1.Clinical research of intercalated combination of osimertinib and docetaxel in T790M mutation-positive lung adenocarcinoma patients with bone metastasis in the southern Hainan Province
Long CHEN ; Ling LIN ; Cuiying WANG ; Lin WANG ; Donglei HE ; Jun FENG
Journal of International Oncology 2019;46(7):399-403
Objective To study the clinical application of intercalated combination of osimertinib and docetaxel in T790M mutation-positive lung adenocarcinoma patients with bone metastasis in the southern Hainan Province. Methods T790M mutation-positive lung adenocarcinoma patients with bone metastasis in the sou-thern Hainan Province treated at the Third People's Hospital of Hainan Province from January 2018 to October 2018 were enrolled,and they were divided into intercalated combination of osimertinib and docetaxel group (n = 32)and osimertinib group (n = 28)according to the treatment. The patients in intercalated combination of osimertinib and docetaxel group received oral osimertinib (80 mg,qd),and received docetaxel (75 mg/ m2 , repeated in three-week intervals)when taking to tumor progression,and oral osimertinib treatment (80 mg, qd)was maintained until tumor partial response or stable disease after chemotherapy. The patients in osimer-tinib group received oral osimertinib (80 mg,qd). The patients in both groups received zoledronic acid. The response rate,disease control rate,overall survival (OS)and the incidence of adverse reactions of both groups were contrastively analyzed. Results The response rate of intercalated combination of osimertinib and doceta-xel group (62. 5%,20 / 32)was higher than that of osimertinib group (35. 7%,10 / 28),and disease control rate (93. 8%,30 / 32)was also higher than that of osimertinib group (67. 9%,19 / 28),with statistically sig-nificant differences (χ2 = 4. 286,P = 0. 038;χ2 = 6. 687,P = 0. 010). The median OS of intercalated combi-nation of osimertinib and docetaxel group was 10. 0 months,which was longer than that of osimertinib group (9. 0 months),with statistically significant difference (χ2 = 5. 917,P = 0. 015). Moreover,the adverse reac-tions in both groups were all grade Ⅰ or Ⅱ,which could be relieved or improved through symptomatic treat-ment. Conclusion Intercalated treatment of osimertinib with docetaxel is safe and effective in T790M muta-tion-positive lung adenocarcinoma patients with bone metastasis in the southern Hainan Province. It can prolong the survival time of patients.
2.Exercise intervention methods for senile sarcopenia
Donglei LU ; Zhanpeng FENG ; Liquan CAO ; Yi TANG ; Sijie TAN ; Zhongtao YU
Chinese Journal of Tissue Engineering Research 2024;28(35):5723-5731
BACKGROUND:Sarcopenia refers to age-related progressive,systemic muscle mass reduction and/or muscle strength decline or muscle physiological function decline,which is related to the occurrence of a variety of adverse outcomes in older adults.Exercise is considered to be one of the main strategies for combating sarcopenia in older adults,but there is a lack of specific intervention methods of different exercise patterns to intervene in sarcopenia. OBJECTIVE:To elaborate the main influencing factors of sarcopenia and the research progress of different exercise methods to improve sarcopenia in older adults,providing reference and basis for combating sarcopenia in older adults. METHODS:Web of Science,PubMed,CNKI,VIP,WanFang databases were retrieved for relevant literature published from January 2000 to October 2023 using the keywords of"sarcopenia,sport,exercise intervention,resistant training,aerobic exercise,whole body vibration training,mixed training,physical performance,muscle strength,muscle mass"in Chinese and English,respectively.A total of 126 articles were included for review. RESULTS AND CONCLUSION:Resistance exercise is still the most effective way to prevent and treat senile sarcopenia,and the effect of high-intensity resistance exercise is more significant.However,in practical application,we should pay attention to the gradual increase of training load intensity.Aerobic exercise combined with resistance exercise is more effective to improve muscle mass and function in the elderly than a single exercise mode.It is suggested that older adults can carry out the transition of low-intensity aerobic exercise in the early stage and increase resistance exercise individually in the late stage.Whole body vibration training is a new treatment method for the prevention and treatment of senile sarcopenia,but particular attention should be paid to the effects of frequency,amplitude,and duration on patients during practical application.Multicomponent exercise combines different exercise modes,which can give full play to their respective advantages,so as to personalize exercise interventions.
