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1.
Article in Chinese | WPRIM | ID: wpr-912149

ABSTRACT

Objective:To investigate the clinical application value of magnetically controlled capsule endoscopy (MCCE) for risk assessment of upper gastrointestinal bleeding in elderly patients taking enteric-coated aspirin.Methods:Clinical data of elderly patients taking enteric-coated aspirin and undergoing MCCE from January 2018 to December 2020 in Beijing Chaoyang and Beijing Anzhen Hospital, Capital Medical University were analyzed. Patients were divided into low-risk group (scores ≤ 3) and moderate/high risk group (scores >3) to study the risk assessment of upper gastrointestinal bleeding in elderly patients taking enteric-coated aspirin.Results:A total of 66 patients (aged 60-81 years, 45 males and 21 females) were enrolled and 17 patients developed bleeding. The indicators of low-risk ( n=51) and moderate/high risk groups ( n=15) were as follows: the incidences of upper gastrointestinal bleeding were 17.6% and 53.3%( P<0.001), gastric ulcer 5.9% and 26.7% ( P<0.001), median gastric Lanza score 2.0 and 2.0( P=0.621), duodenal ulcer 2.0% and 18.8% ( P<0.001), median duodenal mucosal injury score 1.0 and 1.0( P=0.936), respectively. Receiver operator characteristic curve showed that the area under the curve of risk assessment of upper gastrointestinal bleeding in elderly patients taking enteric-coated aspirin by MCCE was 0.855. Conclusion:Risk assessment of upper gastrointestinal bleeding in elderly patients taking enteric-coated aspirin can be used to predict the risk of upper gastrointestinal bleeding, but the scoring rules need to be further improved. Moderate and high-risk patients should undergo MCCE to monitor aspirin related upper gastrointestinal mucosal injury.

2.
Article in Chinese | WPRIM | ID: wpr-911675

ABSTRACT

Objective:To compare the results of three detection methods, single antigen-bead assay(SAB), Luminex screening assay(LMX), and ELISA assay for detecting HLA antibody, and compares the two screening methods, LMX and ELISA with SAB detection as a reference method to provide a reference for organ transplantation laboratories to choose a reasonable HLA antibody test strategy.Methods:A lot of 124 consecutive samples were tested using SAB, ELISA, and LMX methods at the same time, and analyze the differences of these results. SAB testing was used as a reference method to analyze the sensitivity and specificity of the two screening assays. Chi-square analysis was used to compare the two methods, and P<0.05 was considered statistically significant. Results:Both ELISA and LMX methods showed low sensitivity of 34.4% and 31.3% for HLA class I, and 29.7% and 51.3% for class Ⅱ. Otherwise, the specificity of the ELISA and LMX method was much higher. For class, I both was 98.9%, and for class Ⅱ were 100% and 91.9% respectively. Out of 124 samples, the number of SAB(+ )ELISA(-)LMX(-) results was 17, and SAB(-)ELISA(+ )LMX(+ ) results was zero indicating that there were considerably screening assays probably with missed detection. In the cases of SAB(+ )ELISA(-)LMX(-), the distribution of MFI value of SAB assay ranges from 750 to 7000.Conclusions:Because the sensitivity of the two screening methods is relatively low, there is a greater risk of missed antibody detection in the scheme of testing for specific antibodies after the screening test is positive. This should be paid attention to, especially for patients with a history of sensitization. For negative screening test results, SAB or other assays should be considered to check the result. It could provide more accurate results when SAB which is recognized as higher sensitivity and specificity is directly used as an initial test. At the same time, the MFI value of the SAB test can serve as an indicator to determine whether to add other assays to check the ASB result.

3.
Chinese Journal of Dermatology ; (12): 1001-1004, 2021.
Article in Chinese | WPRIM | ID: wpr-911562

ABSTRACT

Objective:To deliver understanding of the latest research progress on clinical trials and approval of dermatological drugs in China in 2020.Methods:A registration and information disclosure platform for drug clinical studies and a query system for domestic and imported drugs in the National Medical Products Administration of China were searched for registered clinical trials and approved dermatological drugs, respectively. The number and stages of clinical trials, indications and classification of involved products, and listed dermatological drugs in 2020 were summarized and depicted.Results:There were 157 dermatological drug trials registered in China in 2020, accounting for 6.16% of all the 2 548 clinical drug trials, including 127 (80.9%) initiated by Chinese pharmaceutical enterprises and 25 (15.9%) international multicenter trials. Among the 127 drug trials initiated by Chinese pharmaceutical enterprises, bioequivalence trials were mostly common, accounting for 55.9% (71/127) . Compared with global pharmaceutical enterprises, domestic pharmaceutical companies initiated significantly decreased proportions of international multicenter trials (1.9% [3/157] vs. 14.0% [22/157], P < 0.001) , but significantly increased proportions of phaseⅠclinical trials and bioequivalence trials (24.4% [31/127] vs. 10.0% [3/30], 55.9% [71/127] vs. 0, respectively, both P < 0.001) . Totally, 90 kinds of dermatological drug were involved in all the trials, psoriasis, atopic dermatitis and melanoma were the most common indications, and innovative drugs accounted for 53.3% (48/90) ; the proportion of innovative drugs was significantly lower in domestic pharmaceutical companies than in global pharmaceutical companies (43.2% [32/74] vs. 16/16, P < 0.001) . In addition, 28 dermatological drugs developed by 22 pharmaceutical companies were approved in China in 2020, of which 21 drugs were developed by domestic pharmaceutical companies. Conclusion:Clinical drug trials carried out by domestic pharmaceutical companies mostly focus on generic drugs, and it is still necessary for domestic pharmaceutical companies to further improve the innovation ability.

