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Li J, Liu L, Gu J, Cao M, Lei J, Li H, He J, He J. The impact of air pollutants on spontaneous abortion: a case-control study in Tongchuan City. Public Health 2024; 227:267-273. [PMID: 38320452 DOI: 10.1016/j.puhe.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 11/27/2023] [Accepted: 12/04/2023] [Indexed: 02/08/2024]
Abstract
OBJECTIVES Studies related to air pollutants and spontaneous abortion in urban northwestern China are scarce, and the main exposure windows of pollutants acting on pregnant women are unclear. STUDY DESIGN Case-control study. METHODS Data were collected from pregnant women in Tongchuan City from 2018 to 2019. A total of 289 cases of spontaneous abortion and 1156 cases of full-term labor were included and analyzed using a case-control study. Logistic regression models were developed to explore the relationship between air pollutants and spontaneous abortion after Chi square analysis and Air pollutant description. RESULTS O3 (odds ratio [OR] = 1.028) is a risk factor for spontaneous abortion throughout pregnancy. PM2.5 (OR = 1.015), PM10 (OR = 1.010), SO2 (OR = 1.026), and NO2 (OR = 1.028) are risk factors for spontaneous abortion in the 30 days before the last menstrual period. PM2.5 (OR = 1.015), PM10 (OR = 1.013), SO2 (OR = 1.036), and NO2 (OR = 1.033) are risk factors for spontaneous abortion in the 30-60 days before the last menstrual period. PM2.5 (OR = 1.028), PM10 (OR = 1.013), SO2 (OR = 1.035), and NO2 (OR = 1.059) are risk factors for spontaneous abortion in the 60-90 days before the last menstrual period. CONCLUSION Exposure to high levels of air pollutants may be a cause of increased risk of spontaneous abortion, especially in the first trimester of the last menstrual period.
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Affiliation(s)
- J Li
- Medical School of Yan'an University, Shaanxi, China
| | - L Liu
- Medical School of Yan'an University, Shaanxi, China
| | - J Gu
- Medical School of Yan'an University, Shaanxi, China
| | - M Cao
- Medical School of Yan'an University, Shaanxi, China
| | - J Lei
- Yan'an University School Hospital, Shaanxi, China
| | - H Li
- Department of Laboratory, Yan'an University Affiliated Hospital, Shaanxi, China
| | - J He
- College of Mathematics and Computer Science of Yan'an University, Shaanxi, China
| | - J He
- Medical School of Yan'an University, Shaanxi, China.
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2
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Ávila A, Cao M, Espinosa M, Manrique J, Morales E. Recommendations for the individualised management of atypical hemolytic uremic syndrome in adults. Front Med (Lausanne) 2023; 10:1264310. [PMID: 38105887 PMCID: PMC10722909 DOI: 10.3389/fmed.2023.1264310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 11/15/2023] [Indexed: 12/19/2023] Open
Abstract
Background Despite significant advances in therapeutic management of atypical hemolytic uremic syndrome (aHUS), guidelines are not timely updated and achieving a consensus on management recommendations remains a topic of ongoing discussion. Methods A Scientific Committee with five experts was set up. A literature review was conducted and publications addressing the classification of aHUS, patient profiles and therapeutic approach were selected. Recommendations were proposed at an initial meeting, evaluated through an online questionnaire and validated during a second meeting. Results Patients with confirmed or clear suspicion of aHUS should be treated with C5 inhibitors within 24 h of the diagnosis or suspicion of aHUS. Treatment monitoring and the decision to interrupt treatment should be individualised according to the risk of relapse and each patient's evolution. aHUS with a genetic variant or associated with pregnancy should be treated for at least 6-12 months; de novo aHUS associated with kidney transplant until renal function is recovered and genetic variants are ruled out; aHUS associated with malignant hypertension until genetic variants are ruled out; aHUS associated with non-kidney transplant, autoimmune diseases, infection-or drug-induced until the thrombotic microangiopathy is resolved. Patients with a high risk of relapse should be treated for longer than 6-12 months. Conclusion These recommendations provides physicians who are not familiar with the disease with recommendations for the management of aHUS in adults. The experts who participated advocate early treatment, maintenance for at least 6-12 months and treatment interruption guided by genetic background, trigger factors, risk of relapse and evolution.
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Affiliation(s)
- Ana Ávila
- Department of Nephrology, Hospital Universitario Dr. Peset, Valencia, Spain
| | - Mercedes Cao
- Department of Nephrology, Hospital Universitario A Coruña, A Coruña, Spain
| | - Mario Espinosa
- Department of Nephrology, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Joaquín Manrique
- Department of Nephrology, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Enrique Morales
- Department of Nephrology, Hospital Universitario 12 de Octubre, Madrid, Spain
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Naumann LM, Lauria M, Kishan AU, Kaprealian TB, Cao M, Savjani RR, Iwamoto K, Sandstrom RE, Strause L, Steinberg ML, Low D. Clinical Implementation of Weak Magnetic Field Generator in Radiation Therapy. Int J Radiat Oncol Biol Phys 2023; 117:e701-e702. [PMID: 37786058 DOI: 10.1016/j.ijrobp.2023.06.2188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The application of weak magnetic fields may improve radiation therapy efficacy by manipulating the free radical activity induced by radiation to optimize tumor death. Once the device is commercially available, we will conduct clinical trials to determine the clinical impact of the weak magnetic field. However, the magnetic field generator (MFG) restricts Linac gantry rotation to approximately 180° and this limitation may limit treatment plan quality. This work is a continuation of an ongoing study to determine if the gantry angle restrictions can be compensated for during treatment planning. MATERIALS/METHODS Previous work has demonstrated the feasibility for GBM cases. For this work, 10 prostate cancer treatment plans were retrospectively replanned using only coplanar arcs that spanned from 90° to 270° (half-arcs). The prescriptions were 60 Gy for 6 patients, 55.8 Gy for 2 patients, 54 Gy for 1 patient, and 40.05 Gy for 1 patient. The prescription doses were delivered to 95% of the planning target volume (PTV = GTV + 2 cm). The critical structure doses were compared to determine if clinically equivalent plans could be delivered using half-arcs. RESULTS The dose criteria that were met by the clinical plans were also met by the half-arc plans except for the cases shown in Table 1. Table 1: Doses that did not meet criteria CONCLUSION: The half-arc plans were able to deliver clinically equivalent dose distributions as the clinical treatment plans. This provides continuing evidence that clinical trials will be able to be developed to evaluate the use of weak magnetic fields for radiation therapy.
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Affiliation(s)
- L M Naumann
- Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA
| | | | - A U Kishan
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA
| | - T B Kaprealian
- Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA
| | - M Cao
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA
| | - R R Savjani
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA
| | - K Iwamoto
- Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA
| | | | | | - M L Steinberg
- Department of Radiation Oncology, UCLA, Los Angeles, CA
| | - D Low
- Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA
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Jiang T, Valle L, Steinberg ML, Reiter RE, Rettig M, Nickols NG, Casado M, Lamb JM, Cao M, Raman S, Sung KH, Romero T, Kishan AU. One Year Radiographic Response Following Prostrate SBRT: An Exploratory Analysis of a Phase III Randomized Trial. Int J Radiat Oncol Biol Phys 2023; 117:e396-e397. [PMID: 37785326 DOI: 10.1016/j.ijrobp.2023.06.1524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Radiographic MRI response following prostate radiotherapy, particularly stereotactic body radiotherapy (SBRT), remains poorly understood. Our objective was to describe radiographic changes to the prostate gland and prostate tumor following SBRT of men treated on a prospective, randomized trial. MATERIALS/METHODS MIRAGE (NCT04384770) is a single center, randomized phase III trial of patients receiving either CT or MRI guided SBRT for localized prostate cancer. Patients underwent pre-treatment and annual post-treatment MRIs, in addition to routine PSA surveillance. Outcomes reported include percent gland shrinkage, percent PSA response at one year, and presence of residual tumor based on radiographic interpretation. Patient characteristics were compared via two-sample t-test or Fischer's exact test. Both univariate and multivariable logistical analysis were employed to identify potential clinical predictors of residual tumor on 1-year follow up MRI. RESULTS This study cohort included 94 eligible patients with baseline characteristics in Table 1. Residual lesions were seen in 13 patients (14%), 5/27 (18.5%) treated without ADT and 8/67 (12%) with ADT. PSA ablation was deep, with a 79% median decrease without ADT and 98% median decrease with ADT. Patients receiving ADT showed more gland shrinkage (17% vs. 34% shrinkage, p = 0.0001), while radiographic non-responders and responders experienced similar gland shrinkage (median 21% vs 29% shrinkage, p > 0.05). No significant clinical predictors of residual tumor were identified on univariate and multivariate analysis. No patient had any clinical or biochemical evidence of failure. CONCLUSION A total of 14% of patients were found to have residual tumor detected on MRI one year after SBRT. These data highlight the protracted nature of radiographic tumor response to radiation therapy, even with ablative radiation techniques. The analysis is limited by the lack of biopsy data to quantify whether visualized residual tumor harbor active cancer.
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Affiliation(s)
- T Jiang
- University of California, Los Angeles, Los Angeles, CA
| | - L Valle
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA
| | - M L Steinberg
- Department of Radiation Oncology, UCLA, Los Angeles, CA
| | - R E Reiter
- Department of Urology, University of California, Los Angeles, Los Angeles, CA
| | - M Rettig
- Department of Medical Oncology, University of California, Los Angeles, Los Angeles, CA
| | - N G Nickols
- University of California Los Angeles, Department of Radiation Oncology, Los Angeles, CA
| | - M Casado
- Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA
| | - J M Lamb
- Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA
| | - M Cao
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA
| | - S Raman
- Department of Diagnostic and Interventional Radiology, University of California, Los Angeles, Los Angeles, CA
| | | | - T Romero
- Department of Medicine, University of California, Los Angeles, Los Angeles, CA
| | - A U Kishan
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA
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Ma TM, Neylon JP, Savjani RR, Low D, Steinberg ML, Cao M, Kishan AU. Treatment Delivery Gating of MRI-Guided Stereotactic Radiotherapy for Prostate Cancer: An Exploratory Analysis of a Phase III Randomized Trial of CT-Vs. MR-Guided Radiotherapy (MIRAGE). Int J Radiat Oncol Biol Phys 2023; 117:e692-e693. [PMID: 37786034 DOI: 10.1016/j.ijrobp.2023.06.2168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Compared to CT-guided radiotherapy, MRI-guided radiotherapy (MRgRT) has been shown to reduce acute physician-scored and patient-reported gastrointestinal and genitourinary (GU) toxicities associated with prostate stereotactic body radiotherapy (SBRT) in the MIRAGE randomized trial (NCT04384770). We hypothesize that real-time intrafraction tracking/gating is important and is a critical enabler of aggressive margin reduction with MRgRT. MATERIALS/METHODS 79 patients received MRgRT on the MIRAGE trial with a planning margin of 2mm around the prostate and proximal seminal vesicles, which were treated to 40 Gy in five fractions on an MR-Linac. Tracking was performed at 4 frames/second in the sagittal plane during treatment with a gating boundary of 3mm for automatic beam hold. An in-house tool was developed to extract treatment time and beam gating status based on treatment logs and real-time cine images. The ratio of the time that the target was within the gating window/total time of target inside or outside the gating boundary was defined as the duty cycle (DC). Target contours were extracted from each frame of tracking and overlaid to create a motion-convolved target occupancy map. Minimum isotropic expansions of the prostate to cover 85%, 90% and 95% of the intrafraction motion were calculated with and without gating. RESULTS Median treatment time per fraction including image guidance procedure and beam delivery was 24.3 min (IQR: 22.2-27.7 min). The median time for image guidance 5.4 min (IQR: 4.2-6.7 min). A total of 391 treatment fractions were analyzed and the median DC per fraction was 0.974 (IQR: 0.926 -0.983). 89 (22.8%) and 35 (9.0%) of fractions had DC<90% and <80%, respectively, corresponding to 50/79 (62.3%) and 24/79 (30.4%) of patients having at least one fraction with a DC<90% and <80%, respectively. The minimum duty cycle of all fractions was lower among patients with grade ≥2 GU toxicity compared to those with grade 0-1 GU toxicity (mean 79.8% vs. 85.9%, p = 0.06). The proportion of patients with grade ≥2 GU toxicity was also greater in patients with a minimum gating cycle <80% (37.5% vs. 18.2%, p = 0.06). Gating significantly decreased the minimum isotropic expansion of the prostate to cover 85%, 90% and 95% of the intrafraction motion (p<0.0001 for all). Prostate intrafraction motion tended to be along the bladder-rectum axis secondary to bladder filling, rectal gas and bulk motion. Fractions with large prostate motion were mostly stochastic. CONCLUSION A large fraction (30%) of patients had at least of one treatment fraction with DC<80%, which correlated with increased acute GU toxicity. Gating effectively reduces the expansion needed to cover prostate intrafraction motion, and is necessary for real-time motion management given the unpredictable nature of prostate motion.
