1.NK and NKT cells in acute pancreatitis
Zhining LIU ; Xiaoping GENG ; Shengyun WAN ; Hui HOU ; Zongfan YU
Chinese Journal of General Surgery 2016;31(12):1031-1033
Objective To investigate natural killer(NK) and NKT cells in acute pancreatitis(AP).Methods Changes of NK and NKT cells in peripheral blood of 86 AP cases were detected using muhiparameter flow cytometry.Results Compared with control group,the NKT cells decreased in AP patients (t =5.23,P =0.00),but NK cells didn't (t =-1.15,P =0.25).NKT cells in severe SAP and mnoderate MAP were lower than that in the control group (t =-3.92,P =0.00;t =4.84,P =0.00).There was no statistically significant difference of NK cells between MAP and the controls (t =-0.54,P =0.59),but NK cells in SAP group was obviously higher than that in control group (t =3.12,P =0.00).After one week treatment,NK cells significantly decreased (t =8.43,P =0.00).NKT cells were higher than control group (t =-4.44,P =0.00).Dynamic monitoring in AP patients found continuous declination in NK cells,and NKT cells experienced an increase before a falling.Conclusion Monitoring of NK and NKT cells can be used as an important index for the severity and response to treatment in acute pancreatitis.
2.Clinical trial data management and quality metrics system.
Zhaohua CHEN ; Qin HUANG ; Yazhong DENG ; Yue ZHANG ; Yu XU ; Hao YU ; Zongfan LIU
Acta Pharmaceutica Sinica 2015;50(11):1374-9
Data quality management system is essential to ensure accurate, complete, consistent, and reliable data collection in clinical research. This paper is devoted to various choices of data quality metrics. They are categorized by study status, e.g. study start up, conduct, and close-out. In each category, metrics for different purposes are listed according to ALCOA+ principles such us completeness, accuracy, timeliness, traceability, etc. Some general quality metrics frequently used are also introduced. This paper contains detail information as much as possible to each metric by providing definition, purpose, evaluation, referenced benchmark, and recommended targets in favor of real practice. It is important that sponsors and data management service providers establish a robust integrated clinical trial data quality management system to ensure sustainable high quality of clinical trial deliverables. It will also support enterprise level of data evaluation and bench marking the quality of data across projects, sponsors, data management service providers by using objective metrics from the real clinical trials. We hope this will be a significant input to accelerate the improvement of clinical trial data quality in the industry.
3.Development and validation of a nomogram model for preoperative prediction of hepatocellular carcinoma with microvascular invasion
Kangkang WAN ; Shubo PAN ; Liangping NI ; Qiru XIONG ; Shengxue XIE ; Longsheng WANG ; Tao LIU ; Haonan SUN ; Ju MA ; Huimin WANG ; Zongfan YU
Chinese Journal of Hepatobiliary Surgery 2023;29(8):561-566
Objective:To develop and validate a nomogram model for predicting microvascular invasion (MVI) in hepatocellular carcinoma (HCC) based on preoperative enhanced computed tomography imaging features and clinical data.Methods:The clinical data of 210 patients with HCC undergoing surgery in the Second Affiliated Hospital of Anhui Medical University from May 2018 to May 2022 were retrospectively analyzed, including 172 males and 38 females, aged (59±10) years old. Patients were randomly divided into the training group ( n=147) and validation group ( n=63) by systematic sampling at a ratio of 7∶3. Preoperative enhanced computed tomography imaging features and clinical data of the patients were collected. Logistic regression was conducted to analyze the risk factors for HCC with MVI, and a nomogram model containing the risk factors was established and validated. The diagnostic efficacy of predicting MVI status in patients with HCC was assessed by receiver operating characteristic (ROC) curve, calibration curves, decision curve analysis (DCA), and clinical impact curve (CIC) of the subjects in the training and validation groups. Results:The results of multifactorial analysis showed that alpha fetoprotein ≥400 μg/ml, intra-tumor necrosis, tumor length diameter ≥3 cm, unclear tumor border, and subfoci around the tumor were independent risk factors predicting MVI in HCC. A nomogram model was established based on the above factors, in which the area under the curve (AUC) of ROC were 0.866 (95% CI: 0.807-0.924) and 0.834 (95% CI: 0.729-0.939) in the training and validation groups, respectively. The DCA results showed that the predictive model thresholds when the net return is >0 ranging from 7% to 93% and 12% to 87% in the training and validation groups, respectively. The CIC results showed that the group of patients with predictive MVI by the nomogram model are highly matched with the group of patients with confirmed MVI. Conclusion:The nomogram model based on the imaging features and clinical data could predict the MVI in HCC patients prior to surgery.
