X, Shahid A, Suresh G, Wilcha R, Atiyah A, Davies E, Dermanis A, Gibbons H, Hyde A, Lawson A, Lee C, Leung-Tack M, Li Saw Hee J, Mostafa O, Nair D, Pattani N, Plumbley-Jones J, Pufal K, Ramesh P, Sanghera J, Saram S, Scadding S, See S, Stringer H, Torrance A, Vardon H, Wyn-Griffiths F, Brew A, Kaur G, Soni D, Tickle A, Akbar Z, Appleyard T, Figg K, Jayawardena P, Johnson A, Kamran Siddiqui Z, Lacy-Colson J, Oatham R, Rowlands B, Sludden E, Turnbull C, Allin D, Ansar Z, Azeez Z, Dale VH, Garg J, Horner A, Jones S, Knight S, McGregor C, McKenna J, McLelland T, Packham-Smith A, Rowsell K, Spector-Hill I, Adeniken E, Baker J, Bartlett M, Chikomba L, Connell B, Deekonda P, Dhar M, Elmansouri A, Gamage K, Goodhew R, Hanna P, Knight J, Luca A, Maasoumi N, Mahamoud F, Manji S, Marwaha PK, Mason F, Oluboyede A, Pigott L, Razaq AM, Richardson M, Saddaoui I, Wijeyendram P, Yau S, Atkins W, Liang K, Miles N, Praveen B, Ashai S, Braganza J, Common J, Cundy A, Davies R, Guthrie J, Handa I, Iqbal M, Ismail R, Jones C, Jones I, Lee KS, Levene A, Okocha M, Olivier J, Smith A, Subramaniam E, Tandle S, Wang A, Watson A, Wilson C, Chan XHF, Khoo E, Montgomery C, Norris M, Pugalenthi PP, Common T, Cook E, Mistry H, Shinmar HS, Agarwal G, Bandyopadhyay S, Brazier B, Carroll L, Goede A, Harbourne A, Lakhani A, Lami M, Larwood J, Martin J, Merchant J, Pattenden S, Pradhan A, Raafat N, Rothwell E, Shammoon Y, Sudarshan R, Vickers E, Wingfield L, Ashworth I, Azizi S, Bhate R, Chowdhury T, Christou A, Davies L, Dwaraknath M, Farah Y, Garner J, Gureviciute E, Hart E, Jain A, Javid S, Kankam HK, Kaur Toor P, Kaz R, Kermali M, Khan I, Mattson A, McManus A, Murphy M, Nair K, Ngemoh D, Norton E, Olabiran A, Parry L, Payne T, Pillai K, Price S, Punjabi K, Raghunathan A, Ramwell A, Raza M, Ritehnia J, Simpson G, Smith W, Sodeinde S, Studd L, Subramaniam M, Thomas J, Towey S, Tsang E, Tuteja D, Vasani J, Vio M, Badran A, Adams J, Anthony Wilkinson J, Asvandi S, Austin T, Bald A, Bix E, Carrick M, Chander B, Chowdhury S, Cooper Drake B, Crosbie S, D Portela S, Francis D, Gallagher C, Gillespie R, Gravett H, Gupta P, Ilyas C, James G, Johny J, Jones A, Kinder F, MacLeod C, Macrow C, Maqsood-Shah A, Mather J, McCann L, McMahon R, Mitham E, Mohamed M, Munton E, Nightingale K, O'Neill K, Onyemuchara I, Senior R, Shanahan A, Sherlock J, Spyridoulias A, Stavrou C, Stokes D, Tamang R, Taylor E, Trafford C, Uden C, Waddington C, Yassin D, Zaman M, Bangi S, Cheng T, Chew D, Hussain N, Imani-Masouleh S, Mahasivam G, McKnight G, Ng HL, Ota HC, Pasha T, Ravindran W, Shah K, Vishnu K S, Zaman S, Carr W, Cope S, Eagles EJ, Howarth-Maddison M, Li CY, Reed J, Ridge A, Stubbs T, Teasdaled D, Umar R, Worthington J, Dhebri A, Kalenderov R, Alattas A, Arain Z, Bhudia R, Chia D, Daniel S, Dar T, Garland H, Girish M, Hampson A, Kyriacou H, Lehovsky K, Mullins W, Omorphos N, Vasdev N, Venkatesh A, Waldock W, Bhandari A, Brown G, Choa G, Eichenauer CE, Ezennia K, Kidwai Z, Lloyd-Thomas A, Macaskill Stewart A, Massardi C, Sinclair E, Skajaa N, Smith M, Tan I, Afsheen N, Anuar A, Azam Z, Bhatia P, Davies-kelly N, Dickinson S, Elkawafi M, Ganapathy M, Gupta S, Khoury EG, Licudi D, Mehta V, Neequaye S, Nita G, Tay VL, Zhao S, Botsa E, Cuthbert H, Elliott J, Furlepa M, Lehmann J, Mangtani A, Narayan A, Nazarian S, Parmar C, Shah D, Shaw C, Zhao Z, Beck C, Caldwell S, Clements JM, French B, Kenny R, Kirk S, Lindsay J, McClung A, McLaughlin N, Watson S, Whiteside E, Alyacoubi S, Arumugam V, Beg R, Dawas K, Garg S, Lloyd ER, Mahfouz Y, Manobharath N, Moonesinghe R, Morka N, Patel K, Prashar J, Yip S, Adeeko ES, Ajekigbe F, Bhat A, Evans C, Farrugia A, Gurung C, Long T, Malik B, Manirajan S, Newport D, Rayer J, Ridha A, Ross E, Saran T, Sinker A, Waruingi D, Allen R, Al Sadek Y, Alves do Canto Brum H, Asharaf H, Ashman M, Balakumar V, Barrington J, Baskaran R, Berry A, Bhachoo H, Bilal A, Boaden L, Chia WL, Covell G, Crook D, Dadnam F, Davis L, De Berker H, Doyle C, Fox C, Gruffydd-Davies M, Hafouda Y, Hill A, Hubbard E, Hunter A, Inpadhas V, Jamshaid M, Jandu G, Jeyanthi M, Jones T, Kantor C, Kwak SY, Malik N, Matt R, McNulty P, Miles C, Mohomed A, Myat P, Niharika J, Nixon A, O'Reilly D, Parmar K, Pengelly S, Price L, Ramsden M, Turnor R, Wales E, Waring H, Wu M, Yang T, Ye TTS, Zander A, Zeicu C, Bellam S, Francombe J, Kawamoto N, Rahman MR, Sathyanarayana A, Tang HT, Cheung J, Hollingshead J, Page V, Sugarman J, Wong E, Chiong J, Fung E, Kan SY, Kiang J, Kok J, Krahelski O, Liew MY, Lyell B, Sharif Z, Speake D, Alim L, Amakye NY, Chandrasekaran J, Chandratreya N, Drake J, Owoso T, Thu YM, Abou El Ela Bourquin B, Alberts J, Chapman D, Rehnnuma N, Ainsworth K, Carpenter H, Emmanuel T, Fisher T, Gabrel M, Guan Z, Hollows S, Hotouras A, Ip Fung Chun N, Jaffer S, Kallikas G, Kennedy N, Lewinsohn B, Liu FY, Mohammed S, Rutherfurd A, Situ T, Stammer A, Taylor F, Thin N, Urgesi E, Zhang N, Ahmad MA, Bishop A, Bowes A, Dixit A, Glasson R, Hatta S, Hatt K, Larcombe S, Preece J, Riordan E, Fegredo D, Haq MZ, Li C, McCann G, Stewart D, Baraza W, Bhullar D, Burt G, Coyle J, Deans J, Devine A, Hird R, Ikotun O, Manchip G, Ross C, Storey L, Tan WWL, Tse C, Warner C, Whitehead M, Wu F, Court EL, Crisp E, Huttman M, Mayes F, Robertson H, Rosen H, Sandberg C, Smith H, Al Bakry M, Ashwell W, Bajaj S, Bandyopadhyay D, Browlee O, Burway S, Chand CP, Elsayeh K, Elsharkawi A, Evans E, Ferrin S, Fort-Schaale A, Iacob M, I K, Impelliziere Licastro G, Mankoo AS, Olaniyan T, Otun J, Pereira R, Reddy R, Saeed D, Simmonds O, Singhal G, Tron K, Wickstone C, Williams R, Bradshaw E, De Kock Jewell V, Houlden C, Knight C, Metezai H, Mirza-Davies A, Seymour Z, Spink D, Wischhusen S. Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study. Lancet Digit Health 2022; 4:e520-e531. [PMID: 35750401 DOI: 10.1016/s2589-7500(22)00069-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 01/07/2022] [Accepted: 04/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications. METHODS We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC). FINDINGS In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]). INTERPRETATION In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required. FUNDING British Journal of Surgery Society.
Collapse
|
11
|
Huang Q, Liu FY, Mao NY, Sun JY, Dong M, Xie H, Liu F, Zhang H, Yu XL, Dong JP, Xu W, Huang F. [Application of oral fluid in SARS-CoV-2 nucleic acid and antibody detection]. Zhonghua Yu Fang Yi Xue Za Zhi 2022; 56:355-359. [PMID: 35381659 DOI: 10.3760/cma.j.cn112150-20211211-01146] [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 study aimed to explore the application value of new biological specimen oral fluid in SARS-CoV-2 nucleic acid and antibody detection. Oral fluid and paired respiratory and blood specimens from 7 confirmed cases of two COVID-19 cluster epidemic were collected in Beijing from October to November 2021. SARS-CoV-2 virus and IgG antibody were detected by real time PCR kits and serum antibody detection reagents, and SARS-CoV-2 IgG antibody in oral fluids was detected by a new established method of magnetic particle chemiluminescence. The results showed that the nucleic acid amplification test of SARS-CoV-2 on nasopharyngeal swabs, throat swabs and oral fluid specimens from 3 confirmed cases of COVID-19 was positive, among which the Ct value for ORF1a/b and N gene of oral fluid samples in 2 cases was close to that of throat swab, and the Ct value of oral fluid sample for 1 case was higher than that of throat swab. The complete genome sequence of one oral fluid specimen was obtained, which belonged to the VOC/Delta variant strain. The SARS-CoV-2 IgG antibodies of the paired oral fluid and serum were all positive, and the S/CO values of oral fluid were all lower than those of serum. The series of oral fluid results showed that SARS-CoV-2 IgG antibody level increased from 11 to 32 days after the onset of the disease.
Collapse
Affiliation(s)
- Q Huang
- School of Public Health, Capital Medical University, Beijing 100069, China Institute of Preventive Immunization, Beijing Center for Disease Control and Prevention/Beijing Academy for Preventive Medicine/Beijing Institute of Tuberculosis Control Research and Prevention, Beijing 100013, China
| | - F Y Liu
- Department of Microbiology Laboratory, Beijing Haidian Center for Disease Control and Prevention, Beijing 100094, China
| | - N Y Mao
- Institute for Viral Disease Control and Prevention, Chinese Centers for Disease control and Prevention, Beijing 102206, China NHC Key Laboratory for Medical Virology and Viral Diseases, Beijing 102206, China
| | - J Y Sun
- Department Infectious Disease, Beijing Haidian Hospital, Beijing 100080, China
| | - M Dong
- Institute of Preventive Immunization, Beijing Center for Disease Control and Prevention/Beijing Academy for Preventive Medicine/Beijing Institute of Tuberculosis Control Research and Prevention, Beijing 100013, China
| | - H Xie
- Institute of Preventive Immunization, Beijing Center for Disease Control and Prevention/Beijing Academy for Preventive Medicine/Beijing Institute of Tuberculosis Control Research and Prevention, Beijing 100013, China
| | - F Liu
- Department of Microbiology Laboratory, Beijing Haidian Center for Disease Control and Prevention, Beijing 100094, China
| | - H Zhang
- Department of Microbiology Laboratory, Beijing Haidian Center for Disease Control and Prevention, Beijing 100094, China
| | - X L Yu
- Institute of Preventive Immunization, Beijing Center for Disease Control and Prevention/Beijing Academy for Preventive Medicine/Beijing Institute of Tuberculosis Control Research and Prevention, Beijing 100013, China
| | - J P Dong
- Department Infectious Disease, Beijing Haidian Hospital, Beijing 100080, China
| | - Wenbo Xu
- Institute for Viral Disease Control and Prevention, Chinese Centers for Disease control and Prevention, Beijing 102206, China NHC Key Laboratory for Medical Virology and Viral Diseases, Beijing 102206, China
| | - Fang Huang
- School of Public Health, Capital Medical University, Beijing 100069, China Institute of Preventive Immunization, Beijing Center for Disease Control and Prevention/Beijing Academy for Preventive Medicine/Beijing Institute of Tuberculosis Control Research and Prevention, Beijing 100013, China
| |
Collapse
|
12
|
Yin J, Wu JB, Qi C, Yao DH, Zheng JR, Ding LH, Zhu LL, Liu FY, Mei LY, Wu K. [Investigation on high-frequency hearing loss of noise workers in an automobile factory]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2021; 39:543-546. [PMID: 34365770 DOI: 10.3760/cma.j.cn121094-20200529-00301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the high-frequency hearing loss (HFHL) of workers in an automobile factory and its influencing factors, so as to provide a scientific basis for occupational health management of noise workers. Methods: From March to July 2019, 2647 workers from an automobile factory were selected as the research objects by cluster sampling method. The basic personal information (such as gender, age, education level, height, weight, etc.) , history of ear disease, the history of detonation, history of exposure to ototoxic drugs, history of exposure to occupational noise, etc., were investigated by questionnaire and occupational health examination. Chi-square test was used to compare the detection rates of HFHL in different populations, and multivariate logistic regression model was used to analyze the influencing factors of HFHL. Results: The noise level of 2647 individual workers ranged from 75.0 dB (A) to 92.0 dB (A) , with an average of (84.14±2.47) dB (A) . The detection rate of HFHL was 17.2% (456/2647) . There were significant differences in the the detection rate of HFHL among workers of different gender, age, educational level, working age, noise exposure level, diabetes history, detonation history, smoking and drinking workers (P<0.05) . Multivariate logistic regression analysis showed that male, age ≥30 years old, smoking and noise exposure were risk factors for HFHL (P<0.05) . Conclusion: The detection rate of HFHL in automobile factory workers is high. Gender, age, smoking and noise are the influencing factors of HFHL. It is necessary to strengthen the noise control in the workplace and guide workers to choose healthy lifestyle.