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Affiliation(s)
- T M Ma
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA
| | | | - R R Savjani
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA
| | - D Low
- Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA
| | - M L Steinberg
- Department of Radiation Oncology, UCLA, Los Angeles, CA
| | - M Cao
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA
| | - A U Kishan
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA
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Jiang T, Smith LM, Valle L, Ballas LK, Steinberg ML, Reiter RE, Nikitas J, Cao M, Kishan AU. Dosimetric Implications of Prostate Bed Deformability: An Analysis of the SCIMITAR Clinical Trial. Int J Radiat Oncol Biol Phys 2023; 117:e396. [PMID: 37785325 DOI: 10.1016/j.ijrobp.2023.06.1523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The post-operative prostate bed is a dynamic target volume due to the deformable nature of the bladder and rectum. These changes can lead to incorrect dosing of the prostate bed and organs at risk (OARs). Our objective was to quantify the dosimetric impact of prostate bed and OAR deformation. MATERIALS/METHODS SCIMITAR (NCT03541850) is a prospective phase II clinical trial evaluating stereotactic body radiotherapy (SBRT) in the post-prostatectomy setting. This analysis included a subset of patients who received 5 fractions of 6-6.8 Gy to the prostate bed under CT-based image guidance. The clinical target volume (CTV) and OARs were contoured on fractional CBCT images. Changes in volume, shape (via the dice similarity coefficient [DSC]), and dosimetry were quantified. Student's t-test was used to analyze the differences between planning and daily treatment outcomes. RESULTS A total of 29 patients (145 fractional images) were analyzed. We found the CTV volume remained stable (median change 1.1%; IQR: -15.1% - 16.1%), whereas the CTV shape was deformable (DSC of 0.76 [IQR: 0.71 - 0.79]). The bladder and rectum exhibited changes with median volume change of 5.7% (IQR: -24.3% - 51.0%) and 5.5% (IQR: -8.7% - 21.9%), respectively and median DSC of 0.77 (IQR: 0.68 - 0.84) and 0.74 (IQR: 0.69 - 0.80) respectively. The CTV received less radiation dose than planned (volume receiving 95%: 93.2% actual vs 99.6% planned, p < 0.01). 39% (56/145) of total fractions and 52% (15/29) of patients met criteria for CTV under-coverage (volume receiving 95% of the prescription dose < 93%). The rectum received higher dose than planned on several parameters (e.g., V27.5 Gy increased from 15.4% to 21.0% [p = 0.009] and V32.5 Gy increased from 6.0% to 10.9% [p = 0.006]) (Table 1). CONCLUSION We found underdosing of the prostate CTV and overdosing of the rectum in patients receiving CT-guided postoperative SBRT. While future work will correlate these dosimetric consequences with toxicity, these data suggest that approaches such as adaptive radiotherapy may be beneficial.
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Affiliation(s)
- T Jiang
- University of California, Los Angeles, Los Angeles, CA
| | - L M Smith
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA
| | - L Valle
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA
| | - L K Ballas
- Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, CA
| | - M L Steinberg
- Department of Radiation Oncology, UCLA, Los Angeles, CA
| | - R E Reiter
- Department of Urology, University of California, Los Angeles, Los Angeles, CA
| | - J Nikitas
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA
| | - M Cao
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA
| | - A U Kishan
- David Geffen School of Medicine at UCLA, Los Angeles, CA
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Liu H, Neilsen BK, Xu D, Pham J, Cao M, Ruan D, Kishan AU, Sheng K. Towards Automated Dosimetric Analysis of the Bladder Trigone: Deep-Learning-Based Joint Segmentation and Landmark Localization. Int J Radiat Oncol Biol Phys 2023; 117:S118. [PMID: 37784306 DOI: 10.1016/j.ijrobp.2023.06.452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The bladder trigone dosimetry is hypothesized to have a stronger correlation with post-SBRT urinary toxicity than that of the entire bladder. However, the trigone tends to move significantly between simulation and daily treatment. Its small size, large daily motion, and proximity to the target lead to potentially consequential but unaccounted-for dosimetric uncertainties. Manual segmentation of the structure can be inconsistent and time-consuming, even with MR-guided RT. Here, we propose and demonstrate a deep-learning-based framework for joint segmentation and landmark localization to support deformable registration and comprehensive dosimetric analysis. MATERIALS/METHODS A total of 30 patients were randomly selected for training, and 20 were held out for testing. Each patient had 1 simulation and 5 daily pre-treatment images obtained from a clinical 0.35T MR Linac. The trigone is defined as the triangular bladder section among three landmarks (2 ureteral orifices and the internal urethral orifice). In the manual contouring process, the 3 landmarks were identified first, followed by trigone segmentation. The proposed joint method uses a modified 3D nnU-Net with 2 decoders, one for segmentation and the other for landmark localization. The shared encoder is expected to extract features useful for both tasks. The joint framework was compared with a baseline method using two separate 3D nnU-Nets for landmark localization and trigone segmentation, respectively. Since the trigone is small (∼2% of the bladder volume), we further experimented with a second-stage prediction mimicking the human contouring process. The predicted landmarks from the first stage were used to crop the trigone region, and a second network was trained on cropped images. Evaluation metrics included the Dice score, 95% Hausdorff distance (HD95), and average surface distance (ASD) for segmentation, and Euclidean distance (ED) between the predicted and ground truth landmarks for localization. RESULTS The quantification metrics are summarized in the table below. The joint approach shows similar Dice performance to the baseline method but markedly better HD95 by 13%. For landmark localization, the proposed method is similar to the baseline, but the integration of the segmentation task stabilizes the training process. The two-stage approach further improves HD95, ASD, and ED by 27%, 24%, and 19%. CONCLUSION Combining segmentation and landmark localization exhibits a synergistic effect. The proposed two-stage approach provided additional improvement. Future studies will explore the deformable registration of the trigone based on the segmentation and landmark detection, as well as analyze cumulated dose distribution.
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Affiliation(s)
- H Liu
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA; Physics and Biology in Medicine, University of California, Los Angeles, Los Angeles, CA
| | - B K Neilsen
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA
| | - D Xu
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA; Computer Science, University of California, Los Angeles, Los Angeles, CA
| | - J Pham
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA; Physics and Biology in Medicine, University of California, Los Angeles, Los Angeles, CA
| | - M Cao
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA
| | - D Ruan
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA; Physics and Biology in Medicine, University of California, Los Angeles, Los Angeles, CA
| | - A U Kishan
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA; Department of Urology, University of California, Los Angeles, Los Angeles, CA
| | - K Sheng
- University of California, San Francisco, San Francisco, CA
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Lan W, Yao J, Cao M, Wang Z, Xiang B, Zhou J, Liao W, Liu X, Yang M, Zhang S, Zhao Y. Bifunctional Role of Monocyte Subsets in Modulating Radiotherapy Combined Intra-Tumor αCD40 Agonist Induced Abscopal Effect. Int J Radiat Oncol Biol Phys 2023; 117:S121. [PMID: 37784314 DOI: 10.1016/j.ijrobp.2023.06.459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Abscopal effect induced by radiotherapy and immune checkpoint blockade is a promising yet far from satisfactory strategy in clinical. The underlying immune mechanism, especially driven by monocytes remains poorly undefined. Monocytes consist of two phenotypically and functionally distinct subsets distinguished by expression of chemokine receptors CCR2 and CX3CR1: classical inflammatory Ly6ChiCCR2hi monocytes and nonclassical patrolling Ly6CloCCR2loCX3CR1hi monocytes. Monocytes differentiate and transit to other myeloid cells such as dendritic cells and macrophages according to various environmental cues. Herein we investigated the roles of monocyte subsets in modulating tumor control consisting of combination RT and myeloid checkpoint agonist αCD40 to specifically ignite myeloid cell activation. MATERIALS/METHODS To establish abscopal model, contralateral tumors were implanted in each mouse, while only one side were treated with RT (8 Gy × 3) + αCD40 agonist (50 μg, intra-tumor). Tumor volume and mice survival were compared in each group (control, RT, αCD40 and RT + αCD40). Ccr2RFP/+ Cx3cr1GFP/+ (R2 × 3), Ccr2RFP/RFPCx3cr1+/+ (R2-KO) and Ccr2+/+Cx3cr1GFP/GFP (X3-KO) mice were used for cell tracking and to dissect chemokine receptor CCR2 and CX3CR1 on monocyte. Tumor infiltrating immune cells were analyzed by flowcytometry and RNA-seq. RESULTS RT combined with αCD40 significantly dampened tumor growth on both ipsilateral and contralateral sides in abscopal model (p< 0.01), accompanied by upregulation of chemokine receptors CCR2 and CX3CR1 on myeloid cells were both increased in tumor and peripheral blood. Chemokine ligands CCL2, CCL3, CCL5, CCL7, CCL12 and CX3CL1 were upregulated in tumor after RT and αCD40 treatment, recruiting CCR2 and CX3CR1 expressing monocytes in situ. To elucidate the roles of CCR2 and CX3CR1 in mediating local and systemic anti-tumor immunity, R2 × 3, R2-KO and X3-KO mice with combined treatment were used. Tumor size on ipsilateral leg were similar among groups. However, tumor growth was significantly delayed on contralateral side in X3-KO mice while accelerated in R2-KO mice compared with that in R2 × 3 mice. Mechanistically, remarkable decrease of antigen presenting dendritic cells (MHCII+Ly6ChiCD11c+) were observed in R2-KO mice. Moreover, phagocytosis was strengthened in macrophages (F4/80+CD11b+) of X3-KO mice. CONCLUSION CX3CR1 deletion ignite anti-tumor immunity elicited by RT and αCD40 through enhanced phagocytosis in macrophages, while CCR2 deletion renders inferior tumor control through reduction of dendritic cells. Preferential targeting nonclassical patrolling monocyte may lead to enhanced local and systemic tumor control.
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Affiliation(s)
- W Lan
- Sichuan Cancer Hospital & Institute, Sichuan Cancer Center; Cancer Hospital affiliate to University of Electronic Science and Technology of China, Chengdu, China
| | - J Yao
- Sichuan Cancer Hospital & Institute, Sichuan Cancer Center; Cancer Hospital affiliate to University of Electronic Science and Technology of China, Chengdu, China
| | - M Cao
- Sichuan Cancer Hospital & Institute, Sichuan Cancer Center; Cancer Hospital affiliate to University of Electronic Science and Technology of China, Chengdu, China; Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Z Wang
- Sichuan Cancer Hospital & Institute, Sichuan Cancer Center; Cancer Hospital affiliate to University of Electronic Science and Technology of China, Chengdu, China
| | - B Xiang
- Sichuan Cancer Hospital & Institute, Sichuan Cancer Center; Cancer Hospital affiliate to University of Electronic Science and Technology of China, Chengdu, China
| | - J Zhou
- Sichuan Cancer Hospital & Institute, Sichuan Cancer Center; Cancer Hospital affiliate to University of Electronic Science and Technology of China, Chengdu, China
| | - W Liao
- Sichuan Cancer Hospital & Institute, Sichuan Cancer Center; Cancer Hospital affiliate to University of Electronic Science and Technology of China, Chengdu, China
| | - X Liu
- Sichuan Cancer Hospital & Institute, Sichuan Cancer Center; Cancer Hospital affiliate to University of Electronic Science and Technology of China, Chengdu, China
| | - M Yang
- Sichuan Cancer Hospital & Institute, Sichuan Cancer Center; Cancer Hospital affiliate to University of Electronic Science and Technology of China, Chengdu, China
| | - S Zhang
- Sichuan Cancer Hospital & Institute, Sichuan Cancer Center; Cancer Hospital affiliate to University of Electronic Science and Technology of China, Chengdu, China
| | - Y Zhao
- Sichuan Cancer Hospital & Institute, Sichuan Cancer Center; Cancer Hospital affiliate to University of Electronic Science and Technology of China, Chengdu, China
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Zou RY, Zhao Q, Tian YQ, Yan X, Qiu XH, Gao YJ, Liu Y, Huang M, Cao M, Dai JH, Cai HR. [Clinical characteristics and prognostic factors of patients with anti-melanoma differentiation-associated gene 5 antibody-positive dermatomyositis associated interstitial lung disease]. Zhonghua Jie He He Hu Xi Za Zhi 2023; 46:781-790. [PMID: 37536988 DOI: 10.3760/cma.j.cn112147-20221017-00821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
Objective: To analyze the clinical characteristics and prognostic factors of patients with anti-melanoma differentiation-associated gene 5 (anti-MDA5)-positive dermatomyositis associated interstitial lung disease (DM-ILD). Methods: The patients with MDA5+DM-ILD who were admitted to Department of Respiratory Medicine, Nanjing Drum Tower Hospital from January 2017 to March 2021 were enrolled. The clinical data and survival information were analyzed retrospectively. Patients were divided into survival group or death group, and rapid progressive ILD (RP-ILD) group or non-rapid progressive ILD group, according to their survival status and clinical progression. Results: A total of 105 patients with anti-MDA5+DM-ILD (median age of onset 54 years) were enrolled, 58% being female (61 cases). The main sub-type of dermatomyositis was amyopathic dermatomyositis (n=74, 70%), followed by dermatomyositis (n=31, 30%). The main extrapulmonary manifestations were skin lesions (n=60, 57.1%), muscle manifestations(n=20, 19%) and arthralgia/arthritis (n=20, 19%). 15.4% of the patients had positive ANA (antibody titer≥1∶320), and 61.9% of the patients had anti-RO-52 kDa antibody. A total of 66 patients (62.8%) developed RP-ILD, and 58 patients (56.3%) died. Lower oxygenation index (OR=0.974, 95%CI:0.954-0.994, P=0.012) and no joint pain (OR=0.032, 95%CI: 0.002-0.663 P=0.026) were independent risk factors for RP-ILD. Cox regression analysis showed that RP-ILD (HR=3.194, 95%CI:1.025-9.954, P=0.045), older than 53 years (HR=3.450, 95%CI: 1.388-8.577, P=0.008), ferritin level more than 1 330.5 ng/ml (HR=3.032, 95%CI 1.208-7.610, P=0.018) and C-reactive protein (CRP) above 16.95 mg/L (HR=2.794, 95%CI:1.102-7.084, P=0.030) were independent predictors of mortality. Conclusions: The clinical manifestations of patients with anti-MDA5+DM-ILD presenting to the respiratory department were heterogeneous, with most being amyopathic dermatomyositis, and both the incidence of RP-ILD and the risk of death were high. Even in the absence of associated rash, joint, or muscle manifestations, anti-MDA5 antibody screening should be considered in patients with rapidly progressive ILD who were negative on baseline autoantibody screening but positive for anti-RO52kDa antibody.
