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1.
Article in Chinese | WPRIM | ID: wpr-876160

ABSTRACT

Objective:To analyze recent economic evaluation studies of low-dose CT screening for lung cancer in order to provide recommendations for such economic evaluation in China. Methods:A systematic search and analysis was conducted to identify articles on low-dose CT screening for lung cancer published from 2015 to 2019. Results:According to the literature inclusion criteria, 15 studies were included. Most of the studies were conducted in Europe, the United States and other developed countries. The majority adopted model simulation approaches. Low-dose CT screening was suggested to be cost-effective compared with no-screening or chest radiography for lung cancer in 13 studies. Only 2 studies showed no cost-effectiveness. Conclusion:The latest evidence of economic evaluation shows that low-dose CT screening for lung cancer is cost-effective and has a more consistent result than previous reviews. Methodologically, use of microsimulation models is increasing for better economic evaluation at the individual level. However, evidence from developing countries is still insufficient. It is necessary to conduct economic evaluation in combination with the domestic practice of lung cancer screening and localized data.

2.
Article in English | WPRIM | ID: wpr-874870

ABSTRACT

Background/Aims@#Gastroparesis is identified as a subject that is understudied in Asia. The scientific committee of the Asian Neurogastroenterology and Motility Association performed a Knowledge, Attitude, and Practices survey on gastroparesis among doctors in Asia. @*Methods@#The questionnaire was created and developed through a literature review of current gastroparesis works of literature by the scientific committee of Asian Neurogastroenterology and Motility Association. @*Results@#A total of 490 doctors from across Asia (including Bangladesh, China, Hong Kong, Indonesia, Japan, Malaysia, Myanmar, the Philippines, Singapore, South Korea, Taiwan, Thailand, and Vietnam) participated in the survey. Gastroparesis is a significant gastrointestinal condition. However, a substantial proportion of respondents was unable to give the correct definition and accurate diagnostic test. The main reason for lack of interest in diagnosing gastroparesis was “the lack of reliable diagnostic tests” (46.8%) or “a lack of effective treatment” (41.5%). Only 41.7% of respondents had access to gastric emptying scintigraphy. Most doctors had never diagnosed gastroparesis at all (25.2%) or diagnosed fewer than 5 patients a year (52.1%). @*Conclusions@#Gastroparesis can be challenging to diagnose due to the lack of instrument, standardized method, and paucity of research data on normative value, risk factors, and treatment studies in Asian patients. Future strategies should concentrate on how to disseminate the latest knowledge of gastroparesis in Asia. In particular, there is an urgent need to estimate the magnitude of the problems in high risk and idiopathic patients as well as a standardized diagnostic procedure in Asia.

3.
Article in Chinese | WPRIM | ID: wpr-799357

ABSTRACT

Objective@#To evaluate the application of calcium suppressed (CaSupp) spectral CT technique in evaluating disk position and measuring the thickness of the posterior band of temporomandibular joint (TMJ).@*Methods@#The twenty-three temporomandibular disorder patients [mean age 23(12~62) years, male/female=14/9] were performed with oblique sagittal and coronal proton density weighted imaging (PDWI) and spectral CT scans from February to July, 2019 in Department of Radiology, Hainan Hospital of General Hospital of Chinese PLA, and 45 TMJ joints were evaluated. The subjects were classified into two groups according to the scanning modalities: MRI measurement group and CaSupp spectral-based CT group. The CaSupp technique were applied with the spectral-based CT images and CaSupp images were generated. The oblique sagittal and coronal CaSupp imaged were reformatted by perpendicular to the long axis of the condyle. The TMJ disk positions were evaluated on oblique sagittal and coronal images, and the maximal disk thickness were measured on the oblique sagittal images.@*Results@#The joint position was basically consistent on MRI and CaSupp images for the 45 TMJ joints. The intra-class coefficient value was 0.843 (0.712, 0.914) for the measurement of the posterior band of the TMJ disk between MRI and CaSupp images. Bland-Altman presented that the [95.6% (43/45)] points with the difference located in the 95% agreement interval. Wilcoxon paired text demonstrated that there was no significant different for the thickness of the posterior band between MRI [2.57 (1.76, 3.65) mm] and CaSupp images [2.67 (1.74, 4.56) mm] (P=0.07).@*Conclusions@#The CaSupp spectral-based CT could be used to evaluated the TMJ disk position and the thickness of the posterior band.

