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Liufu R, Weng L, Wang CY, Du B. Pitfalls of Acute Respiratory Distress Syndrome Diagnosis Based on Interventions. Am J Respir Crit Care Med 2024; 209:1278-1279. [PMID: 38507733 DOI: 10.1164/rccm.202308-1368le] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 03/19/2024] [Indexed: 03/22/2024] Open
Affiliation(s)
- Rong Liufu
- State Key Laboratory of Complex Severe and Rare Diseases, Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Li Weng
- State Key Laboratory of Complex Severe and Rare Diseases, Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Chun-Yao Wang
- State Key Laboratory of Complex Severe and Rare Diseases, Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Bin Du
- State Key Laboratory of Complex Severe and Rare Diseases, Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
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2
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An R, Wan XX, Chen Y, Dong R, Wang CY, Jiang W, Weng L, Du B. Central venous oxygen saturation changes as a reliable predictor of the change of CI in septic shock: To explore potential influencing factors. Chin J Traumatol 2024:S1008-1275(24)00058-0. [PMID: 38789315 DOI: 10.1016/j.cjtee.2024.05.001] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 05/09/2024] [Accepted: 05/12/2024] [Indexed: 05/26/2024] Open
Abstract
PURPOSE Assessing fluid responsiveness relying on central venous oxygen saturation (ScvO2) yields varied outcomes across several studies. This study aimed to determine the ability of the change in ScvO2 (ΔScvO2) to detect fluid responsiveness in ventilated septic shock patients and potential influencing factors. METHODS In this prospective, single-center study, all patients conducted from February 2023 to January 2024 received fluid challenge. Oxygen consumption was measured by indirect calorimetry, and fluid responsiveness was defined as an increase of cardiac index (CI) ≥ 10% measured by transthoracic echocardiography. Multivariate linear regression analysis was conducted to evaluate the impact of oxygen consumption, arterial oxygen saturation, CI, and hemoglobin on ScvO2 and its change before and after fluid challenge. RESULTS Among 49 patients (31 men, aged (59 ± 18) years), 27 were responders. The patients had an acute physiology and chronic health evaluation II score of 24 ± 8, a sequential organ failure assessment score of 11 ± 4, and a blood lactate level of (3.2 ± 3.1) mmol/L at enrollment. After the fluid challenge, the ΔScvO2 (mmHg) in the responders was greater than that in the non-responders (4 ± 6 vs. 1 ± 3, p = 0.019). Multivariate linear regression analysis suggested that CI was the only independent influencing factor of ScvO2, with R2 = 0.063, p = 0.008. After the fluid challenge, the change in CI became the only contributing factor to ΔScvO2 (R2 = 0.245, p < 0.001). ΔScvO2 had a good discriminatory ability for the responders and non-responders with a threshold of 4.4% (area under the curve = 0.732, p = 0.006). CONCLUSION ΔScvO2 served as a reliable surrogate marker for ΔCI and could be utilized to assess fluid responsiveness, given that the change of CI was the sole contributing factor to the ΔScvO2. In stable hemoglobin conditions, the absolute value of ScvO2 could serve as a monitoring indicator for adequate oxygen delivery independent of oxygen consumption.
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Affiliation(s)
- Ran An
- Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Xi-Xi Wan
- Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China; Department of Critical Care Medicine, The Second Affiliated Hospital of Jiaxing University, Jiaxing, 314001, Zhejiang province, China
| | - Yan Chen
- Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Run Dong
- Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Chun-Yao Wang
- Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Wei Jiang
- Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Li Weng
- Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Bin Du
- Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China.
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3
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Wang JY, Chen Y, Dong R, Li S, Peng JM, Hu XY, Jiang W, Wang CY, Weng L, Du B. Extracorporeal vs. conventional CPR for out-of-hospital cardiac arrest: A systematic review and meta-analysis. Am J Emerg Med 2024; 80:185-193. [PMID: 38626653 DOI: 10.1016/j.ajem.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 04/01/2024] [Accepted: 04/04/2024] [Indexed: 04/18/2024] Open
Abstract
BACKGROUND Out-of-hospital cardiac arrest (OHCA) remains a significant cause of mortality and morbidity worldwide. Extracorporeal cardiopulmonary resuscitation (ECPR) is a potential intervention for OHCA, but its effectiveness compared to conventional cardiopulmonary resuscitation (CCPR) needs further evaluation. METHOD We systematically searched PubMed, Embase, the Cochrane Library, Web of Science, and ClinicalTrials.gov for relevant studies from January 2010 to March 2023. Pooled meta-analysis was performed to investigate any potential association between ECPR and improved survival and neurological outcomes. RESULTS This systematic review and meta-analysis included two randomized controlled trials enrolling 162 participants and 10 observational cohort studies enrolling 4507 participants. The pooled meta-analysis demonstrated that compared to CCRP, ECPR did not improve survival and neurological outcomes at 180 days following OHCA (RR: 3.39, 95% CI: 0.79 to 14.64; RR: 2.35, 95% CI: 0.97 to 5.67). While a beneficial effect of ECPR was obtained regarding 30-day survival and neurological outcomes. Furthermore, ECPR was associated with a higher risk of bleeding complications. Subgroup analysis showed that ECPR was prominently beneficial when exclusively initiated in the emergency department. Additional post-resuscitation treatments did not significantly impact the efficacy of ECPR on 180-day survival with favorable neurological outcomes. CONCLUSIONS There is no high-quality evidence supporting the superiority of ECPR over CCPR in terms of survival and neurological outcomes in OHCA patients. However, due to the potential for bias, heterogeneity among studies, and inconsistency in practice, the non-significant results do not preclude the potential benefits of ECPR. Further high-quality research is warranted to optimize ECPR practice and provide more generalizable evidence. Clinical trial registration PROSPERO, https://www.crd.york.ac.uk/prospero/, registry number: CRD42023402211.
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Affiliation(s)
- Jing-Yi Wang
- Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Yan Chen
- Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Run Dong
- Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Shan Li
- Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Jin-Min Peng
- Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Xiao-Yun Hu
- Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Wei Jiang
- Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Chun-Yao Wang
- Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Li Weng
- Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China.
| | - Bin Du
- Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China.
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4
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Li YY, Chen Y, Li S, Li YY, An R, Hu XY, Jiang W, Wang CY, Dong R, Yang QW, Weng L, Peng JM, Du B. Impact of Immunosuppressed Status on Prognosis of Carbapenem-Resistant Organisms Bloodstream Infections. Infect Dis Ther 2024; 13:861-874. [PMID: 38536646 PMCID: PMC11058147 DOI: 10.1007/s40121-024-00956-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 03/04/2024] [Indexed: 04/30/2024] Open
Abstract
INTRODUCTION The impact of immunosuppression on prognosis of carbapenem-resistant organism (CRO) bloodstream infection (BSI) remains unclear. The aim of this study was to clarify the relationship between immunosuppression and mortality of CRO-BSI and to identify the risk factors associated with mortality in immunosuppressed patients. METHODS This retrospective study included 279 patients with CRO-BSI from January 2018 to March 2023. Clinical characteristics and outcomes were compared between the immunosuppressed and immunocompetent patients. The relationship between immunosuppression and 30-day mortality after BSI onset was assessed through logistic-regression analysis, propensity score matching (PSM) and inverse probability of treatment weighting (IPTW). Factors associated with mortality in immunosuppressed patients were analyzed using multivariable logistic regression analysis. RESULTS A total of 88 immunocompetent and 191 immunosuppressed patients were included, with 30-day all-cause mortality of 58.8%. Although the 30-day mortality in immunosuppressed patients was significantly higher than in immunocompetent patients (46.6% vs. 64.4%, P = 0.007), immunosuppression was not an independent risk factor for mortality in multivariate logistic regression analysis (odds ratio [OR] 3.53, 95% confidence interval [CI] 0.74-18.89; P = 0.123), PSM (OR 1.38, 95% CI 0.60-3.18; P = 0.449,) or IPTW (OR 1.40, 95% CI 0.58-3.36; P = 0.447). For patients with CRO-BSI, regardless of immune status, appropriate antibiotic therapy was associated with decreased 30-day mortality, while Charlson comorbidity index (CCI), intensive care unit (ICU)-acquired infection and thrombocytopenia at CRO-BSI onset were associated with increased mortality. CONCLUSION Despite the high mortality rate of CRO-BSI, immunosuppression did not affect the mortality. Appropriate antibiotic therapy is crucial for improving the prognosis of CRO-BSI, regardless of the immune status.
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Affiliation(s)
- Yuan-Yuan Li
- Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 1 Shuai Fu Yuan, Beijing, 100730, China
| | - Yan Chen
- Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 1 Shuai Fu Yuan, Beijing, 100730, China
| | - Shan Li
- Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 1 Shuai Fu Yuan, Beijing, 100730, China
| | - Yuan-Yuan Li
- Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 1 Shuai Fu Yuan, Beijing, 100730, China
| | - Ran An
- Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 1 Shuai Fu Yuan, Beijing, 100730, China
| | - Xiao-Yun Hu
- Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 1 Shuai Fu Yuan, Beijing, 100730, China
| | - Wei Jiang
- Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 1 Shuai Fu Yuan, Beijing, 100730, China
| | - Chun-Yao Wang
- Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 1 Shuai Fu Yuan, Beijing, 100730, China
| | - Run Dong
- Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 1 Shuai Fu Yuan, Beijing, 100730, China
| | - Qi-Wen Yang
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 1 Shuai Fu Yuan, Beijing, 100730, China
| | - Li Weng
- Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 1 Shuai Fu Yuan, Beijing, 100730, China
| | - Jin-Min Peng
- Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 1 Shuai Fu Yuan, Beijing, 100730, China.
| | - Bin Du
- Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 1 Shuai Fu Yuan, Beijing, 100730, China.
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Zhang ZW, Wang CY, He B. [Reperfusion strategies for STEMI patients: recent advances in comparative study of pharmaco-invasive strategy and primary PCI]. Zhonghua Xin Xue Guan Bing Za Zhi 2024; 52:295-299. [PMID: 38514333 DOI: 10.3760/cma.j.cn112148-20231130-00471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Affiliation(s)
- Z W Zhang
- Cardiovascular Department of Shanghai Chest Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200030, China
| | - C Y Wang
- Cardiovascular Department of Shanghai Chest Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200030, China
| | - B He
- Cardiovascular Department of Shanghai Chest Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200030, China
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Lin M, Griffin SO, Li CH, Wei L, Espinoza L, Wang CY, Thornton-Evans G. Exploring Recent Decreases in First Molar Sealants among US Children. J Dent Res 2024:220345241231774. [PMID: 38410889 DOI: 10.1177/00220345241231774] [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: 02/28/2024] Open
Abstract
Analyses of National Health and Nutrition Examination Survey (NHANES) data suggested a significant decrease in sealant prevalence among children between 2011 to 2014 and 2015 to 2018. We explore whether this decrease could be associated with possible changes in 1) clinical sealant delivery, 2) dental materials (i.e., increased use of glass ionomer [GI] sealants resulting in an inability to detect sealant fragments that still provide preventive benefits or increased use of composite restorations leading to misclassifying sealants as restorations), and 3) examination sensitivity and specificity. We used NHANES data to estimate the prevalences of sealants, untreated caries, and restorations in ≥1 first permanent molar among children aged 7 to 10 y and used Medical Expenditure Panel Survey data to estimate the annual clinical delivery of sealants and fluoride treatments. We examined changes in outcomes between 2 periods (P < 0.05) controlling for selected sociodemographic characteristics. NHANES sealant examination quality was based on the reference examiner's replicate examinations. The adjusted prevalence of sealants decreased relatively by 27.5% (46.6% vs. 33.8%). Overall, untreated caries decreased. Untreated caries and restoration decreased among children without sealants. Annual clinical sealant delivery did not change, whereas fluoride treatment delivery increased. The decrease in sealant prevalence held when assessed for various age ranges and NHANES cycle combinations. While sealant examination specificity remained similar between the periods, sensitivity (weighted by the proportion of exams by each examiner) decreased relatively by 17.4% (0.92 vs. 0.76). These findings suggest that decreased sealant prevalence was not supported by decreased clinical sealant delivery nor increased use of composite restorations. Decreased examination sensitivity, which could be due to an increased use of GI sealants, could contribute to the decrease in sealant prevalence. The decrease in caries among children without sealants could suggest the increased use of GI sealants. However, we could not rule out that the decrease in caries could be attributable to increased fluoride treatment delivery.
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Affiliation(s)
- M Lin
- Division of Oral Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - S O Griffin
- Division of Oral Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - C H Li
- CyberData Technologies, Inc., Herndon, VA, USA
| | - L Wei
- DB Consulting Group, Inc., Atlanta, GA, USA
| | - L Espinoza
- Division of Oral Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - C Y Wang
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, CDC, Hyattsville, MD, USA
| | - G Thornton-Evans
- Division of Oral Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
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7
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Roshanov PS, Chan MTV, Borges FK, Conen D, Wang CY, Xavier D, Berwanger O, Marcucci M, Sessler DI, Szczeklik W, Spence J, Alonso-Coello P, Fernández C, Pearse RM, Malaga G, Garg AX, Srinathan SK, Jacka MJ, Tandon V, McGillion M, Popova E, Sigamani A, Abraham V, Biccard BM, Villar JC, Chow CK, Polanczyk CA, Tiboni M, Whitlock R, Ackland GL, Panju M, Lamy A, Sapsford R, Williams C, Wu WKK, Cortés OL, MacNeil SD, Patel A, Belley-Côté EP, Ofori S, McIntyre WF, Leong DP, Heels-Ansdell D, Gregus K, Devereaux PJ. One-year Outcomes after Discharge from Noncardiac Surgery and Association between Predischarge Complications and Death after Discharge: Analysis of the VISION Prospective Cohort Study. Anesthesiology 2024; 140:8-24. [PMID: 37713506 DOI: 10.1097/aln.0000000000004763] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/17/2023]
Abstract
BACKGROUND In previous analyses, myocardial injury after noncardiac surgery, major bleeding, and sepsis were independently associated with most deaths in the 30 days after noncardiac surgery, but most of these deaths occurred during the index hospitalization for surgery. The authors set out to describe outcomes after discharge from hospital up to 1 yr after inpatient noncardiac surgery and associations between predischarge complications and postdischarge death up to 1 yr after surgery. METHODS This study was an analysis of patients discharged after inpatient noncardiac surgery in a large international prospective cohort study across 28 centers from 2007 to 2013 of patients aged 45 yr or older followed to 1 yr after surgery. The study estimated (1) the cumulative postdischarge incidence of death and other outcomes up to a year after surgery and (2) the adjusted time-varying associations between postdischarge death and predischarge complications including myocardial injury after noncardiac surgery, major bleeding, sepsis, infection without sepsis, stroke, congestive heart failure, clinically important atrial fibrillation or flutter, amputation, venous thromboembolism, and acute kidney injury managed with dialysis. RESULTS Among 38,898 patients discharged after surgery, the cumulative 1-yr incidence was 5.8% (95% CI, 5.5 to 6.0%) for all-cause death and 24.7% (95% CI, 24.2 to 25.1%) for all-cause hospital readmission. Predischarge complications were associated with 33.7% (95% CI, 27.2 to 40.2%) of deaths up to 30 days after discharge and 15.0% (95% CI, 12.0 to 17.9%) up to 1 yr. Most of the association with death was due to myocardial injury after noncardiac surgery (15.6% [95% CI, 9.3 to 21.9%] of deaths within 30 days, 6.4% [95% CI, 4.1 to 8.7%] within 1 yr), major bleeding (15.0% [95% CI, 8.3 to 21.7%] within 30 days, 4.7% [95% CI, 2.2 to 7.2%] within 1 yr), and sepsis (5.4% [95% CI, 2.2 to 8.6%] within 30 days, 2.1% [95% CI, 1.0 to 3.1%] within 1 yr). CONCLUSIONS One in 18 patients 45 yr old or older discharged after inpatient noncardiac surgery died within 1 yr, and one quarter were readmitted to the hospital. The risk of death associated with predischarge perioperative complications persists for weeks to months after discharge. EDITOR’S PERSPECTIVE
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Affiliation(s)
- Pavel S Roshanov
- Department of Medicine, Western University, London, Canada; Population Health Research Institute, Hamilton, Canada
| | - Matthew T V Chan
- Department of Anaesthesia and Intensive Care, Chinese University of Hong Kong and Prince of Wales Hospital, Hong Kong, Hong Kong
| | - Flavia K Borges
- Department of Medicine, McMaster University, Hamilton, Canada; Population Health Research Institute, Hamilton, Canada
| | - David Conen
- Department of Medicine, McMaster University, Hamilton, Canada; Population Health Research Institute, Hamilton, Canada
| | - C Y Wang
- Honorary Professor; Department of Anesthesiology, University of Malaya, Kuala Lumpur, Malaysia
| | - Denis Xavier
- St. John's Medical College Hospital, Bangalore, India
| | - Otavio Berwanger
- George Institute for Global Health, London, United Kingdom; Imperial College London, London, United Kingdom
| | - Maura Marcucci
- Clinical Epidemiology and Research Centre (CERC), Department of Biomedical Sciences, Humanitas University and IRCCS Humanitas Research Hospital, Milan, Italy; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Daniel I Sessler
- Department of Outcomes Research, Cleveland Clinic, Cleveland, Ohio
| | - Wojciech Szczeklik
- Center for Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Jessica Spence
- Anesthesia and Critical Care, McMaster University, Hamilton, Canada; Population Health Research Institute, Hamilton, Canada
| | - Pablo Alonso-Coello
- Iberoamerican Cochrane Center, Hospital Sant Pau, Barcelona, Spain; Centro de Investigación Biomédica en Red (CIBER) de Epidemiología y Salud Pública, Madrid, Spain
| | - Carmen Fernández
- Department of Anesthesiology and Intensive Care Medicine, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Rupert M Pearse
- Barts and the London School of Medicine & Dentistry, Queen Mary University of London, London, United Kingdom
| | - German Malaga
- Department of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Amit X Garg
- Department of Medicine, University of Western Ontario, London, Canada
| | | | - Michael J Jacka
- Department of Critical Care and Anesthesia, University of Alberta, Edmonton, Canada
| | - Vikas Tandon
- Department of Medicine, McMaster University, Hamilton, Canada
| | - Michael McGillion
- School of Nursing, McMaster University, Hamilton, Canada; Population Health Research Institute, Hamilton, Canada
| | - Ekaterine Popova
- IIB Sant Pau, Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain; Centro Cochrane Iberoamericano, Barcelona, Spain
| | - Alben Sigamani
- Numen Health, Bangalore, India; Narayana Hrudayalaya Health City Bangalore, Bangalore, India
| | - Valsa Abraham
- Christian Medical College and Hospital Ludhiana, Ludhiana, India
| | - Bruce M Biccard
- Department of Anaesthesia and Perioperative Medicine, Groote Schuur Hospital, University of Cape Town, Observatory, South Africa
| | | | - Clara K Chow