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Affiliation(s)
- R Y Zou
- Department of Respiratory and Critical Care Medicine of Nanjing Drum Tower Hospital, Nanjing 210000, China
| | - Q Zhao
- Department of Respiratory and Critical Care Medicine of Nanjing Drum Tower Hospital, Nanjing 210000, China
| | - Y Q Tian
- Department of Respiratory and Critical Care Medicine of Nanjing Drum Tower Hospital, Nanjing 210000, China
| | - X Yan
- Department of Respiratory and Critical Care Medicine of Nanjing Drum Tower Hospital, Nanjing 210000, China
| | - X H Qiu
- Department of Respiratory and Critical Care Medicine of Nanjing Drum Tower Hospital, Nanjing 210000, China
| | - Y J Gao
- Department of Respiratory and Critical Care Medicine of Nanjing Drum Tower Hospital, Nanjing 210000, China
| | - Y Liu
- Department of Respiratory and Critical Care Medicine of Nanjing Drum Tower Hospital, Nanjing 210000, China
| | - M Huang
- Department of Respiratory and Critical Care Medicine of Nanjing Drum Tower Hospital, Nanjing 210000, China
| | - M Cao
- Department of Respiratory and Critical Care Medicine of Nanjing Drum Tower Hospital, Nanjing 210000, China
| | - J H Dai
- Department of Respiratory and Critical Care Medicine of Nanjing Drum Tower Hospital, Nanjing 210000, China
| | - H R Cai
- Department of Respiratory and Critical Care Medicine of Nanjing Drum Tower Hospital, Nanjing 210000, China
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Cao M, Xu Q, Zhang QR, Su XQ, Ye YL, Zhu WS, Yin XD, Zhang ZQ. [Exploration of the effect of blood lipids on the lesion distribution pattern in acute ischemic stroke based on MRI study with population standard spatial analysis]. Zhonghua Yi Xue Za Zhi 2023; 103:1739-1745. [PMID: 37305932 DOI: 10.3760/cma.j.cn112137-20230424-00663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Objective: To explore the effect of blood lipids on the lesion distribution pattern in patients with acute ischemic stroke by using MRI technology based on population standard spatial analysis. Methods: The MRI data of 1 202 patients with acute ischemic stroke in General Hospital of Eastern Theater Command from January 2015 to December 2020 and Nanjing First Hospital from January 2013 to December 2021 were retrospectively collected, including 871 males and 331 females, aged 26 to 94 (64±11) years. According to the condition of blood lipids, they were divided into the dyslipidemia group (n=683) and the normal blood lipids group (n=519). After the automatic segmentation of diffusion-weighted imaging (DWI) images by artificial intelligence, the infarct sites were registered to the standard space which was used to draw the frequency heat map. The chi-square test was used to compare the difference in lesion location between the two groups. Generalized linear model regression analysis was used to observe the correlation between each blood lipid index and lesion site, and inter-group comparison and correlation analysis were used to observe the relationship between each blood lipid index and lesion volume. Results: Compared with the normal blood lipid group, the lesions in the dyslipidemia group were more extensive, mostly distributed in the occipital temporal region of the right posterior cerebral artery and the frontal region of the left middle cerebral artery. The brain regions of higher triglyceride(TG) and higher low-density lipoprotein cholesterol(LDL-C) groups were concentrated in the posterior circulation. The brain regions in the higher total cholesterol(TC) and lower high-density lipoprotein cholesterol(HDL-C) groups were concentrated in the anterior circulation(all P<0.05). In the anterior circulation infarct volume, the higher TC group was significantly higher than the normal TC group[(27.58±5.34) vs (17.73±1.18)ml, P=0.029]. In the posterior circulation infarct volume, the higher LDL-C group and the TG group were significantly higher than the normal LDL-C and TG groups[(7.55±2.51) vs (3.55±0.31) ml; (5.76±1.19) vs (3.36±0.30) ml](both P<0.05). Correlation analysis showed that TC and LDL-C were non-linearly (U-shaped) correlated with anterior circulation infarct volume (both P<0.05). Conclusions: Different blood lipids have effects on the distribution pattern and volume of ischemic stroke infarcts. Different hyperlipidemia is related to the specific distribution site and the larger extent of infarction.
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Affiliation(s)
- M Cao
- School of Medical Imaging Xuzhou Medical University, Xuzhou 221004, China
| | - Q Xu
- Department of Radiology, General Hospital of Eastern Theater Command, Nanjing 210002, China
| | - Q R Zhang
- Department of Radiology, General Hospital of Eastern Theater Command, Nanjing 210002, China
| | - X Q Su
- Department of Radiology, General Hospital of Eastern Theater Command, Nanjing 210002, China
| | - Y L Ye
- Department of Radiology, General Hospital of Eastern Theater Command, Nanjing 210002, China
| | - W S Zhu
- Department of Neurology, General Hospital of Eastern Theater Command, Nanjing 210002, China
| | - X D Yin
- Department of Radiology, Nanjing Hospital Affilicated to Nanjing Medical University (Nanjing First Hospital), Nanjing 210006, China
| | - Z Q Zhang
- School of Medical Imaging Xuzhou Medical University, Xuzhou 221004, China
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Liu B, Liu L, Ran J, Xie N, Li J, Xiao H, Yang X, Tian C, Wu H, Lu J, Gao J, Hu X, Cao M, Shui Z, Hu ZY, Ouyang Q. A randomized trial of eribulin monotherapy versus eribulin plus anlotinib in patients with locally recurrent or metastatic breast cancer. ESMO Open 2023; 8:101563. [PMID: 37285718 DOI: 10.1016/j.esmoop.2023.101563] [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: 03/21/2023] [Revised: 04/16/2023] [Accepted: 04/18/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND Eribulin mesylate is a novel, nontaxane, microtubule dynamics inhibitor. In this study, we assessed the efficacy and safety of eribulin versus eribulin plus the oral small-molecule tyrosine kinase inhibitor anlotinib in patients with locally recurrent or metastatic breast cancer. PATIENTS AND METHODS In this single-center, open-label, phase II clinical study (NCT05206656) conducted in a Chinese hospital, patients with human epidermal growth factor receptor 2 (HER2)-negative, locally recurrent or metastatic breast cancer previously treated with anthracycline- or taxane-based chemotherapy were randomized (1 : 1) to receive eribulin alone or in combination with anlotinib. The primary efficacy endpoint was investigator-assessed progression-free survival (PFS). RESULTS From June 2020 to April 2022, a total of 80 patients were randomly assigned to either eribulin monotherapy or eribulin plus anlotinib combination therapy, with 40 patients in each group. The data cut-off was 10 August 2022. The median PFS was 3.5 months [95% confidence interval (CI) 2.8-5.5 months] for eribulin and 5.1 months (95% CI 4.5-6.9 months) for eribulin plus anlotinib (hazard ratio = 0.56, 95% CI 0.32-0.98; P = 0.04). The objective response rates were 32.5% versus 52.5% (P = 0.07), respectively, and disease control rates were 67.5% versus 92.5% (P = 0.01), respectively. Patients <50 years of age, with an Eastern Cooperative Oncology Group performance status score of 0, visceral metastasis, number of treatment lines of four or more, hormone receptor negative (triple-negative), and HER2 low expression appeared to benefit more from combined treatment. The most common adverse events in both groups were leukopenia (n = 28, 70.0%, patients in the eribulin monotherapy group versus n = 35, 87.5%, patients in the combination therapy group), aspartate aminotransferase elevations (n = 28, 70.0%, versus n = 35, 87.5%), neutropenia (n = 25, 62.5%, versus n = 31, 77.5%), and alanine aminotransferase elevations (n = 25, 62.5%, versus n = 30, 75.0%). CONCLUSION Eribulin plus anlotinib can be considered an alternative treatment option for HER2-negative locally advanced or metastatic breast cancer.
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Affiliation(s)
- B Liu
- Department of Breast Cancer Medical Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, P. R. China
| | - L Liu
- Department of Breast Cancer Medical Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, P. R. China
| | - J Ran
- Department of Biostatistics and Bioinformatics, Rollins School of Public Heath, Emory University, Atlanta, USA
| | - N Xie
- Department of Breast Cancer Medical Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, P. R. China
| | - J Li
- Department of Breast Cancer Medical Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, P. R. China
| | - H Xiao
- Department of Breast Cancer Medical Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, P. R. China
| | - X Yang
- Department of Breast Cancer Medical Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, P. R. China
| | - C Tian
- Department of Breast Cancer Medical Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, P. R. China
| | - H Wu
- Department of Breast Cancer Medical Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, P. R. China
| | - J Lu
- Department of Breast Cancer Medical Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, P. R. China
| | - J Gao
- Department of Breast Cancer Medical Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, P. R. China
| | - X Hu
- Department of Breast Cancer Medical Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, P. R. China
| | - M Cao
- Department of Breast Cancer Medical Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, P. R. China
| | - Z Shui
- Department of Breast Cancer Medical Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, P. R. China
| | - Z-Y Hu
- Department of Breast Cancer Medical Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, P. R. China
| | - Q Ouyang
- Department of Breast Cancer Medical Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, P. R. China.
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Nikitas J, Gao Y, Smith L, Ma T, Sachdeva A, Yoon S, Steinberg M, Ballas L, Cao M, Kishan A. Dosimetric Implications of Margin-Reduced MRI-Guided Stereotactic Body Radiotherapy to the Prostate Bed Following Radical Prostatectomy: Post-Hoc Analysis of a Phase II Study. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Naumann L, Kaprealian T, Cao M, Savjani R, Iwamoto K, Sandstrom R, Strause L, Steinberg M, Low D. Dosimetric Evaluation of Physical Radiation Delivery Limits of a Weak Magnetic Field Generator on GBM Dose Distributions. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.2151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Sang Y, McNitt-Gray M, Yang Y, Cao M, Low D, Ruan D. Inference-Time Adaptation for Improved Transfer Ability and Generalization in Deformable Image Registration Deep Learning. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kishan A, Ma T, Lamb J, Casado M, Wilhame H, Low D, Yang Y, Gao Y, Neylon J, Basehart V, Cao M, Steinberg M. Magnetic Resonance Imaging-Guided vs. Computed Tomography-Guided Stereotactic Body Radiotherapy for Prostate Cancer (MIRAGE): Primary Endpoint Analysis of a Phase III Randomized Trial. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Sonni I, Pra AD, O'Connell D, Benz M, Nguyen K, Yoon S, Deng J, Smith C, Nickols N, Cao M, Kishan A, Calais J. PSMA PET/CT–Based Atlas for Prostatic Bed Recurrence of Prostate Cancer after Radical Prostatectomy: Clinical Implications for Salvage Radiation Therapy. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Cao M, Ong MTY, Yung PSH, Tuan RS, Jiang Y. Role of synovial lymphatic function in osteoarthritis. Osteoarthritis Cartilage 2022; 30:1186-1197. [PMID: 35487439 DOI: 10.1016/j.joca.2022.04.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 11/19/2021] [Revised: 04/01/2022] [Accepted: 04/20/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Osteoarthritis (OA) affects the entire joint, initially with a low degree of inflammation. Synovitis is correlated with the severity of OA clinical symptoms and cartilage degradation. The synovial lymphatic system (SLS) plays a prominent role in clearing macromolecules within the joint, including the pro-inflammatory cytokines in arthritic status. Scattered evidence shows that impaired SLS drainage function leads to the accumulation of inflammatory factors in the joint and aggravates the progression of OA, and the role of SLS function in OA is less studied. DESIGN This review summarizes the current understanding of synovial lymphatic function in OA progression and potential regulatory pathways and aims to provide a framework of knowledge for the development of OA treatments targeting lymphatic structure and functions. RESULTS SLS locates in the subintima layer of the synovium and consists of lymphatic capillaries and lymphatic collecting vessels. Vascular endothelial growth factor C (VEGF-C) is the most critical regulating factor of lymphatic endothelial cells (LECs) and SLS. Nitric oxide production-induced impairment of lymphatic muscle cells (LMCs) and contractile function may attribute to drainage dysfunction. Preclinical evidence suggests that promoting lymphatic drainage may help restore intra-articular homeostasis to attenuate the progression of OA. CONCLUSION SLS is actively involved in the homeostatic maintenance of the joint. Understanding the drainage function of the SLS at different stages of OA development is essential for further design of therapies targeting the function of these vessels.
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Affiliation(s)
- M Cao
- Department of Orthopaedics & Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - M T Y Ong
- Department of Orthopaedics & Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - P S H Yung
- Department of Orthopaedics & Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; Institute for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - R S Tuan
- Institute for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Y Jiang
- Department of Orthopaedics & Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; Institute for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
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Shi M, Chang Y, Cao M, Zhang J, Zhang L, Xie H, Miao Z. Effects of dietary yam polysaccharide on growth performance and
intestinal microflora in growing Huoyan geese. J Anim Feed Sci 2022. [DOI: 10.22358/jafs/151561/2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Cavero T, Auñón P, Caravaca-Fontán F, Trujillo H, Arjona E, Morales E, Guillén E, Blasco M, Rabasco C, Espinosa M, Blanco M, Rodríguez-Magariños C, Cao M, Ávila A, Huerta A, Rubio E, Cabello V, Barros X, Goicoechea de Jorge E, Rodríguez de Córdoba S, Praga M. Thrombotic microangiopathy in patients with malignant hypertension. Nephrol Dial Transplant 2022; 38:1217-1226. [PMID: 36002030 DOI: 10.1093/ndt/gfac248] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 05/17/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Thrombotic microangiopathy (TMA) is a complication of malignant hypertension (mHTN) attributed to the high levels of blood pressure (BP). However, no studies have investigated in patients with mHTN of different etiologies whether the presence of TMA is associated with specific causes of mHTN. METHODS We investigate the presence of TMA (microangiopathic hemolytic anemia and thrombocytopenia) in a large and well characterized cohort of 199 patients with mHTN of different etiologies (primary HTN 44%, glomerular diseases 16.6%, primary atypical hemolytic uremic syndrome (aHUS) 13.1%, renovascular HTN 9.5%, drug-related HTN 7%, systemic diseases 5.5%, endocrine diseases 4.5%). Outcomes of the study were kidney recovery and kidney failure. RESULTS Patients with TMA (40 cases, 20.1%) were younger, had a lower proportion of males, lower BP levels and worse kidney function at presentation. Their underlying diseases were primary aHUS (60%), drug-related mHTN (15%), glomerular diseases (all of them IgA nephropathy) (10%), systemic diseases (10%) and primary HTN (5%). The presence of TMA was 92.3% in primary aHUS, 42.9% in drug-related HTN, 36.4% in systemic diseases, 12.1% in glomerular diseases and 2.3% in primary HTN. No patient with renovascular HTN or mHTN caused by endocrine diseases developed TMA, despite BP levels as severe as patients with TMA. A higher proportion of TMA patients developed kidney failure as compared to patients without TMA (56.4% versus 38.9%, respectively). CONCLUSIONS The presence of TMA in patients with mHTN should guide the diagnosis towards primary aHUS, drug-related mHTN, some systemic diseases and IgA nephropathy, while it is exceptional in other causes of mHTN.
