1.Influence of cancer in pregnancy on obstetric and neonatal outcomes:an observational retrospective cohort study
Xuan HUANG ; Chen ZHANG ; Jialei ZHU ; Yueyan LI ; Jing TANG
Journal of Gynecologic Oncology 2024;35(6):e74-
Objective:
The study aimed to review the oncological characteristics and treatment of pregnancy-associated cancers and analyze the obstetric and neonatal outcomes to provide evidence-based recommendations for reproductive function preservation, oncological treatment, and obstetric management.
Methods:
We conducted an observational retrospective cohort study among pregnant patients with cancer in 7 Chinese tertiary A hospitals from 2003 to 2021. We conducted multiple logistic regression to determine the influence of various factors on preterm birth and small-for-gestational-age infants, log-binomial regression to analyze temporal changes, and χ 2 tests to explore the effects of cancer type/treatment.
Results:
Of 204 women, 17% terminated their pregnancies; 59% received pre-delivery treatment. Every 6 years, the rates of pregnancy termination (relative risk [RR]=0.48;95% confidence interval [CI]=0.35–0.67) and iatrogenic preterm births (RR=0.73; 95% CI=0.54–0.98) reduced, and that of pre-delivery treatment increased, mainly due to increased rates of surgery (RR=1.87; 95% CI=1.31–2.67). Maternal systemic diseases were related to small-for-gestational-age infants (odds ratio [OR]=12.02; 95% CI=1.82–79.43).Chemotherapy with taxanes plus platinum-based agents was related to adverse obstetric outcomes (OR=1.87; 95% CI=1.42–2.46; p<0.05). Thyroid (OR=0.36; 95% CI=0.22–0.57) and ovarian cancer (OR=0.70; 95% CI=0.50–0.98) were associated with fewer cesarean sections.Thyroid cancer was associated with fetal growth restriction (OR=5.21; 95% CI=1.21–22.55).
Conclusion
Rates of pregnancy termination in cancer declined. Taxane plus platinum-based chemotherapy was associated with adverse obstetric outcomes. Cancer type influenced outcomes.
2.Influence of cancer in pregnancy on obstetric and neonatal outcomes:an observational retrospective cohort study
Xuan HUANG ; Chen ZHANG ; Jialei ZHU ; Yueyan LI ; Jing TANG
Journal of Gynecologic Oncology 2024;35(6):e74-
Objective:
The study aimed to review the oncological characteristics and treatment of pregnancy-associated cancers and analyze the obstetric and neonatal outcomes to provide evidence-based recommendations for reproductive function preservation, oncological treatment, and obstetric management.
Methods:
We conducted an observational retrospective cohort study among pregnant patients with cancer in 7 Chinese tertiary A hospitals from 2003 to 2021. We conducted multiple logistic regression to determine the influence of various factors on preterm birth and small-for-gestational-age infants, log-binomial regression to analyze temporal changes, and χ 2 tests to explore the effects of cancer type/treatment.
Results:
Of 204 women, 17% terminated their pregnancies; 59% received pre-delivery treatment. Every 6 years, the rates of pregnancy termination (relative risk [RR]=0.48;95% confidence interval [CI]=0.35–0.67) and iatrogenic preterm births (RR=0.73; 95% CI=0.54–0.98) reduced, and that of pre-delivery treatment increased, mainly due to increased rates of surgery (RR=1.87; 95% CI=1.31–2.67). Maternal systemic diseases were related to small-for-gestational-age infants (odds ratio [OR]=12.02; 95% CI=1.82–79.43).Chemotherapy with taxanes plus platinum-based agents was related to adverse obstetric outcomes (OR=1.87; 95% CI=1.42–2.46; p<0.05). Thyroid (OR=0.36; 95% CI=0.22–0.57) and ovarian cancer (OR=0.70; 95% CI=0.50–0.98) were associated with fewer cesarean sections.Thyroid cancer was associated with fetal growth restriction (OR=5.21; 95% CI=1.21–22.55).
Conclusion
Rates of pregnancy termination in cancer declined. Taxane plus platinum-based chemotherapy was associated with adverse obstetric outcomes. Cancer type influenced outcomes.
3.Influence of cancer in pregnancy on obstetric and neonatal outcomes:an observational retrospective cohort study
Xuan HUANG ; Chen ZHANG ; Jialei ZHU ; Yueyan LI ; Jing TANG
Journal of Gynecologic Oncology 2024;35(6):e74-
Objective:
The study aimed to review the oncological characteristics and treatment of pregnancy-associated cancers and analyze the obstetric and neonatal outcomes to provide evidence-based recommendations for reproductive function preservation, oncological treatment, and obstetric management.