3.Anterior approach combined with blocking plates and screws in the management of acetabular fracture involving the quadrilateral area
Wei LIU ; Jianwen CHENG ; Shiting TANG ; Zhi YANG ; Zhen TAN ; Xiaorong SHI ; Yuquan LI ; Donglei WEI ; Feng HU ; Jinmin ZHAO
Chinese Journal of Trauma 2021;37(10):919-925
Objective:To investigate the clinical efficacy of anterior approach combined with blocking plates and screws in the management of acetabular fracture involving the quadrilateral area.Methods:A retrospective case series analysis was performed for 16 patients with acetabular fracture involving the quadrilateral area admitted to First and Second Affiliated Hospital of Guangxi Medical University from January 2017 to January 2019. There were 12 males and 4 females,with the age of 21-66 years[(45.3±10.6)years]. According to Letournel-Judet classification,there were 9 patients with bi-column fracture,6 with anterior and posterior traverse fracture and 1 with anterior column fracture. A total of 9 patients were operated via the ilioinguinal approach and 7 via the lateral-rectus approach. Reduction and fixation of the pelvis and acetabulum were performed,using 3.5 mm cortical bone screws or plates to block the internal displacement of fracture in the quadrilateral body. The incision length,operation time and intraoperative blood loss were recorded. The quality of fracture reduction was assessed according to the Matta reduction criteria at postoperative 2 days and hip function by the modified Merle D'Aubigne-Postel score at postoperative 3 months and 12 months. Postoperative complications were observed.Results:All patients were followed up for 13-24 months[(16.1±2.9)months]. The ilioinguinal approach and lateral-rectus approach showed surgical incision of 12-26 cm[(18.6±4.0)cm]and 8-15 cm[(10.7±2.3)cm],respectively. The operation time was 107-215 minutes[(159.2±27.8)minutes]and the intraoperative blood loss was 200-2,300 ml[(853.1±489.7)ml]. According to Matta reduction criteria,the results were excellent in 9 patients and good in 7. Three months after operation,the modified Merle D'Aubigne-Postel score was 11-18 points[(15.2±2.2)points],which showed the results were excellent in 4 patients,good in 7,fair in 4 and poor in 1,with the excellent and good rate of 69%. Twelve months after operation,the modified Merle D'Aubigne-Postel score was 13-18 points[(16.9±1.4)points],which showed the results were excellent in 7 patients,good in 8 and fair in 1,with the excellent and good rate of 94%. The liquefaction of post-surgical incision was seen in a patient,bladder injury in a patient,lateral femoral cutaneous nerve injury in a patient,and heterotopic ossification in a patient. There was no loosening or breakage of the internal fixation.Conclusion:For acetabular fracture involving the quadrilateral area,anterior approach combined with blocking plates and screws can prevent the displacement of quadrilateral fracture and attain satisfactory reductiongood hip function recovery and few complications.
4.IgA nephropathy standard dataset and quality control
Jingyuan XIE ; Yan OUYANG ; Jing CHEN ; Feng DING ; Leyi GU ; Lifeng ZHU ; Donglei FENG ; Yanyan SONG ; Zhangsheng YU ; Hong REN ; Nan CHEN
Chinese Journal of Nephrology 2022;38(6):543-549
Objective:To establish a IgA nephropathy (IgAN) standard dataset for the structured and standardization of IgAN clinical information, which will be beneficial to the integration and utilization of clinical information among different medical institutions. Therefore, the IgAN Expert Collaboration Group composed the "IgA Nephropathy Standard Dataset".Methods:Referring to the domestic information standards, guidelines, data standard and consensus of related fields, based on electronic medical history, the patient identification number was used as the primary key of the system to collect information. By standardizing each data element in the data set, the standardization of the management system in data and information exchange, data collaboration and sharing was ensured, and a quality control system was developed.Results:This standard dataset included 607 data elements and 8 business domains, which were patient information, medical history information, physical examination, laboratory examination, assistant examination, renal pathology, drug treatment, and follow-up, respectively. Each module was composed of module name, data element name, English name, definition, range, reference standard, etc. At the same time, a corresponding quality control system was formulated to evaluate data quality from multiple dimensions such as completeness, standardization, accuracy, timeliness, and security for ensuring the high quality and security of the data.Conclusion:The IgAN standard dataset is established, which will contribute to the structuration and standardization of clinical information of IgAN patients.
