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So M, Goldberg SA, Lu S, Garcia-Knight M, Davidson MC, Tassetto M, Murray VW, Anglin K, Pineda-Ramirez J, Chen JY, Rugart PR, Richardson ET, Briggs-Hagen M, Midgley CM, Andino R, Seitzman GD, Gonzales J, Peluso MJ, Martin JN, Kelly JD. Prevalence, Patterns, and Predictors of SARS-CoV-2 RNA and Culturable Virus in Tears of a Case-Ascertained Household Cohort. Am J Ophthalmol 2024; 265:48-53. [PMID: 38663502 DOI: 10.1016/j.ajo.2024.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 03/30/2024] [Accepted: 04/14/2024] [Indexed: 05/20/2024]
Abstract
PURPOSE To investigate the prevalence, patterns, and predictors of SARS-CoV-2 RNA and culturable virus in tears of a case-ascertained household cohort. DESIGN Prospective, longitudinal case-ascertained household cohort identified through convenience sampling. METHODS This analysis was restricted to individuals who were non-hospitalized, symptomatic, and tested positive for SARS-CoV-2 by nasal RT-PCR. Tears and anterior nasal biospecimens were serially collected throughout the acute period. Tears specimens were collected by the study staff using Schirmer test strips, and nasal specimens were self-collected. For both, SARS-CoV-2 RNA was quantified using qRT-PCR, and culturable virus was detected using presence of cytopathic effect (CPE) in tissue culture; positive CPE was confirmed by a qRT-PCR step. A series of cross-sectional unadjusted analyses were performed investigating the relationship between different sociodemographic determinants and biological factors associated with tears RNA positivity. RESULTS Among the 83 SARS-CoV-2 infected participants, 10 (12%) had at least one RNA-positive tears specimen. Amongst these 10, 5 (50%) had concurrent presence of culturable virus, at a median of 7 days postsymptom onset (IQR: 4-7 days) (absolute range: 4-8 days). CONCLUSIONS In this longitudinal cohort, we found evidence of culturable virus in the tears of a small proportion of nonhospitalized SARS-CoV-2 infected individuals. Current public health infection precautions do not account for transmission via tears, so these findings may improve our understanding of potential sources of SARS-CoV-2 transmission and contribute to developing future guidelines.
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Affiliation(s)
- Matthew So
- Institute for Global Health Sciences (M.S, S.A.G, S.L, K.A, J.P.-R, J.Y.C, J.D.K), University of California, San Francisco, California, USA
| | - Sarah A Goldberg
- Institute for Global Health Sciences (M.S, S.A.G, S.L, K.A, J.P.-R, J.Y.C, J.D.K), University of California, San Francisco, California, USA; Department of Epidemiology and Biostatistics (S.A.G, S.L, P.R.R, J.N.M, J.D.K), University of California, San Francisco, San Francisco, California, USA
| | - Scott Lu
- Institute for Global Health Sciences (M.S, S.A.G, S.L, K.A, J.P.-R, J.Y.C, J.D.K), University of California, San Francisco, California, USA; Department of Epidemiology and Biostatistics (S.A.G, S.L, P.R.R, J.N.M, J.D.K), University of California, San Francisco, San Francisco, California, USA
| | - Miguel Garcia-Knight
- Department of Microbiology and Immunology (M.G.-K, M.T), University of California, San Francisco, San Francisco, California, USA
| | - Michelle C Davidson
- School of Medicine (M.C.D), University of California, San Francisco, San Francisco, California, USA
| | - Michel Tassetto
- Department of Microbiology and Immunology (M.G.-K, M.T), University of California, San Francisco, San Francisco, California, USA
| | - Victoria Wong Murray
- School of Medicine (V.W.M), Cooper Medical School of Rowan University, Camden, New Jersey, USA
| | - Khamal Anglin
- Institute for Global Health Sciences (M.S, S.A.G, S.L, K.A, J.P.-R, J.Y.C, J.D.K), University of California, San Francisco, California, USA
| | - Jesus Pineda-Ramirez
- Institute for Global Health Sciences (M.S, S.A.G, S.L, K.A, J.P.-R, J.Y.C, J.D.K), University of California, San Francisco, California, USA
| | - Jessica Y Chen
- Institute for Global Health Sciences (M.S, S.A.G, S.L, K.A, J.P.-R, J.Y.C, J.D.K), University of California, San Francisco, California, USA
| | - Paulina R Rugart
- Department of Epidemiology and Biostatistics (S.A.G, S.L, P.R.R, J.N.M, J.D.K), University of California, San Francisco, San Francisco, California, USA
| | - Eugene T Richardson
- Department of Global Health and Social Medicine (E.T.R), Harvard Medical School, Boston, Massachusetts, USA; Division of Infectious Diseases (E.T.R), Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Melissa Briggs-Hagen
- Coronavirus and Other Respiratory Viruses Division (M.B.H, C.M.M), National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Claire M Midgley
- Coronavirus and Other Respiratory Viruses Division (M.B.H, C.M.M), National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Raul Andino
- Department of Microbiology and Immunology (M.G.-K, M.T), University of California, San Francisco, San Francisco, California, USA
| | - Gerami D Seitzman
- F.I. Proctor Foundation (G.D.S, J.G, J.D.K), University of California, San Francisco, San Francisco, California, USA; Department of Ophthalmology (G.D.S, J.G), University of California, San Francisco, California, USA
| | - John Gonzales
- F.I. Proctor Foundation (G.D.S, J.G, J.D.K), University of California, San Francisco, San Francisco, California, USA; Department of Ophthalmology (G.D.S, J.G), University of California, San Francisco, California, USA
| | - Michael J Peluso
- Division of HIV, Infectious Diseases and Global Medicine (M.J.P), Zuckerberg San Francisco General Hospital, San Francisco, California, USA
| | - Jeffrey N Martin
- Department of Epidemiology and Biostatistics (S.A.G, S.L, P.R.R, J.N.M, J.D.K), University of California, San Francisco, San Francisco, California, USA
| | - John Daniel Kelly
- Institute for Global Health Sciences (M.S, S.A.G, S.L, K.A, J.P.-R, J.Y.C, J.D.K), University of California, San Francisco, California, USA; Department of Epidemiology and Biostatistics (S.A.G, S.L, P.R.R, J.N.M, J.D.K), University of California, San Francisco, San Francisco, California, USA; F.I. Proctor Foundation (G.D.S, J.G, J.D.K), University of California, San Francisco, San Francisco, California, USA; Division of Hospital Medicine (J.D.K), San Francisco Veterans Affairs Medical Center, San Francisco, California, USA.
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Chen JY, Yu BL, Wu XJ, Li YF, Zhong LY, Chen M. A longitudinal and cross-sectional study of placental circulation between normal and placental insufficiency pregnancies. Placenta 2024; 149:29-36. [PMID: 38490095 DOI: 10.1016/j.placenta.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 02/11/2024] [Accepted: 03/03/2024] [Indexed: 03/17/2024]
Abstract
INTRODUCTION To longitudinally and cross-sectionally study the differences in the uterine artery pulsatility index (UTPI), umbilical artery pulsatility index (UAPI) and placental vascularization indices (PVIs, derived from 3-dimensional power Doppler) between normal and placental insufficiency pregnancies throughout gestation. METHODS UTPI, UAPI and PVI were measured 6 times at 4- to 5- week intervals from 11 to 13+6 weeks-36 weeks. Preeclampsia (PE) and fetal growth restriction (FGR) were defined as placental insufficiency. Comparisons of UTPI, UAPI and PVI between normal and insufficiency groups were performed by one-way repeated measures analysis of variance. RESULTS A total of 125 women were included: monitored regularly from the first trimester to 36 weeks of gestation: 109 with normal pregnancies and 16 with placental insufficiency. Longitudinal study of the normal pregnancy group showed that UTPI and UAPI decreased significantly every 4 weeks, while PVIs increased significantly every 8 weeks until term. In the placental insufficiency group however, this decrease occurred slower at 8 weeks intervals and UTPI stabilized after 24 weeks. No significant difference was noted in PVIs throughout pregnancy. Cross-sectional study from different stages of gestation showed that UTPI was higher in the insufficiency group from 15 weeks onward and PVIs were lower after 32 weeks. DISCUSSION Compared to high-risk pregnancies with normal outcome, UTPI and UAPI needed a longer time to reach a significant change in those with clinical confirmation of placental insufficiency pregnancies and no significant change was found in PVI throughout gestation. UTPI was the earliest factor in detecting adverse outcome pregnancies.
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Affiliation(s)
- J Y Chen
- Department of Obstetrics and Gynecology, Department of Fetal Medicine and Prenatal Diagnosis, Guangzhou, China; Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangzhou, China; Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, Guangzhou, China; Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, Guangzhou, China; The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - B L Yu
- Department of Bio Resource Research Center, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - X J Wu
- Department of Obstetrics and Gynecology, Department of Fetal Medicine and Prenatal Diagnosis, Guangzhou, China; Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangzhou, China; Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, Guangzhou, China; Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, Guangzhou, China; The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Y F Li
- Department of Obstetrics and Gynecology, Department of Fetal Medicine and Prenatal Diagnosis, Guangzhou, China; Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangzhou, China; Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, Guangzhou, China; Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, Guangzhou, China; The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - L Y Zhong
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - M Chen
- Department of Obstetrics and Gynecology, Department of Fetal Medicine and Prenatal Diagnosis, Guangzhou, China; Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangzhou, China; Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, Guangzhou, China; Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, Guangzhou, China; The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
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Chen JY, Wu LD, Wang RX. [Research progress of calsequestrin in ventricular arrhythmias]. Zhonghua Xin Xue Guan Bing Za Zhi 2024; 52:199-204. [PMID: 38326073 DOI: 10.3760/cma.j.cn112148-20231010-00298] [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: 02/09/2024]
Affiliation(s)
- J Y Chen
- Department of Cardiology, Wuxi People's Hospital of Nanjing Medical University, Wuxi 214023, China
| | - L D Wu
- Department of Cardiology, Wuxi People's Hospital of Nanjing Medical University, Wuxi 214023, China
| | - R X Wang
- Department of Cardiology, Wuxi People's Hospital of Nanjing Medical University, Wuxi 214023, China
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Li Y, Chen JY, Jia JF, He SH, Xu D. [Comparison of robotic-assisted single-incision-plus-one-port laparoscopic pyeloplasty and single-incision laparoscopic pyeloplasty in the treatment of pediatric ureteropelvic junction obstruction]. Zhonghua Yi Xue Za Zhi 2024; 104:371-376. [PMID: 38281806 DOI: 10.3760/cma.j.cn112137-20231002-00624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
Objective: To compare the efficacy of robotic-assisted single-incision-plus- one-port laparoscopic pyeloplasty (R-SILP+1) with single-incision laparoscopic pyeloplasty (SILP) in pediatric ureteropelvic junction obstruction (UPJO). Methods: The clinical data of 47 children with UPJO who underwent surgery from October 2020 to September 2022 in the Department of Pediatric Surgery of Fujian Provincial Hospital were retrospectively analyzed. According to the surgical method chosen by parents, the children were divided into R-SILP+1 group and SILP group. Baseline data, operative time, intraoperative anastomosis time, volume of blood loss, postoperative hospitalization time, complications, total costs, preoperative and postoperative renal parenchymal thickness (PT), anterior posterior diameter of renal pelvis (APD), and differential renal function (DRF) before and after operation were compared between the two groups, and the clinical efficacy of the two kinds of operation was evaluated. Results: Among the 47 children, 27 were in R-SILP+1 group, including 16 males and 11 females, aged (6.6±3.5) years; 20 were in SILP group, including 12 males and 8 females, aged (6.5±3.5) years. The operations were successful in both groups without conversion to open operation. There were no significant differences between the two groups in baseline data, volume of blood loss, complications, APD and PT at postoperative 6 months, APD, PT and DRF at postoperative 12 months (all P>0.05). Compared with the SILP group, the operative time [(153.0±14.4) vs (189.9±32.6) minutes, P<0.001], intraoperative anastomosis time [(68.8±16.8) vs (97.5±12.0) minutes, P<0.001], postoperative hospitalization time [(6.0±1.3) vs (9.0±1.3) d, P<0.001] were shorter, but the total cost was higher[(57 390±7 664) vs (30 183±4 219) yuan RMB, P<0.001]. Conclusions: Compared with the SILP group, R-SILP+1 can achieve considerable efficacy in treating pediatric UPJO, and has certain advantages in shortening operative time, intraoperative anastomosis time, and postoperative hospitalization time. However, the cost is high.
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Affiliation(s)
- Y Li
- Department of Pediatric Surgery, Fujian Provincial Hospital, Provincial Clinical Medical College of Fujian Medical University, Fuzhou 350001, China
| | - J Y Chen
- Department of Pediatric Surgery, Fujian Provincial Hospital, Provincial Clinical Medical College of Fujian Medical University, Fuzhou 350001, China
| | - J F Jia
- Department of Pediatric Surgery, Fujian Provincial Hospital, Provincial Clinical Medical College of Fujian Medical University, Fuzhou 350001, China
| | - S H He
- Department of Pediatric Surgery, Fujian Provincial Hospital, Provincial Clinical Medical College of Fujian Medical University, Fuzhou 350001, China
| | - D Xu
- Department of Pediatric Surgery, Fujian Provincial Hospital, Provincial Clinical Medical College of Fujian Medical University, Fuzhou 350001, China
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Zhuang LC, Fu Y, Chen JY, Wu HY, Yang J, Zhang B, Chen J, Fan XS. [Multiple undifferentiated embryonal sarcoma of the liver in adult: report of a case]. Zhonghua Bing Li Xue Za Zhi 2024; 53:92-94. [PMID: 38178757 DOI: 10.3760/cma.j.cn112151-20230915-00179] [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: 01/06/2024]
Affiliation(s)
- L C Zhuang
- Department of Pathology, Affiliated Drum Tower Hospital Nanjing University Medical School, Nanjing 210008, China
| | - Y Fu
- Department of Pathology, Affiliated Drum Tower Hospital Nanjing University Medical School, Nanjing 210008, China
| | - J Y Chen
- Department of Pathology, Affiliated Drum Tower Hospital Nanjing University Medical School, Nanjing 210008, China
| | - H Y Wu
- Department of Pathology, Affiliated Drum Tower Hospital Nanjing University Medical School, Nanjing 210008, China
| | - J Yang
- Department of Pathology, Affiliated Drum Tower Hospital Nanjing University Medical School, Nanjing 210008, China
| | - B Zhang
- Department of Pathology, Affiliated Drum Tower Hospital Nanjing University Medical School, Nanjing 210008, China
| | - J Chen
- Department of Pathology, Affiliated Drum Tower Hospital Nanjing University Medical School, Nanjing 210008, China
| | - X S Fan
- Department of Pathology, Affiliated Drum Tower Hospital Nanjing University Medical School, Nanjing 210008, China
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Maimaiti Z, Li Z, Xu C, Fu J, Hao LB, Liu L, Chen JY, Chai W. [Research progress of phage therapy in orthopedic implant-related infection]. Zhonghua Wai Ke Za Zhi 2023; 62:83-87. [PMID: 38044612 DOI: 10.3760/cma.j.cn112139-20230720-00020] [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: 12/05/2023]
Abstract
The widespread application of implantable materials has brought about a corresponding increase in implant-related complications, with implant-associated infections being the most critical. Biofilms, which often form on these implants, can significantly impede the effectiveness of traditional antibiotic therapies. Therefore, strategies such as surgical removal of infected implants and prolonged antibiotic treatment have been acknowledged as effective measures to eradicate these infections. However,the challenges of antibiotic resistance and biofilm persistence often result in recurrent or hard-to-control infections, posing severe health threats to patients. Recent studies suggest that phages, a type of virus, can directly eliminate pathogenic bacteria and degrade biofilms. Furthermore, clinical trials have demonstrated promising therapeutic results with the combined use of phages and antibiotics. Consequently, this innovative therapy holds significant potential as an effective solution for managing implant-associated infections. This paper rigorously investigates and evaluates the potential value of phage therapy in addressing orthopedic implant-associated infections, based on a comprehensive review of relevant scientific literature.
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Affiliation(s)
- Zulipikaer Maimaiti
- Department of Orthopedics, Beijing Luhe Hospital, Capital Medical University, Beijing 101199, China
| | - Z Li
- The Medical School of Nankai University,Tianjin 300074,China
| | - C Xu
- Department of Orthopedics, the Fourth Medical Center, General Hospital, Chinese People's Liberation Army,Beijing 100048,China
| | - J Fu
- Department of Orthopedics, the Fourth Medical Center, General Hospital, Chinese People's Liberation Army,Beijing 100048,China
| | - L B Hao
- Department of Orthopedics, the Fourth Medical Center, General Hospital, Chinese People's Liberation Army,Beijing 100048,China
| | - L Liu
- Department of Orthopedics, Beijing Luhe Hospital, Capital Medical University, Beijing 101199, China
| | - J Y Chen
- Department of Orthopedics, the Fourth Medical Center, General Hospital, Chinese People's Liberation Army,Beijing 100048,China
| | - W Chai
- Department of Orthopedics, the Fourth Medical Center, General Hospital, Chinese People's Liberation Army,Beijing 100048,China
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Palsamy K, Chen JY, Skaggs K, Qadeer Y, Connors M, Cutler N, Richmond J, Kommidi V, Poles A, Affrunti D, Powell C, Goldman D, Parent JM. Microglial depletion after brain injury prolongs inflammation and impairs brain repair, adult neurogenesis and pro-regenerative signaling. Glia 2023; 71:2642-2663. [PMID: 37449457 PMCID: PMC10528132 DOI: 10.1002/glia.24444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 06/28/2023] [Accepted: 06/30/2023] [Indexed: 07/18/2023]
Abstract
The adult zebrafish brain, unlike mammals, has a remarkable regenerative capacity. Although inflammation in part hinders regeneration in mammals, it is necessary for zebrafish brain repair. Microglia are resident brain immune cells that regulate the inflammatory response. To explore the microglial role in repair, we used liposomal clodronate or colony stimulating factor-1 receptor (csf1r) inhibitor to suppress microglia after brain injury, and also examined regeneration in two genetic mutant lines that lack microglia. We found that microglial ablation impaired telencephalic regeneration after injury. Microglial suppression attenuated cell proliferation at the intermediate progenitor cell amplification stage of neurogenesis. Notably, the loss of microglia impaired phospho-Stat3 (signal transducer and activator of transcription 3) and ß-Catenin signaling after injury. Furthermore, the ectopic activation of Stat3 and ß-Catenin rescued neurogenesis defects caused by microglial loss. Microglial suppression also prolonged the post-injury inflammatory phase characterized by neutrophil accumulation, likely hindering the resolution of inflammation. These findings reveal specific roles of microglia and inflammatory signaling during zebrafish telencephalic regeneration that should advance strategies to improve mammalian brain repair.