- Westmead Applied Research Centre, University of Sydney, Sydney, Australia; Department of Cardiology, Westmead Hospital, Sydney, Australia
| | - Carísi A Polanczyk
- Graduate Program in Epidemiology and Cardiovascular Science, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; Institute for Health Technology Assessment, Porto Alegre, Rio Grande do Sul, Brazil
| | - Maria Tiboni
- Department of Medicine, McMaster University, Hamilton, Canada
| | - Richard Whitlock
- Department of Surgery, McMaster University, Hamilton, Canada; Population Health Research Institute, Hamilton, Canada
| | - Gareth L Ackland
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Mohamed Panju
- Department of Medicine, McMaster University, Hamilton, Canada
| | - André Lamy
- Department of Surgery, McMaster University, Hamilton, Canada; Population Health Research Institute, Hamilton, Canada
| | - Robert Sapsford
- Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Colin Williams
- Royal Liverpool University Hospital, Liverpool, United Kingdom
| | - William Ka Kei Wu
- Department of Anaesthesia and Intensive Care, Chinese University of Hong Kong, New Territories, Hong Kong
| | - Olga L Cortés
- Research Department and Nursing Department, Fundación Cardioinfantil-Instituto de Cardiología, Bogotá DC, Colombia
| | - S Danielle MacNeil
- Schulich School of Medicine and Dentistry, Western University, London, Canada; Otolaryngology-Head & Neck Surgery, London Health Sciences Centre, London, Canada
| | - Ameen Patel
- Department of Medicine, McMaster University, Hamilton, Canada
| | - Emilie P Belley-Côté
- Department of Medicine, McMaster University, Hamilton, Canada; Population Health Research Institute, Hamilton, Canada
| | - Sandra Ofori
- Population Health Research Institute, Hamilton, Canada; Department of Medicine, McMaster University, Hamilton, Canada
| | - William F McIntyre
- Department of Medicine, McMaster University, Hamilton, Canada; Population Health Research Institute, Hamilton, Canada
| | - Darryl P Leong
- Department of Medicine, McMaster University, Hamilton, Canada; Population Health Research Institute, Hamilton, Canada
| | - Diane Heels-Ansdell
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Canada
| | | | - P J Devereaux
- Department of Medicine, McMaster University, Hamilton, Canada; Population Health Research Institute, Hamilton, Canada
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Zhou QH, Song ZH, Jin XD, Liu YH, Qian ZY, Wang CY. [Study on reproductive toxicity of nano-cadmium sulfide with different particle sizes on male mice]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2023; 41:887-892. [PMID: 38195222 DOI: 10.3760/cma.j.cn121094-20220615-00317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
Objective: To investigate the reproductive toxicity of cadmium sulfide nanoparticles (Nano-CdS) with different particle sizes on male mice. Methods: In January 2019, 30 SPF grade male mice were randomly divided into a control group, an experimental group[CdS Ⅰ group (particle size approximately 5 nm), and a CdS Ⅱ group (particle size approximately 50 nm) ], with 10 mice in each group. The experimental group was orally gavaged with 100 mg/kg, once a day, while the control group was gavaged with an equal volume of physiological saline for 45 consecutive days. After 45 days, levels of cadmium accumulation in testis were determined directly by AAS, deformity and testicular histopathological changes were also observed. Serum testosterone levels were measured by enzyme-linked immunosorbentassay (ELISA), expression levels of P450scc, 17β-HSD and P450c17 mRNA were determined by real-time PCR. P450c17 protein was determinated by Western Blot. Results: The histopathological results showed that the testes of the experimental group mice showed varying degrees of damage; Ultrastructural observation showed that the ultrastructure of mouse testicular cells in each experimental group showed varying degrees of mitochondrial expansion and disappearance of cristae, as well as irregular nuclear membranes. The degree of damage in CdS Ⅰ group was milder than that in CdS Ⅱ group. Compared with the control group, the cadmium content in the testes of the CdS Ⅰ and CdS Ⅱ groups significantly increased (P=0.001, 0.001), and the CdS Ⅱ group was higher than the CdS Ⅰ group (P=0.001). Compared with the control group, the levels of testosterone in the CdS Ⅰ and CdS Ⅱ groups decreased with statistical significance (P=0.001, 0.001). Real time fluorescence quantitative PCR results showed that compared with the control group, the experimental group's P450scc, 17β-HSD. The expression levels of 17β-HSD and P450c17 mRNA were significantly reduced, with statistically significant differences (P=0.001, 0.001, 0.001), and CdS Ⅱ group 17β-HSD. The expression levels of 17β-HSD and P450c17 mRNA were significantly lower than those of CdS Ⅰ group (P=0.001, 0.036). The Western Blot assay results showed that the expression levels of P450c17 protein in the testes of CdS Ⅰ and CdS Ⅱ groups of mice were significantly reduced, with statistical significance (P=0.001, 0.001) ; And the CdS Ⅱ group was significantly lower than the CdS Ⅰ group (P=0.001). According to Spearman correlation analysis, testosterone levels are correlated with P450scc, P450c17, 17β-HSD mRNA. There is a highly positive correlation between 17β-HSD mRNA levels, with statistically significant differences (r(s)=0.88, 0.80, 0.70, P=0.001, 0.001, 0.004) . Conclusion: Nano cadmium sulfide may induce reproductive toxicity by reducing the expression levels of key enzyme genes and enzyme protein activity in testosterone and its synthesis in mice, and the CdS Ⅱ group has a stronger toxic effect.
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Affiliation(s)
- Q H Zhou
- Department of Toxicology, Tianjin Centers for Disease Control and Prevention, Tianjin 300011, China
| | - Z H Song
- Department of Amesthsiology Tianjin Medical University General Hospital, Tianjin 300052, China
| | - X D Jin
- Department of Amesthsiology Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Y H Liu
- Department of Toxicology, Tianjin Centers for Disease Control and Prevention, Tianjin 300011, China
| | - Z Y Qian
- Department of Toxicology, Tianjin Centers for Disease Control and Prevention, Tianjin 300011, China
| | - C Y Wang
- Department of Amesthsiology Tianjin Medical University General Hospital, Tianjin 300052, China
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9
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Wei H, Wang CY, Yin YY, Wang Y. [Analysis on morbidity characteristics of occupational diseases in Taian City from 2006 to 2021]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2023; 41:841-845. [PMID: 37935551 DOI: 10.3760/cma.j.cn121094-20220506-00237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
Objective: To analyze the morbidity characteristics of new occupational diseases in Taian City from 2006 to 2021 and provide scientific evidence for local prevention and treatment of occupational diseases. Methods: In March 2022, the data of newly diagnosed occupational diseases in Taian City from 2006 to 2021 were obtained from Information Monitoring System for Occupational Diseases and Health Hazards. A descriptive analysis was performed for the distribution of onset age, working years, types of occupational diseases, region, industries, enterprise scale, enterprise economic type and the epidemic trend of occupational diseases. Results: 1362 cases of occupational diseases in 29 species of 9 categories were reported in Taian City from 2006 to 2021, including 1311 males and 51 females. The M (P(25), P(75)) of onset age and working age were 53 (47, 64) and 24.08 (16.56, 29.25) respectively. The top three categories of occupational diseases were occupational pneumoconiosis and other respiratory diseases (1128 cases, 82.82%), occupational otolaryngology and oral diseases (107 cases, 7.86%), and occupational chemical poisoning (70 cases, 5.14%) in sequence. Coal worker's pneumoconiosis, noise deafness, silicosis, poisoning of manganese and its compounds and cataract were the top five species of occupational diseases, which accounted for 69.60% (948/1362), 7.64% (104/1362), 5.58% (76/1362), 3.38% (46/1362) and 2.94% (40/1362) of the total cases of occupational diseases.There were significant differences among the composition of occupational diseases categories reported annually (P<0.001), but the number of occupational pneumoconiosis and other respiratory diseases was the highest on each year. The number of occupational diseases showed a decreasing trend with the year, and the optimal fitting curve was an growth curve. The number of newly diagnosed occupational diseases was predicted to be 172 cases from 2022 to 2026. Occupational pneumoconiosis and other respiratory diseases was the main disease in 6 counties. The occupational diseases cases were mainly distributed in Feicheng County and Xintai County, with 520 cases and 504 cases respectively, accounting for 75.18% of occupational diseases cases. The coal mining and washing industry had the largest number of occupational diseases cases, accounting for 73.05% of all occupational diseases cases. 91.85% of occupational diseases cases came from large and medium-sized enterprises. The economic type of enterprises with the most occupational diseases was state-owned enterprises, accounting for 74.52% of occupational diseases cases. Conclusion: The predominant occupational diseases in Taian City are occupational pneumoconiosis and other respiratory diseases, occupational otolaryngology and oral diseases, occupational chemical poisoning. And the prevention and control of occupational diseases should be strengthened in key industries such as coal mining and washing industry, key enterprises such as state-owned large and medium-sized enterprises.
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Affiliation(s)
- H Wei
- Occupational Health Department, Taian Municipal Center for Diseases Control and Prevention, Taian 271000, China
| | - C Y Wang
- Occupational Health Department, Taian Municipal Center for Diseases Control and Prevention, Taian 271000, China
| | - Y Y Yin
- Occupational Health Department, Taian Municipal Center for Diseases Control and Prevention, Taian 271000, China
| | - Y Wang
- Occupational Health Department, Taian Municipal Center for Diseases Control and Prevention, Taian 271000, China
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10
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Rao J, Wang CY, Yao B, Chen ZJ, Zhao KX, Lu W. Meterscale Strong Coupling between Magnons and Photons. Phys Rev Lett 2023; 131:106702. [PMID: 37739385 DOI: 10.1103/physrevlett.131.106702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/13/2023] [Accepted: 08/09/2023] [Indexed: 09/24/2023]
Abstract
We experimentally realize a meterscale strong coupling effect between magnons and photons at room temperature, with a coherent coupling of ∼20 m and a dissipative coupling of ∼7.6 m. To this end, we integrate a saturable gain into a microwave cavity and then couple this active cavity to a magnon mode via a long coaxial cable. The gain compensates for the cavity dissipation, but preserves the cavity radiation that mediates the indirect photon-magnon coupling. It thus enables the long-range strong photon-magnon coupling. With full access to traveling waves, we demonstrate a remote control of photon-magnon coupling by modulating the phase and amplitude of traveling waves, rather than reconfiguring subsystems themselves. Our method for realizing long-range strong coupling in cavity magnonics provides a general idea for other physical systems. Our experimental achievements may promote the construction of information networks based on cavity magnonics.
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Affiliation(s)
- Jinwei Rao
- School of Physical Science and Technology, ShanghaiTech University, Shanghai 201210, China
| | - C Y Wang
- School of Physical Science and Technology, ShanghaiTech University, Shanghai 201210, China
| | - Bimu Yao
- School of Physical Science and Technology, ShanghaiTech University, Shanghai 201210, China
- State Key Laboratory of Infrared Physics, Shanghai Institute of Technical Physics, Chinese Academy of Sciences, Shanghai 200083, China
| | - Z J Chen
- School of Physical Science and Technology, ShanghaiTech University, Shanghai 201210, China
| | - K X Zhao
- School of Physical Science and Technology, ShanghaiTech University, Shanghai 201210, China
| | - Wei Lu
- School of Physical Science and Technology, ShanghaiTech University, Shanghai 201210, China
- State Key Laboratory of Infrared Physics, Shanghai Institute of Technical Physics, Chinese Academy of Sciences, Shanghai 200083, China
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11
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Liu S, Wang CY, Huang ML, Yang YX, Zhang M. [Mechanisms of trained immunity and impacts on atherosclerosis]. Zhonghua Xin Xue Guan Bing Za Zhi 2023; 51:879-886. [PMID: 37583340 DOI: 10.3760/cma.j.cn112148-20230701-00386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
Affiliation(s)
- S Liu
- Center for Coronary Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - C Y Wang
- Center for Coronary Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - M L Huang
- Center for Coronary Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Y X Yang
- Surgical Center of Structural Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - M Zhang
- Center for Coronary Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
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12
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Yang LQ, Zhu L, Shi X, Miao CH, Yuan HB, Liu ZQ, Gu WD, Liu F, Hu XX, Shi DP, Duan HW, Wang CY, Weng H, Huang ZL, Li LZ, He ZZ, Li J, Hu YP, Lin L, Pan ST, Xu SH, Tang D, Sessler DI, Liu J, Irwin MG, Yu WF. Postoperative pulmonary complications in older patients undergoing elective surgery with a supraglottic airway device or tracheal intubation. Anaesthesia 2023; 78:953-962. [PMID: 37270923 DOI: 10.1111/anae.16030] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2023] [Indexed: 06/06/2023]
Abstract
The two most commonly used airway management techniques during general anaesthesia are supraglottic airway devices and tracheal tubes. In older patients undergoing elective non-cardiothoracic surgery under general anaesthesia with positive pressure ventilation, we hypothesised that a composite measure of in-hospital postoperative pulmonary complications would be less frequent when a supraglottic airway device was used compared with a tracheal tube. We studied patients aged ≥ 70 years in 17 clinical centres. Patients were allocated randomly to airway management with a supraglottic airway device or a tracheal tube. Between August 2016 and April 2020, 2900 patients were studied, of whom 2751 were included in the primary analysis (1387 with supraglottic airway device and 1364 with a tracheal tube). Pre-operatively, 2431 (88.4%) patients were estimated to have a postoperative pulmonary complication risk index of 1-2. Postoperative pulmonary complications, mostly coughing, occurred in 270 of 1387 patients (19.5%) allocated to a supraglottic airway device and 342 of 1364 patients (25.1%) assigned to a tracheal tube (absolute difference -5.6% (95%CI -8.7 to -2.5), risk ratio 0.78 (95%CI 0.67-0.89); p < 0.001). Among otherwise healthy older patients undergoing elective surgery under general anaesthesia with intra-operative positive pressure ventilation of their lungs, there were fewer postoperative pulmonary complications when the airway was managed with a supraglottic airway device compared with a tracheal tube.
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Affiliation(s)
- L Q Yang
- Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Key Laboratory of Anesthesiology (Shanghai Jiao Tong University), Ministry of Education, Shanghai, China
| | - L Zhu
- Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Key Laboratory of Anesthesiology (Shanghai Jiao Tong University), Ministry of Education, Shanghai, China
| | - X Shi
- Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - C H Miao
- Fudan University Shanghai Cancer Center, Shanghai, China
| | - H B Yuan
- Shanghai Changzheng Hospital, Shanghai, China
| | - Z Q Liu
- Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - W D Gu
- Huadong Hospital, Fudan University, Shanghai, China
| | - F Liu
- West China Hospital, Sichuan University, Chengdu, China
| | - X X Hu
- Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - D P Shi
- Jiading District Central Hospital Affiliated Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - H W Duan
- Shanghai Pudong Hospital Fudan University Pudong Medical Center, Shanghai, China
| | - C Y Wang
- Huangpu Branch of Ninth People's Hospital Affiliated to Medical College of Shanghai Jiao Tong University, Shanghai, China
| | - H Weng
- Shanghai Fengxian District Central Hospital, Shanghai, China
| | - Z L Huang
- Ren Ji Hospital (West) affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - L Z Li
- Shanghai Pudong New Area People's Hospital, Shanghai, China
| | - Z Z He
- Ren Ji Hospital (South) affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - J Li
- First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Y P Hu
- The Second Hospital of Wuxi affiliated to Nanjing Medical University, Wuxi, China
| | - L Lin
- The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - S T Pan
- Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - S H Xu
- Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - D Tang
- Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | | | - J Liu
- West China Hospital, Sichuan University, Chengdu, China
| | - M G Irwin
- Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - W F Yu
- Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Key Laboratory of Anesthesiology (Shanghai Jiao Tong University), Ministry of Education, Shanghai, China
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13
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Liu LJ, Li X, Wang CY, Wang AJ, Huang RR, Zhang GW. [Computed tomography manifestations in a case of a giant solid pseudopapillary tumor of the pancreas combined with multi-step metastasis]. Zhonghua Gan Zang Bing Za Zhi 2023; 31:750-751. [PMID: 37580259 DOI: 10.3760/cma.j.cn501113-20230329-00132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Affiliation(s)
- L J Liu
- Department of Radiology, Yantaishan Hospital, Yantai 264001, China
| | - X Li
- Dechengqu Chinese Medical Hospital, Special Inspection Section, Dezhou 253000, China
| | - C Y Wang
- Department of Radiology, Yantaishan Hospital, Yantai 264001, China
| | - A J Wang
- Department of Radiology, Yantaishan Hospital, Yantai 264001, China
| | - R R Huang
- Department of Radiology, Yantaishan Hospital, Yantai 264001, China
| | - G W Zhang
- Department of Radiology, Yantaishan Hospital, Yantai 264001, China
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14
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Tsan SEH, Viknaswaran NL, Cheong CC, Cheah S, Ng KT, Mong SXY, Wang CY. Prophylactic intravenous tranexamic acid and thromboembolism in non-cardiac surgery: a systematic review, meta-analysis and trial sequential analysis. Anaesthesia 2023. [PMID: 37314744 DOI: 10.1111/anae.16058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2023] [Indexed: 06/15/2023]
Abstract
Tranexamic acid is an antifibrinolytic drug that is widely used during surgery, but there are concerns about its thromboembolic effects. We aimed to investigate the effect of prophylactic intravenous tranexamic acid on thromboembolic outcomes in patients undergoing non-cardiac surgery. The MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials were searched. Randomised controlled trials comparing intravenous tranexamic acid with placebo or no treatment in patients undergoing non-cardiac surgery were included. The primary outcome was a composite of peri-operative cardiovascular thromboembolic events, defined as any deep vein thrombosis, pulmonary embolism, myocardial ischaemia/infarction or cerebral ischaemia/infarction. A total of 191 randomised controlled trials (40,621 patients) were included in the review. The primary outcome occurred in 4.5% of patients receiving intravenous tranexamic acid compared with 4.9% of patients in the control group. Our analysis showed that there was no difference between groups for composite cardiovascular thromboembolic events (risk ratio 1.02, 95%CI 0.94-1.11, p = 0.65, I2 0%, n = 37,512). This finding remained robust when sensitivity analysis was performed with continuity correction and in studies with a low risk of bias. However, in trial sequential analysis, our meta-analysis only achieved 64.6% of the required information size. There was no association between intravenous tranexamic acid and seizure rate or mortality rate within 30 days. Intravenous tranexamic acid was associated with a reduced blood transfusion rate compared with control (9.9% vs. 19.4%, risk ratio 0.46, 95%CI 0.41-0.51, p < 0.0001). It was encouraging to see the evidence that the administration of intravenous tranexamic in patients undergoing non-cardiac surgery was not associated with an increased risk of thromboembolic outcomes. However, our trial sequential analysis demonstrated that currently available evidence is not yet sufficient to reach a firm conclusion.
