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Lu K, Liao QQ, Zhu KW, Yao Y, Cui XJ, Chen P, Bi Y, Zhong M, Zhang H, Tang JC, Yu Q, Yue JK, He H, Zhu ZF, Cai ZZ, Yang Z, Zhang W, Dong YT, Wei QM, He X. Efficacy and Safety of Different Doses of Rivaroxaban and Risk Factors for Bleeding in Elderly Patients with Venous Thromboembolism: A Real-World, Multicenter, Observational, Cohort Study. Adv Ther 2024; 41:391-412. [PMID: 37987918 DOI: 10.1007/s12325-023-02717-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 10/20/2023] [Indexed: 11/22/2023]
Abstract
INTRODUCTION Venous thromboembolism (VTE) consists of deep vein thrombosis (DVT) and pulmonary embolism (PE). Rivaroxaban is a direct oral anticoagulant (DOAC) inhibiting activated coagulation factor X (FXa), and exerts several advantages in the treatment of VTE compared to conventional therapy. However, the efficacy and safety of rivaroxaban in elderly patients with VTE was still poorly understood. METHODS The study was carried out using an observational and non-interventional approach. A total of 576 patients aged ≥ 60 years with newly diagnosed VTE were included in the study. All patients received rivaroxaban with recommended treatment duration of ≥ 3 months for secondary prevention. In addition, 535 elderly patients with various diseases except VTE were included in the study in a retrospective and randomized way. RESULTS The total bleeding rate was 12.2% (70/576). Major bleeding and non-major clinically relevant (NMCR) bleeding occurred in 4 (0.69%) patients and 5 (0.87%) patients, respectively. The rate of recurrent VTE was 5.4%. The mean level of D-dimers was increased by 467.2% in the elderly patients with VTE compared with the elderly patients without VTE. The elderly patients with VTE receiving rivaroxaban at a dose of 10 mg once daily (n = 134) had lower risk for bleeding (3.7% vs 14.7%; P = 0.001) and a similar rate of recurrent VTE (4.5% vs 5.7%; P = 0.596) as compared to the elderly patients with VTE receiving rivaroxaban at higher doses including 15 mg once daily and 20 mg once daily (n = 442). In addition, age, concomitant aspirin, hemoglobin, activated partial thromboplastin time (APTT), and rivaroxaban doses were independent predictive factors for bleeding events. CONCLUSIONS The study suggested that a dose of 10 mg once daily should be the priority in elderly patients with VTE receiving long-term rivaroxaban anticoagulation therapy in view of reduced bleeding risk.
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Affiliation(s)
- Kepeng Lu
- Department of Pharmacy, The First Affiliated Hospital of Henan University of Science and Technology, No. 24 Jinghua Road, Jianxi District, Luoyang, China
| | - Qian-Qian Liao
- Department of Pharmacy, People's Hospital of Guilin, No.12 Civilization Road, Xiangshan District, Guilin, China
| | - Ke-Wei Zhu
- Office of Pharmacovigilance, GuangZhou BaiYunShan Pharmaceutical Holdings CO., LTD. BaiYunShan Pharmaceutical General Factory, No. 88 Yunxiang Road Tonghe Street, Baiyun District, Guangzhou, 510515, Guangdong Province, China.
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, No. 110 Xiangya Road, Changsha, China.