5.Analysis of related factors for long-term results and prognosis of personalized treatment in T790M-positive lung adenocarcinoma patients with bone metastasis
CHEN Long ; WANG Lin ; HE Donglei ; LIANG Dong ; FENG Jun
Chinese Journal of Cancer Biotherapy 2019;26(2):200-205
Objective: To explore the related factors for efficacy and prognosis of personalized comprehensive treatment for T790Mpositive lung adenocarcinoma patients with bone metastasis. Methods: The clinical data of 68 patients undergoing personalized comprehensive treatment for T790M-positive lung adenocarcinoma with bone metastasis were retrospectively reviewed; chemotherapy, radiotherapy, molecule-targeted agents, Bevacizumab, bisphosphonate and other therapies were chosen for the patients, and the efficacy and prognosis were observed to explore the related factors. Results: Effective rate of personalized comprehensive treatment was 60.3% (41/ 68), with a median survival time of 23 months. Multiple factors showed significant effects on long-term efficacy, such as no radiotherapy, T790M mutation but no KRAS mutation, adjuvant scheme+rescue scheme in prior chemotherapy treatment, N1 stage, isolated bone metastasis, alternative treatment of osimertinib with chemotherapy, less metastasized organs and ECOG scores<2 (P<0.05). Multivariate analysis revealed that T790M mutation but no KRAS mutation (P=0.012), number of metastasized organs =0 or 1 (P=0.000), alternative treatment of osimertinib with chemotherapy (P=0.020), and isolated bone metastasis (P=0.006) were independent protective factors for long-term results of personalized comprehensive treatment for T790M-positive lung adenocarcinoma patients with bone metastasis. Conclusion: Chemotherapy combined with osimertinib, agents of bisphosphonate and other personalized comprehensive treatment prolongs survival time in T790M-positive lung adenocarcinoma patients without KRAS mutation, providing a potential therapeutic model for those patients.
6.Clinical characteristics and risk factors for major thrombosis in 604 Chinese patients with low-risk essential thrombocythemia.
Rongfeng FU ; Min XUAN ; Liyan ZHANG ; Huiyuan LI ; Tiantian SUN ; Donglei ZHANG ; Xian ZHANG ; Cuicui LYU ; Feng XUE ; Xiaofan LIU ; Lei ZHANG ; Renchi YANG
Chinese Journal of Hematology 2014;35(9):785-790
OBJECTIVETo analyze clinical and molecular characteristics of low-risk essential thrombocythemia (ET) in a large cohort of Chinese patients and to explore risk factors for major thrombosis and treatment strategies.
METHODSMedical records of patients with an initial diagnosis of ET from March 1982 to May 2012 in our hospital were retrospectively analyzed.
RESULTSA total of 604 low-risk ET patients were enrolled with a median follow-up of 49 months (range:0-338). 43(7.1%) patients experienced major thrombotic events. Cox proportional hazards regression revealed JAK2 V617F mutation (HR=2.279; P=0.035) and cardiovascular risk factors (CVF) (HR=2.541; P=0.006) to be risk factors for total thrombotic events, while only CVF (HR=2.633; P=0.008) was risk factor for arterial thrombosis. None of the evaluated factors was related to venous thrombosis. Patients with both JAK2 V617F mutation and CVF had a worse thrombosis- free survival than those with only one risk factor (P<0.05). In patients with JAK2 V617F or CVF alone, antiplatelet treatment (P=0.016) significantly decreased the risk of thrombosis, while those with both JAK2 V617F and CVF could benefit from cytoreductive agents (P=0.018).
CONCLUSIONChinese low-risk ET patients have a lower risk of thrombosis than Caucasian low-risk ET patients. JAK2 V617F mutation and CVF are the most significant risk factors for thrombosis. Existence of both risk factors further increases the thrombotic risk. Treatment strategies on low-risk ET patients should be made based on presence or absence of risk factors.
Asian Continental Ancestry Group ; Humans ; Janus Kinase 2 ; Mutation ; Retrospective Studies ; Risk Factors ; Thrombocytopenia ; complications ; Thrombosis ; genetics