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Affiliation(s)
- S E H Tsan
- Department of Anaesthesiology and Intensive Care, Faculty of Medicine and Health Sciences, University of Malaysia Sarawak, Malaysia
| | | | - C C Cheong
- Department of Anaesthesia, Faculty of Medicine, University of Malaya, Malaysia
| | - S Cheah
- Department of Anaesthesiology and Intensive Care, Hospital Sultanah Nora Ismail, Batu Pahat, Malaysia
| | - K T Ng
- Department of Anaesthesia, Faculty of Medicine, University of Malaya, Malaysia
| | - S X Y Mong
- Department of Anaesthesiology and Intensive Care, Hospital Raja Permaisuri Bainun, Ipoh, Malaysia
| | - C Y Wang
- Department of Anaesthesiology and Intensive Care, Hospital Sultanah Nora Ismail, Batu Pahat, Malaysia
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15
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Chen Y, Peng JM, Hu XY, Li S, Wan XX, Liu RT, Wang CY, Jiang W, Dong R, Su LX, He HW, Long Y, Weng L, Du B. Tissue oxygen saturation is predictive of lactate clearance in patients with circulatory shock. BMC Anesthesiol 2023; 23:179. [PMID: 37231341 DOI: 10.1186/s12871-023-02139-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 05/14/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Tissue oxygen saturation (StO2) decrease could appear earlier than lactate alteration. However, the correlation between StO2 and lactate clearance was unknown. METHODS This was a prospective observational study. All consecutive patients with circulatory shock and lactate over 3 mmol/L were included. Based on the rule of nines, a BSA (body surface area) weighted StO2 was calculated from four sites of StO2 (masseter, deltoid, thenar and knee). The formulation was as follows: masseter StO2 × 9% + (deltoid StO2 + thenar StO2) × (18% + 27%)/ 2 + knee StO2 × 46%. Vital signs, blood lactate, arterial and central venous blood gas were measured simultaneously within 48 h of ICU admission. The predictive value of BSA-weighted StO2 on 6-hour lactate clearance > 10% since StO2 initially monitored was assessed. RESULTS A total of 34 patients were included, of whom 19 (55.9%) had a lactate clearance higher than 10%. The mean SOFA score was lower in cLac ≥ 10% group compared with cLac < 10% group (11 ± 3 vs. 15 ± 4, p = 0.007). Other baseline characteristics were comparable between groups. Compared to non-clearance group, StO2 in deltoid, thenar and knee were significantly higher in clearance group. The area under the receiver operating curves (AUROC) of BSA-weighted StO2 for prediction of lactate clearance (0.92, 95% CI [Confidence Interval] 0.82-1.00) was significantly higher than StO2 of masseter (0.65, 95% CI 0.45-0.84; p < 0.01), deltoid (0.77, 95% CI 0.60-0.94; p = 0.04), thenar (0.72, 95% CI 0.55-0.90; p = 0.01), and similar to knee (0.87, 0.73-1.00; p = 0.40), mean StO2 (0.85, 0.73-0.98; p = 0.09). Additionally, BSA-weighted StO2 model had continuous net reclassification improvement (NRI) over the knee StO2 and mean StO2 model (continuous NRI 48.1% and 90.2%, respectively). The AUROC of BSA-weighted StO2 was 0.91(95% CI 0.75-1.0) adjusted by mean arterial pressure and norepinephrine dose. CONCLUSIONS Our results suggested that BSA-weighted StO2 was a strong predictor of 6-hour lactate clearance in patients with shock.
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Affiliation(s)
- Yan Chen
- Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Jin-Min Peng
- Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Xiao-Yun Hu
- Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Shan Li
- Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Xi-Xi Wan
- Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Rui-Ting Liu
- Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Chun-Yao Wang
- Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Wei Jiang
- Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Run Dong
- Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Long-Xiang Su
- Department of Critical Care Medicine, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Huai-Wu He
- Department of Critical Care Medicine, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Yun Long
- Department of Critical Care Medicine, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Li Weng
- Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China.
| | - Bin Du
- Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China.
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Yang L, Wang CY, Zhang YD, Geng Q, Qin WH. [Determination of cobalt and tungsten in human urine by inductively coupled plasma mass spectrometry]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2023; 41:371-374. [PMID: 37248085 DOI: 10.3760/cma.j.cn121094-20211214-00614] [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: 05/31/2023]
Abstract
Objective: To establish a inductively coupled plasma mass spectrometry method for the determination of trace cobalt and tungsten in human urine. Methods: The authors used 1% nitric acid solution as diluent in October-December 2021, the sample dilution factor and internal standard element were optimized by single factor rotation experiment, and the difference between the working curve and the standard curve was compared. Results: The method uses working curve to determine cobalt and tungsten in urine, the linear range of this method was 0.0~10.0 μg/L, the correlation coefficient was 0.999 9, the detection limits respectively were 0.005 μg/L (cobalt) and 0.09 μg/L (tungsten), the recoveries of samples respectively were 87.0%~100.2% (cobalt) and 89.4%~104.8% (tungsten), the relative standard deviations respectively were 0.4%~4.4% (cobalt) and 0.6%~3.8% (tungsten) . Conclusion: A simple and rapid method for determination of cobalt and tungsten in urine has been established. This method has the advantages of simple operation, high sensitivity, low detection limit and good stability. It is suitable for determination of cobalt and tungsten in urine of all kinds of people.
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Affiliation(s)
- L Yang
- The Third People's Hospital of Henan Province (Henan Hospital for Occupational Diseases) Occupational and Environmental Testing and Inspection Center, Henan Provincial Key Laboratory of Chemical Toxicology Detection, Zhengzhou 450052, China
| | - C Y Wang
- The Third People's Hospital of Henan Province (Henan Hospital for Occupational Diseases) Occupational and Environmental Testing and Inspection Center, Henan Provincial Key Laboratory of Chemical Toxicology Detection, Zhengzhou 450052, China
| | - Y D Zhang
- The Third People's Hospital of Henan Province (Henan Hospital for Occupational Diseases) Occupational and Environmental Testing and Inspection Center, Henan Provincial Key Laboratory of Chemical Toxicology Detection, Zhengzhou 450052, China
| | - Q Geng
- The Third People's Hospital of Henan Province (Henan Hospital for Occupational Diseases) Occupational and Environmental Testing and Inspection Center, Henan Provincial Key Laboratory of Chemical Toxicology Detection, Zhengzhou 450052, China
| | - W H Qin
- The Third People's Hospital of Henan Province (Henan Hospital for Occupational Diseases) Occupational and Environmental Testing and Inspection Center, Henan Provincial Key Laboratory of Chemical Toxicology Detection, Zhengzhou 450052, China
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Hu XY, Zhang W, Wang D, Sun Y, Hu Z, Zang B, Feng Y, Wang H, Zhou J, Zhao Q, Liu H, Wang T, Jiang W, Wang CY, Jin C, Dong K, Chen S, Yao X, Hu P, Du B. Safety, tolerability, pharmacokinetics, and efficacy of kukoamine B in patients with sepsis: A randomized phase IIa trial. J Crit Care 2023; 76:154294. [PMID: 37116228 DOI: 10.1016/j.jcrc.2023.154294] [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: 12/07/2022] [Revised: 03/13/2023] [Accepted: 03/16/2023] [Indexed: 04/30/2023]
Abstract
PURPOSE To evaluate the safety, tolerability, pharmacokinetics, and efficacy of kukoamine B (KB), an alkaloid compound with high affinity for both lipopolysaccharide (LPS) and oligodeoxynucle-otides containing CpG motifs (CpG DNA), in patients with sepsis-induced organ failure. MATERIALS AND METHODS This was a multicenter, randomized, double-blind, placebo-controlled phase IIa trial. Patients with sepsis-induced organ failure were randomized to receive either KB (0.06, 0.12, or 0.24 mg/kg) or placebo, every 8 h for 7 days. Primary endpoint was safety, and secondary endpoints included pharmacokinetic (PK) parameters, changes in inflammatory mediators' level, and prognostic parameters. RESULTS Of 44 patients enrolled, adverse events occurred in 28 patients [n = 20, 66.7% (KB pooled); n = 8, 57.1% (placebo)], while treatment emergent adverse events were reported in 14 patients [n = 10, 33.3% (KB pooled); n = 4, 28.6% (placebo)]. Seven patients died at 28-day follow-up [n = 4, 13.3% (KB pooled); n = 3, 21.4% (placebo)], none was related to study drug. PK parameters suggested dose-dependent drug exposure and no drug accumulation. KB did not affect clinical outcomes such as ΔSOFA score, vasopressor-free days or ventilator-free days. CONCLUSIONS In patients with sepsis-induced organ failure, KB was safe and well tolerated. Further investigation is warranted. TRIAL REGISTRATION http://ClinicalTrials.gov, NCT03237728.
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Affiliation(s)
- Xiao-Yun Hu
- Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 1 Shuai Fu Yuan, Beijing 100730, China; State Key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, 1 Shuai Fu Yuan, Beijing 100730, China
| | - Weiwen Zhang
- Department of Critical Care Medicine, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, No. 100 Minjiang Road, Kecheng District, Quzhou, Zhejiang 324000, China
| | - Difen Wang
- Department of Critical Care Medicine, The Affiliated Hospital of Guizhou Medical University, 28 Guiyi Street, Guiyang, Guizhou 550004, China
| | - Yunbo Sun
- Department of Critical Care Medicine, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Shinan District, Qingdao, Shandong Province 266003, China
| | - Zhenjie Hu
- Department of Intensive Care Unit, The Fourth Hospital of Hebei Medical University and Hebei Cancer Hospital, 12 Jiankang Road, Shijiazhuang, Hebei Province 050011, China
| | - Bin Zang
- Department of Critical Care Medicine, Shengjing Hospital of China Medical University, 36 Sanhao Street, Shenyang, Liaoning Province 110004, China
| | - Yongwen Feng
- Department of Critical Care Medicine, Shenzhen Second People's Hospital, 3002 Sungang West Road, Futian District, Shenzhen, Guangdong Province 518035, China
| | - Huaxue Wang
- Department of Critical Care Medicine, The First Affiliated Hospital of Bengbu Medical College, 287 Changhuai Road, Bengbu, Anhui Province 233004, China
| | - Jianxin Zhou
- Department of Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University, 119 South Fourth Ring West Road, Fengtai District, Beijing 100070, China
| | - Qian Zhao
- State Key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, 1 Shuai Fu Yuan, Beijing 100730, China; Clinical Pharmacology Research Center, Peking Union Medical College Hospital, State Key Laboratory of Complex Severe and Rare Diseases, NMPA Key Laboratory for Clinical Research and Evaluation of Drug, Beijing Key Laboratory of Clinical PK & PD Investigation for Innovative Drugs, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 1 Shuaifuyuan, Dongcheng District, Beijing 100730, China
| | - Hongzhong Liu
- State Key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, 1 Shuai Fu Yuan, Beijing 100730, China; Clinical Pharmacology Research Center, Peking Union Medical College Hospital, State Key Laboratory of Complex Severe and Rare Diseases, NMPA Key Laboratory for Clinical Research and Evaluation of Drug, Beijing Key Laboratory of Clinical PK & PD Investigation for Innovative Drugs, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 1 Shuaifuyuan, Dongcheng District, Beijing 100730, China
| | - Teng Wang
- Clinical Trial Center, West China hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Wei Jiang
- Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 1 Shuai Fu Yuan, Beijing 100730, China; State Key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, 1 Shuai Fu Yuan, Beijing 100730, China
| | - Chun-Yao Wang
- Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 1 Shuai Fu Yuan, Beijing 100730, China; State Key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, 1 Shuai Fu Yuan, Beijing 100730, China
| | - Chunyan Jin
- Clinical Research Center for Innovative Drugs, Tianjin Chasesun Pharmaceutical Co., Ltd., 20 Quan Fa Road, WuQing District, Tianjin 301700, China
| | - Kai Dong
- Clinical Research Center for Innovative Drugs, Tianjin Chasesun Pharmaceutical Co., Ltd., 20 Quan Fa Road, WuQing District, Tianjin 301700, China
| | - Shuai Chen
- Clinical Research Center for Innovative Drugs, Tianjin Chasesun Pharmaceutical Co., Ltd., 20 Quan Fa Road, WuQing District, Tianjin 301700, China
| | - Xiaoqing Yao
- Clinical Research Center for Innovative Drugs, Tianjin Chasesun Pharmaceutical Co., Ltd., 20 Quan Fa Road, WuQing District, Tianjin 301700, China.
| | - Pei Hu
- State Key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, 1 Shuai Fu Yuan, Beijing 100730, China; Clinical Pharmacology Research Center, Peking Union Medical College Hospital, State Key Laboratory of Complex Severe and Rare Diseases, NMPA Key Laboratory for Clinical Research and Evaluation of Drug, Beijing Key Laboratory of Clinical PK & PD Investigation for Innovative Drugs, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 1 Shuaifuyuan, Dongcheng District, Beijing 100730, China.
| | - Bin Du
- Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 1 Shuai Fu Yuan, Beijing 100730, China; State Key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, 1 Shuai Fu Yuan, Beijing 100730, China.
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Guan J, Wang LL, Wang CY, Zhu XM, Shuai HZ, Yi X, Zou L, Yu D, Cheng H. [A new form of familial platelet disorder caused by germline mutations in RUNX1 in a pedigree]. Zhonghua Nei Ke Za Zhi 2023; 62:393-400. [PMID: 37032134 DOI: 10.3760/cma.j.cn112138-20220414-00273] [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: 04/11/2023]
Abstract
Objective: To investigate the clinical and biological characteristics of familial platelet disorder (FPD) with germline Runt-related transcription factor (RUNX) 1 mutations. Methods: Patients diagnosed with myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML) with RUNX1 mutations from February 2016 to December 2021 in Wuhan No.1 Hospital underwent pedigree analysis and were screened for gene mutations (somatic and germline). Patients diagnosed with FPD with germline RUNX1 mutations were enrolled and evaluated in terms of clinical characteristics and biological evolution. Bioinformatics analysis was used to assess the pathogenicity of mutations and to analyze the effect of mutated genes on the function of the corresponding protein. Results: Germline RUNX1 mutations were detected in three out of 34 patients suffering from MDS/AML who had RUNX1 mutations. A pedigree of FPD with RUNX1 (RUNX1-FPD) c.562A>C and RUNX1 c.1415T>C mutations was diagnosed, and the mutations were of patrilineal origin. Bioinformatics analysis indicated that the locus at positions 188 and 472 in the AML-1G type of RUNX1 was highly conserved across different species, and that variations might influence functions of the proteins. The mutations were evaluated to be highly pathogenic. Of the nine cases with germline RUNX1 mutations: two patients died due AML progression; one case with AML survived without leukemia after transplantation of hemopoietic stem cells; four patients showed mild-to-moderate thrombocytopenia; two cases had no thrombocytopenia. During the disease course of the proband and her son, mutations in RUNX1, NRAS and/or CEBPA and KIT appeared in succession, and expression of cluster of differentiation-7 on tumor cells was enhanced gradually. None of the gene mutations correlated with the tumor were detected in the four cases not suffering from MDS/AML, and they survived until the end of follow-up. Conclusions: RUNX1-FPD was rare. The mutations c.562A>C and c.1415T>C of RUNX1 could be the disease-causing genes for the family with RUNX1-FPD, and these mutations could promote malignant transformation. Biological monitoring should be carried out regularly to aid early intervention for family members with RUNX1-FPD.
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Affiliation(s)
- J Guan
- The Department of Hematology, Wuhan No.1 Hospital, Wuhan 430022, China
| | - L L Wang
- The Department of Hematology, Wuhan No.1 Hospital, Wuhan 430022, China
| | - C Y Wang
- The Department of Hematology, Tongji Hospital of Huazhong University of Science and Technology, Wuhan 430074, China
| | - X M Zhu
- Department of Lymphoma, Hubei Cancer Hospital, Wuhan 430079, China
| | - H Z Shuai
- The Department of Hematology, Wuhan No.1 Hospital, Wuhan 430022, China
| | - X Yi
- The Department of Hematology, Wuhan No.1 Hospital, Wuhan 430022, China
| | - L Zou
- The Department of Hematology, Wuhan No.1 Hospital, Wuhan 430022, China
| | - D Yu
- The Department of Hematology, Wuhan No.1 Hospital, Wuhan 430022, China
| | - H Cheng
- The Department of Hematology, Wuhan No.1 Hospital, Wuhan 430022, China
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Weng L, Xu Y, Yin P, Wang Y, Chen Y, Liu W, Li S, Peng JM, Dong R, Hu XY, Jiang W, Wang CY, Gao P, Zhou MG, Du B. National incidence and mortality of hospitalized sepsis in China. Crit Care 2023; 27:84. [PMID: 36870989 PMCID: PMC9985297 DOI: 10.1186/s13054-023-04385-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023] Open
Abstract
BACKGROUND Sepsis is a leading cause of preventable death around the world. Population-based estimation of sepsis incidence is lacking in China. In this study, we aimed to estimate the population-based incidence and geographic variation of hospitalized sepsis in China. METHODS We retrospectively identified hospitalized sepsis from the nationwide National Data Center for Medical Service (NDCMS) and the National Mortality Surveillance System (NMSS) by ICD-10 codes for the period from 2017 to 2019. In-hospital sepsis case fatality and mortality rate were calculated to extrapolate the national incidence of hospitalized sepsis. The geographic distribution of hospitalized sepsis incidence was examined using Global Moran's Index. RESULTS We identified 9,455,279 patients with 10,682,625 implicit-coded sepsis admissions in NDCMS and 806,728 sepsis-related deaths in NMSS. We estimated that the annual standardized incidence of hospitalized sepsis was 328.25 (95% CI 315.41-341.09), 359.26 (95% CI 345.4-373.12) and 421.85 (95% CI 406.65-437.05) cases per 100,000 in 2017, 2018 and 2019, respectively. We observed 8.7% of the incidences occurred among neonates less than 1 year old, 11.7% among children aged 1-9 years, and 57.5% among elderly older than 65 years. Significant spatial autocorrelation for incidence of hospitalized sepsis was observed across China (Moran's Index 0.42, p = 0.001; 0.45, p = 0.001; 0.26, p = 0.011 for 2017, 2018, 2019, respectively). Higher number of hospital bed supply and higher disposable income per capita were significantly associated with a higher incidence of hospitalized sepsis. CONCLUSION Our study showed a greater burden of sepsis hospitalizations than previous estimated. The geographical disparities suggested more efforts were needed in prevention of sepsis.