Methods:
We conducted an observational retrospective cohort study among pregnant patients with cancer in 7 Chinese tertiary A hospitals from 2003 to 2021. We conducted multiple logistic regression to determine the influence of various factors on preterm birth and small-for-gestational-age infants, log-binomial regression to analyze temporal changes, and χ 2 tests to explore the effects of cancer type/treatment.
Results:
Of 204 women, 17% terminated their pregnancies; 59% received pre-delivery treatment. Every 6 years, the rates of pregnancy termination (relative risk [RR]=0.48;95% confidence interval [CI]=0.35–0.67) and iatrogenic preterm births (RR=0.73; 95% CI=0.54–0.98) reduced, and that of pre-delivery treatment increased, mainly due to increased rates of surgery (RR=1.87; 95% CI=1.31–2.67). Maternal systemic diseases were related to small-for-gestational-age infants (odds ratio [OR]=12.02; 95% CI=1.82–79.43).Chemotherapy with taxanes plus platinum-based agents was related to adverse obstetric outcomes (OR=1.87; 95% CI=1.42–2.46; p<0.05). Thyroid (OR=0.36; 95% CI=0.22–0.57) and ovarian cancer (OR=0.70; 95% CI=0.50–0.98) were associated with fewer cesarean sections.Thyroid cancer was associated with fetal growth restriction (OR=5.21; 95% CI=1.21–22.55).
Conclusion
Rates of pregnancy termination in cancer declined. Taxane plus platinum-based chemotherapy was associated with adverse obstetric outcomes. Cancer type influenced outcomes.
4.Effects of early essential newborn care technology on the health outcomes of mothers and infants after full-term cesarean section
Jun LIU ; Dongshu ZHU ; Huan CHENG ; Airong BAO ; Hongyan DUAN ; Jialei FENG ; Huixia YANG
Chinese Journal of Modern Nursing 2023;29(3):354-358
Objective:To explore the effect of early essential newborn care technology during cesarean section on early health outcomes of mothers and infants and breast feeding.Methods:This study was a randomized controlled study. From October 2020 to August 2021, 104 delivery women and their newborns who were scheduled for full-term cesarean section in Peking University First Hospital were selected as the study subject. The subjects were randomly divided into control group and intervention group, 52 cases in each group. The control group received routine nursing of the newborn after cesarean section, while the intervention group received early essential newborn care technology after cesarean section. The amount of postpartum hemorrhage, hospital stay, Apgar score at one and five minutes after birth, the incidence of abnormal conditions within 90 minutes after birth, the time of umbilical cord shedding, the time of the first feeding sign of the newborn, the success rate of early initiation of breastfeeding and the implementation of breast feeding at discharge were compared between the two groups.Results:There was no statistical difference between the two groups in the amount of postpartum hemorrhage within two hours, the amount of postpartum hemorrhage within two to 24 hours and the number of days in hospital ( P>0.05) . There was no statistical difference between the two groups in Apgar scores at one and five min after birth ( P>0.05) . There was no statistical difference between the two groups in the occurrence of re-attraction, respiratory abnormalities, resuscitation, Neonatal Intensive Care Unit (NICU) transfer and other abnormalities within 90 minutes after birth ( P>0.05) . There was no statistical difference in the time of umbilical cord shedding between the two groups ( P>0.05) , and no umbilical infection occurred. The first foraging reflex in the intervention group was earlier than that in the control group, and the success rate of early initiation of breastfeeding was higher than that in the control group, and the differences was statistically significant ( P<0.05) . There was no statistical difference in the implementation of breast feeding between the two groups at discharge ( P>0.05) . Conclusions:It is safe and feasible to implement early essential newborn care technology during cesarean section, and it can effectively promote early initiation of breastfeeding, which is of great significance for breast feeding and has the value of clinical promotion.