| | - Ying Yao
- Department of Pharmacy, People's Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University, No. 301 Zhengyuan North Street, Jinfeng District, Yinchuan, China
| | - Xiao-Jiao Cui
- Department of Pharmacy, Personalized Drug Therapy Key Laboratory of Sichuan Province, Sichuan Academy of Medical Science and Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, No. 32 West Second Section, 1st Ring Road, Qingyang District, Chengdu, China
| | - Peng Chen
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, No. 110 Xiangya Road, Changsha, China
| | - Ying Bi
- Department of Pharmacy, Nanchang Hongdu Hospital of TCM, No. 128 Xiangshan North Road, Donghu District, Nanchang, China
| | - Meng Zhong
- Department of Pharmacy, The Affiliated Hospital of Southwest Medical University, No. 25 Taiping Street, Jiangyang District, Luzhou, China
| | - Hao Zhang
- Department of Pharmacy, People's Hospital of Guilin, No.12 Civilization Road, Xiangshan District, Guilin, China
| | - Jing-Cai Tang
- Administration Office of Medication Clinical Trial, People's Hospital of Guilin, No.12 Civilization Road, Xiangshan District, Guilin, China
| | - Qin Yu
- Department of Pharmacy, People's Hospital of Guilin, No.12 Civilization Road, Xiangshan District, Guilin, China
| | - Jia-Kui Yue
- Department of Pharmacy, The Second Affiliated Hospital of Guilin Medical University, No. 212 Renmin Road, Lingui District, Guilin, China
| | - Hui He
- Department of Pharmacology, Renshou People's Hospital, No. 177, Section 1, Longtan Avenue, Huairen Street, Renshou County, Meishan, China
| | - Ze-Feng Zhu
- Department of Pharmacy, Affiliated Hospital of Guilin Medical University, No. 15 Lequn Road, Guilin, China
| | - Ze-Zheng Cai
- Department of Pharmacology, People's Hospital of Qiandongnan Prefecture, No. 31 Shaoshan South Road, Kaili, Qiandongnan Miao and Dong Autonomous Prefecture, China
| | - Zhe Yang
- Department of Pharmacy, North China Medical Health Group Xingtai General Hospital, No. 202 Bayi Street, Xingtai, China
| | - Wei Zhang
- Department of Pharmacy, Yangquan Coal Industry (Group) General Hospital, No. 218 North Street, Mining Area, Yangquan, China
- Department of Pharmacy, The First Affiliated Hospital of Hainan Medical University, No.31 Longhua Road, Longhua District, Haikou, China
| | - Yang-Tao Dong
- Department of Pharmacy, People's Hospital of Guilin, No.12 Civilization Road, Xiangshan District, Guilin, China
| | - Qiu-Mian Wei
- Department of Pharmacy, People's Hospital of Guilin, No.12 Civilization Road, Xiangshan District, Guilin, China
| | - Xuegai He
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Henan University of Science and Technology, No. 24 Jinghua Road, Jianxi District, Luoyang, 471003, Henan Province, China.
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He XF, Wang H, Tian Y, Zhang T, Qiu ZP, Cui XJ, Zhou JS, Yan XL, Wu YW, Pan YS, Ning YB, Chen L, Zhang KL, Zhao WH, Sharma D, Tan XD, Zhang MB. Evaluation of Copper Levels in Dental Calculus of OSF Patients with Chewing Dried Areca-Nut Quids in Hunan Province of Mainland China. Biol Trace Elem Res 2023; 201:677-682. [PMID: 35332437 DOI: 10.1007/s12011-022-03210-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 03/15/2022] [Indexed: 01/21/2023]
Abstract
Dental calculus is a potential material that can be used for assessing chronic exposure to trace heavy metals in oral cavity as it is a long-term reservoir. The aim of this study was to investigate the correlation between dental calculus copper levels and risk of oral submucous fibrosis (OSF) due to chewing dried areca-nut quids in Mainland China. This study included 34 OSF (grade 1) sufferers with dried areca-nut quids chewing as the patient group and 23 healthy individuals without areca-nut chewing as the control group. The dental calculus sample was obtained from all 57 participants and evaluated by inductively coupled plasma mass spectrometry (ICP-MS) for dental calculus level of copper. This work revealed that the mean copper level of dental calculus was significantly higher in OSF (grade 1) sufferers with areca-nut chewing than those in healthy individuals without areca-nut chewing (p < 0.001). This work provided an evidence to support that there may be a positive correlation between elevated levels of copper in dental calculus caused by chewing dried areca-nut quids and an increased risk of developing OSF in Mainland China.