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Affiliation(s)
- Kanagaraj Palsamy
- Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA
| | - Jessica Y Chen
- Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA
| | - Kaia Skaggs
- Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA
- University of Findlay, Findlay, Ohio, USA
| | - Yusuf Qadeer
- Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA
| | - Meghan Connors
- Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA
| | - Noah Cutler
- Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA
| | - Joshua Richmond
- Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA
| | - Vineeth Kommidi
- Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA
| | - Allison Poles
- Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA
| | - Danielle Affrunti
- Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA
| | - Curtis Powell
- Michigan Neuroscience Institute, Ann Arbor, Michigan, USA
- Department of Biological Chemistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Daniel Goldman
- Michigan Neuroscience Institute, Ann Arbor, Michigan, USA
- Department of Biological Chemistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Jack M Parent
- Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA
- Michigan Neuroscience Institute, Ann Arbor, Michigan, USA
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
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Xu FF, Zheng SF, Cai G, Wang SB, Cao L, Chen JY. Prognostic and Predictive Significance of Tumor Immune Microenvironment in Breast Ductal Carcinoma In Situ. Int J Radiat Oncol Biol Phys 2023; 117:e269-e270. [PMID: 37785019 DOI: 10.1016/j.ijrobp.2023.06.1234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) This study aims to identify the role of different subtypes of tumor infiltrating lymphocytes (TILs) in ductal carcinoma in situ (DCIS) in predicting risk of recurrence and benefit of whole breast irradiation (WBI). MATERIALS/METHODS Immunohistochemical stain for CD3, CD4, CD8, FOXP3 and CD20 were carried in a well characterized DCIS cohort who received breast-conserving surgery (BCS) from Jan 2009 to Dec 2018. All the TILs subtypes were evaluated by the average numbers of touching-TILs which defined as TILs touching or within one lymphocyte cell thickness from the malignant ducts' basement membrane. The optimal cut-off values of TILs subtypes were selected by the X-tile. RESULTS In total, 167 patients were enrolled in this analysis with 114 patients received WBI. After a median follow-up of 67 months, 15 IBTR events occurred with 6 invasive-IBTRs. Nine out of 15 IBTRs occurred outside of the original quadrant (elsewhere failure event, EFE). CD3+ lymphocytes were the predominant cell subtype while Treg showed the lowest levels. High abundance of TILs subtypes was associated with high tumor grade, presence of microinvasion, high Ki67 index, ER negativity and HER2 positivity. For various TILs subtypes, the multivariate analyses showed that dense CD4+ TILs (HR = 9.84, 95% CI 2.43-39.91, p<0.01) and dense Treg (HR = 4.22, 95% CI 1.24-14.36, p = 0.02) were independent prognostic factors for higher IBTR. As the infiltration of TIL subsets was correlated with one another, we also analyzed the relationship between IBTR and the ratios of different TILs subtypes. By adjusted by clinicopathological parameters, high ratios of CD4+/CD8+, Treg/CD4+ and Treg/CD8+ were found to be independent prognostic factors for higher IBTR (HR = 11.31, 95% CI 3.14-40.76, p<0.01; HR = 3.09, 95% CI 1.05-9.11, p = 0.04; HR = 7.14, 95% CI 1.98-25.73, p<0.01). Consistent with the results of IBTR, the 5-y rate of invasive-IBTR and EFE was both significantly associated with the high CD4+/CD8+, Treg/CD4+ and Treg/CD8+ TILs ratios (all p<0.01). WBI reduced the rate of 5y-IBTR risk from 8.4% to 1.3% (p = 0.02) in the low Treg/CD8+ group, but there was no benefit of WBI in the high group. With respect to EFE, WBI significantly reduced the rate from 2.8% to 0.0% (p = 0.03) in the low Treg/CD8+ group while not in the high group. The benefits of WBI in reducing IBTR and EFE were not significant difference between different CD4+/CD8+ and Treg/CD4+ groups. CONCLUSION Assessment of overall TILs provides a tool for comprehensive evaluation of the DCIS immune microenvironment. Patients with pro-tumoral immune infiltrate (high Treg, high ratios of CD4+/CD8+, Treg/CD4+ and Treg/CD8+) in tumor microenvironment show an increased risk of IBTR and less benefit from breast radiotherapy.
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Affiliation(s)
- F F Xu
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - S F Zheng
- Department of Pathology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - G Cai
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - S B Wang
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - L Cao
- Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - J Y Chen
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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Yang J, Xiong WQ, Wang SM, Chen JY, Cao L. A Cascaded Deep Learning-Based Cardiac Substructures Segmentation Frame and on Non-Gated Non-Enhanced Planning CT Scans in Breast Cancer Patients. Int J Radiat Oncol Biol Phys 2023; 117:e493-e494. [PMID: 37785557 DOI: 10.1016/j.ijrobp.2023.06.1729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To develop a deep learning-based segmentation frame for cardiac substructures especially coronary arteries (CAs) on non-gated non-enhanced planning computed tomography (CT) scans in breast cancer (BC) patients. MATERIALS/METHODS Non-gated non-enhanced CT scans of 39 BC patients receiving adjuvant radiotherapy (RT) were collected. Cardiac substructures were manually labelled, including four chambers, left main (LM), left anterior descending (LAD), left circumflex (LCX) and right coronary artery (RCA). The training, validation, and test sample is 28, 7 and 4, respectively. A cascaded network, using nnUNet as the backbone, is proposed to use chambers as prior information to constrain the segmentation of CAs. The mean Dice similarity coefficient (DSC), 95th percentile Hausdorff distance (HD95) and average symmetrical surface distance (ASSD) were used as geometric metrics. Dosimetric parameters of cardiac substructures was calculated based on the segmentation frame and manually labeled contouring, respectively. The data of cardiac examination including ultrasonography, electrocardiogram before and during the follow-up after RT were retrospectively collected. The cardiac event was any symptomatic heart disease or new-onset abnormality in the cardiac examination after RT. RESULTS The mean DSC of heart, atriums and ventricles of the proposed frame was 0.93, 0.90, and 0.93, respectively. As shown in Table 1, compared with direct segmentation (as baseline), the proposed frame had a better performance in terms of HD95, ASSD, and the mean dose (Dmean) absolute error for all CAs. Compared to the dosimetric parameters of the heart collected based on the manual labelled contours, the relative errors of D5, D95, and V15Gy for LAD was 4.3±7.8%, 11.7±5.9%, and 14.6±13.0% collected based on the direct segmentation contours and 2.4±4.4%, 3.9±3.1%, 8.5±6.9% collected based on the auto-segmented contours, respectively. Multivariate analysis showed that increased V15Gy of LAD was an independent cardiac toxicity risk factor ([HR] = 1.07, 95% CI 1-1.15, p = 0.0387). CONCLUSION We developed a cascaded network for cardiac substructures segmentation with dosimetric validation on non-enhanced CT scans in breast cancer radiotherapy. This is the first attempt to use chambers as prior information for CAs' segmentation and had a superior stable performance. Accurate segmentation will help radiation oncologists to better evaluate DVHs based on substructures and thus to estimate cardiovascular risk. An optimized cardiac substructure-based dosimetric constrain may be proposed accordingly.
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Affiliation(s)
- J Yang
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - W Q Xiong
- Shanghai United Imaging Healthcare Co., Ltd., Shanghai, China
| | - S M Wang
- Centeral Research Institute, United Imaging Healthcare Group, Shanghai, China
| | - J Y Chen
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - L Cao
- Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Huang JQ, Zheng SY, Cao L, Chen JY. Identification and Dosimetric Analysis of Axillary Substructures Associated with Breast Cancer Related Lymphedema. Int J Radiat Oncol Biol Phys 2023; 117:S177. [PMID: 37784440 DOI: 10.1016/j.ijrobp.2023.06.648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) It has been hypothesized that substructures in the axillary region may be involved in the development of upper limb lymphedema in breast cancer patients. We aimed to compare dosimetric parameters of different substructures to identify risk regions and dose indicators related to the development of lymphedema. MATERIALS/METHODS A total of 486 patients with breast cancer treated with axillary node dissection (ALND) and regional node irradiation (RNI) between 2017 and 2020 were analyzed. Ten axillary substructures were retrospectively contoured, and dose-volume histogram (DVH) parameters (maximum dose [Dmax], Dmean, Dmin, V5 Gy, V10 Gy, V15 Gy, V20 Gy, V25 Gy, V30 Gy, V35 Gy, V40 Gy, V45 Gy and V50 Gy) were evaluated. EQD2 using α/β = 3 was applied for hypofractionation. RESULTS The cumulative incidence of lymphedema was 32.5% during the median follow-up of 25 month (IQR 15-35). Higher BMI (≥21.77 kg/m2, hazard ratio [HR]1.6, 95% CI 1.1-2.3, p = 0.019) and higher number of dissected lymph nodes (≥13, HR 1.8, 95% CI 1.1-3.0, p = 0.026) were baseline risk factors associated with breast cancer related lymphedema (BCRL). A cohort of 196 patients was obtained by 1:1 propensity score matching based on the above two factors (154 treated with 50 Gy/25 fractions [Fx] and 42 with 40.05 Gy/15Fx). The optimal metric was axillary-lateral thoracic vessel juncture (ALTJ) Dmean ≥36.84 Gy (HR 3.7, 95% CI 1.6-8.6, p = 0.002). Other significant risk factors are Medial of Axillary Nodes level I(ALN-I-M) Dmin <9.19 Gy (HR 2.3, 95% CI 1.4-3.7, p = 0.001) and Posterior of Axillary Nodes level II(ALN-II-P) Dmax <52.75 Gy (HR 2.0, 95% CI 1.2-3.5, p = 0.015). A nomogram incorporated the above three parameters was created to predict the risk of lymphedema with reasonable accuracy confirmed by both self-training (area under curve [AUC], 0.76; 95% CI, 0.67-0.84) and internal validation (AUC 0.66; 95% CI, 0.50-0.80). CONCLUSION A mean dose of 36.84 Gy of ALTJ may be a suggested dose limit for patients indicated RNI after ALND, especially when patients with higher BMI and higher dissected nodes. Ideally, avoidance of ALTJ may be realized without compromising dose coverage to high-risk nodal region. Confirmation of this finding in future prospective studies is needed.
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Affiliation(s)
- J Q Huang
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - S Y Zheng
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - L Cao
- Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - J Y Chen
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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Cao L, Yang J, Zhou M, Yu B, Lin Q, Yao Y, Wu HL, Zhu QW, Ye M, Xie H, Wu JW, Chen JY. Does Dual Anti-HER2 Therapy Increase Early Cardiac Toxicity in Comparison with Trastuzumab Alone in Breast Cancer Patients Receiving Adjuvant Radiotherapy? A Multicenter Retrospective Study. Int J Radiat Oncol Biol Phys 2023; 117:e166. [PMID: 37784767 DOI: 10.1016/j.ijrobp.2023.06.1002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Adjuvant trastuzumab in combination with RT has proved its safety in terms of cardiac events. Dual anti-HER2 therapy with pertuzumab is currently standard adjuvant therapy in N+ and high-risk N0 early breast cancer (BC) patients. Our study aims to find if it increases early cardiac toxicity compared with trastuzumab alone in BC patients receiving adjuvant radiotherapy. MATERIALS/METHODS Operable BC patients who received adjuvant radiotherapy (RT) and trastuzumab with or without pertuzumab between January 2017 and September 2020 in 7 Chinese centers were retrospectively reviewed. The cardiac examination included ultrasonography, electrocardiogram (ECG), NT-proBNP, and cTnI before RT and during follow-up. The cardiac event was any new-onset symptomatic heart disease or abnormality in the cardiac examination after RT. RESULTS In total, 711 patients with a median age of 52 years were included, of whom 567 (79.7%) patients were treated with trastuzumab-only and 144 (20.3%) patients received dual anti-HER2 therapy. Adjuvant RT was given concurrently in 140/144 (97.2%) of dual anti-HER2 therapy and 562/567 (99.1%) of trastuzumab alone, respectively. With a median follow-up of 11 months, no patients developed symptomatic heart diseases. Among patients with normal baseline, 17 (2.4%), 86 (12.1%), 18 (2.5%) and 14 (7.3%) developed new-onset diastolic dysfunction, left ventricular ejection fraction (LVEF) decline, abnormal ECG, and abnormal NT-proBNP, respectively. No significant difference was found between the trastuzumab-only and dual anti-HER2 cohort in the incidence of all kinds of new-onset cardiac events (all p > 0.1). Multivariate analysis showed that left-sided (vs right-sided) RT significantly increased the risk of ECG abnormality (HR = 2.32, 95% CI 1.62-3.32, p<0.001). Increased age was an independent risk factor for diastolic dysfunction (HR = 1.1, 95% CI 1.02-1.18, p = 0.0098). Dosimetric analysis showed that patients who developed any cardiac events had increased mean heart dose (397.67±251.08 vs 344.87±236.75 cGy, p = 0.032). A significant increase in risk of cardiac events was found in patients with mean heart dose > 450 cGy (HR = 1.55, 95% CI 1.17-2.05, p = 0.0024), V5 > 26% (HR = 1.51, 95% CI 1.09-2.09, p = 0.013), and V30 > 5.5% (HR = 1.49, 95% CI 1.09-2.04, p = 0.0117), respectively. Further analysis was done in the subgroup of patients treated with left-sided RT, internal mammary nodes RT, or anthracyclines, no difference in risk of cardiac events was found between trastuzumab alone and dual anti-HER2 therapy in concurrent with RT (all p > 0.05). CONCLUSION Compared with trastuzumab-only, dual anti-HER2 therapy does not increase early cardiac toxicity in combination with adjuvant RT in BC patients. Cardiac radiation exposure remains the primary risk factor associated with early cardiac toxicity.
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Affiliation(s)
- L Cao
- Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - J Yang
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - M Zhou
- Department of Radiotherapy, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Changzhou, China
| | - B Yu
- Department of Radiotherapy, the Affiliated Jiangyin Hospital of Nantong University, Jiangyin, China
| | - Q Lin
- Department of Radiation Oncology, Shanghai Tenth People's Hospital, Shanghai, China
| | - Y Yao
- Department of Radiotherapy, Shanghai Ninth People's Hospital, Shanghai, China
| | - H L Wu
- Department of Radiation Oncology, Shanghai Tenth People's Hospital, Shanghai, China
| | - Q W Zhu
- Department of Radiation Oncology, Affiliated Tumor Hospital of Nantong University, Nantong, China
| | - M Ye
- Department of Radiation Oncology, Renji Hospital, Shanghai Jiaotong University School of Medicine, China, Shanghai, China
| | - H Xie
- Department of Radiation Oncology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - J W Wu
- Department of Radiotherapy, Shanghai Ninth People's Hospital, Shanghai, China
| | - J Y Chen
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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Lu ZH, Chen JY, Chen BR, Xie Y, Li DY, Zhang LX, Jiang MD, Mao JH. [A child of Fabry disease with appendicitis as initial symptom and family screening]. Zhonghua Nei Ke Za Zhi 2023; 62:1220-1222. [PMID: 37766442 DOI: 10.3760/cma.j.cn112138-20230112-00017] [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: 09/29/2023]
Affiliation(s)
- Z H Lu
- Department of Nephrology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China
| | - J Y Chen
- Department of Nephrology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China
| | - B R Chen
- Department of Pediatrics, Yongkang First People's Hospital, Zhejiang Province, Yongkang 321300, China
| | - Y Xie
- Department of Nephrology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China
| | - D Y Li
- Department of Nephrology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China
| | - L X Zhang
- Department of Nephrology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China
| | - M D Jiang
- Department of Nephrology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China
| | - J H Mao
- Department of Nephrology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China
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Yang J, Cao L, Mao HD, Xiong WQ, Chen JY. Convolution Neural Network-Based Automatic Scoring of Coronary Artery Calcification and Its Value to Identify the Risk of Radiation-Induced Cardiac Toxicity on Radiotherapy Planning CT Scans in Breast Cancer Patients. Int J Radiat Oncol Biol Phys 2023; 117:e214-e215. [PMID: 37784884 DOI: 10.1016/j.ijrobp.2023.06.1108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To develop an automatic scoring of coronary artery calcification (CAC) on breast cancer radiotherapy (RT) planning computed tomography (CT) scans, and to explore its predictive value of CAC for radiation-induced cardiac toxicity. MATERIALS/METHODS Planning CT scans of 668 breast cancer patients from two prospective clinical trials (NCT02942615, NCT03829553) were retrospectively reviewed. In total, 34 CTs containing CAC were identified. The training and test samples were 29 and 5, respectively. We proposed a two-stage model for CAC segmentation task with nnU-Net as backbone. The segmentation results were processed by threshold extraction and region growth algorithm. We also employed transfer learning to automatically identify calcification of left anterior descending artery (LAD), right coronary artery (RCA), left circumflex artery (LCX), and left main coronary artery (LM) based on a public dataset of 430 cases from Stanford University. The data of cardiac examination of these 34 patients before and during the follow-up after RT were collected. The cardiac event was any symptomatic heart disease or new-onset abnormality in the cardiac examination after RT. RESULTS The mean dice coefficients (DSC) and 95% Harsdorf distance (95HD) of test samples were 0.992 and 0.599 mm, respectively. The mean absolute error (MAE) of CAC Angaston score between ground truth (GT) and predictions was 0.532. The detailed consistency parameters of 5 test samples were shown in Table 1. After 1:2 propensity score matching (PSM), 21 patients had CAC and 42 patients had no CAC were selected. The number of patients with CAC scores of 1 to 10, 11 to 100, and greater than 100 was 10, 9 and 2, respectively. During median follow-up of 9.2 months (range, 1-42.7), 90.5% and 38.1% of patients in CAC cohort and no CAC cohort developed cardiac event (p<0.001). Patients with CAC had significantly increased cardiac events (HR = 2.4; 95% CI, 1.22-4.75; p = 0.0117). The risk of cardiac events increased with CAC scores ([HR]1-10 = 2.1, 95% CI 0.9-4.9; [HR]11-100 = 2.5, 95% CI 1.0-5.9; [HR]>100 = 4.0, 95% CI 0.9-17.4). CONCLUSION Our primary results showed that this two-stage segmentation model is capable of achieving automatic CAC scoring which might assist to predict the risk of post-RT cardiac events in breast cancer patients.
