1.Biobank development in the context of precision medicine:roadblocks and countermeasures
Xiaoli JI ; Zhibao LYU ; Fang CHEN ; Junmei ZHOU
Chinese Journal of Hospital Administration 2016;32(9):692-694
Introduced in this paper are the current situation of biobank in China in the context of precision medicine.As a vital platform of precision medicine,biobank constitutes a resource support for this plan.Establishing high quality biobank has important implications for the implement of precision medicine in China.This paper focused on the problems existing in biobank development in the context of precision medicine and put forward corresponding countermeasures as well as suggestions.
2.Evaluation of the new scoring system for gastric cancer screening and risk assessment of gastric precancerous lesions
Xiaoteng WANG ; Zizhong JI ; Feng HAN ; Bin LYU
Chinese Journal of Digestive Endoscopy 2021;38(5):379-383
Objective:To evaluate the new scoring system for gastric cancer screening and risk assessment of gastric precancerous lesions.Methods:A total of 442 patients who underwent endoscopy due to stomach discomfort at the First Hospital of Jiaxing from March 2018 to September 2019 were enrolled. The patients were divided into three groups based on the new scoring system for gastric cancer screening before endoscopy: low-risk group (0-11 points), median-risk group (12-16 points) and high-risk group (17-23 points). The detection rates of gastric cancer and atrophic gastritis in three groups were analyzed. According to the range or degree of atrophy or intestinal metaplasia, patients were divided into five groups of stage 0 to Ⅳ based on the operative link for gastritis assessment (OLGA) or operative link for gastritis intestinal metaplasia (OLGIM). The correlation between the new gastric cancer screening scoring system and OLGA or OLGIM staging system were evaluated.Results:Among 442 patients, 211 were assigned to low-risk group, 207 median-risk group and 24 high-risk group according to the new scoring system. For OLGA staging system, there were 241 cases of stage-0, 105 of stage-Ⅰ, 58 stage-Ⅱ, 27 stage-Ⅲ and 11 stage-Ⅳ. For OLGIM staging system, there were 224 cases of stage-0, 113 stage-Ⅰ, 61 stage-Ⅱ, 31 stage-Ⅲ and 13 stage-Ⅳ. The pepsinogen (PG) Ⅰ and pepsinogen ratio (PGR) levels had differences among different OLGA stages ( F=2.844, P=0.027; F=5.435, P=0.001), and these two variables at Stage-Ⅲ and Ⅳ were significantly lower than three other OLGA stages (all P<0.001). The PGR level had differences among different OLGIM stages ( F=3.887, P=0.008), which was significantly lower at Stage-Ⅳ than at other OLGIM stages (all P<0.001). Gamma coefficient analysis and Kendall′s tau-b analysis showed significant correlations between OLGA/OLGIM staging system and new gastric cancer screening scoring system ( P<0.001). Conclusion:The new scoring system is reliable for gastric cancer screening, and is closely linked with OLGA/OLGIM staging system in the risk assessment of gastric precancerous lesions.
3.Tumor angiogenic mechanisms of esophageal squamous cell carcinoma
Yajing LYU ; Wei WANG ; Chushu JI ; Bing HU
Journal of International Oncology 2016;43(6):465-467
Vascular endothelial growth factor,hypoxia inducible factor,interleukin,angiopoietin-like protein,integrin and epithelial mesenchymal transition can provide nutritional support and favorable environment for the growth,invasion and metastasis of cancer cells.Researches about mechanisms of the angiogenesis in esophageal squamous cell carcinoma may provide more ideas and potential targets for the anti-angiogenesis targeted therapy.
4.A comparative study of new gastric cancer screening scoring system and new ABC method for screening gastric cancer and precancerous lesions
Xiaoteng WANG ; Zizhong JI ; Feng HAN ; Bin LYU
Chinese Journal of Internal Medicine 2021;60(3):227-232
Objective:To compare the value of new gastric cancer screening scoring system and serum pepsinogen (PG) combined with gastrin-17 (G-17) (new ABC method) in screening gastric cancer and precancerous lesions.Methods:A total of 576 patients were enrolled after the examination of endoscopy at Endoscopy Center,Department of Gastroenterology,from December 2017 to December 2019. There were 275 males and 301 females with an age of 40-72 (52±10) years. According to the new ABC method and the new gastric cancer screening scoring system, the population was divided into three groups according to age,gender,serum helicobacter pylori antibody test, PG Ⅰ/PG Ⅱ(PGR) and G-17 before endoscopy. The detection rates of gastric cancer and atrophic gastritis by two different methods were analyzed and the value in screening gastric cancer and precancerous lesions were evaluated. Statistical analysis was accomplished by Chi-square test and Gamma coefficient analysis. Results:A total of 576 patients were enrolled. According to the new ABC method, 382 patients were classified into low-risk group, 170 patients into middle-risk group and 24 patients into high-risk group, respectively. In the new ABC method, 1 case of gastric cancer (0.3%) was detected in low-risk group, 8 cases (4.7%) in middle-risk group and 3 cases (12.5%) in high-risk group. As for atrophic gastritis, 89 cases (23.3%) was detected in low-risk group, 94 cases (55.3%) in middle-risk group and 18 cases (75.0%) in high-risk group. According to the new gastric cancer screening scoring system, 336 patients were classified into low-risk group, 205 patients into middle-risk group and 35 patients into high-risk group, respectively. One case of gastric cancer (0.3%) was detected in low-risk group, 6 cases (2.9%) in middle-risk group and 5 cases (14.3%) in high-risk group. As for atrophic gastritis, 41 cases (12.2%) were detected in low-risk group, 134 cases (65.4%) in middle-risk group and 26 cases (74.3%) in high-risk group. In this two methods, the prevalence of gastric cancer increased according to the disease stage ( χ2 =22.509, P<0.01; χ2=24.156, P<0.01); in terms of atrophic gastritis, the detection rate of the new screening scoring system in the low-risk group was significantly lower than that in the new ABC method ( χ2=14.844, P<0.01), but higher in the middle-risk group ( χ2=3.955, P=0.047). Gamma coefficient test showed that there were strong correlations between gastroscopy pathology and classification grade of both methods ( P<0.01). Conclusions:Both methods are suitable for screening gastric cancer and precancerous lesions, and the new scoring system may be more valuable in screening gastric cancer and precancerous lesions.