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Affiliation(s)
- Xi-Fan He
- Department of Oral and Maxillofacial Surgery, Hunan Provincial People's Hospital and The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, People's Republic of China
- Department of Stomatology, Second Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
- Department of Stomatology, First Affiliated Hospital of Hunan College of Traditional Chinese Medicine (Zhuzhou Hospital of Traditional Chinese Medicine), Zhuzhou, People's Republic of China
| | - Hui Wang
- Changsha Institute for Food and Drug Control & National Alcohol Products Quality Supervision and Inspection Center, Changsha, Hunan, People's Republic of China
| | - Ye Tian
- Hunan Provincial Key Laboratory of Chemical Power Sources, College of Chemistry and Chemical Engineering, Central South University, Changsha, Hunan, People's Republic of China
| | - Te Zhang
- Department of Oral and Maxillofacial Surgery, Hunan Provincial People's Hospital and The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, People's Republic of China
| | - Zhi-Peng Qiu
- Changsha Institute for Food and Drug Control & National Alcohol Products Quality Supervision and Inspection Center, Changsha, Hunan, People's Republic of China
| | - Xiao-Jiao Cui
- Changsha Institute for Food and Drug Control & National Alcohol Products Quality Supervision and Inspection Center, Changsha, Hunan, People's Republic of China
| | - Jing-Sha Zhou
- Changsha Institute for Food and Drug Control & National Alcohol Products Quality Supervision and Inspection Center, Changsha, Hunan, People's Republic of China
| | - Xin-Lan Yan
- Department of Oral and Maxillofacial Surgery, Hunan Provincial People's Hospital and The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, People's Republic of China
| | - Yi-Wei Wu
- Department of Oral and Maxillofacial Surgery, Hunan Provincial People's Hospital and The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, People's Republic of China
| | - Yi-Sha Pan
- Department of Oral and Maxillofacial Surgery, Hunan Provincial People's Hospital and The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, People's Republic of China
| | - Yang-Bo Ning
- Department of Oral and Maxillofacial Surgery, Hunan Provincial People's Hospital and The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, People's Republic of China
| | - Lin Chen
- Department of Stomatology, Second Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
| | - Kun-Lun Zhang
- Hanwoo DNA Solutions Co., Ltd, Changsha, People's Republic of China
| | - Wei-Hao Zhao
- Hanwoo DNA Solutions Co., Ltd, Changsha, People's Republic of China
| | - David Sharma
- Hanwoo DNA Solutions Co., Ltd, Changsha, People's Republic of China
| | - Xiao-Dan Tan
- Hanwoo DNA Solutions Co., Ltd, Changsha, People's Republic of China
- Hunan Legal Forensic Center, Changsha, People's Republic of China
| | - Michael Bo Zhang
- Department of Oral and Maxillofacial Surgery, Hunan Provincial People's Hospital and The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, People's Republic of China.
- Hanwoo DNA Solutions Co., Ltd, Changsha, People's Republic of China.
- Hunan Legal Forensic Center, Changsha, People's Republic of China.
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Liao QQ, Ren YF, Zhu KW, Qin D, Mo YJ, Cong S, Wu J, Wang CY, Cui XJ, Xu HZ, Guo LZ, Zhang YY, Song HX, Zhang W, Yang Z, Tang YF, Li ZJ, Xie ZN, Li LM, Wang HJ, Zhou MM, Wei FN, Chen P, Shi YH. Long-Term Prognostic Factors in Patients With Antineutrophil Cytoplasmic Antibody-Associated Vasculitis: A 15-Year Multicenter Retrospective Study. Front Immunol 2022; 13:913667. [PMID: 35844610 PMCID: PMC9279612 DOI: 10.3389/fimmu.2022.913667] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 05/13/2022] [Indexed: 12/02/2022] Open
Abstract
Background Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a multisystem autoimmune disease with small-vessel involvement. In AAV, microscopic polyangiitis (MPA) and granulomatosis with polyangiitis (GPA) are major clinicopathologic variants. In addition, myeloperoxidase (MPO) and proteinase 3 (PR3) are major target antigens. The objective of the study was to explore the predictive factors for long-term survival in AAV patients. Materials and Methods A multicenter retrospective study was carried out on 407 patients between 2005 and 2020. Clinical parameters were obtained from laboratory tests including the ANCA types, antinuclear antibody (ANA), extractable nuclear antigen (ENA), anti-streptolysin O (ASO), glomerular filtration rate (GFR), and the laboratory examinations for the blood routine, liver function, renal function, and immunity, etc. The data for clinical parameters were collected from electronic medical records (EMRs), and the data for patient survival were acquired through regular follow-up. The association of clinical parameters with overall survival (OS) along with 3-year and 5-year survival rates was analyzed, and the nomogram as a predictive model was established according to the analysis results. Results In the present study, 336 (82.6%) patients and 46 (11.3%) patients were diagnosed with MPA and GPA, respectively. The mean and median OS for all the patients were 2,285 and 2,290 days, respectively. The 1-year, 3-year, 5-year, and 10-year cumulative survival rates for all the patients were 84.2%, 76.3%, 57.2%, and 32.4%, respectively. Univariate and multivariate survival analyses indicated that the independent prognostic factors included age, pathological categories (MPA, GPA, and other types), serum ANCA types (negative or positive for MPO and/or PR3), ANA, ASO, GFR, lymphocyte, neutrophil-to-lymphocyte ratio (NLR), and C-reactive protein (CRP), and these clinical parameters except for ASO were used to construct a nomogram. The nomogram for 3-year and 5-year survival rates had a C-index of 0.721 (95% CI 0.676–0.766). The calibration curves showed that the predicted values of the nomogram for 3-year and 5-year survival rates were generally consistent with practical observed values, and decision curve analysis (DCA) further demonstrated the practicability and accuracy of the predictive model. Conclusion Laboratory tests at diagnosis have great significance in the prediction of long-term survival in AAV patients.