4.
Article in Chinese | WPRIM | ID: wpr-798852

ABSTRACT

Pulmonary fibrosis is the late stage of many lung diseases. It′s a pathological process with excessive deposition of extracellular matrix, tissue scar formation and lung tissue remodeling. Recently, DNA methylation has been demonstrated to involve in organ fibrosis, includingpulmonary, liver, renal fibrosis and so on. DNA methylation plays an important role in clinical diagnosis and treatment. This article reviews the role of DNA methylation in the development of pulmonary fibrosis and discusses thepathogenic mechanism of pulmonary fibrosis and new anti-fibrotic strategy.

5.
Article in English | WPRIM | ID: wpr-880519

ABSTRACT

OBJECTIVE@#To investigate the ameliorate effect and underlying mechanism of Xueshuantong for Injection (Lyophilized, , XST) in streptozocin (STZ)-induced diabetic retinopathy (DR) rats.@*METHODS@#Diabetes mellitus (DM) model was induced by intraperitoneal (i.p.) injection of STZ (60 mg/kg) in Sprague-Dawley rats. Diabetic rats were randomized into 3 groups (n=10) according to a random number table, including DM, XST50 and XST100 groups. XST treatment groups were daily i.p. injected with 50 or 100 mg/kg XST for 60 days, respectively. The control and DM groups were given i.p. injection with saline. Blood glucose level and body weight were recorded every week. Histological changes in the retina tissues were observed with hematoxylin-eosin staining. Apoptosis and inflammation related factors, including cleaved caspase-3, glial fifibrillary acidic protein (GFAP), tumor necrosis factor-α (TNF-α) and intercellular cell adhesion molecule-1 (ICAM-1) were detected by Western blot or real-time polymerase chain reaction. Then, the levels of advanced glycation end product (AGE) and its receptor (RAGE) were investigated. Tight junctions proteins (Zonula occludens-1 (ZO-1), Occludin and Claudin-5) of blood-retinal barrier were detected by Western blot. The levels of retinal fifibrosis, transforming growth factor-β1 (TGF-β1)-Smad2/3 signaling pathway were evaluated at last.@*RESULTS@#There was no signifificant difference in the body weight and blood glucose level between XST and DM groups (P>0.05). Compared with the DM group, XST treatment signifificantly increased the retinal thickness of rats (P<0.05 or P<0.01), and suppressed cleaved caspase-3 expression (P<0.01). XST increased the protein expressions of ZO-1, Occludin and Claudin-5 and decreased the mRNA expressions of matrix metalloproteinase 2 (MMP-2) and MMP-9 (P<0.05 or P<0.01). Moreover, XST signifificantly reduced the productions of AGE and RAGE proteins in the retina of rats (P<0.05 or P<0.01), suppressed the over-expression of TNF-α, and decreased the elevated level of ICAM-1 in retina of rats (P<0.05 or P<0.01). XST signifificantly reduced the levels of α-smooth muscle actin (α-SMA), connective tissue growth factor (CTGF), TGF-β1 and phosphorylation of Smad2/3 protein in rats (P<0.05 or P<0.01).@*CONCLUSIONS@#XST had protective effects on DR with possible mechanisms of inhibiting the inflammation and apoptosis, up-regulating the expression of tight junction proteins, suppressing the productions of AGE and RAGE proteins, and blocking the TGF-β/Smad2/3 signaling pathway. XST treatment might play a role for the future therapeutic strategy against DR.