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Affiliation(s)
- Teresa Cavero
- Department of Nephrology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Pilar Auñón
- Department of Nephrology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Fernando Caravaca-Fontán
- Department of Nephrology, Hospital Universitario 12 de Octubre, Madrid, Spain.,Research Institute Hospital Universitario 12 de Octubre (imas12), Madrid, Spain
| | - Hernando Trujillo
- Department of Nephrology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Emi Arjona
- Centro de Investigaciones Biológicas, Consejo Superior de Investigaciones Científicas, Centro de Investigación Biomédica en Red en Enfermedades Raras, Madrid, Spain
| | - Enrique Morales
- Department of Nephrology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Elena Guillén
- Department of Nephrology and Renal Transplantation, Hospital Clínic, Centro de Referencia en Enfermedad Glomerular Compleja del Sistema Nacional de Salud de España (CSUR), Department of Medicine, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Miquel Blasco
- Department of Nephrology and Renal Transplantation, Hospital Clínic, Centro de Referencia en Enfermedad Glomerular Compleja del Sistema Nacional de Salud de España (CSUR), Department of Medicine, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Cristina Rabasco
- Department of Nephrology, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Mario Espinosa
- Department of Nephrology, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Marta Blanco
- Department of Nephrology, Hospital Universitario A Coruña, A Coruña, Spain
| | | | - Mercedes Cao
- Department of Nephrology, Hospital Universitario A Coruña, A Coruña, Spain
| | - Ana Ávila
- Department of Nephrology, Hospital Universitario Dr Peset, Valencia, Spain
| | - Ana Huerta
- Department of Nephrology, Hospital Universitario Puerta de Hierro, Madrid, Spain
| | - Esther Rubio
- Department of Nephrology, Hospital Universitario Puerta de Hierro, Madrid, Spain
| | - Virginia Cabello
- Department of Nephrology, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Xoana Barros
- Department of Nephrology, Hospital Universitario Dr Josep Trueta, Gerona, Spain
| | - Elena Goicoechea de Jorge
- Research Institute Hospital Universitario 12 de Octubre (imas12), Madrid, Spain.,Department of Immunology, Complutense University, Madrid, Spain
| | - Santiago Rodríguez de Córdoba
- Centro de Investigaciones Biológicas, Consejo Superior de Investigaciones Científicas, Centro de Investigación Biomédica en Red en Enfermedades Raras, Madrid, Spain
| | - Manuel Praga
- Research Institute Hospital Universitario 12 de Octubre (imas12), Madrid, Spain.,Department of Medicine, Complutense University, Madrid, Spain
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Lu M, Zhao HJ, Li WX, Zhang H, Cao M. [Orthodontic and surgical treatment of a patient with skeletal class Ⅲ subdivision malocclusion and mandibular asymmetry accompanied by an maxillary horizontal impacted canine]. Zhonghua Kou Qiang Yi Xue Za Zhi 2022; 57:745-748. [PMID: 35790515 DOI: 10.3760/cma.j.cn112144-20211221-00560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- M Lu
- Department of Orthodontics, School of Stomatology, The Fourth Military Medical University & State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Xi'an 710032, China
| | - H J Zhao
- Department of Orthodontics, School of Stomatology, The Fourth Military Medical University & State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Xi'an 710032, China
| | - W X Li
- Department of Orthodontics, School of Stomatology, The Fourth Military Medical University & State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Xi'an 710032, China
| | - H Zhang
- Department of Orthodontics, School of Stomatology, The Fourth Military Medical University & State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Xi'an 710032, China
| | - M Cao
- Department of Orthodontics, School of Stomatology, The Fourth Military Medical University & State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Xi'an 710032, China
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Gui XH, Qiu YY, Chen TT, Li H, Dai JH, Cai HR, Xiao YL, Cao M. [Idiopathic pleuroparenehymal fibroelastosis: five case reports and review of literature]. Zhonghua Jie He He Hu Xi Za Zhi 2022; 45:453-459. [PMID: 35527460 DOI: 10.3760/cma.j.cn112147-20210917-00655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To raise the awareness of idiopathic pleuroparenehymal fibroelastosis (iPPFE) through investigating the clinical, radiographic and pathological features. Methods: Five cases of iPPFE proved by pathology. The clinical data were studied respectively, and the relevant literature was reviewed. Results: All the cases of iPPFE were manifested by cough and dyspnea. The patients including 3 males and 2 females, aged from 30 to 70 years Chest CT scan showed pleural thickening, subpleural consolidation in both upper lungs complicated with tractive bronchiectasis.Computed tomography-guided percutaneous lung biopsy or surgical lung were performed and the same pathological showed pleura and subpleural dense elastic and collagen fibers. The elastic fibers stain was also positive,which was consistent with PPFE. One patient received low-dose corticosteroid, two received pirfenidone therapy, the others received no treatment. Three patients were stable during the follow-up. Conclusions: iPPFE has characteristic pathological features. However, the number of clinically reported cases is low due to missed diagnosis or misdiagnosed. Improving the understanding of features of iPPFE is helpful for the dianosis, therapy, and prognosis of this disease.
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Affiliation(s)
- X H Gui
- Department of Respiratory and Critical Care Medicine, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing 210008, China
| | - Y Y Qiu
- Department of Respiratory and Critical Care Medicine, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing 210008, China
| | - T T Chen
- Department of Pathology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing 210008, China
| | - H Li
- Department of Respiratory and Critical Care Medicine, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing 210008, China
| | - J H Dai
- Department of Respiratory and Critical Care Medicine, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing 210008, China
| | - H R Cai
- Department of Respiratory and Critical Care Medicine, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing 210008, China
| | - Y L Xiao
- Department of Respiratory and Critical Care Medicine, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing 210008, China
| | - M Cao
- Department of Respiratory and Critical Care Medicine, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing 210008, China
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Liu T, Wang C, Sun J, Chen W, Meng L, Li J, Cao M, Liu Q, Chen C. The Effects of an Integrated Exercise Intervention on the Attenuation of Frailty in Elderly Nursing Homes: A Cluster Randomized Controlled Trial. J Nutr Health Aging 2022; 26:222-229. [PMID: 35297463 DOI: 10.1007/s12603-022-1745-4] [Citation(s) in RCA: 4] [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] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The frail elderly have an increased risk of frailty because of reduced physical activity, cognitive ability and quality of life. This study aims to evaluate the effects of integrated exercise intervention on the attenuation of frailty in elderly nursing home residents. DESIGN This study was a cluster randomized controlled trial. SETTING AND PARTICIPANTS 146 elderly frailty people from 8 elderly nursing homes in Harbin, China, were randomly assigned into the intervention group and control group after obtaining their informed consent. INTERVENTION The intervention group performed integrated exercise interventions for 12 months, while the control group only continued with their daily activities. MEASUREMENTS Sociodemographic, health-related data, frailty levels, gait parameters, cognition, and quality of life were evaluated. RESULTS The mean age of participants was 80.74± 2.89 years, and 70.37% (n=95) were female. The Difference-in-difference regression showed that, compared with the control group, phenotypic frailty score (β3 =-1.40, p < 0.001) and stride time (β3 = -0.38, p <0.001) decreased significantly in the intervention group, stride velocity (β3 = 0.24, p < 0.001), step length (β3 = 0.08, p <0.001), cadence (β3 = 17.79, p < 0.001), MMSE total score (β3 = 1.90, p < 0.001) and QOL total score (β3 = 11.84, p < 0.001) increased significantly in the intervention group. CONCLUSION The integrated exercise intervention can effectively improve the attenuation of frailty, gait parameters, cognitive function, and quality of life in elderly nursing homes. We can use the findings of this study as a reference for the design of activities for the elderly nursing home residents, to provide them with appropriate exercises, improve their physical functions, and improve or delay their frailty level, which is principally important for developing countries in east Asia where rehabilitation resources are generally scarce.
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Affiliation(s)
- T Liu
- Chen Chen, PhD. Department of the Ward 5 of Acupuncture and Moxibustion, the Second Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, No. 144, Gogol Road, Harbin City 150040, Heilongjiang Province, China. Telephone: +0451-87093470;
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Li H, Cao M, Feng A, Cai H. Silicosis: enlarged cervical lymph nodes, pericardial effusion and lung abnormalities. Occup Med (Lond) 2021; 72:415-419. [PMID: 34897505 DOI: 10.1093/occmed/kqab178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Silicosis is an occupational lung parenchymal disease caused by inhaling silica. It requires differentiation from a malignant tumour and granulomatous disease. We describe the case of a woman with silicosis who exhibited enlargement of bilateral cervical lymph nodes, pericardial effusion and lung abnormalities. She was diagnosed with silicosis based on histological examination of a resected cervical lymph node, lung tissue biopsy and history of silica exposure. She underwent glucocorticoid therapy during hospitalization. The lung abnormalities, enlarged cervical lymph nodes and pericardial effusion were ameliorated by glucocorticoid therapy, but she relapsed shortly thereafter. In conclusion, silicosis with cervical lymph node enlargement and pericardial effusion is rare and should be differentiated from a malignant tumour and granulomatous disease. Some patients may respond well to steroids in the short term.
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Affiliation(s)
- H Li
- Division of Pulmonary and Critical Care Medicine, The Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - M Cao
- Division of Pulmonary and Critical Care Medicine, The Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - A Feng
- Division of Pathology, The Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
| | - H Cai
- Division of Pulmonary and Critical Care Medicine, The Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, China
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Li L, Tang W, Zhao M, Gong B, Cao M, Li J. Study on the regulation mechanism of lipopolysaccharide on oxidative stress and lipid metabolism of bovine mammary epithelial cells. Physiol Res 2021; 70:777-785. [PMID: 34505530 DOI: 10.33549/physiolres.934682] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The long-term feeding of a high-concentrate diet (the concentrate ratio is greater than 60 %) leads to mammary gland inflammatory response in ruminants and decreased quality in dairy cows and affects the robust development of the dairy industry. The main reason is closely related to elevated lipopolysaccharide (LPS) in the body. In this experiment, a bovine mammary epithelial cell line (MAC-T) was used as a model, and LPS at different concentrations (0 ng/ml, 1 ng/ml, 10 ng/ml, 100 ng/ml, 1000 ng/ml, 10000 ng/ml) was added to the cells. The cell survival rate, oxidative stress indicators, total lipid droplet area, triglyceride content and key genes regulating lipid metabolism were detected by 3-(4,5)-dimethylthiahiazo(-z-y1)-3,5-di-phenytetrazoliumromide (MTT), assay kit, microscope observation and RT-PCR methods to explore the regulatory mechanism of mammary health and milk fat synthesis. The results showed that compared with those of the control group, the survival rates of cells were significantly decreased after 9 h of stimulation with 1000 ng/ml and 10000 ng/ml LPS (P<0.01). The contents of superoxide dismutase (SOD), catalase (CAT) and total antioxidant capacity (T-AOC) in cells were significantly decreased (P<0.05). Compared with that of the control group, the content of malondialdehyde (MDA) in cells was significantly increased (P<0.05) after stimulation with 10000 ng/ml LPS for 9 h. After 9 h of stimulation with 100 ng/ml, 1000 ng/ml and 10000 ng/ml LPS, the total lipid drop area and triglyceride (TG) content of MAC-T cells were significantly decreased (P<0.05). The expression levels of fatty acid synthesis-related genes Acetyl-CoA carboxylase (ACC) and Stearoyl-CoA desaturase 1 (SCD-1) were significantly decreased after 9 h of stimulation with 100 ng/ml, 1000 ng/ml and 10000 ng/ml LPS (P<0.05), while the expression levels of Fatty Acid synthetase (FAS) were significantly decreased after stimulation with 1000 ng/ml and 10000 ng/ml LPS (P<0.05). TG synthesis by the related gene Diacylglycerol acyltransferase-1 (DGAT1) was significantly lower than that of the control group after stimulation with 1000 ng/ml and 10000 ng/ml LPS for 9 h (P<0.05), and Diacylglycerol acyltransferase-2 (DGAT2) also showed a significant decrease after 10000 ng/ml LPS stimulation (P<0.05). In conclusion, adding different concentrations of LPS to MAC-T cells not only led to a decrease in cell activity, resulting in oxidative damage, but also affected fatty acid and TG synthesis, which may ultimately be closely related to the decrease in milk fat synthesis.
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Affiliation(s)
- L Li
- School of Biological Science and Engineering, Xingtai University, Xingtai, China.
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Goicoechea M, Gomez-Preciado F, Benito S, Torras J, Torra R, Huerta A, Restrepo A, Ugalde J, Astudillo DE, Agraz I, Lopez-Mendoza M, de Arriba G, Corchete E, Quiroga B, Gutierrez MJ, Martin-Conde ML, Lopes V, Ramos C, Mendez I, Cao M, Dominguez F, Ortiz A. Predictors of outcome in a Spanish cohort of patients with Fabry disease on enzyme replacement therapy. Nefrologia 2021; 41:652-660. [PMID: 36165155 DOI: 10.1016/j.nefroe.2022.01.003] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 01/18/2021] [Indexed: 06/16/2023] Open
Abstract
UNLABELLED Fabry disease may be treated by enzyme replacement therapy (ERT), but the impact of chronic kidney disease (CKD) on the response to therapy remains unclear. The aim of the present study was to analyse the incidence and predictors of clinical events in patients on ERT. STUDY DESIGN Multicentre retrospective observational analysis of patients diagnosed and treated with ERT for Fabry disease. The primary outcome was the first renal, neurological or cardiological events or death during a follow-up of 60 months (24-120). RESULTS In 69 patients (42 males, 27 females, mean age 44.6±13.7 years), at the end of follow-up, eGFR and the left ventricular septum thickness remained stable and the urinary albumin: creatinine ratio tended to decrease, but this decrease only approached significance in patients on agalsidase-beta (242-128mg/g (p=0.05). At the end of follow-up, 21 (30%) patients had suffered an incident clinical event: 6 renal, 2 neurological and 13 cardiological (including 3 deaths). Events were more frequent in patients with baseline eGFR≤60ml/min/1.73m2 (log Rank 12.423, p=0.001), and this remained significant even after excluding incident renal events (log Rank 4.086, p=0.043) and in males and in females. Lower baseline eGFR was associated with a 3- to 7-fold increase the risk of clinical events in different Cox models. CONCLUSIONS GFR at the initiation of ERT is the main predictor of clinical events, both in males and in females, suggesting that start of ERT prior to the development of CKD is associated with better outcomes.