Collapse
Affiliation(s)
- J Yin
- Shiyan Occupational Disease Prevention and Control Hospital, Shiyan 442001, China
| | - J B Wu
- Shiyan Occupational Disease Prevention and Control Hospital, Shiyan 442001, China
| | - C Qi
- Shiyan Occupational Disease Prevention and Control Hospital, Shiyan 442001, China
| | - D H Yao
- Shiyan Occupational Disease Prevention and Control Hospital, Shiyan 442001, China
| | - J R Zheng
- Shiyan Occupational Disease Prevention and Control Hospital, Shiyan 442001, China
| | - L H Ding
- Shiyan Occupational Disease Prevention and Control Hospital, Shiyan 442001, China
| | - L L Zhu
- Shiyan Occupational Disease Prevention and Control Hospital, Shiyan 442001, China
| | - F Y Liu
- Shiyan Occupational Disease Prevention and Control Hospital, Shiyan 442001, China
| | - L Y Mei
- Hubei Center forDisease Control and Prevention, Wuhan 430070, China
| | - K Wu
- Shiyan Occupational Disease Prevention and Control Hospital, Shiyan 442001, China
| |
Collapse
|
13
|
Liu J, Wu Z, Zhang J, Xie Y, Sun P, Wu H, Chang X, Zhang L, Liu F. Effect of partial splenic embolization on transarterial chemoembolization for hepatocellular carcinoma with hypersplenism. Medicine (Baltimore) 2021; 100:e26441. [PMID: 34190168 PMCID: PMC8257862 DOI: 10.1097/md.0000000000026441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 06/06/2021] [Indexed: 02/07/2023] Open
Abstract
This study retrospectively studied transarterial chemoembolization (TACE) combined with partial splenic embolization (PSE) in the treatment of hepatocellular carcinoma (HCC) with severe hypersplenism.Seventy patients with HCC in Barcelona Clinic Liver Cancer (BCLC) stage B or C with hypersplenism were divided into non-partial splenic embolization group (N-PSE, n = 51) and partial splenic embolization group (PSE, n = 19). The N-PSE group was further divided into N-PSE with mild to moderate hypersplenism (N-PSE-M, 47 cases) and N-PSE with severe hypersplenism (N-PSE-S, 4 cases).In the PSE group, leukocytes, neutrophils, lymphocytes, and platelets were significantly increased (P < .05) and were significantly different from that in the N-PSE group (P < .05). In the N-PSE group, except for a slight increase in neutrophils, other blood cells were decreased, including lymphocytes that were significantly decreased (P < .05). There was no significant difference in the changes of liver function between the 2 groups before and after surgery (P > .05). The analysis showed a significant increase in ascites after 6 months of TACE in the N-PSE group (P < .05). According to the follow-up results, the median overall survival (OS) in the PSE group was 24.47 ± 3.68 (months) and progression-free survival (PFS) was 12.63 ± 4.98 (months). Regardless of OS or PFS, the PSE group was superior to the N-PSE group and its subgroups, with a statistically significant difference in PFS between the N-PSE group and PSE group (P < .05). Moreover, the time of extrahepatic progression was significantly earlier in the N-PSE group than in the PSE group (P < .05). N-PSE-S group had the worst prognosis, and PFS and OS were worse than the other 2 groups, suggesting that PSE in severe hypersplenism may improve PFS and OS.In patients with HCC and severe hypersplenism, TACE should be actively combined with PSE treatment.
Collapse
Affiliation(s)
- Jibing Liu
- Department of Interventional Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences
| | - Zhijuan Wu
- Department of Geriatrics, Jinan Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong
| | - Jianxin Zhang
- Department of Interventional Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences
| | - Yinfa Xie
- Department of Interventional Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences
| | - Peng Sun
- Department of Interventional Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences
| | - Huiyong Wu
- Department of Interventional Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences
| | - Xu Chang
- Department of Interventional Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences
| | - Lin Zhang
- Department of Interventional Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences
| | - Fengyong Liu
- Department of Intervention Therapy, General Hospital of the Chinese People's Liberation Army, Beijing, China
| |
Collapse
|
14
|
Liu FY, Zhang Q, Guo XX, Song X, Zhang CX. [Study on the mechanism of resistance to cypermethrin in Culex pipiens pallens using proteomics]. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi 2021; 33:189-194. [PMID: 34008367 DOI: 10.16250/j.32.1374.2020347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To compare the differentially expressed proteins between cypermethrin-resistant and -sensitive Culex pipiens pallens, so as to unravel the mechanism underlying the resistance to cypermethrin in Cx. p. pallens. METHODS A quantitative proteomic analysis was performed among cypermethrin-sensitive and -resistant isolates of Cx. p. pallens using isobaric tags for relative and absolute quantification (iTRAQ) labeling coupled with liquid chromatography with tandem mass spectrometry (LC-MS/MS). RESULTS A total of 164 differentially expressed proteins were identified between cypermethrin-sensitive and -resistant isolates of Cx. p. pallens, including 54 up-regulated proteins and 110 down-regulated proteins. A large number of cuticular proteins, larval cuticular proteins, pupal cuticular proteins and cuticular structural constituent proteins, which are associated with cytoskeletal structure and components, were differentially expressed between cypermethrin-sensitive and -resistant isolates of Cx. p. pallens. Thirteen proteins, which were involved in energy production and conversion, translation, ribosomal structure and biogenesis, lipid transport and metabolism, post-translational modification, protein turnover, chaperones, cytoskeleton and intracellular transportation, were validated to be differentially expressed between cypermethrin-sensitive and -resistant isolates of Cx. p. pallens, which may serve as potential markers of cypermethrin resistance. CONCLUSIONS Multiple insecticide resistance mechanisms contribute to the resistance to cypermethrin in Cx. p. pallens, including cuticular resistance and metabolic resistance, and the cuticular protein genes and cytochrome P450 enzymes may play an important role in the resistance of Cx. p. pallens to cypermethrin.
Collapse
Affiliation(s)
- F Y Liu
- Shandong Institute of Parasitic Diseases, Shandong First Medical University & Shandong Academy of Medical Sciences, Jining 272000, China.,Clinical Laboratory, Affiliated Hosptial of Jining Medical University, China
| | - Q Zhang
- Jining Municipal Hospital of Traditional Chinese Medicine, Shandong Province, China
| | - X X Guo
- Shandong Institute of Parasitic Diseases, Shandong First Medical University & Shandong Academy of Medical Sciences, Jining 272000, China
| | - X Song
- Shandong Institute of Parasitic Diseases, Shandong First Medical University & Shandong Academy of Medical Sciences, Jining 272000, China
| | - C X Zhang
- Shandong Institute of Parasitic Diseases, Shandong First Medical University & Shandong Academy of Medical Sciences, Jining 272000, China
| |
Collapse
|
15
|
Zuo T, Lin W, Liu F, Xu J. Artificial pneumothorax improves radiofrequency ablation of pulmonary metastases of hepatocellular carcinoma close to mediastinum. BMC Cancer 2021; 21:505. [PMID: 33957875 PMCID: PMC8101170 DOI: 10.1186/s12885-021-08223-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 04/20/2021] [Indexed: 02/08/2023] Open
Abstract
Background To investigate the feasibility, safety and efficacy of percutaneous radiofrequency ablation (RFA) of pulmonary metastases from hepatocellular carcinoma (HCC) contiguous with the mediastinum using the artificial pneumothorax technique. Method A total of 40 lesions in 32 patients with pulmonary metastases from HCC contiguous with the mediastinum accepted RFA treatment from August 2014 to May 2018 via the artificial pneumothorax technique. After ablation, clinical outcomes were followed up by contrast enhanced CT. Technical success, local tumor progression (LTP), intrapulmonary distant recurrence (IDR), and adverse events were evaluated. Overall survival (OS) and local tumor progression free survival (LTPFS) were recorded for each patient. Results The tumor size was 1.4 ± 0.6 cm in diameter. RFA procedures were all successfully performed without intra-ablative complications. Technical success was noted in 100% of the patients. Five cases of LTP and 8 cases of IDR occurred following the secondary RFA for treatment. Slight pain was reported in all patients. No major complications were observed. The 1, 2, and 3-year LTPFS rates were 90.6, 81.2, and 71.8%, and the 1, 2, and 3-year OS rates were 100, 100 and 87.5%, respectively. Conclusion Artificial pneumothorax adjuvant RFA is a feasible, safe, and efficient method for treatment of pulmonary metastases from HCC contiguous with the mediastinum.
Collapse
Affiliation(s)
- Taiyang Zuo
- Department of Interventional Oncology, Jinan Central Hospital Affiliated to Shandong University, Jinan, 250013, Shandong, China.,Department of Interventional Radiology, Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, 100853, Shandong, China
| | - Wenli Lin
- Department of Interventional Oncology, Jinan Central Hospital Affiliated to Shandong University, Jinan, 250013, Shandong, China
| | - Fengyong Liu
- Department of Interventional Oncology, Jinan Central Hospital Affiliated to Shandong University, Jinan, 250013, Shandong, China.,Department of Interventional Radiology, Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, 100853, Shandong, China
| | - Jinshun Xu
- Department of Interventional Oncology, Jinan Central Hospital Affiliated to Shandong University, Jinan, 250013, Shandong, China. .,Department of Interventional Radiology, Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, 100853, Shandong, China. .,Department of Medical Ultrasound, Laboratory of Ultrasound Imaging Drug, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
| |
Collapse
|
16
|
Tu LK, Nie ML, Fu J, Liu FY, Chen YK, Sun JM, Wang HY. Comparing the efficacy of endovascular treatment for iliac vein compression syndrome with or without acute deep venous thrombosis: A single-center retrospective study. Vascular 2021; 30:341-348. [PMID: 33853455 DOI: 10.1177/17085381211003776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND To compare the efficacy of endovascular treatment for iliac vein compression syndrome (IVCS) with or without acute deep venous thrombosis of lower extremity. METHODS This study retrospectively analyzed the clinical data of 300 IVCS patients, who received endovascular treatment between January 2013 and December 2017. According to whether IVCS was complicated by deep venous thrombosis or not, these patients were divided into non-thrombotic iliac vein lesion group (NIVL group, n = 127) and post-thrombotic iliac vein lesion group (PIVL group, n = 173). After endovascular treatment, all patients were followed up to assess the symptoms improvement and to evaluate the patency of iliac vein. RESULTS The technical success rate was 98% (294/300), and percutaneous transluminal angioplasty with stenting was adopted in 294 cases. The incidence of perioperative complications was 36.33% (109/300), but no severe complications occurred. During a mean follow-up of 22.3 months (range 6-30 months), 9(6.82%, 9/132) patients in PIVL group had recurrence of deep venous thrombosis, but nobody had deep venous thrombosis and varicose veins recurrence in NIVL group. The effective rate of endovascular treatment in NIVL group and PIVL group was 96.88% and 90.15% (P = 0.050), while the cumulative primary patency of iliac vein in NIVL group was significantly higher than that in PIVL group (P = 0.008). CONCLUSIONS The endovascular treatment is an effective, feasible, safe method for treating IVCS. There is no difference in the efficacy of IVCS patients with or without deep venous thrombosis, but the medium and long-term patency of patients with deep venous thrombosis is lower than that in patients without deep venous thrombosis.
Collapse
Affiliation(s)
- L K Tu
- Department of Gastroenterology, University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - M L Nie
- Department of Abdominal Wall, Hernia and Vascular Surgery, Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - J Fu
- Department of Abdominal Wall, Hernia and Vascular Surgery, Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - F Y Liu
- Department of Abdominal Wall, Hernia and Vascular Surgery, Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Y K Chen
- Department of Abdominal Wall, Hernia and Vascular Surgery, Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - J M Sun
- Department of Gastroenterology, University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - H Y Wang
- Department of Gastroenterology, University-Town Hospital of Chongqing Medical University, Chongqing, China
| |
Collapse
|
17
|
Tang J, Liu F, Yuan H, Li X, Tian X, Ji K, Li X, Wang W. Pretreatment Apparent Diffusion Coefficient as a Predictor of Response to Transcatheter Arterial Chemoembolization Immediately Combined with Radiofrequency Ablation for Treatment of Solitary Large Hepatocellular Carcinoma. Cancer Manag Res 2020; 12:10127-10138. [PMID: 33116868 PMCID: PMC7569047 DOI: 10.2147/cmar.s270470] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 09/08/2020] [Indexed: 12/16/2022] Open
Abstract
Purpose To evaluate whether the pretreatment apparent diffusion coefficient (ADC) measured with diffusion weighted imaging (DWI) of tumor can be used as an imaging biomarker for predicting prognosis in solitary large hepatocellular carcinomas (HCCs) treated with transcatheter arterial chemoembolization (TACE) immediately combined with radiofrequency ablation (RFA). Patients and Methods In this single institution retrospective study, 40 solitary large HCCs that underwent treatment with TACE immediately combined with RFA were analyzed. All patients underwent abdominal dynamic contrast-enhanced magnetic resonance imaging within one month before treatment with DWI, and ADC values in the lesions were measured by two independent radiologists. Associations among patients’ preoperative ADC values and objective response (OR), progression-free survival (PFS) and overall survival (OS) were examined. Survival curves were drawn with the Kaplan–Meier method, and differences were determined with the Log rank test. The Cox proportional-hazards model was used for univariate and multivariate analyses of PFS and OS. Results Forty solitary large HCCs (mean 9.54 cm, range 5.04–16.06 cm) were successfully treated with TACE in immediate combination with RFA (OR 75%). The ADC values were significantly higher in the response group than the non-response group (1.51±0.32×10−3 mm2/s vs 1.09±0.17×10−3 mm2/s; P<0.001). As predicted on the basis of the ADC values, the optimal cutoff value for the efficacy of TACE combined with RFA was 1.32×10−3 mm2/s, with a predictive sensitivity of 0.63 and a specificity of 1.00. Patients with high ADC had longer PFS than those with low ADC (14.9 months vs 5.3 months; P<0.001) and had significantly longer survival rates (22.6 months vs 12.1 months; P=0.004). Conclusion Preoperative ADC values <1.32×10−3 mm2/s are an independent predictor of poorer prognosis in patients with solitary large HCCs who have undergone TACE immediately combined with RFA.
Collapse
Affiliation(s)
- Jing Tang
- Medical School of Chinese PLA, Beijing, People's Republic of China.,Department of Interventional Radiology, The First Medical Center, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Fengyong Liu
- Department of Interventional Radiology, The First Medical Center, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Hongjun Yuan
- Department of Interventional Radiology, The First Medical Center, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Xin Li
- Department of Interventional Radiology, The First Medical Center, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Xiaomei Tian
- Department of Interventional Radiology, The First Medical Center, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Kan Ji
- Department of Interventional Radiology, The First Medical Center, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Xueping Li
- Department of Radiology, The First Medical Center, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Wei Wang
- Department of Radiology, The First Medical Center, Chinese PLA General Hospital, Beijing, People's Republic of China
| |
Collapse
|
18
|
Yuan H, Li X, Tian X, Ji K, Liu F. Comparison of Angio-CT and cone-beam CT-guided immediate radiofrequency ablation after transcatheter arterial chemoembolization for large hepatocellular carcinoma. Abdom Radiol (NY) 2020; 45:2585-2592. [PMID: 32107583 DOI: 10.1007/s00261-020-02462-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE To evaluate the rapeutic effectiveness of Angio-CT or cone-beam CT (CBCT)-guided immediate radiofrequency ablation (RFA) after transcatheter arterial chemoembolization (TACE) for large hepatocellular carcinoma (HCC). METHODS 117 large HCC patients (mean maximum diameter: 9.3 cm; range 5.3-17.7 cm) were retrospective studied and divided into Angio-CT group (n = 66 cases), CBCT group (n = 21 cases), and single TACE group (n = 30 cases) according to treatment (Angio-CT/CBCT-guided immediate RFA after TACE, single TACE, respectively). The operative time, effective radiation dose, local-regional tumor responses, overall survival (OS), and progression‑free survival (PFS) time and complications were recorded. RESULTS The operative time and effective radiation dose of Angio-CT group and CBCT group were higher than those of TACE group (P < 0.01). The local-regional tumor responses on 1-month follow-up MRI (complete response + partial response) of Angio-CT group and CBCT group were 100%, which were significantly higher than that of single TACE group (76.7%, P < 0.05). There was no significant difference in local-regional tumor responses of 1-month follow-up between Angio-CT group and CBCT group (P = 0.831). The median PFS and OS time of Angio-CT group were 14.7 ± 1.43 months and 18.21 ± 0.88 months, CBCT group were 13.9 ± 1.53 months and 17.87 ± 1.78 months, TACE group were 10.4 ± 1.21 months and 12.87 ± 0.91 months, respectively. No procedure-related major complications occurred. CONCLUSIONS MIYABI Angio-CT or CBCT-guided immediate RFA after TACE for large HCC both have more effective than single TACE. The former is worth popularizing, due to its advantages of convenience, shorter operative time, and less radiation dose for doctors.