6.
Neurology Asia ; : 377-381, 2020.
Article in English | WPRIM | ID: wpr-877272

ABSTRACT

@#Objective: This study aimed to evaluate the effects of implementation of a neurological sub-specialized nursing module in critically ill neurological patients. Methods: We selected 22 neurological nurses from our hospital in Nanchang, China as study subjects. The outcome of 100 neurological patients were documented and evaluated. The period from December 2017 to March 2018 was the preimplementation period, in which the conventional nursing was implemented in 50 patients. The time from April 2018 to July 2018 was the post-implementation period, in which the sub-specialized nursing module was implemented with another 50 patients. We conducted assessment and evaluation consisting of doctor satisfaction, nursing complications (aspiration, diarrhea, pressure sores, and ventilatorassociated pneumonia), and the comprehensive ability of nurses in the pre- and post-implementation periods. Results: The total comprehensive ability score of the nurses after implementing the nursing module was higher than that before the implementation (P < 0.05). The satisfaction rate of doctors after implementation (95.45%) was also higher (68.18%) (P < 0.05), and the incidences of nursing complications (aspiration, diarrhea, pressure sores, and ventilator-associated pneumonia) among patients were lower after implementing the nursing module (P < 0.05). Conclusion: The implementation of a sub-specialized nursing module in the care of patients with critically ill neurological diseases can improve the comprehensive ability of nurses and the satisfaction rate of doctors as well as reducing the incidence of nursing-related complications.

7.
Article in Chinese | WPRIM | ID: wpr-876389

ABSTRACT

Objective To study the relationship between cytology of cervical lesion and HPV in female medical workers. Methods From Fudan University Hospital of Obstetrics and Gynacology the results of cervical cytology screening in 1 093 female medical staff in 2015-2017 and results of HPV screening in 1 085 cases in 2017 were collected.SurePath liquid-based cell preparation was used for cytology and the segr-21 typing kit was used for HPV detection.The relationship between the pathological results of cervical colposcopy biopsy and HPV infection was studied by single factor and multiple factor regression analysis. Results The rate of HPV infection for subjects in the study was 10.0% (108/1 085), with increase in age, the infection rate showed an insignificant rising trend(χ2=4.43, P=0.11).High-risk HPV infection accounted for 95.37% (103/108), and the major high-risk HPV infections were HPV 52, HPV53, HPV58, and HPV16 in descending order.The 3-year cytological positive rates were 1.5%, 1.6% and 4.0%, respectively.Sixty-six of the HPV and/or cytological positive cases underwent colposcopy biopsy, and the proportion of cytology being positive, HPV positive, HPV16 positive, cytology negative in 2015 and 2016 was 41.1%, 19.1%, 60% and 29.7%, respectively.Multiple logistic regression showed that cytology was an independent risk factor, OR=7.87 (95%CI:1.85-33.54). Conclusion The rate of HPV infection in medical staff is lower than that in the general population, but the composition ratio of high-risk HPV infection is very high.It is recommended that women should undergo HPV test regularly from sexual life; early detection of high-risk HPV infection could prevent the occurrence of cervical cancer.The sensitivity and specificity of cervical cytology screening prove to be higher than those of HPV screening in people with low infection rate, and the cytology screening cycle should not exceed one year.

8.
Article in Chinese | WPRIM | ID: wpr-872868

ABSTRACT

Objective:To investigate the effect of salvianolate lyophilized injection and Xueshuantong injection (lyophilized) on the permeability of blood-brain barrier (BBB) via inhibition of metallomatrix protease(MMPs) in cerebral ischemia/reperfusion injury rats. Method:The focal cerebral ischemia/reperfusion model in rats was built by middle cerebral artery occlusion/reperfusion (MCAO/R) technique. Male Wistar rats were randomly divided into sham operation group, ischemia/reperfusion (I/R) group, edaravone (Eda, 6 mg·kg-1) group, salvianolate lyophilized injection (SLI, 21 mg·kg-1) group, Xueshuantong (XST, 100 mg·kg-1) group and SLI combined with XST (SLI+XST, 21 mg·kg-1+100 mg·kg-1) group. Drugs were injected via tail vein for 2 d, while sham group and I/R group were injected with the same amount of normal saline. Neurological deficit score, hematoxylin-eosin (HE) staining and Nissl staining were assessed 2 d after MCAO/R. The permeability of BBB was observed by the leakage of IgG/CD31. The expressions of Claudin-5,Occludin,collagen-Ⅳ(Col- Ⅳ),Laminin,Fibronectin were observed by immunofluorescence staining,and MMP-2 and MMP-9 were observed by Western blot. Result:Compared with the I/R group, SLI group, XST group and SLI+XST group showed improvements in neurological deficit score, HE staining and Nissl staining. The leakage of IgG was alleviated; The positive expressions of Claudin-5,Occludin,Col-Ⅳ,Laminin,Fibronectin in ischemic penumbra were significantly up-regulated, while the expressions of MMP-2 and MMP-9 were down-regulated. The effect in improving SLI combined with XST was much better than a single factor. Conclusion:Salvianolate lyophilized injection and Xueshuantong injection (lyophilized) can alleviate cerebral ischemia/reperfusion injury and exert the synergistic effect when they are used in combination. The mechanisms might be associated with the improvement in the permeability of blood-brain barrier by inhibiting MMPs in cerebral ischemia/reperfusion injury rats.