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Affiliation(s)
- Marian Goicoechea
- Servicio de Nefrología Hospital General Universitario Gregorio Marañon, Spain; Red de Investigación Renal (REDinRen), Fondos FEDER, Spain.
| | | | | | - Joan Torras
- Red de Investigación Renal (REDinRen), Fondos FEDER, Spain; Servicio de Nefrología Hospital Universitario de Bellvitge, Spain
| | - Roser Torra
- Red de Investigación Renal (REDinRen), Fondos FEDER, Spain; Servicio de Nefrología Fundacion Puigvert, Spain
| | - Ana Huerta
- Servicio de Nefrología Hospital Universitario Puerta del Hierro Majadahonda, Spain
| | | | - Jessica Ugalde
- Servicio de Nefrología Hospital Clinic de Barcelona, Spain
| | | | - Irene Agraz
- Servicio de Nefrología Hospital Vall d'Hebron, Spain
| | | | - Gabriel de Arriba
- Servicio de Nefrología Hospital General Universitario de Guadalajara, Universidad de Alcalá de Henares, Spain
| | | | - Borja Quiroga
- Servicio de Nefrología Hospital Universitario de la Princesa, Spain
| | | | | | - Vanessa Lopes
- Servicio de Nefrología del Hospital Universitario Ramon y Cajal, Spain
| | - Carmela Ramos
- Servicio de Nefrología del Hospital Clínico Universitario de Valencia, Spain
| | - Irene Mendez
- Servicio de Cardiología del Hospital General Universitario Gregorio Marañon, Spain
| | - Mercedes Cao
- Servicio de Nefrología Complexo Hospitalario Universitario A Coruña, Spain
| | | | - Alberto Ortiz
- Red de Investigación Renal (REDinRen), Fondos FEDER, Spain; Servicio de Nefrología de la Fundación Jimenez Diaz, Spain
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Hsieh S, Ng L, Cao M, Lee P. Comparison of In-Room Biplane Radiography and Tomosynthesis in Simulation. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Cao M, Gao Y, Yoon S, Yang Y, Sheng K, Sachdeva A, Ballas L, Steinberg M, Kishan A. Interfractional Geometric Variations and Dosimetric Benefits of Online Adaptive Stereotactic Body Radiotherapy of Prostate Bed After Radical Prostatectomy. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Li H, Zhang X, Wei W, Zhang L, Chen Z, Cao M, Cheng J, Du L, Zhao J, Fang Z, Li X, Chen P. An innovative application of follicular unit extraction technique in the treatment of bromhidrosis. J Eur Acad Dermatol Venereol 2021; 35:2300-2304. [PMID: 34331817 DOI: 10.1111/jdv.17571] [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: 04/12/2021] [Accepted: 07/21/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Surgery is the most effective way to treat bromhidrosis, but postoperative complications are still the biggest obstacles for patients to choose surgical treatment. OBJECTIVES To introduce an innovative application of follicular unit extraction (FUE) in the treatment of bromhidrosis. METHODS We conducted a case series study on 20 patients who received FUE technique for the treatment of bromhidrosis. The axillary hair follicles were extracted with a one-millimetre punch. The released hair follicles were collected for histological examination. After the operation, the wounds were wrapped with moderate pressure. The dressing was removed 24 h after the FUE operation. The postoperative complications were collected, and the improvement of malodour was evaluated by the 10-point visual analogue scale. RESULTS Immediately postoperation, many needle-shaped holes appeared in the armpits. The holes healed 7 days after the operation, with no scar or pinpoint-like scars. Except for a female who complained of mild pain in the left armpit, no other patients had any discomfort. The malodour level varied between 0 and 4 during the follow-up period. The tissue examination showed that more than 90% of the completely plucked hair follicles were accompanied by apocrine glands, and many blocked and dilated apocrine glands were observed. The lumens of the blocked glands were filled with decapitation products, which were positive for K5, Brst-2 and CEA. CONCLUSIONS Patients with bromhidrosis have a positive response to FUE technique. The FUE technique is well-tolerated, with only a few postoperative complications, which deserves to be widely promoted.
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Affiliation(s)
- H Li
- Department of Wound Repair and Dermatologic Surgery, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - X Zhang
- Department of Wound Repair and Dermatologic Surgery, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - W Wei
- Department of Wound Repair and Dermatologic Surgery, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - L Zhang
- Mental Health Center, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Z Chen
- Department of Wound Repair and Dermatologic Surgery, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - M Cao
- Department of Wound Repair and Dermatologic Surgery, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - J Cheng
- Department of Wound Repair and Dermatologic Surgery, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - L Du
- Department of Wound Repair and Dermatologic Surgery, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - J Zhao
- Department of Wound Repair and Dermatologic Surgery, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Z Fang
- Department of Wound Repair and Dermatologic Surgery, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - X Li
- Department of Wound Repair and Dermatologic Surgery, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - P Chen
- Department of Wound Repair and Dermatologic Surgery, Taihe Hospital, Hubei University of Medicine, Shiyan, China
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Cao M, Zhao JH, Zhang J, Yu WZ, Yin ZD, Cao L, Ye JK, Wu J, Cao XQ, Shu YC, Wang HT, Wang XL, Liu YL, Feng ZJ. [Analysis of the time for observation and related factors at clinics after vaccination among children's parents]. Zhonghua Liu Xing Bing Xue Za Zhi 2021; 42:1080-1085. [PMID: 34814511 DOI: 10.3760/cma.j.cn112338-20201010-01222] [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: 06/13/2023]
Abstract
Objective: To understand the time for observation and related factors in the clinics after vaccination among children's parents. Methods: From December 2019 to January 2020, parents of children aged 0-3 years were recruited by multiple-stage sampling from 34 vaccination clinics in 12 districts and counties in 6 provinces (Shandong, Guangdong, Henan, Sichuan, Inner Mongolia, and Liaoning). A questionnaire survey on the time of observation after vaccination was conducted. A multivariate logistic regression model was used to analyze the related factors of parental observation time after vaccination. Results: A total of 3 292 parents of 0-3 year's old children were selected, and 3 178 parents were finally included in the analysis. 87.85%(2 792/3 178) of the parents reported that the observation time after vaccination at clinics was ≥30 minutes. Multivariate logistic regression analysis showed that, after adjusting for the regions, the main factors affecting the observation time at clinics after vaccination among parents appeared as observation time informed by physicians at the clinic appeared ≥30 minutes (OR=31.622, 95%CI: 19.847-50.384), parents were medical personnel (OR=2.779, 95%CI: 1.505-5.133), parents being volunteers working on vaccination-related publicity and education activities (OR=1.986, 95%CI: 1.438-2.743), parents aged 35 years old or above (OR=1.900, 95%CI: 1.215-2.971), being parents of the first child (OR=1.663, 95%CI: 1.282-2.156), per capita annual income of the family as 8 000- Yuan (OR=1.646, 95%CI: 1.168-2.319), children aged 0-12 months old (OR=1.646, 95%CI: 1.203-2.252) or 13-24 months old (OR=1.506, 95%CI: 1.064-2.133), obedient to physicians' advice at the clinic (OR=1.481, 95%CI: 1.067-2.055). Conclusions: The proportions of parents observed for ≥30 minutes at the clinics of vaccination were high. When the information was from the physicians at the vaccination clinic, the observation time was the most critical factor for parents to observe at clinics as required.
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Affiliation(s)
- M Cao
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - J H Zhao
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - J Zhang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - W Z Yu
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Z D Yin
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - L Cao
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - J K Ye
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - J Wu
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - X Q Cao
- Peking Union Medical College Training Center, Beijing 100730, China
| | - Y C Shu
- Peking Union Medical College Training Center, Beijing 100730, China
| | - H T Wang
- Peking Union Medical College Training Center, Beijing 100730, China
| | - X L Wang
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Y L Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Z J Feng
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China
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Cao M, Zhao JH, Zhang J, Yu WZ, Cao L, Ye JK, Wu J, Yin ZD, Liu YL, Cao XQ, Shu YC, Wang HT, Wang XL, Huang CR. [Impact of additional time spent for vaccination services on overall satisfaction rate in parents]. Zhonghua Liu Xing Bing Xue Za Zhi 2021; 42:833-839. [PMID: 34814475 DOI: 10.3760/cma.j.cn112338-20200803-01013] [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: 06/13/2023]
Abstract
Objective: To understand the overall satisfaction rate with vaccination services in parents of children, and the impact of additional time consumed for vaccination service on overall satisfaction rate. Methods: From December 2019 to January 2020, a total of 3 178 parents of 0-3 years old children were investigated to collect the information about their basic characteristics, additional time spent for vaccination service and overall satisfaction through questionnaires. Binary logistic regression model and restricted cubic spline model were used to evaluate the impact of additional time spend on the overall satisfaction rate. Results: The overall satisfaction rate of parents with vaccination services was 92.32%. The median time for parents to move from home to vaccination clinic was 10.00 (10.00, 20.00) minutes, the median waiting time to make an appointment was 10.00 (5.00, 15.00) minutes, the median waiting time for vaccination was 5.00 (3.00, 10.00) minutes, and the median total additional time spent was 30.00 (20.00, 45.00) minutes. The binary logistic regression analysis showed that after adjusting the relevant factors, the main factors affecting the overall satisfaction rate were the waiting time for making an appointment (the 4- minutes group vs. 8- minutes group: OR=1.863, 95%CI: 1.307-2.657), waiting time for vaccination (the <4 minutes group vs. 8- minutes group: OR=1.529, 95%CI: 1.102-2.120; the 4- minutes group vs. 8- minutes group: OR=1.534, 95%CI: 1.104-2.130), total additional time spent (the 15- minutes group vs. 30- minutes group: OR=1.470, 95%CI: 1.094-1.976). Restricted cubic spline analysis showed that the waiting time for making an appointment (non-linear: χ2=13.18, P=0.001), the waiting time for vaccination (non-linear: χ2=13.50, P=0.001), and the total additional time consumed (non-linear: χ2=9.38, P=0.009) showed a non-linear inverted "V" dose response relationship to the overall satisfaction of vaccination services. Conclusions: The waiting time for parents to make an appointment, the waiting time for vaccination and the total additional time spent for receiving vaccination services affected the overall satisfaction rate of the vaccination services. And the waiting time for making an appointment was the most important factor, and it is necessary to shorten the waiting time for appointment. It is suggested that the vaccination clinic should make use of information technology (such as WeChat public account, APP) to make accurate appointments, make appointments to the time period to control the number of people within time period.
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Affiliation(s)
- M Cao
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - J H Zhao
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - J Zhang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - W Z Yu
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - L Cao
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - J K Ye
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - J Wu
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Z D Yin
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Y L Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - X Q Cao
- Peking Union Medical College Training Center, Beijing 100730, China
| | - Y C Shu
- Peking Union Medical College Training Center, Beijing 100730, China
| | - H T Wang
- Peking Union Medical College Training Center, Beijing 100730, China
| | - X L Wang
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - C R Huang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
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Liu Y, Baskin CC, Baskin JM, Yang J, Cao M, Wen B. Seed dormancy profiles for forest dynamics plot data: focusing on a tropical seasonal rainforest in Xishuangbanna, southwest China. Plant Biol (Stuttg) 2021; 23:420-426. [PMID: 33350038 DOI: 10.1111/plb.13232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 12/04/2020] [Indexed: 06/12/2023]
Abstract
Long-term forest dynamics monitoring plots provide information on number of individual species in the plot, allowing us for the first time to construct seed dormancy profiles at the species and individual levels for a specific site. Focusing on the Xishuangbanna tropical season rainforest plot (XTRDP), we used data from nine forest dynamics plots (two for tropical, four for subtropical and three for temperate) and information on kind of seed dormancy to generate seed dormancy profiles for communities across tropical to temperate latitudes at the species and individual levels. Seed dormancy information was collected from previous publications, and some data were provided by two germplasm banks that test seed germination of wild plants in China. In XTRDP, 35% of the species and 58% of individuals have non-dormant seeds; the dominant species have non-dormant seeds. In all plots, the most common kind of dormancy among species and individuals with dormant seeds was physiological dormancy. At the species level, the profile for tropical, subtropical and temperate plots was similar to profiles for each of these vegetation regions. In all plots, except one subtropical plot, the percentage of species versus individuals with dormant seeds differed. All temperate plots had a higher percentage of individuals than species with dormant seeds, but this pattern was not consistent for tropical or subtropical plots. We show that dormancy increases with latitude at both the species and individual levels. Dormancy profiles at the individual tree level provide new insight into seed dormancy relationships within plant communities.
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Affiliation(s)
- Y Liu
- CAS Key Laboratory of Tropical Forest Ecology, Xishuangbanna Tropical Botanical Garden, Chinese Academy of Sciences, Mengla, Yunnan, China
- University of Chinese Academy of Sciences, Beijing, China
| | - C C Baskin
- Department of Biology, University of Kentucky, Lexington, KY, USA
- Department of Plant and Soil Sciences, University of Kentucky, Lexington, KY, USA
| | - J M Baskin
- Department of Biology, University of Kentucky, Lexington, KY, USA
| | - J Yang
- CAS Key Laboratory of Tropical Forest Ecology, Xishuangbanna Tropical Botanical Garden, Chinese Academy of Sciences, Mengla, Yunnan, China
| | - M Cao
- CAS Key Laboratory of Tropical Forest Ecology, Xishuangbanna Tropical Botanical Garden, Chinese Academy of Sciences, Mengla, Yunnan, China
| | - B Wen
- CAS Key Laboratory of Tropical Forest Ecology, Xishuangbanna Tropical Botanical Garden, Chinese Academy of Sciences, Mengla, Yunnan, China
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Goicoechea M, Gomez-Preciado F, Benito S, Torras J, Torra R, Huerta A, Restrepo A, Ugalde J, Astudillo DE, Agraz I, Lopez-Mendoza M, de Arriba G, Corchete E, Quiroga B, Gutierrez MJ, Martin-Conde ML, Lopes V, Ramos C, Mendez I, Cao M, Dominguez F, Ortiz A. Predictors of outcome in a Spanish cohort of patients with Fabry disease on enzyme replacement therapy. Nefrologia 2021; 41:S0211-6995(21)00031-X. [PMID: 33714629 DOI: 10.1016/j.nefro.2021.01.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 01/17/2021] [Accepted: 01/18/2021] [Indexed: 11/21/2022] Open
Abstract
Fabry disease may be treated by enzyme replacement therapy (ERT), but the impact of chronic kidney disease (CKD) on the response to therapy remains unclear. The aim of the present study was to analyse the incidence and predictors of clinical events in patients on ERT. STUDY DESIGN Multicentre retrospective observational analysis of patients diagnosed and treated with ERT for Fabry disease. The primary outcome was the first renal, neurological or cardiological events or death during a follow-up of 60 months (24-120). RESULTS In 69 patients (42 males, 27 females, mean age 44.6±13.7 years), at the end of follow-up, eGFR and the left ventricular septum thickness remained stable and the urinary albumin: creatinine ratio tended to decrease, but this decrease only approached significance in patients on agalsidase-beta (242-128mg/g (p=0.05). At the end of follow-up, 21 (30%) patients had suffered an incident clinical event: 6 renal, 2 neurological and 13 cardiological (including 3 deaths). Events were more frequent in patients with baseline eGFR≤60ml/min/1.73m2 (log Rank 12.423, p=0.001), and this remained significant even after excluding incident renal events (log Rank 4.086, p=0.043) and in males and in females. Lower baseline eGFR was associated with a 3- to 7-fold increase the risk of clinical events in different Cox models. CONCLUSIONS GFR at the initiation of ERT is the main predictor of clinical events, both in males and in females, suggesting that start of ERT prior to the development of CKD is associated with better outcomes.