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Affiliation(s)
- Li Weng
- Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 1 Shuai Fu Yuan, Beijing, 100730, China
| | - Yang Xu
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China.,Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Peng Yin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing, 100050, China
| | - Yi Wang
- Medical Record Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yan Chen
- Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 1 Shuai Fu Yuan, Beijing, 100730, China
| | - Wei Liu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing, 100050, China
| | - Shan Li
- Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 1 Shuai Fu Yuan, Beijing, 100730, China
| | - Jin-Min Peng
- Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 1 Shuai Fu Yuan, Beijing, 100730, China
| | - Run Dong
- Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 1 Shuai Fu Yuan, Beijing, 100730, China
| | - Xiao-Yun Hu
- Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 1 Shuai Fu Yuan, Beijing, 100730, China
| | - Wei Jiang
- Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 1 Shuai Fu Yuan, Beijing, 100730, China
| | - Chun-Yao Wang
- Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 1 Shuai Fu Yuan, Beijing, 100730, China
| | - Pei Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Mai-Geng Zhou
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing, 100050, China.
| | - Bin Du
- Medical Intensive Care Unit, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 1 Shuai Fu Yuan, Beijing, 100730, China.
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20
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Rao JW, Yao B, Wang CY, Zhang C, Yu T, Lu W. Unveiling a Pump-Induced Magnon Mode via Its Strong Interaction with Walker Modes. Phys Rev Lett 2023; 130:046705. [PMID: 36763434 DOI: 10.1103/physrevlett.130.046705] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 11/16/2022] [Accepted: 01/05/2023] [Indexed: 06/18/2023]
Abstract
We observe a power-dependent anticrossing of Walker spin-wave modes under microwave pumping when a ferrimagnet is placed in a microwave waveguide that does not support any discrete photon mode. We interpret this unexpected anticrossing as the generation of a pump-induced magnon mode that couples strongly to the Walker modes of the ferrimagnet. This anticrossing inherits an excellent tunability from the pump, which allows us to control the anticrossing via the pump power, frequency, and waveform. Further, we realize a remarkable functionality of this anticrossing, namely, a microwave frequency comb, in terms of the nonlinear interaction that mixes the pump and probe frequencies. Such a frequency comb originates from the magnetic dynamics and thereby does not suffer from the charge noise. The unveiled hybrid magnonics driven away from its equilibrium enriches the utilization of anticrossing for coherent information processing.
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Affiliation(s)
- J W Rao
- School of Physical Science and Technology, ShanghaiTech University, Shanghai 201210, China
| | - Bimu Yao
- School of Physical Science and Technology, ShanghaiTech University, Shanghai 201210, China
- State Key Laboratory of Infrared Physics, Shanghai Institute of Technical Physics, Chinese Academy of Sciences, Shanghai 200083, China
| | - C Y Wang
- School of Physical Science and Technology, ShanghaiTech University, Shanghai 201210, China
| | - C Zhang
- School of Physical Science and Technology, ShanghaiTech University, Shanghai 201210, China
| | - Tao Yu
- School of Physics, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Wei Lu
- School of Physical Science and Technology, ShanghaiTech University, Shanghai 201210, China
- State Key Laboratory of Infrared Physics, Shanghai Institute of Technical Physics, Chinese Academy of Sciences, Shanghai 200083, China
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21
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Chang L, Wang CY, Li ZH, Zhou DB, Cao XX. [Low-oxygen-affinity hemoglobinopathy Hemoglobin Sunshine Seth: a case report and literature review]. Zhonghua Xue Ye Xue Za Zhi 2023; 44:72-74. [PMID: 36987728 PMCID: PMC10067374 DOI: 10.3760/cma.j.issn.0253-2727.2023.01.014] [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: 03/30/2023]
Affiliation(s)
- L Chang
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730 China
| | - C Y Wang
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730 China
| | - Z H Li
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730 China
| | - D B Zhou
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730 China
| | - X X Cao
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730 China
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Liu ZY, Han YT, Wang CY, Lei XJ, Wang YY, Dong WF, Xie QJ, Fu YJ, Gao CQ. The growth-regulating factor PdbGRF1 positively regulates the salt stress response in Populus davidiana × P. bolleana. Plant Sci 2023; 326:111502. [PMID: 36252856 DOI: 10.1016/j.plantsci.2022.111502] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 08/26/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
Growth-regulating factor (GRF) is a transcription factor unique to plants that plays a crucial role in the growth, development and stress adaptation of plants. However, information on the GRFs related to salt stress in Populus davidiana × P. bolleana is lacking. In this study, we characterized the activity of PdbGRF1 in transgenic Populus davidiana × P. bolleana under salt stress. qRTPCR analyses showed that PdbGRF1 was highly expressed in young leaves and that the pattern of PdbGRF1 expression was significantly changed at most time points under salt stress, which suggests that PdbGRF1 expression may be related to the salt stress response. Moreover, PdbGRF1 overexpression enhanced tolerance to salt stress. A physiological parameter analysis showed that the overexpression of PdbGRF1 significantly decreased the contents of hydrogen peroxide (H2O2) and malondialdehyde (MDA) and increased the activities of antioxidant enzymes (SOD and POD) and the proline content. A molecular analysis showed that PdbGRF1 regulated the expression of PdbPOD17 and PdbAKT1 by binding to the DRE ('A/GCCGAC') in their respective promoters. Together, our results demonstrate that the binding of PdbGRF1 to DRE regulates genes related to stress tolerance and activates the associated physiological pathways, and these effects increase the ROS scavenging ability, reduce the degree of damage to the plasma membrane and ultimately enhance the salt stress response in Populus davidiana × P. bolleana.
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Affiliation(s)
- Zhong-Yuan Liu
- State Key Laboratory of Tree Genetics and Breeding, Northeast Forestry University, Harbin 150040, China; Key Laboratory of Forest Plant Ecology, Ministry of Education, Northeast Forestry University, Harbin 150040, China; College of Chemistry, Chemical Engineering and Resource Utilization, Northeast Forestry University, Harbin 150040, China
| | - Ya-Ting Han
- State Key Laboratory of Tree Genetics and Breeding, Northeast Forestry University, Harbin 150040, China
| | - Chun-Yao Wang
- State Key Laboratory of Tree Genetics and Breeding, Northeast Forestry University, Harbin 150040, China
| | - Xiao-Jin Lei
- State Key Laboratory of Tree Genetics and Breeding, Northeast Forestry University, Harbin 150040, China
| | - Yuan-Yuan Wang
- State Key Laboratory of Tree Genetics and Breeding, Northeast Forestry University, Harbin 150040, China
| | - Wen-Fang Dong
- State Key Laboratory of Tree Genetics and Breeding, Northeast Forestry University, Harbin 150040, China
| | - Qing-Jun Xie
- State Key Laboratory of Tree Genetics and Breeding, Northeast Forestry University, Harbin 150040, China
| | - Yu-Jie Fu
- Key Laboratory of Forest Plant Ecology, Ministry of Education, Northeast Forestry University, Harbin 150040, China; College of Chemistry, Chemical Engineering and Resource Utilization, Northeast Forestry University, Harbin 150040, China.
| | - Cai-Qiu Gao
- State Key Laboratory of Tree Genetics and Breeding, Northeast Forestry University, Harbin 150040, China.
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Huang YW, Chen Y, Wang CY, Wu L. [Impact of late sodium current inhibition on cardiac electrophysiology parameters and ventricular arrhythmias in isolated Langendorff perfused rabbit hearts with short QT interval]. Zhonghua Xin Xue Guan Bing Za Zhi 2022; 50:1087-1093. [PMID: 36418277 DOI: 10.3760/cma.j.cn112148-20220705-00518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Objective: To determine the electrophysiological effects and related mechanisms of late sodium current inhibitors on hearts with short QT intervals. Methods: The electrophysiological study was performed on isolated Langendorff perfused rabbit hearts. A total of 80 New Zealand White rabbits were used and 34 hearts without drug treatment were defined as control group A, these hearts were then treated with IKATP opener pinacidil, defined as pinacidil group A. Then, 27 hearts from pinacidil group A were selected to receive combined perfusion with sodium channel inhibitors or quinidine, a traditional drug used to treat short QT syndrome, including ranolazine combined group (n=9), mexiletine combined group (n=9), and quinidine combined group (n=9). Nineteen out of the remaining 46 New Zealand rabbits were selected as control group B (no drug treatments, n=19), and then treated with pinacidil, defined as pinacidil group B (n=19). The remaining 27 rabbits were treated with sodium inhibitors or quinidine alone, including ranolazine alone group (n=9), mexiletine alone group (n=9), and quinidine alone group (n=9). Electrocardiogram (ECG) physiological parameters of control group A and pinacidil group A were collected. In control group B and pinacidil group B, programmed electrical stimulation was used to induce ventricular arrhythmias and ECG was collected. ECG physiological parameters and ventricular arrhythmia status of various groups were analyzed. The concentrations of pinacidil, ranolazine, mexiletine and quinidine used in this study were 30, 10, 30 and 1 μmol/L, respectively. Results: Compared with control group A, the QT interval, 90% of the repolarization in epicardial and endocardial monophasic action potential duration (MAPD90-Epi, MAPD90-Endo) was shortened, the transmural dispersion of repolarization (TDR) was increased, and the effective refractor period (ERP) and post-repolarization refractoriness (PRR) were reduced in pinacidil group A (all P<0.05). Compared with the pinacidil group A, MAPD90-Epi, MAPD90-Endo, QT interval changes were reversed in quinidine combined group and mexiletine combined group (all P<0.05), but not in ranolazine combined group. All these three drugs reversed the pinacidil-induced increases of TDR and the decreases of ERP and PRR. The induced ventricular arrhythmia rate was 0 in control group B, and increased to 10/19 (χ2=13.6, P<0.05) in pinacidil group B during programmed electrical stimulation. Compared with the pinacidil group B, incidences of ventricular arrhythmia decreased to 11% (1/9), 11% (1/9) and 0 (0/9) (χ2=4.5, 4.5, 7.4, P<0.05) respectively in ranolazine group, mexiletine group and quinidine group. Conclusions: Inhibition of late sodium current does not increase but even decreases the risk of malignant arrhythmia in hearts with a shortened QT interval. The antiarrhythmic mechanism might be associated with the reversal of the increase of TDR and the decrease of refractoriness (including both ERP and PRR) of hearts with shortened QT interval.
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Affiliation(s)
- Y W Huang
- Department of Cardiology, Peking University First Hospital, Beijing 100034, China
| | - Y Chen
- Department of Cardiology, Peking University First Hospital, Beijing 100034, China
| | - C Y Wang
- Department of Cardiology, Peking University First Hospital, Beijing 100034, China
| | - L Wu
- Department of Cardiology, Peking University First Hospital, Beijing 100034, China
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Wang QW, Zhang W, Zhu ZM, Jia CY, Wang CY, Zhang RL, Zhang Y, Wang QF, Dou JG, Wen J. [Evaluation of bladder function and sleep patterns in children with primary mono-symptomatic nocturnal enuresis by polysomnography combined with ambulatory urodynamic monitoring]. Zhonghua Yi Xue Za Zhi 2022; 102:2994-3000. [PMID: 36229199 DOI: 10.3760/cma.j.cn112137-20220122-00169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Objective: To evaluate the bladder function and sleep pattern in the children with primary mono-symptomatic nocturnal enuresis (PMNE) by the polysomnography (PSG) and ambulatory urodynamic monitoring (AUM). Methods: From October 2019 to October 2021, forty-three patients with PMNE were selected as PMNE group from the First Affiliated Hospital of Zhengzhou University and further subdivided into the severe PMNE group (enuresis>4 times/week) and the non-severe PMNE group (enuresis times 4 times/week) according to the severity. The conventional urodynamics (CUD), AUM, and PSG examinations and bladder diary were completed in the PMNE group. The control group consisted of 23 children with normal PSG findings and without the lower urinary tract symptoms. Results: The severe PMNE group included 9 males and 14 females, aged(12.1±3.2)years, and nocturnal enuresis number per week is 6.7±1.7. The non-severe PMNE group included 9 males and 11 females, aged(12.0±3.4)years, and nocturnal enuresis number per week is 2.3±1.0. The incidences of nocturnal polyuria and the reduction in maximum bladder capacity in the PMNE group was 34.9% and 11.6%, respectively. The incidence and frequency of detrusor overactivity (DO) in the severe PMNE group were significantly higher than those in the non-severe PMNE group [78.3% vs 45.0%, (5.5±1.8) times/h vs (3.4±1.0) times/h, respectively, all P<0.05]. It was found by the PSG that the severe PMNE group had significantly higher cortical arousal index, apnea hypopnea index (AHI), and percentage of N1+N2 phase in total sleep time, compared with the control group[(58.6±9.8)% vs (49.3±9.5)%, (9.4±4.4) times/h vs (3.1±1.5) times/h, (2.7±0.9) times/h vs (0.9±0.7) times/h] (all P<0.05). While the sleep efficiency of the severe PMNE group was substantially lower than that of the non-severe PMNE group [(86.4±4.3)% vs (91.0±3.9)%], the cortical arousal index and AHI were significantly greater than those of the non-severe PMNE group[(9.4±4.4) times/h vs (5.7±3.2) times/h, (2.7±0.9) times/h vs (1.9±0.7) times/h] (all P<0.05). In the PMNE group, there were positive correlations between cortical arousal index and nocturnal DO frequency or AHI (r=0.705, 0.765, P=0.001). Conclusions: Children with PMNE have nocturnal bladder dysfunction and abnormal sleep pattern, and there is a certain correlation between them. PSG and AUM are necessary for the evaluation and treatment of children with PMNE.
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Affiliation(s)
- Q W Wang
- Department of Urology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - W Zhang
- Department of Urology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Z M Zhu
- Department of Urology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - C Y Jia
- Department of Urology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - C Y Wang
- Department of Urology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - R L Zhang
- Department of Urology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Y Zhang
- Department of Urodynamic Center, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Q F Wang
- Department of Urology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - J G Dou
- Department of Urology, the First Affiliated Hospital of Xinxiang Medical University, Xinxiang 453100, China
| | - Jianguo Wen
- Henan Joint International Pediatric Urodynamic Laboratory, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
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Wang CY, Xu HM, Tian J, Hong SQ, Liu G, Wang SX, Gao F, Liu J, Liu FR, Yu H, Wu X, Chen BQ, Shen FF, Zheng G, Yu J, Shu M, Liu L, Du LJ, Li P, Xu ZW, Zhu MQ, Huang LS, Huang HY, Li HB, Huang YY, Wang D, Wu F, Bai ST, Tang JJ, Shan QW, Lan LC, Zhu CH, Xiong Y, Tian JM, Wu JH, Hao JH, Zhao HY, Lin AW, Song SS, Lin DJ, Zhou QH, Guo YP, Wu JZ, Yang XQ, Zhang XH, Guo Y, Cao Q, Luo LJ, Tao ZB, Yang WK, Zhou YK, Chen Y, Feng LJ, Zhu GL, Zhang YH, Xue P, Li XQ, Tang ZZ, Zhang DH, Su XW, Qu ZH, Zhang Y, Zhao SY, Qi ZZ, Pang L, Wang CY, Deng HL, Liu XL, Chen YH, Shu S. [A multicenter epidemiological study of acute bacterial meningitis in children]. Zhonghua Er Ke Za Zhi 2022; 60:1045-1053. [PMID: 36207852 DOI: 10.3760/cma.j.cn112140-20220608-00522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Objective: To analyze the clinical epidemiological characteristics including composition of pathogens , clinical characteristics, and disease prognosis acute bacterial meningitis (ABM) in Chinese children. Methods: A retrospective analysis was performed on the clinical and laboratory data of 1 610 children <15 years of age with ABM in 33 tertiary hospitals in China from January 2019 to December 2020. Patients were divided into different groups according to age,<28 days group, 28 days to <3 months group, 3 months to <1 year group, 1-<5 years of age group, 5-<15 years of age group; etiology confirmed group and clinically diagnosed group according to etiology diagnosis. Non-numeric variables were analyzed with the Chi-square test or Fisher's exact test, while non-normal distrituction numeric variables were compared with nonparametric test. Results: Among 1 610 children with ABM, 955 were male and 650 were female (5 cases were not provided with gender information), and the age of onset was 1.5 (0.5, 5.5) months. There were 588 cases age from <28 days, 462 cases age from 28 days to <3 months, 302 cases age from 3 months to <1 year of age group, 156 cases in the 1-<5 years of age and 101 cases in the 5-<15 years of age. The detection rates were 38.8% (95/245) and 31.5% (70/222) of Escherichia coli and 27.8% (68/245) and 35.1% (78/222) of Streptococcus agalactiae in infants younger than 28 days of age and 28 days to 3 months of age; the detection rates of Streptococcus pneumonia, Escherichia coli, and Streptococcus agalactiae were 34.3% (61/178), 14.0% (25/178) and 13.5% (24/178) in the 3 months of age to <1 year of age group; the dominant pathogens were Streptococcus pneumoniae and the detection rate were 67.9% (74/109) and 44.4% (16/36) in the 1-<5 years of age and 5-<15 years of age . There were 9.7% (19/195) strains of Escherichia coli producing ultra-broad-spectrum β-lactamases. The positive rates of cerebrospinal fluid (CSF) culture and blood culture were 32.2% (515/1 598) and 25.0% (400/1 598), while 38.2% (126/330)and 25.3% (21/83) in CSF metagenomics next generation sequencing and Streptococcus pneumoniae antigen detection. There were 4.3% (32/790) cases of which CSF white blood cell counts were normal in etiology confirmed group. Among 1 610 children with ABM, main intracranial imaging complications were subdural effusion and (or) empyema in 349 cases (21.7%), hydrocephalus in 233 cases (14.5%), brain abscess in 178 cases (11.1%), and other cerebrovascular diseases, including encephalomalacia, cerebral infarction, and encephalatrophy, in 174 cases (10.8%). Among the 166 cases (10.3%) with unfavorable outcome, 32 cases (2.0%) died among whom 24 cases died before 1 year of age, and 37 cases (2.3%) had recurrence among whom 25 cases had recurrence within 3 weeks. The incidences of subdural effusion and (or) empyema, brain abscess and ependymitis in the etiology confirmed group were significantly higher than those in the clinically diagnosed group (26.2% (207/790) vs. 17.3% (142/820), 13.0% (103/790) vs. 9.1% (75/820), 4.6% (36/790) vs. 2.7% (22/820), χ2=18.71, 6.20, 4.07, all P<0.05), but there was no significant difference in the unfavorable outcomes, mortility, and recurrence between these 2 groups (all P>0.05). Conclusions: The onset age of ABM in children is usually within 1 year of age, especially <3 months. The common pathogens in infants <3 months of age are Escherichia coli and Streptococcus agalactiae, and the dominant pathogen in infant ≥3 months is Streptococcus pneumoniae. Subdural effusion and (or) empyema and hydrocephalus are common complications. ABM should not be excluded even if CSF white blood cell counts is within normal range. Standardized bacteriological examination should be paid more attention to increase the pathogenic detection rate. Non-culture CSF detection methods may facilitate the pathogenic diagnosis.