5.Effect and mechanism of transcutaneous electrical acustimulation on the improving gastrointestinal motility and inflammation in patients with acute pancreatitis
Gaojue WU ; Wenhui XU ; Jialei XUAN ; Xuejun TANG ; Lei GONG ; Yingwei ZHU
Chinese Journal of Digestion 2022;42(7):445-451
Objective:To explore the regulation effect and possible mechanism of transcutaneous electrical acustimulation (TEA) on the improvement of gastrointestinal motility and inflammation in patients with acute pancreatitis (AP).Methods:A randomized, single-blinded, sham-controlled study was performed. A total of 62 AP patients were randomly divided into the TEA group ( n=31) and sham-TEA group ( n=31), on the basis of regular treatment, who received TEA treatment at Neiguan (PC6) and Zusanli (ST36) or sham-TEA treatment at corresponding pseudo stimulation acupoints for 2 days. Abdominal distension score, time to first defecation, gastric slow wave, heart rate variability (low frequency and high frequency, reflecting sympathetic and vagal activity, respectively), serum level of tumor tecrosis factor (TNF)-α, plasma levels of motilin, ghrelin and vasoactive intestinal peptide(VIP) tested by enzyme linked immunosorbent assay were compared before and after the treatment. Wilcoxon rank test, Mann-Whitney U test, t-test and two factor repeated measurement analysis of variance were used for statistical analysis. Results:After the treatment, abdominal distension score of TEA group was lower than that of sham-TEA group(1 (0 to 2) vs.5(3 to 6)) and time to first defecation was earlier than that of sham-TEA group((55.00±24.27) h vs.(67.95±23.84) h), the percentage of normal gastric slow wave was higher than that of sham-TEA group((57.42±11.16)% vs. (40.92±8.52)%), and the differences were statistically significant ( Z=-4.95、 t=-2.12、 F=61.53, all P<0.05). After the treatment, the serum level of TNF-α of TEA group was significantly lower than that of sham-TEA group((4.27±1.28) ng/L vs.(6.19±2.03) ng/L), and the difference was statistically significant ( F=28.65, P<0.05). The ratio of post/pre-treatment of low frequency heart rate variability of the TEA group was significantly lower than that of sham-TEA group, however, the result of high frequency was opposite (0.87±0.18 vs.1.14±0.16, 1.19±0.18 vs.0.96±0.13), and the differences were statistically significant ( t=-6.22 and 5.74, both P<0.05). After the treatment, the plasma level of ghrelin of TEA group was higher than that of sham-TEA group ((2.02±0.62) μg/L vs. (0.93±0.49) μg/L), the VIP level was lower than of sham-TEA group ((30.58±12.20) μg/L vs.(44.35±29.52) μg/L), and the differences were statistically significant ( F=59.22 and 5.50, both P<0.05). However, there was no significant difference in motilin levels between two groups ((24.57±9.58) ng/L vs. (22.75±9.58) ng/L, P>0.05). Conclusion:TEA treatment can improve gastrointestinal motility and inhibit the inflammation in early AP, which may be related with the regulation of autonomic function, gastrointestinal hormone ghrelin and VIP.
6.Comparison of different immobilization methods in breast cancer radiotherapy after breast-conserving surgery
Xuechen LUO ; Jialei YU ; Lin ZHU ; Xuenan LI ; Gaofeng LI ; Xia XIU ; Qiuzi ZHONG ; Yonggang XU
Chinese Journal of Radiological Medicine and Protection 2022;42(7):522-526
Objective:To compare and analyze the differences in the setup accuracy of different immobilization method in breast cancer radiotherapy after breast-conserving surgery.Methods:A retrospective study was conducted on 60 patients who received radiotherapy after breast-conserving surgery from January to August, 2021. These patients were divided into two groups. One group consisted of 30 cases who were immobilized using a modified body thermoplastic membrane combined with a multifunction body board during the breast cancer radiotherapy and was called the modified body thermoplastic membrane group. The other group comprised 30 cases immobilized using a vacuum cushion during breast cancer radiotherapy and was referred to as the vacuum cushion group. The setup errors, 3D vector errors, the proportion of errors of > 5 mm, and the dosimetric differences in the planning target volume (PTV) and the clinical target volume (CTV) before and after simulated treatment bed moving (including the PTV_ V100, PTV_ V95, and CTV_ V95 before simulated treatment bed moving and the PTV_ V100 S, PTV_ V95 S, and CTV_ V95 S after simulated treatment bed moving) were compared between two groups. Moreover, for the modified body thermoplastic membrane group, the changes in the average setup errors at different radiotherapy stages were also analyzed. Results:A total of 369 cone-beam CT scans were conducted for 60 patients, including 195 CT scans for the modified body thermoplastic membrane group and 174 CT scans for the vacuum cushion group. The setup errors in the x, y, and z directions (right-left, anterior-posterior, and superior-inferior, respectively) of the modified body thermoplastic membrane group were (2.59±1.98) mm, (2.38±2.04) mm, and (1.45±1.16) mm, respectively, while those of the other group were (2.24±1.63) mm, (2.78±2.17) mm, and (2.70±1.88) mm, respectively. The 3D vector errors of both groups were (4.32±2.28) mm and (5.13±2.14) mm, respectively. Therefore, the setup error in direction z and the 3D vector error of the modified body thermoplastic membrane group were less than those of the vacuum cushion group ( t = -7.77, -3.41, P<0.05). Moreover, the proportion of setup errors of > 5 mm in the x direction of the vacuum cushion group was lower than that of the modified body thermoplastic membrane group ( χ2 = 7.13, P<0.05), while such proportion in the z direction of the modified body thermoplastic membrane group was lower than that of the vacuum cushion group ( χ2= 5.90, P<0.05). After the simulated treatment bed moving, the PTV_ V100 S of the modified body thermoplastic membrane group was better than that of the vacuum cushion group ( t = 2.47, P < 0.05). Furthermore, for the modified body thermoplastic membrane group, the setup errors in the x direction in the first week were higher than those in the 2-3 weeks and 4-5 weeks ( P<0.05). Conclusions:The modified body thermoplastic membrane combined with a multifunction body board yield better immobilization effects than a vacuum cushion. However, it produces high setup errors in the x direction in the first week of the radiotherapy, to which special attention should be paid.