4.
Chinese Journal of Urology ; (12): 550-553, 2021.
Article in Chinese | WPRIM | ID: wpr-911070

ABSTRACT

Exosomes are widely distributed in various body fluids. They are extracellular vesicles with a diameter of 30-100nm that contain a variety of biologically active substances. They play an important role in a variety of biological processes such as tumor invasion, migration and immune escape. With the progress of research, exosomes derived from bladder cancer have shown great potential in the early diagnosis and treatment of bladder cancer. This article reviews the main biological characteristics of exosomes and their new developments in the diagnosis and treatment of bladder cancer.

5.
Chinese Journal of Urology ; (12): 548-549, 2021.
Article in Chinese | WPRIM | ID: wpr-911069

ABSTRACT

Urethral fistula caused by anterior urethral valve combined with penile curvature is a rare clinical disease, which is rarely reported at home and abroad. We diagnosed 2 cases, treated with urethral diverticulum resection + urethral valve resection + dorsal albuginea of the penis + Duplay one-stage urethroplasty and urethral diverticulum resection + urethral valve resection + penis Dorsal albuginea fold + Duckett one-stage urethroplasty respectively. There were no surgical complications such as penile recurvation, urinary fistula, urethral stricture or urethral diverticulum, during the follow-up period of 10 and 15 months.

6.
Article in Chinese | WPRIM | ID: wpr-910790

ABSTRACT

Objective:To investigate the therapeutic effect of levo-thyroxine ( L-T 4) gel on hypothyroidism in rat model. Methods:A total of 30 Wistar rats (15 males, 15 females, 2-month age) were completely randomized into 6 groups ( n=5 per group) with one group as the normal control and the other 5 groups were established as the hypothyroidism models by intraperitoneal injection of 18.5 MBq 131I. Of the 5 hypothyroidism groups, 3 groups were given 0.2 g (high-dose group), 0.1 g (medium-dose group) and 0.05 g (low-dose group) L-T 4 gel per 100 g body mass on alternate days, respectively, one group was given 0.1 g blank gel per 100 g body mass daily and the other group was given 5 μg levo-thyroxine sodium tablets (Euthyrox) per 100 g body mass daily. The levels of total thyroxine (TT 4), free triiodothyronine (FT 3), free thyroxine (FT 4) and thyroid stimulating hormone (TSH) in serum were determined by radioimmunoassay and chemiluminescence immunoassay at 2, 4 and 8 weeks after administration, respectively. One-way analysis of variance and Bonferroni test were used for data analysis. Results:At 2 weeks after administration, compared with the normal control group, TT 4, FT 4 decreased and TSH increased in the oral Euthyrox group (TT 4: (65.04±8.20) vs (40.34±1.41) nmol/L, FT 4: (29.63±4.03) vs (18.03±2.76) pmol/L, TSH: (6.04±0.80) vs (10.07±1.01) mU/L; F values: 60.081-108.128, t values: from -4.44 to 4.86, all P<0.05). However, TT 4 ((67.88±14.27) nmol/L), FT 3 ((4.04±0.84) vs (4.45±0.34) pmol/L), FT 4 ((33.76±7.71) pmol/L) and TSH ((8.20±0.40) mU/L) in the L-T 4 gel low-dose group showed no significant differences with the normal control group ( t values: 0.44-2.61, all P>0.05). At 4 weeks after administration, there were no significant differences of TT 4, FT 3, FT 4 and TSH between the L-T 4 gel low-dose group/the oral Euthyrox group and the normal control group ( F values: 34.527-90.976, t values: from -0.95 to 0.35, all P>0.05). The differences of TT 4, FT 3, FT 4 and TSH were not significant between the L-T 4 gel low-dose group and the oral Euthyrox group ( t values: from -0.71 to 1.03, all P>0.05), which was still not significantly different at 8 weeks ( F values: 47.239-160.679, t values: from -0.58 to 1.02, all P>0.05). Conclusions:L-T 4 gel has obvious therapeutic effect on hypothyroidism in rats. Its effect is fast and stable, and its therapeutic effect is better than L-T 4 sodium tablets (Euthyrox).

