1.Clinical effect of neoadjuvant chemo-radiation combined with thoracoscopic and laparoscopic three-incision esophagectomy
Liang ZHAO ; Gefei ZHAO ; Jiagen LI ; Shugeng GAO ; Qi XUE
Chinese Journal of Digestive Surgery 2017;16(5):469-473
Objective To explore the clinical effect of neoadjuvant chemo-radiation combined with thoracoscopic and laparoscopic three-incision esophagectomy for esophageal cancer.Methods The retrospective cohort study was conducted.The clinicopathological data of 111 esophageal cancer patients who underwent neoadjuvant chemo-radiation combined with thoracoscopic and laparoscopic three-incision esophagectomy in the Cancer Hospital of Chinese Academy of Medical Sciences between January 2010 and December 2016 were collected.Among 111 patients,68 with interval time between neoadjuvant chemo-radiation and thoracoscopic and laparoscopic three-incision esophagectomy < 8 weeks were allocated into the < 8 weeks group and 43 with interval time between neoadjuvant chemo-radiation and thoracoscopic and laparoscopic three-incision esophagectomy ≥8 weeks were allocated into the ≥8 weeks group.Patients underwent preoperative radiotherapy and chemotherapy with TP regimen,and then underwent selective thoracoscopic and laparoscopic three-incision esophagectomy.Observation indicators:(1) neoadjuvant chemo-radiation situations;(2) surgical and postoperative situations;(3) follow-up.Follow-up using outpatient examination and telephone interview was performed to detect postoperative survival of patients and tumor recurrence or metastasis up to March 2017.Measurement data with normal distribution were represented as (x)±s and comparison between groups was analyzed using the t test.Count data were analyzed using the chi-square test or Fisher exact probability.Comparison of ranked data was done by the nonparametric test.Results (1) Neoadjuvant chemo-radiation situations:all the patients underwent neoadjuvant chemo-radiation,without severe adverse reaction.Number of patients with complete remission based on oncopathology were 34 in the <8 weeks group and 15 in the ≥ 8 weeks group,with no statistically significant difference between the 2 groups (x2=2.441,P>0.05).(2) Surgical and postoperative situations:all the patients underwent successful thoracoscopic and laparoscopic three-incision esophagectomy,with negative surgical margins.Operation time,volume of intraoperative blood loss,number of lymph node dissected,time of postoperative intrathoracic drainagetube removal,time of postoperative neck drainage-tube removal,hoarseness,upper gastrointestinal hemorrhage,anastomotic fistula,respiratory complication,pleural effusion and empyema,cardiovascular complication,incision abnormal healing,death within postoperative 30 days and duration of hospital stay were (354±103)minutes,(400± 76)mL,19±4,(11±4)days,(4.9±1.6)days,5,1,12,3,6,5,8,0,(19± 17) days in the < 8 weeks group and (343±92) minutes,(392±51)mL,19±3,(12±6)days,(4.5±1.0)days,2,0,7,5,3,4,3,2,(18± 11) days in the ≥ 8 weeks group,respectively,with no statistically significant difference between the 2 groups (t =1.080,0.569,0.326,1.223,1.286,x2=0.029,0.035,1.114,0.000,0.000,0.246,t=0.315,P> 0.05).(3) Follow-up:90 of 111 patients were followed up for 3-82 months,with a median time of 25 months,including 55 in the <8 weeks group and 35 in the ≥8 weeks group.During follow-up,death and tumor recurrence were detected in 9,11 patients in the <8 weeks group and 6,11 patients in the ≥ 8 weeks group,respectively.Conclusion Neoadjuvant chemo-radiation combined with thoracoscopic and laparoscopic three-incision esophagectomy is safe and effective,and it doesn't increase the perioperative risks based on preoperative 8-week interval time.
2.Research on the efficacy of endoscopic resection of thyroid benign tumor
Jiagen LI ; Weijun WANG ; Qian FANG ; Jianfeng LI ; Chuanguang LI ; Pengfei JIN ; Zhitao LI ; Yanguo ZHENG
Chinese Journal of Primary Medicine and Pharmacy 2010;17(6):725-726
Objective To observe the efficacy of endoscopic resection with thyroid benign tumor. Methods 60 cases of thyroid benign tumor were randomly divided into the endoscopic group and the traditional group, 30 cases in each group. The operation time, blood loss ,drainage volume, postoperative hospital stay, postoperative complications and hospitalization expenses in two groups were compared. Results There was no significant difference ( P >0. 05) between the two groups of postoperative hospital stay; endoscopic group blood loss (25.3 ± 15.6) ml significantly less than the traditional group (57. 2 ± 33. 8) ml, the difference was statistically significant ( P < 0. 05); endoscopic postoperative drainage volume ( 85.6 ± 53.2) ml significantly more than the traditional group ( 23. 5 ±37.2) ml (P < 0. 05); endoscopic operative time of ( 105.3 ± 23. 5) min, while the traditional group ( 80. 4 ±25. 3 ) min, the difference was significant ( P < 0. 05 ); hospitalization costs were significantly higher than conventional endoscopy group ( P < 0. 05). Both groups were not have obvious complications postoperation. Conclusion Compared with traditional open surgery, endoscopic surgery for benign thyroid tumors has advantages of superior cosmetic results and less bleeding,it is a good choice for the treatment of the disease.