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Affiliation(s)
- J Yang
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - L Cao
- Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - H D Mao
- Shanghai United Imaging Healthcare Co., Ltd., Shanghai, China
| | - W Q Xiong
- Shanghai United Imaging Healthcare Co., Ltd., Shanghai, China
| | - J Y Chen
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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Cao L, Huang JQ, Li C, Chen M, Zhang YB, Chen JY. Dosimetry Comparison of Incidental Irradiation to the Low Axilla in Whole Breast Irradiation Using IMRT and IMPT Therapy. Int J Radiat Oncol Biol Phys 2023; 117:e166-e167. [PMID: 37784768 DOI: 10.1016/j.ijrobp.2023.06.1003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) It has been hypothesized that incidental dose to low axilla contributes to regional control in patients receiving whole breast irradiation (WBI), especially in patients with limited metastatic sentinel nodes who were spared from subsequent axillary dissection. We aimed to compare axillary dose between intensity-modulated radiotherapy (IMRT) and intensity-modulated proton radiotherapy (IMPT). MATERIALS/METHODS Dosimetric comparisons between IMRT and IMPT were conducted in 15 patients treated with WBI without planned regional node irradiation (RNI). The prescribed dose was 40.05 Gy (RBE)/15 Fx. Axillary lymph nodes levels I, II (ALN I, ALN II) and rotter's lymph nodes (RN) were contoured and evaluated. RESULTS The dose to the axilla was generally low for IMPT, with mean dose to ALN I, ALN II, and RN of 896.31, 194.64, and 2111.58 cGy (RBE), respectively. The mean V90% and V50% of ALN I was higher for IMRT (11.5 cm3, 22.9% of structure volume, p < 0.0001; 36.1 cm3, 66.6%, p < 0.0001) compared to IMPT (1.1 cm3, 2.0%; 8.1cm3, 15.9%). Similar finding was found in other low axilla. Mean dose to total ALN caudal to axillary vein was 936.6 cGy (RBE) in IMPT compared to 2407.3 cGy in IMRT (p < 0.0001). Within all substructures of axilla, mean dose to RN was the highest, but it remains lower in IMPT than in IMRT [2111.58 cGy (RBE) versus 3510.88 cGy, p < 0.0001]. CONCLUSION WBI treated with IMPT leads to a significant reduction of axilla dose compared to IMRT. In clinical scenarios like Z0011 or likewise requiring incidental irradiation to the low axilla without additional RNI, contouring should be modified based on individual risk.
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Affiliation(s)
- L Cao
- Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - J Q Huang
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - C Li
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - M Chen
- Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Y B Zhang
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - J Y Chen
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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Zheng S, Qi WX, Li S, Xu FF, Li H, Chen JY, Zhao S. Sarcopenia as a Predictor of Neoadjuvant Therapy-Related Toxicity in Esophageal Squamous Cell Carcinoma Patients. Int J Radiat Oncol Biol Phys 2023; 117:e359. [PMID: 37785234 DOI: 10.1016/j.ijrobp.2023.06.2444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Sarcopenia, characterized by loss of muscle mass, plays a critical role in patients with esophageal squamous cell cancer (ESCC). Preoperative chemoradiotherapy and immunotherapy in ESCC patients has been reported to improve survival. Therefore, we sought to evaluate the predictive value of preoperative sarcopenia for toxicity and pathological tumor response to neoadjuvant therapy (NAT) in ESCC patients. MATERIALS/METHODS A retrospective analysis was performed using a prospectively collected patient cohort of an academic cancer center diagnosed with cT2-4N0-3M0 ESCC between 2019-2022 and treated with neoadjuvant chemoradiotherapy ± pembrolizumab. Sarcopenia was assessed by skeletal muscle index at the third lumbar vertebra in computed tomography scans before NAT (men: 43cm²/m² for body mass index (BMI) < 25kg/m², 53cm²/m² for BMI≥25 kg/m²; women: 41cm²/m²). Logistic regression was performed to assess the association between sarcopenia and preoperative therapy-related toxicity and tumor response. RESULTS The study included 59 locally advanced ESCC patients (53 male and 6 female), 48 (81.4%) in the non-sarcopenia group, and 11 (18.6%) in the sarcopenia group. Mean age at diagnosis was 62±8 years. Mean BMI at diagnosis was 22.13±2.85 kg/m². 19 patients (32.2%) were stage ⅢA, 25 patients (42.4%) were ⅢB, 15 patients (25.4%) were ⅣA. No significant differences were found between both groups regarding sex, age, BMI, and clinical stage. Acute grade ≥3 toxicity occurred significantly more frequently in the sarcopenia group (54.5% vs. 22.9%, p = 0.045), which mainly included leukopenia, neutropenia, anemia and thrombocytopenia. The discontinuation of NAT owing to toxicity occurred in 8 patients (13.5%), which was significantly associated with sarcopenia (p = 0.003). All patients proceeded to surgery and 33 patients (55.9%) had a pathological complete response (pCR). Univariate analysis revealed no significant association between sarcopenia and pCR (p = 0.071). CONCLUSION Among patients with locally advanced EC, sarcopenia is not a predictor of poor NAT response, but it is strongly associated with discontinuation of NAT due to toxicity.
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Affiliation(s)
- S Zheng
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - W X Qi
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - S Li
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - F F Xu
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - H Li
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - J Y Chen
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - S Zhao
- Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Li H, Xu C, Cao L, Chen JY. A Modified Robust Nomogram for Predicting the Probability of Pelvic Lymph Node Invasion in Localized Prostate Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e406. [PMID: 37785350 DOI: 10.1016/j.ijrobp.2023.06.1545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Improved predictive models for the risk of pelvic lymph node invasion (LNI) in localized prostate cancer (PCa) is important in decision making of pelvic lymph node dissection (PLND) or whole pelvic RT (WPRT). We aimed to establish a nomogram with improved robustness (Ruijin model) based on pre-treatment information. MATERIALS/METHODS Continuous localized PCa patients with detailed prostate tumor biopsy information, treated with laparoscopic radical prostatectomy and PLND between 2013 and 2022 in single institution were retrospectively reviewed. A multivariable logistic regression model was fitted and represented the basis for a coefficient-based nomogram of predicting LNI. Comparisons between the Ruijin model and the Roach formula were conducted using the receiver operating characteristic-derived area under the curve (AUC), calibration plot, and decision-curve analyses (DCAs). RESULTS In total, 624 patients with median age (69.5 year) were included in this analysis. The median number of pelvis lymph nodes removed was 6 (range: 2-30). LNI was found in 35 (5.6%) patients. In the multivariable logistic regression model, total prostate-specific antigen (OR = 1.008, P = 0.025), percentage of cores with the highest-grade PCa (OR = 14.822, P<0.001), clinical stage (III vs. I-II: OR = 7.733, P = 0.008), and biopsy Gleason Grading Group (G3 vs G1-2: OR = 3.152, P = 0.082; G4 vs G1-2: OR = 3.065, P = 0.083; G5 vs G1-2: OR = 5.262, P = 0.008;) were included and formed the basis for the nomogram. The predictive accuracy of Ruijin nomogram in our cohort was 87.7%. Using a cutoff of 4% based on Ruijin nomogram, 395 (63%) PLND would be spared and LNI would be missed in only two (0.5%) patients. The sensitivity, specificity, and negative predictive value associated with the 4% cutoff were 94.3%, 66.7%, and 99.5%, respectively. As compared with the Roach formula, the Ruijin model showed higher AUC (87.7% vs 80.9%, Z = -2.013, P = 0.044), better calibration characteristics, and a higher net benefit at DCA. CONCLUSION We developed a novel nomogram for predicting the LNI in localized PCa patients with detailed biopsy information. PLND or WPRT could be avoided in patients with a risk of LNI <4%, so as to spare more than 60% of unnecessary pelvic nodal treatment with a cost of missing only 0.5% LNIs.
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Affiliation(s)
- H Li
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - C Xu
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - L Cao
- Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - J Y Chen
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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Fadadu RP, Chee E, Jung A, Chen JY, Abuabara K, Wei ML. Air pollution and global healthcare use for atopic dermatitis: A systematic review. J Eur Acad Dermatol Venereol 2023; 37:1958-1970. [PMID: 37184289 DOI: 10.1111/jdv.19193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 05/03/2023] [Indexed: 05/16/2023]
Abstract
Increasing air pollution is common around the world, but the impacts of outdoor air pollution exposure on atopic dermatitis (AD) are unclear. We synthesized the current global epidemiologic evidence for air pollution exposure and associated medical visits for AD among adults and children. This review followed PRISMA guidelines, and searches were conducted on PubMed, MEDLINE, Web of Science and EMBASE databases. The searches yielded 390 studies, and after screening, 18 studies around the world assessing at least 5,197,643 medical visits for AD in total were included for the final analysis. We found that exposure to particulate matter ≤2.5 μm in diameter (PM2.5 ) [(10/11) of studies], particulate matter ≤10 μm in diameter (PM10 ) (11/13), nitrogen dioxide (NO2 ) (12/14) and sulfur dioxide (SO2 ) (10/13) was positively associated with AD visits. Results were equivocal for ozone [(4/8) of studies reported positive association] and limited for carbon monoxide [(1/4) of studies reported positive association]. When stratifying results by patient age, patient sex and season, we found that the associations with particulate matter, NO2 and O3 may be affected by temperature. Exposure to selected air pollutants is associated with AD visits, and increasingly poor worldwide air quality may increase global healthcare use for AD.
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Affiliation(s)
- R P Fadadu
- Department of Dermatology, University of California, San Francisco, San Francisco, California, USA
- Dermatology Service, San Francisco VA Health Care System, San Francisco, California, USA
| | - E Chee
- Department of Dermatology, University of California, San Francisco, San Francisco, California, USA
| | - A Jung
- Department of Dermatology, University of California, San Francisco, San Francisco, California, USA
- School of Information, University of California, Berkeley, Berkeley, California, USA
| | - J Y Chen
- Department of Dermatology, University of California, San Francisco, San Francisco, California, USA
- Dermatology Service, San Francisco VA Health Care System, San Francisco, California, USA
| | - K Abuabara
- Department of Dermatology, University of California, San Francisco, San Francisco, California, USA
- School of Public Health, University of California, Berkeley, Berkeley, California, USA
| | - M L Wei
- Department of Dermatology, University of California, San Francisco, San Francisco, California, USA
- Dermatology Service, San Francisco VA Health Care System, San Francisco, California, USA
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Wang DQ, Huang Z, Zhu L, Huang XB, Wang WH, Tie J, Shen L, Shi M, Chen JY, Liu M, Cheng J, Zhang J, Li YX, Wang S. Recurrence Risk Score Model for Evaluating the Impact of Postmastectomy Radiotherapy in Breast Cancer Patients with Pathologic Nodal Negative after Neoadjuvant Chemotherapy and Mastectomy. Int J Radiat Oncol Biol Phys 2023; 117:e211. [PMID: 37784877 DOI: 10.1016/j.ijrobp.2023.06.1100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Recurrence risk score model was established to distinguish the recurrent risk of patients with pathologic nodal negative (ypN0) after neoadjuvant chemotherapy (NACT) and mastectomy and determine the impact of postmastectomy radiotherapy (PMRT). MATERIALS/METHODS This multicenter retrospective study reviewed 766 patients who underwent mastectomy and NACT with ypN0 from 2000 to 2014. Recurrent risk score model was assigned proportionally to the relative contribution of independent prognostic factors in the multivariate Cox model of disease-free survival (DFS). Decision tree analysis was conducted to determine two optimal cutoff points for stratification. RESULTS The median follow-up time was 74 months. The 5-year locoregional control (LRC), DFS, and overall survival (OS) rates for the entire group were 96.5%, 89.1% and 95.3%, respectively. 353 (46.1%) patients received PMRT and 413 (53.9%) patients did not. Patients with PMRT have more high-risk factors, including age <40 years, clinical stage III, grade III, or ER and PR negative. Chest wall and regional nodal region were irradiated in 307 (87.0%) and chest wall only in 46 (13.0%). The median radiation dose was 50 Gy (range: 36-60 Gy) in 25 fractions (range: 15-30 fractions). There were no significant differences between the PMRT and No-PMRT groups in the LRC, DFS and OS rates. Recurrent risk score model consisted of five factors and used a range of zero to eleven scoring points: age <40 years and clinical N1 stage for one point; clinical N2, NACT ≥4 cycles, lymphovascular invasion and ypT1-2 for two points; ypT3-4 for four points. 456 (59.5%) patients scoring zero to four points, 188 (24.5%) scoring five points and 122 (15.9%) scoring six to eleven points were assigned to the low-, intermediate-, and high-risk group. LRC, DFS and OS rates in three risk groups were significantly distinct from each other (5yr-LRC: 98.6% vs. 95.5% vs. 89.8%, p < .001; 5yr-DFS: 94.4% vs. 87.4% vs. 71.5%, p < .001; 5yr-OS: 97.6% vs. 93.2% vs. 90.0%, p < .001). PMRT had no impact on the LRC, DFS and OS rates in either low-, intermediate-, or high-risk group. CONCLUSION The recurrence risk score model can effectively distinguish patients with different recurrent risk stratification. PMRT in patients with ypN0 after NAC and mastectomy cannot improve LRC, DFS or OS. Table 1. Survival outcomes and comparison between PMRT and No-PMRT arms in different groups.
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Affiliation(s)
- D Q Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Z Huang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, Beijing, China
| | - L Zhu
- Department of Radiation Oncology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - X B Huang
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - W H Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, Beijing, China
| | - J Tie
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, Beijing, China
| | - L Shen
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, China
| | - M Shi
- Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - J Y Chen
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - M Liu
- Department of Radiation Oncology, the First Hospital, Jilin University, Changchun, China
| | - J Cheng
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - J Zhang
- Department of Radiation Oncology, Forth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Y X Li
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - S Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Ou D, Cai R, Qi WX, Chen JY, Xu HP. Toripalimab Combined with Chemoradiotherapy for Locally Advanced Cervical Squamous Cell Carcinoma Patients: Early Results of Safety and Feasibility. Int J Radiat Oncol Biol Phys 2023; 117:S40. [PMID: 37784493 DOI: 10.1016/j.ijrobp.2023.06.311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To assess the safety and efficacy of toripalimab combined with chemoradiotherapy for locally advanced cervical squamous cell carcinoma. MATERIALS/METHODS Twenty-two locally advanced cervical cancer patients, regardless of programmed death ligand-1 (PD-L1) status, received toripalimab treatment combined with concurrent chemoradiotherapy (CCRT), includes cisplatin (40 mg/m2, once a week for 5 weeks), radiotherapy (45-50.4 Gy/25-28Fx, 5 fractions a week, followed by brachytherapy 24-30 Gy/3-5Fx) and toripalimab (240mg on day 1, 22 and 43). The primary endpoints were safety and 2-year progression-free survival (PFS). RESULTS The median age was 55 years old (42 to 72), with 2 patients in FIGO stage Ⅱ, 15 patients in stage ⅢC, and 5 patients in stage ⅣA. All patients completed CCRT successfully. Grade Ⅲ and higher adverse events (AEs) were observed in 11 patients (11/22, 50%), and no patient had a grade Ⅴ AE. The most frequent grade Ⅲ AE was leukopenia (8/22, 36.4%). The most common immunotherapy-related adverse event was hypothyroidism (2/22, 9.1%). The objective response rate (ORR) was 100%. At data cutoff (Sep 30, 2022), the median follow-up was 19.7 months (7.67 to 26.1 months). The LC and the PFS rate were 95.5% and 81.8%, and the OS rate was 90.9%. The patients with baseline absolute lymphocyte count (ALC) ≤1.255 × 10^9/L had significant higher rates of metastasis than those with ALC >1.255 × 10^9/L (42.9% vs 0%, p = 0.023). CONCLUSION Toripalimab combined with CCRT achieved good tolerance and demonstrated promising anti-tumor effects in patients with locally advanced cervical cancer. Longer follow-up results and further phase Ⅱ/Ⅲ studies are expected. Chinese Clinical Trial Registry number, ChiCTR2000032879.