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Affiliation(s)
- Marian Goicoechea
- Servicio de Nefrología Hospital General Universitario Gregorio Marañon, Spain; Red de Investigación Renal (REDinRen), Fondos FEDER, Spain.
| | | | | | - Joan Torras
- Red de Investigación Renal (REDinRen), Fondos FEDER, Spain; Servicio de Nefrología Hospital Universitario de Bellvitge, Spain
| | - Roser Torra
- Red de Investigación Renal (REDinRen), Fondos FEDER, Spain; Servicio de Nefrología Fundacion Puigvert, Spain
| | - Ana Huerta
- Servicio de Nefrología Hospital Universitario Puerta del Hierro Majadahonda, Spain
| | | | - Jessica Ugalde
- Servicio de Nefrología Hospital Clinic de Barcelona, Spain
| | | | - Irene Agraz
- Servicio de Nefrología Hospital Vall d'Hebron, Spain
| | | | - Gabriel de Arriba
- Servicio de Nefrología Hospital General Universitario de Guadalajara, Universidad de Alcalá de Henares, Spain
| | | | - Borja Quiroga
- Servicio de Nefrología Hospital Universitario de la Princesa, Spain
| | | | | | - Vanessa Lopes
- Servicio de Nefrología del Hospital Universitario Ramon y Cajal, Spain
| | - Carmela Ramos
- Servicio de Nefrología del Hospital Clínico Universitario de Valencia, Spain
| | - Irene Mendez
- Servicio de Cardiología del Hospital General Universitario Gregorio Marañon, Spain
| | - Mercedes Cao
- Servicio de Nefrología Complexo Hospitalario Universitario A Coruña, Spain
| | | | - Alberto Ortiz
- Red de Investigación Renal (REDinRen), Fondos FEDER, Spain; Servicio de Nefrología de la Fundación Jimenez Diaz, Spain
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Zhang SZ, Mei F, Gao ML, Zhang L, Ma L, Wu H, Liu LX, Cao M, He XL. Plasma Neurofilament Light Combined with Risk Genes for the Diagnosis of Alzheimer?s Disease. Indian J Pharm Sci 2021. [DOI: 10.36468/pharmaceutical-sciences.spl.322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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34
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Fernández-Juárez G, Rojas-Rivera J, Logt AEVD, Justino J, Sevillano A, Caravaca-Fontán F, Ávila A, Rabasco C, Cabello V, Varela A, Díez M, Martín-Reyes G, Diezhandino MG, Quintana LF, Agraz I, Gómez-Martino JR, Cao M, Rodríguez-Moreno A, Rivas B, Galeano C, Bonet J, Romera A, Shabaka A, Plaisier E, Espinosa M, Egido J, Segarra A, Lambeau G, Ronco P, Wetzels J, Praga M. The STARMEN trial indicates that alternating treatment with corticosteroids and cyclophosphamide is superior to sequential treatment with tacrolimus and rituximab in primary membranous nephropathy. Kidney Int 2020; 99:986-998. [PMID: 33166580 DOI: 10.1016/j.kint.2020.10.014] [Citation(s) in RCA: 90] [Impact Index Per Article: 22.5] [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: 08/13/2020] [Revised: 09/24/2020] [Accepted: 10/11/2020] [Indexed: 10/23/2022]
Abstract
A cyclical corticosteroid-cyclophosphamide regimen is recommended for patients with primary membranous nephropathy at high risk of progression. We hypothesized that sequential therapy with tacrolimus and rituximab is superior to cyclical alternating treatment with corticosteroids and cyclophosphamide in inducing persistent remission in these patients. This was tested in a randomized, open-label controlled trial of 86 patients with primary membranous nephropathy and persistent nephrotic syndrome after six-months observation and assigned 43 each to receive six-month cyclical treatment with corticosteroid and cyclophosphamide or sequential treatment with tacrolimus (full-dose for six months and tapering for another three months) and rituximab (one gram at month six). The primary outcome was complete or partial remission of nephrotic syndrome at 24 months. This composite outcome occurred in 36 patients (83.7%) in the corticosteroid-cyclophosphamide group and in 25 patients (58.1%) in the tacrolimus-rituximab group (relative risk 1.44; 95% confidence interval 1.08 to 1.92). Complete remission at 24 months occurred in 26 patients (60%) in the corticosteroid-cyclophosphamide group and in 11 patients (26%) in the tacrolimus-rituximab group (2.36; 1.34 to 4.16). Anti-PLA2R titers showed a significant decrease in both groups but the proportion of anti-PLA2R-positive patients who achieved immunological response (depletion of anti-PLA2R antibodies) was significantly higher at three and six months in the corticosteroid-cyclophosphamide group (77% and 92%, respectively), as compared to the tacrolimus-rituximab group (45% and 70%, respectively). Relapses occurred in one patient in the corticosteroid-cyclophosphamide group, and three patients in the tacrolimus-rituximab group. Serious adverse events were similar in both groups. Thus, treatment with corticosteroid-cyclophosphamide induced remission in a significantly greater number of patients with primary membranous nephropathy than tacrolimus-rituximab.
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Affiliation(s)
| | - Jorge Rojas-Rivera
- Nephrology Division, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Anne-Els van de Logt
- Nephrology Division, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Joana Justino
- Institut de Pharmacologie Moléculaire et Cellulaire (IPMC), Université Côte d'Azur, Centre National de la Recherche Scientifique (CNRS), Valbonne Sophia Antipolis, France
| | - Angel Sevillano
- Nephrology Division, Instituto de Investigación Hospital Universitario 12 Octubre, Madrid, Spain
| | - Fernando Caravaca-Fontán
- Nephrology Division, Instituto de Investigación Hospital Universitario 12 Octubre, Madrid, Spain
| | - Ana Ávila
- Nephrology Division, Hospital Dr Peset, Valencia, Spain
| | | | | | - Alfonso Varela
- Nephrology Division, Hospital Virgen de la Victoria de Málaga, Málaga, Spain
| | - Montserrat Díez
- Fundació Puigvert, Nephrology Division, Institut Investigaci Biosanitaria Sant Pau, Autonomous University of Barcelona (UAB), Barcelona, Spain
| | | | | | - Luis F Quintana
- Centro de Referencia en Enfermedad Glomerular Compleja del Sistema Nacional de Salud (CSUR), Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Irene Agraz
- Nephrology Division, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | | | - Mercedes Cao
- Nephrology Division, Hospital Universitario de A Coruña, A Coruña, Spain
| | | | - Begoña Rivas
- Nephrology Division, Hospital Universitario La Paz, Madrid, Spain
| | - Cristina Galeano
- Nephrology Division, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Jose Bonet
- Nephrology Division, Hospital Germans Trias i Pujol, Barcelona, Spain
| | - Ana Romera
- Nephrology Division, Hospital de Ciudad Real, Ciudad Real, Spain
| | - Amir Shabaka
- Nephrology Division, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Emmanuelle Plaisier
- Sorbonne Université, Université Pierre et Marie Curie Paris 06, and Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche S1155, Paris, France; Centre de Référence Maladies Rares Syndrome Néphrotique Idiopathique - Hôpital de Jour Néphrologie - Hôpital TENON-Assistance Publique-Hôpitaux de Paris (APHP)- Sorbonne Université, Paris, France
| | - Mario Espinosa
- Nephrology Division, Hospital Reina Sofía, Córdoba, Spain
| | - Jesus Egido
- Nephrology Division, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Alfonso Segarra
- Nephrology Division, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Gérard Lambeau
- Institut de Pharmacologie Moléculaire et Cellulaire (IPMC), Université Côte d'Azur, Centre National de la Recherche Scientifique (CNRS), Valbonne Sophia Antipolis, France
| | - Pierre Ronco
- Sorbonne Université, Université Pierre et Marie Curie Paris 06, and Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche S1155, Paris, France; Centre de Référence Maladies Rares Syndrome Néphrotique Idiopathique - Hôpital de Jour Néphrologie - Hôpital TENON-Assistance Publique-Hôpitaux de Paris (APHP)- Sorbonne Université, Paris, France
| | - Jack Wetzels
- Nephrology Division, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Manuel Praga
- Nephrology Division, Instituto de Investigación Hospital Universitario 12 Octubre, Madrid, Spain; Department of Medicine, Complutense University, Madrid, Spain.
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Zhang Q, Cao M, Fan ZX, Xiang L, Zhang J. [Using structured decision-making to identify the appropriate type of entity for the centers for disease control and prevention of China]. Zhonghua Yu Fang Yi Xue Za Zhi 2020; 54:1243-1248. [PMID: 33147924 DOI: 10.3760/cma.j.cn112150-20200713-00999] [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 develop evidence-based appropriate type of entity for the Centers for Disease Control and Prevention in order to improve the performance of disease control and prevention system in China. Methods: This study firstly proposed the core functions and essential public health programs for the Centers for Disease Control and Prevention. Using Structured Decision-Making, this study presented three alternative options for type of entity to make essential public health programs succeed, and reviewed the pros and cons of alternative options based on 15 evaluation indicators. Questionnaires were distributed to 47 stakeholders between April 10 and April 20 of 2020. Finally, an appropriate type of entity for the Centers for Disease Control and Prevention was identified by using both qualitative and quantitative methods. Results: A total of 47 stakeholders ranked alternative options. Aggregated scores of each alternative option was computed after weighting each indicators. The results shows that Option 1(professional technical civil service organization)has the highest score (58.22). Conclusion: Professional technical civil service organization is appropriate type of entity for Centers for Disease Control and Prevention.
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Affiliation(s)
- Q Zhang
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - M Cao
- School of Health Policy and Management, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Z X Fan
- School of Health Policy and Management, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - L Xiang
- School of Population Medicine and Public Health, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - J Zhang
- School of Population Medicine and Public Health, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
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Li Q, Chen M, Cao M, Yuan G, Hu X, Dai W, Zang M, Cheng X, Huang J, Hou J, Chen J. 182P Lenvatinib (LEN) plus anti-PD-1 antibodies vs LEN alone for advanced hepatocellular carcinoma (HCC): A real-world study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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37
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Vijayakumar B, Cao M, Mackillop L, Sarangmat N, Leite MI, Wathen CG, Nickol AH, Turnbull CD. A challenging case of hypercapnic respiratory failure during pregnancy. Obstet Med 2020; 14:121-124. [PMID: 34394724 DOI: 10.1177/1753495x20944707] [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: 02/23/2020] [Accepted: 06/30/2020] [Indexed: 11/16/2022] Open
Abstract
We describe a 40-year-old female who presented with progressive breathlessness and hypercapnic respiratory failure during pregnancy secondary to undiagnosed muscle-specific kinase myasthenia gravis. Her presentation was progressive and protracted, having over five contacts with healthcare professionals over nine months, many of these predating her pregnancy. Her atypical presentation for myasthenia with minimal limb weakness led to consideration of other causes of hypercapnic respiratory failure. Once diagnosed, she was treated with intravenous immunoglobulin and non-invasive ventilation. She gave birth to a pre-term infant by planned caesarean section. Her insidious presentation and the progressive nature of her breathlessness were unusual and our report highlights the predominant involvement of respiratory muscles in muscle-specific kinase myasthenia. Her pregnancy may have further delayed her diagnosis due the attribution of some symptoms to normal pregnancy. Early recognition and treatment of myasthenia gravis are important to prevent life-threatening complications.
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Affiliation(s)
- B Vijayakumar
- Department of Respiratory Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - M Cao
- Nuffield Department of Clinical Neurosciences, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - L Mackillop
- Women's Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - N Sarangmat
- Nuffield Department of Clinical Neurosciences, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - M I Leite
- Nuffield Department of Clinical Neurosciences, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - C G Wathen
- Department of Respiratory Medicine, Buckinghamshire Healthcare Trust, Wycombe Hospital, High Wycombe, UK
| | - A H Nickol
- Department of Respiratory Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - C D Turnbull
- Department of Respiratory Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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38
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Cao M, Gou L, Chen Y, Huang M. 241P Germline genetic features of Chinese patients with breast cancer. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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39
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Liu Y, Zhang X, Wang L, Cao M, Zhang S, Zhang H, Zhou Y, Wang J. 270P Apatinib added to taxanes and platinum neoadjuvant chemotherapy for patients with triple-negative and HER2-positive breast cancer: A multicenter, randomized, phase II, open-label trial. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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40
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Li C, Cao M, Qi T, Ye X, Ma L, Pan W, Luo J, Chen P, Liu J, Zhou J. The association of bisphenol A exposure with premature ovarian insufficiency: a case-control study. Climacteric 2020; 24:95-100. [PMID: 32668991 DOI: 10.1080/13697137.2020.1781078] [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: 10/23/2022]
Abstract
BACKGROUND A few epidemiological investigations and animal studies have demonstrated that bisphenol A (BPA) may affect female reproductive health. However, no epidemiologic study has investigated the relationship between BPA exposure and the risk of premature ovarian insufficiency (POI). METHODS In this case-control study, urinary concentrations of BPA and serum levels of reproductive hormone were measured. Associations between BPA concentrations and the risk of POI and POI-related hormone levels were estimated. RESULTS Among BPA quartiles, no obvious association was found between BPA levels and the risk of POI (p = 0.603). Although the adjusted odds ratio (OR) of POI was slightly increased for participants in the highest BPA concentration quartile, the association was not statistically significant (OR = 1.282, 95% confidence interval [CI] 0.615-2.049 for the highest vs. lowest quartile, p = 0.508). Although follicle stimulating hormone (FSH) and anti-Mullerian hormone (AMH) levels showed no tendency of an association with BPA (p = 0.941 and p = 0.876 for FSH and AMH, respectively), the highest quartile of luteinizing hormone was significantly positively associated with BPA levels (OR = 1.333, 95% CI 0.986-1.803, p = 0.042). CONCLUSIONS The urinary concentrations of BPA determined in this study were consistent with the range of exposure currently observed in Chinese women. However, BPA exposure at a relatively low level is not associated with POI in Chinese women. Further epidemiological studies are needed to confirm our findings.