7.The accuracy of Computed Tomography Angiography (CTA) in diagnosis of multiple intracranial aneurysms
Qinjiang HUANG ; Zongduo GUO ; Xiaodong ZHANG ; Meng ZHOU ; Xiaochuan SUN ; Fajin LYU ; Ji ZHU ; Zhaohui HE
Chinese Journal of Nervous and Mental Diseases 2016;42(6):330-333
Objective The purpose of this study is to explore the clinical value of CT angiography( CTA) in the diagnosis of multiple intracranial aneurysms.Methods The data of CTA and DSA from 74 patients with multiple intracra-nial aneurysms from July 2011 to March 2015 were reviewed retrospectively.Results One hundred seventy-seven aneu-rysms were detected by DSA, and 175 aneurysms were detected by CTA.Among the aneurysms identified by CTA, 4 aneu-rysms were false positive and the correct detection rate of CTA was 96.6%.One hundred sixty-five aneurysms identified by CTA were confirmed by DSA and the correct diagnostic rate of CTA was 96.5%.CTA failed to detect 6 aneurysms and mis-diagnosed 10 aneurysms.Conclusions The correct detection rate and diagnostic rate of CT angiography ( CTA) in multiple intracranial aneurysms is relatively high.But previous surgery, spasm of the vessels, the size and number of aneurysms, radiologists'experience can influence the accuracy of ( CTA) in the diagnosis of multiple intracranial aneurysms, indicating that we should combine CTA with DSA to avoid the misdiagnosis and missed diagnosis.
8.Correlation between 3 instruments for measurement of surgical outcomes of tibial plateau fractures
Liang YUAN ; Yang LYU ; Fang ZHOU ; Hongquan JI ; Yun TIAN ; Zhishan ZHANG ; Yan GUO
Chinese Journal of Orthopaedic Trauma 2017;19(4):349-352
Objective To evaluate the correlation between 3 different instruments,SF-36 Health Survey,Hospital for Special Surgery (HSS) knee score and Rasmussen Score,for measurement of surgical outcomes of tibial plateau fractures,and their clinical significances as well.Methods Included in this study were 94 patients with tibial plateau fracture who had been consecutively treated and followed up from January 2009 through February 2015 at our department.Their surgical outcomes were measured by SF-36 Health Survey,HSS-knee score and Rasmussen Score respectively for health-related quality of life (HRQL),knee function,and reduction of fracture.Pearson correlation test was used to determine the correlation between the 3 measurement instruments.Results 94 cases eventually finished their following-ups.The mean follow-up was 41.2 months (range,from 12 to 75 months).The Rasmussen scores for their first postoperative X-ray films averaged 14.7 ± 2.1 points,their HSS-knee scores at the final follow-up averaged 81.0 ± 13.7 points,and their SF-36 scores at the final follow-up averaged 85.5 ± 10.0 points.Statistical analysis showed that the HSS-knee score was positively related to the SF-36 score and Rasmussen score (P < 0.05) but not to the Rasmussen score (P > 0.05).Conclusions Fine reduction may be the basis for good functional recovery of the knee and good functional recovery may benefit the HRQL of the patients,but merely good fracture reduction does not promise a high HRQL for patients with tibial plateau fracture.In the treatment of tibial plateau fractures,it is not enough to take care of fracture reduction and functional recovery,and the HRQL of patients should be taken into consideration.More attention should be paid to other important factors influencing the HRQL of patients.