Collapse
|
19
|
Wang B, Huang Q, Liu K, Fan Y, Peng C, Gu L, Shi T, Zhang P, Chen W, Du S, Niu S, Liu R, Zhao G, Li Q, Xiao C, Wang R, Li S, Wang M, Liu F, Wang H, Li H, Ma X, Zhang X. Robot-assisted Level III-IV Inferior Vena Cava Thrombectomy: Initial Series with Step-by-step Procedures and 1-yr Outcomes. Eur Urol 2020; 78:77-86. [DOI: 10.1016/j.eururo.2019.04.019] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 04/12/2019] [Indexed: 11/15/2022]
|
20
|
Guo Z, Fan D, Liu FY, Kong CY, Tang QZ. [Effects of maslinic acid on isoproterenol-induced myocardial fibrosis in mice]. Zhonghua Yi Xue Za Zhi 2020; 100:1820-1825. [PMID: 32536130 DOI: 10.3760/cma.j.cn112137-20190924-02105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the effect of maslinic acid (MA) on isoproterenol (ISO)-induced myocardial fibrosis in mice. Methods: ISO was used to induce myocardial fibrosis in adult male C57BL/6 mice, and MA was administered for two weeks to detect the effects of MA on cardiac function and fibrosis. Molecular changes of fibrosis markers and signaling pathways were detected by RT-PCR and western blotting. Phosphate buffer saline (PBS), PBS+SB203580 (p38 MAPK inhibitor), PBS+MA, ISO, ISO+SB203580, ISO+MA were added to the primary cultured rat fibroblasts. Cells were collected after 48 h for subsequent detection. Results: In this study, the mouse model of myocardial fibrosis was successfully established. The left ventricular faction shortening (FS) and maximum rate of rise and maximum rate of fall of pressure in left ventricular chamber (±dp/dt) of the ISO+MA group were significantly higher than those of the ISO group ((35.1±1.8)% vs (28.5±2.6)%, (7 256±153) mmHg/s vs (6 402±240) mmHg/s, (7 156±163) mmHg/s vs (6 319±219) mmHg/s, all P<0.05). The levels of interstitial and perivascular collagen deposition in the ISO+MA group were higher than those in the ISO group (P<0.05), the relative mRNA levels of COL-1, COL-3 and TGF-β in the ISO+MA group were significantly lower than those in the ISO group, with the relative expression levels of 1.70±0.24 vs 3.69±0.34, 1.72±0.56 vs 4.84±0.82, 1.52±0.19 vs 2.64±0.29, respectively (all P<0.05). The phosphorylation levels of p38 MAPK, Smad3 and protein expression level of TGF-β1 in ISO+MA group were lower than those in ISO group (relative expression levels were 1.67±0.35 vs 2.61±0.58, 1.68±0.23 vs 2.52±0.19,1.56±0.15 vs 2.48±0.26, respectively, all P<0.05). The results of in vitro cell experiments showed that the mRNA levels of COL-1, COL-3 and TGF-β in the SB203580 and MA groups were significantly lower than those in the ISO group (relative expression levels were 2.25±0.51, 2.16±0.48 vs 5.29±1.21; 1.58±0.34, 1.69±0.29 vs 4.97±1.32; 1.41±0.31, 1.55±0.38 vs 3.53±0.56, respectively, all P<0.05). The phosphorylation levels of p38 MAPK and Smad3 in the SB203580 MA groups was significantly lower than those in the ISO group, and the protein expression level of TGF-β1 was lower than that in the ISO group (1.81±0.18, 1.77±0.16 vs 2.56±0.32; 1.85±0.21, 1.81±0.17 vs 2.48±0.37; 1.84±0.24, 1.72±0.17 vs 2.52±0.29, all P<0.05). Conclusion: Maslinic acid can inhibit the phosphorylation of p38 MAPK, thereby preventing the canonical TGF-β1/Smads fibrosis signaling pathway to achieve an anti-fibrosis role.
Collapse
Affiliation(s)
- Z Guo
- Department of Cardiology, Renmin Hospital of Wuhan University; Cardiovascular Research Institute of Wuhan University; Hubei Key Laboratory of Cardiology, Wuhan 430060, China
| | - D Fan
- Department of Cardiology, Renmin Hospital of Wuhan University; Cardiovascular Research Institute of Wuhan University; Hubei Key Laboratory of Cardiology, Wuhan 430060, China
| | - F Y Liu
- Department of Cardiology, Renmin Hospital of Wuhan University; Cardiovascular Research Institute of Wuhan University; Hubei Key Laboratory of Cardiology, Wuhan 430060, China
| | - C Y Kong
- Department of Cardiology, Renmin Hospital of Wuhan University; Cardiovascular Research Institute of Wuhan University; Hubei Key Laboratory of Cardiology, Wuhan 430060, China
| | - Q Z Tang
- Department of Cardiology, Renmin Hospital of Wuhan University; Cardiovascular Research Institute of Wuhan University; Hubei Key Laboratory of Cardiology, Wuhan 430060, China
| |
Collapse
|
21
|
Pan X, Wang W, Huang Z, Liu S, Guo J, Zhang F, Yuan H, Li X, Liu F, Liu H. MOF‐Derived Double‐Layer Hollow Nanoparticles with Oxygen Generation Ability for Multimodal Imaging‐Guided Sonodynamic Therapy. Angew Chem Int Ed Engl 2020; 59:13557-13561. [DOI: 10.1002/anie.202004894] [Citation(s) in RCA: 101] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Indexed: 11/08/2022]
Affiliation(s)
- Xueting Pan
- Department of Interventional Radiology the First Medical Center of Chinese PLA General Hospital Beijing 100853 China
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering State Key Laboratory of Organic-Inorganic Composites Bionanomaterials & Translational Engineering Laboratory Beijing Key Laboratory of Bioprocess Beijing Laboratory of Biomedical Materials Beijing University of Chemical Technology Beijing 100029 China
| | - Weiwei Wang
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering State Key Laboratory of Organic-Inorganic Composites Bionanomaterials & Translational Engineering Laboratory Beijing Key Laboratory of Bioprocess Beijing Laboratory of Biomedical Materials Beijing University of Chemical Technology Beijing 100029 China
| | - Zhijun Huang
- Beijing National Laboratory of Molecular Sciences Key Laboratory of Green Printing Institute of Chemistry Chinese Academy of Sciences Beijing 100190 China
| | - Shuang Liu
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering State Key Laboratory of Organic-Inorganic Composites Bionanomaterials & Translational Engineering Laboratory Beijing Key Laboratory of Bioprocess Beijing Laboratory of Biomedical Materials Beijing University of Chemical Technology Beijing 100029 China
| | - Juan Guo
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering State Key Laboratory of Organic-Inorganic Composites Bionanomaterials & Translational Engineering Laboratory Beijing Key Laboratory of Bioprocess Beijing Laboratory of Biomedical Materials Beijing University of Chemical Technology Beijing 100029 China
| | - Fengrong Zhang
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering State Key Laboratory of Organic-Inorganic Composites Bionanomaterials & Translational Engineering Laboratory Beijing Key Laboratory of Bioprocess Beijing Laboratory of Biomedical Materials Beijing University of Chemical Technology Beijing 100029 China
| | - Hongjun Yuan
- Department of Interventional Radiology the First Medical Center of Chinese PLA General Hospital Beijing 100853 China
| | - Xin Li
- Department of Interventional Radiology the First Medical Center of Chinese PLA General Hospital Beijing 100853 China
| | - Fengyong Liu
- Department of Interventional Radiology the First Medical Center of Chinese PLA General Hospital Beijing 100853 China
| | - Huiyu Liu
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering State Key Laboratory of Organic-Inorganic Composites Bionanomaterials & Translational Engineering Laboratory Beijing Key Laboratory of Bioprocess Beijing Laboratory of Biomedical Materials Beijing University of Chemical Technology Beijing 100029 China
| |
Collapse
|
22
|
Pan X, Wang W, Huang Z, Liu S, Guo J, Zhang F, Yuan H, Li X, Liu F, Liu H. MOF‐Derived Double‐Layer Hollow Nanoparticles with Oxygen Generation Ability for Multimodal Imaging‐Guided Sonodynamic Therapy. Angew Chem Int Ed Engl 2020. [DOI: 10.1002/ange.202004894] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Xueting Pan
- Department of Interventional Radiology the First Medical Center of Chinese PLA General Hospital Beijing 100853 China
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering State Key Laboratory of Organic-Inorganic Composites Bionanomaterials & Translational Engineering Laboratory Beijing Key Laboratory of Bioprocess Beijing Laboratory of Biomedical Materials Beijing University of Chemical Technology Beijing 100029 China
| | - Weiwei Wang
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering State Key Laboratory of Organic-Inorganic Composites Bionanomaterials & Translational Engineering Laboratory Beijing Key Laboratory of Bioprocess Beijing Laboratory of Biomedical Materials Beijing University of Chemical Technology Beijing 100029 China
| | - Zhijun Huang
- Beijing National Laboratory of Molecular Sciences Key Laboratory of Green Printing Institute of Chemistry Chinese Academy of Sciences Beijing 100190 China
| | - Shuang Liu
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering State Key Laboratory of Organic-Inorganic Composites Bionanomaterials & Translational Engineering Laboratory Beijing Key Laboratory of Bioprocess Beijing Laboratory of Biomedical Materials Beijing University of Chemical Technology Beijing 100029 China
| | - Juan Guo
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering State Key Laboratory of Organic-Inorganic Composites Bionanomaterials & Translational Engineering Laboratory Beijing Key Laboratory of Bioprocess Beijing Laboratory of Biomedical Materials Beijing University of Chemical Technology Beijing 100029 China
| | - Fengrong Zhang
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering State Key Laboratory of Organic-Inorganic Composites Bionanomaterials & Translational Engineering Laboratory Beijing Key Laboratory of Bioprocess Beijing Laboratory of Biomedical Materials Beijing University of Chemical Technology Beijing 100029 China
| | - Hongjun Yuan
- Department of Interventional Radiology the First Medical Center of Chinese PLA General Hospital Beijing 100853 China
| | - Xin Li
- Department of Interventional Radiology the First Medical Center of Chinese PLA General Hospital Beijing 100853 China
| | - Fengyong Liu
- Department of Interventional Radiology the First Medical Center of Chinese PLA General Hospital Beijing 100853 China
| | - Huiyu Liu
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering State Key Laboratory of Organic-Inorganic Composites Bionanomaterials & Translational Engineering Laboratory Beijing Key Laboratory of Bioprocess Beijing Laboratory of Biomedical Materials Beijing University of Chemical Technology Beijing 100029 China
| |
Collapse
|
23
|
Du S, Huang Q, Yu H, Shen D, Gu L, Yan F, Liu F, Zhang X, Ma X, Wang B. Initial Series of Robotic Segmental Inferior Vena Cava Resection in Left Renal Cell Carcinoma With Caval Tumor Thrombus. Urology 2020; 142:125-132. [PMID: 32339559 DOI: 10.1016/j.urology.2020.03.053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 03/18/2020] [Accepted: 03/24/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To present our preliminary experience of robotic left radical nephrectomy (LRN) and segmental inferior vena cava (IVC) resection without caval replacement for left renal cell carcinoma (RCC) with inferior vena cava tumor thrombus. MATERIALS AND METHODS Between 2017 and 2018, 7 patients underwent segmental IVC resection and LRN robotically. All patients underwent preoperative cavography, demonstrating complete IVC occlusion. Computed tomography-based 3-dimensional reconstruction revealed sufficient collateralization of the IVC and right renal vein (RRV). The cephalic IVC was circumferentially resected and ligated just below the second porta hepatis. The caudal IVC was circumferentially resected above the RRV with preservation of the major collaterals. The RRV was not dissected during the procedure to avoid compromising its neocollaterals. The IVC portion between the RRV and the second porta hepatis was removed en bloc with the tumor thrombus, and the LRN was performed. RESULTS All cases were successfully performed by robotic surgery without conversion. Median operative time was 420 minutes. Median intensive care unit stay was 3 days. Four grade Ⅱ complications occurred in 2 patients. One patient had mild LEE postoperatively and recovered without special medication. Median preoperative and 3-6 months follow-up serum creatinine was 118.7 μmol/L and 135.2 μmol/L, respectively. No patient needed dialysis postoperatively. One case occurred disease progression. No patient died during the follow-up period. CONCLUSION Robotic segmental IVC resection for left RCC with inferior vena cava tumor thrombus is feasible in well-selected cases. Three-dimensional reconstruction and cavography are helpful in the preoperative evaluation of neocollaterals in patients with suprarenal IVC occlusion.