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Affiliation(s)
- D Ou
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - R Cai
- Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - W X Qi
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - J Y Chen
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - H P Xu
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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Hua X, Long ZQ, Wang SF, Xu F, Wang MD, Chen JY, Zhang YL, Ni W, Gao Y. Prognostic Significance of the Novel Nutrition-Inflammation Marker of Lymphocyte-C-Reactive Protein Ratio in Patients with Nasopharyngeal Carcinoma Receiving Concurrent Chemoradiotherapy. Int J Radiat Oncol Biol Phys 2023; 117:e588-e589. [PMID: 37785781 DOI: 10.1016/j.ijrobp.2023.06.1936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Recent studies indicate that the novel lymphocyte-C-reactive protein ratio (LCR) is strongly associated with the survival of various tumors, but its prognostic value in nasopharyngeal carcinoma (NPC) is understudied. This study aimed to explore the relationship between the LCR and overall survival (OS) in NPC and to develop a predictive model. MATERIALS/METHODS A total of 841 NPC patients received concurrent chemoradiotherapy (CCRT) were retrospectively enrolled and randomly divided into training cohort (n = 589) and validation cohort (n = 252). Univariate and multivariate Cox analyses were performed to identify variables associated with OS and construct a predictive nomogram. The predictive accuracy of the nomogram was evaluated and independently validated. RESULTS The LCR score differentiated NPC patients into two groups with distinct prognoses (HR = 0.53; 95% CI: 0.32-0.89, P = 0.014). Multivariate analysis showed that age, T stage, N stage, EBV-DNA status, and LCR score were independently associated with OS and a predictive nomogram was developed. The nomogram had a good performance for the prediction of OS [C-index = 0.770 (95% CI: 0.675-0.864)] and outperformed the traditional staging system [C-index = 0.589 (95% CI: 0.385-0.792)]. The results were internally validated using an independent cohort. CONCLUSION The novel nutrition-inflammation marker of LCR could serve as a simplified, affordable, easy-to-obtain, non-invasive, and readily promotive prognostic marker for NPC patients received CCRT, and the LCR-based prognostic nomogram outperformed the conventional staging system in terms of predictive power.
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Affiliation(s)
- X Hua
- Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China
| | - Z Q Long
- State Key Laboratory of Oncology in South China, Guangzhou, China
| | - S F Wang
- SunYat-sen University Cancer Center, Guangzhou, China
| | - F Xu
- Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China
| | - M D Wang
- Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China
| | - J Y Chen
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Y L Zhang
- Jiangxi Provincial People's Hospital, Nanchang, China
| | - W Ni
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Y Gao
- Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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Goldberg SA, Lu S, Garcia-Knight M, Davidson MC, Tassetto M, Anglin K, Pineda-Ramirez J, Chen JY, Rugart PR, Mathur S, Forman CA, Donohue KC, Abedi GR, Saydah S, Briggs-Hagen M, Midgley CM, Andino R, Peluso MJ, Glidden DV, Martin JN, Kelly JD. Viral Determinants of Acute COVID-19 Symptoms in a Nonhospitalized Adult Population in the Pre-Omicron Era. Open Forum Infect Dis 2023; 10:ofad396. [PMID: 37636517 PMCID: PMC10456204 DOI: 10.1093/ofid/ofad396] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 07/20/2023] [Indexed: 08/29/2023] Open
Abstract
Background The influence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA level and presence of infectious virus on symptom occurrence is poorly understood, particularly among nonhospitalized individuals. Methods The study included 85 nonhospitalized, symptomatic adults, who were enrolled from September 2020 to November 2021. Data from a longitudinal cohort studied over 28 days was used to analyze the association of individual symptoms with SARS-CoV-2 viral RNA load, or the presence or level of infectious (culturable) virus. Presence of infectious virus and viral RNA load were assessed daily, depending on specimen availability, and amount of infectious virus was assessed on the day of maximum RNA load. Participants were surveyed for the start and end dates of 31 symptoms at enrollment and at days 9, 14, 21, and 28; daily symptom presence was determined analytically. We describe symptoms and investigate their possible association with viral determinants through a series of single or pooled (multiple days across acute period) cross-sectional analyses. Results There was an association between viral RNA load and the same-day presence of many individual symptoms. Additionally, individuals with infectious virus were more than three times as likely to have a concurrent fever than individuals without infectious virus, and more than two times as likely to have concurrent myalgia, chills, headache, or sore throat. Conclusions We found evidence to support the association of viral RNA load and infectious virus on some, but not all symptoms. Fever was most strongly associated with the presence of infectious virus; this may support the potential for symptom-based isolation guidance for COVID-19.
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Affiliation(s)
- Sarah A Goldberg
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
- Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Scott Lu
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
- Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Miguel Garcia-Knight
- Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, California, USA
| | - Michelle C Davidson
- School of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Michel Tassetto
- Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, California, USA
| | - Khamal Anglin
- Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Jesus Pineda-Ramirez
- Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Jessica Y Chen
- Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Paulina R Rugart
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
| | - Sujata Mathur
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
| | - Carrie A Forman
- College of Medicine, Drexel University, Philadelphia, Pennsylvania, USA
| | - Kevin C Donohue
- School of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Glen R Abedi
- Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sharon Saydah
- Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Melissa Briggs-Hagen
- Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Claire M Midgley
- Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Raul Andino
- Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, California, USA
| | - Michael J Peluso
- Division of HIV, Infectious Diseases and Global Medicine, Zuckerberg San Francisco General Hospital, San Francisco, California, USA
| | - David V Glidden
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
| | - Jeffrey N Martin
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
| | - J Daniel Kelly
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
- Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California, USA
- F.I. Proctor Foundation, University of California, San Francisco, San Francisco, California, USA
- Division of Hospital Medicine, San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
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22
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Chen YH, Long LS, Chen JY, Xie ZY, Ding HL, Cheng LY. [Recognition of the membrane anatomy-based laparoscopic assisted right hemicolectomy]. Zhonghua Wei Chang Wai Ke Za Zhi 2023; 26:701-706. [PMID: 37583029 DOI: 10.3760/cma.j.cn441530-20230312-00079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
Abstract
Although it has become a consensus in the field of colorectal surgery to perform radical tumor treatment and functional protection under the minimally invasive concept, there exist many controversies during clinical practice, including the concept of embryonic development of abdominal organs and membrane anatomy, the principle of membrane anatomy related to right hemicolectomy, D3 resection, and identification of the inner boundary. In this paper, we analyzed recently reported literature with high-level evidence and clinical data from the author's hospital to recognize and review the membrane anatomy-based laparoscopic assisted right hemicolectomy for right colon cancer, emphasizing the importance of priority of surgical dissection planes, vascular orientation, and full understanding of the fascial space, and proposing that the surgical planes should be dissected in the parietal-prerenal fascial space, and the incision should be 1 cm from the descending and horizontal part of the duodenum. The surgery should be performed according to a standard procedure with strict quality control. To identify the resection range of D3 dissection, it is necessary to establish a clinical, imaging, and pathological evaluation model for multiple factors or to apply indocyanine green and nano-carbon lymphatic tracer intraoperatively to guide precise lymph node dissection. We expect more high-level evidence of evidence-based medicine to prove the inner boundary of laparoscopic assisted radical right colectomy and a more rigorous consensus to be established.
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Affiliation(s)
- Y H Chen
- Department of General Surgery, the General Hospital of Southern Theater Command, Guangzhou 510010, China
| | - L S Long
- Department of General Surgery, the General Hospital of Southern Theater Command, Guangzhou 510010, China
| | - J Y Chen
- Department of General Surgery, the General Hospital of Southern Theater Command, Guangzhou 510010, China
| | - Z Y Xie
- Department of General Surgery, the General Hospital of Southern Theater Command, Guangzhou 510010, China
| | - H L Ding
- Department of General Surgery, the General Hospital of Southern Theater Command, Guangzhou 510010, China
| | - L Y Cheng
- Department of General Surgery, the General Hospital of Southern Theater Command, Guangzhou 510010, China
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Shen CY, Li GR, Wei D, Wang W, Yang XS, Jiang C, Sheng YT, Yang ZK, Nie XW, Chen JY. [Expression and protective effect of chemerin in idiopathic pulmonary fibrosis]. Zhonghua Jie He He Hu Xi Za Zhi 2023; 46:688-696. [PMID: 37402659 DOI: 10.3760/cma.j.cn112147-20221119-00910] [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: 07/06/2023]
Abstract
Objective: To explore the expression and the role of chemerin in idiopathic pulmonary fibrosis (IPF). Methods: Quantitative PCR and Western blotting were used to determine the mRNA and protein levels of chemerin in lung tissues from IPF patients and the controls. Clinical serum level of chemerin was analyzed by enzyme-linked immunosorbent assay. The mouse lung fibroblasts isolated and cultured in vitro were divided into the control, TGF-β, TGF-β+chemerin and chemerin groups. Immunofluorescence staining was used to observe the expression of α-smooth muscle actin (α-SMA). C57BL/6 mice were randomly divided into the control, bleomycin, bleomycin+chemerin, and chemerin groups. Masson and immunohistochemical staining were performed to evaluate the severity of pulmonary fibrosis. Expression of epithelial to mesenchymal transition (EMT) markers was detected by quantitative PCR and immunohistochemical staining in the in vitro and in vivo models of pulmonary fibrosis, respectively. Results: Compared with the control group, the expression of chemerin was downregulated in both the lung tissue and the serum of IPF patients. Immunofluorescence showed that treatment of fibroblasts with TGF-β alone resulted in a robust expression of α-SMA, whereas treatment with TGF-β and chemerin together exhibited the similar expression levels of α-SMA as the control group. Masson staining indicated that the bleomycin-induced pulmonary fibrosis model was constructed successfully, while treatment of chemerin partially alleviated the damage of lung tissue. Immunohistochemical staining showed that the expression of chemerin in the lung tissue was significantly decreased in the bleomycin group. Quantitative PCR and immunohistochemistry showed that chemerin attenuated EMT induced by TGF-β and bleomycin both in vitro and in vivo. Conclusions: The expression of chemerin was reduced in patients with IPF. Chemerin may play a protective role in the development of IPF by regulating EMT, providing a new idea for the clinical treatment of IPF.
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Affiliation(s)
- C Y Shen
- Laboratory of Human Organ Transplantation, Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi 214023, China
| | - G R Li
- Laboratory of Human Organ Transplantation, Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi 214023, China
| | - D Wei
- Transplant Center, Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi 214023, China
| | - W Wang
- Laboratory of Human Organ Transplantation, Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi 214023, China
| | - X S Yang
- Laboratory of Human Organ Transplantation, Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi 214023, China
| | - C Jiang
- Laboratory of Human Organ Transplantation, Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi 214023, China
| | - Y T Sheng
- Laboratory of Human Organ Transplantation, Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi 214023, China
| | - Z K Yang
- Department of Clinical Laboratory, Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi 214023, China
| | - X W Nie
- Laboratory of Human Organ Transplantation, Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi 214023, China
| | - J Y Chen
- Transplant Center, Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi 214023, China
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Xie XJ, Chen JY, Jiang J, Duan H, Wu Y, Zhang XW, Yang SJ, Zhao W, Shen SS, Wu L, He B, Ding YY, Luo H, Liu SY, Han D. [Development and validation of prognostic nomogram for malignant pleural mesothelioma]. Zhonghua Zhong Liu Za Zhi 2023; 45:415-423. [PMID: 37188627 DOI: 10.3760/cma.j.cn12152-20211124-00871] [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] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Objective: To development the prognostic nomogram for malignant pleural mesothelioma (MPM). Methods: Two hundred and ten patients pathologically confirmed as MPM were enrolled in this retrospective study from 2007 to 2020 in the People's Hospital of Chuxiong Yi Autonomous Prefecture, the First and Third Affiliated Hospital of Kunming Medical University, and divided into training (n=112) and test (n=98) sets according to the admission time. The observation factors included demography, symptoms, history, clinical score and stage, blood cell and biochemistry, tumor markers, pathology and treatment. The Cox proportional risk model was used to analyze the prognostic factors of 112 patients in the training set. According to the results of multivariate Cox regression analysis, the prognostic prediction nomogram was established. C-Index and calibration curve were used to evaluate the model's discrimination and consistency in raining and test sets, respectively. Patients were stratified according to the median risk score of nomogram in the training set. Log rank test was performed to compare the survival differences between the high and low risk groups in the two sets. Results: The median overall survival (OS) of 210 MPM patients was 384 days (IQR=472 days), and the 6-month, 1-year, 2-year, and 3-year survival rates were 75.7%, 52.6%, 19.7%, and 13.0%, respectively. Cox multivariate regression analysis showed that residence (HR=2.127, 95% CI: 1.154-3.920), serum albumin (HR=1.583, 95% CI: 1.017-2.464), clinical stage (stage Ⅳ: HR=3.073, 95% CI: 1.366-6.910) and the chemotherapy (HR=0.476, 95% CI: 0.292-0.777) were independent prognostic factors for MPM patients. The C-index of the nomogram established based on the results of Cox multivariate regression analysis in the training and test sets were 0.662 and 0.613, respectively. Calibration curves for both the training and test sets showed moderate consistency between the predicted and actual survival probabilities of MPM patients at 6 months, 1 year, and 2 years. The low-risk group had better outcomes than the high-risk group in both training (P=0.001) and test (P=0.003) sets. Conclusion: The survival prediction nomogram established based on routine clinical indicators of MPM patients provides a reliable tool for prognostic prediction and risk stratification.
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Affiliation(s)
- X J Xie
- Department of Medical Imaging, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - J Y Chen
- Department of Radiology, the Third Affiliated Hospital of Kunming Medical University, Kunming 650106, China
| | - J Jiang
- Department of Medical Imaging, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - H Duan
- Department of Medical Imaging, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Y Wu
- Department of Radiology, Chuxiong People's Hospital, Chuxiong 675099, China
| | - X W Zhang
- Department of Radiology, Chuxiong People's Hospital, Chuxiong 675099, China
| | - S J Yang
- Department of Thoracic Surgery, Chuxiong People's Hospital, Chuxiong 675099, China
| | - W Zhao
- Department of Medical Imaging, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - S S Shen
- Department of Medical Imaging, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - L Wu
- Department of Medical Imaging, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - B He
- Department of Medical Imaging, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Y Y Ding
- Department of Radiology, the Third Affiliated Hospital of Kunming Medical University, Kunming 650106, China
| | - H Luo
- Deputy President's Office, Chuxiong People's Hospital, Chuxiong 675099, China
| | - S Y Liu
- GE Healthcare (China), Beijing 100176, China
| | - D Han
- Department of Medical Imaging, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
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25
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Li FY, Fu Y, Wu HY, Chen JY, Yang J, Shi J, Fan XS. [Synchronous adenocarcinoma and intravascular large B-cell lymphoma of prostate: report of a case]. Zhonghua Bing Li Xue Za Zhi 2023; 52:402-404. [PMID: 36973205 DOI: 10.3760/cma.j.cn112151-20221124-00989] [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: 03/29/2023]
Affiliation(s)
- F Y Li
- Department of Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - Y Fu
- Department of Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - H Y Wu
- Department of Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - J Y Chen
- Department of Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - J Yang
- Department of Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - J Shi
- Department of Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - X S Fan
- Department of Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
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Chen JY, Wang T, Wang PH, Sun YY, Xue N, Xu CJ, Shi RJ. [Study on static parameters of internal nasal valve in 3-dimensional model of nasal cavity space]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2023; 58:206-211. [PMID: 36878498 DOI: 10.3760/cma.j.cn115330-20220618-00357] [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: 03/08/2023]
Abstract
Objective: To identify the internal nasal valve (INV) and to evaluate its key parameters in the established 3D models of nasal cavity space via Mimics from CT images, in order to provide evidence for quantitative diagnosis of nasal valve compromise. Methods: A total of 32 Han adults without nasal diseases who underwent maxillofacial CT test in Shanghai Ninth People's Hospital from January 2015 to December 2018 were retrospectively recruited, including 16 males and 16 females, with the age ranged from 20 to 80 years (50% age<50 years old). Maxillofacial CT images were used to create 3D model of nasal cavity space. The INV was identified and the following parameters were measured: the angle between the INV and the nasal bone (θINV-B), unilateral cross-sectional area of the INV (AINV-R, AINV-L), total cross-sectional area of the INV (AINV), unilateral height of the INV (HINV-R, HINV-L), unilateral nasal valve angle (αINV-R, αINV-L), and the sum of nasal valve angle (αINV). The AINV in our study was compared with the results of the previously adopted planes (PlaneC, perpendicular to the hard palate and PlaneB, plane perpendicular to the nasal bone). The parameters above were compared among genders, age and race groups. SPSS 26 and GraphPad Prism 9 software were used for statistical analysis and mapping of data. Results: The AINV in our study was (214.87±52.94) mm², which was significantly less than that of PlaneC (254.97±47.80) mm² and PlaneB (226.07±57.36) mm². The measured parameters were as follows: θINV-B was (82.07±7.06)°; AINV-R was (112.66±31.39) mm²; AINV-L was (102.21±27.14) mm²; AINV was (214.87±52.94) mm²; HINV-R was (24.87±4.62) mm; HINV-L was (24.35±4.86) mm; αINV-R was (20.48±2.99)°; αINV-L was (19.65±3.82)°; αINV was (40.13±6.24)°. The AINV-R was larger than AINV-L (t=2.33, P<0.05); The HINV, AINV-R, AINV-L and AINV of males were more than those of females (t value was 5.77, 3.21, 2.91 and 3.52, respectively, all P<0.01). The AINV of the young group (<50 years) was larger than that of the old group (t=2.83, P<0.01); The θINV-B was different between the Han people and the Caucasian (t=2.92,P<0.01). The αINV of the Han people was larger than that of Caucasians (Z=-6.92, P<0.01), but the HINV was smaller (Z=-3.89, P<0.01). Conclusion: The AINV carried out in 3D models of nasal cavity space is significantly smaller than that obtained by the previous methods of CT evaluation. INV static parameters differ among genders, age and race groups.