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Affiliation(s)
- C Y Wang
- Department of Infectious Diseases, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310052, China
| | - H M Xu
- Department of Infectious Diseases, Children's Hospital of Chongqing Medical University, Chongqing 400014, China
| | - J Tian
- Department of Infectious Diseases, Children's Hospital of Chongqing Medical University, Chongqing 400014, China
| | - S Q Hong
- Department of Infectious Diseases, Children's Hospital of Chongqing Medical University, Chongqing 400014, China
| | - G Liu
- Department of Infectious Diseases, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
| | - S X Wang
- Department of Infectious Diseases, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
| | - F Gao
- Department of Infectious Diseases, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310052, China
| | - J Liu
- Department of Infectious Diseases, Hunan Children's Hospital, Changsha 410007, China
| | - F R Liu
- Department of Infectious Diseases, Hunan Children's Hospital, Changsha 410007, China
| | - H Yu
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai 201102, China
| | - X Wu
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai 201102, China
| | - B Q Chen
- Department of Infectious Diseases, Anhui Provincial Children's Hospital, Hefei 230022, China
| | - F F Shen
- Department of Infectious Diseases, Anhui Provincial Children's Hospital, Hefei 230022, China
| | - G Zheng
- Department of Neurology, Children's Hospital of Nanjing Medical University,Nanjing 210008, China
| | - J Yu
- Department of Neurology, Children's Hospital of Nanjing Medical University,Nanjing 210008, China
| | - M Shu
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu 610044, China
| | - L Liu
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu 610044, China
| | - L J Du
- Department of Neurology, Children's Hospital of Shanxi, Taiyuan 030006, China
| | - P Li
- Department of Neurology, Children's Hospital of Shanxi, Taiyuan 030006, China
| | - Z W Xu
- Department of Infectious Diseases, the Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China
| | - M Q Zhu
- Department of Infectious Diseases, the Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China
| | - L S Huang
- Department of Infectious Diseases, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - H Y Huang
- Department of Infectious Diseases, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - H B Li
- Department of Pediatrics, the First Hospital of Jilin University, Changchu 130061, China
| | - Y Y Huang
- Department of Pediatrics, the First Hospital of Jilin University, Changchu 130061, China
| | - D Wang
- Department of Neurology, the Affiliated Children's Hospital of Xi'an Jiao Tong University, Xi'an 710002, China
| | - F Wu
- Department of Neurology, the Affiliated Children's Hospital of Xi'an Jiao Tong University, Xi'an 710002, China
| | - S T Bai
- Department of Pediatrics, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - J J Tang
- Department of Pediatrics, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Q W Shan
- Department of Pediatrics, the First Affiliated Hospital of Guangxi Medical University,Nanning 530021, China
| | - L C Lan
- Department of Pediatrics, the First Affiliated Hospital of Guangxi Medical University,Nanning 530021, China
| | - C H Zhu
- Department of Infectious Diseases, Jiangxi Provincial Children's Hospital, Nanchang 330006, China
| | - Y Xiong
- Department of Infectious Diseases, Jiangxi Provincial Children's Hospital, Nanchang 330006, China
| | - J M Tian
- Department of Infectious Diseases, Children's Hospital of Soochow University,Suzhou 215002, China
| | - J H Wu
- Department of Infectious Diseases, Children's Hospital of Soochow University,Suzhou 215002, China
| | - J H Hao
- Department of Infectious Diseases, Kaifeng Children's Hospital, Kaifeng 475000, China
| | - H Y Zhao
- Department of Infectious Diseases, Kaifeng Children's Hospital, Kaifeng 475000, China
| | - A W Lin
- Department of Infectious Diseases, Children's Hospital Affiliated Shandong University, Jinan 250022, China
| | - S S Song
- Department of Infectious Diseases, Children's Hospital Affiliated Shandong University, Jinan 250022, China
| | - D J Lin
- Department of Infectious Diseases, Hainan Women and Children's Medical Center, Haikou 571103, China
| | - Q H Zhou
- Department of Infectious Diseases, Hainan Women and Children's Medical Center, Haikou 571103, China
| | - Y P Guo
- Department of Infectious Diseases, Hainan Women and Children's Medical Center, Haikou 571103, China
| | - J Z Wu
- Department of Pediatrics, Women's and Children's Hospital Affiliated to Xiamen University, Xiamen 361003, China
| | - X Q Yang
- Department of Pediatrics, Women's and Children's Hospital Affiliated to Xiamen University, Xiamen 361003, China
| | - X H Zhang
- Department of Neonatology, Children's Hospital of Shanxi, Taiyuan 030006, China
| | - Y Guo
- Department of Neonatology, Children's Hospital of Shanxi, Taiyuan 030006, China
| | - Q Cao
- Department of Infectious Diseases, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - L J Luo
- Department of Infectious Diseases, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - Z B Tao
- Department of Pediatrics, the First Hospital of Lanzhou University, Lanzhou 730013, China
| | - W K Yang
- Department of Pediatrics, the First Hospital of Lanzhou University, Lanzhou 730013, China
| | - Y K Zhou
- Department of Pediatrics, the First Hospital of Lanzhou University, Lanzhou 730013, China
| | - Y Chen
- Department of Pediatrics, the Second Hospital of Hebei Medical University, Shijiazhuang 050004, China
| | - L J Feng
- Department of Pediatrics, the Second Hospital of Hebei Medical University, Shijiazhuang 050004, China
| | - G L Zhu
- Department of Infection and Digestive, Qinghai Province Women and Children's Hospital, Xining 810007, China
| | - Y H Zhang
- Department of Infection and Digestive, Qinghai Province Women and Children's Hospital, Xining 810007, China
| | - P Xue
- Department of Pediatrics, Taiyuan Maternal and Child Health Care Hospital, Taiyuan 030012, China
| | - X Q Li
- Department of Pediatrics, Taiyuan Maternal and Child Health Care Hospital, Taiyuan 030012, China
| | - Z Z Tang
- Department of Pediatrics, the First People's Hospital of Zunyi, Zunyi 563099, China
| | - D H Zhang
- Department of Pediatrics, the First People's Hospital of Zunyi, Zunyi 563099, China
| | - X W Su
- Department of Pediatrics, Inner Mongolia People's Hospital, Inner Mongolia 750306, China
| | - Z H Qu
- Department of Pediatrics, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - Y Zhang
- Department of Pediatrics, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - S Y Zhao
- Department of Infectious Diseases, Hangzhou Children's Hospital, Hangzhou 310005, China
| | - Z Z Qi
- Department of Infectious Diseases, Hangzhou Children's Hospital, Hangzhou 310005, China
| | - L Pang
- Department of Pediatrics, Beijing Ditan Hospital, Capital Medical University, Beijing 100102, China
| | - C Y Wang
- Department of Pediatrics, Beijing Ditan Hospital, Capital Medical University, Beijing 100102, China
| | - H L Deng
- Department of Pediatrics, Xi'an Central Hospital, Xi'an 710004, China
| | - X L Liu
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Y H Chen
- Department of Infectious Diseases, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310052, China
| | - Sainan Shu
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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Li S, Jiang W, Wang CY, Weng L, Du B, Peng JM. A case of disseminated Legionnaires’ disease: The value of metagenome next-generation sequencing in the diagnosis of Legionnaires. Front Med (Lausanne) 2022; 9:955955. [PMID: 36226140 PMCID: PMC9548583 DOI: 10.3389/fmed.2022.955955] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 09/09/2022] [Indexed: 12/24/2022] Open
Abstract
BackgroundLegionella rarely causes hospital-acquired pneumonia (HAP), although it is one of the most common pathogens of community-acquired pneumonia. Hospital-acquired Legionnaires’ disease, mainly occurring in immunocompromised patients, is often delayed in diagnosis with high mortality. The use of the metagenome Next-Generation Sequencing (mNGS) method, which is fast and unbiased, allows for the early detection and identification of microorganisms using a culture-independent strategy.Case reportA 52-year-old male, with a past medical history of Goods syndrome, was admitted due to nephrotic syndrome. The patient developed severe pneumonia, rhabdomyolysis, and soft tissue infection after receiving immunosuppressive therapy. He did not respond well to empiric antibiotics and was eventually transferred to the medical intensive care unit because of an acute respiratory failure and septic shock. The patient then underwent a comprehensive conventional microbiological screening in bronchoalveolar lavage fluid (BALF) and blood, and the results were all negative. As a last resort, mNGS of blood was performed. Extracellular cell-free and intracellular DNA fragments of Legionella were detected in plasma and blood cell layer by mNGS, respectively. Subsequent positive results of polymerase chain reaction for Legionella in BALF and soft tissue specimens confirmed the diagnosis of disseminated Legionnaires’ disease involving the lungs, soft tissue, and blood stream. The patient’s condition improved promptly after a combination therapy of azithromycin and moxifloxacin. He was soon extubated and discharged from ICU with good recovery.ConclusionEarly recognition and diagnosis of disseminated Legionnaires’ disease is challenging. The emergence and innovation of mNGS of blood has the potential to address this difficult clinical issue.
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Ni J, Jiang JJ, Wang CY, Wen W, Tang JK, Chen C, You Y, Hu SQ, Zhang XW, Wang MW. [Association between non-alcoholic fatty liver disease and coronary heart disease]. Zhonghua Xin Xue Guan Bing Za Zhi 2022; 50:835-839. [PMID: 35982021 DOI: 10.3760/cma.j.cn112148-20220412-00264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- J Ni
- Department of Cardiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou Institute of Cardiovascular Diseases, Hangzhou 310015, China
| | - J J Jiang
- Department of Cardiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou Institute of Cardiovascular Diseases, Hangzhou 310015, China
| | - C Y Wang
- Department of Cardiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou Institute of Cardiovascular Diseases, Hangzhou 310015, China
| | - W Wen
- Department of Cardiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou Institute of Cardiovascular Diseases, Hangzhou 310015, China
| | - J K Tang
- Department of Cardiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou Institute of Cardiovascular Diseases, Hangzhou 310015, China
| | - C Chen
- Department of Cardiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou Institute of Cardiovascular Diseases, Hangzhou 310015, China
| | - Y You
- Department of Cardiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou Institute of Cardiovascular Diseases, Hangzhou 310015, China
| | - S Q Hu
- Department of Cardiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou Institute of Cardiovascular Diseases, Hangzhou 310015, China
| | - X W Zhang
- Department of Cardiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou Institute of Cardiovascular Diseases, Hangzhou 310015, China
| | - M W Wang
- Department of Cardiology, Affiliated Hospital of Hangzhou Normal University, Hangzhou Institute of Cardiovascular Diseases, Hangzhou 310015, China
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Chen M, Wang ST, Liu Y, Xiong P, Tao ZX, Zhang L, Jia JL, Wang CY, Xu S. [Genetic characteristics of varicella zoster virus in Shandong province from 2020 to 2021]. Zhonghua Yu Fang Yi Xue Za Zhi 2022; 56:1080-1086. [PMID: 35922235 DOI: 10.3760/cma.j.cn112150-20220105-00017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To investigate the genetic characteristics of varicella zoster virus (VZV) in Shandong province from 2020 to 2021. Methods: From April 2020 to December 2021, 85 herpes fluid samples from suspected varicella patients in Shandong province were collected. The qPCR was used to detect viral DNA and screen suspected samples. Six single nucleotide polymorphisms (SNPs) of ORF22 fragment and ORF38 fragment in positive samples were examined via PCR and Sanger sequencing to identify the viral genotypes. Four SNPs of ORF38 and ORF62 were examined to identify the vaccine and wild-type strains. The sequences were analyzed with Sequencher and MEGA7 software, using the VZV reference strain sequences from GenBank. Results: In the 85 samples suspected of varicella, 80 were VZV positive and wild-type strains belonging to Clade 2. Compared with clade 2 representative strains, the nucleotide and amino acid similarities of ORF22 fragment were 99.5%-100% and 98.5%-100%, respectively. SD20-1, SD20-5, SD20-6, SD20-8, SD20-9, SD20-10, SD20-11, SD20-12, SD20-13, SD20-30 and SD20-31 had a A➝G nucleotide mutation at 37990, causing amino acid change from glutamine to arginine. SD21-1 had a C➝A nucleotide mutation at 38059, causing threonine to asparagine during coding. Conclusions: From 2020 to 2021, all VZV strains in Shandong province are the wild-type strains belonging to Clade 2.
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Affiliation(s)
- M Chen
- Division of EPI, Shandong Center for Disease Control and Prevention, Jinan 250014, China Shandong Qidu Pharmaceutical Co. Ltd./Shandong Provincial Key Laboratory of Neuroprotective Drugs, Zibo 255400, China
| | - S T Wang
- Division of EPI, Shandong Center for Disease Control and Prevention, Jinan 250014, China
| | - Y Liu
- Division of EPI, Shandong Center for Disease Control and Prevention, Jinan 250014, China
| | - P Xiong
- Division of EPI, Shandong Center for Disease Control and Prevention, Jinan 250014, China
| | - Z X Tao
- Division of EPI, Shandong Center for Disease Control and Prevention, Jinan 250014, China
| | - L Zhang
- Division of EPI, Shandong Center for Disease Control and Prevention, Jinan 250014, China
| | - J L Jia
- Liaocheng Center for Disease Control and Prevention, Liaocheng 252000, China
| | - C Y Wang
- Division of EPI, Shandong Center for Disease Control and Prevention, Jinan 250014, China
| | - Songtao Xu
- National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing 102206, China
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Wang CY, Cao Y, Feng YM, Li J, Jiang B, Zhang Y, Wen J, Zhu YJ, Li J. [Analysis and significance of HBV DNA below the lower detection limit of HBV RNA levels after long-term NAs antiviral therapy in patients with hepatitis B virus cirrhosis]. Zhonghua Gan Zang Bing Za Zhi 2022; 30:758-762. [PMID: 36038347 DOI: 10.3760/cma.j.cn501113-20201126-00629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To analyze the significance of HBV DNA below the lower detection limit of HBV RNA levels after long-term nucleos(t)ide analogues (NAs) antiviral therapy in patients with hepatitis B virus cirrhosis. Methods: 97 cases with hepatitis B virus cirrhosis treated with NAs antiviral therapy for at least 3 years between May 2018 to July 2019 were selected. High-sensitivity HBV DNA (<20 IU/ml), alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyltransferase (GGT), HBsAg, HBeAg and HBV RNA at least twice every 6 months were detected. According to Child-Pugh classification, HBeAg, HBsAg level, and HBV RNA level intergroup comparison was performed. Rank sum test, χ2 test and linear regression analysis were performed on the data. Results: Compared with the HBV RNA level of child-Pugh class A patients, the HBV RNA level of Child-Pugh class B+C patients were significantly higher [4.1 (0,4.9) log10 copies/ml and 2.0 (0,3.5) log10 copies/ml], and the difference was statistically significant (Z=2.370, P<0.05). According to different HBeAg levels, they were divided into HBeAg positive and negative group, and the quantitative comparison of HBV RNA levels between the two groups were 2.0 (0, 4.5) log10 copies/ml and 1.0 (1.0, 2.0) log10 copies/ml, respectively, and the difference was statistically significant (Z=3.233, P<0.05). According to different HBsAg levels, they were divided into three groups: HBsAg≤100 IU/ml, 100<HBsAg<1 000 IU/ml, and HBsAg≥1 000 IU/ml, and the quantitative comparison of HBV RNA levels among the three groups were 0 (0, 2.0) log10, 2.0 (0,4.6) log10, and 2.2 (2.0, 4.7) log10 copies/ml, respectively, and the difference was statistically significant (H=11.265, P<0.05). Gender, age, ALT, AST, GGT, HBsAg, and HBeAg were included for linear regression analysis, and the HBsAg and AST levels were correlated with HBV RNA quantification (P<0.05). Adverse events occurrence during 1-year follow-up were recorded. 19 (31.7%) out of 60 cases had adverse events with detectable HBV RNA, and 3 (8.1%) out of 37 cases had adverse events with undetectable HBV RNA, and the difference was statistically significant (χ2=7.24, P<0.05). Conclusion: HBV RNA can still be detected after HBV DNA falls below the detection limit in patients with hepatitis B virus cirrhosis treated with long-term NAs antiviral therapy. HBV RNA quantification level is higher in patients with Child Pugh class B and C. Patients with detectable HBV RNA has higher proportion of adverse events, and AST and HBsAg levels may be correlated with serum HBV RNA.
