1.Drug-eluting beads in the treatment of hepatocellular carcinoma with hepatic arterio-portal shunt
Xionghui ZHENG ; Zishu ZHANG ; Yudong XIAO ; Chunjuan CAO ; Weiqian LU
Journal of Chinese Physician 2019;21(2):220-223
Objective To investigate the safety and efficiency of drug-eluting beads (DEB) in the treatment of hepatocellular carcinoma (HCC) with hepatic arterio-portal shunt (HAPS).Methods 26 HCC patients with HAPS who underwent DEB-TACE (transcatheter arterial chemoembolization) were included in this retrospective study.Liver function level included preoperative serum albumin level,ascites,Child-Pugh classification,imaging manifestations of HAPS,follow-up and record survival time and response to cancer treatment.According to the degree of HAPS,all the patients were divided into 4 groups.After performing Kaplan-Meier,survival rate was calculated.Tumor response was measured by mRECIST criteria.Results The median survivals were 310 days,261 days,333 days,and 250 days in the entire study population,group 1,group 2,and group 3,respectively.There was no statistical significance in the survival curve among three groups (P =0.456).In the entire study population,the survival rates were 76.9%,37.3%,and 12.4% at 6 months,12 months,and 24 months,respectively.After performing proportional hazards model,the preoperative serum albumin level,presence or absence of ascites,and preoperative Child-Pugh classification were independent predict factors for prognosis.Conclusions DEB-TACE is a safe and effective treatment for HCC with HAPS.The preoperative liver function is essential for patients'prognosis.
2.Preliminary evaluation of sunitinib as first line therapy in treating patients with metastatic renal cell carcinoma
Jianlin YUAN ; Fuli WANG ; Weijun QIN ; Jun QIN ; Xiaojian YANG ; Chunjuan TIAN ; Rongliang QIN ; Chen SHAO ; Lijun YANG ; Fei LIU ; Geng ZHANG ; Ping MENG ; Longlong ZHANG ; Yu ZHENG ; Guojun WU
Chinese Journal of Urology 2015;(10):742-745
[Abstact] Objective To investigate the efficacy and safety of sunitinib as first line therapy in treating those patients with metastatic renal cell carcinoma ( mRCC ) .Methods A total of 66 patients , including 42 male and 24 female cases ,with metastatic renal cell carcinoma were enrolled from January 2009 to June 2014.The median age was 52 years (range 26-75 years).According to American Joint Committee On Cancer (AJCC) staging,there were 35 cases of T3 stage,31 cases of T4 stage.All patients had distant metastasis ,including single organ metastasis in 52 patients and multiple organ metastasis in 14 cases.Sixty-one patients received prior radical nephrectomy ,5 patients received biopsy .Sixty-two patients were diagnosed as renal clear cell carcinoma and 4 patients were diagnosed as renal papillary cell carcinoma .Sunitinib was administered in standard 4/2 regimens.Briefly, patient takes 50 mg once a day orally for 4 weeks.Then the sunitinib will be stopped for 2 weeks.Six weeks was defined as 1 cycle.It should be continued until disease progression or occurrence of intolerable adverse reactions .The efficacy of sunitinib should be evaluated within 2 cycles.Results The duration of following-up ranged from 5 to 66 months.The efficacy could be evaluated in 63 patients.Two patients ( 3.2%) achieved complete remission .Twelve patients ( 19.0%) achieved partial remission.Forty-five patients (71.4%) demonstrated stable disease and 4 patients (6.3%)
developed progressive disease .The disease control rate was 93.7%(59/63) and the objective response rate was 22.2%(14/63).2 (3.2%) patients died due to the progression of disease .The most commonⅠ-Ⅱadverse events included fatigue in 36 cases ( 57.1%) , thrombocytopenia in 36 cases ( 57.1%) , hand-foot syndrome in 32 cases (50.8%),hypertension in 27 cases (42.9%),neutropenia in 15 cases (23.8%), hypothyroidism in 12 cases (19.0%), diarrhea in 6 cases (9.5%) and alopecia in 4 cases (6.3%).Ⅲ-Ⅳ adverse events were hand-foot syndrome in 4 cases ( 6.3%) , hypertension in 2 cases ( 3.2%) , neutropenia in 5 cases (7.9%) and thrombocytopenia in 5 cases (7.9%).Most mild adverse reactions after symptomatic treatment could be alleviated ,did not affect the medication .When the adverse events returned to the Ⅰ-Ⅱdegree, the 37.5 mg sunitinib was resumed once daily by orally.NoⅢ-Ⅳadverse events were reported again.Conclusions Sunitinib was efficacious in the treatment of advanced renal cell carcinoma.Most mild adverse events were tolerable ,and severe adverse events need medical treatment .
