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1.
Zhonghua Wai Ke Za Zhi ; 59(11): 902-906, 2021 Nov 01.
Artigo em Chinês | MEDLINE | ID: mdl-34743451

RESUMO

Objective: To examine the effect of robotic assisted laparoscopic radical prostatectomy with different approaches on early postoperative effects. Methods: Totally 44 patients (average age of 65.9 years, range: 46 to 81 years) underwent robotic assisted laparoscopic radical prostatectomy by a single operator at Department of Urology, Peking Union Medical Collage Hospital from March 2018 to March 2020 were retrospectively analyzed. The mean age was 65.9 years (range: 46 to 81 years), including 24 cases in the anterior bladder approach group (anterior approach group) and 20 cases in the posterior bladder approach group (posterior approach group). The preoperative clinical data, perioperative related data and postoperative urinary control recovery were compared between the two groups by t test, χ2 test or Fisher exact test. Results: In terms of clinical data, there was no difference in age, prostate volume, preoperative prostate specific antigen and Gleason score(all P>0.05). There was no significant difference in operation time ((184±43) minutes vs. (193±42) minutes, t=-0.599, P=0.55), bleeding volume ((218±88) ml vs. (225±115) ml, t=-0.244, P=0.81), postoperative stage (T2/T3: 15/9 vs. 12/8, χ²=0.029, P=0.87) and positive rate of cutting edge (29.2% (7/24) vs. 30.0% (6/20), χ²=0.004, P=0.95). In terms of postoperative urinary control, patient rates who achieved urinary control immediately after extubation was significantly higher for the posterior approach group than the anterior approach group (30.0% (6/20) vs. 4.2% (1/24), P=0.04). There was no significant difference between two groups for those who achieved urinary control 3 months after operation (6 cases vs. 11 cases, P=0.06), 6 months after operation (20 cases vs. 19 cases, P=0.36) and those who achieved urinary control 12 months after operation (23 cases vs. 19 cases, P=1). Conclusion: For robotic assisted laparoscopic radical prostatectomy, the posterior approach does not prolong the operation time, does not increase the amount of bleeding, and improves the short-term postoperative urinary control.


Assuntos
Laparoscopia , Neoplasias da Próstata , Procedimentos Cirúrgicos Robóticos , Idoso , Humanos , Masculino , Próstata/cirurgia , Prostatectomia , Neoplasias da Próstata/cirurgia , Estudos Retrospectivos , Resultado do Tratamento , Bexiga Urinária/cirurgia
2.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi ; 39(10): 744-747, 2021 Oct 20.
Artigo em Chinês | MEDLINE | ID: mdl-34727654

RESUMO

Objective: To explore the predictive value of low T3 syndrome (LT3S) for patients with delayed encephalopathy after acute carbon monoxide poisoning (DEACMP) . Methods: In May 2020, 137 severe acute carben monoxide poisoning (SACMP) patients were selected from Harrison International Peace Hospital Affiliated to Hebei Medical University from January 2019 to January 2020 as subjects. Blood samples were taken after admission to test thyroid function. Followed up for 60 d, the patients were divided into DEACMP group (45 cases) and non DEACMP group (92 cases) according to their prognosis. Clinical data of patients in two groups were collected and compared. The Cox regression with multiple independent variables was used to analyze the independent risk factors of DEACMP. Pearson correlation analysis was used to evaluate the correlation between totall triiodochyronine (TT3) level and Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱ score. The receiver operating characteristic (ROC) curve of TT3 and APACHE Ⅱ scores for predicting DEACMP were drawn. Results: Compared with non DEACMP group, the age, APACHE II score, LT3S rate and diabetes prevalence in DEACMP group were higher, and the Glasgow coma scale (GCS) score was lower (P<0.05) . Cox regression analysis showed that age, APACHEⅡ score and LT3S were independent risk factors of DEACMP in patients with SACMP (OR=1.040, 95%CI:1.005-1.077; OR=1.070, 95%CI: 1.002-1.143; OR=4.210, 95%CI: 1.707-10.379; P<0.05) . Pearson correlation analysis showed that TT3 level was negatively correlated with APACHE Ⅱ score (r=-0.397, P=0.000) . ROC curve showed that the cut-off value of TT3 level for DEACMP prediction was 1.078 nmol/L, the area under curve (AUC) was 0.755, the sensitivity was 82.6%, and the specificity was 73.3%. The cut-off value of the APACHE Ⅱ score for predicting DEACMP was 16, and the AUC was 0.725, sensitivity was 93.3%, and specificity was 60.9%. Conclusion: This study showed that LT3S minght be an independent predictor of DEACMP in patients with SACMP. Thyroid function is closely related to the severity of SACMP patients.


Assuntos
Encefalopatias , Intoxicação por Monóxido de Carbono , Síndromes do Eutireóideo Doente , Área Sob a Curva , Intoxicação por Monóxido de Carbono/complicações , Humanos , Prognóstico , Curva ROC , Estudos Retrospectivos
3.
Zhonghua Xue Ye Xue Za Zhi ; 42(10): 834-839, 2021 Oct 14.
Artigo em Chinês | MEDLINE | ID: mdl-34788923