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Affiliation(s)
- C Y Wang
- Department of Chronic Liver Disease,Tianjin Second People's Hospital, Tianjin 300192, China
| | - Y Cao
- Hepatopathy Research Institute, Tianjin Second People's Hospital, Tianjin 300192, China
| | - Y M Feng
- Department of Chronic Liver Disease,Tianjin Second People's Hospital, Tianjin 300192, China
| | - J Li
- Graduate School of Tianjin Medical University, Tianjin 300192, China
| | - B Jiang
- Hepatopathy Research Institute, Tianjin Second People's Hospital, Tianjin 300192, China
| | - Y Zhang
- Department of Chronic Liver Disease,Tianjin Second People's Hospital, Tianjin 300192, China
| | - J Wen
- Department of Chronic Liver Disease,Tianjin Second People's Hospital, Tianjin 300192, China
| | - Y J Zhu
- Graduate School of Tianjin Medical University, Tianjin 300192, China
| | - J Li
- Department of Chronic Liver Disease,Tianjin Second People's Hospital, Tianjin 300192, China
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Wang CY, Xiong B, Liu JC, Yang CT, Ju SG, Bai YW, Yao W, Wang YL. [Effect of underdilated stent on the occurrence of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt creation]. Zhonghua Nei Ke Za Zhi 2022; 61:537-542. [PMID: 35488604 DOI: 10.3760/cma.j.cn112138-20211010-00685] [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 evaluate whether underdilated stent could reduce the occurrence of hepatic encephalopathy (HE) after transjugular intrahepatic portosystemic shunt (TIPS) creation. Methods: A total of 197 patients with decompensated liver cirrhosis, who had underwent TIPS creation at Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, were analyzed retrospectively, including 110 males and 87 females with age 25-79 (54±11) years old. Uncovered and covered stents with 8 mm diameter were implanted in all subjects, and then dilated by balloon catheters with 6 mm or 8 mm diameter. The patients were divided into two groups, including underdilated group (6 mm, n=105) and control group (8 mm, n=92).Kaplan-Meier curves were used to illustrate cumulative rate of HE, and the differences were assessed with the log-rank test. Multivariate analyses with a Cox regression model were conducted to explore the risk factors for HE. Results: During a median follow-up period of 29 (12-54) months, 16 (15.2%) patients developed HE in the underdilated group and 27 (29.3%) patients in the control group. There was a significant difference in the cumulative rate of HE (P=0.014), but no statistical differences were found in terms of variceal rebleeding, shunt dysfunction and survival between the two groups (P=0.608, P=0.659, P=0.968). In multivariated analysis, group assignment (underdilated vs. control, HR=0.291, 95%CI 0.125-0.674, P=0.004) was identified as an independent risk factor for HE after TIPS creation. Conclusion: Underdilated TIPS could reduced the risk of HE compared with completely dilated TIPS, with comparable risk of variceal rebleeding, shunt dysfunction and mortality. And it is worthy of applying this technique to a large sample of patients in clinical practice.
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Affiliation(s)
- C Y Wang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
| | - B Xiong
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
| | - J C Liu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
| | - C T Yang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
| | - S G Ju
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
| | - Y W Bai
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
| | - W Yao
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
| | - Y L Wang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
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Wang CY, Liu J, Liang XP, Guo BL, Hu RZ, Liu Y. [Clinical characteristics and prognostic features of 63 HIV-associated diffuse large B-cell lymphoma: a single-center real-world study in China]. Zhonghua Xue Ye Xue Za Zhi 2022; 43:203-208. [PMID: 35405777 PMCID: PMC9072062 DOI: 10.3760/cma.j.issn.0253-2727.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Indexed: 11/09/2022]
Abstract
Objective: This study aimed to look into the clinical characteristics and prognosis of patients with human immunodeficiency virus (HIV) -associated diffuse large B-cell lymphoma (DLBCL) . Methods: Retrospective review of the clinical data of 63 HIV-infected patients with DLBCL diagnosed at Chongqing University Cancer Hospital between July 2008 and August 2021. The Kaplan-Meier method was used to calculate survival curves, and the log-rank test method was used to compare survival between groups. The Cox proportional hazards model was used for multivariate analysis. Results: In 63 patients with HIV-associated DLBCL, 57 (90.5% ) were men, and the median age was 49 (23-87) years. The most common pathological subtype was the germinal center B-cell-like lymphoma (74.6% ) ; 46.0% (29/63) were combined with extranodal lesions. Seventeen of 63 (27.0% ) patients had large masses (≥7.5 cm) . Twenty of 63 (31.7% ) patients had B symptoms. The median CD4(+) T cell count was 203 (4-1022) ×10(6)/L. A total of 49% (25/51) patients had CD4(+) cell count <200×10(6)/L, 56.9% (33/58) had high (3-5) International Prognostic Index (IPI) scores, and 43.1% (25/58) had low (0-2) IPI scores. Further, 78% (46/59) were diagnosed with Ann Arbor Stage Ⅲ/Ⅳ, and 25.4% (16/63) didn't receive chemotherapy. A total of 22.2% (14/63) of patients received less than four cycles of chemotherapy, and 52.4% (33/63) received four or more cycles of chemotherapy. Among patients undergoing chemotherapy, 61.7% (29/47) received R-CHOP-like regimens, and 38.3% (18/47) used CHOP-like regimens. The 1-, 2-, 3-, and 5-year overall survival (OS) rates were 65.0% , 53.8% , 47.1% , and 43.5% , respectively. Univariate analysis revealed that age ≥ 60 years (P=0.012) , Eastern Cooperative Oncology Gruop Performance Status (ECOG-PS) score 2-4 points (P=0.043) , IPI score 3-5 points (P=0.001) , β(2)-MG elevation (≥5.5 mg/L) (P=0.007) , and systemic chemotherapy cycles less than four times (P<0.001) were the negative prognostic factors affecting the OS of patients. The Cox multivariate analysis depicted that age ≥60 years (HR=2.272, 95% CI 1.110-4.651, P=0.025) , IPI score 3-5 points (HR=3.562, 95% CI 1.794-7.074, P<0.001) , ECOG-PS score 2-4 points (HR=2.675, 95% CI 1.162-6.153, P=0.021) , and number of cycles of chemotherapy<4 (HR=0.290, 95% CI 0.176-0.479, P<0.001) were independent risk factors for adverse prognosis of OS. Conclusion: HIV-associated DLBCL is the most common HIV-related tumor, is most commonly seen in men, and has a high 1-year mortality rate. Chemotherapy combined with antiretroviral therapy can improve patient prognosis.
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Affiliation(s)
- C Y Wang
- Department of Hematology-Oncology, Chongqing University Cancer Hospital, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing 400030, China
| | - J Liu
- Department of Hematology-Oncology, Chongqing University Cancer Hospital, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing 400030, China
| | - X P Liang
- Department of Hematology-Oncology, Chongqing University Cancer Hospital, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing 400030, China
| | - B L Guo
- Department of Hematology-Oncology, Chongqing University Cancer Hospital, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing 400030, China
| | - R Z Hu
- Department of Hematology-Oncology, Chongqing University Cancer Hospital, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing 400030, China
| | - Y Liu
- Department of Hematology-Oncology, Chongqing University Cancer Hospital, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing 400030, China
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Wang CY, Hsieh MK, Hu YJ, Bit A, Lai PL. Monocarboxylate transporter 1-mediated lactate accumulation promotes nucleus pulposus degeneration under hypoxia in a 3D multilayered nucleus pulposus degeneration model. Eur Cell Mater 2022; 43:53-65. [PMID: 35188217 DOI: 10.22203/ecm.v043a06] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
During intervertebral disc degeneration (IVDD), due to endplate calcification, diminished oxygen and nutrient concentrations and accumulated lactate are present in the microenvironment of the nucleus pulposus (NP). The disadvantages of 3D layered culture include uneven oxygen and nutrient gradients. In the present study, to mimic the in vivo microenvironment of the NP, a 5-layered 3D culture was constructed using clinical haemostatic gelatine sponges and developed as a NP degeneration (NPD) model. Subsequently, cell distribution as well as expression of NP chondrogenic markers (type II collagen and aggrecan), glycosaminoglycan (GAG) and degeneration markers [e.g. matrix metalloproteinase (MMP) 3] were measured from the top to the bottom layer. However, in a single NP-cell-loaded disc model, the chondrogenic potency in the middle or bottom layer was higher than that in the top layer. To further study the mechanism underlying the degeneration of NP cells in this NPD model, the contribution of secreted metabolites was examined. Lactate identified in the supernatant modulated GAG accumulation and MMP3 expression. Inhibition of lactate influx by the monocarboxylate transporter (MCT)-1 inhibitor, AZD3965, reversed the effect of lactate on GAG accumulation and MMP3 expression and further improved NP cell degeneration in the NPD model. Thanks to the homogenous expression of lactate in the model, it was possible to further identified that the combination of lactate and hypoxia enhanced MMP3 expression. Taken together, multilayered cell-loaded sponges, with oxygen and nutrient gradients as well as lactate accumulation, can represent a 3D multilayered NPD model for exploring potential agents for IVDD.
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Affiliation(s)
| | | | | | | | - P L Lai
- Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, No. 5, Fuxing Street, Guishan District, Taoyuan City, 33305,
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Ma MS, Wang W, Zhou Y, Zhong LQ, Yu ZX, Gou LJ, Li J, Wang L, Wang CY, Tang XY, Quan MY, Song HM. [Analysis of clinical characteristics of 35 inflammasomopathies cases]. Zhonghua Er Ke Za Zhi 2022; 60:114-118. [PMID: 35090227 DOI: 10.3760/cma.j.cn112140-20210906-00756] [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 summarize the clinical characteristics of inflammasomopathies, enhance the recognition of those diseases, and help to establish the early diagnosis. Methods: The clinical manifestations including fever, rash, systems involvement as well as laboratory results and genotypic characteristics of 35 children with inflammasomopathies diagnosed by the Department of Pediatrics, Peking Union Medical College Hospital, from January 1, 2008 to December 31, 2020 were analyzed retrospectively. Results: A total of 35 cases of inflammasomopathies were diagnosed, and 20 of them were boys while 15 were girls. Inflammasomopathies patients have early onset, the age of onset as well as diagnostic age were 1 (0,7) and 7 (3,12), respectively. Among those patients, 10 had familial mediterranean fever, 3 had mevalonate kinase deficiency, 15 cases had NLRP3 gene associated autoinflammatory disease, 4 cases had NLRP12-associated autoinflammatory disease, 2 cases had familial cold autoinflammatory syndrome 3, and 1 case had familial cold autoinflammatory syndrome 4. A total of 34 cases (97%) showed recurrent fever, 27 cases (77%) had skin rashes, while 11 cases (31%), 10 cases (29%), and 8 cases (23%) were presented with lymphadenopathy, hepatosplenomegaly and growth retardation, respectively. In terms of systemic involvement, there were 18 cases (51%), 12 cases (34%), 8 cases (23%), and 5 cases (14%) with skeletal, neurological, auditory, and renal involvement, respectively. Central nervous system involvement was seen only in NLRP3 gene associtated autoinflammatory diseases (12 cases), sensorineural deafness was seen in NLRP3 gene associtated autoinflammatory diseases (6 cases) and NLRP12 gene associated autoinflammatory diseases (2 cases), and abdominal pain was observed in familial Mediterranean fever (5 cases), mevalonate kinase deficiency (1 case) and NLRP12 gene related autoinflammatory diseases (1 case). In the acute inflammatory phase, the acute phase reactants (erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)) of 35 cases (100%) were significantly increased. There were 21 cases received ferritin examination, and only 4 cases (19%) showed an increase of it. In terms of autoantibodies, among all 35 patients, 4 cases (11%) were positive for antinuclear antibodies (ANA). Conclusions: Fever, skin rash, and skeletal manifestations are the most common clinical features, accompanied with increased CRP and ESR, and negative results of autoantibodies such as ANA. The clinical manifestations of those diseases are complex and diverse, and it is prone to delayed diagnosis and treatment.
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Affiliation(s)
- M S Ma
- Department of Pediatrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - W Wang
- Department of Pediatrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Y Zhou
- Department of Pediatrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - L Q Zhong
- Department of Pediatrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Z X Yu
- Department of Pediatrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - L J Gou
- Department of Pediatrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - J Li
- Department of Pediatrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - L Wang
- Department of Pediatrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - C Y Wang
- Department of Pediatrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - X Y Tang
- Department of Pediatrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - M Y Quan
- Department of Pediatrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - H M Song
- Department of Pediatrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
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Garg AX, Cuerden M, Aguado H, Amir M, Belley-Cote EP, Bhatt K, Biccard BM, Borges FK, Chan M, Conen D, Duceppe E, Efremov S, Eikelboom J, Fleischmann E, Giovanni L, Gross P, Jayaram R, Kirov M, Kleinlugtenbelt Y, Kurz A, Lamy A, Leslie K, Likhvantsev V, Lomivorotov V, Marcucci M, Martínez-Zapata MJ, McGillion M, McIntyre W, Meyhoff C, Ofori S, Painter T, Paniagua P, Parikh C, Parlow J, Patel A, Polanczyk C, Richards T, Roshanov P, Schmartz D, Sessler D, Short T, Sontrop JM, Spence J, Srinathan S, Stillo D, Szczeklik W, Tandon V, Torres D, Van Helder T, Vincent J, Wang CY, Wang M, Whitlock R, Wittmann M, Xavier D, Devereaux PJ. Effect of a Perioperative Hypotension-Avoidance Strategy Versus a Hypertension-Avoidance Strategy on the Risk of Acute Kidney Injury: A Clinical Research Protocol for a Substudy of the POISE-3 Randomized Clinical Trial. Can J Kidney Health Dis 2022; 9:20543581211069225. [PMID: 35024154 PMCID: PMC8744204 DOI: 10.1177/20543581211069225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 11/30/2021] [Indexed: 11/24/2022] Open
Abstract
Background: Most patients who take antihypertensive medications continue taking them on
the morning of surgery and during the perioperative period. However, growing
evidence suggests this practice may contribute to perioperative hypotension
and a higher risk of complications. This protocol describes an acute kidney
injury substudy of the Perioperative Ischemic Evaluation-3 (POISE-3) trial,
which is testing the effect of a perioperative hypotension-avoidance
strategy versus a hypertension-avoidance strategy in patients undergoing
noncardiac surgery. Objective: To conduct a substudy of POISE-3 to determine whether a perioperative
hypotension-avoidance strategy reduces the risk of acute kidney injury
compared with a hypertension-avoidance strategy. Design: Randomized clinical trial with 1:1 randomization to the intervention (a
perioperative hypotension-avoidance strategy) or control (a
hypertension-avoidance strategy). Intervention: If the presurgery systolic blood pressure (SBP) is <130 mmHg, all
antihypertensive medications are withheld on the morning of surgery. If the
SBP is ≥130 mmHg, some medications (but not angiotensin receptor blockers
[ACEIs], angiotensin receptor blockers [ARBs], or renin inhibitors) may be
continued in a stepwise manner. During surgery, the patients’ mean arterial
pressure (MAP) is maintained at ≥80 mmHg. During the first 48 hours after
surgery, some antihypertensive medications (but not ACEIs, ARBs, or renin
inhibitors) may be restarted in a stepwise manner if the SBP is ≥130
mmHg. Control: Patients receive their usual antihypertensive medications before and after
surgery. The patients’ MAP is maintained at ≥60 mmHg from anesthetic
induction until the end of surgery. Setting: Recruitment from 108 centers in 22 countries from 2018 to 2021. Patients: Patients (~6800) aged ≥45 years having noncardiac surgery who have or are at
risk of atherosclerotic disease and who routinely take antihypertensive
medications. Measurements: The primary outcome of the substudy is postoperative acute kidney injury,
defined as an increase in serum creatinine concentration of either ≥26.5
μmol/L (≥0.3 mg/dL) within 48 hours of randomization or ≥50% within 7 days
of randomization. Methods: The primary analysis (intention-to-treat) will examine the relative risk and
95% confidence interval of acute kidney injury in the intervention versus
control group. We will repeat the primary analysis using alternative
definitions of acute kidney injury and examine effect modification by
preexisting chronic kidney disease, defined as a prerandomization estimated
glomerular filtration rate <60 mL/min/1.73 m2. Results: Substudy results will be analyzed in 2022. Limitations: It is not possible to mask patients or providers to the intervention;
however, objective measures will be used to assess acute kidney injury. Conclusions: This substudy will provide generalizable estimates of the effect of a
perioperative hypotension-avoidance strategy on the risk of acute kidney
injury.
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Affiliation(s)
| | | | | | - Mohammed Amir
- Shifa International Hospital (STMU), Islamabad, Pakistan
| | | | - Keyur Bhatt
- SIDS Hospital & Research Centre, Guntur, India
| | | | | | - Matthew Chan
- The Chinese University of Hong Kong, Shatin, Hong Kong
| | - David Conen
- Population Health Research Institute, Hamilton, ON, Canada
| | | | | | | | | | | | | | | | - Mikhail Kirov
- Northern State Medical University of the Ministry of Healthcare of the Russian Federation, Arkhangelsk, Russia
| | | | | | - Andre Lamy
- Population Health Research Institute, Hamilton, ON, Canada
| | | | | | | | | | | | | | | | | | - Sandra Ofori
- Population Health Research Institute, Hamilton, ON, Canada
| | | | | | | | | | | | | | - Toby Richards
- The University of Western Australia, Perth, Australia
| | | | | | | | - Tim Short
- Auckland District Health Board, New Zealand
| | | | | | | | - David Stillo
- Population Health Research Institute, Hamilton, ON, Canada
| | | | | | | | | | | | - C Y Wang
- University of Malaya, Kuala Lumpur, Malaysia
| | | | | | | | - Denis Xavier
- St. John's National Academy of Health Sciences, Bangalore, India
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Zhu W, Shan SS, Zhang QY, Zhang J, Zhang CY, Wang CY, Jia ZM, Zhang GX, Wang Y, Che YY, Wen JG, Wang QW. [Evaluation of the efficacy of a new variable frequency stimulation sacral neuromodulation in the treatment of detrusor hyperactivity with impaired contractility]. Zhonghua Yi Xue Za Zhi 2022; 102:147-151. [PMID: 35012305 DOI: 10.3760/cma.j.cn112137-20210408-00849] [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
A total of 16 detrusor hyperactivity with impaired contractility (DHIC) patients who received 12 weeks remote variable frequency stimulation (VFS) were enrolled at the First Affiliated Hospital of Zhengzhou University from September 2020 to February 2021. The voiding diary, symptom score scales and incidence of complications were completed and recorded at baseline, constant frequency stimulation (CFS) and VFS phases. Compared with the CFS phase, voiding times, urge incontinence times and daily catheterization volume were reduced; average voiding amount and functional bladder capacity increased; and the quality of life score and mental health questionnaire assessment were improved in the VFS phase(all P<0.05). In the end, among all 16 patients, there were 14 whose symptoms had improved, and there were no new complications such as pain or infection at the implantation site, electrode displacement, and electric shock sensation in the stimulation area. VFS-SNM can not only improve the DHIC patients' lower urinary tract symptoms during storage and urination period, but also improve the patients' quality of life and satisfaction of the therapy.