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Affiliation(s)
- J Y Chen
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Ear Institute, Shanghai JiaoTong University School of Medicine, Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai 200011, China
| | - T Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Ear Institute, Shanghai JiaoTong University School of Medicine, Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai 200011, China
| | - P H Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Ear Institute, Shanghai JiaoTong University School of Medicine, Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai 200011, China
| | - Y Y Sun
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Ear Institute, Shanghai JiaoTong University School of Medicine, Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai 200011, China
| | - N Xue
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Ear Institute, Shanghai JiaoTong University School of Medicine, Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai 200011, China
| | - C J Xu
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Ear Institute, Shanghai JiaoTong University School of Medicine, Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai 200011, China
| | - R J Shi
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Ear Institute, Shanghai JiaoTong University School of Medicine, Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai 200011, China
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Khaing ZZ, Chen JY, Safarians G, Ezubeik S, Pedroncelli N, Duquette RD, Prasse T, Seidlits SK. Clinical Trials Targeting Secondary Damage after Traumatic Spinal Cord Injury. Int J Mol Sci 2023; 24:3824. [PMID: 36835233 PMCID: PMC9960771 DOI: 10.3390/ijms24043824] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/06/2023] [Accepted: 02/09/2023] [Indexed: 02/17/2023] Open
Abstract
Spinal cord injury (SCI) often causes loss of sensory and motor function resulting in a significant reduction in quality of life for patients. Currently, no therapies are available that can repair spinal cord tissue. After the primary SCI, an acute inflammatory response induces further tissue damage in a process known as secondary injury. Targeting secondary injury to prevent additional tissue damage during the acute and subacute phases of SCI represents a promising strategy to improve patient outcomes. Here, we review clinical trials of neuroprotective therapeutics expected to mitigate secondary injury, focusing primarily on those in the last decade. The strategies discussed are broadly categorized as acute-phase procedural/surgical interventions, systemically delivered pharmacological agents, and cell-based therapies. In addition, we summarize the potential for combinatorial therapies and considerations.
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Affiliation(s)
- Zin Z. Khaing
- Department of Neurological Surgery, University of Washington, Seattle, WA 98195, USA
| | - Jessica Y. Chen
- Department of Bioengineering, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Gevick Safarians
- Department of Bioengineering, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Sohib Ezubeik
- Department of Bioengineering, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Nicolas Pedroncelli
- Department of Bioengineering, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Rebecca D. Duquette
- Department of Bioengineering, University of California Los Angeles, Los Angeles, CA 90095, USA
- Department of Biomedical Engineering, University of Texas at Austin, Austin, TX 78712, USA
| | - Tobias Prasse
- Department of Neurological Surgery, University of Washington, Seattle, WA 98195, USA
- Department of Orthopedics and Trauma Surgery, University of Cologne, 50931 Cologne, Germany
| | - Stephanie K. Seidlits
- Department of Bioengineering, University of California Los Angeles, Los Angeles, CA 90095, USA
- Department of Biomedical Engineering, University of Texas at Austin, Austin, TX 78712, USA
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Peluso MJ, Deveau TM, Munter SE, Ryder D, Buck A, Beck-Engeser G, Chan F, Lu S, Goldberg SA, Hoh R, Tai V, Torres L, Iyer NS, Deswal M, Ngo LH, Buitrago M, Rodriguez A, Chen JY, Yee BC, Chenna A, Winslow JW, Petropoulos CJ, Deitchman AN, Hellmuth J, Spinelli MA, Durstenfeld MS, Hsue PY, Kelly JD, Martin JN, Deeks SG, Hunt PW, Henrich TJ. Chronic viral coinfections differentially affect the likelihood of developing long COVID. J Clin Invest 2023; 133:e163669. [PMID: 36454631 PMCID: PMC9888380 DOI: 10.1172/jci163669] [Citation(s) in RCA: 63] [Impact Index Per Article: 63.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 11/30/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUNDThe presence and reactivation of chronic viral infections, such as EBV, CMV, and HIV, have been proposed as potential contributors to long COVID (LC), but studies in well-characterized postacute cohorts of individuals with COVID-19 over a longer time course consistent with current case definitions of LC are limited.METHODSIn a cohort of 280 adults with prior SARS-CoV-2 infection, we assessed the presence and types of LC symptoms and prior medical history (including COVID-19 history and HIV status) and performed serological testing for EBV and CMV using a commercial laboratory. We used covariate-adjusted binary logistic regression models to identify independent associations between variables and LC symptoms.RESULTSWe observed that LC symptoms, such as fatigue and neurocognitive dysfunction, at a median of 4 months following initial diagnosis were independently associated with serological evidence suggesting recent EBV reactivation (early antigen-diffuse IgG positivity) or high nuclear antigen (EBNA) IgG levels but not with ongoing EBV viremia. Serological evidence suggesting recent EBV reactivation (early antigen-diffuse IgG positivity) was most strongly associated with fatigue (OR = 2.12). Underlying HIV infection was also independently associated with neurocognitive LC (OR = 2.5). Interestingly, participants who had serologic evidence of prior CMV infection were less likely to develop neurocognitive LC (OR = 0.52).CONCLUSIONOverall, these findings suggest differential effects of chronic viral coinfections on the likelihood of developing LC and association with distinct syndromic patterns. Further assessment during the acute phase of COVID-19 is warranted.TRIAL REGISTRATIONLong-term Impact of Infection with Novel Coronavirus; ClinicalTrials.gov NCT04362150.FUNDINGThis work was supported by NIH/National Institute of Allergy and Infectious Diseases grants (3R01AI141003-03S1, R01AI158013, and K24AI145806); the Zuckerberg San Francisco General Hospital Department of Medicine and Division of HIV, Infectious Diseases, and Global Medicine; and the UCSF-Bay Area Center for AIDS Research (P30-AI027763).
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Affiliation(s)
| | | | | | | | | | | | - Fay Chan
- Division of Experimental Medicine, and
| | - Scott Lu
- Department of Epidemiology and Biostatistics, UCSF, San Francisco, California, USA
| | - Sarah A. Goldberg
- Department of Epidemiology and Biostatistics, UCSF, San Francisco, California, USA
| | - Rebecca Hoh
- Division of HIV, Infectious Diseases, and Global Medicine
| | - Viva Tai
- Division of HIV, Infectious Diseases, and Global Medicine
| | | | | | - Monika Deswal
- Division of HIV, Infectious Diseases, and Global Medicine
| | - Lynn H. Ngo
- Division of HIV, Infectious Diseases, and Global Medicine
| | | | | | | | - Brandon C. Yee
- Monogram Biosciences Inc., South San Francisco, California, USA
| | - Ahmed Chenna
- Monogram Biosciences Inc., South San Francisco, California, USA
| | - John W. Winslow
- Monogram Biosciences Inc., South San Francisco, California, USA
| | | | | | | | | | | | | | - J. Daniel Kelly
- Department of Epidemiology and Biostatistics, UCSF, San Francisco, California, USA
| | - Jeffrey N. Martin
- Department of Epidemiology and Biostatistics, UCSF, San Francisco, California, USA
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Lu S, Anglin K, Tassetto M, Garcia-Knight M, Pineda-Ramirez J, Sanchez RD, Zhang A, Romero M, Goldberg SA, Chen JY, Donohue K, Davidson M, Lugtu K, Yee B, Chenna A, Winslow J, Petropoulos CJ, Briggs-Hagen M, Peluso MJ, Andino R, Midgley C, Martin J, Saydah S, Kelly D, Deeks S. 1048. Biological Determinants of Post-Acute Sequelae of SARS-CoV-2. Open Forum Infect Dis 2022. [DOI: 10.1093/ofid/ofac492.889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Abstract
Background
The biological determinants of post-acute sequelae of SARS-CoV-2 infection (PASC), defined as the persistence or recurrence of symptoms not explained by an alternative medical diagnosis, are poorly understood. We assessed viral and immunological determinants during acute SARS-CoV-2 infection for an association with PASC at 4 to 8 months.
Methods
From September 2020 to February 2022, symptomatic non-hospitalized individuals with laboratory-confirmed SARS-CoV-2 infection were identified within 5 days of symptom onset. We used anterior nasal biospecimens to measure the magnitude and duration of RNA and infectious viral shedding as well as blood samples to measure soluble markers of inflammation during the acute phase (first 28 days post-enrollment). PASC was defined as self-report of 1 or more COVID-19 attributed symptoms between 4 and 8 months after initial illness. We compared virologic and inflammatory markers, GFAP (a marker of neuronal damage) and neutralizing antibody levels from the acute phase between those with and without PASC using Mann-Whitney U tests or repeated measures mixed effects linear models.
Results
Among 71 SARS-CoV-2-positive participants with a completed follow-up visit between 4 to 8 months, we included 69 with virologic data and 61 with inflammatory marker data. Median age was 37 (IQR: 29 to 48) Overall, 16/72 (23%) reported at least one qualifying PASC symptom. Report of PASC was associated with >9 days of RNA shedding (p=0.04); all participants stopped RNA shedding by day 20. During acute illness, those with subsequent PASC had increased levelsof INF-alpha, INF-gamma, IP-10, IL-10, and MCP-1; these differences were greatest in the early period and normalized over 2 to 3 weeks post-illness onset. Compared to those without PASC, during the acute illness those with PASC had increased levels of GFAP and decreased levels of neutralizing antibodies but these differences were not statistically significant.
Conclusion
We found indications that viral and immunological factors during acute illness may be associated with PASC, suggesting acute immunologic response to SARS-CoV-2 may have longer term effects and play a role in PASC. Further understanding of the clinically significance of these observations is needed.
Disclosures
Ahmed Chenna, PhD, LabCorp: Employee John Winslow, PhD, Labcorp-Monogram Bioscience: Issued patents on VeraTag immunoassay-not applicable to present work|Labcorp-Monogram Bioscience: Employee|Labcorp-Monogram Biosciences: Issued patents on VeraTag immunoassay-not applicable to present work|Labcorp-Monogram Biosciences: Employee of Labcorp-Monogram Biosciences Christos J. Petropoulos, PhD, Labcorp-Monogram Biosciences: employee, corporate officer|Labcorp-Monogram Biosciences: Stocks/Bonds.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Brandon Yee
- Monogram Biosciences , San Francisco, California
| | - Ahmed Chenna
- Monogram Biosciences-LabCorp , South San Francisco, California
| | - John Winslow
- Labcorp-Monogram Biosciences , South San Francisco, California
| | | | | | - Michael J Peluso
- University of California San Francisco , San Francisco, California
| | | | - Claire Midgley
- Centers for Disease Control and Prevention , Atlanta , Georgia
| | | | - Sharon Saydah
- Centers for Disease Control and Prevention , Atlanta , Georgia
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Tan C, Hou Y, Qiao YS, Chen JY, Sun XH. [The study of the correlation between age and the pathogenic factors of primary glaucoma: a review]. Zhonghua Yan Ke Za Zhi 2022; 58:1106-1110. [PMID: 36480899 DOI: 10.3760/cma.j.cn112142-20220616-00297] [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: 06/17/2023]
Abstract
Age is an important risk factor for primary glaucoma. While the specific mechanism of primary glaucoma remained unclear, the change of ocular anatomy, the disturbance of aqueous humor balance, the change of ocular biomechanics and the disorder of neurometabolism contribute to the occurrence and development of primary glaucoma. This paper reviewes the latest studies on the correlation between age and the risk factors of glaucoma in the above four aspects, so as to provide some references for the in-depth discussion of the pathophysiology of primary glaucoma, and advancement on diagnosis, treatment and research of primary glaucoma.
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Affiliation(s)
- C Tan
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, NHC Key Laboratory of Myopia, Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai 200031, China
| | - Y Hou
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, NHC Key Laboratory of Myopia, Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai 200031, China
| | - Y S Qiao
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, NHC Key Laboratory of Myopia, Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai 200031, China
| | - J Y Chen
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, NHC Key Laboratory of Myopia, Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai 200031, China
| | - X H Sun
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, NHC Key Laboratory of Myopia, Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai 200031, China
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Chen JY, Huang WQ, Li HY, Lu YY, Yao YH, Zhu YP, Liang Y. [A meta-analysis on prevalence of primary angle-closure glaucoma in the middle-aged and elderly chinese population]. Zhonghua Yan Ke Za Zhi 2022; 58:896-906. [PMID: 36348526 DOI: 10.3760/cma.j.cn112142-20220601-00275] [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 prevalence and relevant factors of primary angle-closure glaucoma (PACG) in the middle-aged and elderly (40 years old and above) Chinese population. Methods: Epidemiological literature (of English and/or Chinese language) on prevalence of PACG in China between 2000 and 2022 were retrieved from PubMed, Embase, Web of Science, CNKI, and Wanfang database. Two researchers conducted the process of document retrieval, inclusion, quality assessment and data extraction independently based on inclusion and exclusion criteria. Disagreement was resolved by consensus with a third researcher. The heterogeneity among studies was assessed by using the I2 statistics, and a corresponding model was used for the meta-analysis. Subgroup analysis (gender, age, survey date, place of residence, diagnostic criteria, and temperature zone), as well as sensitivity analysis and publication bias analysis, were conducted. Results: Twenty-three studies were included in this research. Among them, eight were of high-quality and fifteen were of middle-quality. In the past 20 years, the PACG prevalence in middle-aged and elderly (40 years and older) Chinese population was 1.35% (95%CI:1.08% to 1.61%). Chinese women (1.40%) were more likely to have PACG than men (0.96%, P<0.01). The PACG prevalence had a positive correlation with age (P<0.01). The prevalence was similar between urban (1.3%) and rural (1.2%, P=0.61) areas. The PACG prevalence from studies in which the diagnostic criteria of PACG requested the symptom of vision or optic nerve damage (1.1%) was lower than that those without such requirement (1.7%, P<0.01). In mid-temperate zone, the prevalence was higher (1.7%, P=0.02). Conclusions: The PACG prevalence in middle-aged and elderly (40 years old and above) Chinese population was 1.35% in the last 20 years. The prevalence of PACG varies across age, regions, and other variations. This risk is higher in the elderly, women, and people in cold regions among Chinese population.
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Affiliation(s)
- J Y Chen
- Department of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, Fujian Institute of Ophthalmology, Fuzhou 350004, China
| | - W Q Huang
- Eye Hospital of Liuzhou, Liuzhou Red Cross Hospital, Liuzhou 545001, China
| | - H Y Li
- Department of Ophthalmology, The Second Xiangya Hospital of Central South University, Changsha 410000, China
| | - Y Y Lu
- Department of Ophthalmology, Fujian Provincial Hospital, Fuzhou 350001, China
| | - Y H Yao
- Department of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, Fujian Institute of Ophthalmology, Fuzhou 350004, China
| | - Y P Zhu
- Department of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, Fujian Institute of Ophthalmology, Fuzhou 350004, China
| | - Yuanbo Liang
- Eye Hospital of Wenzhou Medical University, National Clinical Research Center for Ocular Diseases, Wenzhou 325027, China
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Chen JY, Sun XH. [Strengthening the clinical research of minimally invasive glaucoma surgery]. Zhonghua Yan Ke Za Zhi 2022; 58:863-867. [PMID: 36348522 DOI: 10.3760/cma.j.cn112142-20220909-00446] [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
Glaucoma is a leading cause of irreversible blindness in the world. The reduction of intraocular pressure is the main clinical treatment. Due to the limitations of traditional filter surgery, a variety of minimally invasive glaucoma surgery (MIGS) procedures have been applied in clinical practice in recent years. Quite a few of them have been carried out in China and achieved good results. At the same time, domestic technology enterprises are actively engaged in the development, innovation and localization of the MIGS equipment. However, there are still some problems in MIGS in China, which need to be paid attention to and require corresponding clinical research, so as to make it a new highlight in the clinical diagnosis and treatment of glaucoma.
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Affiliation(s)
- J Y Chen
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai 200031, China
| | - X H Sun
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai 200031, China
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Mathur S, Davidson MC, Anglin K, Lu S, Goldberg SA, Garcia-Knight M, Tassetto M, Zhang A, Romero M, Pineda-Ramirez J, Diaz-Sanchez R, Rugart P, Chen JY, Donohue K, Shak JR, Chenna A, Winslow JW, Petropoulos CJ, Yee BC, Lambert J, Glidden DV, Rutherford GW, Deeks SG, Peluso MJ, Andino R, Martin JN, Kelly JD. Evaluation of Severe Acute Respiratory Syndrome Coronavirus 2 Nucleocapsid Antigen in the Blood as a Diagnostic Test for Infection and Infectious Viral Shedding. Open Forum Infect Dis 2022; 9:ofac563. [PMID: 36381627 PMCID: PMC9620332 DOI: 10.1093/ofid/ofac563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 10/21/2022] [Indexed: 11/07/2022] Open
Abstract
Background SARS-CoV-2 nucleocapsid antigen can be detected in plasma, but little is known about its performance as a diagnostic test for acute SARS-CoV-2 infection or infectious viral shedding among nonhospitalized individuals. Methods We used data generated from anterior nasal and blood samples collected in a longitudinal household cohort of SARS-CoV-2 cases and contacts. Participants were classified as true positives if polymerase chain reaction (PCR) positive for SARS-CoV-2 and as true negatives if PCR negative and seronegative. Infectious viral shedding was determined by the cytopathic effect from viral culture. Stratified by 7 days after symptom onset, we constructed receiver operating characteristic (ROC) curves to describe optimized accuracy (Youden index), optimized sensitivity, and specificity. Results Of 80 participants, 58 (73%) were true positives while 22 (27%) were true negatives. Using the manufacturer's cutoff of 1.25 pg/mL for evaluating infection, sensitivity was higher from 0 to 7 days (77.6% [95% confidence interval {CI}, 64%-88.2%]) than from 8 to 14 days (43.2% [95% CI, 31.1%-54.5%]) after symptom onset; specificity was unchanged at 100% (95% CI, 88.1%-100%). This test had higher sensitivity (100% [95% CI, 88.4%-100%]) and lower specificity (65% [95% CI, 40.8%-84.6%]) for infectious viral shedding as compared with infection, particularly within the first week of symptom onset. Although the presence of N-antigen correlated with infectious viral shedding (r = 0.63; P < .01), sensitivity still declined over time. Additional cutoffs from ROC curves were identified to optimize sensitivity and specificity. Conclusions We found that this SARS-CoV-2 N-antigen test was highly sensitive for detecting early but not late infectious viral shedding, making it a viable screening test for community-dwelling individuals to inform isolation practices.