Collapse
Affiliation(s)
- Songliang Du
- School of Medicine, Nankai University, Tianjin, China; Department of Urology/ State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital, Beijing, China
| | - Qingbo Huang
- Department of Urology/ State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital, Beijing, China
| | - Hongkai Yu
- Department of Urology/ State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital, Beijing, China
| | - Donglai Shen
- Department of Urology/ State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital, Beijing, China
| | - Liangyou Gu
- Department of Urology/ State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital, Beijing, China
| | - Fei Yan
- Department of Radiology, Chinese PLA General Hospital, Beijing, China
| | - Fengyong Liu
- Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, China
| | - Xu Zhang
- School of Medicine, Nankai University, Tianjin, China; Department of Urology/ State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital, Beijing, China
| | - Xin Ma
- School of Medicine, Nankai University, Tianjin, China; Department of Urology/ State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital, Beijing, China
| | - Baojun Wang
- School of Medicine, Nankai University, Tianjin, China; Department of Urology/ State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital, Beijing, China.
| |
Collapse
|
24
|
Shi T, Huang Q, Liu K, Du S, Fan Y, Yang L, Peng C, Shen D, Wang Z, Gao Y, Gu L, Niu S, Ai Q, Li H, Liu F, Li Q, Wang H, Guo A, Fu B, Yang X, Zhang X, Wang D, Wang D, Guo H, Li H, Olivero A, Fam XI, Ma X, Wang B, Zhang X. Robot-assisted Cavectomy Versus Thrombectomy for Level II Inferior Vena Cava Thrombus: Decision-making Scheme and Multi-institutional Analysis. Eur Urol 2020; 78:592-602. [PMID: 32305170 DOI: 10.1016/j.eururo.2020.03.020] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 03/13/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Robot-assisted thrombectomy (RAT) for inferior vena cava (IVC) thrombus (RAT-IVCT) is being increasingly reported. However, the techniques and indications for robot-assisted cavectomy (RAC) for IVC thrombus are not well described. OBJECTIVE To develop a decision-making program and analyze multi-institutional outcomes of RAC-IVCT versus RAT-IVCT. DESIGN, SETTING, AND PARTICIPANTS Ninety patients with renal cell carcinoma (RCC) with level II IVCT were included from eight Chinese urological centers, and underwent RAC-IVCT (30 patients) or RAT-IVCT (60 patients) from June 2013 to January 2019. SURGICAL PROCEDURE The surgical strategy was based on IVCT imaging characteristics. RAT-IVCT was performed with standardized cavotomy, thrombectomy, and IVC reconstruction. RAC-IVCT was mainly performed in patients with extensive IVC wall invasion when the collateral blood vessels were well-established. For right-sided RCC, the IVC from the infrarenal vein to the infrahepatic veins was stapled. For left-sided RCC, the IVC from the suprarenal vein to the infrahepatic veins was removed and caudal IVC reconstruction was performed to ensure the right renal vein returned through the IVC collaterals. MEASUREMENTS Clinicopathological, operative, and survival outcomes were collected and analyzed. RESULTS AND LIMITATIONS All procedures were successfully performed without open conversion. The median operation time (268 vs 190 min) and estimated blood loss (1500 vs 400 ml) were significantly greater for RAC-IVCT versus RAT-IVCT (both p < 0.001). IVC invasion was a risk factor for progression-free and overall survival at midterm follow-up. Large-volume and long-term follow-up studies are needed. CONCLUSIONS RAC-IVCT or RAT-IVCT represents an alternative minimally invasive approach for selected RCC patients with level II IVCT. Selection of RAC-IVCT or RAT-IVCT is mainly based on preoperative IVCT imaging characteristics, including the presence of IVC wall invasion, the affected kidney, and establishment of the collateral circulation. PATIENT SUMMARY In this study we found that robotic surgeries for level II inferior vena cava thrombus were feasible and safe. Preoperative imaging played an important role in establishing an appropriate surgical plan.
Collapse
Affiliation(s)
- Taoping Shi
- Department of Urology, Chinese PLA General Hospital/PLA Medical School, Beijing, China
| | - Qingbo Huang
- Department of Urology, Chinese PLA General Hospital/PLA Medical School, Beijing, China
| | - Kan Liu
- Department of Urology, Chinese PLA General Hospital/PLA Medical School, Beijing, China
| | - Songliang Du
- Department of Urology, Chinese PLA General Hospital/PLA Medical School, Beijing, China
| | - Yang Fan
- Department of Urology, Chinese PLA General Hospital/PLA Medical School, Beijing, China
| | - Luojia Yang
- Department of Urology, Chinese PLA General Hospital/PLA Medical School, Beijing, China
| | - Cheng Peng
- Department of Urology, Chinese PLA General Hospital/PLA Medical School, Beijing, China
| | - Dan Shen
- Department of Urology, Chinese PLA General Hospital/PLA Medical School, Beijing, China
| | - Zhongxin Wang
- Department of Urology, Chinese PLA General Hospital/PLA Medical School, Beijing, China
| | - Yu Gao
- Department of Urology, Chinese PLA General Hospital/PLA Medical School, Beijing, China
| | - Liangyou Gu
- Department of Urology, Chinese PLA General Hospital/PLA Medical School, Beijing, China
| | - Shaoxi Niu
- Department of Urology, Chinese PLA General Hospital/PLA Medical School, Beijing, China
| | - Qing Ai
- Department of Urology, Chinese PLA General Hospital/PLA Medical School, Beijing, China
| | - Hongzhao Li
- Department of Urology, Chinese PLA General Hospital/PLA Medical School, Beijing, China
| | - Fengyong Liu
- Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, China
| | - Qiuyang Li
- Department of Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Haiyi Wang
- Department of Radiology, Chinese PLA General Hospital, Beijing, China
| | - Aitao Guo
- Department of Pathology, Chinese PLA General Hospital, Beijing, China
| | - Bin Fu
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xiaojian Yang
- Department of Urology, Xijing Hospital of Chinese PLA Air Force Medical University, Xi'an, China
| | - Xuepei Zhang
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Delin Wang
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Dongwen Wang
- Department of Urology, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Hongqian Guo
- Department of Urology, Nanjing Drum Tower Hospital of Nanjing Medical school, Nanjing, China
| | - Hengping Li
- Department of Urology, Gansu Provincial Hospital, Lanzhou, China
| | - Alberto Olivero
- Department of Urology, San Martino Policlinico Hospital, University of Genova, Genoa, Italy
| | - Xeng Inn Fam
- Urology Unit, Surgery Department, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Xin Ma
- Department of Urology, Chinese PLA General Hospital/PLA Medical School, Beijing, China.
| | - Baojun Wang
- Department of Urology, Chinese PLA General Hospital/PLA Medical School, Beijing, China.
| | - Xu Zhang
- Department of Urology, Chinese PLA General Hospital/PLA Medical School, Beijing, China.
| |
Collapse
|
25
|
Huang Q, Gu L, Zhu J, Peng C, Du S, Liu Q, Chen J, Wang B, Fan Y, Gao Y, Fam X, Wang H, Liu F, Guo A, Li H, Zhang X, Ma X. A three-dimensional, anatomy-based nephrometry score to guide nephron-sparing surgery for renal sinus tumors. Cancer 2020; 126 Suppl 9:2062-2072. [PMID: 32293724 DOI: 10.1002/cncr.32748] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 08/08/2019] [Revised: 11/28/2019] [Accepted: 01/10/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND A quantitative nephrometry scoring system specifically for renal sinus tumors will assist in classifying surgical complexity and treatment planning. METHODS By using preoperative computed tomography, magnetic resonance imaging, and 3-dimensional image reconstruction, 5 critical components were assessed: the ratio of the sinus area occupied by the tumor in relation to the whole sinus area (R), the compression of the renal segmental vessels or collection system by the tumor (O), the anteroposterior relation of the tumor relative to the segmental vessels or collection system (A), the tumor diameter (D), and whether the tumor affects a solitary kidney (S) ("ROADS"). The ROADS score, indicating low, moderate, or high surgical complexity, was then used to guide surgical strategy planning, including cooling techniques, surgical approaches, and parenchyma incision techniques. A cohort of 134 patients with renal sinus tumors was treated based on their ROADS score and was retrospectively analyzed. RESULTS The authors successfully performed 113 nephron-sparing surgeries and 21 radical nephrectomies with a complication rate of 7.9%. During follow-up, 3 cases were classified according to surgical margin status because they lacked an intact tumor capsule. There was only 1 case of local recurrence, and there were no cases of metastasis. A high ROADS score was correlated with greater operative complexity, such as longer operation and ischemia times and higher estimated blood loss and complication rates. However, renal function and short-term oncologic outcomes were not related to the score. CONCLUSIONS The ROADS scoring system provides a standardized, quantitative, 3-dimensional anatomic classification to guide surgical strategy in renal sinus tumors.
Collapse
Affiliation(s)
- Qingbo Huang
- Department of Urology, Chinese People's Liberation Army (PLA) General Hospital/PLA Medical School, Beijing, China
| | - Liangyou Gu
- Department of Urology, Chinese People's Liberation Army (PLA) General Hospital/PLA Medical School, Beijing, China
| | - Jie Zhu
- Department of Urology, Chinese People's Liberation Army (PLA) General Hospital/PLA Medical School, Beijing, China
| | - Cheng Peng
- Department of Urology, Chinese People's Liberation Army (PLA) General Hospital/PLA Medical School, Beijing, China
| | - Songliang Du
- Department of Urology, Chinese People's Liberation Army (PLA) General Hospital/PLA Medical School, Beijing, China
| | - Qiming Liu
- Department of Urology, Chinese People's Liberation Army (PLA) General Hospital/PLA Medical School, Beijing, China
| | - Jianwen Chen
- Department of Urology, Chinese People's Liberation Army (PLA) General Hospital/PLA Medical School, Beijing, China
| | - Baojun Wang
- Department of Urology, Chinese People's Liberation Army (PLA) General Hospital/PLA Medical School, Beijing, China
| | - Yang Fan
- Department of Urology, Chinese People's Liberation Army (PLA) General Hospital/PLA Medical School, Beijing, China
| | - Yu Gao
- Department of Urology, Chinese People's Liberation Army (PLA) General Hospital/PLA Medical School, Beijing, China
| | - Xenginn Fam
- Urology Unit, Department of Surgery, Kebangsaan Malaysia University Medical Center, Kuala Lumpur, Malaysia
| | - Haiyi Wang
- Department of Radiology, Chinese PLA General Hospital/PLA Medical School, Beijing, China
| | - Fengyong Liu
- Department of Interventional Radiology, Chinese PLA General Hospital/PLA Medical School, Beijing, China
| | - Aitao Guo
- Department of Pathology, Chinese PLA General Hospital/PLA Medical School, Beijing, China
| | - Hongzhao Li
- Department of Urology, Chinese People's Liberation Army (PLA) General Hospital/PLA Medical School, Beijing, China
| | - Xu Zhang
- Department of Urology, Chinese People's Liberation Army (PLA) General Hospital/PLA Medical School, Beijing, China
| | - Xin Ma
- Department of Urology, Chinese People's Liberation Army (PLA) General Hospital/PLA Medical School, Beijing, China
| |
Collapse
|
26
|
Liu F, Yuan H, Li X, Tang J, Tian X, Ji K. A new management strategy for renal angiomyolipomas: superselective arterial embolization in combination with radiofrequency ablation. Ann Transl Med 2020; 7:766. [PMID: 32042782 DOI: 10.21037/atm.2019.11.63] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Background The present study analyzed the safety and efficacy of superselective arterial embolization (SAE) combined with radiofrequency ablation (RFA) to treat renal angiomyolipoma (RAML). Methods This retrospective study included the clinical data of 6 patients with RAML treated between March 2016 and October 2017. All patients underwent RFA treatment immediately after SAE guided by angio-computed tomography (angio-CT). The tumor size, renal function and complications, and time to recurrence were compared before and after treatment. Results The success rate of the SAE + RFA technique was 100%, and no serious complications were found during or after surgery. After treatment, the patients' symptoms, including low back pain and hematuria, were relieved. The pre-treatment creatinine level (55.6±11.0 µmol/L) did not differ significantly from the post-treatment creatinine level (68.2±13.7 µmol/L), which was measured 1 day after surgery (t=1.75, P=0.109). The mean follow-up time was 29.5±6.1 months. By the end of the follow-up period, the maximum diameter of the tumor was 3.1±0.6 cm, which was significantly smaller than the pre-treatment diameter of 5.9±1.01 cm (t=5.83, P<0.001). At 3 months after surgery, the maximum diameter of the tumor was reduced by 22-38% in all 6 patients. At the last follow-up examination, the maximum diameter of the tumor was reduced by 36-61%. Contrast-enhanced CT or magnetic resonance imaging scans showed that the enhanced part of the original lesion had disappeared, the renal parenchyma was full of even fat signals, and only one patient had new enhanced lesions at the site of the original lesions. Conclusions SAE combined with RFA is a safe and effective treatment for RAML, and its strengths qualify it to become a new treatment strategy for RAML.
Collapse
Affiliation(s)
- Fengyong Liu
- The First Medical Center of PLA General Hospital, Beijing 100853, China
| | - Hongjun Yuan
- The First Medical Center of PLA General Hospital, Beijing 100853, China
| | - Xin Li
- The First Medical Center of PLA General Hospital, Beijing 100853, China
| | - Jing Tang
- The First Medical Center of PLA General Hospital, Beijing 100853, China
| | - Xiaomei Tian
- The First Medical Center of PLA General Hospital, Beijing 100853, China
| | - Kan Ji
- The First Medical Center of PLA General Hospital, Beijing 100853, China
| |
Collapse
|
27
|
Yuan H, Li X, Tang J, Zhou M, Liu F. Local application of doxorubicin- loaded Iron oxid nanoparticles and the vascular disrupting agent via the hepatic artery: chemoembolization-photothermal ablation treatment of hepatocellular carcinoma in rats. Cancer Imaging 2019; 19:71. [PMID: 31685015 PMCID: PMC6829940 DOI: 10.1186/s40644-019-0257-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 10/25/2019] [Indexed: 12/19/2022] Open
Abstract
Objectives This study investigates the effectiveness of local application of doxorubicin(Dox)-loaded, polydopamine (PDA)- coated single crystal hematite (α- Fe2O3) nanocubes (Fe2O3-PDA-Dox) and combretastatin A-4 phosphate disodium(CA4P)in treating hepatocellular carcinoma (HCC) in rats. Methods The magnetic characteristics and photothermal effects of the nanoparticles were determined in vitro. Tumor-bearing Sprague–Dawley rats were divided into 3 groups of 8 according to treatment: controls, transarterial chemoembolization–photothermal ablation (pTACE) (Lipidol+Fe2O3-PDA-Dox + NIR), and CA4P + pTACE (CA4P+ Lipidol+Fe2O3-PDA-Dox + NIR). Drugs were administered through the hepatic artery, and the tumors exposed to 808-nm near-infrared radiation. The Fe content of tumors was assessed using neutron activation analysis. Treatment effectiveness was assessed using heating curves, magnetic resonance imaging, pathology results, and immunohistochemical analysis. Results The mean tumor Fe content was greater in rats treated with CA4P + pTACE (1 h, 23.72 ± 12.45 μg/g; 24 h, 14.61 ± 8.23 μg/g) than in those treated with pTACE alone (1 h, 5.66 ± 4.29 μg/g; 24 h, 2.76 ± 1.33 μg/g). The tumor T2 imaging signal was lower in rats treated with CA4P + pTACE. Following laser irradiation, the tumor temperature increased, with higher temperatures reached in the CA4P + pTACE group (62 °C vs 55 °C). Tumor cells exhibited necrosis, apoptosis, and proliferation inhibition, with greater effects in the CA4P + pTACE group. Transient liver and kidney toxicity were observed on day 3, with more severe effects after CA4P + pTACE. Conclusions Fe2O3-PDA-Dox nanoparticles are effective for TACE–PTA. Pretreatment with CA4P increases nanoparticle uptake by tumors, increasing the treatment effectiveness without increasing hepatorenal toxicity.