RESUMO

Objective: To compare the prognostic value of four prognostic models in predicting time to first treatment (TTFT) in patients with Binet A Chinese chronic lymphocytic leukemia (CLL) . Methods: This retrospective analysis included one hundred and ten patients with Binet A CLL, initially diagnosed in the First Affiliated Hospital of Nanjing Medical University (Pukou CLL center) from June 2009 to January 2020. Risk stratification was conducted according to IPS-E, CLL-IPI, CLL1-PM, and Barcelona-Brno prognostic models. Results: Among 110 patients with Binet A CLL patients, the median age was 58 (25-84) years. The median follow-up time was 35 (4-189) months, and 57 (51.8%) patients met the indication for treatment due to symptomatic disease progression during follow-up. Log-rank analysis of nine variables was conducted involving age, Rai stage, absolute lymphocyte count (ALC) , lymph node size, lymphocyte doubling time (LDT) , ß(2)-Microglobulin, IGHV status, TP53, and Del (11q) . Additionally, Rai Ⅰ-Ⅲ, ALC>15×10(9)/L, palpable lymph node size ≥1cm, ß(2)-Microglobulin>3.5 mg/L, unmutated IGHV, TP53 mutation or deletion, and 11q deletion were independent risk factors of TTFT. Predictive value of each model was assessed by Harrel C-index and Akaike information criterion (AIC) with CLL1-PM (C-index=0.736, AIC=777) , followed by CLL-IPI (C-index=0.722, AIC=933) , IPS-E (C-index=0.683, AIC=1004) , and Barcelona-Brno prognostic model (C-index=0.663, AIC=986) . Conclusion: All four prognostic models effectively predicted TTFT. IPS-E might be an ideal model to guide clinical surveillance because of its easy accessibility and low expenses in routine clinical practice. Therefore, for patients receiving fluorescence in situ hybridization (FISH) and next-generation sequencing (NGS) examination at diagnosis, CLL-IPI or CLL1-PM could be applied to evaluate their prognosis more comprehensively.


Assuntos
Leucemia Linfocítica Crônica de Células B , Humanos , Hibridização in Situ Fluorescente , Leucemia Linfocítica Crônica de Células B/diagnóstico , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida
4.
Zhonghua Xin Xue Guan Bing Za Zhi ; 49(11): 1089-1093, 2021 Nov 24.
Artigo em Chinês | MEDLINE | ID: mdl-34775718

RESUMO

Objective: To explore the effect of remote "Internet+" interactive management strategy on blood pressure control in patients with hypertension during normalized epidemic prevention and control of COVID-19. Methods: This is a randomized controlled study. A total of 394 patients with hypertension who were treated in Chinese People's Liberation Army General Hospital from October 2019 to December 2020 were randomly divided into experimental group (197 cases) and control group (197 cases). The experimental group adopted remote "Internet+" interaction mode to carry out remote blood pressure intervention, and the control group received traditional blood pressure control mode, and the intervention time was 6 months. Evaluation indicators included blood pressure level, blood pressure lowering speed, time to target blood pressure, blood pressure measurement times, communication times with doctors, medication compliance, blood pressure measurement compliance and disease awareness after 6 months of intervention. The evaluation indexes of the two groups were compared, and the bivariate Pearson correlation analysis was used to explore the relationship between the speed of blood pressure reduction and the times of blood pressure measurement and doctor communication in all patients. Results: A total of 394 patients with hypertension were included in this study, including 209 males, aged (67.6±2.8) years old. After 6 months of intervention, the systolic and diastolic blood pressure of the two groups were both lower than the baseline blood pressure before intervention (both P<0.05), the systolic blood pressure ((125.7±11.7) mmHg (1 mmHg=0.133 kPa) vs. (132.6±12.9) mmHg, P<0.001) and diastolic blood pressure ((72.4±10.7) mmHg vs. (79.8±11.6) mmHg, P<0.001) in the experimental group were lower than those in the control group. The blood pressure reduction speed of the experimental group was faster than that of the control group ((18.63±1.59) mmHg/d vs. (13.26±2.85) mmHg/d, P<0.001), and the time to reach the target blood pressure in the experimental group was shorter than that in the control group ((23.69±2.93) d vs. (47.12±5.81) d, P<0.001). Compared with the control group, the blood pressure measurement times ((0.98±0.13) times/d vs. (0.20±0.40) times/d, P<0.05) and the number of communications with doctors ((0.97±0.16) times/week vs. (0.12±0.32) times/week, P<0.05) were significantly higher in the experimental group. Correlation analysis showed that the speed of blood pressure reduction was positively correlated with the number of blood pressure measurements (r=0.419, P<0.01) and the number of communications with doctors (r=0.857, P<0.01). The proportion of standardized medication (93.91% (185/197) vs. 51.78% (102/197), P<0.001), timely measurement (97.46% (192/197) vs. 47.21% (93/197), P<0.001) and high-degree disease awareness (94.42% (186/197) vs. 49.24% (97/197), P<0.001) were significantly higher in the experimental group than those in the control group. Conclusions: The remote "Internet+" interactive management strategy can effectively improve patients' blood pressure control. The doctor-patient interaction can improve medication compliance and measurement compliance of patients, and help shorten the time to reach the target blood pressure.


Assuntos
COVID-19 , Epidemias , Hipertensão , Idoso , Pressão Sanguínea , Humanos , Hipertensão/prevenção & controle , Internet , Masculino , Pessoa de Meia-Idade , SARS-CoV-2
5.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(3): 544-548, 2021 Mar 10.
Artigo em Chinês | MEDLINE | ID: mdl-34814427

RESUMO

Objective: To evaluate the value of measles IgG antibody avidity assay in identifying the measles cases. Methods: Data from the Measles Surveillance Information System was used to collect laboratory confirmed or discarded cases in 2013-2015, and then tracing back the blood specimens from all measles network laboratories in Tianjin. Measles antibody avidity assay was used to detect and to redefine cases from the discarded ones. Results: A total of 326 measles cases including 267 laboratory-confirmed and 59 discarded cases were enrolled into this study, with 92.33% (301/326) of them aged ≥20 years. Result from the measles IgG antibody avidity assay showed that the ratio of high-avidity was 91.23%(52/57) of the discarded cases, which was significantly higher than 66.95% (158/236) of the laboratory confirmed cases (χ2=13.33, P<0.001). According to the case criterion, 15.25% (9/59) of the discarded cases were redefined as measles cases. Eight out of the nine cases were high-avidity with measles containing vaccine (MCV) vaccination history that named as SVF cases. One in nine cases with low-avidity was with typical clinical symptomatic measles but with no vaccination history of MCV. Conclusion: Measles IgG antibody avidity assay could provide reference serological evidence to reduce the error from those discarded cases caused by false negative results on IgM antibody, when diagnosing the measles cases.