4.Open hepatectomy versus laparoscopic in the treatment of primary left-sided hepatolithiasis: a propensity, long-term follow-up analysis at a single center
Shubo PAN ; Chunli WU ; Hui HOU ; Dachen ZHOU ; Xiao CUI ; Liang HE ; Jiong GU ; Lei WANG ; Zongfan YU ; Guiyin DONG ; Shengxue XIE ; Qiru XIONG ; Xiaoping GENG
Chinese Journal of Surgery 2020;58(7):530-538
Methods:Clinical data of 187 patients with left-sided hepatolithiasis and underwent laparoscopically or open left-sided hepatectomy from October 2014 to October 2019 at the Second Affiliated Hospital of Anhui Medical University were retrospectively analyzed in this propensity score matching (PSM) study and were matched in terms of age, sex, body mass index, liver function, ASA score, comorbidities, history of biliary surgery, and smoking history on the ratio of 1∶1.There were 47 cases in each group and the mean age were (54.7±12.3)years old(range:34 to 75 years old) and (53.2±12.6) years old (range: 34 to 75 years old) in open and laparoscopically group respectively. The data of operation time, intraoperative blood loss, postoperative hospital-stay, complication rate, biliary fistula rate, stone clearance rate, and stone recurrence rate were compared. The quantitative data were compared using t-test or rank-sum test. Count data were analyzed with χ 2 test or Fisher test. Results:No significant difference was observed in the clinical characteristics of included 94 patients in this study(all P>0.05).The length of the postoperative hospital-stay after OLH was significantly higher than that in the LLH group((10.8±3.1) days vs.(8.5±2.2)days, t=4.085, P=0.000). LLR significantly decreased the incidence of postoperative biliary fistula compared with the OLH (6.3% vs.21.2%, χ 2=4.374, P=0.036) and the rates of postoperative complications in the OLH group was significantly higher than that in the LLH group (48.9% vs.27.6%, χ 2=4.502, P=0.034). Moreover, the stone recurrence rates in the LLH group was significantly lower than that after OLR (4.2% vs. 17.0%, χ 2=4.029, P=0.045). OLH (95 % CI: 1.55 to 10.75, P=0.004) and postoperative complications (95 % CI: 1.29 to 9.52, P=0.013) were independent risk factors for prolonged hospital stay. OLH (95 % CI: 1.428 to 44.080, P=0.018) and residual stones (95 % CI: 1.580 to 62.379, P=0.014) were independent risk factors for the occurrence of postoperative biliary fistula. Biliary fistula (95 % CI: 1.078 to 24.517, P=0.040) was an independent risk factor for the recurrence of stones. Conclusion:Compared with OLH, LLH is safe and effective for the treatment of the primary left-sided hepatolithiasis with the clinical benefits of shorter hospital stay, fewer morbidity and biliary fistula occurrence, and lower stone recurrence rates.