3.Injection of sclerosing agent lauromacrogol for the treatment of lymph leakage:clinical analysis of 15 cases
Huipeng ZHU ; Yilin ZHOU ; Zhongyou XU ; Jiagen LI ; Daye JIN ; Jibo MA
Journal of Interventional Radiology 2014;(9):767-768
Objective To evaluate the clinical effect of ultrasound - guided sclerosing agent lauromacrogol injection in treating lymph leakage. Methods A total of 31 patients with postoperative lymph leakage were selected for this study. Of the 31 patients, successful conservative oppression treatment was accomplished in 16, and lauromacrogol injection had to be carried out in 15 as conservative oppression treatment failed. The patients were followed up and the results were analyzed. Results In 15 patients receiving lauromacrogol injection treatment, complete cure of lymph leak was obtained in 14 with a success rate of 93.33%. Among the 14 cases, the second lauromacrogol injection was employed in 3 at one week after the first injection. Infection occurred in another case one day after the injection , which was cured after dressing change for 15 days. Conclusion For the treatment of lymph leakage, ultrasound-guided sclerosing agent lauromacrogol injection is effective and safe.
4.Regulation of drug release performance using mixed doxorubicin-doxorubicin dimer nanoparticles as a pH-triggered drug self-delivery system
Jiagen LI ; Xinming LI ; Pengwei XIE ; Peng LIU
Journal of Pharmaceutical Analysis 2022;12(1):122-128
A mixed drug self-delivery system(DSDS)with high drug content(>50%)was developed to regulate pH-triggered drug release,based on two doxorubicin(DOX)-DOX dimmers:D-DOXADH and D-DOXcar con-jugated with acid-labile dynamic covalent bonds(hydrazone and carbamate,respectively)and stabilized with PEGylated D-DOXADH(D-DOXADH-PEG).Owing to the different stability of the dynamic covalent bonds in the two dimers and the noncovalent interaction between them,pH-triggered drug release could be easily regulated by adjusting the feeding ratios of the two DOX-DOX dimers in the mixed DSDS.Similar in vitro cellular toxicity was achieved with the mixed DSDS nanoparticles prepared with different feeding ratios.The mixed DSDS nanoparticles had a similar DOX content and diameter but different drug releasing rates.The MTT assays revealed that a high anti-tumor efficacy could be achieved with the slow-release mixed DSDS nanoparticles.
5.Mechanisms of long non-coding RNA in osteoarthritis and traditional Chinese medicine intervention
Keqi HUANG ; Jiagen LI ; Shangtong CHEN ; Xiangbin RONG
Chinese Journal of Tissue Engineering Research 2024;28(34):5571-5576
BACKGROUND:The etiology of osteoarthritis is varied and its pathogenesis is still unclear.As bioinformatics has been deepening in recent years,increasing studies have found that the aberrant expression of long non-coding RNAs(lncRNAs)and microRNAs(miRNAs)in joint tissues may mediate the downstream signaling pathways involved in the development of osteoarthritis. OBJECTIVE:To review the mechanism of lncRNA in the development of osteoarthritis and the therapeutic effects of monomers and active compounds derived from traditional Chinese medicine that modulate lncRNA and downstream signaling pathways in osteoarthritis. METHODS:We searched CNKI,WanFang,VIP,and PubMed using the search terms of"long non-coding RNA,knee osteoarthritis,miRNA,chondrocytes,signaling pathway,and traditional Chinese medicine"in Chinese and English,respectively.The search time was from the inception of each database to March 2023.A total of 61 articles were included according to the inclusion and exclusion criteria. RESULTS AND CONCLUSION:The pathogenesis of knee osteoarthritis involves a complex molecular regulatory network,including aberrant expression of lncRNAs and miRNAs in cartilage tissues,which may lead to apoptosis of chondrocytes,degradation of cartilage extracellular matrix,and production of large amounts of pro-inflammatory cytokines.These changes interact with each other to cause degeneration of articular cartilage and progression of osteoarthritis.Therefore,further in-depth studies are needed to reveal the fine mechanisms of the molecular regulatory network.The mechanism of traditional Chinese medicine in the treatment of osteoarthritis mainly focuses on regulating the expression of lncRNA and miRNA,thereby alleviating chondrocyte apoptosis and extracellular matrix degradation,promoting cell proliferation,and slowing down the development of osteoarthritis.