3.Clinical application of surgical intervention model for repairing tuberculosis wound with sinus tract.
Chiyu JIA ; Pengcheng LI ; Lin CHENG ; Mengli ZHENG ; Wenbo JIN ; Yujia WU ; Chunjuan CHANG ; Yuanyuan ZHANG ; Bin SHU ; Bin YIN
Chinese Journal of Burns 2016;32(6):326-330
OBJECTIVETo retrospectively explore the effectiveness of surgical intervention model for repairing the tuberculosis wound with sinus tract.
METHODSForty-three patients with tuberculosis wound with sinus tract who met the inclusion criteria were admitted to the 309th Hospital of PLA from January 2010 to October 2015. These patients were divided into test group (n=38) and control group (n=5) according to the different treatment and patient's consent. Patients in test group were treated as follows. Firstly, antituberculosis drugs were taken orally for at least 3 weeks, and the wounds were accurately assessed using magnetic resonance imaging combined with 3-dimensional reconstruction software. Then sinus tract and its surrounding devitalized tissue were completely excised, and vacuum sealing drainage (VSD) treatment with negative pressure value of -26.6 kPa was performed for 1 to 2 weeks (dressing change was performed per 7 days). Lastly, the wounds were covered through direct suture or grafting skin or flap. Patients in control group were firstly given antituberculosis drugs orally for at least 3 weeks, and then they were treated with routine dressing change in outpatient service every 3 days. After the former therapy, patients in both groups were given antituberculosis drugs by oral administration for at least 6 months and were followed up for 6 to 36 months. Detection of Bacillus tuberculosis, Acid-fast bacilli, and tuberculosis granuloma, wound healing time, and relapse of tuberculosis wound in patients of both groups were recorded. The rates of single sinus tract, two sinus tracts, and more than or equal to 3 sinus tracts of patients in test group were recorded. Data were processed with Fisher's exact test and Wilcoxon rank-sum test.
RESULTSBacillus tuberculosis was respectively detected in wounds of 5 patients in test group and 2 patients in control group. Acid-fast bacilli were positively expressed in wounds of 8 patients in test group and 3 patients in control group. A typical tuberculosis granuloma phenomenon was observed in the wounds of 27 patients in test group and 4 patients in control group. These differences in above-mentioned 3 indexes between two groups were not statistically significant (with P values respectively 0.238 4, 0.154 4, 1.000 0). The median of wound healing time of patients in test group was 19.6 d, which was significantly shorter than that in control group (94.4 d, χ(2)=12.986 0, P=0.000 3). There were 2 and 1 patients with recurrent tuberculosis wound in test group and control group respectively, without statistically significant difference (P=0.363 0). Among patients in test group, the rate of single sinus tract was 23.7%(9/38), the rate of two sinus tracts was 28.9%(11/38), and the rate of more than or equal to 3 sinus tracts was 47.4% (18/38).
CONCLUSIONSRepairing the tuberculosis wound with sinus tract in surgical intervention model of antituberculosis therapy+ accurate wound assessment+ debridement+ VSD treatment+ surgical repair is beneficial to making the optimal operation plan under the premise of knowing location of sinus tract, which can reduce surgical risk.