Assuntos
Vírus do Sarampo , Sarampo , Anticorpos Antivirais , Afinidade de Anticorpos , Humanos , Imunoglobulina G , Sarampo/diagnóstico , Sarampo/epidemiologia , Vacina contra Sarampo
6.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(5): 823-826, 2021 May 10.
Artigo em Chinês | MEDLINE | ID: mdl-34814473

RESUMO

Objective: Based on the data of the baseline survey of hypertension and sodium intake monitoring in Anhui province in 2019, the salt intake in adult residents was estimated. Methods: Multi-stage stratified cluster random sampling was used to select participants aged 18-69 years, questionnaire survey and related measurements were conducted. Salt intake in participants with different characteristics were estimated with complex sample and linearization of Taylor series based on design and the correlation between salt intake and blood pressure, waist circumference and BMI were tested by linear regression. Results: A total of 1 500 participants were included. The overall salt intake was 9.14 g/d, which was 9.84 g/d in men and 8.47 g/d in women (P<0.05). The differences in salt intake across different subgroups were significant (P<0.05). Univariate linear regression analysis showed that salt intake was positively correlated with SBP, DBP, waist circumference and BMI (P<0.05), while multivariate linear regression analysis (adjusted for other factors) only showed a positive correlation between salt intake and BMI (ß=0.053,95%CI: 0.028-0.078, P<0.05). Conclusion: The dietary salt intake in adult residents in Anhui was higher than WHO recommendation, suggesting that public health education need to be taken to reduce salt intake.


Assuntos
Hipertensão , Cloreto de Sódio na Dieta , Adulto , Pressão Sanguínea , Estudos Transversais , Feminino , Humanos , Hipertensão/epidemiologia , Masculino , Circunferência da Cintura
7.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(7): 1240-1245, 2021 Jul 10.
Artigo em Chinês | MEDLINE | ID: mdl-34814538

RESUMO

Objective: To understand the spatiotemporal distribution of pulmonary tuberculosis (TB) and influencing factors in Beijing from 2008 to 2018. Methods: The incidence data of pulmonary TB in Beijing from 2008 to 2018 were from Tuberculosis Information Management System of Chinese Disease Prevention and Control Information System. Software ArcGIS 10.2 was used to visualize the spatiotemporal distribution of pulmonary TB incidence. Getis's Gi* statistic was applied to analyze the spatial clustering of pulmonary TB incidence at street/township scale. Bayesian spatiotemporal model was applied to analyze factors affecting its spatiotemporal distribution, including urbanization rate, GDP per capita, number of hospital beds per thousand population, permanent migrant population and population density. Results: The reported pulmonary TB incidence showed a downward trend in the past 11 years in Beijing, from 58.64/100 000 to 30.43/100 000. The incidences were higher in Tongzhou, Changping and other newly developed urban districts, with the hot spots concentrated in local areas of these districts. The incidences of pulmonary TB were lower in Dongcheng, Xicheng and other old urban districts-with the cold spots also concentrated in these area. The risk for the incidence of pulmonary TB was associated with the urbanization rate and the permanent migrant population. For every 1% increase in the urbanization rate, the relative risk of pulmonary TB would increase by 1%. For every 10 000 person increase of permanent migrant population, the relative risk of pulmonary TB would increase by 0.6%. Conclusions: In Beijing, the current pulmonary TB prevention and control needs to be focused on the newly developed urban areas. Due to the accelerated process of urbanization, it is necessary to strengthen TB prevention and control in permanent migrant population to reduce the incidence of TB in Beijing.


Assuntos
Tuberculose Pulmonar , Tuberculose , Teorema de Bayes , Pequim , China/epidemiologia , Humanos , Incidência , Análise Espaço-Temporal , Tuberculose Pulmonar/epidemiologia
8.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(8): 1487-1492, 2021 Aug 10.
Artigo em Chinês | MEDLINE | ID: mdl-34814572

RESUMO

Objective: To study the genomic sequence of Coxsackievirus A8 (CV-A8) associated with hand, foot and mouth disease (HFMD) from 2013 to 2018 in China and to analyze the genetic evolution of each coding region of the full-length genome. Methods: The genome sequences of 11 CV-A8 strains isolated from patients with HFMD in different regions of China from 2013 to 2018 were determined. Sequence alignment and genetic evolution analysis were performed by Sequencher 5.0 and MEGA 7.0 software, etc. Results: Sequence alignment showed that the genome length of 11 CV-A8 strains ranged from 7 393 bp to 7 400 bp. There was no base insertion or deletion in the coding region compared with the prototype strain, but there were individual base insertion or deletion in the non-coding region. The nucleotide and amino acid similarities in the VP1 region of 11 CV-A8 strains were 78.3%-98.6% and 92.6%-99.7%, respectively, and the nucleotide and amino acid sequences identities with the CV-A8 prototype strain were 78.3%-98.2% and 92.6%-99.7%, respectively. Based on the phylogenetic analysis of VP1 region sequences, the CV-A8 can be divided into five genotypes: A, B, C, D and E. The 11 CV-A8 strains in this study belonged to genotypes C (1 strain), D (2 strains) and E (8 strains). The nucleotide and amino acid similarities of 11 CV-A8 full-length genomes were 81.3%-98.8% and 95.9%-99.5%, respectively. The phylogenetic tree of the P2 region showed that the eight E genotypes CV-A8 had the closest evolutionary distance with CV-A4, CV-A14, and CV-A16. The phylogenetic tree of the P3 region showed that the eight E genotypes CV-A8 had a close evolutionary distance with CV-A5, CV-A16, CV-A14 and CV-A4. Conclusions: The 11 CV-A8 stains in this study showed significant intra-genotype diversity in capsid region and recombinant diversity in non-capsid region which indicated that CV-A8 quasispecies were still undergoing dynamics variation. CV-A8 may become an important pathogen of HFMD and the monitoring of CV-A8 needs to be further strengthened.