Collapse
Affiliation(s)
- Hongjun Yuan
- Department of Interventional Radiology, The First Medical Center of PLA General Hospital, Beijing, 100853, China
| | - Xin Li
- Department of Interventional Radiology, The First Medical Center of PLA General Hospital, Beijing, 100853, China
| | - Jing Tang
- Department of Interventional Radiology, The First Medical Center of PLA General Hospital, Beijing, 100853, China
| | - Min Zhou
- Institute of Translational Medicine, Zhejiang University, Hangzhou, 310009, China
| | - Fengyong Liu
- Department of Interventional Radiology, The First Medical Center of PLA General Hospital, Beijing, 100853, China.
| |
Collapse
|
28
|
Zhou Q, Wang K, Dou J, Cao F, Liu F, Yuan H, Mu M, Xu J, Zhang D, Li X, Tian J, Yu J, Liang P. Theranostic liposomes as nanodelivered chemotherapeutics enhanced the microwave ablation of hepatocellular carcinoma. Nanomedicine (Lond) 2019; 14:2151-2167. [PMID: 31411535 DOI: 10.2217/nnm-2018-0424] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Aim: This study aimed to develop indocyanine green- and doxorubicin-loaded liposomes (DILPs) as theranostic nanoplatform for the detection of hepatocellular carcinoma (HCC) and as an efficient chemotherapeutic to enhance microwave ablation. Materials & methods: DILPs were synthesized and thoroughly characterized. Biocompatibility, tumor uptake and accumulation, and synergistic ablation-chemotherapeutic efficiency were systematically explored in them. In addition, human HCC surgical samples were used to test the affinity of DILPs for HCC. Results: The combination of microwave ablation and DILPs enhanced the ablation efficiency of HCC with apparent tumor inhibition. DILPs exhibited excellent diagnostic ability and could detect 2.5-mm HCC lesions via optoacoustic tomography imaging. DILPs had better affinity for human HCC surgical samples compared with normal liver tissue. Conclusion: Theranostic DILPs could serve as promising nanoparticles for treatment and management of HCC in the clinic.
Collapse
Affiliation(s)
- Qunfang Zhou
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing 100853, PR China.,Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, PR China
| | - Kun Wang
- Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, PR China
| | - Jianping Dou
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing 100853, PR China
| | - Feng Cao
- Department of Cardiology, Chinese PLA General Hospital, Beijing 100853, PR China
| | - Fengyong Liu
- Department of Interventional Radiology, Chinese PLA General Hospital, Beijing 100853, PR China
| | - Hongjun Yuan
- Department of Interventional Radiology, Chinese PLA General Hospital, Beijing 100853, PR China
| | - Mengjuan Mu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing 100853, PR China
| | - Jinshun Xu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing 100853, PR China
| | - Dongyun Zhang
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing 100853, PR China
| | - Xin Li
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing 100853, PR China
| | - Jie Tian
- Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, PR China
| | - Jie Yu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing 100853, PR China
| | - Ping Liang
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing 100853, PR China
| |
Collapse
|
29
|
Liu F, Yuan H, Li X, Ma X, Wang M. Application of Hypothermic Perfusion via a Renal Artery Balloon Catheter During Robot-assisted Partial Nephrectomy and Effect on Renal Function. Acad Radiol 2019; 26:e196-e201. [PMID: 31284936 DOI: 10.1016/j.acra.2018.09.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 09/25/2018] [Accepted: 09/26/2018] [Indexed: 10/28/2022]
Abstract
RATIONALE OBJECTIVES To assess the feasibility, safety, and effect of hypothermic perfusion on postoperative renal function employing a renal artery balloon catheter inserted via robot-assisted partial nephrectomy (h-RAPN) to treat renal tumors. MATERIALS AND METHODS Forty-three patients with renal tumors were studied between March 2013 and August 2017. Renal artery balloon catheters were placed under angiographic guidance, and the balloon was fully inflated to occlude the renal artery during surgery. After establishing venous outflow, a robot-assisted partial nephrectomy was performed following perfusion with sodium lactate Ringer's solution at 4°C through the balloon catheter. Renal dynamic imaging was used to assess renal function, with calculation units consisting of glomerular filtration rate per unit volume of the kidney (GFR-UV). RESULTS Six patients were converted to radical nephrectomy intraoperatively, and the remaining 37 patients successfully underwent the h-RAPN procedure. Two patients had incomplete occlusion of the renal artery and received supplementary arterial clamp occlusion intraoperatively. One patient's balloon catheter slipped out of position preoperatively, and the patient was returned to the interventional radiology suite for balloon reinsertion, after which the patient underwent surgery successfully. No patients had severe complications. The average cold ischemia time was 39.5 ± 9.7 min (range, 22-123 min), the average temperature of the affected kidney during surgery was 19.3 ± 3.5°C (17.2-26.7°C), the average postoperative GFR-UV of the affected kidney was 0.42 ± 0.09 ml/min/ml (0.21-1.24 ml/min), and the average postoperative GFR-UV of the healthy kidney was 0.30 ± 0.04 ml/min/ml (P > 0.05). Multiple regression analysis indicated that cold ischemia time was an independent risk factor affecting the postoperative GFR of the affected kidney. CONCLUSION The advantages of h-RAPN include a clear surgical field enabling precise resection. When hypothermic perfusion via a renal artery balloon catheter is performed in conjunction with h-RAPN, the surgical time can be lengthened without increasing impairment of the affected kidney function, making this a safe and effective method of treating kidney tumors.
Collapse
|
30
|
Yuan H, Lan Y, Li X, Tang J, Liu F. Large hepatocellular carcinoma with local remnants after transarterial chemoembolization: treatment by sorafenib combined with radiofrequency ablation or sorafenib alone. Am J Cancer Res 2019; 9:791-799. [PMID: 31106004 PMCID: PMC6511642] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 03/25/2019] [Indexed: 06/09/2023] Open
Abstract
The present study aims to investigate retrospectively the efficacy and safety of sorafenib combined with radiofrequency ablation (RFA) to treat unresectable remnant large hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE). The 229 consecutive patients with unresectable remnant large HCC (diameter ≥ 5 cm) received RFA and sorafenib (RFA + Sor group, n = 102) or sorafenib (Sor group, n = 127) from January 2010 to January 2016. Complications and overall survival (OS) of the two groups were compared and subgroup analysis carried out. Survival curves were drawn using the Kaplan-Meier method. The RFA + Sor group had no additional serious adverse events. The average OS was 18.3 ± 1.6 months (95% confidence interval [CI]: 15.2-21.4) in the RFA + Sor group and 14.1 ± 1.1 months (95% CI: 11.8-16.3) in the Sor group, a difference the log-rank test indicated was significant (P = 0.03). The 1-, 2- and 3-year survival rates of the RFA + Sor group were 56.9%, 34.3%, and 11.7%, and those of the Sor group were 42.5%, 22.0%, and 5.5%, respectively. The between-group differences in 1- and 2-year survival rates were statistically significant, but not the difference in 3-year survival rates. Subgroup analysis showed that the RFA + Sor group achieved significantly more lifetime benefits than the Sor group in: patients with tumors 5-10 cm in diameter (hazard ratio [HR] 0.42, 95% CI 0.21-1.06 vs. HR 0.94, 95% CI 0.63-1.22); patients with an isolated tumor (HR 0.36, 95% CI 0.19-0.81 vs. HR 0.93, 95% CI 0.55-1.24); and patients with remnant lesion volume < 50% after TACE (HR 0.47, 95% CI 0.21-1.12 vs. HR 0.77, 95% CI 0.46-0.81). RFA with sorafenib is safe and effective for unresectable remnant large HCC, controlling tumor progression and prolonging survival better than sorafenib alone.
Collapse
Affiliation(s)
- Hongjun Yuan
- Department of Interventional Radiology, The First Medical Center of PLA General Hospital28 Fuxing Road, Beijing 100853, China
| | - Yina Lan
- Department of Radiology, The First Medical Center of PLA General Hospital28 Fuxing Road, Beijing 100853, China
| | - Xin Li
- Department of Interventional Radiology, The First Medical Center of PLA General Hospital28 Fuxing Road, Beijing 100853, China
| | - Jing Tang
- Department of Interventional Radiology, The First Medical Center of PLA General Hospital28 Fuxing Road, Beijing 100853, China
| | - Fengyong Liu
- Department of Interventional Radiology, The First Medical Center of PLA General Hospital28 Fuxing Road, Beijing 100853, China
| |
Collapse
|
31
|
Yuan H, Liu F, Li X, Guan Y, Wang M. Angio-CT-Guided Transarterial Chemoembolization Immediately in Combination with Radiofrequency Ablation for Large Hepatocellular Carcinoma. Acad Radiol 2019; 26:224-231. [PMID: 29907399 DOI: 10.1016/j.acra.2018.04.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 04/14/2018] [Accepted: 04/15/2018] [Indexed: 12/12/2022]
Abstract
RATIONALE AND OBJECTIVES To evaluate the method and effectiveness of Angio-CT-guided transcatheter arterial chemoembolization (TACE) immediately in combination with radiofrequency ablation (RFA) in the treatment of large hepatocellular carcinomas (HCCs; maximum enhancing diameter >5 cm). MATERIALS AND METHODS A retrospective analysis was conducted on 48 patients with solitary large HCCs who were admitted from October 2012 to June 2016 and treated by immediate combination therapy, and 48 patients with solitary large HCCs who were treated by a sequential combination (RFA at 2-4 weeks after TACE) therapy in the same period were randomly selected as controls. After treatment, the success rates of the immediately combined technique, the short-term outcomes of the immediately combined treatment (using the modified response evaluation criteria in solid tumor standard), and the survival rates were evaluated. RESULTS The success rate of the immediately combined technique was 100%. The complete remission rates 1, 3, and 6 months after treatment in the study group were 58.3%༌56.2%, and 47.9%, respectively, while the corresponding complete remission rates of control group were 37.5%, 33.3%, and 27.1%, respectively. The 1-, 2-, and 3-year survival rates of the study group were 95.8%, 85.4%, and 58.3%, respectively, while the corresponding survival rates of the control group were 83.3%, 68.7%, and 43.8%, respectively. None of the patients had any serious complications. CONCLUSION Angio-CT-guided TACE immediately in combination with RFA is a feasible, safe method for the treatment of large HCCs with excellent short-term outcomes and improved long-term prognoses.
Collapse
Affiliation(s)
- Hongjun Yuan
- Chinese People's Liberation Army General Hospital, Department of Interventional Radiology, 28 Fuxing Road, Beijing 100853, China
| | - Fengyong Liu
- Chinese People's Liberation Army General Hospital, Department of Interventional Radiology, 28 Fuxing Road, Beijing 100853, China.
| | - Xin Li
- Chinese People's Liberation Army General Hospital, Department of Interventional Radiology, 28 Fuxing Road, Beijing 100853, China
| | - Yang Guan
- Chinese People's Liberation Army General Hospital, Department of Interventional Radiology, 28 Fuxing Road, Beijing 100853, China
| | - Maoqiang Wang
- Chinese People's Liberation Army General Hospital, Department of Interventional Radiology, 28 Fuxing Road, Beijing 100853, China
| |
Collapse
|
32
|
Qiao Y, Ping Y, Zhang H, Zhou B, Liu F, Yu Y, Xie T, Li W, Zhong D, Zhang Y, Yao K, Santos HA, Zhou M. Laser-Activatable CuS Nanodots to Treat Multidrug-Resistant Bacteria and Release Copper Ion to Accelerate Healing of Infected Chronic Nonhealing Wounds. ACS Appl Mater Interfaces 2019; 11:3809-3822. [PMID: 30605311 PMCID: PMC6727190 DOI: 10.1021/acsami.8b21766] [Citation(s) in RCA: 127] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Accepted: 01/03/2019] [Indexed: 05/15/2023]
Abstract
Chronic nonhealing wounds have imposed serious challenges in the clinical practice, especially for the patients infected with multidrug-resistant microbes. Herein, we developed an ultrasmall copper sulfide (covellite) nanodots (CuS NDs) based dual functional nanosystem to cure multidrug-resistant bacteria-infected chronic nonhealing wound. The nanosystem could eradicate multidrug-resistant bacteria and expedite wound healing simultaneously owing to the photothermal effect and remote control of copper-ion release. The antibacterial results indicated that the combination treatment of photothermal CuS NDs with photothermal effect initiated a strong antibacterial effect for drug-resistant pathogens including methicillin-resistant Staphylococcus aureus (MRSA) and extended-spectrum β-lactamase Escherichia coli both in vitro and in vivo. Meanwhile, the released Cu2+ could promote fibroblast cell migration and endothelial cell angiogenesis, thus accelerating wound-healing effects. In MRSA-infected diabetic mice model, the nanosystem exhibited synergistic wound healing effect of infectious wounds in vivo and demonstrated negligible toxicity and nonspecific damage to major organs. The combination of ultrasmall CuS NDs with photothermal therapy displayed enhanced therapeutic efficacy for chronic nonhealing wound in multidrug-resistant bacterial infections, which may represent a promising class of antibacterial strategy for clinical translation.
Collapse
Affiliation(s)
- Yue Qiao
- Eye Center &
Department of Nuclear Medicine, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
- Institute of Translational Medicine and Key Laboratory
of Cancer Prevention and Intervention, National Ministry of Education, Zhejiang University, Hangzhou 310009, China
| | - Yuan Ping
- College of Pharmaceutical Sciences and State Key Laboratory
of Modern Optical Instrumentations, Zhejiang
University, Hangzhou 310058, China
| | - Hongbo Zhang
- Department of Pharmaceutical
Science Laboratory, Åbo Akademi University, Turku 20520, Finland
| | - Bo Zhou
- Institute of Translational Medicine and Key Laboratory
of Cancer Prevention and Intervention, National Ministry of Education, Zhejiang University, Hangzhou 310009, China
| | - Fengyong Liu
- Department of Interventional Radiology, Chinese PLA General Hospital, Beijing 100853, China
| | - Yinhui Yu
- Eye Center &
Department of Nuclear Medicine, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
- Zhejiang Provincial Key Laboratory of Ophthalmology, Hangzhou 310009, China
| | - Tingting Xie
- Institute of Translational Medicine and Key Laboratory
of Cancer Prevention and Intervention, National Ministry of Education, Zhejiang University, Hangzhou 310009, China
| | - Wanli Li
- Institute of Translational Medicine and Key Laboratory
of Cancer Prevention and Intervention, National Ministry of Education, Zhejiang University, Hangzhou 310009, China
| | - Danni Zhong
- Institute of Translational Medicine and Key Laboratory
of Cancer Prevention and Intervention, National Ministry of Education, Zhejiang University, Hangzhou 310009, China
| | - Yuezhou Zhang
- Department of Pharmaceutical
Science Laboratory, Åbo Akademi University, Turku 20520, Finland
| | - Ke Yao
- Eye Center &
Department of Nuclear Medicine, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
- Zhejiang Provincial Key Laboratory of Ophthalmology, Hangzhou 310009, China
| | - Hélder A. Santos
- Drug Research Program, Division
of Pharmaceutical Chemistry and Technology, Faculty of Pharmacy and Helsinki Institute
of Life Science, HiLIFE, University of Helsinki, Helsinki FI-00014, Finland
| | - Min Zhou
- Eye Center &
Department of Nuclear Medicine, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
- Institute of Translational Medicine and Key Laboratory
of Cancer Prevention and Intervention, National Ministry of Education, Zhejiang University, Hangzhou 310009, China
- College of Pharmaceutical Sciences and State Key Laboratory
of Modern Optical Instrumentations, Zhejiang
University, Hangzhou 310058, China
| |
Collapse
|
33
|
Liu F, Li X, Li Y, Qi Y, Yuan H, He J, Li W, Zhou M. Designing pH-triggered drug release iron oxide nanocomposites for MRI-guided photothermal-chemoembolization therapy of liver orthotopic cancer. Biomater Sci 2019; 7:1842-1851. [PMID: 30942214 DOI: 10.1039/c9bm00056a] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
In an orthotopic liver cancer model, non-toxic versatile theranostic NPs consisting of an MRI contrast agent and a pH-sensitive and photothermal functional coating were delivered to improve tumor targeting efficacy.