9.
Article in Chinese | WPRIM | ID: wpr-871943

ABSTRACT

Apolipoprotein M (apoM), a member of apolipoprotein family, is primarily combined to high density lipoprotein (HDL) in plasma. The study of apoM developed into a new period since it was discovered as the major carrier of Sphingosine-1-phosphate (S1P) in circulation. apoM-S1P regulates diverse downstream signaling pathways mainly by binding to and activating specific cell-surface receptors. Being aware of the functions of apoM-S1P in different diseases helps us to explore the pathogenesis of diseases and casts new lights on its precaution and treatment. The relationship between apoM-S1P axis and diseases is reviewed below.

10.
Article in Chinese | WPRIM | ID: wpr-871850

ABSTRACT

Pulmonary fibrosis is the late stage of many lung diseases. It′s a pathological process with excessive deposition of extracellular matrix, tissue scar formation and lung tissue remodeling. Recently, DNA methylation has been demonstrated to involve in organ fibrosis, includingpulmonary, liver, renal fibrosis and so on. DNA methylation plays an important role in clinical diagnosis and treatment. This article reviews the role of DNA methylation in the development of pulmonary fibrosis and discusses thepathogenic mechanism of pulmonary fibrosis and new anti-fibrotic strategy.

11.
Article in Chinese | WPRIM | ID: wpr-868473

ABSTRACT

Objective:To explore the changes in activity of indoleamine 2, 3-dioxygenase(IDO)before and after stereotactic body radiation therapy (SBRT) in early stage non-small cell lung cancer(NSCLC) and its relationship with survival.Methods:The retrospective study was to assess IDO activity by serum kynurenine (Kyn) and Kyn to tryptophan (Trp) ratio before and after SBRT of early stage NSCLC.Thirty early stage NSCLC patients who received SBRT in the Cancer Hospital of the University of Chinese Academy of Sciences were enrolled, from December 2014 to July 2017. High-performance liquid chromatography and mass spectrometry were used to detect serum Kyn and Trp before and after SBRT. The ratios of Kyn after SBRT to Kyn before SBRT were divided into high and low group according to the median value. Similarly, the ratios of Kyn to Trp after SBRT were divided into high and low group.The correlation between overall survival (OS), progression-free survival (PFS) and IDO activity was evaluated. The factors influencing prognosis were analyzed.Results:In all patients, lower ratio of Kyn after SBRT to Kyn before SBRT significantly was correlated with better PFS (median PFS: not reached vs. 26.8 months, HR=0.31, 95% CI =0.11-0.90, P<0.05). The lower Kyn∶Trp ratio after SBRT had longer OS (median OS: not reached vs. 36.5 months, HR=0.27, 95% CI =0.079-0.95, P<0.05). In multivariate analysis, smoking <30 packs/year, higher BED, and lower ratio of Kyn after SBRT to Kyn before SBRT were associated with longer PFS. Lower Kyn∶Trp ratio after SBRT and higher BED were associated with longer OS. Conclusions:SBRT could alter IDO-mediated antitumor immune activity. IDO is a potentially valuable biomarker for monitoring immune status and predicting survival in early NSCLC patients after SBRT.

12.
Chinese Journal of Stomatology ; (12): 537-539, 2019.
Article in Chinese | WPRIM | ID: wpr-805699

ABSTRACT

This pilot study aimed to investigate the feasibility of trans-oral ultrasonography of the temporomandibular joint (TMJ) in oblique sagittal plane. Six volunteers who were receiving residency training at Hainan Hospital of General Hospital of Chinese PLA were recruited into this study, five of them had normal TMJ and one had anterior displaced disc all of which had been confirmed by MRI. A hockey-stick-shaped ultrasound probe was placed between the cheek and maxilla to push against the mucosa lateral to posterior maxillary tuberosity, and every volunteer underwent bilateral scans. The sonographic imaging were completed successfully on the six volunteers; the condyle, the superior and the inferior head of the lateral pterygoid muscle, the disc and the maxillary vein were clearly identified in all the twelve ultrasonographic scans. The feasibility of trans-oral ultrasonography of TMJ in oblique sagittal plane was confirmed.