Debridement ; Humans ; Magnetic Resonance Imaging ; Negative-Pressure Wound Therapy ; Paranasal Sinuses ; pathology ; surgery ; Retrospective Studies ; Skin Transplantation ; Surgical Flaps ; Treatment Outcome ; Tuberculosis ; drug therapy ; surgery ; Wound Healing
4.Experience of perioperative treatment of lung transplantation: report of 7 cases
Ting LIN ; Qifei WU ; Chunjuan YE ; Junke FU ; Guangjian ZHANG ; Yong ZHANG ; Zhe WANG ; Zheng WANG ; Chang LIU
Organ Transplantation 2019;10(1):74-
Objective To summarize the experience of perioperative treatment of lung transplantation for end-stage lung disease. Methods Perioperative clinical data of 7 recipients undergoing lung transplantation were retrospectively analyzed, including 3 cases with bilateral lung transplantation and 4 cases with unilateral lung transplantation. The perioperative status and clinical prognosis of lung transplantation recipients were observed. Results The operation time of 7 lung transplantation recipients was (344±133) min. Cold ischemia time was (236±74) min in 4 cases of single-lung transplantation and (480±120) min in 3 cases of bilateral-lung transplantation. The length of Intensive care unit(ICU) stay was 21 (13-25) d and the length of hospital stay was 101 (64-117) d. In the first 3 d after surgery, the daily fluid output was significantly larger than the fluid input (all
5. Recurrence and progression factors of papillary urothelial neoplasm of low malignant potential
Wanxiang ZHENG ; Xuelin GAO ; Guangdong HOU ; Longlong ZHANG ; Di WEI ; Luguang HUANG ; Chunjuan TIAN ; Geng ZHANG ; Jianlin YUAN
Chinese Journal of Urology 2020;41(1):8-12
Objective:
To investigate the pathological characteristics of bladder low malignant potential papillary urothelial tumors (PUNLMP) and the predic factors of recurrence and pathological progress.
Methods:
We retrospectively analyzed 150 patients of bladder PUNLMP in the Department of Urology of Xijing Hospital from February 2009 to February 2019. Among the 150 patients, 118 patients were males and 32 patients were females. The average age was 57 years, ranging 20-93 years. There were 112 cases of single tumor and 38 cases of multiple tumor. All patients received transurethral resection of bladder tumor (TURBT) and 136 patients received bladder infusion chemotherapy, including 61 patients for pirarubicin, 58 patients for gemcitabine, 11 patients for epirubicin, and 11 patients for mitomycin. 14 patients did not receive bladder infusion chemotherapy. In this study, univariate and multivariate logistic regression analysis were used to investigate independent predictors of recurrence and pathological progression in patients of bladder PUNLMP who received TURBT.
Results:
The average follow-up time was 25.6 months, ranging 5.5-122.7 months. Among the patients, 21 patients occurred recurrence. The recurrent duration ranged from 2.2 to 108.3 months (mean 23.1 months). 12 patients had pathological progression, including 9 patients for low-grade non-invasive papillary urothelial carcinoma, 1 patient for high-grade non-invasive papillary urothelial carcinoma, 1 patient for high-grade invasive urothelial carcinoma, 1 patient for squamous cell carcinoma. The progressive duration ranged from 2.2 to 56.3 months (mean 21.5 months). Among the 150 patients, 18 patients with inverted growth pattern did not recur. There were significant differences in the number of tumors and the tumor length between the recurrence and non-recurrence groups, same as the progression and non-progression groups. The univariate and multivariate logistic regression analysis results showed that the number of tumors was an independent predictor of tumor recurrence (
6.Cascade two-stage tumor re-oxygenation and immune re-sensitization mediated by self-assembled albumin-sorafenib nanoparticles for enhanced photodynamic immunotherapy.