Collapse
Affiliation(s)
- Fengyong Liu
- Department of Interventional Radiology
- The First Medical Center of Chinese PLA General Hospital
- Beijing 100853
- China
| | - Xin Li
- Department of Interventional Radiology
- The First Medical Center of Chinese PLA General Hospital
- Beijing 100853
- China
| | - Yangyang Li
- Department of Nuclear Medicine & Key Laboratory of Cancer Prevention and Intervention
- National Ministry of Education
- The Second Affiliated Hospital
- School of Medicine
- Zhejiang University
| | - Yuchen Qi
- Institute of Translational Medicine
- Zhejiang University
- Hangzhou 310009
- China
| | - Hongjun Yuan
- Department of Interventional Radiology
- The First Medical Center of Chinese PLA General Hospital
- Beijing 100853
- China
| | - Jian He
- Institute of Translational Medicine
- Zhejiang University
- Hangzhou 310009
- China
| | - Wanlin Li
- Institute of Translational Medicine
- Zhejiang University
- Hangzhou 310009
- China
| | - Min Zhou
- Department of Nuclear Medicine & Key Laboratory of Cancer Prevention and Intervention
- National Ministry of Education
- The Second Affiliated Hospital
- School of Medicine
- Zhejiang University
| |
Collapse
|
34
|
Dong YZ, Liu FY, Guo YC. [Clinical analysis of the double-wing flap for treatment of toe syndactyly]. Zhonghua Wai Ke Za Zhi 2018; 56:906-909. [PMID: 30497117 DOI: 10.3760/cma.j.issn.0529-5815.2018.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the clinical effect of double-wing flap for the treatment of toe syndactyly. Methods: Retrospective analysis of 47 patients (60 syndactyly toes) who underwent double-wing flap to reconstruct toe web space in orthopedics department of the Third Affiliated Hospital of Zhengzhou University from February 2010 to October 2017.There were 21 males and 26 females, with an average age of 18.9 months (range: 10-48 months). All patients were treated with zigzag incisions to separate the toe syndactylys without skin grafts.The condition of wound healing and appearance of toes were observed. Results: The average follow-up time was 62.3 months (range: 6 to 80 months). There were no complications such as hematoma, infection, flap necrosis and no flexion contracture and obvious scar hyperplasia in all the 47 cases, 4 of the 60 webs developed web creep.All webs had good appearance with 45 degrees inclination from the dorsal to the metatarsal side and had good flexion and abduction function. Conclusions: The double-wing flap is a simple and safe operation for toe syndactyly which has a good clinical effect.
Collapse
Affiliation(s)
- Y Z Dong
- Orthopedics Department, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | | | | |
Collapse
|
35
|
Zhang D, Liang W, Zhang M, Liang P, Gu Y, Kuang M, Cao F, Yu X, Liu F, Yu J. Multiple antenna placement in microwave ablation assisted by a three-dimensional fusion image navigation system for hepatocellular carcinoma. Int J Hyperthermia 2018; 35:122-132. [PMID: 30300036 DOI: 10.1080/02656736.2018.1484183] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Affiliation(s)
- Dezhi Zhang
- Chinese PLA General Hospital, Interventional Ultrasound, Beijing, China
- Department of Ultrasound, First Hospital of Jilin University, ChangChun, China
| | - Wenzhao Liang
- China-Japan Union Hospital of Jilin University, Changchun, China
| | - Min Zhang
- General Hospital of Xinjiang Military Region, Ultrasound, Urumqi, China
| | - Ping Liang
- Department of Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Ying Gu
- Chinese PLA General Hospital, Laser Medicine, Beijing, China
| | - Ming Kuang
- Department of Liver Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Division of Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Feng Cao
- Chinese PLA General hospital, Cardiology, Beijing, China
| | - Xiaoling Yu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Fengyong Liu
- Chinese PLA General Hospital, Interventional Radiology, Beijing, China
| | - Jie Yu
- Interventional Ultrasound Department, Chinese PLA General Hospital, Beijing, China
| |
Collapse
|
36
|
Yuan H, Liu F, Li X, Guan Y, Wang M. Transcatheter arterial chemoembolization combined with simultaneous DynaCT-guided radiofrequency ablation in the treatment of solitary large hepatocellular carcinoma. Radiol Med 2018; 124:1-7. [PMID: 30132184 PMCID: PMC6339665 DOI: 10.1007/s11547-018-0932-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 08/07/2018] [Indexed: 01/01/2023]
Abstract
PURPOSE To introduce the technique and investigate the clinical efficacy of transcatheter arterial chemoembolization (TACE) in combination with simultaneous DynaCT-guided radiofrequency ablation (RFA) in the treatment of solitary large hepatocellular carcinomas (HCCs) (maximal diameter > 5 cm). MATERIALS AND METHODS Forty-six patients who received TACE combined with simultaneous DynaCT-guided RFA for solitary large HCCs between January 2012 and August 2016 were reviewed, and the success rate, safety, local tumor progression (LTP), and overall survival (OS) were retrospectively investigated. OS and time to progression were analyzed with the Kaplan-Meier method. RESULTS Technical success rate was 100%, average operative time for DynaCT-guided RFA was 45.3 ± 4.8 min, average radiation dose was 730.5 ± 78.8 mGy, and no life-threatening complications were observed. At 1-month follow-up enhanced MRI, complete remission was achieved in 82.6% of patients (38/46), and partial remission in 17.4% (8/46). The median follow-up period was 29.5 months (interquartile range 4.0-69.0 months). At 1, 2, and 3 years after surgery, the LTP rates were 4.3, 13.1, and 30.4%, respectively, and the OS rates were 89.1, 71.7, and 56.5%, respectively. CONCLUSION DynaCT-guided TACE + RFA is safe and feasible for the treatment of solitary large HCCS. TACE combined with simultaneous RFA provides a new treatment option for solitary large HCCs in which DynaCT has important clinical value.
Collapse
Affiliation(s)
- Hongjun Yuan
- Department of Interventional Radiology, General Hospital of People's Liberation Army, 28 Fuxing Road, Beijing, 100853, People's Republic of China
| | - Fengyong Liu
- Department of Interventional Radiology, General Hospital of People's Liberation Army, 28 Fuxing Road, Beijing, 100853, People's Republic of China.
| | - Xin Li
- Department of Interventional Radiology, General Hospital of People's Liberation Army, 28 Fuxing Road, Beijing, 100853, People's Republic of China
| | - Yang Guan
- Department of Interventional Radiology, General Hospital of People's Liberation Army, 28 Fuxing Road, Beijing, 100853, People's Republic of China
| | - Maoqiang Wang
- Department of Interventional Radiology, General Hospital of People's Liberation Army, 28 Fuxing Road, Beijing, 100853, People's Republic of China
| |
Collapse
|
37
|
Yuan H, Liu F, Li X, Guan Y, Wang M. Clinical efficacy of chemoembolization with simultaneous radiofrequency ablation for treatment of adrenal metastases from hepatocellular carcinoma. Cancer Imaging 2018; 18:24. [PMID: 30064514 PMCID: PMC6069544 DOI: 10.1186/s40644-018-0157-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 03/30/2018] [Accepted: 07/16/2018] [Indexed: 12/11/2022] Open
Abstract
Background This study investigated the safety and efficacy of transcatheter arterial chemoembolization (TACE) with simultaneous radiofrequency ablation (RFA) as treatment for adrenal metastases (AM) from hepatocellular carcinoma(HCC). Methods The records of 63 patients with AM who were treated at our Hospital between February 2013 and August 2016 were retrospectively reviewed. Patients were divided into a TACE+RFA group (n = 38) and a control group that received TACE alone (n = 25) according to different treatment methods. The success rate, tumor control rate, and safety of these groups were compared, and survival was evaluated using the Kaplan-Meier method. Results All treatments could be completed technically successful in both groups. The tumor control rate at first imaging after 1 months was 92.1% (35/38) in the TACE+RFA group and 76.0% (19/25) in the TACE group(P = 0.041). The assisted local tumor control rate allowing repeated interventions in case of local recurrence was 70.0% (7/10) in the TACE+RFA group and 30.8% (4/13) in the TACE group (P = 0.039). During the follow up period, the TACE+RFA group had better survival than the TACE group at 1 year (92.1% vs. 88.0%), 2 years (73.7% vs. 64.0%), and 3 years (55.3% vs. 44.0%) (P = 0.040). The mean survival time was 26.8 ± 2.0 months (95% CI, 22.8–30.7) in the TACE+RFA group and 17.5 ± 2.2 months (95% CI, 13.1–21.8) in the TACE group. Conclusion TACE+RFA led to better control of local disease progression and longer survival time than TACE alone in the treatment of AM from HCC. Although patients given TACE+RFA had more complications than those given TACE alone, these complications were easily managed.
Collapse
Affiliation(s)
- Hongjun Yuan
- Department of Interventional Radiology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, People's Republic of China
| | - Fengyong Liu
- Department of Interventional Radiology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, People's Republic of China.
| | - Xin Li
- Department of Interventional Radiology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, People's Republic of China
| | - Yang Guan
- Department of Interventional Radiology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, People's Republic of China
| | - Maoqiang Wang
- Department of Interventional Radiology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, People's Republic of China
| |
Collapse
|
38
|
Liu XJ, Wang BY, Ren YC, Zhao Y, Liu DC, Zhang DD, Chen X, Liu LL, Cheng C, Liu FY, Zhou QG, Chen GZ, Hong SH, Liu D, Hu SQ, Zhang M, Hu DS. [A cohort study on body mass index and risk of all-cause mortality among hypertensive population]. Zhonghua Liu Xing Bing Xue Za Zhi 2018; 39:914-919. [PMID: 30060304 DOI: 10.3760/cma.j.issn.0254-6450.2018.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the relationship between body mass index (BMI) and all-cause mortality in hypertensive population. Methods: All participants were selected from a prospective cohort study based on a rural population from Henan province, China. Cox proportional hazards regression models were used to estimate the associations of different levels of BMI stratification with all-cause mortality. Restricted cubic spline models were used to detect the dose-response relation. Results: Among the 5 461 hypertensive patients, a total of 31 048.38 person-years follow-up was conducted. The median of follow-up time was 6 years, and 589 deaths occurred during the follow-up period. Compared to normal weight group (18.5 kg/m(2)<BMI<24.0 kg/m(2)) the multivariate-adjusted hazard ratios for all-cause mortality associated with BMI levels (<18.5 kg/m(2), 24-28 kg/m(2), and ≥28 kg/m(2)) were 0.83 (95%CI: 0.37-1.87), 0.81 (95%CI: 0.67-0.97), and 0.72 (95%CI: 0.56-0.91), respectively. The dose-response analysis showed a nonlinear, reverse "S" shaped relationship (non-linearity P<0.001). Conclusion: Overweight or obese might have a protective effect on all-cause mortality in hypertensive population, which supports the "obesity paradox" phenomenon.
Collapse
Affiliation(s)
- X J Liu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - B Y Wang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Y C Ren
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Y Zhao
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - D C Liu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - D D Zhang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - X Chen
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - L L Liu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - C Cheng
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - F Y Liu
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen 518060, China
| | - Q G Zhou
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen 518060, China
| | - G Z Chen
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen 518060, China
| | - S H Hong
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen 518060, China
| | - D Liu
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen 518060, China
| | - S Q Hu
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen 518060, China
| | - M Zhang
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen 518060, China
| | - D S Hu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| |
Collapse
|
39
|
Li Y, Liu Y, Liu C, Liu F, Dou D, Zheng W, Liu W, Liu F. Role of a non-canonical splice variant of the Helios gene in the differentiation of acute lymphoblastic leukemic T cells. Oncol Lett 2018; 15:6957-6966. [PMID: 29725423 DOI: 10.3892/ol.2018.8214] [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: 08/13/2017] [Accepted: 02/21/2018] [Indexed: 11/05/2022] Open
Abstract
T-cell acute lymphoblastic leukemia is a hematopoietic malignant disease, which arises from a genetic defect in the T-cell maturation signaling pathway. As a result, it is necessary to identify the molecules that impact T-cell development and control lymphoid-lineage malignancy. The present study utilized Jurkat T lymphoblastic cells as a well-established approach for the investigation into the function of the non-canonical alternative splice variant of Helios for the in vitro study of T-cell differentiation and leukemogenesis. In the present study, the Jurkat T-cell lines with stable overexpression of the wild-type (Helios-1) or the non-canonical short isoform (Helios-Δ326-1431), were established. RNA microarray, reverse transcription-quantitative polymerase chain reaction and flow cytometry were used to assess changes in the gene expression profiles and to monitor the cell surface markers during T-cell differentiation. Multiple genes associated with T-cell differentiation and leukemogenesis were identified as being either activated or suppressed. In addition, the results indicated that the stable overexpression of the Helios isoforms stimulated the differentiation pathway of the T-lineage lymphoblastic cells. Therefore, these results suggest that full-length Helios-1 has a tumor suppressor-like and immunomodulatory role, in contrast to the oncogenic function of the non-canonical short isoform Helios-Δ326-1431.
Collapse
Affiliation(s)
- Yinghui Li
- Department of Immunology, School of Medicine, Nankai University, Tianjin 300071, P.R. China
| | - Yanhua Liu
- Department of Immunology, School of Medicine, Nankai University, Tianjin 300071, P.R. China
| | - Can Liu
- Department of Immunology, School of Medicine, Nankai University, Tianjin 300071, P.R. China
| | - Fengyong Liu
- Department of Pathophysiology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin 300070, P.R. China
| | - Daolei Dou
- Department of Experimental Facility, State Key Laboratory of Medical Chemical Biology, Tianjin 300071, P.R. China
| | - Wenjie Zheng
- Technical Center for Safety of Industrial Products, Tianjin Entry-Exit Inspection and Quarantine Bureau, Tianjin 300308, P.R. China
| | - Wei Liu
- Technical Center for Safety of Industrial Products, Tianjin Entry-Exit Inspection and Quarantine Bureau, Tianjin 300308, P.R. China
| | - Feifei Liu
- Department of Immunology, School of Medicine, Nankai University, Tianjin 300071, P.R. China
| |
Collapse
|
40
|
Li Y, Wei Q, Ma F, Li X, Liu F, Zhou M. Surface-enhanced Raman nanoparticles for tumor theranostics applications. Acta Pharm Sin B 2018; 8:349-359. [PMID: 29881674 PMCID: PMC5989827 DOI: 10.1016/j.apsb.2018.03.007] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [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: 01/14/2018] [Revised: 03/07/2018] [Accepted: 03/14/2018] [Indexed: 02/07/2023] Open
Abstract
Raman spectroscopy, amplified by surface-enhanced Raman scattering (SERS) nanoparticles, can provide an in vivo imaging modality due to its high molecular specificity, high sensitivity, and negligible autofluorescence. The basis, composition, and methodologies developed for SERS nanoparticles are herein described. The research hotspots that are the focus in this paper are tumor imaging-guided theranostics and biosensing. The next breakthrough may be the development of biocompatible SERS nanoparticles and spectroscopic devices for clinical applications.