9.Influencing factors of hemorrhagic transformation and clinical outcomes in acute ischemic stroke after mechanical thrombectomy
Yuanyuan ZHANG ; Hongzhi ZHOU ; Meiyun LYU ; Qiuhong JI ; Ziyang GAO ; Shuhong LIU ; Yunfeng ZHANG
International Journal of Cerebrovascular Diseases 2016;24(10):882-886
Objective To investigate the risk factors for hemorrhagic transformation (HT) and poor outcomes in patients with acute ischemic stroke after mechanical thrombectomy.Methods The patients with acute ischemic stroke received mechanical thrombectomy were enrolled retrospectively.The demography,vascular risk factors and other clinical data of the patents were collected.The modified Rankin scale (mRS) was used to evaluate the clinical outcomes at day 90.Good outcome was defined as mRS score 0-2.The patients were divided into either a HT group or a non-HT group according to their HT conditions.Multivariate logistic regression analysis was used to identify the independent risk factors for HT and poor outcomes.Results A total of 48 patients with acute ischemic stroke received mechanical thrombectomy were enrolled,including 25 males (52.1%).Their mean age was 64.77± 9.14 years.The mean National Institutes of Health Stroke Scale (NIHSS) score was 17.70 ± 3.77.Twenty-two patients (45.8%) occured HT,of which 9 were symptomatic HT;24 (50.0%) had good outcomes.The proportion of males in the HT group was significantly lower than that in the non-HT goup (30.4%vs.72.0%;x2 =8.293,P =0.004),while the proportions in patients with diabetes (65.2% vs.36.0%;x2 =4.090,P =0.043) and atrial fibrillation (78.3% vs.44.0%;x2 =5.880,P =0.015),as well as the baseline fasting blood glucose level (8.514 ± 4.400 mmol/L vs.6.354 ± 1.472 mmol/L;t =2.319,P =0.025) were significantly higher than those in the non-HT group.Multivariate logistic regression analysis showed that the atrial fibrillation (odds ratio [OR] 6.136,95% confidence interval [CI] 1.617-23.291;P =0.042) was a risk factor for the occurrence of HT after mechanical thrombectomy.The proportion of diabetic patients (29.2% vs.70.8%;x2 =8.333,P=0.04) and baseline NIHSS score (16.050±4.865 vs.19.210±4.423);t=2.310,P=0.026) of the good outcome group were significantly lower than those of the poor outcome group,while the proportions of patients in atrial fibrillation (75.0% vs.45.8%;x2 =4.269,P =0.039),anterior circulation stroke (87.5% vs.62.5%;x2 =4.000,P =0.046) middle cerebral artery (75.0% vs.29.2%;x2 =10.113,P =0.006),vertebral basilar artery (37.5% vs.12.5%;x2 =10.113,P =0.006) occlusion and parenchymal hematoma (33.3% vs.4.1%;P=0.011) were significantly higher than the poor outcome group.Multivariate logistic regression analysis showed that diabetes (OR 5.898,95% CI 1.699-20.479;P=0.005),baseline NIHSS score (OR 1.167,95% CI 1.011-1.347;P =0.035),and parenchymal hematoma (OR 1.295,95% CI 1.099-1.875;P=0.028) were the independent risk factors for poor outcomes.Conclusions Atrial fibrillation is an independent predictor of HT risk in patients with acute ischemic stroke after mechanical thrombectomy.Diabetes mellitus,higher baseline NIHSS score,and concurrent brain parenchymal hematoma are the independent predictors of poor outcomes.Therefore,the risk of HT and adverse outcomes should be fully assessed before mechanical thrombectomy in patients with acute ischemic stroke.
10.Evaluation of tri-endoscopy for choledocholithiasis accompanied with cholecystolithiasis
Fujing LYU ; Shutian ZHANG ; Ming JI ; Yongjun WANG ; Peng LI ; Qiaozhi ZHOU ; Wei HAN
Chinese Journal of Digestive Endoscopy 2015;(5):277-280
Objective To evaluate a method named “one-step procedure”,i.e.,combined duode-noscopy,laparoscopy and choledochoscopy for choledocholithiasis accompanied with cholecystolithiasis.Meth-ods Fifty-three cases with gallbladder stones combined with common bile duct stones diagnosed from February 2012 to February 2014 were assigned to two groups,29 cases in “one-step procedure”group,who underwent duodenoscopy,laparoscopy and choledochoscopy in one operation,and 24 cases in the control group,who first-ly underwent endoscopic sphincterotomy to remove common bile duct stones,and then LC was performed after several days.The rate of complications related to the procedure,success rate of complete stone removal,length of hospital stay and hospitalization expenses were compared between the two groups.Results All 53 patients underwent the surgery and ERCP procedure successfully.There were no significant differences between the“one-step procedure”group and the control group in complication rates[3.4%(1 /29)VS 12.5%(3 /24),P =0.21],complete stone removal rates[96.6%(28 /29)VS 100.0%(24/24),P =0.37].Differences were sig-nificant in length of hospital stay (6.7 ±1.3d VS 10.9 ±1.6d,P <0.01 )and hospitalization expenses (15 724 ±1 613 yuan VS 19 829 ±2 433 yuan,P <0.05)between the “one-step procedure”group and the control group.Conclusion The “one-step procedure”,the combined duodenoscopy,laparoscopy and chole-dochoscopy,is safe,effective,and has smaller length of hospital stay and lower hospitalization expenses.