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Affiliation(s)
- Sujata Mathur
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
- Institute for Global Health Sciences, University of California, San Francisco, California, USA
- Francis I. Proctor Foundation, University of California, San Francisco, California, USA
| | - Michelle C Davidson
- Francis I. Proctor Foundation, University of California, San Francisco, California, USA
- School of Medicine, University of California, San Francisco, California, USA
| | - Khamal Anglin
- Institute for Global Health Sciences, University of California, San Francisco, California, USA
- Francis I. Proctor Foundation, University of California, San Francisco, California, USA
| | - Scott Lu
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
- Institute for Global Health Sciences, University of California, San Francisco, California, USA
- Francis I. Proctor Foundation, University of California, San Francisco, California, USA
| | - Sarah A Goldberg
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
- Institute for Global Health Sciences, University of California, San Francisco, California, USA
- Francis I. Proctor Foundation, University of California, San Francisco, California, USA
| | - Miguel Garcia-Knight
- Department of Microbiology and Immunology, University of California, San Francisco, California, USA
| | - Michel Tassetto
- Department of Microbiology and Immunology, University of California, San Francisco, California, USA
| | - Amethyst Zhang
- Department of Microbiology and Immunology, University of California, San Francisco, California, USA
| | - Mariela Romero
- Institute for Global Health Sciences, University of California, San Francisco, California, USA
- Francis I. Proctor Foundation, University of California, San Francisco, California, USA
| | - Jesus Pineda-Ramirez
- Institute for Global Health Sciences, University of California, San Francisco, California, USA
- Francis I. Proctor Foundation, University of California, San Francisco, California, USA
| | - Ruth Diaz-Sanchez
- Institute for Global Health Sciences, University of California, San Francisco, California, USA
- Francis I. Proctor Foundation, University of California, San Francisco, California, USA
| | - Paulina Rugart
- Institute for Global Health Sciences, University of California, San Francisco, California, USA
- Francis I. Proctor Foundation, University of California, San Francisco, California, USA
| | - Jessica Y Chen
- Institute for Global Health Sciences, University of California, San Francisco, California, USA
- Francis I. Proctor Foundation, University of California, San Francisco, California, USA
| | - Kevin Donohue
- School of Medicine, University of California, San Francisco, California, USA
| | - Joshua R Shak
- San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
| | - Ahmed Chenna
- Labcorp-Monogram Biosciences, South San Francisco, California, USA
| | - John W Winslow
- Labcorp-Monogram Biosciences, South San Francisco, California, USA
| | | | - Brandon C Yee
- Labcorp-Monogram Biosciences, South San Francisco, California, USA
| | | | - David V Glidden
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - George W Rutherford
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
- Institute for Global Health Sciences, University of California, San Francisco, California, USA
| | - Steven G Deeks
- Division of HIV, Infectious Disease, and Global Medicine, Department of Medicine, University of California, San Francisco, California, USA
| | - Michael J Peluso
- Division of HIV, Infectious Disease, and Global Medicine, Department of Medicine, University of California, San Francisco, California, USA
| | - Raul Andino
- Department of Microbiology and Immunology, University of California, San Francisco, California, USA
| | - Jeffrey N Martin
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - J Daniel Kelly
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
- Institute for Global Health Sciences, University of California, San Francisco, California, USA
- Francis I. Proctor Foundation, University of California, San Francisco, California, USA
- San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
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Wu LD, Chen JY, Li F, Qian LL, Wang RX. [Research advances on the role of endoplasmic reticulum stress in arrhythmias related to heart failure]. Zhonghua Xin Xue Guan Bing Za Zhi 2022; 50:1034-1039. [PMID: 36299229 DOI: 10.3760/cma.j.cn112148-20211025-00911] [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: 06/16/2023]
Affiliation(s)
- L D Wu
- Department of Cardiology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi 214023, China
| | - J Y Chen
- Department of Cardiology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi 214023, China
| | - F Li
- Department of Cardiology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi 214023, China
| | - L L Qian
- Department of Cardiology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi 214023, China
| | - R X Wang
- Department of Cardiology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi 214023, China
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Zhou DS, Xu L, Zhang Y, Zhang TT, Chen YQ, Chen JY, Zhang J, Liu CL, Wang J. [Establishment and effect evaluation of nomogram model for diagnosis and prediction of pulmonary hypertension in patients with chronic obstructive pulmonary disease]. Zhonghua Yi Xue Za Zhi 2022; 102:3019-3025. [PMID: 36229203 DOI: 10.3760/cma.j.cn112137-20220512-01045] [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 construct a diagnostic and predictive model for chronic obstructive pulmonary disease complicated with pulmonary hypertension (COPD-PH) and evaluate its effect. Methods: A total of 1 514 COPD patients treated in 5 hospitals from January 1, 2014 to December 31, 2019 were retrospectively collected and divided into training cohort (1 072 cases) and validation cohort (442 cases) according to the ratio of 7∶3 according to the inclusion time. Data including demographic data, smoking status, history of disease, and clinical examination were collected through patient medical records and electronic medical record systems. Multivariate logistic regression models were used to explore the related factors of COPD-PH, and the nomogram model was constructed using the "rms" program package. The calibration curve was used to evaluate the consistency between the prediction probability of the model and the actual results. The C index and the area under the receiver operating characteristic curve (ROC) were used to evaluate the discrimination of the model. The decision curve analysis (DCA) was used to evaluate the clinical practicability of the model. Results: In the training cohort, 3.7%, 15.2% and 81.1% were aged 50-59, 60-69 and ≥70 years, respectively, which were significantly different from the age composition of the validation cohort (7.9%, 27.8% and 64.3%, respectively) (P=0.041). There was no significant difference between the training cohort (79.4%) and the validation cohort (84.6%) (P=0.243). Multivariate logistic regression analysis of the training cohort showed that age ≥70 years [OR (95%CI): 3.32 (1.49-7.36)] and smoking status [former (current) smoking, OR (95%CI)] were 3.67 (2.51-5.37) and 2.04 (1.44-2.90), respectively], NT-probNP≥1 400 ng/L[OR (95%CI): 9.88 (6.23-15.66)], right atrial diameter [OR (95%CI): 1.11 (1.07-1.15)] was COPD-related factors of PH, based on the above factors-PH nomogram COPD model was set up and develop for online tools (https://ph-666.shinyapps.io/zhonghua-PH/). The calibrated C index (95%CI) of the training cohort and the validation cohort were 0.82 (0.77-0.87) and 0.77 (0.68-0.86), respectively. The calibration curve was close to the diagonal in both the training cohort and the validation cohort. The AUC (95%CI) of the nomogram model was 0.82 (0.80-0.85) in the training cohort and 0.77 (0.73-0.82) in the validation cohort. ROC curve showed that the optimal threshold in the training cohort was 0.60, and the sensitivity and specificity under this value were 0.74 and 0.78, respectively; the optimal threshold for the validation cohort was 0.70, and the sensitivity and specificity under this value were 0.76 and 0.65, respectively. DCA analysis showed that the nomogram model provided better net benefits than the all-variable selection and no-variable selection strategies with threshold probabilities greater than 15.0% and 13.0% in the training and validation cohorts, respectively. Conclusions: The nomogram model for the diagnosis and prediction of COPD-PH is simple and accurate, which has a good clinical application prospect.
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Affiliation(s)
- D S Zhou
- State Key Laboratory of Respiratory Diseases, National Center for Respiratory Medicine, Guangdong Provincial Key Laboratory of Vascular Diseases, National Clinical Research Center for Respiratory Diseases, Guangzhou Academy of Respiratory Health, Department of Respiratory Medicine, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - L Xu
- Department of Pulmonary and Intensive Care, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010059, China
| | - Y Zhang
- Department of Pulmonary and Critical Care Medicine, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China
| | - T T Zhang
- Department of Intensive Care, Guangzhou First People's Hospital, South China University of Technology, Guangzhou 510180, China
| | - Y Q Chen
- State Key Laboratory of Respiratory Diseases, National Center for Respiratory Medicine, Guangdong Provincial Key Laboratory of Vascular Diseases, National Clinical Research Center for Respiratory Diseases, Guangzhou Academy of Respiratory Health, Department of Respiratory Medicine, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - J Y Chen
- State Key Laboratory of Respiratory Diseases, National Center for Respiratory Medicine, Guangdong Provincial Key Laboratory of Vascular Diseases, National Clinical Research Center for Respiratory Diseases, Guangzhou Academy of Respiratory Health, Department of Respiratory Medicine, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - J Zhang
- Department of Respiratory Medicine, Henan Provincial People's Hospital, Zhengzhou 450003, China
| | - C L Liu
- State Key Laboratory of Respiratory Diseases, National Center for Respiratory Medicine, Guangdong Provincial Key Laboratory of Vascular Diseases, National Clinical Research Center for Respiratory Diseases, Guangzhou Academy of Respiratory Health, Department of Respiratory Medicine, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - J Wang
- State Key Laboratory of Respiratory Diseases, National Center for Respiratory Medicine, Guangdong Provincial Key Laboratory of Vascular Diseases, National Clinical Research Center for Respiratory Diseases, Guangzhou Academy of Respiratory Health, Department of Respiratory Medicine, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
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Chen JY, Li TT, Hao YQ, Tang HP. [Pulmonary cryptococcosis coexisting with lung cancer confirmed by pathological examinations: report of 3 cases and literature review]. Zhonghua Jie He He Hu Xi Za Zhi 2022; 45:1009-1014. [PMID: 36207957 DOI: 10.3760/cma.j.cn112147-20220312-00197] [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 describe the clinical characteristics of pulmonary cryptococcosis(PC)coexisting with lung cancer. Methods: We reported 3 cases of PC coexisting with lung cancer confirmed by pathology in Qingdao Municipal Hospital from January 2017 to December 2021.We reviewed the literature with"pulmonary cryptococcosis" and "lung cancer" as the keywords to search Wanfang database, China HowNet and PubMed database. Results: The patients consisted of 2 males and 1 female. Two patients were diagnosed with nodular type of PC and one with diffuse mixed type of PC. One patient had underlying cardiovascular diseases and the other two had no medical history. The clinical manifestations varied including fever, cough, sputum, and no specific symptoms. All the patients received surgery and postoperative medical therapy, and all 3 patients were pathologically confirmed with adenocarcinoma. A total of 18 cases were retrieved from related literatures. To our knowledge, one of our cases was the first one with diffuse mixed type of PC coexisting with lung cancer. Conclusions: Coexistence of pulmonary cryptococcosis and lung cancer is rare and the clinical symptoms are nonspecific. When PC coexists with lung cancer, it is extremely easy to be misdiagnosed. Therefore, PC should be considered in the differential diagnosis of pulmonary nodules and multiple imaging changes.
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Affiliation(s)
- J Y Chen
- Department of Respiratory Medicine, Qingdao Municipal Hospital, Qingdao 266071, China
| | - T T Li
- Department of Respiratory Medicine, Qingdao Municipal Hospital, Qingdao 266071, China
| | - Y Q Hao
- Department of Respiratory Medicine, Qingdao Municipal Hospital, Qingdao 266071, China
| | - H P Tang
- Department of Respiratory Medicine, Qingdao Municipal Hospital, Qingdao 266071, China
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Daniel Kelly J, Lu S, Anglin K, Garcia-Knight M, Pineda-Ramirez J, Goldberg SA, Tassetto M, Zhang A, Donohue K, Davidson MC, Romero M, Sanchez RD, Djomaleu M, Mathur S, Chen JY, Forman CA, Servellita V, Montejano RD, Shak JR, Rutherford GW, Deeks SG, Abedi GR, Rolfes MA, Saydah S, Briggs-Hagen M, Peluso MJ, Chiu C, Midgley CM, Andino R, Martin JN. Magnitude and Determinants of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Household Transmission: A Longitudinal Cohort Study. Clin Infect Dis 2022; 75:S193-S204. [PMID: 35788827 PMCID: PMC9278251 DOI: 10.1093/cid/ciac545] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 06/20/2022] [Accepted: 06/22/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Households have emerged as important venues for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission. Little is known, however, regarding the magnitude and determinants of household transmission in increasingly vaccinated populations. METHODS From September 2020 to January 2022, symptomatic nonhospitalized individuals with SARS-CoV-2 infection by RNA detection were identified within 5 days of symptom onset; all individuals resided with at least 1 other SARS-CoV-2-uninfected household member. These infected persons (cases) and their household members (contacts) were subsequently followed with questionnaire-based measurement and serial nasal specimen collection. The primary outcome was SARS-CoV-2 infection among contacts. RESULTS We evaluated 42 cases and their 74 household contacts. Among the contacts, 32 (43%) became infected, of whom 5 (16%) were asymptomatic; 81% of transmissions occurred by 5 days after the case's symptom onset. From 21 unvaccinated cases, 14-day cumulative incidence of SARS-CoV-2 infection among contacts was 18/40 (45% [95% confidence interval {CI}, 29%-62%]), most of whom were unvaccinated. From 21 vaccinated cases, 14-day cumulative incidence of SARS-CoV-2 infection was 14/34 (41% [95% CI, 25%-59%]) among all contacts and 12/29 (41% [95% CI, 24%-61%]) among vaccinated contacts. At least 1 comorbid condition among cases and 10 or more days of RNA detection in cases were associated with increased risk of infection among contacts. CONCLUSIONS Among households including individuals with symptomatic SARS-CoV-2 infection, both vaccinated-to-vaccinated and unvaccinated-to-unvaccinated transmission of SARS-CoV-2 to household contacts was common. Because vaccination alone did not notably reduce risk of infection, household contacts will need to employ additional interventions to avoid infection.
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Affiliation(s)
- J Daniel Kelly
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
- Institute for Global Health Sciences, University of California, San Francisco, CA, USA
- F.I. Proctor Foundation, University of California, San Francisco, CA, USA
- San Francisco VA Medical Center, San Francisco, CA, USA
| | - Scott Lu
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
- Institute for Global Health Sciences, University of California, San Francisco, CA, USA
| | - Khamal Anglin
- Institute for Global Health Sciences, University of California, San Francisco, CA, USA
| | | | - Jesus Pineda-Ramirez
- Institute for Global Health Sciences, University of California, San Francisco, CA, USA
| | - Sarah A Goldberg
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | | | | | - Kevin Donohue
- School of Medicine, University of California, San Francisco, CA, USA
| | | | - Mariela Romero
- Institute for Global Health Sciences, University of California, San Francisco, CA, USA
| | - Ruth Diaz Sanchez
- Institute for Global Health Sciences, University of California, San Francisco, CA, USA
| | - Manuella Djomaleu
- School of Medicine, University of California, San Francisco, CA, USA
| | - Sujata Mathur
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Jessica Y Chen
- Institute for Global Health Sciences, University of California, San Francisco, CA, USA
| | - Carrie A Forman
- School of Medicine, Drexel University, Philadelphia, PA, USA
| | - Venice Servellita
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
| | - Rubi D Montejano
- School of Medicine, University of California, San Francisco, CA, USA
| | - Joshua R Shak
- San Francisco VA Medical Center, San Francisco, CA, USA
| | - George W Rutherford
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
- Institute for Global Health Sciences, University of California, San Francisco, CA, USA
| | - Steven G Deeks
- Division of HIV, Infectious Diseases and Global Medicine, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA
| | - Glen R Abedi
- Respiratory Viruses Branch, Division of Viral Diseases, CDC, Atlanta, GA, USA
| | - Melissa A Rolfes
- Respiratory Viruses Branch, Division of Viral Diseases, CDC, Atlanta, GA, USA
| | - Sharon Saydah
- Respiratory Viruses Branch, Division of Viral Diseases, CDC, Atlanta, GA, USA
| | | | - Michael J Peluso
- Division of HIV, Infectious Diseases and Global Medicine, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA
| | - Charles Chiu
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
| | - Claire M Midgley
- Respiratory Viruses Branch, Division of Viral Diseases, CDC, Atlanta, GA, USA
| | - Raul Andino
- Department of Microbiology and Immunology, UCSF
| | - Jeffrey N Martin
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
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Peluso MJ, Spinelli MA, Deveau TM, Forman CA, Munter SE, Mathur S, Tang AF, Lu S, Goldberg SA, Arreguin MI, Hoh R, Tai V, Chen JY, Martinez EO, Yee BC, Chenna A, Winslow JW, Petropoulos CJ, Sette A, Weiskopf D, Kumar N, Lynch KL, Hunt PW, Durstenfeld MS, Hsue PY, Kelly JD, Martin JN, Glidden DV, Gandhi M, Deeks SG, Rutishauser RL, Henrich TJ. Postacute sequelae and adaptive immune responses in people with HIV recovering from SARS-COV-2 infection. AIDS 2022; 36:F7-F16. [PMID: 35866847 PMCID: PMC9444925 DOI: 10.1097/qad.0000000000003338] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Limited data are available on the long-term clinical and immunologic consequences of SARS-CoV-2 infection in people with HIV (PWH). METHODS We measured SARS-CoV-2-specific humoral and cellular responses in people with and without HIV recovering from COVID-19 ( n = 39 and n = 43, respectively) using binding antibody, surrogate virus neutralization, intracellular cytokine staining, and inflammatory marker assays. We identified individuals experiencing postacute sequelae of SARS-CoV-2 infection (PASC) and evaluated immunologic parameters. We used linear regression and generalized linear models to examine differences by HIV status in the magnitude of inflammatory and virus-specific antibody and T-cell responses, as well as differences in the prevalence of PASC. RESULTS Among PWH, we found broadly similar SARS-CoV-2-specific antibody and T-cell responses as compared with a well matched group of HIV-negative individuals. PWH had 70% lower relative levels of SARS-CoV-2-specific memory CD8 + T cells ( P = 0.007) and 53% higher relative levels of PD-1+ SARS-CoV-2-specific CD4 + T cells ( P = 0.007). Higher CD4 + /CD8 + ratio was associated with lower PD-1 expression on SARS-CoV-2-specific CD8 + T cells (0.34-fold effect, P = 0.02). HIV status was strongly associated with PASC (odds ratio 4.01, P = 0.008), and levels of certain inflammatory markers (IL-6, TNF-alpha, and IP-10) were associated with persistent symptoms. CONCLUSION We identified potentially important differences in SARS-CoV-2-specific CD4 + and CD8 + T cells in PWH and HIV-negative participants that might have implications for long-term immunity conferred by natural infection. HIV status strongly predicted the presence of PASC. Larger and more detailed studies of PASC in PWH are urgently needed.