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Affiliation(s)
- W Zhu
- Department of Urology, the First Affiliated Hospital of Zhengzhou University, Henan 450000, China
| | - S S Shan
- Henan Joint International Pediatric Urodynamic Laboratory, the First Affiliated Hospital of Zhengzhou University, Henan 450000, China
| | - Q Y Zhang
- Department of Urology, the First Affiliated Hospital of Zhengzhou University, Henan 450000, China
| | - J Zhang
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Henan 450000, China
| | - C Y Zhang
- Department of Urology, the First Affiliated Hospital of Zhengzhou University, Henan 450000, China
| | - C Y Wang
- Department of Urology, the First Affiliated Hospital of Zhengzhou University, Henan 450000, China
| | - Z M Jia
- Department of Urology, the First Affiliated Hospital of Zhengzhou University, Henan 450000, China
| | - G X Zhang
- Department of Urology, the First Affiliated Hospital of Zhengzhou University, Henan 450000, China
| | - Y Wang
- Department of Urology, the First Affiliated Hospital of Zhengzhou University, Henan 450000, China
| | - Y Y Che
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Henan 450000, China
| | - J G Wen
- Henan Joint International Pediatric Urodynamic Laboratory, the First Affiliated Hospital of Zhengzhou University, Henan 450000, China
| | - Q W Wang
- Department of Urology, the First Affiliated Hospital of Zhengzhou University, Henan 450000, China
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Wang CY, Wang P, Wang XJ, Wang XY. Sessile serrated adenoma of the appendix coexists with anaplastic carcinoma mural nodules originating from ovarian mucinous tumors: A case report. Niger J Clin Pract 2022; 25:964-966. [DOI: 10.4103/njcp.njcp_1782_21] [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: 11/04/2022]
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Wang CY, Liu J, Wen J, Ma HX, Li J. [A case of HCV genotype 3b with compensated stage cirrhosis who have two times treatment-experienced with the use of glecaprevir/pibrentasvir combined with sofosbuvir and ribavirin for 16 weeks]. Zhonghua Gan Zang Bing Za Zhi 2021; 29:1194-1195. [PMID: 35045636 DOI: 10.3760/cma.j.cn501113-20200526-00275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- C Y Wang
- Tianjin Second People's Hospital, Tianjin 300192, China
| | - J Liu
- Tianjin Second People's Hospital, Tianjin 300192, China
| | - J Wen
- Tianjin Second People's Hospital, Tianjin 300192, China
| | - H X Ma
- Tianjin Second People's Hospital, Tianjin 300192, China
| | - J Li
- Tianjin Second People's Hospital, Tianjin 300192, China
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Yu W, Lyu YP, Li YY, Zhang F, Geng CX, Wang CY, Zhang QQ. [Diagnosis and treatment of extensive osteonecrosis of maxilla caused by enterobacter cloacae infection in diabetes: a case report]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2021; 56:1109-1110. [PMID: 34666476 DOI: 10.3760/cma.j.cn115330-20210112-00018] [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)
- W Yu
- Department of Otorhinolaryngology, Zhifu Branch of Yantai Yuhuangding Hospital (Yantai Zhifu Hospital), Yantai 264000, Shandong Province, China
| | - Y P Lyu
- Department of Oncology, Zhifu Branch of Yantai Yuhuangding Hospital (Yantai Zhifu Hospital), Yantai 264000, Shandong Province, China
| | - Y Y Li
- Department of Otorhinolaryngology, Zhifu Branch of Yantai Yuhuangding Hospital (Yantai Zhifu Hospital), Yantai 264000, Shandong Province, China
| | - F Zhang
- Department of Otorhinolaryngology, Zhifu Branch of Yantai Yuhuangding Hospital (Yantai Zhifu Hospital), Yantai 264000, Shandong Province, China
| | - C X Geng
- Department of Oncology, Zhifu Branch of Yantai Yuhuangding Hospital (Yantai Zhifu Hospital), Yantai 264000, Shandong Province, China
| | - C Y Wang
- Department of Otorhinolaryngology, Zhifu Branch of Yantai Yuhuangding Hospital (Yantai Zhifu Hospital), Yantai 264000, Shandong Province, China
| | - Q Q Zhang
- Department of Otorhinolaryngology, Zhifu Branch of Yantai Yuhuangding Hospital (Yantai Zhifu Hospital), Yantai 264000, Shandong Province, China Department of Otorhinolaryngology Head and Neck Surgery, Yantai Yuhuangding Hospital of Qingdao University, Yantai 264000, Shandong Province, China
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Wei QT, Liu BY, Ji HY, Lan YF, Tang WH, Zhou J, Zhong XY, Lian CL, Huang QZ, Wang CY, Xu YM, Guo HB. Exosome-mediated transfer of MIF confers temozolomide resistance by regulating TIMP3/PI3K/AKT axis in gliomas. Mol Ther Oncolytics 2021; 22:114-128. [PMID: 34514093 PMCID: PMC8413833 DOI: 10.1016/j.omto.2021.08.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 08/12/2021] [Indexed: 01/08/2023]
Abstract
Temozolomide (TMZ) resistance is an important cause of clinical treatment failure and poor prognosis in gliomas. Increasing evidence indicates that cancer-derived exosomes contribute to chemoresistance; however, the specific contribution of glioma-derived exosomes remains unclear. The aim of this study was to explore the role and underlying mechanisms of exosomal macrophage migration inhibitory factor (MIF) on TMZ resistance in gliomas. We first demonstrated that MIF was upregulated in the exosomes of TMZ-resistant cells, engendering the transfer of TMZ resistance to sensitive cells. Our results indicated that exosomal MIF conferred TMZ resistance to sensitive cells through the enhancement of cell proliferation and the repression of cell apoptosis upon TMZ exposure. MIF knockdown enhanced TMZ sensitivity in resistant glioma cells by upregulating Metalloproteinase Inhibitor 3 (TIMP3) and subsequently suppressing the PI3K/AKT signaling pathway. Additionally, exosomal MIF promoted tumor growth and TMZ resistance of glioma cells in vivo, while IOS-1 (MIF inhibitor) promotes glioma TMZ sensitive in vivo. Taken together, our study demonstrated that exosome-mediated transfer of MIF enhanced TMZ resistance in glioma through downregulating TIMP3 and further activating the PI3K/AKT signaling pathway, highlighting a prognostic biomarker and promising therapeutic target for TMZ treatment in gliomas.
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Affiliation(s)
- Q T Wei
- Department of Neurosurgery Center, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, 253 Gongye Middle Avenue, Haizhu District, Guangzhou, Guangdong 510280, China.,Department of Neurosurgery, The First Affiliated Hospital of Shantou University, Shantou 515041, Guangdong, China
| | - B Y Liu
- Department of Neurosurgery Center, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, 253 Gongye Middle Avenue, Haizhu District, Guangzhou, Guangdong 510280, China
| | - H Y Ji
- Department of Neurosurgery Center, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, 253 Gongye Middle Avenue, Haizhu District, Guangzhou, Guangdong 510280, China.,Department of Neurosurgery, The First Affiliated Hospital of Shantou University, Shantou 515041, Guangdong, China
| | - Y F Lan
- Department of Neurosurgery Center, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, 253 Gongye Middle Avenue, Haizhu District, Guangzhou, Guangdong 510280, China
| | - W H Tang
- Department of Neurosurgery Center, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, 253 Gongye Middle Avenue, Haizhu District, Guangzhou, Guangdong 510280, China
| | - J Zhou
- Department of Neurosurgery Center, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, 253 Gongye Middle Avenue, Haizhu District, Guangzhou, Guangdong 510280, China
| | - X Y Zhong
- Department of Neurosurgery Center, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, 253 Gongye Middle Avenue, Haizhu District, Guangzhou, Guangdong 510280, China
| | - C L Lian
- Department of Neurosurgery Center, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, 253 Gongye Middle Avenue, Haizhu District, Guangzhou, Guangdong 510280, China
| | - Q Z Huang
- Department of Neurosurgery Center, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, 253 Gongye Middle Avenue, Haizhu District, Guangzhou, Guangdong 510280, China
| | - C Y Wang
- Department of Neurosurgery Center, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, 253 Gongye Middle Avenue, Haizhu District, Guangzhou, Guangdong 510280, China
| | - Y M Xu
- Department of Neurosurgery, The First Affiliated Hospital of Shantou University, Shantou 515041, Guangdong, China
| | - H B Guo
- Department of Neurosurgery Center, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, 253 Gongye Middle Avenue, Haizhu District, Guangzhou, Guangdong 510280, China
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Wang CY, Jiang KY, Yang L, Qin WH. [Optimizing experimental conditions of graphite furnace atomic absorption spectrometer using orthogonal design for determination of cobalt in urine]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2021; 39:616-618. [PMID: 34488274 DOI: 10.3760/cma.j.cn121094-20200413-00192] [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 select and optimize the conditions of urine cobalt determination by graphite furnace atomic absorption spectroscopy and establish a method for urine cobalt determination. Methods: In April 2020, the matrix modifier and spectrum wavelength were selected by mathematical statistics method, the heating procedure of graphite furnace was optimized, the variance of orthogonal test results was analyzed, and the working curve was quantified by external standard method. Results: The results showed that the diammonium hydrogen phosphate was a matrix modifier with a wavelength of 240.7 nm, and the optimized graphite furnace heating procedure showed a good linear relationship at 5-80 μg/L. The correlation coefficient was 0.9991. The detection limit was 0.9 μg/L, the lowest detection concentration was 1.8 μg/L. The recovery was 94.0%-101.4%, and the precision was 2.6%-5.8%. Conclusion: The orthogonal design method can efficiently and scientifically optimize the optimal combination of the various factor levels of graphite furnace atomic absorption spectrometry. The determination method established based on this has high precision and good accuracy, and can be applied to the determination of cobalt in urine.
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Affiliation(s)
- C Y Wang
- Henan Institute for Occupational Health, Zhengzhou 450052, China
| | - K Y Jiang
- Henan Institute for Occupational Health, Zhengzhou 450052, China
| | - L Yang
- Henan Institute for Occupational Health, Zhengzhou 450052, China
| | - W H Qin
- Henan Institute for Occupational Health, Zhengzhou 450052, China
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Zhang Y, Liu JY, Shao JW, Luo QQ, Zhang YQ, Song G, Wang CY, Zhao SY, Wan C, Du XH, Xu LZ. Effective Model of Food Allergy in Mice Sensitized with Ovalbumin and Freud's Adjuvant. Bull Exp Biol Med 2021; 171:352-356. [PMID: 34297293 DOI: 10.1007/s10517-021-05226-z] [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: 11/27/2020] [Indexed: 12/29/2022]
Abstract
To better explore the pathophysiology of FA and its therapy, we aimed to establish a simple and practicable FA model with Freund's adjuvant and introduce an easy and reliable laboratory evaluation method for assessment of inflammation in intestinal segments at different anatomical locations. BALB/c mice were sensitized with ovalbumin combined with Freund's adjuvant. Complete Freund's adjuvant was chosen for the first sensitization and two weeks later incomplete Freund's adjuvant was used for a second sensitization. Two weeks later, the sensitized mice were challenged with 50 mg ovalbumin every other day. After the 6 challenge, all mice were assessed for systemic anaphylaxis, and then sacrificed for sample collection. All sensitized mice showed anaphylactic symptoms and markedly increased levels of serum ovalbumin-specific IgE and IgG1. The activity of mast cell protease-1 (mMCPT-1) was significantly increased in the serum and interstitial fluid of the duodenum, jejunum, ileum, and colon. A successful FA model was established, of which inflammation occurred in the duodenum, jejunum, ileum, and colon. This model provides a reliable and simple tool for analysis of the mechanism of FA and methods of immunotherapy. Moreover, combined detection of ovalbumin-specific antibody and local mMCPT-1 levels could potentially be used as the major indicator for assessment of food allergy.
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Affiliation(s)
- Y Zhang
- Key Lab for Immunology, Universities of Shandong Province, School of Basic Medical Sciences, Weifang Medical University, Weifang, China
| | - J Y Liu
- Key Lab for Immunology, Universities of Shandong Province, School of Basic Medical Sciences, Weifang Medical University, Weifang, China
| | - J W Shao
- Key Lab for Immunology, Universities of Shandong Province, School of Basic Medical Sciences, Weifang Medical University, Weifang, China
| | - Q Q Luo
- Key Lab for Immunology, Universities of Shandong Province, School of Basic Medical Sciences, Weifang Medical University, Weifang, China
| | - Y Q Zhang
- Key Lab for Immunology, Universities of Shandong Province, School of Basic Medical Sciences, Weifang Medical University, Weifang, China
| | - G Song
- Key Lab for Immunology, Universities of Shandong Province, School of Basic Medical Sciences, Weifang Medical University, Weifang, China
| | - C Y Wang
- Key Lab for Immunology, Universities of Shandong Province, School of Basic Medical Sciences, Weifang Medical University, Weifang, China
| | - S Y Zhao
- Key Lab for Immunology, Universities of Shandong Province, School of Basic Medical Sciences, Weifang Medical University, Weifang, China
| | - C Wan
- Key Lab for Immunology, Universities of Shandong Province, School of Basic Medical Sciences, Weifang Medical University, Weifang, China
| | - X H Du
- Key Lab for Immunology, Universities of Shandong Province, School of Basic Medical Sciences, Weifang Medical University, Weifang, China
| | - L Z Xu
- Key Lab for Immunology, Universities of Shandong Province, School of Basic Medical Sciences, Weifang Medical University, Weifang, China.
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Mao CQ, Lu M, Lai YZ, Wang CY, Chen WH. [Using rotation cross-advancement flap for repairing complete unilateral cleft lip and nasolabial deformity]. Zhonghua Kou Qiang Yi Xue Za Zhi 2021; 56:697-700. [PMID: 34275227 DOI: 10.3760/cma.j.cn112144-20200920-00508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
To evaluate the efficacy of rotation cross-advancement flap method in repairing the nasolabial deformity of complete unilateral cleft lip. A retrospective study was performed to analyze the children who were treated by using the rotating cross-advancement flap for repairing the complete unilateral cleft lip at the Fujian Medical University Union Hospital from October 2018 to July 2019. The clinical data such as patient's lip height, lip length, nostril height, nostril width, nostril area and so on were collected at the pre-operation, post-operation and following-up visits respectively and used to evaluate the efficacy of the treatment. Six children were included in the present study. The ratios of lip height on noncleft side to cleft side were 2∶1 at the pre-operation time. The ratios of nostril height on the noncleft side to the cleft side were about 2∶1. The ratios of the width and the area of the nostril were 1∶2 to 1∶3. At the post-operation time, the ratios of length and height of the lip at the cleft side to the noncleft side were around 1∶1. The shape of the nostrils and nasolabial fold were almost symmetrical between the cleft side and noncleft side. The shapes of the nasal sill were acceptable and the postoperative scars were not obvious. There were no obvious incision healing complications and the treatment effects were satisfactory. Rotation cross-advancement flap method was safe and reliable for repairing the nasolabial deformities in children with complete unilateral cleft lip.
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Affiliation(s)
- C Q Mao
- Department of Stomatology, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - M Lu
- Department of Stomatology, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - Y Z Lai
- Department of Stomatology, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - C Y Wang
- Department of Stomatology, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - W H Chen
- Department of Stomatology, Fujian Medical University Union Hospital, Fuzhou 350001, China
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Wang YL, Liang RH, Wang CY, Zhang RP, Wu SY, Han X, Zhang GL. MicroRNA-543 inhibits the proliferation, migration, invasion, and epithelial-mesenchymal transition of triple-negative breast cancer cells via down-regulation of ACTL6A gene. Clin Transl Oncol 2021; 24:84-92. [PMID: 34181232 DOI: 10.1007/s12094-021-02672-z] [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: 05/06/2021] [Accepted: 06/17/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To investigate the effect of microRNA-543 (miR-543) on the proliferation, migration, invasion, and epithelial-mesenchymal transition (EMT) of triple-negative breast cancer (TNBC) cells, and the associated mechanism. METHODS Human breast cancer cells (MDA-MB-231, HCC1937, and MCF-7, ZR-75-1) and normal human breast epithelial cell line (MCF10A) were transfected with miR-543 mimics or inhibitor using lipofectamine 2000. Quantitative reverse transcription polymerase chain reaction (qRT-PCR) and Western blotting were used to determine the mRNA and protein expression levels of miR-543, actin-like protein 6A (ACTL6A), vimentin, Snail, and E-cadherin in breast cancer cells/tissue. Cell counting kit-8 (CCK-8), wound-healing, and Transwell assays were used to measure the effect of miR-543 on TNBC cell proliferation, invasion, and migration. Overall survival was determined using data from Gene Expression Omnibus (GEO) and Cancer Genome Atlas (TCGA) databases. Bioinformatics analysis and luciferase reporter gene assay were used to determine the regulatory effect of miR-543 on ACTL6A. RESULTS The level of expression of miR-543 was significantly lower in breast cancer cells/tissue than in normal human breast epithelial cell/tissue (p < 0.05). MicroRNA-543 expression level was significantly reduced in TNBC cells/tissue, relative to the other breast cancer cells/normal breast tissue (p < 0.05). MicroRNA-543 significantly suppressed tumor growth and the proliferation, migration, invasion, and epithelial-mesenchymal transition (EMT) of TNBC cells, in mouse xenograft model (p < 0.05). CONCLUSIONS miR-543 influences the biological behavior of TNBC cells by directly targeting ACTL6A gene. miR-543 could serve as a novel diagnostic and therapeutic target for TNBC.