5.Open hepatectomy versus laparoscopic in the treatment of primary left-sided hepatolithiasis: a propensity, long-term follow-up analysis at a single center
Shubo PAN ; Chunli WU ; Hui HOU ; Dachen ZHOU ; Xiao CUI ; Liang HE ; Jiong GU ; Lei WANG ; Zongfan YU ; Guiyin DONG ; Shengxue XIE ; Qiru XIONG ; Xiaoping GENG
Chinese Journal of Surgery 2020;58(7):530-538
Methods:Clinical data of 187 patients with left-sided hepatolithiasis and underwent laparoscopically or open left-sided hepatectomy from October 2014 to October 2019 at the Second Affiliated Hospital of Anhui Medical University were retrospectively analyzed in this propensity score matching (PSM) study and were matched in terms of age, sex, body mass index, liver function, ASA score, comorbidities, history of biliary surgery, and smoking history on the ratio of 1∶1.There were 47 cases in each group and the mean age were (54.7±12.3)years old(range:34 to 75 years old) and (53.2±12.6) years old (range: 34 to 75 years old) in open and laparoscopically group respectively. The data of operation time, intraoperative blood loss, postoperative hospital-stay, complication rate, biliary fistula rate, stone clearance rate, and stone recurrence rate were compared. The quantitative data were compared using t-test or rank-sum test. Count data were analyzed with χ 2 test or Fisher test. Results:No significant difference was observed in the clinical characteristics of included 94 patients in this study(all P>0.05).The length of the postoperative hospital-stay after OLH was significantly higher than that in the LLH group((10.8±3.1) days vs.(8.5±2.2)days, t=4.085, P=0.000). LLR significantly decreased the incidence of postoperative biliary fistula compared with the OLH (6.3% vs.21.2%, χ 2=4.374, P=0.036) and the rates of postoperative complications in the OLH group was significantly higher than that in the LLH group (48.9% vs.27.6%, χ 2=4.502, P=0.034). Moreover, the stone recurrence rates in the LLH group was significantly lower than that after OLR (4.2% vs. 17.0%, χ 2=4.029, P=0.045). OLH (95 % CI: 1.55 to 10.75, P=0.004) and postoperative complications (95 % CI: 1.29 to 9.52, P=0.013) were independent risk factors for prolonged hospital stay. OLH (95 % CI: 1.428 to 44.080, P=0.018) and residual stones (95 % CI: 1.580 to 62.379, P=0.014) were independent risk factors for the occurrence of postoperative biliary fistula. Biliary fistula (95 % CI: 1.078 to 24.517, P=0.040) was an independent risk factor for the recurrence of stones. Conclusion:Compared with OLH, LLH is safe and effective for the treatment of the primary left-sided hepatolithiasis with the clinical benefits of shorter hospital stay, fewer morbidity and biliary fistula occurrence, and lower stone recurrence rates.
6.Sulforaphane down⁃regulates the expression of eIF4F translation initiation complex in colorectal cancer
Yun Xing ; Dachen Zhou ; Liang He ; Xiao Cui ; Zongfan Yu
Acta Universitatis Medicinalis Anhui 2022;57(10):1645-1650
Objective :
To study the relationship between the expression of eIF4F complex and human colorectal cancer (CRC), and the possible mechanism of sulforaphane on the proliferation of CRC cells.
Methods :
Immunohistochemical staining was used to detect the expression of eIF4F complex related proteins in tumor and adjacent tissues of 12 colorectal cancer patients. MTT colorimetry was used to detect the cell activity of colorectal cancer cells treated with sulforaphane. Western blot was used to detect the expression of eIF4F complex related proteins in colorectal cancer cells treated with sulforaphane. In the animal experiment ( tumor formation in nude mice), the growth of subcutaneous tumors in nude mice after intraperitoneal injection of sulforaphane was compared, and the expressions of PI3K/AKT/mTOR/4EBP1 signal pathway related proteins and eIF4F complex related proteins were detected by immunohistochemical staining.
Results :
In the specimens of CRC patients, the expression of eIF4F complex related protein in tumor tissues was significantly higher than that in paracancerous tissues. SFN could inhibit the proliferation of CRC cells, and the higher the concentration, the stronger the inhibitory ability. SFN could inhibit the growth and development of CRC cells and down⁃regulate the expression of eIF4F complex in CRC cells.
Conclusion
The expression of eIF4F complex is closely related to the development of colorectal cancer. Sulforaphane may affect the up⁃regulation of eIF4F complex through PI3K/AKT/mTOR/4EBP1 signal pathway, thus affecting the development of colorectal cancer cells.