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Affiliation(s)
- Michael J. Peluso
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, CA, USA
| | - Matthew A. Spinelli
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, CA, USA
| | - Tyler-Marie Deveau
- Division of Experimental Medicine, University of California, San Francisco, CA, USA
| | - Carrie A. Forman
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, CA, USA
| | - Sadie E. Munter
- Division of Experimental Medicine, University of California, San Francisco, CA, USA
| | - Sujata Mathur
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Alex F. Tang
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, CA, USA
| | - Scott Lu
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Sarah A. Goldberg
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Mireya I. Arreguin
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, CA, USA
| | - Rebecca Hoh
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, CA, USA
| | - Viva Tai
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, CA, USA
| | - Jessica Y. Chen
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, CA, USA
| | - Enrique O. Martinez
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, CA, USA
| | | | - Ahmed Chenna
- Monogram Biosciences, South San Francisco, CA, USA
| | | | | | - Alessandro Sette
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology (LJI), La Jolla, CA, USA
- Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego, La Jolla, CA, USA
| | - Daniella Weiskopf
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology (LJI), La Jolla, CA, USA
| | - Nitasha Kumar
- Division of Experimental Medicine, University of California, San Francisco, CA, USA
| | - Kara L. Lynch
- Division of Laboratory Medicine, University of California, San Francisco, CA, USA
| | - Peter W. Hunt
- Division of Experimental Medicine, University of California, San Francisco, CA, USA
| | | | - Priscilla Y. Hsue
- Division of Cardiology, University of California, San Francisco, CA, USA
| | - J. Daniel Kelly
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Jeffrey N. Martin
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - David V. Glidden
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Monica Gandhi
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, CA, USA
| | - Steven G. Deeks
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, CA, USA
| | | | - Timothy J. Henrich
- Division of Experimental Medicine, University of California, San Francisco, CA, USA
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Lin JX, Wu D, Jiang YM, Chen JY, Lin GT, Li P, Xie JW, Wang JB, Lu J, Chen QY, Cao LL, Zheng CH, Huang CM. [Effect of splenic hilar lymphadenectomy on locally advanced Siewert type Ⅱ and Ⅲ adenocarcinoma of esophagogastric junction with a tumor diameter ≥4 cm: a five-year survival analysis]. Zhonghua Wai Ke Za Zhi 2022; 60:853-859. [PMID: 36058712 DOI: 10.3760/cma.j.cn112139-20220415-00167] [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 examine the long term outcome of splenic hilar lymphadenectomy (SHL) for locally advanced Siewert type Ⅱ and Ⅲ adenocarcinoma of esophagogastric junction (AEG) with a tumor diameter ≥4 cm. Methods: A total of 489 locally advanced Siewert type Ⅱ and Ⅲ AEG patients with a tumor diameter ≥4 cm who underwent radical resection from January 2010 to April 2016 were included. There were 383 males and 106 females. There were 225 patients aged≥65 years and 264 patients aged <65 years. SHL was conducted in 270 patients(SHL group). Wilcoxon rank-sum test or χ2 test were conducted for inter-group comparison. Cox proportional hazard regression was used to analyze the long term outcome of SHL and the prognosis factors of overall survival. Kaplan-Meier curve was drawn finally. The results of survival analysis were verified by Log-rank test. Results: Followed-up to April 2021,the median follow-up time was 78.0 months (range: 74.0 to 85.0 months), the follow-up rate was 95.5%(467/489). The splenic hilar lymphnode metastasis rate of the SHL group was 12.6% (34/270). Younger patients (<65 years old), less complications, higher proportion of patients received adjuvant chemotherapy were demonstrated in the SHL group (χ2: 5.644 to 6.744, all P<0.05). Multivariate analysis showed that SHL was the independent prognosis factor of overall survival for patients with Siewert type Ⅱ and Ⅲ AEG and a tumor diameter≥4 cm (HR=0.68, 95%CI: 0.52 to 0.88, P=0.004) along with preoperative CA19-9, pathological T stage, pathological N stage, adjuvant chemotherapy and postoperative complication. Further subgroup analysis demonstrated that the SHL group had better 5-year overall survival than non-SHL group (62.4% vs. 39.2%, χ2=17.983, P=0.006) in Siewert type Ⅲ AEG rather than in Siewert type Ⅱ AEG(57.3% vs. 53.7%, χ2=3.031, P=0.805). Conclusion: In experienced center, splenic hilar lymphadenectomy can improve the prognosis of Siewert type Ⅲ AEG with a tumor diameter ≥4 cm.
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Affiliation(s)
- J X Lin
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Gastrointestinal Cancer, (Ministry of Education), Fuzhou 350001, China
| | - D Wu
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Gastrointestinal Cancer, (Ministry of Education), Fuzhou 350001, China
| | - Y M Jiang
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Gastrointestinal Cancer, (Ministry of Education), Fuzhou 350001, China
| | - J Y Chen
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Gastrointestinal Cancer, (Ministry of Education), Fuzhou 350001, China
| | - G T Lin
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Gastrointestinal Cancer, (Ministry of Education), Fuzhou 350001, China
| | - P Li
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Gastrointestinal Cancer, (Ministry of Education), Fuzhou 350001, China
| | - J W Xie
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Gastrointestinal Cancer, (Ministry of Education), Fuzhou 350001, China
| | - J B Wang
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Gastrointestinal Cancer, (Ministry of Education), Fuzhou 350001, China
| | - J Lu
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Gastrointestinal Cancer, (Ministry of Education), Fuzhou 350001, China
| | - Q Y Chen
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Gastrointestinal Cancer, (Ministry of Education), Fuzhou 350001, China
| | - L L Cao
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Gastrointestinal Cancer, (Ministry of Education), Fuzhou 350001, China
| | - C H Zheng
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Gastrointestinal Cancer, (Ministry of Education), Fuzhou 350001, China
| | - C M Huang
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Key Laboratory of Gastrointestinal Cancer, (Ministry of Education), Fuzhou 350001, China
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Liu FF, Chen JY, Zhang H, Wang YD, Jiang JZ, Hu J, Zhu ZF, Chen Y, Chu Q. [Incidence and risk factors of thromboembolism in patients with lung cancer receiving immunotherapy]. Zhonghua Yi Xue Za Zhi 2022; 102:2489-2494. [PMID: 36008318 DOI: 10.3760/cma.j.cn112137-20220124-00175] [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 evaluate the incidence of thromboembolism in a cohort of patients with lung cancer who received immune checkpoint inhibitors (ICIs), and explore relevant clinical risk factors. Methods: We retrospectively collected and analyzed the clinical data of patients with confirmed primary lung cancer and treated with ICIs between March 2018 and June 2021 at three hospitals in China (Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Fudan University Shanghai Cancer Center and Zhongshan Hospital of Fudan University). The cumulative incidence and risk factors of thromboembolism in these patients were analyzed using a competitive risk model. Results: A total of 804 patients were enrolled, there were 623 males and 181 females, with a median age of 59 years (ranged 28-86 years). Of these, 62 patients encountered 65 thromboembolic events, including 51 venous thromboembolism events (VTE) and 14 arterial thromboembolism events. The cumulative incidence of thromboembolism events at 3, 6, 12 and 24 months were 4.3%, 6.1%, 10.1% and 16.8%, respectively. And the cumulative incidence of venous thromboembolism events at 3, 6, 12 and 24 months were 3.4%, 4.7%, 9.0% and 13.3%, respectively. Multivariate analysis showed that history of thromboembolism (HR=6.345, 95%CI: 2.917-13.802,P<0.001),liver metastasis (HR=2.249, 95%CI: 1.123-4.502,P=0.022) and peripherally inserted central venous catheter (HR=3.674, 95%CI: 1.751-7.712, P<0.001) were independent risk factors for venous thromboembolism during ICIs therapy in patients with lung cancer. Conclusions: Patients with lung cancer under ICIs therapy are at high risk of thromboembolism. And history of thromboembolism, liver metastasis and peripherally inserted central venous catheter are risk factors of venous thromboembolism.
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Affiliation(s)
- F F Liu
- Department of Oncology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - J Y Chen
- Department of Oncology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - H Zhang
- Department of Oncology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Y D Wang
- School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - J Z Jiang
- Department of Oncology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - J Hu
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Z F Zhu
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China
| | - Y Chen
- Department of Oncology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Q Chu
- Department of Oncology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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Wang LL, Yang HX, Chen JY, Fan LX, Zhang XX. [Prediction and analysis of adverse pregnancy outcomes in pregnant women with cesarean scar diverticulum]. Zhonghua Fu Chan Ke Za Zhi 2022; 57:587-593. [PMID: 36008285 DOI: 10.3760/cma.j.cn112141-20220107-00011] [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 pregnancy outcomes of pregnant women with cesarean scar diverticulum (CSD) and to find the relevant factors that predict the occurrence of adverse pregnancy outcomes. Methods: From January 2015 to March 2019, 501 singleton pregnant women with a history of cesarean section who underwent regular prenatal examination in early pregnancy and eventually delivered in Peking University First Hospital were prospectively collected. According to the presence or absence of CSD in the first trimester of pregnancy, the pregnant women were divided into the CSD group (n=127, 25.3%) and the non-CSD group (n=374, 74.7%). According to the mode of delivery and the classification of the lower uterine segment seen during cesarean section, the CSD group was further divided into the non-rupture group (including spontaneous delivery and lower uterine segment grade Ⅰ;n=108, 85.0%) and rupture group (including lower uterine segment grade Ⅱ-Ⅳ;n=19, 15.0%). The general clinical data, pregnancy outcomes, diverticulum-related indexes [including length, width, depth (D), average diameter, volume, and residual myometrial thickness (RMT)] were compared. The predictive values of D/adjacent myometrial thickness≥50%, RMT≤2.2 mm and D/RMT>1.3 for uterine rupture in CSD pregnant women were verified. Results: (1) Comparison between CSD group and non-CSD group: the lower uterine segment thickness in the third trimester of pregnancy in the CSD group was lower than that in the non-CSD group [(1.2±0.5) vs (1.4±0.6) mm, respectively], and the incidence of uterine rupture was higher than that in the non-CSD group [15.0% (19/127) vs 8.0% (30/374), respectively], and the differences were statistically significant (both P<0.05). There were no significant differences in other clinical data and pregnancy outcomes between the two groups (all P>0.05). (2) Comparison of rupture group and non-rupture group: the lower uterine segment thickness in the third trimester of pregnancy in rupture group [(0.6±0.5) mm] was lower than that in non-rupture group [(1.2±0.6) mm], and the difference was statistically significant (t=3.486, P=0.001). There were no significant differences in diverticulum-related indexes between the two groups (all P>0.05). (3) Relationship between high risk predictors of uterine rupture and actual uterine rupture: the sensitivity of D/adjacent muscle thickness ≥50%, RMT≤2.2 mm and D/RMT>1.3 in predicting the high risk of uterine rupture were 94.7%, 57.9% and 73.6%, the specificity were 12.0%, 40.7% and 24.1%, the positive predictive value were 15.9%, 14.7%, 14.6%, and the negative predictive value were 92.8%, 84.6%, 83.9%, respectively. Conclusions: The risk of uterine rupture in pregnant women with CSD is higher than that in those without CSD. There is no significant correlation between CSD related indexes and uterine rupture in the first trimester. Monitoring the lower uterine segment thickness in the third trimester might be helpful to predict the occurrence of adverse pregnancy outcomes.
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Affiliation(s)
- L L Wang
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China
| | - H X Yang
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China
| | - J Y Chen
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China
| | - L X Fan
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China
| | - X X Zhang
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China
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Lin GT, Chen JY, Wu D, Lin JX, Huang CM. [Quality of life after totally laparoscopic versus laparoscopic-assisted total gastrectomy: a retrospective cohort study with propensity score matching]. Zhonghua Wei Chang Wai Ke Za Zhi 2022; 25:699-707. [PMID: 35970804 DOI: 10.3760/cma.j.cn441530-20220301-00074] [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 evaluate the postoperative quality of life in patients after totally laparoscopic total gastrectomy (TLTG). Methods: A retrospective cohort study based on propensity score matching was performed. Clinical and follow-up data of patients who underwent laparoscopic radical gastrectomy at Union Hospital of Fujian Medical University from January 2014 to May 2015 were collected. Case indusion criteria: (1) primary gastric cancer confirmed by postoperative pathology; (2) receiving TLTG or laparoscopic-assisted total gastrectomy (LATG);(3) R0 resection; (4) completing follow-up for 12 months and complete follow-up data. Exclusion criteria: (1) gastric stump cancer; (2) concurrent tumor; (3) distal metastasis found during operation; (4) history of upper abdominal operation. According to surgical procedures, patients were divided into the LATG group (1076 cases) and the TLTG group (106 cases). To eliminate potential bias in baseline data between the two groups, the propensity score was calculated using a logistic regression model with the following covariates, including age, sex, body mass index, American Society of Anesthesiologists score, tumor location, tumor size, pathology type, and stage. The two groups were matched using a 1:2 propensity assessment ratio and a caliper width of 0.01 standard deviation was specified. The primary outcomes were the quality of life of the two groups at 3, 6 and 12 months after gastrectomy, including physical symptoms and social function. Higher function score indicated better function, and higher symptom score presented worse symptoms. Quality of life score = (100 - somatic symptom scale score + social function scale score) / 2. The secondary outcomes were postoperative nutritional recovery and food tolerance at 3, 6 and 12 months after gastrectomy. The categorical variables were expressed as n(%), and compared using the χ2 test or Fisher exact test. The continuous variables conforming to the normal distribution were represented by Mean ± SD and compared with the paired t-test. Repeated measurement of variance was used to compare nutrition-related indicators within the group among pre-operation, postoperative 1, 3, 6, 12 months. Results: After PSM, there were no significant differences in clinicopathological baseline data between the TLTG group (n=104) and the LATG group (n=208) (all P>0.05). The physical symptoms scores in the TLTG group before operation and 3, 6 and 12 months after operation were 8.6±5.8, 15.5±8.4, 10.1±5.9 and 6.1±2.4 respectively (F=43.493, P<0.001). In the LATG group, the above mentioned scores were 9.7±6.9, 23.7±10.4, 13.3±8.3 and 8.5±4.2 respectively (F=112.588, P<0.001). Compared with the LATG group, the symptom scores in the TLTG group were lower at 3 and 6 months after operation, and the differences were statistically significant (t=-3.653, P<0.001; t=-2.513, P=0.012). At 12 months after operation, although the physical symptom score in the TLTG group was also lower than that in LATG group, the difference was not statistically significant (t=-1.487, P=0.138). The social function scores in the TLTG group before operation and 3, 6 and 12 months after operation were 90.3±8.9, 77.5±14.3, 87.4±10.3 and 91.7±6.7 respectively (F=28.524, P<0.001). In the LATG group, the above mentioned scores were 92.5±6.3, 68.5±16.8, 79.8±14.7 and 84.7±11.1 respectively (F=57.975, P<0.001). Compared with the LATG group, the social function scores of patients in the LATG group were higher at 3, 6 and 12 months after operation (t=3.543, P<0.001; t=3.216, P=0.001; t=2.235, P=0.026). The total scores of quality of life at 3, 6 and 12 months after operation in the TLTG group were 81.0±15.6, 88.3±8.1 and 93.3±9.1 respectively, and the above mentioned scores in the LATG group were 72.4±13.6, 83.3±11.5 and 88.1±7.7 respectively, whose differences at corresponding time point were all significant between the two groups (all P<0.05). The change of total body mass[(-8.4±1.4)% vs. (-13.2±1.6)%, t=2.273, P=0.024], serum albumin[(-5.1±0.7)% vs. (-7.4±0.8)%,t=2.095, P=0.037], meal quantity [(-15.6±4.7)% vs. (-24.1±6.0)%, t=2.885, P=0.004] and meal times [(20.8±7.1)% vs. (30.6±11.5)%, t=3.043, P<0.001] in the TLTG group were significantly lower than those in the LATG group one year after operation (all P<0.05). At 3, 6 and 12 months after operation, the diet proportions of solid and soft food in the TLTG group were higher than those in the LATG group (all P<0.05). Conclusions: Compared with LATG, patients with gastric cancer undergoing TLTG have better health-related quality of life and faster recovery of nutrition.
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Affiliation(s)
- G T Lin
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350004, China
| | - J Y Chen
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350004, China
| | - D Wu
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350004, China
| | - J X Lin
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350004, China
| | - C M Huang
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350004, China
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Chen ZP, Wu XF, Zheng BW, Chen QL, Yuan T, Zheng R, Chen JY, Kong WF, Wu S, Kang Z, Ren J, Yang QT. [Application of locating supratrochlear artery and supraorbital artery in combined transfrontal and intranasal endoscopic approaches]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2022; 57:931-936. [PMID: 36058658 DOI: 10.3760/cma.j.cn115330-20210805-00526] [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 localization methods of supratrochlear artery (STA) and supraorbital artery (SOA), and to explore the clinical benefit of locating nerve via accompanying vascular localization in combined transfrontal and intranasal endoscopic approaches. Methods: From June 2019 to May 2021, 14 patients, including 11 males and 3 females, aging from 18 to 69 years old, were underwent frontal sinus surgery through the combined transfrontal and intranasal endoscopic approaches in the Department of Otorhinolaryngology Head and Neck Surgery of the Third Affiliated Hospital of Sun Yat-sen University. Before the surgery, localization of STA and SOA was determined by color doppler flow imaging (CDFI), computerized topographic angiography (CTA) and contrast enhanced magnetic resonance angiography (CE-MRA) respectively, and the distances between STA and SOA from facial midline were measured on 28 eyebrows. The position of external incision was determined according to the preoperative localization of STA and SOA. The examination time, cost and postoperative complications of the three methods were recorded. The accuracy of localization at 14 sides was verified by the surgery. GraphPad Prism 8.3 software was used for statistical analysis. Results: STA and SOA could be located by CDFI, CTA and CE-MRA. There was no significant difference in the measurement of the distance between STA and SOA from the facial midline among 3 methods (all P>0.05). Determining the position of external incision according to the localization of STA and SOA could protect both the blood vessels and accompanying nerves. No postoperative complications such as numbness of the forehead skin occurred. The measurement time of CDFI, CTA and CE-MRA was 22.50 (15.75, 30.00), 30.00 (28.00, 34.25) and 48.00 (44.00, 52.75) min (M (Q1, Q3)), respectively (all P<0.05). CDFI incurred the lowest costs and took the shortest time. Conclusions: CDFI is an efficient and economic localization method. The localization of STA and SOA facilitates the precise selection of the position of external incision, protects the accompanying nerve and reduces postoperative complications.