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Affiliation(s)
- Qian-Qian Liao
- Department of Pharmacy, People’s Hospital of Guilin, Guilin, China
| | - Ya-Fei Ren
- Department of Rheumatology and Immunology, Affiliated Hospital of Guilin Medical University, Guilin, China
| | - Ke-Wei Zhu
- Department of Clinical Research, Institute of Pharmacology, Guangzhou Baiyunshan Pharmaceutical Holding Co., Ltd., Baiyunshan Pharmaceutical General Factory, Guangzhou, China
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, China
| | - Dong Qin
- Department of Pharmacy, People’s Hospital of Guilin, Guilin, China
| | - Yan-Ju Mo
- Department of Respiratory and Critical Care Medicine, People’s Hospital of Guilin, Guilin, China
| | - Shan Cong
- Department of Pharmacy, The Second Affiliated Hospital of Qiqihar Medical University, Qiqihar, China
| | - Juan Wu
- Department of Rheumatology, Ganzhou People’s Hospital, Ganzhou, China
| | - Chun-Ying Wang
- Department of Pharmacy, The Third Affiliated Hospital of Qiqihar Medical University, Qiqihar, China
| | - Xiao-Jiao Cui
- Department of Pharmacy, Personalized Drug Therapy Key Laboratory of Sichuan Province, Sichuan Academy of Medical Science and Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Hong-Zhen Xu
- Department of Pharmacy, People’s Hospital of Guilin, Guilin, China
| | - Lin-Zheng Guo
- Department of Thyroid, Breast and Vascular Surgery, People’s Hospital of Guilin, Guilin, China
| | - You-Yan Zhang
- Department of Rheumatology and Immunology, People’s Hospital of Guilin, Guilin, China
| | - Hai-Xia Song
- Department of Rheumatology and Immunology, People’s Hospital of Guilin, Guilin, China
| | - Wei Zhang
- Department of Pharmacy, Yangquan Coal Industry (Group) General Hospital, Yangquan, China
| | - Zhe Yang
- Department of Pharmacy, North China Medical Health Group Xingtai General Hospital, Xingtai, China
| | - Yan-Feng Tang
- Department of Geriatrics, People’s Hospital of Guilin, Guilin, China
| | - Zhuo-Jun Li
- Department of Neurology, People’s Hospital of Guilin, Guilin, China
| | - Zhou-Ni Xie
- Department of General Medicine, People’s Hospital, Guilin, China
| | - Li-Mei Li
- Department of Rheumatology and Immunology, People’s Hospital of Guilin, Guilin, China
| | - Hui-Juan Wang
- Department of General Medicine, People’s Hospital, Guilin, China
| | - Meng-Meng Zhou
- School of Public Health, Guilin Medical University, Guilin, China
| | - Fang-Ning Wei
- School of Clinical Pharmacy, Guilin Medical University, Guilin, China
| | - Peng Chen
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, China
| | - Yu-Hong Shi
- Department of Rheumatology and Immunology, Affiliated Hospital of Guilin Medical University, Guilin, China
- *Correspondence: Yu-Hong Shi,
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Liu HJ, Guo XF, Hu FL, Yan CP, Cui XJ, Yan XL, Li ZG, Jia Y, Song SL. [Increased receptor activator of nuclear factor kappa B ligand expressed on B10 cells in rheumatoid arthritis]. Beijing Da Xue Xue Bao Yi Xue Ban 2018; 50:968-974. [PMID: 30562766] [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: 06/09/2023]
Abstract
OBJECTIVE To detect receptor activator of nuclear factor kappa B ligand (RANKL) expressed on B10 cells in rheumatoid arthritis (RA) and to evaluate the correlation between RANKL-producing B10 cells in RA and clinical features and laboratory parameters, trying to reveal the possible role of B10 cells in the pathogenesis of RA and the potential mechanism of impaired immunosuppressive capacities. METHODS 25 RA patients and 20 healthy volunteers were enrolled. These RA patients did not received treatment with glucocorticoids, disease-modifying anti-rheumatic drug and biologics during the recent half of a year. The levels of RANKL-producing B10 cells were measured by flow cytometry (FCM) and polymerase chain reaction (PCR). The correlation between the frequencies of RANKL-producing B10 cells in RA and clinical data, laboratory parameters were analyzed. The role of tumor necrosis factor α (TNF-α) and interleukin 1β (IL-1β) in inducing RANKL expression in B10 cells was evaluated by in vitro stimulation assay. Independent samples t test, Pearson and Spearman correlation were used for statistical analysis. RESULTS B10 cells were capable of producing RANKL at a low level in health controls. The frequencies of RANKL-producing B10 cells were markedly higher in RA patients than in health controls (3.65%±1.59% vs. 2.25%±0.68%, P<0.01). The frequencies of these cells correlated positively with RA tender joint counts, swollen joint counts and disease activity score in 28 joints (DAS28) (r=0.479, P=0.035; r=0.519, P=0.008; r=0.526, P=0.019). However, no correlation was found between these cells and RA patient age, disease duration, or the levels of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF) and anti-citrullinated peptide antibody (ACPA). After in vitro stimulation by TNF-α, but not IL-1β, B10 cells isolated from healthy donors demonstrated fundamentally upregulated expression of RANKL. CONCLUSION Our studies showed the frequencies of RANKL-producing B10 cells were markedly higher in RA patients, and their frequencies were positively correlated with RA tender joint counts, swollen joint counts and DAS28. These findings suggested that B10 cells might be involved in RA bone destruction.