13.
Chinese Medical Journal ; (24): 1400-1405, 2019.
Article in English | WPRIM | ID: wpr-799954

ABSTRACT

Background@#Necroptosis plays an important role in human atherosclerosis and atheroma development. Since receptor interacting protein kinase-3 (RIP3) acts as a key mediator of necroptosis, this study aimed to explore its relationship between plasma RIP3 levels and coronary artery disease (CAD) and discover a potential new biomarker for screening CAD subtypes and severity.@*Methods@#A total of 318 patients with CAD who had coronary angiography and 166 controls in Peking Union Medical College Hospital from September 2017 to January 2018 were enrolled in this study. Patients with CAD were divided into three subgroups: patients with stable coronary artery disease (SCAD), patients with unstable angina (UA), and patients with myocardial infarction (MI). The severity of atherosclerosis was determined by Gensini score (GSS). Logistic regression was used to determine the relationship between plasma RIP3 levels and CAD. The correlation between plasma RIP3 and GSS was calculated using multiple linear regression models.@*Results@#Overall, plasma RIP3 levels were significantly higher than serum RIP3 levels. Plasma RIP3 levels in patients with CAD were significantly higher than those in controls. Plasma RIP3 levels were strongly associated with CAD (odds ratio: 6.00, 95% confidence interval 3.04–11.81; P < 0.001). Plasma RIP3 levels increased linearly from controls to patients with SCAD, then patients with UA, and finally to patients with MI. We found a significantly positive correlation between proportion of cases of acute coronary syndrome in subjects and their plasma RIP3 level quartile. Plasma RIP3 levels were also associated with GSS (B 0.027; standard error 0.012; P < 0.05).@*Conclusions@#Plasma RIP3 levels were independently associated with CAD. Plasma RIP3 levels could potentially supplement clinical assessment to screen CAD and determine CAD severity.

14.
Chinese Journal of Stomatology ; (12): 632-638, 2019.
Article in Chinese | WPRIM | ID: wpr-797553

ABSTRACT

Objective@#To investigate the regulation of curculigoside on osteogenic differentiation of MG63 and the protective effect on osteoporosis model mice.@*Methods@#The effects of curculigoside on the survival rate of dexamethasone or H2O2 treated MG63 were detected by methyl thiazolyl tetrazolium (MTT). The specimens were divided into six groups: blank control group, blank administration group, model group (dexamethasone or H2O2 treatment group), low dose group (dexamethasone or H2O2+1.0 μmol/L curculigoside), medium dose group (dexamethasone or H2O2+2.5 μmol/L curculigoside) and high dose group (dexamethasone or H2O2+5.0 μmol/L curculigoside), the sample size of each group was 10. Western blotting was used to detect the expression of osteogenic differentiation-related proteins [type Ⅰ collagen, integrin β1, osteoblast-specific transcription factor (Osterix), osteocalcin and osteopontin] in MG63 cells after 1, 7 and 14 days incubated with 0, 1.0, 2.5 and 5.0 μmol/L of curculigoside. The sample size for each group at each time point was six. The experimental mice were divided into 4 groups: blank group, model group (dexamethasone treatment group), curculigoside low-dose group (dexamethasone+5 mg/kg curculigoside) and high-dose group (dexamethasone+45 mg/kg curculigoside), twenty each. After treatment, the tibia of the mice in each group were subjected to sacral HE staining. The number of osteoclasts was counted, and the levels of oxidative related factors in serum were determined by enzyme-linked immunosorbent assay (ELISA).@*Results@#The MTT results showed that compared with the blank control group [(100±3.7)%], the cell survival rate decreased to (44.1±5.7)% after treatment with dexamethasone, and the survival rate increased to (79.7±3.8)% after treatment with 5.0 μmol/L of curculigoside. The cell survival rate decreased to (59.1±4.7)% after H2O2 treatment, and the survival rate increased to (80.8±3.5)% after treatment with 2.5 μmol/L of curculigoside. The results of Western blotting showed that the expression of type Ⅰ collagen and integrin β1 in MG63 cells was significantly increased after 1.0, 2.5 and 5.0 μmol/L of curculigoside for 1, 7 and 14 days compared with 0 μmol/L of curculigo side for the same period. After increasing (P<0.05), the expression of Osterix and osteocalcin was significantly increased after 1 day of incubation (P<0.05). However, compared with 0 μmol/L curculigoside treatment, the expression of osteopontin in MG63 cells was not significantly different after incubation with 1.0, 2.5, 5.0 μmol/L of curculigoside for 7 and 14 days (P>0.05). Compared with the blank group, the number of tibia osteoclasts in the osteoporosis model group increased. In the low-dose and high-dose groups of curculigoside, the tibia cortex was more continuous and the number of osteoclasts decreased. Compared with the blank group, the activity of oxygen in the osteoporosis model group was significantly increased (P<0.05), and superoxide dimutase and catalase were significantly decreased (P<0.05).@*Conclusions@#Curculigoside promotes the differentiation of MG63 cells by increasing the expression of osteoblast differentiation-related proteins, and has a certain therapeutic effect on dexamethasone-induced osteoporosis mice.