Assuntos
Enterovirus Humano A , Doença de Mão, Pé e Boca , China/epidemiologia , Enterovirus Humano A/genética , Genótipo , Doença de Mão, Pé e Boca/epidemiologia , Humanos , Filogenia
9.
Clin Transl Oncol ; 2021 Nov 23.
Artigo em Inglês | MEDLINE | ID: mdl-34811696

RESUMO

BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) is one of the most fatal malignant tumors of the digestive system. Many patients are diagnosed at an advanced stage and lose eligibility for surgery. Moreover, there are few effective methods for treating pancreatic ductal cell carcinoma. Increasing attention has been given to microRNAs (miRNAs) and their regulatory roles in tumor progression. In this study, we investigated the effects of exosomes extracted from human umbilical cord mesenchymal stem cells (HUCMSCs) carrying hsa-miRNA-128-3p on pancreatic cancer cells. METHODS: Based on existing experimental and database information, we selected Galectin-3, which is associated with pancreatic cancer, and the corresponding upstream hsa-miRNA-128-3p. We extracted HUCMSCs from a fresh umbilical cord, hsa-miRNA-128-3p was transfected into HUCMSCs, and exosomes containing hsa-miRNA-128-3p were extracted and collected. The effect of exosomes rich in hsa-miRNA-128-3p on pancreatic cancer cells was analyzed. RESULTS: The expression of Galectin-3 in normal pancreatic duct epithelial cells was significantly lower than that in PDAC cell lines. We successfully extracted HUCMSCs from the umbilical cord and transfected hsa-miRNA-128-3p into HUCMSCs. Then we demonstrated that HUCMSC-derived exosomes with hsa-miRNA-128-3p could suppress the proliferation, invasion, and migration of PANC-1 cells in vitro by targeting Galectin-3. CONCLUSION: Hsa-miRNA-128-3p could be considered as a potential therapy for pancreatic cancer. We provided a new idea for targeted therapy of PDAC.

10.
J Nutr Health Aging ; 25(9): 1090-1095, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34725666

RESUMO

OBJECTIVES: Motoric cognitive risk syndrome (MCR) is a newly described pre-dementia syndrome characterized by cognitive complaints and slow gait and is associated with numerous adverse outcomes. Previous studies have indicated an association between C-reactive protein (CRP) and cognitive decline, but no clear relationship between CRP and MCR has been reported. The purpose of the study is to examine the associations between CRP with MCR and MCR subtypes. METHODS: Participants were 5,642 adults aged ≥60 years from the China Health and Retirement Longitudinal Study (CHARLS). MCR was defined as cognitive complaints and slow gait speed without dementia or impaired mobility. Two subtypes of MCR were defined by whether memory impairment (MI) was also present, such as MCR-MI and MCR-non-MI. MI was evaluated through the immediate recall and delayed recall in a word recall test during the CHARLS and was defined as 1.0 standard deviation or more below the mean values of the test scores in this cohort. RESULTS: Of the participants, 421 (7.46%) met the criteria for MCR. After multivariate adjustment, participants with higher CRP levels had an increased likelihood of MCR (fourth quartile: adjusted odds ratio [OR]=1.44; 95% confidence interval [CI]: 1.06-1.95) compared with those in the first quartile group. The OR for MCR-MI was 2.04 (95% CI: 1.35-3.09) for the highest quartile of CRP compared to the lowest quartile. No significant associations between CRP levels and odds of MCR-non-MI were observed. CONCLUSIONS: Higher CRP levels were associated with increased odds of prevalent MCR-MI but not MCR-non-MI among community-dwelling older adults.