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Affiliation(s)
- H J Liu
- Department of Rheumatology and Immunology,the People's Hospital of China Three Gorges University,Yichang 443000, Hubei, China
| | - X F Guo
- Department of Rheumatology and Immunology,the People's Hospital of China Three Gorges University,Yichang 443000, Hubei, China
| | - F L Hu
- Department of Rheumatology and Immunology, Peking University People's Hospital, Beijing 100044, China
| | - C P Yan
- Department of Rheumatology and Immunology,the People's Hospital of China Three Gorges University,Yichang 443000, Hubei, China
| | - X J Cui
- Department of Rheumatology and Immunology,the People's Hospital of China Three Gorges University,Yichang 443000, Hubei, China
| | - X L Yan
- Department of Rheumatology and Immunology,the People's Hospital of China Three Gorges University,Yichang 443000, Hubei, China
| | - Z G Li
- Department of Rheumatology and Immunology, Peking University People's Hospital, Beijing 100044, China
| | - Y Jia
- Department of Rheumatology and Immunology, Peking University People's Hospital, Beijing 100044, China
| | - S L Song
- Department of Rheumatology and Immunology,the People's Hospital of China Three Gorges University,Yichang 443000, Hubei, China
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Li LJ, Liu YM, Wang YM, Zhou F, Li H, Xing XQ, Han XD, Chen L, Zhang CX, Wang JX, Liu B, Suo LJ, Yu GH, Wang GQ, Yao XX, Xiao Y, Zhu XL, Xue CX, Cui XJ, Cao B. [Clinical characteristics and prognosis of long-term glucocorticoid users with community-acquired pneumonia]. Zhonghua Yi Xue Za Zhi 2018; 98:738-743. [PMID: 29562397 DOI: 10.3760/cma.j.issn.0376-2491.2018.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Objective: To explore the clinical features, etiological features and prognostic risk factors of long-term glucocorticoid users with community-acquired pneumonia (CAP). Methods: A retrospective study included 100 long-term glucocorticoid users with CAP (G-CAP group) from 11 hospitals of China between January 2014 and December 2014, while 100 non-immunocompromised patients with community-acquired pneumonia were enrolled as controls (nICH-CAP group). Characteristics including age, gender, underlying diseases, corticosteroids, symptoms, disease severity, imaging manifestations, etiology, respiratory failure, mechanical ventilation, whether the application of vasoactive drugs, antibiotics application, hospital mortality rate between the two groups were compared, and the prognostic factors of G-CAP were investigated using Logistic regression. Results: The peripheral blood lymphocytes[1.06(0.70, 1.68) vs 1.44 (0.87, 1.98)]in G-CAP group was less than nICH-CAP group (P<0.05). CT with pulmonary interstitial change (28.6% vs 9.9%), the proportion of patients with respiratory failure (25.0% vs 7.0%), mechanical ventilation (9.0% vs 2.0%), noninvasive mechanical ventilation (12.0% vs 2.0%), septic shock (9.0% vs 2.0%), and the hospital mortality rate (13.0% vs 3.0%) in G-CAP group were significantly higher than in nICH-CAP group (all P<0.05). Bacterial infection accounted for the highest proportion of infection (61.3%) in G-CAP group, but also virus infection (19.4%) and mixed infection (16.1%). Pseudomonas accounted for the highest proportion (47.4%) in bacterial infection of G-CAP. Logistic regression analysis showed that peripheral blood lymphocytes (OR=0.004, 95% CI: 0.000-0.234; P<0.05) and respiratory failure (OR=17.766, 95% CI: 4.933-131.0; P<0.05) were independent predictors of death in G-CAP group. Conclusions: The proportion of severe pneumonia and the mortality rate of patients with G-CAP are higher than the patients with nICH-CAP. Lymphopenia and respiratory failure are associated with poor outcome of patients with G-CAP.