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Affiliation(s)
- C Li
- Department of Gynecology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - M Cao
- MOE Key Laboratory of Environmental Remediation and Ecosystem Health, College of Environmental and Resource Sciences, Zhejiang University, Hangzhou, China
| | - T Qi
- Department of Gynecology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - X Ye
- College of Medical Technology, Zhejiang Chinese Medical University, Hangzhou, China
| | - L Ma
- Department of Gynecology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - W Pan
- MOE Key Laboratory of Environmental Remediation and Ecosystem Health, College of Environmental and Resource Sciences, Zhejiang University, Hangzhou, China
| | - J Luo
- Department of Gynecology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - P Chen
- Department of Gynecology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - J Liu
- MOE Key Laboratory of Environmental Remediation and Ecosystem Health, College of Environmental and Resource Sciences, Zhejiang University, Hangzhou, China
| | - J Zhou
- Department of Gynecology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Zhang B, Wang H, Yang Z, Cao M, Wang K, Wang G, Zhao Y. Protective effect of alpha-pinene against isoproterenol-induced myocardial infarction through NF-κB signaling pathway. Hum Exp Toxicol 2020; 39:1596-1606. [PMID: 32602371 DOI: 10.1177/0960327120934537] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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: 01/14/2023]
Abstract
Monoterpenes present in the essential oils exhibit anti-inflammatory properties. In this study, we investigated the preventive effect of alpha-pinene (AP), a monoterpene, against isoproterenol (ISO)-induced myocardial infarction and inflammation in Wistar rats. Male Wistar rats were pretreated with AP (50 mg/kg body weight (bw)) administration for 21 days and ISO (85 mg/kg bw) was administered subcutaneously for last two consecutive days (20th day and 21st day). We noticed that there was an increased activity of cardiac marker enzymes in ISO-treated rats. We also observed that elevated levels of lipid peroxidative indices decreased activities of antioxidant status in plasma, erythrocyte, and heart tissue in ISO-induced rats. Furthermore, ISO-treated rats showed an increase in the levels of inflammatory mediators like tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in the serum. Besides, we confirmed the upregulated expression of TNF-α, IL-6, and nuclear factor kappa-light-chain-enhancer of activated B cells in ISO-induced rat heart tissue. Conversely, we found that AP pretreatment significantly decreased levels of cardiac markers like serum cardiac troponin T and cardiac troponin I, lipid peroxidative markers, and restored antioxidants status in ISO-treated rats. Besides, AP administration attenuated ISO-induced inflammatory marker expression. The present findings demonstrated that AP significantly protects the myocardium and exerts cardioprotective and anti-inflammatory effects in experimental rats.
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Affiliation(s)
- B Zhang
- Department of Health Care Center, Beijing Friendship Hospital Medical, 12517Capital Medical University, Beijing, China
| | - H Wang
- Department of Pharmacy, 34706The First Affiliated Hospital of Nanhua University, Hengyang City, Hunan Province, China
| | - Z Yang
- Department of ICU, 381901The First People's Hospital of Huaihua, Huaihua City, Hunan Province, China
| | - M Cao
- Department of Cardiovascular, 232831The People's Hospital of Tianjin, Tianjin City, China
| | - K Wang
- Department of Endocrinology, 12476Tianyou Hospital Affiliated to Tongji University, Shanghai, China
| | - G Wang
- Department of Endocrinology, 12476The Putuo People's Hospital Affiliated to Tongji University, Shanghai, China
| | - Y Zhao
- Department of Cardiovascular Biology, 12418Changsha Central Hospital, Changsha City, Hunan Province, China
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Goicoechea M, Gomez-Preciado F, Benito S, Torras J, Torra R, Huerta A, Restrepo A, Ugalde J, Astudillo D, Agraz I, Lopez-Mendoza M, De Arriba G, Corchete E, Quiroga B, Martin-Conde ML, Gutierrez MJ, Lopes V, Ramos C, Mendez I, Cao M, Dominguez F, Ortiz A. P0067PREDICTORS OF LONG-TERM OUTCOME IN A SPANISH COHORT OF PATIENTS WITH FABRY DISEASE ON ENZYME REPLACEMENT THERAPY. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p0067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and Aims
Fabry disease may be treated by enzyme replacement therapy (ERT), but the impact of chronic kidney disease (CKD) on the response to therapy remains unclear. The aim of the present study was to analyse the incidence and predictors of clinical events in Fabry disease patients on ERT.
Method
Multicentre retrospective observational analysis of patients diagnosed and treated with ERT for Fabry disease. The primary outcome was the first renal, neurological or cardiological events or death during a follow-up of 60 months (24-120).
Results
In 69 patients (42 males, 27 females, mean age 44.6 ±13.7 years), at the end of follow-up, eGFR and the left ventricular septum thickness remained stable and the urinary albumin: creatinine ratio tended to decrease, but this decrease only approached significance in patients on agalsidase-beta (242 to 128 mg/g (p = 0.05).
At the end of follow-up, 21 (30%) patients had suffered an incident clinical event: 6 renal, 2 neurological and 13 cardiological (including 3 deaths). Events were more frequent in patients with baseline eGFR ≤60 ml/min/1.73 m2 (log Rank 12.423, p=0.001), and this remained significant even after excluding incident renal events (log Rank 4.086, p=0.043), being these differences more relevant in females (log Rank 18.514, p<0.001) than males (logRank: 3.442, p=0.064). Lower baseline eGFR was associated with a 3- to 7-fold increase in the risk of clinical events in different Cox models.
Conclusion
GFR at the initiation of ERT is the main predictor of clinical events, both in males and in females, suggesting that start of ERT prior to the development of CKD is associated with better outcomes. For the first time, we show that initiation of ERT in women before renal function deteriorates has a similar or even larger impact as in Fabry males to prevent clinical events.
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Affiliation(s)
- Marian Goicoechea
- Hospital General Universitario Gregorio Marañon, Nephrology, Madrid, Spain
- Spanish Kidney Research Network (REDINREN), FEDER FUND, Madrid, Spain
| | | | | | - Joan Torras
- Spanish Kidney Research Network (REDINREN), FEDER FUND, Madrid, Spain
- Hospital Bellvitge, Nephrology
| | - Roser Torra
- Spanish Kidney Research Network (REDINREN), FEDER FUND, Madrid, Spain
- Fundacion Puigvert, Nephrology
| | - Ana Huerta
- Hospital Universitario Puerta de Hierro, Cardiology
| | - Alejandra Restrepo
- Hospital Universitario Puerta de Hierro, CIBERCV, Heart Failure and Inherited Cardiac Diseases Unit, Madrid
| | | | | | | | | | - Gabriel De Arriba
- Hospital Universitario de Guadalajara, Nephrology
- Universidad de Alcala de Henares, Medicine
| | | | | | | | | | | | - Carmela Ramos
- Hospital Universitario y Politecnico La Fe, Nephrology Unit, Valencia, Spain
| | - Irene Mendez
- Hospital Universitario Gregorio Marañon, Cardiology
| | - Mercedes Cao
- Complejo Hospitalario Universitario A Coruña, Nephrology
| | - Fernando Dominguez
- Hospital Universitario Puerta de Hierro, CIBERCV, Heart Failure and Inherited Cardiac Diseases Unit, Madrid
| | - Alberto Ortiz
- Spanish Kidney Research Network (REDINREN), FEDER FUND, Madrid, Spain
- Fundación JImenez Diaz, Nephrology
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Chen J, Liu S, Tang Y, Zhang X, Cao M, Xiao Z, Ren M, Chen T. Diagnostic performance of CT for differentiating peritoneal tuberculosis from peritoneal carcinomatosis: a systematic review and meta-analysis. Clin Radiol 2020; 75:396.e7-396.e14. [PMID: 32081347 DOI: 10.1016/j.crad.2019.12.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 12/12/2019] [Indexed: 01/01/2023]
Abstract
AIM To undertake a systematic review and meta-analysis of the diagnostic performance of CT for differentiating peritoneal tuberculosis (PTB) from peritoneal carcinomatosis (PC). MATERIAL AND METHODS PubMed, Embase, the Web of Science, and the Cochrane Library were searched for papers published before 23 July 2019. The methodological quality of the studies was analysed. Overlapping descriptors used in different studies to denote the same image finding were subsumed under a single CT feature. Sensitivity, specificity, and positive and negative likelihood ratios were pooled. A summary receiver operating characteristic curve (sROC) was constructed and the area under the curve (AUC) of the included studies was calculated when possible. RESULTS Six studies were included and 17 CT features were analysed. The pooled sensitivity and specificity of smooth peritoneal thickening were 59% (95% CI: 52-66%) and 84% (95% CI: 79-88%), respectively. The AUC of smooth peritoneal thickening was 0.83. Omentum line/rim, lymph node necrosis or calcification, and mesenteric macro nodules had a pooled specificity ranging from 95% to 100% and a pooled sensitivity ranging from 12% to 67%. The other 12 signs had a pooled sensitivity ranging from 21% to 79% and a pooled specificity ranging from 19% to 81%. Omentum involvement (cake-like pattern) showed a threshold-effect, so only the AUC (=0.70) was calculated. CONCLUSIONS Smooth peritoneal thickening shows fairly good diagnostic accuracy, while omentum rim/line, lymph nodes necrosis or calcification, mesenteric macro nodules have good specificity but limited sensitivity. The informative features summarised in this study may aid clinical practice and future studies.
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Affiliation(s)
- J Chen
- Department of Radiology, Zhongshan Affiliated Hospital, Guangzhou University of Chinese Medicine, Zhongshan, 528400, PR China.
| | - S Liu
- Department of Radiology, Zhongshan Affiliated Hospital, Guangzhou University of Chinese Medicine, Zhongshan, 528400, PR China
| | - Y Tang
- Department of Radiology, Zhongshan Affiliated Hospital, Guangzhou University of Chinese Medicine, Zhongshan, 528400, PR China
| | - X Zhang
- Department of Radiology, Zhongshan Affiliated Hospital, Guangzhou University of Chinese Medicine, Zhongshan, 528400, PR China
| | - M Cao
- Department of Radiology, Zhongshan Affiliated Hospital, Guangzhou University of Chinese Medicine, Zhongshan, 528400, PR China
| | - Z Xiao
- Department of Radiology, Zhongshan Affiliated Hospital, Guangzhou University of Chinese Medicine, Zhongshan, 528400, PR China
| | - M Ren
- Department of Radiology, Zhongshan Affiliated Hospital, Guangzhou University of Chinese Medicine, Zhongshan, 528400, PR China
| | - T Chen
- Department of Radiology, Zhongshan Affiliated Hospital, Guangzhou University of Chinese Medicine, Zhongshan, 528400, PR China
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Cao M, Li Y, Gao Z, Yan K, Zhong XX, Liu B, Zhang RY. [Malignant mesothelioma of intestinal: report of a case]. Zhonghua Bing Li Xue Za Zhi 2019; 48:897-899. [PMID: 31775444 DOI: 10.3760/cma.j.issn.0529-5807.2019.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- M Cao
- Department of Pathology, Yanzhou Area of Affiliated Hospital of Jining Medical College, Shandong Province, Yanzhou 272100, China
| | - Y Li
- Department of Pathology, Yanzhou Area of Affiliated Hospital of Jining Medical College, Shandong Province, Yanzhou 272100, China
| | - Z Gao
- Department of Pathology, Yanzhou Area of Affiliated Hospital of Jining Medical College, Shandong Province, Yanzhou 272100, China
| | - K Yan
- Department of Pathology, Yanzhou Area of Affiliated Hospital of Jining Medical College, Shandong Province, Yanzhou 272100, China
| | - X X Zhong
- Department of Pathology, Yanzhou Area of Affiliated Hospital of Jining Medical College, Shandong Province, Yanzhou 272100, China
| | - B Liu
- Department of Pathology, Yanzhou Area of Affiliated Hospital of Jining Medical College, Shandong Province, Yanzhou 272100, China
| | - R Y Zhang
- Department of Pathology, Affiliated Hospital of Jining Medical College, Shandong Province, Jining 272029, China
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45
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Palomo M, Blasco M, Molina P, Lozano M, Praga M, Torramade-Moix S, Martinez-Sanchez J, Cid J, Escolar G, Carreras E, Paules C, Crispi F, Quintana LF, Poch E, Rodas L, Goma E, Morelle J, Espinosa M, Morales E, Avila A, Cabello V, Ariceta G, Chocron S, Manrique J, Barros X, Martin N, Huerta A, Fraga-Rodriguez GM, Cao M, Martin M, Romera AM, Moreso F, Manonelles A, Gratacos E, Pereira A, Campistol JM, Diaz-Ricart M. Complement Activation and Thrombotic Microangiopathies. Clin J Am Soc Nephrol 2019; 14:1719-1732. [PMID: 31694864 PMCID: PMC6895490 DOI: 10.2215/cjn.05830519] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [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: 05/13/2019] [Accepted: 10/02/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND OBJECTIVES Atypical hemolytic uremic syndrome is a form of thrombotic microangiopathy caused by dysregulation of the alternative complement pathway. There is evidence showing complement activation in other thrombotic microangiopathies. The aim of this study was to evaluate complement activation in different thrombotic microangiopathies and to monitor treatment response. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Complement activation was assessed by exposing endothelial cells to sera or activated-patient plasma-citrated plasma mixed with a control sera pool (1:1)-to analyze C5b-9 deposits by immunofluorescence. Patients with atypical hemolytic uremic syndrome (n=34) at different stages of the disease, HELLP syndrome (a pregnancy complication characterized by hemolysis, elevated liver enzymes, and low platelet count) or severe preeclampsia (n=10), and malignant hypertension (n=5) were included. RESULTS Acute phase atypical hemolytic uremic syndrome-activated plasma induced an increased C5b-9 deposition on endothelial cells. Standard and lower doses of eculizumab inhibited C5b-9 deposition in all patients with atypical hemolytic uremic syndrome, except in two who showed partial remission and clinical relapse. Significant fibrin formation was observed together with C5b-9 deposition. Results obtained using activated-plasma samples were more marked and reproducible than those obtained with sera. C5b-9 deposition was also increased with samples from patients with HELLP (all cases) and preeclampsia (90%) at disease onset. This increase was sustained in those with HELLP after 40 days, and levels normalized in patients with both HELLP and preeclampsia after 6-9 months. Complement activation in those with malignant hypertension was at control levels. CONCLUSIONS The proposed methodology identifies complement overactivation in patients with atypical hemolytic uremic syndrome at acute phase and in other diseases such as HELLP syndrome and preeclampsia. Moreover, it is sensitive enough to individually assess the efficiency of the C5 inhibition treatment.