11.
Int J Radiat Oncol Biol Phys ; 111(3S): e232, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34700973

RESUMO

PURPOSE/OBJECTIVE(S): Host immunity has a significant impact on radiotherapy (RT) outcomes in cancer. We have previously demonstrated that Indoleamine 2, 3-dioxygenase (IDO), a known immunoinhibitory kinase, predicts the survival of patients with stage I/II after RT alone and stage III non-small cell lung cancer (NSCLC) after chemoradiation. We hypothesize that the IDO activity levels in the blood also change in patients with stage IV NSCLC following radiotherapy. MATERIALS/METHODS: This was part of a prospective study of circulating immune biomarkers for prognosis and prediction. Newly diagnosed or recurrent stage IV NSCLC patients were eligible. Blood samples were obtained before and after RT start and platelet-poor plasma samples were used for the kynurenine (Kyn) and tryptophan (Trp) measurement by high-performance liquid chromatography. Kyn and Trp was detected on a UV/vis channel at 360 nm and 285 nm, respectively, with more than 95% re-productivity. IDO activity was defined as the ratio between Kyn and Trp in synchronization. Student T-test was applied for group comparison. Data are presented as mean and 95% confidence interval (CI). P value < 0.05 was considered as statistical significance. RESULTS: Between July 2019 and Dec 2020, a total of 54 patients with stage IV NSCLC treated with radiotherapy was recruited. RT dose ranged from 20-60 Gray in 5-30 fractions, covering thoracic, spines or brain. Higher concentration of Kyn (mean = 1.88, CI = 1.48-2.27 mM) was detected before RT, compared with the Kyn concentration (mean = 1.20, CI = 0.70-1.70 mM) after RT (P = 0.052). The mean concentration of Trp was 20.81 (CI = 17.01-24.62) mM before RT, compared with 19.01 (CI = 17.03-21.00) mM after RT with no significant change (P = 0.982). In addition, the IDO activity (mean = 0.11, CI = 0.08-0.14) before RT was higher than the IDO activity after RT (mean = 0.08, CI = 0.05-0.10) with P = 0.130. Furthermore, a subgroup analysis of the IDO activity in patients with distant metastasis (n = 31) was conducted. The mean concentration of Kyn was significantly decreased from 1.78 (CI = 1.67-2.67) mM before RT to 0.68 (CI = 0.28-2.09) mM after RT (P = 0.028). The mean concentration of Trp was 18.12 (CI = 15.39-20.84) mM before RT versus 18.64 (CI = 14.41-22.86) mM after RT (P = 0.847). Besides, the IDO activity was also reduced from 0.15 (CI = 0.09-0.20) before RT to 0.07 (CI = 0.01-0.13) after RT (P = 0.051). CONCLUSION: This study reveals that the plasma kynurenine and IDO activity is reduced after RT, suggesting that potential roles of RT in releasing immune suppression status of the host that can be simply tested by IDO activity in patients with stage IV NSCLC.

12.
Int J Radiat Oncol Biol Phys ; 111(3S): e258, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34701031

RESUMO

PURPOSE/OBJECTIVE(S): Radiotherapy (RT) as a traditional treatment for Breast cancer (BC) not only could induce local tumor cell death but also modify the tumor microenvironment to engage antitumor immune response. High level of tumor infiltrating lymphocytes, especially CD8, T helper cells and dendritic cells, have great correlation with pathological complete response in BC patients. However, there is no systematic report on the dynamic changes of circulating immune cells in BC treated with RT. We detected the systemic lymphocyte subsets in the peripheral blood before, during, and after RT of BC patients to evaluate the effects of RT on different lymphocyte subtypes. MATERIALS/METHODS: BC patients treated with RT were recruited to a prospective study. Blood samples were obtained EDTA coated tubes and then centrifuged for white blood cell. The antibodies including CD11b, CD45, CD19, CD3, CD56, CD4, CD8a, CD133, HLA-DR, and FOXP3 were used to identify corresponding cell subtypes. Finally, the percentage of Lymphocytes, MDSC, DC, B cells, T cells, Treg, CD8+ T cells, CD4+ T cells, NK cells, and NKT were analyzed using flow cytometry software. The paired T-test was used to compare and analyze each cell subpopulation from Pre, Dur and End of RT. P < 0.05 was considered to be significant. RESULTS: Between July 2019 and January 2020, a total of 50 BC patients treated with RT that signed consent forms and sampled at three time points (Pre, Dur, End of RT) were enrolled in this study. After RT, the ratio of CD8/CD4 (Pre vs. End mean:0.73 vs. 0.60, P = 0.04) were significantly decreased while Tregs (Pre vs. End mean:2.03 vs. 2.68, P = 0.04) were increased. Analyzing the changes of myeloid Cells, DC were shown a significant gradual increase trend (Pre vs. End mean:0.23 vs. 0.37, P < 0.0001) from baseline (mean:0.23) to during (mean: 0.33) and end (0.37) of RT. Further explore the dynamic changes of lymphocytes subtypes before and after RT under each clinical stage. In stage III patients, CD4 cells (Pre vs. Dur mean:47.62 vs. 55.64, P = 0.03) and Tregs (Pre vs. Dur mean:1.83 vs. 3.37, P = 0.01) were significantly increased during RT treatment. Whereas there were drastically reduced in CD8 cells during (Pre vs. Dur mean:36.21 vs. 30.84, P = 0.003) and after (Pre vs. End mean:36.21 vs. 29.23, P = 0.03) RT treatment. After RT treatment for stage III patients, DC were shown a significant increase trend (Pre vs. Dur mean:0.25 vs. 0.37, P = 0.02; Pre vs. End mean: 0.24 vs. 0.48, P = 0.008). For other stages, there is no significant change in immune cell subsets before and after RT. CONCLUSION: Different immune cell subtypes have different sensitivity to radiotherapy. Overall, RT could induce CD8/CD4 ratio decrease, Treg and DC increase. Interestingly, Stage III Breast cancer patients are more sensitive to RT, and their immune status changes significantly during RT treatment. Although these findings need to be verified for a larger sample size, the preliminary results provide instructions for subsequent personalized and precise treatment for different individuals.