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Affiliation(s)
- L J Li
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Chinical Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing 100029, China
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Cui XJ, Zhao HO, Su P, Chen J, Zhang RY, Pan Y, Ouyang XM, Liu J, Zhang JQ, Yang Y, Yang R, Ding L, Liu ZY. [Clinicopathologic and molecular features of cribriform morular variant of papillary thyroid carcinoma]. Zhonghua Bing Li Xue Za Zhi 2018; 47:354-359. [PMID: 29783802 DOI: 10.3760/cma.j.issn.0529-5807.2018.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the clinicopathologic and molecular features of the rare cribriform morular variant of papillary thyroid carcinoma (CMV-PTC). Methods: The clinicopathologic data of 10 patients with CMV-PTC were retrospectively reviewed. Immunohistochemical (IHC) staining was done using LSAB method. DNA sequencing for APC were applied using Sanger method. BRAF V600E mutation was examined using ARMS method. The cytological, morphological, IHC and molecular features were analyzed. Results: All patients were female at an average age of 27 years old. The tumors were mostly located in the right lobe of thyroid. Fine needle aspiration cytology was performed in three patients; two were diagnosed as suspicious for PTC and one as PTC. Nine tumors presented as solitary nodule and two as multiple nodules in both lobes. Infiltration was demonstrated in three cases. The average size was 2.6 cm. The neoplastic cells were arranged in papillary, cribriform, solid and glandular patterns, with rare or without colloid inside the lumen. The number of morula varied, ranging from zero to many. The neoplastic cells were variably enlarged, showing round, oval or spindle shape. Nuclear irregularity was identified as irregular membrane, nuclear grooves or pseudoinclusion, but no typical ground glass feature. Peculiar nuclear clearing could be observed in the morular cells. IHC staining showed the neoplastic cells were negative for thyroglobulin and p63, but positive for TTF1, cytokeratin 19 and estrogen receptor. Diffuse staining with cytokeratin was seen in the neoplastic cells and the morula. Specific cytoplasmic and nuclear staining of β-catenin was seen in the neoplastic cells but not the morula. Ki-67 proliferation index was 1%-30%. No recurrence or metastasis was observed. One patient was demonstrated to harbor both somatic and germline mutations of the APC gene, who was found to have adenomatous polyposis and her mother died of colonic carcinoma. No BRAF V600E mutation was detected. Conclusions: CMV-PTC is rare and shows atypical cytological and clinicopathological features, and it is easily misdiagnosed.TG, TTF1, ER and β-catenin are specific IHC markers for CMV-PTC. The morula is negative for cytokeratin 19, in contrast to squamous metaplasia. Although CMV-PTC has indolent clinical behavior, a definite diagnosis is necessary to rule out the possibility of APC gene mutation and related extra-thyroidal neoplasm, such as FAP and Gardner syndrome.
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Affiliation(s)
- X J Cui
- Department of Pathology, Shandong University School of Basic Medical Sciences, Jinan 250012, China
| | - H O Zhao
- Department of Pathology, First Affiliated Hospital of Yancheng City, Jiangsu Province, Yancheng 224005, China
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Cui XJ, Zhang CY, Su P, Lyu B, Ren YB, Fan XS, Zhang XF, Wang Y, Song YH, Liu ZY. [Clinicopathologic characteristics of head and neck carcinoma showing thymus-like element]. Zhonghua Bing Li Xue Za Zhi 2017; 46:155-159. [PMID: 28297754 DOI: 10.3760/cma.j.issn.0529-5807.2017.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate clinicopathological features of carcinoma showing thymus-like elements (CASTLE) in the head and neck regions. Methods: Clinicopathological data of 7 patients with CASTLE in the head and neck regions were retrospectively reviewed.Immunohistochemical staining and in situ hybridization for EBER were performed. BRAF(V600E) mutation was examined by ARMS method in 6 cases. Results: There were 5 females and 2 males with age between 49 and 78 years (average of 65.6 years). All tumors were solitary nodular lesions with an infiltrative border, including 6 intrathyroid tumors and 1 extrathyroid tumor in the laryngeal pharynx.The tumors were 1.7-4.1 cm in diameter (average of 3.0 cm). Four cases demonstrated lymph node metastasis.All patients were alive without metastasis during follow-up, except one consultation case (with FNA sample) developed recurrence at the primary site. The cases showed different immunoreaction to CD5, diffuse immunoreaction with p63, CK5/6 and CD117, but negative staining for TTF1, TG and calcitonin. One case showed positive immunoreaction with Synin less than 30% tumor cells. The Ki-67 labeling index was between 3% and 90%. No BRAF(V600E) mutation and EB virus infection were detected. Conclusions: Extrathyroid CASTLE involving laryngeal pharynx shows the similar morphological and immunohistochemical features with intrathyroid CASTLE.Immunohistochemical markers of CD5 and CD117 are helpful in the diagnosis. Ki-67 labeling index can be high in CASTLE, especially in lymphoepithelioma type. CD5-negative CASTLE may have neuroendocrine differentiation. BRAF(V600E) mutation and EB virus may not be involved in the carcinogenesis of CASTLE.