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Affiliation(s)
- Marta Palomo
- Josep Carreras Leukaemia Research Institute; .,Hematopathology, Department of Pathology, Centre de Diagnostic Biomedic (CDB), Hospital Clinic de Barcelona, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.,Barcelona Endothelium Team, Barcelona, Spain
| | - Miquel Blasco
- Department of Nephrology and Renal Transplantation, Hospital Clinic de Barcelona, Universitat de Barcelona, Spain.,Group of nephro-urological diseases and renal transplantation (IDIBAPS), Barcelona, Spain
| | - Patricia Molina
- Hematopathology, Department of Pathology, Centre de Diagnostic Biomedic (CDB), Hospital Clinic de Barcelona, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Miquel Lozano
- Apheresis Unit, Department of Hemotherapy and Hemostasis, Institut Clinic de Malalties Hematologiques i Oncologiques (ICMHO), IDIBAPS, Hospital Clinic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Manuel Praga
- Department of Nephrology, Hospital Universitario 12 de Octubre and Research Institute i+12, Madrid, Spain.,Department of Medicine, Universidad Complutense, Madrid, Spain
| | - Sergi Torramade-Moix
- Hematopathology, Department of Pathology, Centre de Diagnostic Biomedic (CDB), Hospital Clinic de Barcelona, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Julia Martinez-Sanchez
- Josep Carreras Leukaemia Research Institute.,Hematopathology, Department of Pathology, Centre de Diagnostic Biomedic (CDB), Hospital Clinic de Barcelona, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.,Barcelona Endothelium Team, Barcelona, Spain
| | - Joan Cid
- Apheresis Unit, Department of Hemotherapy and Hemostasis, Institut Clinic de Malalties Hematologiques i Oncologiques (ICMHO), IDIBAPS, Hospital Clinic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Gines Escolar
- Hematopathology, Department of Pathology, Centre de Diagnostic Biomedic (CDB), Hospital Clinic de Barcelona, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Enric Carreras
- Josep Carreras Leukaemia Research Institute.,Barcelona Endothelium Team, Barcelona, Spain
| | - Cristina Paules
- Fetal i+D Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clinic de Barcelona and Hospital Sant Joan de Deu), ICGON, IDIBAPS, Universitat de Barcelona and Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBER-ER), Barcelona, Spain
| | - Fatima Crispi
- Fetal i+D Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clinic de Barcelona and Hospital Sant Joan de Deu), ICGON, IDIBAPS, Universitat de Barcelona and Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBER-ER), Barcelona, Spain
| | - Luis F Quintana
- Department of Nephrology and Renal Transplantation, Hospital Clinic de Barcelona, Universitat de Barcelona, Spain.,Group of nephro-urological diseases and renal transplantation (IDIBAPS), Barcelona, Spain
| | - Esteban Poch
- Department of Nephrology and Renal Transplantation, Hospital Clinic de Barcelona, Universitat de Barcelona, Spain.,Group of nephro-urological diseases and renal transplantation (IDIBAPS), Barcelona, Spain
| | - Lida Rodas
- Department of Nephrology and Renal Transplantation, Hospital Clinic de Barcelona, Universitat de Barcelona, Spain
| | - Emma Goma
- Department of Nephrology and Renal Transplantation, Hospital Clinic de Barcelona, Universitat de Barcelona, Spain
| | - Johann Morelle
- Division of Nephrology, Cliniques universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Brussels, Belgium
| | - Mario Espinosa
- Department of Nephrology, Hospital Universitario Reina Sofía e Instituto Maimonides de Investigaciones Biológicas de Córdoba (IMIBIC), Córdoba, Spain
| | - Enrique Morales
- Department of Nephrology, Hospital Universitario 12 de Octubre and Research Institute i+12, Madrid, Spain
| | - Ana Avila
- Department of Nephrology and Renal Transplantation, Hospital Universitario Dr Peset, Valencia, Spain
| | - Virginia Cabello
- Department of Nephrology, Hospital Virgen del Rocio, Sevilla, Spain
| | - Gema Ariceta
- Department of Pediatric Nephrology, Hospital Materno-Infantil, Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Sara Chocron
- Department of Pediatric Nephrology, Hospital Materno-Infantil, Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Joaquin Manrique
- Department of Nephrology, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Xoana Barros
- Department of Nephrology, Hospital Universitari Josep Trueta, Girona, Spain
| | - Nadia Martin
- Department of Nephrology, Hospital Universitari Josep Trueta, Girona, Spain
| | - Ana Huerta
- Department of Nephrology, Hospital Puerta de Hierro Majadahonda, Madrid, Spain
| | - Gloria M Fraga-Rodriguez
- Department of Pediatric Nephrology, Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Mercedes Cao
- Department of Nephrology, Complejo Hospitalario Universitario A Coruña, Coruña, Spain
| | - Marisa Martin
- Department of Nephrology, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - Ana Maria Romera
- Department of Nephrology, Hospital General Universitario, Ciudad Real, Spain
| | - Francesc Moreso
- Department of Nephrology, Hospital Universitari Vall d'Hebron, Universitat Autonoma Barcelona, Barcelona, Spain
| | - Anna Manonelles
- Kidney Transplant Unit, Department of Nephrology, Hospital de Bellvitge, Universitat de Barcelona, Barcelona, Spain; and
| | - Eduard Gratacos
- Fetal i+D Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clinic de Barcelona and Hospital Sant Joan de Deu), ICGON, IDIBAPS, Universitat de Barcelona and Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBER-ER), Barcelona, Spain
| | | | - Josep M Campistol
- Department of Nephrology and Renal Transplantation, Hospital Clinic de Barcelona, Universitat de Barcelona, Spain
| | - Maribel Diaz-Ricart
- Hematopathology, Department of Pathology, Centre de Diagnostic Biomedic (CDB), Hospital Clinic de Barcelona, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.,Barcelona Endothelium Team, Barcelona, Spain
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Fu T, Liu S, Zhao H, Cao M, Zhang R. Effectiveness and Safety of Minimally Invasive Orthodontic Tooth Movement Acceleration: A Systematic Review and Meta-analysis. J Dent Res 2019; 98:1469-1479. [DOI: 10.1177/0022034519878412] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Doctors and patients attempt to accelerate orthodontic tooth movement with a minimally invasive surgery approach. The purpose of this systematic review was to evaluate the evidence of accelerated tooth movement in minimally invasive surgery and the adverse effects from it. A systematic search of the literature was performed in the electronic databases of PubMed, CENTRAL (Cochrane Central Register of Controlled Trials), Embase, Scopus, Web of Science, Science Direct, and Medline and was complemented by a manual search until February 2019. The inclusion criteria were prospective clinical studies of patients treated with a fixed appliance, and the intervention was accelerated orthodontic treatment with minimally invasive surgery. Nineteen articles (538 participants) were included in the review: 9 studies assessed the rate of upper canine movement; 5 considered the treatment time; 1 evaluated the en masse retraction time; and 4 studied adverse effects. We performed a meta-analysis for the rate of canine movement and treatment time and described the results for the adverse effects in a systematic review. The results of the subgroup analysis according to micro-osteoperforation and piezocision were included in the study. No accelerated tooth movement was found in the micro-osteoperforation group. After flapless corticotomy procedures, increased tooth movement rates were identified by weighted mean differences of 0.63 (95%CI = 0.22, 1.03, P = 0.003) and 0.64 (95% CI, −25 to 1.53; P = 0.16) for 1 and 2 mo, respectively. The mean treatment time was 68.42 d (95% CI, −113.19 to −23.65; P = 0.003) less that than for minimally invasive surgery. Moreover, no significant adverse effect was found. Because of the high heterogeneity of the meta-analysis, the results must be validated by additional large-sample multicenter clinical trials. There is not sufficient evidence to support that the single use of micro-osteoperforation could accelerate tooth movement, and there is only low-quality evidence to prove that flapless corticotomy could accelerate tooth movement.
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Affiliation(s)
- T. Fu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Orthodontics, School of Stomatology, The Fourth Military Medical University, Xi’an, China
| | - S. Liu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Orthodontics, School of Stomatology, The Fourth Military Medical University, Xi’an, China
| | - H. Zhao
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Orthodontics, School of Stomatology, The Fourth Military Medical University, Xi’an, China
| | - M. Cao
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Orthodontics, School of Stomatology, The Fourth Military Medical University, Xi’an, China
| | - R. Zhang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Orthodontics, School of Stomatology, The Fourth Military Medical University, Xi’an, China
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Cao M, Yang G, Fang S, Jia H, Hou J, Yu B. P3390Relationship of thrombus healing to underlying plaque characteristics in ST-segment elevation myocardial infarction: an optical coherence tomography study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0266] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Acute ST-segment elevation myocardial infarction (STEMI) is typically characterized by an occlusive coronary thrombus propagation on a disrupted or eroded atherosclerotic plaque. A variable period of plaque instability and thrombus formation occur days or weeks old in approximately 50% of patients with STEMI. Presence of late stage (older) thrombi in aspirated coronary material is an independent predictor of 1-year and long-term mortality in STEMI patients. However, the relationship between coronary thrombus healing to underlying plaque morphology and characteristics in vivo still remains largely unknown.
Purpose
Our objective was to assess differences in thrombus healing between ruptured and eroded plaques in vivo and evaluate the impact of underlying plaque characteristics on thrombus healing using optical coherence tomography (OCT).
Methods
Analyzable coronary material was obtained during primary percutaneous coronary intervention (PCI) from 135 patients with STEMI within 12h of symptom onset. Thrombi were morphologically classified as either early or late stage (lytic changes or organization). Of the 135 patients, 110 were eligible for culprit lesion evaluation using OCT. Quantitative and qualitative underlying plaque characteristics were assessed by OCT.
Results
Late-stage thrombi were found in 49 of 110 (44.5%) culprit plaques. Patients with eroded plaques more frequently had late-stage thrombi compared with ruptured plaques (59.0% vs. 36.6%, p<0.001). Subgroup analysis was performed between plaque rupture, identified in 71 patients (64.5%) and plaque erosion in 39 patients (35.5%). In plaque ruptures, patients with late-stage thrombi had larger lipid core length (12.4±3.3 vs. 14.5±3.8, p=0.020), larger rupture cavity length [1.5 (1.0, 2.0) vs. 1.9 (1.5, 2.8), p=0.034] and increased residual thrombus length [7.8 (6.3, 11.2) vs. 10.3 (7.8, 13.8), p=0.021] assessed by OCT compared with early thrombus group. However, in plaque erosions, late stage thrombi were associated with decreased residual thrombus burden compared with patients with early thrombus group [16.8 (12.8, 20.4) vs. 13.4 (10.7, 14.8), p=0.012]. No significant difference was found between thrombus healing with peak creatine kinase concentration or maximum NT-pro BNP in subgroup analysis.
Conclusions
Coronary thrombi in STEMI patients exhibited diverse phases of healing, depending on the etiology of the underlying culprit plaque in vivo. These observations indicate entirely distinct mechanisms of thrombus propagation, maturation and healing between plaque rupture and erosion, illustrating an opportunity for more tailored treatment in patients with different plaque type.
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Affiliation(s)
- M Cao
- The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - G Yang
- The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - S Fang
- The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - H Jia
- The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - J Hou
- The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - B Yu
- The Second Affiliated Hospital of Harbin Medical University, Harbin, China
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Cavero T, Arjona E, Soto K, Caravaca-Fontán F, Rabasco C, Bravo L, de la Cerda F, Martín N, Blasco M, Ávila A, Huerta A, Cabello V, Jarque A, Alcázar C, Fulladosa X, Carbayo J, Anaya S, Cobelo C, Ramos N, Iglesias E, Baltar J, Martínez-Gallardo R, Pérez L, Morales E, González R, Macía M, Draibe J, Pallardó L, Quintana LF, Espinosa M, Barros X, Pereira F, Cao M, Moreno JA, Rodríguez de Córdoba S, Praga M. Severe and malignant hypertension are common in primary atypical hemolytic uremic syndrome. Kidney Int 2019; 96:995-1004. [DOI: 10.1016/j.kint.2019.05.014] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 04/12/2019] [Accepted: 05/02/2019] [Indexed: 01/29/2023]
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49
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Cao M, Qiao-Guan G, Zhouhuizi S, Steinberg M, Nickols N, Kupelian P, King C, Kishan A. Clinical Assessment of the Planning Target Volume Margins for Stereotactic Body Radiotherapy of Prostate Cancer. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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50
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Chang E, Chin W, Levin-Epstein R, Parikh N, van Dams R, Yuan Y, Cao M, Kishan A, Steinberg M, Venkat P, Shaverdian N. Assessment of the Impact of an Interprofessional Curriculum on Radiation Therapy Knowledge in Radiation Oncology Nursing Staff. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.2197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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