6. Causes analysis and evaluation of correlative factors of high perioperative blood transfusion demand for patients with lung tumors
Qingpeng ZENG ; Jiagen LI ; Fang LYU ; Jinfeng HUANG ; Liangze ZHANG ; Shugeng GAO ; Jun ZHAO
Chinese Journal of Thoracic and Cardiovascular Surgery 2019;35(10):603-607
Objective:
To analyze the causes and correlative factors of high perioperative blood transfusion demand in patients with lung tumor, and to discuss the influence of high blood transfusion demand on patients’ postoperative recovery and its predictive factors.
Methods:
From November 2007 to October 2017, clinical data of patients who had underwent surgery for lung tumors in the Department of Thoracic Surgery, Cancer Hospital, Chinese Academy of Medical Sciences were collected. A total of 83 cases with perioperative transfusion of red blood cells ≥5U were classified as high transfusion demand group. Another 83 cases were selected from the rest of the patients with transfusion of red blood cells <5U as normal transfusion demand group. Related clinical and transfusion data were summarized to analyze the causes of high blood transfusion demand and its effect on postoperative recovery, univariate and multivariate logistic regressions were used to analyse correlative factors.
Results:
From November 2007 to October 2017, 23 898 patients with lung tumor underwent surgery in our department and the high blood transfusion demand rate was 0.35%. In the last 10 years, the ratio of high transfusion demand was 0.61%(46/7 503) in the first 5 years versus 0.23%(37/16 395) in the later 5 years(
7. Comparison of lung cancer surgery in China, 2005 vs. 2015
Ning LI ; Fengwei TAN ; Bin QIU ; Jiagen LI ; Jun ZHAO ; Yushun GAO ; Dali WANG ; Yousheng MAO ; Qi XUE ; Juwei MU ; Shugeng GAO ; Jie HE
Chinese Journal of Oncology 2018;40(4):300-302
Objective:
To study the impact of the advance of the times and technological progress on the surgical treatment of lung cancer.
Methods:
The data of patients with non-small cell lung cancer treated by thoracic surgery at Cancer Hospital of Chinese Academy of Medical Sciences from 2005 to 2015 were retrospectively analyzed. The population distribution, operation methods and treatment results were analyzed retrospectively.
Results:
510 patients (in 2005) and 1 235 (in 2015) non-small cell lung cancer patients were included in this study. The proportions of male patients (79.0% vs. 55.8%), smoking (52.9% vs. 30.1%), squamous cell carcinoma (50.2% vs. 22.4%) and video-assisted thoracoscopic surgery (VATS) (0 vs. 61.1%), stage Ⅰ (15.2% vs. 36.8%), the number of lymph node dissection (21.8 vs. 16.6), intraoperative blood transfusion rate (9.6% vs. 1.9%), palliative resection rate (7.5% vs. 2.0%), the average length of stay (10.8 d vs. 7.6 d) were significantly changed. There was no significant difference in the average age of patients and operation time.
Conclusion
There was a significant change in the distribution of population and surgical techniques in patients undergoing lung cancer surgery in last ten years.
8.Effect of Thoracic Surgeons on Lung Cancer Patients' Survival.
Ning LI ; Fengwei TAN ; Bin QIU ; Jiagen LI ; Jun ZHAO ; Yushun GAO ; Dali WANG ; Yousheng MAO ; Qi XUE ; Juwei MU ; Shugeng GAO ; Jie HE
Chinese Journal of Lung Cancer 2018;21(2):104-109
BACKGROUND:
Surgeons are the direct decision-makers and performers in the surgical treatment of patients with lung cancer. Whether the differences among doctors affect the survival of patients is unclear. This study analyzed the five-year survival rates of different thoracic surgeries in patients undergoing surgery to assess the physician's impact and impact.
METHODS:
A retrospective analysis of five years between 2002-2007 in the Department of Thoracic Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, for surgical treatment of lung cancer patients. According to different surgeons grouping doctors to compare the basic information of patients, surgical methods, short-term results and long-term survival differences.
RESULTS:
A total of 712 patients treated by 11 experienced thoracic surgeons were included in this study. The patients have nosignificant difference with gender, age, smoking, pathological type between groups. There were significant differences in clinical staging, surgery type, operation time, blood transfusion rate, number of lymph node dissection, palliative resection rate, postoperative complications and perioperative mortality. There was a significant difference in five-year survival rates among patients treated by different doctors. This difference can be seen in all clinical stage analyzes with consistency. In the multivariate analysis, it was suggested that surgeon was an independent factor influencing the prognosis of patients.
CONCLUSIONS
Thoracic surgeon has a significant effect on the therapeutic effect of lung cancer patients.
Adult
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Aged
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Aged, 80 and over
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Female
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Humans
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Lung Neoplasms
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surgery
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Male
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Middle Aged
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Multivariate Analysis
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Postoperative Complications
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etiology
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Retrospective Studies
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Surgeons
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statistics & numerical data
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Survival Analysis
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Thoracic Surgery
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Thoracic Surgical Procedures
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adverse effects