Collapse
Affiliation(s)
- Yangyang Li
- Department of Nuclear Medicine & Key Laboratory of Cancer Prevention and Intervention, National Ministry of Education, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China
- Institute of Translational Medicine, Zhejiang University, Hangzhou 310009, China
| | - Qiaolin Wei
- Department of Nuclear Medicine & Key Laboratory of Cancer Prevention and Intervention, National Ministry of Education, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China
- Institute of Translational Medicine, Zhejiang University, Hangzhou 310009, China
| | - Fei Ma
- Department of Nuclear Medicine & Key Laboratory of Cancer Prevention and Intervention, National Ministry of Education, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China
- Institute of Translational Medicine, Zhejiang University, Hangzhou 310009, China
| | - Xin Li
- Department of Interventional Radiology, Chinese PLA General Hospital, Beijing 100853, China
| | - Fengyong Liu
- Department of Interventional Radiology, Chinese PLA General Hospital, Beijing 100853, China
| | - Min Zhou
- Department of Nuclear Medicine & Key Laboratory of Cancer Prevention and Intervention, National Ministry of Education, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China
- Institute of Translational Medicine, Zhejiang University, Hangzhou 310009, China
- State Key Laboratory of Modern Optical Instrumentations, Zhejiang University, Hangzhou 310058, China
| |
Collapse
|
41
|
Li D, Cheng Z, Chen G, Liu F, Wu W, Yu J, Gu Y, Liu F, Ren C, Liang P. A multimodality imaging-compatible insertion robot with a respiratory motion calibration module designed for ablation of liver tumors: a preclinical study. Int J Hyperthermia 2018; 34:1194-1201. [PMID: 29566561 DOI: 10.1080/02656736.2018.1456680] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Affiliation(s)
- Dongrui Li
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Zhigang Cheng
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Gang Chen
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Fangyi Liu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Wenbo Wu
- Beijing Baihui Weikang Medical Robot Technology Co., Ltd, Beijing, China
| | - Jie Yu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Ying Gu
- Department of Laser Medicine, Chinese PLA General Hospital, Beijing, China
| | - Fengyong Liu
- Department of Intervention Therapy, Chinese PLA General Hospital, Beijing, China
| | - Chao Ren
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Ping Liang
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| |
Collapse
|
42
|
Ye SL, Yang J, Bie P, Zhang S, Chen X, Liu F, Liu L, Zhou J, Dou K, Hao C, Shao G, Xia Q, Chen Y, Yang J, Deng X, Liu Y, Yuan Y, Fu Z, Nakajima K, Lv Z. Safety assessment of sorafenib in Chinese patients with unresectable hepatocellular carcinoma: subgroup analysis of the GIDEON study. BMC Cancer 2018; 18:247. [PMID: 29499662 PMCID: PMC5834849 DOI: 10.1186/s12885-018-4144-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 02/19/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND This study aimed to investigate the safety of sorafenib for the treatment of unresectable hepatocellular carcinoma in Chinese patients. METHODS A subgroup of 345 Chinese patients from the international database of the Global Investigation of therapeutic DEcisions in hepatocellular carcinoma and Of its treatment with sorafeNib (GIDEON) study was included in this analysis. Safety assessment measures were adverse events (AEs) and serious adverse events (SAEs) graded using the National Cancer Institute Common Terminology Criteria version 3.0. RESULTS Of 331 evaluable patients, 98% started sorafenib at 800 mg/day. The median treatment duration was 22 weeks (range, 0.1-116 weeks), and median overall survival (OS) was 322 days (10.7 months). Approximately 50% of patients had at least one adverse event, and 6% had grade 3-4 adverse events. Drug-related adverse events were experienced by 29% of patients, and 3.6% had grade 3-4 drug-related adverse events. Overall, 23% of patients (n = 77) experienced serious adverse events, among which only 1 event was drug-related (0.3%). No differences in overall adverse events, serious adverse events, and deaths were observed between Child-Pugh A and Child-Pugh B patients. The most frequent drug-related adverse events were dermatological/skin (24%), hand-foot skin reaction (20%), gastrointestinal (11%), and diarrhea (11%). The majority of adverse events occurred within 30 days of beginning sorafenib. CONCLUSION Sorafenib has satisfactory efficacy and safety in Chinese Child-Pugh A and B patients with unresectable HCC using the recommended dosage of 800 mg/day, and the safety of sorafenib is not affected by liver function. Prophylaxis for gastrointestinal adverse events may help to decrease dose interruptions or discontinuation. TRIAL REGISTRATION ClinicalTrials.gov ; Identifier: NCT00812175. Date of registration: December 19, 2008.
Collapse
Affiliation(s)
- Sheng-Long Ye
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, 136 Yixueyuan Rd, Shanghai, 200032, China.
| | - Jiamei Yang
- Department of Special Treatment, Eastern Hepatobiliary Surgery Hospital, Shanghai, China
| | - Ping Bie
- Institute of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Shuijun Zhang
- Department of General Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaoping Chen
- Department of Surgery, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fengyong Liu
- Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, China
| | - Luming Liu
- Shanghai Cancer Center, Fudan University, Shanghai, China
| | - Jie Zhou
- Department of Hepatobiliary Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, China
| | - Kefeng Dou
- Department of Hepatobiliary Surgery, Xijing Hospital, Xi'an, China
| | - Chunyi Hao
- Department of Hepato-Pancreato-Biliary Surgery, Beijing Cancer Hospital, Peking University, Beijing, China
| | - Guoliang Shao
- Department of Radiology, Zhejiang Cancer Hospital, Hangzhou, China
| | - Qiang Xia
- Department of Liver Surgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yajin Chen
- Department of Hepatobiliary Surgery, Second Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Jijin Yang
- Department of Nuclear Medicine, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Xiaxing Deng
- Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yunpeng Liu
- Department of Medical Oncology, the First Hospital of China Medical University, Shenyang, China
| | - Yunfei Yuan
- Department of Hepatobiliary, Cancer Center, Sun Yat-sen University, Guangzhou, China
| | - Zhiren Fu
- Department of Liver Transplantation, Shanghai Changzheng Hospital, Shanghai, China
| | | | | |
Collapse
|
43
|
Fu J, Liu F, Yuan K, Yan J, Wang Y, Zhang J, Yuan B, Wang M. The Value of Hybrid Angio-CT in Preoperative Detection and Localization of Insulinomas: A Single-Center Retrospective Study. Cardiovasc Intervent Radiol 2017; 41:633-638. [PMID: 29167968 DOI: 10.1007/s00270-017-1847-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 11/13/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To investigate the performance of hybrid angio-CT in preoperative detection and localization for insulinomas. METHODS Fifty-four postoperative pathology-confirmed patients from April 2015 to March 2017 were retrospectively reviewed; all patients underwent angio-CT with administration of contrast media in SMA, GDA and SA due to negative, inconclusive or controversial findings by several preoperative diagnostic methods including TAUS, CEUS, EUS, ECT, EMRI and DSA. Surgery was used as gold standard for localization of insulinomas; detection sensitivity and localization accuracy of angio-CT were assessed and compared with other preoperative image options. RESULTS Fifty-six benign insulinomas (mean diameter, 15.8 mm) in 54 patients (18 men and 36 women) were found according to surgical results; the overall detection sensitivity of TAUS, CEUS, EUS, ECT, EMRI and DSA was 21.4, 78.4, 79.2, 70.0, 79.2 and 72.2%, respectively. The overall localization accuracy was 14.3, 58.8, 68.8, 60.0, 75.0 and 44.4%, respectively. A total of 53 tumors were detected by angio-CT, 51 tumors were accurately located, and the overall detection sensitivity and localization accuracy of angio-CT was 94.4 and 90.7%, which was significantly higher than that of all other preoperative diagnostic methods (p < 0.05). No any serious complications occurred during angio-CT. CONCLUSION Our study indicates the great potential value of angio-CT in the preoperative detection and localization of insulinomas; angio-CT can be used as a preferred invasive diagnostic method.
Collapse
Affiliation(s)
- Jinxin Fu
- Department of Interventional Radiology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, People's Republic of China
| | - Fengyong Liu
- Department of Interventional Radiology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, People's Republic of China
| | - Kai Yuan
- Department of Interventional Radiology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, People's Republic of China
| | - Jieyu Yan
- Department of Interventional Radiology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, People's Republic of China
| | - Yan Wang
- Department of Interventional Radiology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, People's Republic of China
| | - Jinlong Zhang
- School of Medicine, Nankai University, Tianjin, 300071, People's Republic of China
| | - Bing Yuan
- Department of Interventional Radiology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, People's Republic of China
| | - Maoqiang Wang
- Department of Interventional Radiology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, People's Republic of China.
| |
Collapse
|
44
|
Li TS, Qi Y, Wang Y, Wang YX, Liu FY, Dai L, Xia GG. [Extensive burns complicated with infective endocarditis and septic pulmonary embolism: case report and literature review]. Zhonghua Jie He He Hu Xi Za Zhi 2017; 39:773-778. [PMID: 27784495 DOI: 10.3760/cma.j.issn.1001-0939.2016.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To improve the clinical recognition of infective endocarditis (IE) and septic pulmonary embolism (SPE) in patients with extensive burns. Methods: A case of large area burn complicated with IE and SPE confirmed by blood cultures and echocardiography was described. A literature review was performed with "burn" and "infective endocarditis" as the Chinese key words in Wanfang database; with "burn" and "infective endocarditis" as Mesh terms in PubMed. Results: The patient was a 37-year-old male with large area burn, who presented with fever and hemoptysis. Blood cultures were positive for methicillin resistant Staphylococcus aureus (MRSA). Echocardiography disclosed vegetations located in the tricuspid valve. Multiple wedge-shaped lesions were found on chest CT. From January 1978 to December 2015, 26 related articles were retrieved and 134 burned patients complicated with endocarditis were reported, of which, 97 cases were IE and 1 case with SPE. Of the 134 cases, 120 cases were dead, 12 cases cured and 2 cases unknown. The mortality was 89.6%. Conclusions: There was a high mortality of burned patients complicated with IE. SPE should be considered for patients with multiple peripheral nodules in both lungs and a positive blood culture. Combination and prolonged anti-infective therapy may increase the treatment success and reduce the risk of recurrence.
Collapse
Affiliation(s)
- T S Li
- Department of Respiratory and Critical Care Medicine, Beijing Jishuitan Hospital, Beijing 100035, China
| | | | | | | | | | | | | |
Collapse
|
45
|
Ye SL, Chen X, Yang J, Bie P, Zhang S, Liu F, Liu L, Zhou J, Dou K, Yip CS, Yang X. Evaluation of sorafenib in Chinese unresectable hepatocellular carcinoma patients with prior surgery and portal vein tumor thrombosis: A subset analysis of GIDEON study data. Tumour Biol 2017; 39:1010428317695030. [PMID: 28349781 DOI: 10.1177/1010428317695030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The purpose of this study was to examine the safety and efficacy of sorafenib in Chinese patients with unresectable hepatocellular carcinoma. Data of 338 Chinese patients from the Global Investigation of therapeutic DEcisions in hepatocellular carcinoma and Of its treatment with sorafeNib study database were included. Patients were divided into those who received and did not receive sorafenib prior to surgical resection and those with and without portal vein tumor thrombosis. In the non-surgery group, the median survival was 302 days (95% confidence interval: 244-371), and the median time from diagnosis to death was 428 days (95% confidence interval: 352-556); in the surgery group, half of the patients survived for 345 days and the median time from diagnosis to death was 1000 days (95% confidence interval: 750-2816). Median progression-free survival and median time to progression were not different between the two groups. Median overall survival was 360 days (95% confidence interval: 309-435) in the non-portal vein tumor thrombosis group and 240 days (95% confidence interval: 181-296) in the portal vein tumor thrombosis group; median time between hepatocellular carcinoma diagnosis and death was 750 days (95% confidence interval: 472-1000) and 420 days (95% confidence interval: 252-567), respectively, in the two groups. Median progression-free survival was 209 days (95% confidence interval: 166-264) for patients without portal vein tumor thrombosis and 154 days (95% confidence interval: 112-202) for patients with portal vein tumor thrombosis; median time to progression was 295 days (95% confidence interval: 209-463) and 221 days, respectively. Adverse events were generally comparable regardless of prior surgery and portal vein tumor thrombosis status. We thus conclude that earlier administration of sorafenib may result in improved outcomes in patients with unresectable hepatocellular carcinoma and portal vein tumor thrombosis.
Collapse
Affiliation(s)
- Sheng-Long Ye
- 1 Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xiaoping Chen
- 2 Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Jiamei Yang
- 3 Eastern Hepatobiliary Surgery Hospital, Shanghai, China
| | - Ping Bie
- 4 Southwest Hospital, Chongqing, China
| | - Shuijun Zhang
- 5 The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | | | - Luming Liu
- 7 Shanghai Cancer Center, Fudan University, Shanghai, China
| | - Jie Zhou
- 8 Nanfang Hospital, Southern Medical University, Guangzhou, China
| | | | | | - Xiaolei Yang
- 10 Bayer Healthcare Company Ltd., Beijing, China
| |
Collapse
|
46
|
Chen S, Tan X, Wu R, Xu Y, Yang C, Wang M, Liu F, Wang Z, Yuan K. Non-enhanced MR lymphography of the thoracic duct: improved visualization following ingestion of a high fat meal-initial experience. Clin Physiol Funct Imaging 2016; 37:730-733. [PMID: 27555355 DOI: 10.1111/cpf.12366] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 03/07/2016] [Indexed: 11/30/2022]
Abstract
PURPOSE The objective of this study was to compare the clarity of magnetic resonance lymphography (MRL) images of the thoracic duct (TD) obtained from subjects following an overnight fast with those obtained from the same subjects after ingestion of a high fat meal. METHODS Nineteen healthy volunteers were included in this study. TD images were acquired on a 3·0T MRI system with the imaging sequence of magnetic resonance cholangiopancreatography. TD MRL images were obtained from subjects following an overnight fast and from the same subjects 3-4 h after ingestion of a high fat meal. Images were displayed in maximum intensity projection format and degree of visualization was evaluated using a scoring system. RESULTS The mean TD score obtained following an overnight fast was significantly lower than the mean TD score obtained 3-4 h after ingestion of a high fat meal (P<0·05). CONCLUSION The clarity of TD MRL images is improved if subjects have ingested a high fat meal 3-4 h prior to examination.