7.
Article in Chinese | WPRIM | ID: wpr-910528

ABSTRACT

Objective:To explore the motion and influencing factors of implanted gold markers in guiding liver stereotactic body radiation therapy (SBRT) using abdominal compression.Methods:Twenty patients with oligometastatic colorectal cancer or primary hepatocellular carcinoma from January 2016 to December 2019 were included. All patients were treated with SBRT under abdominal compression, with 1-3 gold markers were implanted within 2 cm from the lesion before positioning. Four-dimensional computed tomography (4DCT) scan was used for treatment planning. The respiratory cycle was divided into 0-90% respiratory phase images based on the respiratory signal, which were reconstructed by the system (Pinnacle 3 version 9.1; Philips Medical System, Madison, WI, USA), and cone beam CT validation images before radiation exposure were obtained. The liver volume was divided into 3 parts: within 2 cm from the main hepatic portal vein, 2-5 cm from the main hepatic portal vein, and>5 cm from the main hepatic portal vein. The motion of different tumor locations was evaluated. Results:The average intrafractional motion amplitude was (2.63±2.81) mm in the cranial-caudal (CC) direction, (1.35±1.23) mm in the anterior-posterior (AP) direction, and (0.76±0.88) mm in the left-right (LR) direction, respectively. The average interfractional motion amplitude was (3.45±3.06) mm, (2.64±2.60) mm, and (2.23±2.07) mm, respectively. Both the intra-or inter-fractional motion amplitudes in the CC direction were the highest, followed by those in the AP and LR direction (all P<0.001). The motion varied at different tumor locations. The longer distance from the main hepatic portal vein, the larger the intrafractional motion (all P<0.05). To cover the 95% population-based confidence interval, the internal target volume (ITV) was suggested to include the expansion of 3.9 mm, 5.2 mm and 7.9 mm in the LR, AP and CC direction. The expansion of 4.3 mm, 4.4 mm and 6.1 mm was delivered within 2 cm from the main hepatic portal vein, and 3.5 mm, 7.3 mm and 9.7 mm>5 cm from the main hepatic portal vein, respectively. The expansion varied significantly depending on the tumor location, whereas the motion in the CC direction was the largest regardless of the tumor location. The longer distance of the tumor from the main portal vein, the larger expansion in the CC direction. The expansion of tumor > 5 cm from the main portal vein in the AP direction was larger than that of inner parts. Conclusion:Liver tumors at different locations require individual external expansion of ITV.

8.
Article in Chinese | WPRIM | ID: wpr-910525

ABSTRACT

Objective:To investigate the dosimetric characteristics, acute toxicity and short-term efficacy of postmastectomy hypofractionated internal mammary (IM) chain irradiation with electrons in patients with high-risk breast cancer.Methods:A total of 155 patients with breast cancer who underwent modified mastectomy between November 2018 and January 2020 were selected. Among them, 137(88.4%) patients were classified as stage Ⅲ and 18(11.6%) as stage Ⅱ. All patients received standard chemotherapy, endocrine therapy and anti-Her2 targeted therapy. CTV im was divided into three subregions: CTV im1, CTV im2 and CTV im3, which represented the first, second and third intercostal IM, respectively. The planning target volume of subraclavicular region (PTV sc) was delineated. CTV cw and CTV im were irradiated with 6-15 MeV electron at 43.5 Gy in 15 fractions over 3 weeks. Moreover, PTV sc was irradiated with 6 MV X-ray at 43.5 Gy in 15 fractions over 3 weeks using two-dimensional radiotherapy (2DRT) or three-dimensional radiotherapy (3DRT). The dosimetric characteristics of CTV im, PTV sc, lung, heart, left anterior descending coronary artery (LAD) and right coronary artery (RA) were evaluated, and the acute toxicity and short-term efficacy were analyzed. Results:The mean dose (D mean) of CTV im was (43.3±2.6) Gy, D 95% was (30.5±8.3) Gy, V 90% was (85.0±10.5)% and V 80% was (91.0±7.4)%, respectively. The corresponding parameters of CTV im1 were significantly lower than those of CTV im2 and CTV im3(all P<0.001). Body mass index exerted no significant effect on IM dose ( P>0.05). Compared with 2DRT, 3DRT for SC significantly increased theD mean of CTV im[(43.4±2.6) Gy vs.(41.4±2.3) Gy, P=0.021], and the hot spot within PTV sc[V 110%: (26.7±17.5) cm 3vs.(12.5±8.4) cm 3, P=0.018; V 120%: (6.1±5.3) cm 3vs.(2.0±2.6) cm 3, P=0.023]. TheD mean of the ipsilateral lung was (9.8±1.9) Gy, and V 20Gy was (19.7±4.7)%. TheD mean of heart was (3.3±1.7) Gy in the whole group, (4.7±1.4) Gy for the left-sided breast cancer and (2.6±1.2) Gy for the right-sided breast cancer, respectively. TheD mean of LAD for the left-sided breast cancer was (13.9±4.9) Gy. TheD mean of RA for the right-sided breast cancer was (7.5±3.7) Gy. The incidence rates of ≥ grade 2 acute radiation dermatitis, esophagitis and pneumonitis were 19.3%, 4.5% and 2.6%, respectively. With a median follow-up time of 20.5 months (range: 9.9-41.8 months), 2 cases of chest wall recurrence, 2 regional lymph node recurrence, 6 distant metastases and 1 death were reported. Conclusions:When hypofractionated internal mammary chain is irradiated by electrons after mastectomy, the doses to the lung, heart and coronary artery are low, and the acute toxicities are mild. However, the dose to CTV im1 is inadequate. Although short-term efficacy is high, long-term follow-up is warranted.