13.
Int J Radiat Oncol Biol Phys ; 111(3S): e384-e385, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34701327

RESUMO

PURPOSE/OBJECTIVE(S): Nasopharyngeal cancer (NPC) is traditionally EBV related. However, HPV-positive (HPV+) NPC seems to be increasing in the Western world recently. We describe the clinical behavior and outcomes of HPV+ NPC compared to EBV-positive (EBV+) NPC and HPV+ oropharyngeal cancer (OPC). MATERIALS/METHODS: All newly diagnosed non-metastatic viral-related NPC and OPC treated with IMRT from 2005-2020 were reviewed. Viral etiology was confirmed by p16 staining, supplemented by real-time polymerase chain reaction of DNA for high-risk HPV, and EBER in-situ hybridization for EBV. Clinical characteristics of HPV+ and EBV+ NPC were compared using the 2005-2020 NPC cohort, while locoregional control (LRC), distant control (DC) and overall survival (OS) were compared using the 2005-2018 cohort to allow sufficient follow-up among HPV+ NPC, EBV+ NPC and HPV+ OPC patients. Presenting signs/symptoms of HPV+ NPC and EBV+ NPC were compared by 1:1 matched pair analysis (matched to T category, N category, smoking, age, gender, WHO type IIA vs IIB, and diagnosed year). Multivariable analysis (MVA) evaluated the cohort effect adjusting for confounders. RESULTS: A total of 29 HPV+ NPC (25 Caucasians and 4 Asians), 422 EBV+ NPC, and 1310 HPV+ OPC were eligible. HPV genotype was available in 20/29 HPV+ NPC patients: 14 (70%) HPV-16; 6 (30%) non-HPV-16. Compared to EBV+ NPC overall, HPV+ NPC patients were older (median age: 58 vs 52 years, P = 0.006), were predominantly Caucasian (86% vs 15%, P < 0.001), and had higher T (T2-4: 86% vs 68%, P = 0.039) but similar N categories (N2-3: 66% vs 58%, P = 0.44). Within the matched cohort, more HPV+ NPC patients complained of local pain vs EBV+ NPC (28% vs 3%, P = 0.025) but a similar proportion had cranial neuropathy (21% vs 31%, P = 0.55). No significant difference existed in gross tumor volume or involved lymph node distribution (P > 0.05). Median follow-up for HPV+ NPC, EBV+ NPC and HPV+ OPC was 3.1, 6.0, and 5.2 years respectively. Compared to EBV+ NPC (n = 374), HPV+ NPC (n = 20) had similar 3-year LRC (95% vs 90%, P = 0.416) and OS (84% vs 89%, P = 0.137), but non-significantly lower DC (75% vs 88%, P = 0.13). Compared to HPV+ OPC (n = 1310), HPV+ NPC also had similar 3-year LRC (95% vs 94%, P = 0.74) and OS (84% vs 87%, P = 0.307), but lower DC (75% vs 90%, P = 0.036). The difference in DC became non-significant in MVA [HR 1.83 (0.73-4.58), P = 0.19] after adjusting for T category, N category, smoking pack-years, and chemotherapy. CONCLUSION: HPV+ NPC is an emerging entity, of which about one-third are caused by non-HPV-16 genotype. Compared with the more common EBV+ NPC cases, HPV+ NPC presents with more local pain and advanced T categories but has similar outcomes. HPV+ NPC also has similar outcomes to HPV+ OPC except that DC is lower in univariable analysis, possibly attributable to higher T category and non-HPV-16 genotypes. There may be a role for modification of systemic therapy in HPV+ NPC to address distant failure risk.

14.
Int J Radiat Oncol Biol Phys ; 111(3S): e391-e392, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34701344

RESUMO

PURPOSE/OBJECTIVE(S): Patient-derived xenografts (PDX) can help identify oral cavity squamous cell carcinoma (OSCC) patients at risk for disease recurrence and optimize clinical decision-making. In this study, we develop and validate a prediction score for locoregional failure (LRF) and distant metastases (DM) in OSCC that incorporates PDX engraftment in addition to known clinicopathological risk factors. MATERIALS/METHODS: PDX models were generated from OSCC patients. Patients were scored as a ''non-engrafter" if PDX formation did not occur within 6 months. Multivariable analysis (MVA) was used to identify predictors of LRF and DM. Factors retained in the final MVA were used to construct a prediction score and classify patients into risk groups using a 10-fold cross-validation approach. RESULTS: Overall 288 OSCC patients were analyzed. MVA identified pT3-4, pENE, and engraftment as predictors of LRF and DM. Patients whose tumors engrafted (n = 198) were more likely to develop LRF (HR 1.98, 95% CI: 1.24-3.18, P < 0.01), and DM (HR 2.64, 95% CI 1.21-5.75, P < 0.01) compared to non-engrafters. A prediction score based on the aforementioned variables identified patients at high-risk (defined as having at least two of the three high risk features i.e., engraftment, pT3-4, pENE) and low-risk for LRF (43.5% vs 26.5% at 5-years, P < 0.001), DM (38.2% vs 8.4% at 5-years, P < 0.001), and poorer 5-year OS (34% vs 66%, P < 0.001). The prediction model that included engraftment had the highest discriminatory capacity in the cross-validation analysis (AUC: 67.8 [63.5-72.9]), while removal of engraftment as a predictor resulted in a lower c-index (AUC: 62.7 [57.0-68.4]). In patients classified based on a clinical score only (i.e., presence or absence of pT3-4 and pENE), engraftment remained useful in identifying those with worse outcomes. Compared to non-engrafters, engraftment was associated with higher rates of DM (15.8% vs. 5.4%, P < 0.05) in clinically "high risk" patients as well as higher rates of LRF (31.9% vs. 13.8%, P < 0.05) in clinically "low risk" patients at 5-years. Finally, engraftment was associated with poorer 5-year OS in both clinically "high risk" (36% vs. 65%, P < 0.05), and "low risk" patients (57% vs. 78%, P < 0.01). CONCLUSION: A prediction score utilizing OSCC PDX engraftment, in conjunction with pT3-4 and pENE, improves the prognostic utility of existing clinical models and predicts patients at risk for LRF, DM and poor survival.