15.
Chinese Journal of Stomatology ; (12): 628-631, 2019.
Article in Chinese | WPRIM | ID: wpr-797552

ABSTRACT

Objective@#To explore the feasibility of using da Vinci Surgical System to perform supraomohyoid neck dissection (SOND) to avoid visible scar and reduce trauma.@*Methods@#Between September 2017 and December 2018, twenty patients (two females and 18 males, mean age, 54.8 years) with oral cancer treated in the Department of Stomatology, Hainan Hospital of General Hospital of Chinese PLA were enrolled in this study. Eight patients were assigned into robotic surgery group, and received robot-assisted SOND with retroauricular hairline incision. After the da Vinci Surgical System robotic platform was positioned, the neck dissection was performed in level Ⅱb, Ⅱa, Ⅲ, Ⅰb and Ⅰa orderly from the near region to far region. The other 12 patients were assigned into traditional surgery group, and received SOND with a traditional incision. The operation time, bleeding and amount of lymph node dissected were compared between two groups.@*Results@#All the 8 cases of robot-assisted SOND were completed smoothly. Operation time [(4.5±1.0) h] was significantly longer in robotic surgery group than that [(2.5±1.0) h] in traditional surgery group (P<0.05). The amount of bleeding in robotic surgery group [30.0 (27.5) ml] was significantly lower than that in traditional surgery group [(100.0 (87.5) ml, P<0.05]. There′s no difference in the number of lymph nodes dissected between robotic surgery group (23.6±5.2) and traditional surgery group (22.8±6.0)(P>0.05). No postoperative hemorrhage, symptoms of nerve injury, flap necrosis and secondary healing were observed in robotic surgery group.@*Conclusions@#SOND through retroauricular hairline incision is feasible with the assistance of da Vinci Surgical System. The main advantage of this method is superior esthetic effects due to a hidden incision with minimal bleeding. There was no obvious differences in the amount of lymph nodes dissected and postoperative complications between two methods. However, robotic surgery costs a significantly longer operation time than traditional neck dissection.

16.
Intestinal Research ; : 285-310, 2019.
Article in English | WPRIM | ID: wpr-764161

ABSTRACT

The Asia-Pacific Working Group on inflammatory bowel disease (IBD) was established in Cebu, Philippines, under the auspices of the Asian Pacific Association of Gastroenterology with the goal of improving IBD care in Asia. This consensus is carried out in collaboration with Asian Organization for Crohn's and Colitis. With biologic agents and biosimilars becoming more established, it is necessary to conduct a review on existing literature and establish a consensus on when and how to introduce biologic agents and biosimilars in the conjunction with conventional treatments for ulcerative colitis (UC) and Crohn's disease (CD) in Asia. These statements also address how pharmacogenetics influence the treatments of UC and CD and provide guidance on response monitoring and strategies to restore loss of response. Finally, the review includes statements on how to manage treatment alongside possible hepatitis B and tuberculosis infections, both common in Asia. These statements have been prepared and voted upon by members of IBD workgroup employing the modified Delphi process. These statements do not intend to be all-encompassing and future revisions are likely as new data continue to emerge.