9.
Article in Chinese | WPRIM | ID: wpr-910509

ABSTRACT

Objective:To analyze the prognosis of patients with isolated regional recurrence (RR) after mastectomy, and evaluate the efficacy of radiotherapy and identify the optimal radiation target volumes.Methods:Clinical data of 144 patients with first isolated RR after mastectomy between 2001 and 2018 were retrospectively analyzed. All patients had not received post-mastectomy radiotherapy. The primary endpoints consisted of the subsequent locoregional recurrence (sLRR), distant metastasis (DM), progression-free survival (PFS) and overall survival (OS).Results:With a median follow-up of 82.5 months after RR, the 5-year sLRR, DM, PFS and OS rates for the entire group were 42.1%, 71.9%, 22.9% and 62.6%, respectively. Local plus systemic therapy was an independent favorable prognostic factor for sLRR ( P<0.001) and PFS ( P=0.013). The sLRR rate in the surgery plus radiotherapy group was the lowest ( P<0.001). Surgery plus radiotherapy significantly reduced the 5-year risk of recurrence within the initially involved nodal regions ( P<0.001). Patients with chest wall irradiation obtained the 5-year subsequent chest wall recurrence rate of 12.1% compared to 14.8%( P=0.873) for those without chest wall irradiation. The subsequent supraclavicular recurrence rate was lower in patients with prophylactic supraclavicular irradiation than that without prophylactic supraclavicular irradiation (9.9% vs. 23.8%, P=0.206). The incidence rates of initially uninvolved axillary and internal mammary nodal recurrence were below 10% regardless of prophylactic irradiation or not. Conclusions:Patients with RR alone have an optimistic 5-year OS in the contemporary era. Comprehensive locoregional treatment including surgery and radiotherapy combined with systemic therapy is recommended. The chest wall, axillary and internal mammary nodal prophylactic irradiation should not be routinely performed for all patients with RR. The value of supraclavicular prophylactic irradiation remains to be evaluated.

10.
Article in Chinese | WPRIM | ID: wpr-910508

ABSTRACT

Objective:To evaluate the safety and preliminary efficacy of total neoadjuvant therapy (TNT) model of" neoadjuvant chemoradiotherapy plus consolidation neoadjuvant chemotherapy (CNCT) followed by surgery" for locally advanced gastric cancer.Methods:From 2018 to 2020, 28 patients clinically diagnosed with locally advanced gastric adenocarcinoma or Siewert Ⅱ/Ⅲ adenocarcinoma gastroesophageal junction cancer were prospectively enrolled. The neoadjuvant chemoradiotherapy (NCRT) was delivered with a total dose of 45 Gy, 1.8 Gy/f. Concurrent chemotherapy was S-1 at a dose of 40-60 mg twice daily. Then, patients received four to six cycles of CNCT of SOX regimen at three weeks after neoadjuvant chemoradiotherapy. D 2 lymphadenectomy was performed at 4-6 weeks after CNCT. Results:A total of 28 patients completed the whole therapy. Grade 3 or above adverse events occurred in 3 cases (11%) during CCRT, including thrombocytopenia, leukopenia and anorexia; 2 cases (7%) developed leukopenia and 3 cases (11%) of thrombocytopenia during CNCT. Twenty patients (71%) completed the surgery. The proportion of patients with pathological complete remission (pCR) was 50%. Three patients experienced surgical complications including anastomotic leak, anastomotic stenosis and intra-abdominal sepsis. All were recovered after symptomatic treatment.Conclusion:Interim analysis results demonstrate that TNT can yield significant down-staging for patients with locally advanced gastric cancer, which causes tolerable adverse events and postoperative complications.

11.
Article in Chinese | WPRIM | ID: wpr-910489

ABSTRACT

Objective:To investigate the radiation field and dose selection of patients with isolated chest wall recurrence (ICWR) after modified radical mastectomy, and analyze the prognostic factors related to subsequent chest wall recurrence.Methods:Clinical data of 201 patients with ICWR after mastectomy admitted to the Fifth Medical Center, Chinese PLA General Hospital from 1998 to 2018 were retrospectively analyzed. None of the patients received postoperative adjuvant radiotherapy. After ICWR, 48 patients (73.6%) underwent surgery and 155 patients (77.1%) received radiotherapy. Kaplan-Meier method was used to calculate the post-recurrence progression-free survival (PFS) rates and the difference was compared by log-rank test. Multivariate analysis was performed using Cox regression model. Competing risk model was adopted to estimate the subsequent local recurrence (sLR) rates after ICWR and the difference was compared with Gray test. Multivariate analysis was conducted using F&G analysis. Results:With a median follow up of 92.8 months after ICWR, the 5-year PFS rate was 23.2%, and the 5-year sLR rate was 35.7%. Multivariate analysis showed that patients with surgery plus radiotherapy and recurrence interval o F>12 months had a lower sLR rate. Patients with recurrence interval o F>48 months, local plus systemic treatment and surgery plus radiotherapy had a higher PFS rate. Among the 155 patients who received chest wall radiotherapy after ICWR, total chest wall irradiation plus local boost could improve the 5-year PFS rate compared with total chest wall irradiation alone (34.0% vs. 15.4%, P=0.004). Chest wall radiation dose (≤60 Gy vs.>60 Gy) exerted no significant effect upon the sLR and PFS rates (both P>0.05). In the 53 patients without surgery, the 5-year PFS rates were 9.1% and 20.5%( P=0.061) with tumor bed dose ≤60 Gy and>60 Gy, respectively. Conclusions:Local radiotherapy is recommended for patients with ICWR after modified radical mastectomy of breast cancer, including total chest wall radiation plus local boost. The radiation dose for recurrence should be increased to 60 Gy, and it should be above 60 Gy for those who have not undergone surgical resection. In addition, patients with ICWR still have a high risk of sLR, and more effective treatments need to be explored.