Zaigang ZHOU ; Jiashe CHEN ; Yu LIU ; Chunjuan ZHENG ; Wenjuan LUO ; Lele CHEN ; Shen ZHOU ; Zhiming LI ; Jianliang SHEN
Acta Pharmaceutica Sinica B 2022;12(11):4204-4223
As a promising modality for cancer therapy, photodynamic therapy (PDT) still acquired limited success in clinical nowadays due to the extremely serious hypoxia and immunosuppression tumor microenvironment. To ameliorate such a situation, we rationally designed and prepared cascade two-stage re-oxygenation and immune re-sensitization BSA-MHI148@SRF nanoparticles via hydrophilic and hydrophobic self-assembly strategy by using near-infrared photodynamic dye MHI148 chemically modified bovine serum albumin (BSA-MHI148) and multi-kinase inhibitor Sorafenib (SRF) as a novel tumor oxygen and immune microenvironment regulation drug. Benefiting from the accumulation of SRF in tumors, BSA-MHI148@SRF nanoparticles dramatically enhanced the PDT efficacy by promoting cascade two-stage tumor re-oxygenation mechanisms: (i) SRF decreased tumor oxygen consumption via inhibiting mitochondria respiratory. (ii) SRF increased the oxygen supply via inducing tumor vessel normalization. Meanwhile, the immunosuppression micro-environment was also obviously reversed by two-stage immune re-sensitization as follows: (i) Enhanced immunogenic cell death (ICD) production amplified by BSA-MHI148@SRF induced reactive oxygen species (ROS) generation enhanced T cell infiltration and improve its tumor cell killing ability. (ii) BSA-MHI148@SRF amplified tumor vessel normalization by VEGF inhibition also obviously reversed the tumor immune-suppression microenvironment. Finally, the growth of solid tumors was significantly depressed by such well-designed BSA-MHI148@SRF nanoparticles, which could be potential for clinical cancer therapy.
7.Erratum: Author correction to "Cascade two-stage tumor re-oxygenation and immune re-sensitization mediated by self-assembled albumin-sorafenib nanoparticles for enhanced photodynamic immunotherapy" Acta Pharm Sin B (2022) 4204-4223.
Zaigang ZHOU ; Jiashe CHEN ; Yu LIU ; Chunjuan ZHENG ; Wenjuan LUO ; Lele CHEN ; Shen ZHOU ; Zhiming LI ; Jianliang SHEN
Acta Pharmaceutica Sinica B 2024;14(2):900-903
[This corrects the article DOI: 10.1016/j.apsb.2022.07.023.].
8. Three-dimensional finite element analysis on en-mass retraction of anterior teeth with clear aligner
Xuehuan MENG ; Chunjuan WANG ; Chao WANG ; Rui WANG ; Ye MING ; Leilei ZHENG
Chinese Journal of Stomatology 2019;54(11):753-759
Objective:
To investigate the mechanical effects during en-mass retraction of maxillary anterior teeth with clear aligner using three-dimensional finite element method.
Methods:
Cone-beam CT (CBCT) was used to scan a female orthodontic patient (26 years old, from Department of Orthodontics, Stomatological Hospital of Chongqing Medical University) whose maxillary first premolars were extracted and maxillary dentition had been aligned and leveled. A finite element model including maxillary teeth-periodontal ligament (PDL)-alveolar bone-clear aligner was established by using Mimics 17.0, SolidWorks 2016 and Geomagic Studio 2015 software packages. The process of 0.2 mm en-mass retraction of anterior teeth using clear aligner was simulated by using non-linear contact method of Abaqus 6.14. The trend and displacement of maxillary teeth, the stress distribution of PDL and alveolar fossae, and the deformation trend of clear aligner were obtained and analyzed.
Results:
Under the experimental condition, lingual crown tipping and distal tipping movement of anterior teeth were observed, and all of them had the tendency of overbite increasing.The maximum displacement of the central incisor, lateral incisor and canine were 25.16, 50.34 and 24.98 μm, respectively. Meanwhile, the second premolar, first molar and second molar had the tendency of mesial tipping movement, and the maximum displacement of them were 33.04, 2.90 and 16.63 μm, respectively. The stress distribution both at the PDL and alveolar fossae were consistent with tooth movement pattern. It was noted that the stress in the PDL of the canine and second premolar were comparatively big, and the corresponding apical areas of alveolar fossae appeared stress concentration. Concurrently, it was found that the clear aligner showed stress concentration at the junction of adjacent teeth with a tendency of crown directional dislocation.
Conclusions
During en-mass retraction of anterior teeth with clear aligner, attention should be paid to the overbite and torque in anterior teeth, and the anchorage protection of posterior teeth. At the same time, we should be careful of root resorption of the teeth on both sides of the extraction space.