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Affiliation(s)
- Y L Wang
- Department of Medical Oncology, Baotou Cancer Hospital, Baotou, 014030, Inner Mongolia, China
| | - R H Liang
- Department of Medical Oncology, Baotou Cancer Hospital, Baotou, 014030, Inner Mongolia, China
| | - C Y Wang
- Department of Medical Oncology, Baotou Cancer Hospital, Baotou, 014030, Inner Mongolia, China
| | - R P Zhang
- Department of Medical Oncology, Baotou Cancer Hospital, Baotou, 014030, Inner Mongolia, China
| | - S Y Wu
- Department of Medical Oncology, Baotou Cancer Hospital, Baotou, 014030, Inner Mongolia, China
| | - X Han
- Department of Breast Surgery, Baotou Cancer Hospital, No. 18 Tuanjie Street, Qingshan District, Baotou, 014030, Inner Mongolia, China
| | - G L Zhang
- Department of Breast Surgery, Baotou Cancer Hospital, No. 18 Tuanjie Street, Qingshan District, Baotou, 014030, Inner Mongolia, China.
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Wang CY, Chen JF, Li J. [Masseter nerve-innervated free gracilis muscle transfer for smile reanimation in adults]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2021; 56:465-470. [PMID: 34011000 DOI: 10.3760/cma.j.cn115330-20210225-00087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the outcomes of masseter nerve-innervated free gracilis muscle transfer for smile reanimation in adults and to explore surgical indications. Methods: A retrospective chart review of 37 patients (11 males, 26 females, with (40.3±12.7) years old)who underwent masseter nerve-innervated free gracilis muscle transfer for smile reanimation between 2016 and 2017 was performed. Patient-reported quality of life (facial clinimetric evaluation, FaCE), physician-reported facial function (eFACE facial grading scale), and oral commissure excursion were compared preoperatively and postoperatively. SPSS 11.0 software was used to analyze the data. Results: Thirty-seven patients were followed up in one year after surgery. Significant postoperative improvements were demonstrated for commissure excursion with smile (preoperatively: (-1.2±3.1) mm, postoperatively: (6.1±3.5) mm, t=-31.1, P<0.01), ipsilateral FaCE (preoperatively: (29.4±14.1), postoperatively: (57.6±23.4), t=-38.1, P<0.01), eFACE score (Composite score t=-35.8, Static score t=-29.1, Dynamic score t=-41.3,Midface score t=-43.9, all P<0.01), respectively. Conclusion: Masseter nerve-innervated free gracilis muscle transfer is an good option for dynamic smile reanimation in adult patients who have undergone treatment for long-standing facial paralysis.
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Affiliation(s)
- C Y Wang
- Department of Plastic Surgery, China-Japan Friendship Hospital, Beijing 100029, China
| | - J F Chen
- Department of Plastic Surgery, China-Japan Friendship Hospital, Beijing 100029, China
| | - Junfeng Li
- Department of Otorhinolaryngology, Beijing Aviation General Hospital, Beijing 100029, China
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Wang CY, Tseng YT, Lin JC, Ciou YJ, Hwang YR. Effect of [Zn2+]/[Cu2+] ratio of the bath on the composition and property of Cu–Zn alloy micropillars prepared using microanode-guided electroplating. Electrochim Acta 2021. [DOI: 10.1016/j.electacta.2021.137969] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Liu XJ, Cui ZJ, Zhang ST, Su WG, Meng QN, Guo PF, Wei AZ, Zhou J, Wang CY, Zou SB, Sun JL, Wang X. [Meta-analysis of the effects of triamcinolone acetonide alone and in combination with 5-fluorouracil for treating keloids]. Zhonghua Shao Shang Za Zhi 2021; 36:1191-1198. [PMID: 33379856 DOI: 10.3760/cma.j.cn501120-20190930-00390] [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 compare the efficacy and safety of triamcinolone acetonide (TA) alone and in combination with 5-fluorouracil (5-FU) for treating keloids using meta-analysis. Methods: Databases including PubMed, Embase, and Cochrane Library were retrieved with the search terms of " triamcinolone acetonide, 5-fluorouracil, glucocorticoid, fluorouracil, keloid, scar, TAC, 5-FU, hypertrophic scar " and databases including Chinese Journal Full-Text Database, Chinese Biomedical Database, and Wanfang Data were retrieved with the search terms of ",, 5-,," in Chinese to obtain the publicly published randomized controlled trials about the effects of TA alone and in combination with 5-fluorouracil for treating keloids from the establishment of each database to august 2019. The outcome indexes included effective proportion of treatment, incidence proportion of adverse reactions, and recurrence proportion of keloids. RevMan 5.3 and Stata 14.0 statistical software were used to conduct a meta-analysis of eligible studies. Results: A total of 1 326 patients with keloids were included in 14 studies, including 668 patients in TA+ 5-fluorouracil group whose keloids were injected with TA and 5-fluorouracil and 658 patients in TA alone group whose keloids were injected with TA alone. A total of 7 articles achieved 1 to 3 points in modified Jadad score, while 7 articles achieved 4 to 7 points in modified Jadad score. Patients in TA+ 5-fluorouracil group had a higher effective proportion of treatment than that of TA alone group (relative risk=1.28, 95% confidence interval=1.16-1.41, P<0.01). Subgroup analysis showed that the quality of the included literature and ethnic factors might be the source of heterogeneity in effective proportion of treatment. Patients in TA+ 5-fluorouracil group had a lower incidence proportion of adverse reactions than that of TA alone group (relative risk=0.44, 95% confidence interval=0.25-0.75, P<0.01). Patients in TA+ 5-fluorouracil group had a lower recurrence proportion of keloids than that of TA alone group (relative risk=0.25, 95% confidence interval=0.14-0.44, P<0.01). There was no publication bias in incidence proportion of adverse reactions (P>0.05), while the effective proportion of treatment and recurrence proportion of keloids had publication bias (P<0.05). Conclusions: TA combined with 5-fluorouracil is more effective than TA alone for treating keloids, with less incidence of adverse reactions and recurrence.
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Affiliation(s)
- X J Liu
- Department of Burns and Repair Reconstruction, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
| | - Z J Cui
- Department of Burns and Repair Reconstruction, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
| | - S T Zhang
- Department of Burns and Repair Reconstruction, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
| | - W G Su
- Department of Burns and Repair Reconstruction, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
| | - Q N Meng
- Department of Burns and Repair Reconstruction, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
| | - P F Guo
- Department of Burns and Repair Reconstruction, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
| | - A Z Wei
- Department of Burns and Repair Reconstruction, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
| | - J Zhou
- Department of Burns and Repair Reconstruction, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
| | - C Y Wang
- Department of Burns and Repair Reconstruction, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
| | - S B Zou
- Department of Burns and Repair Reconstruction, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
| | - J L Sun
- Department of Burns and Repair Reconstruction, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
| | - X Wang
- Department of Burns and Repair Reconstruction, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
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Wang CY, Jiang W, Xia Y, Weng L, Du B. [Airborne spread of coronavirus in critical coronavirus disease 2019 patients with different oxygen therapies]. Zhonghua Nei Ke Za Zhi 2020; 59:664-666. [PMID: 32312019 DOI: 10.3760/cma.j.cn112138-20200318-00254] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- C Y Wang
- Department of Medical Intensive Care Unit, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - W Jiang
- Department of Medical Intensive Care Unit, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Y Xia
- Department of Medical Intensive Care Unit, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - L Weng
- Department of Medical Intensive Care Unit, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - B Du
- Department of Medical Intensive Care Unit, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
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Tsan SEH, Kamalanathan A, Lee CK, Zakaria SA, Wang CY. A survey on burnout and depression risk among anaesthetists during COVID-19: the tip of an iceberg? Anaesthesia 2020; 76 Suppl 3:8-10. [PMID: 32776524 PMCID: PMC7436440 DOI: 10.1111/anae.15231] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2020] [Indexed: 11/30/2022]
Affiliation(s)
- S E H Tsan
- University of Malaysia Sarawak, Sarawak, Malaysia
| | | | - C K Lee
- Sungai Buloh Hospital, Ministry of Health, Malaysia
| | - S A Zakaria
- Sungai Buloh Hospital, Ministry of Health, Malaysia
| | - C Y Wang
- University of Malaya, Kuala Lumpur, Malaysia
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Han YY, Wang CY, Yang L, Zhao GY, Liu HL, Li JZ, Chen PL, Cui K. [Significance of microRNA 216a, 324-5p and 29a expression in peripheral blood in patients with acute pancreatitis and their correlation with liver injury]. Zhonghua Yi Xue Za Zhi 2020; 100:2126-2131. [PMID: 32689754 DOI: 10.3760/cma.j.cn112137-20200103-00016] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the significance of microRNA (miR)-216a, miR-324-5p, miR-29a expression in peripheral blood in patients with acute pancreatitis (AP) and their correlation with liver injury. Methods: It was a case-control study design. To select 130 AP patients admitted from June 2017 to May 2019 in the First People's Hospital of Shangqiu, and the patients were divided into mild AP group (MAP group) and moderately severe AP group (SAP group) according to the disease severity, or 54 patients in the liver injury group (20 were MAP and 34 were SAP) and 76 in the non-liver injury group(all were MAP) according to liver injury. And another 40 healthy volunteers were selected as the healthy group. The expressions of miR-216a, miR-324-5p and miR-29a in peripheral blood of MAP group, SAP group, healthy group and liver injury group, non-liver injury group were compared, and the correlation between the miRNA levels and clinical indexes was analyzed. The predictive value of miRNA levels in peripheral blood for AP complicated with liver injury was analyzed by receiver operating characteristic (ROC) curve. Results: The levels of miR-216a and miR-29a in MAP group and SAP group were higher than those in healthy group, and the level of miR-324-5p was lower than that in healthy group (all P<0.01). The levels of miR-216a and miR-29a in SAP group were higher than those in MAP group, and the level of miR-324-5p was lower than that in healthy group (all P<0.01). Balthazar CT Score, acute physiology and chronic health evaluations (APACHE Ⅱ) score, C-reactive protein level, length of hospital stay were positively correlated with the levels of miR-216a and miR-29a in peripheral blood (all P<0.05), and negatively correlated with the levels of miR-324-5p (P<0.05). The levels of miR-216a and miR-29a in the peripheral blood in the liver injury group were higher than those in the non-liver injury group, and they were higher inSAP patients than those in MAP patients in the liver injury group (all P<0.05). The level of miR-324-5p in the peripheral blood in the liver injury group was lower than that in the non-liver injury group, and it was lower in SAP patients than that in MAP patientsin the liver injury group (all P<0.05). The area under ROC curve of miR-216a, miR-324-5p, and miR-29a in peripheral blood to predicate the AP complicated with liver damage was 0.694, 0.750 and 0.814, respectively. Conclusions: The levels of miR-216a and miR-29a increase in peripheral blood and the level of miR-324-5p decreases in patients with AP, and they are closely related to Balthazar CT score, APACHEⅡ score, C-reactive protein and length of hospital stay. The levels of miR-216a, miR-324-5p, miR-29a has certain predictive value for AP with liver injury, of which miR-29a has the highest predictive value.
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Affiliation(s)
- Y Y Han
- Department of Intensive Care, First People's Hospital of Shangqiu City (Shangqiu Clinical College, Xuzhou Medical University), Shangqiu 476100, China
| | - C Y Wang
- Medical Intensive Care Unit, Peking Union Medical College Hospital, Beijing 100730, China
| | - L Yang
- Department of Intensive Care, First People's Hospital of Shangqiu City (Shangqiu Clinical College, Xuzhou Medical University), Shangqiu 476100, China
| | - G Y Zhao
- Department of Intensive Care, First People's Hospital of Shangqiu City (Shangqiu Clinical College, Xuzhou Medical University), Shangqiu 476100, China
| | - H L Liu
- Department of Intensive Care, First People's Hospital of Shangqiu City (Shangqiu Clinical College, Xuzhou Medical University), Shangqiu 476100, China
| | - J Z Li
- Department of Intensive Care, First People's Hospital of Shangqiu City (Shangqiu Clinical College, Xuzhou Medical University), Shangqiu 476100, China
| | - P L Chen
- Department of Intensive Care, First People's Hospital of Shangqiu City (Shangqiu Clinical College, Xuzhou Medical University), Shangqiu 476100, China
| | - K Cui
- Department of Oncology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
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Sessler DI, Conen D, Leslie K, Yusuf S, Popova E, Graham M, Kurz A, Villar JC, Mrkobrada M, Sigamani A, Biccard BM, Meyhoff CS, Parlow JL, Guyatt G, Xavier D, Chan MTV, Kumar PA, Forget P, Malaga G, Fleischmann E, Amir M, Torres D, Wang CY, Paniagua P, Berwanger O, Srinathan S, Landoni G, Manach YL, Whitlock R, Lamy A, Balasubramanian K, Gilron I, Turan A, Pettit S, Devereaux PJ. One-year Results of a Factorial Randomized Trial of Aspirin versus Placebo and Clonidine versus Placebo in Patients Having Noncardiac Surgery. Anesthesiology 2020; 132:692-701. [PMID: 32022771 DOI: 10.1097/aln.0000000000003158] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The authors previously reported that perioperative aspirin and/or clonidine does not prevent a composite of death or myocardial infarction 30 days after noncardiac surgery. Moreover, aspirin increased the risk of major bleeding and clonidine caused hypotension and bradycardia. Whether these complications produce harm at 1 yr remains unknown. METHODS The authors randomized 10,010 patients with or at risk of atherosclerosis and scheduled for noncardiac surgery in a 1:1:1:1 ratio to clonidine/aspirin, clonidine/aspirin placebo, clonidine placebo/aspirin, or clonidine placebo/aspirin placebo. Patients started taking aspirin or placebo just before surgery; those not previously taking aspirin continued daily for 30 days, and those taking aspirin previously continued for 7 days. Patients were also randomly assigned to receive clonidine or placebo just before surgery, with the study drug continued for 72 h. RESULTS Neither aspirin nor clonidine had a significant effect on the primary 1-yr outcome, a composite of death or nonfatal myocardial infarction, with a 1-yr hazard ratio for aspirin of 1.00 (95% CI, 0.89 to 1.12; P = 0.948; 586 patients [11.8%] vs. 589 patients [11.8%]) and a hazard ratio for clonidine of 1.07 (95% CI, 0.96 to 1.20; P = 0.218; 608 patients [12.1%] vs. 567 patients [11.3%]), with effect on death or nonfatal infarction. Reduction in death and nonfatal myocardial infarction from aspirin in patients who previously had percutaneous coronary intervention at 30 days persisted at 1 yr. Specifically, the hazard ratio was 0.58 (95% CI, 0.35 to 0.95) in those with previous percutaneous coronary intervention and 1.03 (95% CI, 0.91to 1.16) in those without (interaction P = 0.033). There was no significant effect of either drug on death, cardiovascular complications, cancer, or chronic incisional pain at 1 yr (all P > 0.1). CONCLUSIONS Neither perioperative aspirin nor clonidine have significant long-term effects after noncardiac surgery. Perioperative aspirin in patients with previous percutaneous coronary intervention showed persistent benefit at 1 yr, a plausible sub-group effect.
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Affiliation(s)
- Daniel I Sessler
- From the Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio (D.I.S., A.K., A.T.) Population Health Research Institute (D.I.S., D.C., S.Y., Y.L.M., A.L., K.B., S.P., P.J.D.) Department of Medicine (D.C., S.Y., G.G., P.J.D.) Department of Health Research Methods, Evidence, and Impact (D.C., S.Y., G.G., Y.L.M., A.L., P.J.D.) Faculty of Health Sciences, Department of Anesthesia (Y.L.M.) Department of Surgery (R.W., A.L.), McMaster University, Hamilton, Ontario, Canada Department of Anaesthesia and Pain Management, Royal Melbourne Hospital and Centre for Integrated Critical Care, University of Melbourne, Melbourne, Australia (K.L.) Public Health and Clinical Epidemiology-Iberoamerican Cochrane Centre, Barcelona, Spain (E.P.) University of Alberta and Mazankowski Alberta Heart Institute, Edmonton, Alberta, Canada (M.G.) Department of Research, Foundation for Pediatric Cardiology, Institute of Cardiology and Faculty of Health Sciences (Departamento de Investigaciones, Fundación Cardioinfantil-Instituto de Cardiología and Facultad de Ciencias de la Salud), Universidad Autónoma de Bucaramanga, Colombia (J.C.V.) University of Western Ontario, London, Ontario, Canada (M.M.) Department of Clinical Research, Narayana Hrudayalaya Limited, Bangalore, India (A.S.) University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa (B.M.B.) Department of Anaesthesia and Intensive Care, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark (C.S.M.) Department of Anesthesiology and Perioperative Medicine, Kingston Health Sciences Centre and Queen's University, Kingston, Canada (J.L.P., I.G.) St. John's Medical College and Research Institute, Bangalore, Karnataka, India (D.X.) Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong (M.T.V.C.) University of North Carolina School of Medicine, Chapel Hills, North Carolina (P.A.K.) NHS Grampian and the University of Aberdeen, Aberdeen, United Kingdom (P.F.) Knowledge and Evidence Unite (Unidad de Conocimiento y Evidencia), Universidad Peruana Cayetano Heredia, Lima, Peru (G.M.) Department of Anaesthesia, Intensive Care, and Pain Medicine, Medical University of Vienna, Vienna, Austria (E.F.) Shifa International Hospitals, Islamabad, Pakistan (M.A.) University of the Andes and Santa Maria Clinic (Universidad de Los Andes and Clinica Santa María), Santiago, Chile (D.T.) Department of Anesthesiology, University of Malaya, Kuala Lumpur, Malaysia (C.Y.W.) Biomedical Research Institute (IIB - Sant Pau), Barcelona, Spain (P.P.) Hospital Israelita Albert Einstein, São Paulo, Brazil (O.B.) Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada (S.S.) Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute and Vita-Salute University, Milan, Italy (G.L.)
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