12.
Article in Chinese | WPRIM | ID: wpr-910470

ABSTRACT

Objective:To investigate the relationship between gastric filling status and intra-or inter-fractional tumor displacement in patients with adenocarcinoma of the esophagogastric junction (AEG) undergoing preoperative radiotherapy.Methods:From October 2018 to June 2019, 10 patients with locally advanced AEG who received totally neoadjuvant therapy were enrolled in this prospective study. Patients received two markers implanted at the cranial and caudal borders of the tumors under gastroscope and a total of 20 fiducial markers were implanted finally. All patients underwent 4DCT scan under the gastric fasting and filling status. Ten images of 0% to 90% respiratory phase were automatically reconstructed by the system (Pinnacle 3, version 9.1, Philips Medical Systems, Eindhoven, The Netherland). Each patient obtained one hundred sets of images. Results:In the tumors proximal to the chest, gastric filling did not significantly affect intrafractional or interfractional tumor displacements. Nevertheless, in the tumors distal to the chest, the interfractional displacement in the cranio-caudal (CC) direction under the gastric fasting status was significantly larger compared with that under the gastric filling status (6.22±4.67 mm vs. 4.13±3.68 mm, P=0.013). To ensure 95% of the prescribed dose irradiated to at least 90% of the tumor volume during the radiotherapy, the margins of tumors proximal to the chest in the left-right (LR), antero-posterior (AP) and CC directions were 9 mm, 8.5 mm, 12.1 mm under gastric filling status with 300 ml semi-fluid. Six patients diagnosed with gastric cancer with proximal thoracic fiducial markers treated by preoperative radiotherapy were included in the validation group, revealing that the fiducial markers of 93% patients were covered in this margin. Conclusion:During the preoperative radiotherapy in AEG patient, the approach of quantitative gastric filling can be considered.

13.
Article in Chinese | WPRIM | ID: wpr-910429

ABSTRACT

Objective:To evaluate the clinical efficacy of radiotherapy in the treatment of extracranial metastatic breast cancer, and to investigate the significance and prognostic factors of whole-lesion radiotherapy (WLRT).Methods:Clinical data of 85 patients with extracranial metastatic breast cancer treated with radiotherapy between 2014 and 2019 were retrospectively analyzed. Thirty-six patients were assigned into the WLRT group and 49 in the non-WLRT group. The local control (LC), progression-free survival (PFS) and overall survival (OS) were calculated by Kaplan- Meier method, log-rank test and univariate prognostic analysis. Cox proportional hazards model was used for multivariate prognostic analysis. Results:The median follow-up time was 26.7 months. The 2-year LC, PFS, OS rates were 77%, 26%, 77%, respectively. The 2-year LC (91% vs. 67%, P=0.001), PFS (47% vs. 8%, P<0.001), OS rates (84% vs. 71%, P=0.010) in the WLRT group were significantly higher than those in the non-WLRT group, respectively. Multivariate analysis demonstrated that WLRT was an independent favorable prognostic factor for the LC, PFS and OS. Furthermore, bone metastasis alone was associated with improved LC and positive hormone receptor status was correlated with improved OS. Conclusions:WLRT has the potential to prolong the survival of patients with extracranial metastatic breast cancer. The patients with bone metastases alone obtain better LC, whereas those with negative hormone receptor status has worse OS.