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Affiliation(s)
- Z P Chen
- Department of Ophthalmology and Otorhinolaryngology, the Second People's Hospital of Longgang District, Shenzhen 518112, China
| | - X F Wu
- Department of Otorhinolaryngology Head and Neck Surgery, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - B W Zheng
- Department of Ultrasonography, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - Q L Chen
- Department of Radiology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - T Yuan
- Department of Otorhinolaryngology Head and Neck Surgery, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - R Zheng
- Department of Otorhinolaryngology Head and Neck Surgery, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - J Y Chen
- Department of Otorhinolaryngology Head and Neck Surgery, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - W F Kong
- Department of Otorhinolaryngology Head and Neck Surgery, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - S Wu
- Department of Otorhinolaryngology Head and Neck Surgery, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - Z Kang
- Department of Radiology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - J Ren
- Department of Ultrasonography, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - Q T Yang
- Department of Otorhinolaryngology Head and Neck Surgery, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
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Peluso MJ, Deveau TM, Munter SE, Ryder D, Buck A, Beck-Engeser G, Chan F, Lu S, Goldberg SA, Hoh R, Tai V, Torres L, Iyer NS, Deswal M, Ngo LH, Buitrago M, Rodriguez A, Chen JY, Yee BC, Chenna A, Winslow JW, Petropoulos CJ, Deitchman AN, Hellmuth J, Spinelli MA, Durstenfeld MS, Hsue PY, Kelly JD, Martin JN, Deeks SG, Hunt PW, Henrich TJ. Impact of Pre-Existing Chronic Viral Infection and Reactivation on the Development of Long COVID. medRxiv 2022:2022.06.21.22276660. [PMID: 35898346 PMCID: PMC9327632 DOI: 10.1101/2022.06.21.22276660] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [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] [Indexed: 02/01/2023]
Abstract
The presence and reactivation of chronic viral infections such as Epstein-Barr virus (EBV), cytomegalovirus (CMV) and human immunodeficiency virus (HIV) have been proposed as potential contributors to Long COVID (LC), but studies in well-characterized post-acute cohorts of individuals with COVID-19 over a longer time course consistent with current case definitions of LC are limited. In a cohort of 280 adults with prior SARS-CoV-2 infection, we observed that LC symptoms such as fatigue and neurocognitive dysfunction at a median of 4 months following initial diagnosis were independently associated with serological evidence of recent EBV reactivation (early antigen-D [EA-D] IgG positivity) or high nuclear antigen IgG levels, but not with ongoing EBV viremia. Evidence of EBV reactivation (EA-D IgG) was most strongly associated with fatigue (OR 2.12). Underlying HIV infection was also independently associated with neurocognitive LC (OR 2.5). Interestingly, participants who had serologic evidence of prior CMV infection were less likely to develop neurocognitive LC (OR 0.52) and tended to have less severe (>5 symptoms reported) LC (OR 0.44). Overall, these findings suggest differential effects of chronic viral co-infections on the likelihood of developing LC and predicted distinct syndromic patterns. Further assessment during the acute phase of COVID-19 is warranted. SUMMARY The authors found that Long COVID symptoms in a post-acute cohort were associated with serological evidence of recent EBV reactivation and pre-existing HIV infection when adjusted for participant factors, sample timing, comorbid conditions and prior hospitalization, whereas underlying CMV infection was associated with a decreased risk of Long COVID.
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Affiliation(s)
- Michael J. Peluso
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, CA, USA
| | - Tyler-Marie Deveau
- Division of Experimental Medicine, University of California, San Francisco, CA, USA
| | - Sadie E. Munter
- Division of Experimental Medicine, University of California, San Francisco, CA, USA
| | - Dylan Ryder
- Division of Experimental Medicine, University of California, San Francisco, CA, USA
| | - Amanda Buck
- Division of Experimental Medicine, University of California, San Francisco, CA, USA
| | | | - Fay Chan
- Division of Experimental Medicine, University of California, San Francisco, CA, USA
| | - Scott Lu
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Sarah A. Goldberg
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Rebecca Hoh
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, CA, USA
| | - Viva Tai
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, CA, USA
| | - Leonel Torres
- Division of Experimental Medicine, University of California, San Francisco, CA, USA
| | - Nikita S. Iyer
- Division of Experimental Medicine, University of California, San Francisco, CA, USA
| | - Monika Deswal
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, CA, USA
| | - Lynn H. Ngo
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, CA, USA
| | - Melissa Buitrago
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, CA, USA
| | - Antonio Rodriguez
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, CA, USA
| | - Jessica Y. Chen
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, CA, USA
| | | | - Ahmed Chenna
- Monogram Biosciences Inc., South San Francisco, CA, USA
| | | | | | | | - Joanna Hellmuth
- Department of Neurology, University of California, San Francisco, CA, USA
| | - Matthew A. Spinelli
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, CA, USA
| | | | - Priscilla Y. Hsue
- Division of Cardiology, University of California, San Francisco, CA, USA
| | - J. Daniel Kelly
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Jeffrey N. Martin
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Steven G. Deeks
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, CA, USA
| | - Peter W. Hunt
- Division of Experimental Medicine, University of California, San Francisco, CA, USA
| | - Timothy J. Henrich
- Division of Experimental Medicine, University of California, San Francisco, CA, USA,To whom correspondence should be addressed: Timothy J. Henrich, MD, MMSc, Division of Experimental Medicine, University of California San Francisco, 1001 Potrero Avenue, Bld 3, Rm 525a, San Francisco CA 94110 USA,
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Chen WL, Zhao L, Guo LJ, Liang CY, Chen JY, Chen WH. [Pneumatosis cystoides intestinalis in lung transplant recipients: three cases report and literature review]. Zhonghua Jie He He Hu Xi Za Zhi 2022; 45:671-676. [PMID: 35768375 DOI: 10.3760/cma.j.cn112147-20220106-00022] [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 report the clinical characteristics and treatment courses of pneumatosis cystoides intestinalis(PCI) after lung transplantation(LT). Methods: We included all cases of PCI after LT from March 2017 to June 2021 in China-Japan Friendship Hospital. In addition to our cases, we searched literatures published in Chinese and English languages using China National Knowledge Infrastructure (CNKI), Wanfang Data and PubMed/MEDLINE with the search terms"pneumatosis intestinalis"and"lung transplantation". The clinical characteristics and treatment courses of all cases were summarized and analyzed. Results: Three cases of PCI occurred after LT in this study, with an incidence of 0.804% (3/373). Thirteen related literatures were retrieved, with 51 cases enrolled. The median age of the 54 patients was 55.4 years (22-79 years), with 33 males and 21 females. 64.81% (35/54) of the 54 patients underwent LT for interstitial lung disease and 90.74% (49/54) underwent bilateral LT. Twenty-two cases(40.7%) were asymptomatic when PCI occurred. Thirty-eight cases (38/54,70.37%)had involvement of ascending colon, and 35 cases(35/54,64.81%)had involvement of transverse colon. Forty-three cases(43/54, 79.63%) were treated conservatively. The average interval between transplantation and PCI was 210 (5-2 495) days. Conclusion: PCI is a rare complication after lung transplantation, most often occurring in the colon. Most patients were asymptomatic and could improve by conservative treatments.
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Affiliation(s)
- W L Chen
- Department of Lung Transplantation, Center of Respiratory Medicine, China-Japan Friendship Hospital, National Center for Respiratory Medicine, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Respiratory Diseases, WHO Collaborating Centre for Tobacco Cessation and Respiratory Diseases Prevention, Beijing 100029,China
| | - L Zhao
- Department of Lung Transplantation, Center of Respiratory Medicine, China-Japan Friendship Hospital, National Center for Respiratory Medicine, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Respiratory Diseases, WHO Collaborating Centre for Tobacco Cessation and Respiratory Diseases Prevention, Beijing 100029,China
| | - L J Guo
- Department of Lung Transplantation, Center of Respiratory Medicine, China-Japan Friendship Hospital, National Center for Respiratory Medicine, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Respiratory Diseases, WHO Collaborating Centre for Tobacco Cessation and Respiratory Diseases Prevention, Beijing 100029,China
| | - C Y Liang
- Department of Lung Transplantation, Center of Respiratory Medicine, China-Japan Friendship Hospital, National Center for Respiratory Medicine, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Respiratory Diseases, WHO Collaborating Centre for Tobacco Cessation and Respiratory Diseases Prevention, Beijing 100029,China
| | - J Y Chen
- Department of Lung Transplantation, Center of Respiratory Medicine, China-Japan Friendship Hospital, National Center for Respiratory Medicine, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Respiratory Diseases, WHO Collaborating Centre for Tobacco Cessation and Respiratory Diseases Prevention, Beijing 100029,China
| | - W H Chen
- Department of Lung Transplantation, Center of Respiratory Medicine, China-Japan Friendship Hospital, National Center for Respiratory Medicine, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Respiratory Diseases, WHO Collaborating Centre for Tobacco Cessation and Respiratory Diseases Prevention, Beijing 100029,China
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Chen JY, Liu J, Li Q, Liu WR, Wu W. [Incidental lymphangioleiomyomatosis in pelvic-celiac lymph nodes of gynecological pelvic malignant tumors: a clinicopathological study of 3 cases]. Zhonghua Bing Li Xue Za Zhi 2022; 51:647-649. [PMID: 35785836 DOI: 10.3760/cma.j.cn112151-20211014-00745] [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 Y Chen
- Department of Pathology, the First People's Hospital of Foshan, Foshan 528000, China
| | - J Liu
- Department of Pathology, the First People's Hospital of Foshan, Foshan 528000, China
| | - Q Li
- Department of Pathology, the First People's Hospital of Foshan, Foshan 528000, China
| | - W R Liu
- Department of Pathology, the First People's Hospital of Foshan, Foshan 528000, China
| | - Weiru Wu
- Department of Ultrasound Diagnosis and Treatment Center, the First People's Hospital of Foshan, Foshan 528000, China
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Peng SS, Wu HY, Yang J, Sun QY, Zhou ZY, Shi QY, He L, Chen JY, Fan XS. [Gastric peripheral T-cell lymphoma-not otherwise specified with CD20 and CD79α aberrant expression: report of a case]. Zhonghua Bing Li Xue Za Zhi 2022; 51:667-669. [PMID: 35785843 DOI: 10.3760/cma.j.cn112151-20220121-00051] [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)
- S S Peng
- Department of Pathology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China Department of Pathology, Nanjing Jiangbei Hospital, Nanjing 210044, China
| | - H Y Wu
- Department of Pathology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - J Yang
- Department of Pathology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - Q Y Sun
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing 210008, China
| | - Z Y Zhou
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing 210008, China
| | - Q Y Shi
- Department of Pathology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - L He
- Department of Pathology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - J Y Chen
- Department of Pathology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - X S Fan
- Department of Pathology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
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Wu N, Chen JY, Shen WD, Yang SM. [Resection of schwannoma in the jugular foramen invading cerebellar pontine angle by the presigmoid-retrofacial-infralabyrinth approach: a case report]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2022; 57:882-885. [PMID: 35866284 DOI: 10.3760/cma.j.cn115330-20211013-00664] [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)
- N Wu
- Senior Department of Otolaryngology-Head and Neck Surgery, the Sixth Medical Center of PLA General Hospital, Beijing 100037, China National Clinical Research Center for Otolaryngologic Diseases, Beijing 100037, China Department of Otolaryngology Head and Neck Surgery, the First Medical Center of PLA General Hospital, Beijing 100853, China State Key Lab of Hearing Science, Ministry of Education, Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing 100853, China
| | - J Y Chen
- Senior Department of Otolaryngology-Head and Neck Surgery, the Sixth Medical Center of PLA General Hospital, Beijing 100037, China National Clinical Research Center for Otolaryngologic Diseases, Beijing 100037, China Department of Otolaryngology Head and Neck Surgery, the First Medical Center of PLA General Hospital, Beijing 100853, China State Key Lab of Hearing Science, Ministry of Education, Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing 100853, China
| | - W D Shen
- Senior Department of Otolaryngology-Head and Neck Surgery, the Sixth Medical Center of PLA General Hospital, Beijing 100037, China National Clinical Research Center for Otolaryngologic Diseases, Beijing 100037, China Department of Otolaryngology Head and Neck Surgery, the First Medical Center of PLA General Hospital, Beijing 100853, China State Key Lab of Hearing Science, Ministry of Education, Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing 100853, China
| | - S M Yang
- Senior Department of Otolaryngology-Head and Neck Surgery, the Sixth Medical Center of PLA General Hospital, Beijing 100037, China National Clinical Research Center for Otolaryngologic Diseases, Beijing 100037, China Department of Otolaryngology Head and Neck Surgery, the First Medical Center of PLA General Hospital, Beijing 100853, China State Key Lab of Hearing Science, Ministry of Education, Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing 100853, China
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H, Sandberg C, Smith H, Al Bakry M, Ashwell W, Bajaj S, Bandyopadhyay D, Browlee O, Burway S, Chand CP, Elsayeh K, Elsharkawi A, Evans E, Ferrin S, Fort-Schaale A, Iacob M, I K, Impelliziere Licastro G, Mankoo AS, Olaniyan T, Otun J, Pereira R, Reddy R, Saeed D, Simmonds O, Singhal G, Tron K, Wickstone C, Williams R, Bradshaw E, De Kock Jewell V, Houlden C, Knight C, Metezai H, Mirza-Davies A, Seymour Z, Spink D, Wischhusen S. Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study. Lancet Digit Health 2022; 4:e520-e531. [PMID: 35750401 DOI: 10.1016/s2589-7500(22)00069-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 01/07/2022] [Accepted: 04/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications. METHODS We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC). FINDINGS In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]). INTERPRETATION In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required. FUNDING British Journal of Surgery Society.
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Wu F, Li SC, Ma QL, Wang YB, Peng WW, Chen M, Chen JY, Xiang ML. First Report of Fusarium oxysporum Causing Fruit Rot on Apricot ( Prunus armeniaca) in China. Plant Dis 2022; 106:PDIS09211967PDN. [PMID: 35084945 DOI: 10.1094/pdis-09-21-1967-pdn] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- F Wu
- College of Agronomy, Jiangxi Agricultural University, Collaborative Innovation Center of Postharvest Key Technology and Quality Safety of Fruits and Vegetables in Jiangxi Province, Jiangxi Key Laboratory for Postharvest Technology and Non-destructive Testing of Fruits & Vegetables, Nanchang, Jiangxi 330045, China
| | - S C Li
- College of Agronomy, Jiangxi Agricultural University, Collaborative Innovation Center of Postharvest Key Technology and Quality Safety of Fruits and Vegetables in Jiangxi Province, Jiangxi Key Laboratory for Postharvest Technology and Non-destructive Testing of Fruits & Vegetables, Nanchang, Jiangxi 330045, China
| | - Q L Ma
- College of Agronomy, Jiangxi Agricultural University, Collaborative Innovation Center of Postharvest Key Technology and Quality Safety of Fruits and Vegetables in Jiangxi Province, Jiangxi Key Laboratory for Postharvest Technology and Non-destructive Testing of Fruits & Vegetables, Nanchang, Jiangxi 330045, China
| | - Y B Wang
- College of Agronomy, Jiangxi Agricultural University, Collaborative Innovation Center of Postharvest Key Technology and Quality Safety of Fruits and Vegetables in Jiangxi Province, Jiangxi Key Laboratory for Postharvest Technology and Non-destructive Testing of Fruits & Vegetables, Nanchang, Jiangxi 330045, China
| | - W W Peng
- College of Agronomy, Jiangxi Agricultural University, Collaborative Innovation Center of Postharvest Key Technology and Quality Safety of Fruits and Vegetables in Jiangxi Province, Jiangxi Key Laboratory for Postharvest Technology and Non-destructive Testing of Fruits & Vegetables, Nanchang, Jiangxi 330045, China
| | - M Chen
- College of Agronomy, Jiangxi Agricultural University, Collaborative Innovation Center of Postharvest Key Technology and Quality Safety of Fruits and Vegetables in Jiangxi Province, Jiangxi Key Laboratory for Postharvest Technology and Non-destructive Testing of Fruits & Vegetables, Nanchang, Jiangxi 330045, China
| | - J Y Chen
- College of Agronomy, Jiangxi Agricultural University, Collaborative Innovation Center of Postharvest Key Technology and Quality Safety of Fruits and Vegetables in Jiangxi Province, Jiangxi Key Laboratory for Postharvest Technology and Non-destructive Testing of Fruits & Vegetables, Nanchang, Jiangxi 330045, China
- Pingxiang University, Pingxiang, Jiangxi 337055, China
| | - M L Xiang
- College of Agronomy, Jiangxi Agricultural University, Collaborative Innovation Center of Postharvest Key Technology and Quality Safety of Fruits and Vegetables in Jiangxi Province, Jiangxi Key Laboratory for Postharvest Technology and Non-destructive Testing of Fruits & Vegetables, Nanchang, Jiangxi 330045, China
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