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Affiliation(s)
- X J Cui
- Department of Pathology, Shandong University Qilu Hospital, Jinan 250012, China
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Cui XJ, Cao B, Li YM. [A case report of Good's syndrome]. Zhonghua Nei Ke Za Zhi 2016; 55:800-802. [PMID: 27686445 DOI: 10.3760/cma.j.issn.0578-1426.2016.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Zhang J, Ku LX, Han ZP, Guo SL, Liu HJ, Zhang ZZ, Cao LR, Cui XJ, Chen YH. The ZmCLA4 gene in the qLA4-1 QTL controls leaf angle in maize (Zea mays L.). J Exp Bot 2014; 65:5063-76. [PMID: 24987012 DOI: 10.1093/jxb/eru271] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Maize architecture is a major contributing factor to their high level of productivity. Maize varieties with an erect-leaf-angle (LA) phenotype, which increases light harvesting for photosynthesis and grain-filling, have elevated grain yields. Although a large body of information is available on the map positions of quantitative trait loci (QTL) for LA, little is known about the molecular mechanism of these QTL. In this study, the ZmCLA4 gene, which is responsible for the qLA4-1 QTL associated with LA, was identified and isolated by fine mapping and positional cloning. The ZmCLA4 gene is an orthologue of LAZY1 in rice and Arabidopsis. Sequence analysis revealed two SNPs and two indel sites in ZmCLA4 between the D132 and D132-NIL inbred maize lines. Association analysis showed that C/T/mutation667 and CA/indel965 were strongly associated with LA. Subcellular localization verified the functions of a predicted transmembrane domain and a nuclear localization signal in ZmCLA4. Transgenic maize plants with a down-regulated ZmCLA4 RNAi construct and transgenic rice plants over-expressing ZmCLA4 confirmed that the ZmCLA4 gene located in the qLA4 QTL regulated LA. The allelic variants of ZmCLA4 in the D132 and D132-NIL lines exhibited significant differences in leaf angle. ZmCLA4 transcript accumulation was higher in D132-NIL than in D132 during all the developmental stages and was negatively correlated with LA. The gravitropic response was increased and cell shape and number at the leaf and stem junctions were altered in D132-NIL relative to D132. These findings suggest that ZmCLA4 plays a negative role in the control of maize LA through the alteration of mRNA accumulation, leading to altered shoot gravitropism and cell development. The cloning of the gene responsible for the qLA4-1 QTL provides information on the molecular mechanisms of LA in maize and an opportunity for the improvement of plant architecture with regard to LA through maize breeding.