14.
Article in Chinese | WPRIM | ID: wpr-910428

ABSTRACT

Objective:To evaluate the prognostic significance of neoadjuvant rectal (NAR) score and downstaging depth score (DDS) after neoadjuvant chemoradiotherapy (nCRT) for locally advanced rectal cancer (LARC).Methods:Retrospective analysis was performed for 200 patients with LARC (T 3-T 4 and/or N 1-N 2, M 0), who were initially treated in the Cancer Hospital of Chinese Academy of Medical Sciences from 2015 to 2018. All patients had baseline MRI data and received preoperative nCRT and radical resection. All patients received preoperative radiotherapy with a dose of 45-50Gy combined with concurrent capecitabine. The effect of NAR and DDS scores on clinical prognosis was statistically compared. The 3-year disease-free survival (DFS) was calculated using the Kaplan- Meier method and compared by the log- rank test. Cox proportional hazards model was used to perform multivariate survival analysis. The predictive performance for 3-year DFS was calculated using the receiver operating characteristic (ROC) curve. Results:The median follow-up time was 30.5(10.6-54.0) months. In terms of DDS, the 3-year DFS rate was 56.4% in the DDS ≤0 group, significantly lower than 83.0% in the DDS >0 group ( P=0.002). In terms of NAR score, the 3-year DFS rates were 90.1%, 73.8% and 53.6% in NAR score ≤8, 8-16 and>16 groups, respectively ( P<0.001). In the whole cohort, the area under the ROC curve (AUC) of DDS and NAR scores for predicting 3-year DFS were 0.683 and 0.756( P=0.037). In yp0-I stage patients ( n=72), the AUC of DDS and NAR scores for predicting 3-year DFS were 0.762 and 0.569( P=0.032). Conclusions:High DDS and low NAR scores after nCRT indicate good prognosis for patients with LARC. NAR score yields better accuracy than DDS in predicting clinical prognosis, but DDS is significantly better than NAR score in yp0-I stage population.

15.
Article in Chinese | WPRIM | ID: wpr-910153

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Objective:To explore the clinical features of poly ADP-ribose polymerase (PARP) inhibitor-related anemia in advanced and relapsed epithelial ovarian cancer (EOC).Methods:Patients diagnosed with advanced or relapsed EOC and treated with PARP inhibitor at National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College between January 2015 to October 2020 were accrued. The data included PARP inhibitors, treatment details, and lab tests before treatment and during treatment were collected and the clinical characteristics of PARP inhibitor-related anemia were analyzed.Results:(1) A total of 98 patients with a median age of 56.5 years old (30-82 years old) were enrolled in this study. All patients were treated with PARP inhibitor (65 cases of olaparib, 17 cases of niraparib, and 16 cases of fluzoparib). The median treatment duration was 37.5 weeks (4-119 weeks). (2) The anemia rate was 40% (39/98), including 5% (5/98) of grade Ⅰ, 14% (14/98) of grade Ⅱ, 11% (11/98) of grade Ⅲ, and 9% (9/98) of grade Ⅳ. Fourteen patients with pre-treatment grade Ⅰ anemia had a higher rate of anemia events than the 80 patients without pre-treatment anemia, 7/14 vs 35% (28/80; χ2=4.281, P=0.039). (3) The median anemia occurrence time was 7.0 weeks (1-52 weeks), including 41% (16/39) of anemia cases occurred in 1-4 weeks, 26% (10/39) occurred in 5-8 weeks, 13% (5/39) occurred in 9-12 weeks, 3% (1/39) occurred in 13-16 weeks, 10% (4/39) occurred in 17-20 weeks, 8% (3/39) occurred ≥21 weeks. At the time of the lowest hemoglobulin tested, the median value of mean corpuscular volume (MCV) was 106 fl,which was higher than the up limit of normal range (100 fl), 74% (29/39) of anemia patients had an elevated MCV level; the median value of mean corpuscular hemoglobin (MCH) was 36 pg, 54% (21/39) of anemia patients had an elevated MCH level; the median value of mean corpuscular hemoglobin concentration (MCHC) was 320 g/L, 69% (27/39) of anemia patients had a higher MCHC level; 92% (36/39) of anemia patients had a normal level of serum iron; 79% (31/39) of anemia patients had a normal level of transferrin. 74% (29/39) of the anemia patients were macrocytic orthochromatic anemia. (4) Among the 39 patients with anemia, 20 patients (51%, 20/39) withhold the treatment of PARP inhibitor due to grade Ⅲ or Ⅳ anemia, including 10 patients (50%, 10/20) who resumed the PARP inhibitor treatment by suppling iron, folate, and vitamin B 12. The median stopping time of PARP inhibitor was 5.5 weeks (2-10 weeks), while the other 10 patients terminated the PARP inhibitor treatment for not recovering from severe anemia. Conclusions:One of the common adverse effects of PARP inhibitors is anemia, which mostly happened in the first 3 months of treatment. In the treatment of EOC, PARP inhibitor-related anemia mainly manifest as macrocytic orthochromatic anemia, and most patients with normal serum iron and transferrin.