Subject(s)
Adalimumab , Asia , Asian Continental Ancestry Group , Biological Factors , Biosimilar Pharmaceuticals , Colitis , Colitis, Ulcerative , Consensus , Cooperative Behavior , Crohn Disease , Gastroenterology , Hepatitis B , Humans , Immunologic Factors , Inflammatory Bowel Diseases , Infliximab , Pharmacogenetics , Philippines , Practice Guidelines as Topic , Tuberculosis , Ulcer
17.
Article in English | WPRIM | ID: wpr-719711

ABSTRACT

PURPOSE: The prevalence of PIK3CA in Chinese breast cancer patients may be underestimated. Therefore, we investigated the distribution of somatic PIK3CA/AKT1 mutations in Chinese breast cancer patients and explored their roles in tumor phenotypes and disease prognosis. MATERIALS AND METHODS: Tumors from 507 breast cancer patients were prospectively collected from the West China Hospital between 2008 and 2013. Whole exons of AKT1 and PIK3CA were detected in fresh-frozen tumors using next-generation sequencing, and correlations between PIK3CA/AKT1 mutations and clinicopathological features were analyzed. RESULTS: The AKT1 mutation was found in 3.6% (18/507) of patients. Tumors from patients that carried the AKT1 mutation were estrogen receptor (ER)+/progesterone receptor (PR)+/human epidermal growth factor receptor 2 (HER2)‒ and were more likely to have high expression levels of Ki67. The prevalence of the PIK3CA mutation was 46.5% (236/507), and 35 patients carried two or three variants of the PIK3CA gene. PIK3CA mutations were associated with ER+/PR+/HER2‒ status. The prognosis of patients with one mutation in PIK3CA (or PIK3CA/AKT1) was not significantly different than that of patients with wild-type PIK3CA (or PIK3CA/AKT1), while patients with two or three variants in PIK3CA (or PIK3CA/AKT1) exhibited poorer outcomes in the entire group and in all three subgroups (ER+, HER2‒, Ki67 high), particularly with respect to overall survival. CONCLUSION: A high frequency of somatic PIK3CA mutations was detected in Chinese breast cancer patients. In addition to the mutation frequency, the tumor mutational burden of the PIK3CA and AKT1 genes should also be of concern, as they may be associated with poor prognosis.


Subject(s)
Asian Continental Ancestry Group , Breast Neoplasms , Breast , China , Estrogens , Exons , Humans , Mutation Rate , Phenotype , Prevalence , Prognosis , Prospective Studies , ErbB Receptors
18.
Acta Pharmaceutica Sinica ; (12): 971-977, 2019.
Article in Chinese | WPRIM | ID: wpr-780178

ABSTRACT

Myeloproliferative neoplasms (MPNs) result from clonal expansion of haematopoietic stem cells and are characterized by abnormal proliferation of myeloid lineage cells in the bone marrow. Sustained activation of JAK-STAT signaling pathway due to JAK2 phosphorylation is an important cause of MPNs, and mutation of JAK2 kinase can keep it in a state of continuous phosphorylation. The most typical mutation in JAK2 is a site mutation of V617F in the pseudokinase domain. The JAK2V617F-activating mutation is highly prevalent in MPNs, with frequencies estimated at approximately 95% in polycythaemia vera (PV) and 50% in primary myelofibrosis (PMF) and essential thrombocytosis (ET) patients. It is now clear that JAK2 is an important target for treatment of MPNs. Inhibiting aberrant activation of the JAK2-STAT signaling pathway has become a popular trend in research for effective treatment of MPNs. This review summarizes the research progress in developing JAK2 inhibitors for treatment of MPNs in recent years, including the new discoveries of the biological functions of JAK2, the relationship between JAK2 and MPN, and the status of development of JAK2 small molecule inhibitors.