15.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 56(10): 1080-1086, 2021 Oct 07.
Artigo em Chinês | MEDLINE | ID: mdl-34666469

RESUMO

Objective: To assess voice outcomes after surgical technique for typeⅡ and type Ⅲ sulcus vocalis. Methods: The data of 39 cases of bilateral type Ⅱ-Ⅲ sulcus vocalis were collected and analyzed retrospectively. There were 29 patients with bilateral type Ⅲ sulcus vocalis, and 10 patients with type Ⅲ on one side and typeⅡon the contralateral vocal cord. All of vocal cords were applied autologous anterior rectus sheath fascia transplant, and 68 sides of vocal cords with type Ⅲ sulcus vocalis were also applied autologous fascia and fat injection. Two male patients, whose results from transplant and injection were not satisfied, were carried out cricothyroid myotomy one year after surgery. Subjective and objective voice evaluations were performed before and after operation. Results: One patient was found mild adhesion on the middle part of vocal cords, and all the other 38 patients recovered well and there were no complications. During 5-6 weeks after surgery, breathy voice was the feather. Then vocal quality and glottal closure were gradually improved and became steady in 12 months. It showed that all the subjective and objective parameters, except for fundamental frequency, were significantly improved (P<0.05), and obvious improvement was achieved in glottal closures and mucosal waves in 35 patients. Three patients obtained no significant vocal quality improvement after transplant and injection surgery, and two male patients of them achieved improvement in mucosal waves and MPT after bilateral cricothyroid muscle amputations. One patient, who was revealed with mild adhesion, achieved a satisfied result after adhesion separation and suture. All the patients who originally had feelings of fatigue and voice discontinuity during phonation gained significant improvement postoperatively. Steady function with no complications was observed during the 36 months (up to 5 years in 20 patients) follow-up period. Conclusions: Autologous fascia transplantation combined fascia and fat injcetion can lead to excellent long-term results, and it is a good treatment option for pathologic sulcus vocalis. Cricothyroid muscle amputations can reduce the tension, and may improve vibration property of the vocal fold in patients with pathological sulcus vocalis.


Assuntos
Músculos Laríngeos , Prega Vocal , Fáscia , Humanos , Masculino , Fonação , Estudos Retrospectivos , Transplante Autólogo , Resultado do Tratamento , Prega Vocal/cirurgia
17.
Artigo em Chinês | MEDLINE | ID: mdl-34521165

RESUMO

Objective: To explore the correlation between eosinophils (Eos) and the incidence of chronic sinusitis with nasal polyps (CRSwNP) in Xinjiang region of China by comparing the proportion of inflammatory cells in the pathological tissues and peripheral blood. Methods: Retrospective analysis was performed on 582 patients with CRSwNP who underwent endoscopic nasal surgery in the First Affiliated Hospital of Xinjiang Medical University from January 2012 to March 2018, including 367 males and 215 females, aged (45.5±13.4) years (x¯±s). Patients were divided into groups according to demographic characteristics, recurrence and complication of allergic rhinitis (AR). Preoperative blood routine and postoperative pathological section data of nasal polyps were collected to compare the ratio of inflammatory cells in pathological tissue and the ratio of peripheral blood Eos in each group. The correlation between the proportion of inflammatory cells in the pathological tissue of nasal polyps and the recurrence of CRSwNP was analyzed, as well as the distribution of (eosCRSwNP) in Uygur and Han CRSwNP patients in Xinjiang region. Statistical analysis was performed by SPSS 19.0 software. Results: Compared with non-recurrent CRSwNP patients, the ratio of Eos in nasal polyp tissue and peripheral blood was increased significantly, (Z value was -3.142 and -2.344, respectively, both P<0.05). Compared with CRSwNP patients without AR, the ratio of Eos in nasal polyps and peripheral blood was also increased significantly in patients with AR (Z value was -6.664 and -4.520, respectively, both P<0.05). There was a positive correlation between tissue Eos and CRSwNP recurrence (r=0.130, P=0.002). The majority of CRSwNP patients were both eosCRSwNP in Uygur and Han ethnic groups. Conclusions: Eos is associated with the recurrence of CRSwNP in Xinjiang region, and eosCRSwNP is the dominant factor in both Uygur and Han patients.


Assuntos
Pólipos Nasais , Rinite , Sinusite , China/epidemiologia , Eosinófilos , Feminino , Humanos , Masculino , Pólipos Nasais/complicações , Pólipos Nasais/epidemiologia , Estudos Retrospectivos , Rinite/complicações , Rinite/epidemiologia , Sinusite/complicações , Sinusite/epidemiologia
18.
Artigo em Chinês | MEDLINE | ID: mdl-34521167