16.
China Pharmacy ; (12): 2970-2974, 2021.
Article in Chinese | WPRIM | ID: wpr-906776

ABSTRACT

OBJECTIVE:To establish a method for the simultaneous determination of eight constituents ,such as scopolin , scopoletin,chlorogenic acid ,cryptochlorogenic acid ,neochlorogenic acid ,isochlorogenic acid A ,isochlorogenic acid B ,and isochlorogenic acid C ,in different medicinal parts (stems,twigs and leaves )of Porana racemosa ,and to compare the contents of eight constituents . METHODS :HPLC method was adopted. The determination was performed on Agilent TC-C 18 column with mobile phase consisted of acetonitrile- 0.1% phosphate acid (gradient elution ) at the flow rate of 1.0 mL/min. The column temperature was 30 ℃,and the detection wavelength was set at 345 nm. The sample size was 10 μL. The contents of above constituents in stems ,twigs and leaves of P. racemosa were compared ,and the principal component analysis was carried out by Markerlynx XS software. RESULTS :The linear range of scopolin ,scopoletin,chlorogenic acid ,cryptochlorogenic acid , neochlorogenic acid ,isochlorogenic acid A ,isochlorogenic acid B ,and isochlorogenic acid C were 0.076 4- 7.64,0.062 8-6.28, 0.090 8-9.08,0.080 0-8.00,0.057 6-5.76,0.094 4-9.44,0.086 0-8.60,0.078 8-7.88 mg/L,respectively(all r>0.999). RSDs of precision,stability(24 h)and reproducibility tests were all lower than 2.0%. The average recoveries were 99.71%(RSD=1.36%, n=6),100.39%(RSD=1.76%,n=6),99.20%(RSD=1.75%,n=6),100.04%(RSD=2.63%,n=6),98.57%(RSD=1.99%, n=6),99.68%(RSD=1.84%,n=6),99.90%(RSD=1.88%,n=6),99.76%(RSD=1.47%,n=6),respectively. The average contents of above eight constituents were 9.725 3,1.286 5,7.271 3,1.347 6,0.997 7,0.710 9,0.656 3,0.364 7 mg/g in stems ; those were 0.690 3,0.411 7,4.394 3,0.639 6,0.531 3,1.392 7,0.989 1,1.129 2 mg/g in twigs ;those were 1.195 1,0.691 1, 27.952 9,6.173 4,1.405 1,0.549 7,0.288 8,0.794 2 mg/g in leaves ,respectively. The results of principal component analysis showed that different parts of P. racemosa could be divided into 3 categories. Among them ,most of the stems ofP. racemosa gathered in the first quadrant of score plot ,all the twigs gathered in the third quadrant , and all the leaves 分m gathered in the fourth quadrant. CONCLUSIONS :Established method is simple and reproducible ,and can be used for the determination of 8 constituents in different medicinal parts of P. racemosa. The average contents of neochlorogenic acid ,chlorogenic acid and cryptochlorogenic acid in the leaves of P. racemosa are relatively high ;the contents of isochlorogenic acid B ,isochlorogenic acid A and isochlorogenic acid C in the twigs are relatively high;the average contents of scopolin and scopoletin in the stems are also relatively high.

17.
Article in Chinese | WPRIM | ID: wpr-906306

ABSTRACT

Objective:To investigate the relationship between the single nucleotide polymorphism(SNP)of function genes and effective components of <italic>Salvia miltiorrhiza</italic> and the molecular mechanism of specific quality formation of <italic>S. miltiorrhiza</italic>. Method:The fingerprints of components in <italic>S. miltiorrhiza</italic> from eight different habitats and varieties were obtained by high-performance liquid chromatography (HPLC). The full-length cDNA of three functional genes<italic> </italic>acetyl-CoA C-acetyltransferase(<italic>SmAACT</italic>),4-diphosphocytidyl-2-C-methyl-<italic>D</italic>-erythritol kinase(<italic>SmCMK</italic>) and isopentenyl diphosphate isomerase(<italic>SmIPPI</italic>) in tanshinone metabolic pathway were amplified by polymerase chain reaction(PCR),cloned, and sequenced,followed by bioinformatics analysis. Result:The full-length cDNA sequences of three functional genes <italic>SmAACT</italic>,<italic>SmCMK</italic>, and <italic>SmIPPI</italic> in tanshinone metabolic pathway were obtained from 23 strains of <italic>S. miltiorrhiza</italic> from eight different habitats and varieties. As revealed by the analysis of SNP and amino acid polymorphisms of three functional genes,18,16, and 14 SNP sites were found respectively. HPLC results showed the samples from Beijing,Hubei,Shandong (No. SDB),Shanxi,Henan, and Shandong (No. SDZ) were clustered into one branch,and those from Hebei and Inner Mongolia were clustered into another branch, which suggested that the variation trend of <italic>S. miltiorrhiza</italic> components had little correlation with geographical distance,but the variety was a critical factor for the quality. Conclusion:There was an obvious genetic differentiation trend in <italic>S. miltiorrhiza</italic> from different habitats,and different origin-specific genotypes were formed. The molecular mechanism of the formation of the specific quality of <italic>S. miltiorrhiza</italic> from different habitats was discussed,which laid a foundation for the stability and effectiveness of clinical medication,and guided the breeding of excellent varieties of <italic>S. miltiorrhiza</italic>.