Collapse
Affiliation(s)
- Shuo Chen
- Department of Medical Imaging Center, The Second Affiliated Hospital of Shantou Universit Medical College, Shantou, China.,Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, China
| | - Xiangliang Tan
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Renhua Wu
- Department of Medical Imaging Center, The Second Affiliated Hospital of Shantou Universit Medical College, Shantou, China
| | - Yikai Xu
- Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Canhong Yang
- Department of Neurology, the Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Maoqiang Wang
- Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, China
| | - Fengyong Liu
- Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, China
| | - Zhijun Wang
- Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, China
| | - Kai Yuan
- Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, China
| |
Collapse
|
47
|
Li J, Zhou M, Liu F, Xiong C, Wang W, Cao Q, Wen X, Robertson JD, Ji X, Wang YA, Gupta S, Li C. Hepatocellular Carcinoma: Intra-arterial Delivery of Doxorubicin-loaded Hollow Gold Nanospheres for Photothermal Ablation-Chemoembolization Therapy in Rats. Radiology 2016; 281:427-435. [PMID: 27347765 DOI: 10.1148/radiol.2016152510] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Purpose To determine if combretastatin A-4 phosphate disodium (CA4P) can enhance the tumor uptake of doxorubicin (Dox)-loaded, polyethylene glycol (PEG)-coated hollow gold nanospheres (HAuNS) mixed with ethiodized oil for improved photothermal ablation (PTA)-chemoembolization therapy (CET) of hepatocellular carcinoma (HCC) in rats. Materials and Methods Animal experiments were approved by the institutional animal care and use committee and performed from February 2014 to April 2015. Male Sprague-Dawley rats (n = 45; age, 12 weeks) were inoculated with N1S1 HCC cells in the liver, and 8 days later, were randomly divided into two groups of 10 rats. Group 1 rats received intrahepatic arterial injection of PEG-HAuNS and ethiodized oil alone; group 2 received pretreatment with CA4P and injection of PEG-HAuNS and ethiodized oil 5 minutes later. The gold content of tumor and liver tissue at 1 hour or 24 hours after injection was quantified by using neutron activation analysis (n = 5 per time point). Five rats received pretreatment CA4P, PEG-copper 64-HAuNS, and ethiodized oil and underwent micro-positron emission tomography (PET)/computed tomography (CT). In a separate study, three groups of six rats with HCC were injected with saline solution (control group); CA4P, Dox-loaded PEG-coated HAuNS (Dox@PEG-HAuNS), and ethiodized oil (CET group); or CA4P, Dox@PEG-HAuNS, ethiodized oil, and near-infrared irradiation (PTA-CET group). Temperature was recorded during laser irradiation. Findings were verified at postmortem histopathologic and/or autoradiographic examination. Wilcoxon rank-sum test and Pearson correlation analyses were performed. Results PEG-HAuNS uptake in CA4P-pretreated HCC tumors was significantly higher than that in non-CA4P-pretreated tumors at both 1 hour (P < .03) and 24 hours (P < .01). Mean ± standard deviation of tumor-to-liver PEG-HAuNS uptake ratios at 1 hour and 24 hours, respectively, were 5.63 ± 3.09 and 1.68 ± 0.77 in the CA4P-treated group and 1.29 ± 2.40 and 0.14 ± 0.11 in the non-CA4P-treated group. Micro-PET/CT allowed clear delineation of tumors, enabling quantitative imaging analysis. Laser irradiation increased temperature to 60°C and 43°C in the tumor and adjacent liver, respectively. Mean HCC tumor volumes 10 days after therapy were 1.68 cm3 ± 1.01, 3.96 cm3 ± 1.75, and 6.13 cm3 ± 2.27 in the PTA-CET, CET, and control groups, respectively, with significant differences between the PTA-CET group and other groups (P < .05). Conclusion CA4P pretreatment caused a higher concentration of Dox@PEG-HAuNS to be trapped inside the tumor, thereby enhancing the efficacy of anti-HCC treatment with PTA-CET in rats. © RSNA, 2016 Online supplemental material is available for this article.
Collapse
Affiliation(s)
- Junjie Li
- From the Departments of Cancer Systems Imaging (J.L., M.Z., C.X., W.W., Q.C., X.W., C.L.) and Interventional Radiology (F.L., S.G.), the University of Texas MD Anderson Cancer Center, Houston, 1515 Holcombe Blvd, TX 77030; Department of Chemistry, University of Missouri, Columbia, Mo (J.D.R.); and Ocean Nanotech, San Diego, Calif (X.J., Y.A.W.)
| | - Min Zhou
- From the Departments of Cancer Systems Imaging (J.L., M.Z., C.X., W.W., Q.C., X.W., C.L.) and Interventional Radiology (F.L., S.G.), the University of Texas MD Anderson Cancer Center, Houston, 1515 Holcombe Blvd, TX 77030; Department of Chemistry, University of Missouri, Columbia, Mo (J.D.R.); and Ocean Nanotech, San Diego, Calif (X.J., Y.A.W.)
| | - Fengyong Liu
- From the Departments of Cancer Systems Imaging (J.L., M.Z., C.X., W.W., Q.C., X.W., C.L.) and Interventional Radiology (F.L., S.G.), the University of Texas MD Anderson Cancer Center, Houston, 1515 Holcombe Blvd, TX 77030; Department of Chemistry, University of Missouri, Columbia, Mo (J.D.R.); and Ocean Nanotech, San Diego, Calif (X.J., Y.A.W.)
| | - Chiyi Xiong
- From the Departments of Cancer Systems Imaging (J.L., M.Z., C.X., W.W., Q.C., X.W., C.L.) and Interventional Radiology (F.L., S.G.), the University of Texas MD Anderson Cancer Center, Houston, 1515 Holcombe Blvd, TX 77030; Department of Chemistry, University of Missouri, Columbia, Mo (J.D.R.); and Ocean Nanotech, San Diego, Calif (X.J., Y.A.W.)
| | - Wanqin Wang
- From the Departments of Cancer Systems Imaging (J.L., M.Z., C.X., W.W., Q.C., X.W., C.L.) and Interventional Radiology (F.L., S.G.), the University of Texas MD Anderson Cancer Center, Houston, 1515 Holcombe Blvd, TX 77030; Department of Chemistry, University of Missouri, Columbia, Mo (J.D.R.); and Ocean Nanotech, San Diego, Calif (X.J., Y.A.W.)
| | - Qizhen Cao
- From the Departments of Cancer Systems Imaging (J.L., M.Z., C.X., W.W., Q.C., X.W., C.L.) and Interventional Radiology (F.L., S.G.), the University of Texas MD Anderson Cancer Center, Houston, 1515 Holcombe Blvd, TX 77030; Department of Chemistry, University of Missouri, Columbia, Mo (J.D.R.); and Ocean Nanotech, San Diego, Calif (X.J., Y.A.W.)
| | - Xiaoxia Wen
- From the Departments of Cancer Systems Imaging (J.L., M.Z., C.X., W.W., Q.C., X.W., C.L.) and Interventional Radiology (F.L., S.G.), the University of Texas MD Anderson Cancer Center, Houston, 1515 Holcombe Blvd, TX 77030; Department of Chemistry, University of Missouri, Columbia, Mo (J.D.R.); and Ocean Nanotech, San Diego, Calif (X.J., Y.A.W.)
| | - J David Robertson
- From the Departments of Cancer Systems Imaging (J.L., M.Z., C.X., W.W., Q.C., X.W., C.L.) and Interventional Radiology (F.L., S.G.), the University of Texas MD Anderson Cancer Center, Houston, 1515 Holcombe Blvd, TX 77030; Department of Chemistry, University of Missouri, Columbia, Mo (J.D.R.); and Ocean Nanotech, San Diego, Calif (X.J., Y.A.W.)
| | - Xin Ji
- From the Departments of Cancer Systems Imaging (J.L., M.Z., C.X., W.W., Q.C., X.W., C.L.) and Interventional Radiology (F.L., S.G.), the University of Texas MD Anderson Cancer Center, Houston, 1515 Holcombe Blvd, TX 77030; Department of Chemistry, University of Missouri, Columbia, Mo (J.D.R.); and Ocean Nanotech, San Diego, Calif (X.J., Y.A.W.)
| | - Y Andrew Wang
- From the Departments of Cancer Systems Imaging (J.L., M.Z., C.X., W.W., Q.C., X.W., C.L.) and Interventional Radiology (F.L., S.G.), the University of Texas MD Anderson Cancer Center, Houston, 1515 Holcombe Blvd, TX 77030; Department of Chemistry, University of Missouri, Columbia, Mo (J.D.R.); and Ocean Nanotech, San Diego, Calif (X.J., Y.A.W.)
| | - Sanjay Gupta
- From the Departments of Cancer Systems Imaging (J.L., M.Z., C.X., W.W., Q.C., X.W., C.L.) and Interventional Radiology (F.L., S.G.), the University of Texas MD Anderson Cancer Center, Houston, 1515 Holcombe Blvd, TX 77030; Department of Chemistry, University of Missouri, Columbia, Mo (J.D.R.); and Ocean Nanotech, San Diego, Calif (X.J., Y.A.W.)
| | - Chun Li
- From the Departments of Cancer Systems Imaging (J.L., M.Z., C.X., W.W., Q.C., X.W., C.L.) and Interventional Radiology (F.L., S.G.), the University of Texas MD Anderson Cancer Center, Houston, 1515 Holcombe Blvd, TX 77030; Department of Chemistry, University of Missouri, Columbia, Mo (J.D.R.); and Ocean Nanotech, San Diego, Calif (X.J., Y.A.W.)
| |
Collapse
|
48
|
Li J, Liu F, Gupta S, Li C. Interventional Nanotheranostics of Pancreatic Ductal Adenocarcinoma. Am J Cancer Res 2016; 6:1393-402. [PMID: 27375787 PMCID: PMC4924507 DOI: 10.7150/thno.15122] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 05/19/2016] [Indexed: 12/13/2022] Open
Abstract
Pancreatic ductal adenocarcinoma (PDAC) accounts for over 90% of all pancreatic cancer. Nanoparticles (NPs) offer new opportunities for image-guided therapy owing to the unique physicochemical properties of the nanoscale effect and the multifunctional capabilities of NPs. However, major obstacles exist for NP-mediated cancer theranostics, especially in PDAC. The hypovascular nature of PDAC may impede the deposition of NPs into the tumor after systemic administration, and most NPs localize predominantly in the mononuclear phagocytic system, leading to a relatively poor tumor-to-surrounding-organ uptake ratio. Image guidance combined with minimally invasive interventional procedures may help circumvent these barriers to poor drug delivery of NPs in PDAC. Interventional treatments allow regional drug delivery, targeted vascular embolization, direct tumor ablation, and the possibility of disrupting the stromal barrier of PDAC. Interventional treatments also have potentially fewer complications, faster recovery, and lower cost compared with conventional therapies. This work is an overview of current image-guided interventional cancer nanotheranostics with specific attention given to their applications for the management of PDAC.
Collapse
|
49
|
Chen JX, Cai GY, Chen XM, Liu H, Chen X, Peng YM, Liu FY, Li Z, Shi SZ. Effect of TIMP1 transfection on PTEN expression in human kidney proximal tubular cells. Genet Mol Res 2015; 14:17373-83. [PMID: 26782378 DOI: 10.4238/2015.december.21.6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
To explore the role of metalloproteinase-1 (TIMP-1) tissue inhibitor in the mechanisms of kidney aging, we observed the effects of sense and antisense transfection of TIMP-1 and of metalloproteinase (MMP) inhibitors on phosphatase and tensin homolog (PTEN), vascular endothelial growth factor (VEGF), and Flk-1 expression in TIMP-1 transgenic human proximal tubular epithelial cells (HKCs). Transfected HKCs were co-incubated with 100 μM MMP-2 and MMP-9 inhibitor III for 24 h to affect enzyme inhibition. TIMP-1, MMP-2, MMP-9, PTEN, VEGF, and Flk-1 mRNA expression was detected by reverse transcription-polymerase chain reaction. PTEN, VEGF, and Flk-1 protein expression in cells of each experimental group was measured by indirect immunofluorescence. We found that PTEN expression was up-regulated (P < 0.05) in the sense TIMP-1-transfected group (P < 0.05) compared with the non-transfected and empty vector groups, and that expression of VEGF and Flk-1 was down-regulated (P < 0.05). In contrast, the antisense TIMP-1 transgenic group showed the opposite results (P < 0.05). No significant differences in expression of PTEN, VEGF, or Flk-1 were observed among the MMP- 2/MMP-9 inhibitor III, non-transfected, and empty vector groups (P > 0.05). These results suggest that in the progression of renal aging, high expression of TIMP-1 up-regulates PTEN expression through an MMP-independent pathway, and subsequently down-regulates the expression of VEGF and Flk-1, indicating that PTEN and TIMP-1 are involved in the aging-associated impairment of renal angiogenesis. Our study provides a theoretical basis for further exploration of the mechanism underlying TIMP- 1 participation in renal aging progression.
Collapse
Affiliation(s)
- J X Chen
- Department of Nephrology, the Second Xiangya Hospital of Central South University, Changsha, China
| | - G Y Cai
- Department of Geriatric Nephrology, General Hospital of PLA, Beijing, China
| | - X M Chen
- Department of Geriatric Nephrology, General Hospital of PLA, Beijing, China
| | - H Liu
- Department of Nephrology, the Second Xiangya Hospital of Central South University, Changsha, China
| | - X Chen
- Department of Nephrology, the Second Xiangya Hospital of Central South University, Changsha, China
| | - Y M Peng
- Department of Geriatric Nephrology, General Hospital of PLA, Beijing, China
| | - F Y Liu
- Department of Nephrology, the Second Xiangya Hospital of Central South University, Changsha, China
| | - Z Li
- Department of Nephrology, the Second Xiangya Hospital of Central South University, Changsha, China
| | - S Z Shi
- Department of Nephrology, the Second Xiangya Hospital of Central South University, Changsha, China
| |
Collapse
|
50
|
Abstract
The presence of collateral veins is one of the most common causes of fistula failure to mature. The traditional approach to eliminate collateral vessel flow is coil embolization under fluoroscopy or surgical cut down and branch vessel ligation. However, both approaches are expensive and time consuming. Here, we described an image-guided nonsurgical method to ligate collateral veins. The collateral veins were ligated using Hawkins-Akins needle under ultrasound guidance. The average time for one ligation procedure was 17 minutes. There was a significant increase of blood flow in the venous outflow postligation procedure. Four weeks postprocedure ultrasound demonstrated occlusion of the target vessels. This procedure was well tolerated without major complications. In summary, the novel procedure described here offers an image-guided nonsurgical approach for collateral vein occlusion.
Collapse
Affiliation(s)
- Jie Cui
- Nephrology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Robert Freed
- Division of Interventional Radiology, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Fengyong Liu
- Division of Interventional Radiology, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Zubin Irani
- Division of Interventional Radiology, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| |
Collapse
|