RESUMO

Objective: To study the oropharyngeal sensory function by Current Perception Threshold(CPT) detection, to explore the detection method of oropharyngeal sensory function in normal population, and to analyze the possible influencing factors. Methods: Fifty-eight normal subjects were included prospectively in this study. Age, gender, body mass index (BMI) were collected. The age of the subjects ranged from 20 to 76 (43.27±13.52) years old. There were 34 females with 17 in childbearing period and 17 in menopause; and 24 males were included.In all the cases, 6 cases were in low BMI, 39 cases were in normal BMI, 10 cases were overweight and 3 cases were suffering from obesity. The CPT system of Neurometer was used to stimulate bilateral palatoglossal arch and tongue base.The current used was 2000 Hz, 250 Hz and 5 Hz respectively.The function of type Aß, Aδ and C sensory nerve fibers were tested and the CPT values were recorded.The values were inversely proportional to pharyngeal sensation function.To evaluate the oropharyngeal sensory function of the subjects, the CPT values of each frequency at each testing point were compared. SPSS 25.0 software was used for statistical analysis. Results: The CPT value of palatoglossal arch was significantly lower than that of tongue base (t=-2.58,-2.65,-2.54,-2.47,-2.37,-2.77,P<0.05), 2 000 Hz>250 Hz>5 Hz, and there was no significant difference between left and right sides(t=-0.03,-0.51,-0.49,0.06,-0.16,0.13,P>0.05). The CPT value of male was slightly higher than that of female (t=0.92,1.55,0.27,0.78,1.44,1.26,0.35,0.77,1.27,0.24,0.78,0.96,P>0.05). The CPT values of women in childbearing period were significantly less than those in menopausal women (t=-3.90,-3.64,-2.14,-4.20,-4.28,-4.28,-3.52,-4.46,-3.41,-3.63,-4.66,-2.86,P<0.05). The CPT value increased with age, and the values of all frequency of 20 to 30 years old group was significantly lower than those of subjects over 40 years old at each point (The t values of bilateral palatoglossal arch at 2 000 Hz were -5.57,-6.22,-10.18,-11.00;the t values of bilateral palatoglossal arch at 250 Hz were -6.39,-8.79,-6.39,-15.61;the t values of bilateral palatoglossal arch at 5 Hz were -7.09, -5.57, -9.26, -15.23;the t values of tongue base at 2 000 Hz were -3.11,-3.88,-7.60,-8.55;the t values of tongue base at 250 Hz were -6.31,-10.59,-8.52,-10.60;the t values of tongue baseat 5 Hz were -6.69,-5.09,-8.70,-7.07,P<0.05).The values at all frequencies and testing points of 30-40 years old group were significantly lower than those of all subjects over 60 years old (The t values of bilateral palatoglossal arch at 2 000 Hz were -10.91,-12.42;the t values of bilateral palatoglossal arch at 250 Hz were -6.25,-10.87;the t values of bilateral palatoglossal arch at 5 Hz were -5.53,-11.01;the t values of tongue base at 2 000 Hz were -8.62,-10.12;the t values of tongue base at 250 Hz were -6.89,-7.82;the t values of tongue base at 5 Hz were -6.13,-6.48,P<0.05). Conclusions: CPT can be used to evaluate oropharyngeal sensory function. The sensitivity of tongue base is lower than that of palatoglossal arch, there is no significant difference in oropharyngeal sensory function between male and female,between left and right sides. There are many factors influencing oropharyngeal sensory function. Age, hormone level changes may affect the sensitivity of oropharyngeal sensory function.


Assuntos
Fibras Nervosas , Sensação , Adulto , Idoso , Estimulação Elétrica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Faringe , Limiar Sensorial , Adulto Jovem
19.
J Dermatolog Treat ; : 1-7, 2021 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-34547967

RESUMO

BACKGROUND: Psoriasis, psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) are chronic inflammatory diseases that often affect women of childbearing age. Detailed information about pregnancy and related outcomes across these indications in patients exposed to ixekizumab is lacking. OBJECTIVES: To evaluate pregnancy outcomes after maternal or paternal exposure to ixekizumab in patients with psoriasis, PsA, or axSpA. METHODS: Pregnancy cases from clinical trials and post-marketing reports, associated with either maternal or paternal exposure to ixekizumab cumulatively through 22 March 2019, were identified in the Eli Lilly Global Safety Database and described separately. RESULTS: One hundred and ninety-three ixekizumab-exposed pregnancies were identified. Maternal exposure occurred in 51.3% of pregnancies (clinical trials: n = 58; post-marketing: n = 41). The majority of paternal exposure pregnancies occurred in clinical trials (91 of 94). Live births were reported for 53.8 and 61.1% of known outcomes in maternal exposure pregnancies during clinical trials and post-marketing surveillance, respectively. No congenital malformations resulting from maternal exposure were reported in clinical trials: one case, not causally related to ixekizumab therapy, was recorded in the post-marketing setting. CONCLUSIONS: This integrated safety analysis provides relevant information for clinicians treating patients with psoriasis, PsA, or axSpA with ixekizumab. No new safety signals were identified in patients receiving ixekizumab.

20.
Zhonghua Yi Xue Za Zhi ; 101(36): 2835-2838, 2021 Sep 28.
Artigo em Chinês | MEDLINE | ID: mdl-34587725

RESUMO

Human respiratory syncytial virus (HRSV) is the main pathogen of severe lower respiratory tract infection in infants and young children. It seriously endangers children's health. In recent years, great breakthroughs have been made in the research and development of HRSV vaccines and antibody-based biological products. The research and development and use strategies are inseparable from the monitoring of HRSV prevalence and virus variation characteristics. The World Health Organization (WHO) pays great attentions to the surveillance of HRSV epidemiology and virus variation characteristics, but China lacks national level and multi-center HRSV surveillance data, the surveillance case definitions used by various laboratories are inconsistent, and the detection and surveillance methods of HRSV are not unified. Results from different laboratories are difficult to be compared and analyzed. Therefore, it is urgent to establish a nation-wide HRSV surveillance network in China, and to persistently monitor the epidemic characteristics and virus variation characteristics of HRSV by using standardized HRSV detection methods and surveillance guideline, so as to provide basic scientific data for the research and development, use and evaluation of monoclonal antibodies and vaccines.


Assuntos
Infecções por Vírus Respiratório Sincicial , Vírus Sincicial Respiratório Humano , Infecções Respiratórias , Anticorpos Monoclonais , Atenção , Criança , Pré-Escolar , Humanos , Lactente , Infecções por Vírus Respiratório Sincicial/diagnóstico , Infecções por Vírus Respiratório Sincicial/epidemiologia
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