18.
Article in Chinese | WPRIM | ID: wpr-906041

ABSTRACT

Osteoporosis (OP) is one of the most common diseases in the aged population worldwide. Due to the rapid change in world population structure, the effective prevention and treatment of OP is increasingly becoming the health problem of global concern and also the hot spot of clinical research. OP can be affected by many factors such as heredity, endocrine dyscrasia, nutritional deficiency, and bad living habits. The breakdown of coupling of osteoclast-mediated bone resorption to osteoblast-mediated bone formation leads to stronger bone resorption than bone formation, which is currently recognized as the main pathogenesis of OP. The exploration of OP in modern medicine based on molecular immunology has revealed that related cytokines play an important role in the pathogenesis of OP,and regulating the osteoclast-mediated bone resorption and osteoblast-mediated bone formation is essential for controlling the occurrence and development of OP. Tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and interleukin-6 (IL-6) are able to stimulate bone formation and inhibit osteoblast function, thus playing a key role in bone destruction. By contrast, such cytokines as vascular endothelial growth factor (VEGF), transforming growth factor-β (TGF-β), bone morphogenetic protein (BMP), and osteoprotegerin (OPG) strengthen osteoblast differentiation and promote bone formation. At present, western medicine like calcitonin, estrogen, and bisphosphonate are mostly used for clinical treatment of OP, but a long-term use of these drugs will result in poor compliance and obvious gastrointestinal adverse reactions. Traditional Chinese medicine (TCM) occupies an important position in the treatment of OP due to its advantages of overall regulation, low price, and few side effects. In addition, with the deepening of research on network pharmacology and molecular biology, it has been found that TCM exerts the therapeutic effect against OP by interfering with the expression of various cytokines and adjusting bone homeostasis. This paper has elaborated the role of related cytokines in the pathogenesis of OP and reviewed the research results concerning the regulation of related cytokines by TCM, in order to provide reference for the prevention and treatment of OP with TCM.

19.
China Pharmacy ; (12): 2743-2747, 2021.
Article in Chinese | WPRIM | ID: wpr-904777

ABSTRACT

OBJECTIVE:To establish the method for the content determination of 7 components,such as puerarin , 3′-methoxypuerarin,daidzein,rutin,hesperidin,salvianolic acid A and quercetin ,in Zhengxin jiangzhi tablets ,and conduct cluster heatmap analysis. METHODS :HPLC method was adopted. The separation was performed on Kromasil C 18 column with mobile phase consisted of acetonitrile- 0.1% formic acid solution (gradient elution )at the flow rate of 0.8 mL/min. The detection wavelength was set at 280 nm,and the column temperature was 25 ℃. The sample size was 10 μL. Taking the content data as the object,the cluster heatmap was drawn by Hiplot scientific research mapping platform. RESULTS :The linear range of puerarin , 3′-methoxypuerarin,daidzein,rutin,hesperidin,salvianolic acid A and quercetin were 17.00-170.00(r=0.999 9),5.14-51.40(r= 0.999 8),3.00-30.00(r=0.999 8),153.00-1 530.00(r=0.999 9),7.88-78.75(r=0.999 8),2.85-28.50(r=0.999 9)and 11.34-113.40 μg/mL(r=0.999 8),respectively. RSDs of precision ,stability(24 h)and repeatability tests were all less than 2%; the average recoveries were 99.58%(RSD=0.83%,n=6),100.31%(RSD=1.17%,n=6),100.61%(RSD=1.08%,n=6), 100.05%(RSD=0.82%,n=6),100.31%(RSD=1.38%,n=6),100.31%(RSD=0.85%,n=6),99.85%(RSD=1.01%, n=6),respectively. The contents of above components in 10 batches of samples were 7.262 5-8.941 5,2.464 9-3.068 9,1.478 9- 1.883 4,58.632 8-79.408 3,3.569 4-4.500 6,1.077 6-1.341 5,1.139 7-5.957 0 mg/g,respectively. Results of cluster heatmap analysis showed that 10 batches of samples could be divided into 4 categories,including S 1-S3 as one category ,S4 as one category,S5-S6 as one category and S 7-S10 as one category. CONCLUSIONS :The established method is simple ,accurate and specific,which can be used for the quality control of Zhengxin jiangzhi tablets ,combined with cluster heatmap analysis. There are some differences in the quality of different batches of samples.

20.
Organ Transplantation ; (6): 70-2021.
Article in Chinese | WPRIM | ID: wpr-862778

ABSTRACT

Objective To evaluate the effect of multi-disciplinary team (MDT) on acute heart failure (AHF) complicated with respiratory failure after allograft nephrectomy. Methods MDT discussion was performed on a patient with hemorrhagic shock caused by sudden renal graft hemorrhage, who developed acute myocardial infarction (AMI) with AHF, acute pulmonary congestion, pulmonary infection and acute respiratory failure 2 weeks after allograft nephrectomy. And treatment plan was formulated and effect evaluation was conducted. Results Based on the opinions of MDT discussion, the patient was given nasal high-flow oxygen therapy, continuous veno-venous hemodiafiltration (CVVHDF) to reduce cardiac load, anticoagulant, dilating blood vessels, reducing myocardial oxygen consumption, improving myocardial remodeling, lipid regulation, anti-infection, nutritional support, and other comprehensive treatment. The clinical outcome of the patient was good and regular hemodialysis treatment was resumed. Conclusions Application of MDT pattern helps to formulate a comprehensive and effective individualized treatment plan for patients with AHF and respiratory failure after allograft nephrectomy, which can enhance clinical treatment effects and improve prognosis of patient.

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