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Affiliation(s)
- J Zhang
- College of Agronomy, Synergetic Innovation Center of Henan Grain Crops and National Key Laboratory of Wheat and Maize Crop Science, Henan Agricultural University, 95, Wenhua Road, Zhengzhou 450002, China
| | - L X Ku
- College of Agronomy, Synergetic Innovation Center of Henan Grain Crops and National Key Laboratory of Wheat and Maize Crop Science, Henan Agricultural University, 95, Wenhua Road, Zhengzhou 450002, China
| | - Z P Han
- College of Agronomy, Synergetic Innovation Center of Henan Grain Crops and National Key Laboratory of Wheat and Maize Crop Science, Henan Agricultural University, 95, Wenhua Road, Zhengzhou 450002, China College of Agronomy, Henan University of Science and Technology, Luoyang 471003, China
| | - S L Guo
- College of Agronomy, Synergetic Innovation Center of Henan Grain Crops and National Key Laboratory of Wheat and Maize Crop Science, Henan Agricultural University, 95, Wenhua Road, Zhengzhou 450002, China
| | - H J Liu
- College of Agronomy, Synergetic Innovation Center of Henan Grain Crops and National Key Laboratory of Wheat and Maize Crop Science, Henan Agricultural University, 95, Wenhua Road, Zhengzhou 450002, China
| | - Z Z Zhang
- College of Agronomy, Synergetic Innovation Center of Henan Grain Crops and National Key Laboratory of Wheat and Maize Crop Science, Henan Agricultural University, 95, Wenhua Road, Zhengzhou 450002, China
| | - L R Cao
- College of Agronomy, Synergetic Innovation Center of Henan Grain Crops and National Key Laboratory of Wheat and Maize Crop Science, Henan Agricultural University, 95, Wenhua Road, Zhengzhou 450002, China
| | - X J Cui
- College of Agronomy, Synergetic Innovation Center of Henan Grain Crops and National Key Laboratory of Wheat and Maize Crop Science, Henan Agricultural University, 95, Wenhua Road, Zhengzhou 450002, China
| | - Y H Chen
- College of Agronomy, Synergetic Innovation Center of Henan Grain Crops and National Key Laboratory of Wheat and Maize Crop Science, Henan Agricultural University, 95, Wenhua Road, Zhengzhou 450002, China
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Wang FL, Schoplocher D, Cui XJ, Quan H. Sources of Diagnosis in Administrative Data: Considerations in Epidemiologic Research and Surveillance. Am J Epidemiol 2006. [DOI: 10.1093/aje/163.suppl_11.s49-a] [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: 11/12/2022] Open
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Abstract
This prospective study investigated whether major depressive disorder can cause negative life events. One hundred and thirteen normal college men have been followed biennially from age 26 until age 62. Fourteen major negative life events were assessed retrospectively by a self-report checklist. A blind rater read each man's complete records over the 35 years and used the same checklist prospectively. The negative life events were divided into dependent and independent groups according to whether the men's own behavior could have played a role in causing the events. In comparison with the normal control group, depressed individuals had a higher density of dependent negative life events after their first episode of depression. This difference did not exist for the occurrence of independent negative life events. Independent negative life events tended to be related to help seeking behaviors rather than to depression. This study confirmed our hypothesis that affective spectrum disorder can generate self-induced negative life events, which may contribute to the chronicity of the disorder.
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Affiliation(s)
- X J Cui
- Division of Psychiatry, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts 02115, USA
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Abstract
OBJECTIVE This study investigated whether negative life events affected subjects' long-term physical and mental health. METHOD One hundred thirteen normal college men completed biennial follow-up questionnaires from age 26 until age 62. At age 62 they retrospectively assessed 16 major negative life events with a self-report checklist. A blind rater read each man's complete records over the 35 years and completed the same checklist prospectively. The men had independent physical examinations at age 65. RESULTS It was demonstrated that negative life events affect men's psychological health more than their physical health. The correlation of negative life events with physical health was so low that no significant relationship between the two variables could be established. Negative life events were significantly associated with affective spectrum disorder and its relevant indicators. Further, the Cox proportional hazards model revealed that negative life events, family history of depression, and psychosocial stability during the college years were independent and statistically significant predictors of depression. CONCLUSIONS This study supports the widely held belief that biological factors (heredity), psychological factors (unstable personality), and social factors (negative life events) are all etiologically related to depression.
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Affiliation(s)
- X J Cui
- Division of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA
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Li LG, Cui XJ, Tian YL. [Primary hepatosarcoma: reports of 8 cases]. Zhonghua Wai Ke Za Zhi 1994; 32:606-7. [PMID: 7750419] [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: 01/26/2023]
Abstract
Eight cases of the primary hepatosarcoma were reported in this paper. These cases were verified by resection and pathological examination. The abdominal pain and mass were of the main clinical features. The image studies showed the occupied lesions of the liver. The preoperative differential diagnosis is of difficulty. All these cases were misdiagnosed: 6 cases (75%) as cystic lesions and 2 cases (25%) as cancer of the liver, The sarcoma of the liver is usually huge and central necrotized which formed liquid-cavity. Therefore the differential diagnosis of huge mixed cystic lesions of the liver should be stressed. During operation, the frozen section pathological examination should be performed as a routine in case misdiagnosis and mistreatment happen. Early surgical resection is suggested in order to raise the survival rate.
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Affiliation(s)
- L G Li
- First Clinical Hospital, China Medical University, Shenyang
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