19.
Journal of Experimental Hematology ; (6): 1166-1172, 2019.
Article in Chinese | WPRIM | ID: wpr-775747

ABSTRACT

OBJECTIVE@#To study the effects of clinicopathological features, laboratory parameters and treatment regimens on the prognosis of patients with multiple myeloma.@*METHODS@#The clinical data of 97 patients with multiple myeloma treated with chemotherapy in Department of Hematology, the 1st Hospital of Hainan Medical College were analyzed retrospectively. The clinicopathological features (age, sex, severe anemia, light chain type, hypoproteinemia, paraplegia, renal injury, amyloidosis, complex karyotype, bone disease classification, Eastern Cooperative Oncology Group (ECOG) physical status score, complete remission, etc.), laboratory parameters (C-reactive protein, lactate dehydrogenase, blood calcium, serum β2 microglobulin, etc.), and treatment schemes (thalidomide maintenance treatment) were recorded. The patients were followed up for 1-60 months, and their total survival time were recorded. A single factor and multiple factors were used to analyze the factors affecting the total and early mortality of the patients. The survival curves were plotted by the Kaplan-Meier method and the survival analysis was carried out by Log-rank test.@*RESULTS@#Among 97 patients, 29 cases (29.90%) achieved complete remission, and 56 cases (57.73%) achineved partial remission. The total effective rate was 87.63% (85/97). At the end of the follow-up, 19 cases (19.59%) died, and 1, 3 and 5 year survival rates were 80.41%, 71.13% and 37.11% respectively. The median overall survival time was 29 (1-60) months. The results of single factor analysis showed that age, hypoproteinemia, severe anemia, paraplegia, renal injury, amyloidosis, complex karyotype, complete remission and thalidomide maintenance therapy were the factors affecting the prognosis of the patients (all P<0.05). Further multiple factor Logistic regression analysis showed that age and hypoproteinemia, severe anemia, paraplegia, amyloidosis, complex karyotype and thalidomide maintenance treatment were factors affecting the prognosis (P<0.05). Of the 97 patients, 8 cases died early. The results of single factor analysis showed that amyloidosis and severe anemia were risk factors for early death (all P<0.05), and further multivariate Logistic regression analysis showed that amyloidosis was an independent risk factor for early death (P<0.05).@*CONCLUSION@#There are many adverse factors affecting the prognosis of patients with multiple myeloma, such as age, hypoproteinemia, severe anemia, paraplegia, amyloidosis, complex karyotype and so on. The risk of early death in the patients with amyloidosis is higher, and salidomide maintenance therapy can help to prolong the life span of the patient.


Subject(s)
Amyloidosis , Humans , Multiple Myeloma , Prognosis , Retrospective Studies , Thalidomide
20.
Journal of Integrative Medicine ; (12): 167-172, 2019.
Article in English | WPRIM | ID: wpr-774265

ABSTRACT

BACKGROUND@#Fire-needle acupuncture, an important kind of acupuncture therapy, has been clinically used to treat upper limb spastic paralysis (ULSP) after stroke. Clinical experience has indicated that fire-needle acupuncture treatment takes less time, requires fewer visits, and has more rapid results and fewer side effects compared to chemical medicine alternatives. This study will evaluate the effects of fire-needle acupuncture for ULSP in the context of standardized clinical research and provide high-quality data to inform clinical procedures and future study design.@*METHODS/DESIGN@#A randomized controlled trial will be carried out to evaluate the effects of fire-needle acupuncture therapy in patients with ULSP from stroke. ULSP patients (n = 120) will be recruited at Changhai Hospital in Shanghai, China. Patients will be randomly divided into three groups, including fire-needle acupuncture group (FAG), filiform-needle acupuncture group (FFAG) and rehabilitation treatment group (RTG). During the 3-week treatment, the FAG will be treated every two days, while FFAG and RTG will be treated 5 d in a row and then rest for 2 d. The Simplified Fugl-Meyer Motor Function Scale and Modified Ashworth Scale will be used as the primary outcome measures. Statistical analysis will be conducted by an independent statistician.@*DISCUSSION@#Through this study, the utility of fire-needle acupuncture in treating ULSP after stroke will be tested, and some specific claims of fire-needle acupuncture therapy will be evaluated, such as relieving spasm and muscular tension, improving activities of daily living, rapidity of response and less frequency of treatment compared with other treatments.@*TRIAL REGISTRATION@#Chinese Clinical Trial Registry (identifier: ChiCTR-IOR-17013875; registration date: 28 December 2016).

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