7.Textual Analysis of Classical Prescription Yangweitang Based on Ancient Literature
Lyuyuan LIANG ; Jialei CAO ; Yiping WANG ; Mengmeng GENG ; Lujun ZHU ; Wenxin WEI ; Bingqi WEI ; Wenli SHI ; Bingxiang MA
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(12):147-157
The classical prescription Yangweitang, derived from Zhengzhi Zhunsheng, is specialized in treating syndromes of chill and fever due to exogenous pathogens, inner-cooling, and malaria, and it has been included in the Catalogue of Ancient Classical Formulas (the First Batch) published by the National Administration of Traditional Chinese Medicine (TCM) in 2018. Through bibliographical research, the relevant ancient books and modern documents were systematically sorted out, and it was found that there were many prescriptions related to the Yangweitang from Zhengzhi Zhunsheng. They were interwoven with Yangweitang from Zhengzhi Zhunsheng and widely used in clinical practice. In order to clarify their history and evolution, this paper combed the historical origin of Yangweitang and its related prescriptions and conducted textual analysis on key information such as semantic composition, herb origin, processing method, and efficacy. A total of 896 pieces of data on Yangweitang from Zhengzhi Zhunsheng were collected. 26 pieces of effective data were included after the screening, involving 17 ancient TCM books. Then, a total of 28 pieces of data on prescriptions related to the Yangweitang from Zhengzhi Zhunsheng were included, involving 23 ancient TCM books for reference. The textual analysis showed that Yangweitang originated from the Renshen Yangweitang recorded in Taiping Huimin Heji Jufang in the Song dynasty. Based on the original formula, medical experts from later generations have modified it into many different versions. A comparative analysis showed that Yangweitang from different generations had similar compositions, and the herb origin and processing method were basically clear. The recommended prescriptions are as follows: 37.3 g of Pinelliae Rhizoma Praeparatum Cum Alumine, Magnoliae Officinalis Cortex(fried with ginger juice), and frying with rice water Atractlodis Rhizoma, 27.98 g of Citri Exocarpium Rubrum, 18.65 g of Pogostemon cablin leaf, Tsaoko Fructus, Poria, and Ginseng Radix et Rhizoma, and 9.33 g of Glycyrrhizae Radix et Rhizoma. They could be ground into a coarse powder, with 14.92 g for every dose, and they could be orally taken after being decocted with 450 mL of water, 7 g of fresh ginger, and 2 g of Mume Fructus to 270 mL in warm conditions. Yangweitang from Zhengzhi Zhunsheng has the effect of warming the middle and releasing the external, and it can treat many syndromes including spleen and stomach disharmony caused by chill and fever due to exogenous pathogens and inner-cooling, as well as all kinds of malaria. Modern clinical applications mainly focus on chronic atrophic gastritis and other digestive system diseases.
8.A broadly neutralizing human monoclonal antibody against the hemagglutinin of avian influenza virus H7N9.
Jingxin LI ; Li ZHANG ; Linlin BAO ; Yuxiao WANG ; Lin QIU ; Jialei HU ; Rong TANG ; Huiyan YU ; Jun SHAN ; Yan LI ; Chuan QIN ; Fengcai ZHU
Chinese Medical Journal 2022;135(7):799-805
BACKGROUND:
The new emerging avian influenza A H7N9 virus, causing severe human infection with a mortality rate of around 41%. This study aims to provide a novel treatment option for the prevention and control of H7N9.
METHODS:
H7 hemagglutinin (HA)-specific B cells were isolated from peripheral blood plasma cells of the patients previously infected by H7N9 in Jiangsu Province, China. The human monoclonal antibodies (mAbs) were generated by amplification and cloning of these HA-specific B cells. First, all human mAbs were screened for binding activity by enzyme-linked immunosorbent assay. Then, those mAbs, exhibiting potent affinity to recognize H7 HAs were further evaluated by hemagglutination-inhibiting (HAI) and microneutralization in vitro assays. Finally, the lead mAb candidate was selected and tested against the lethal challenge of the H7N9 virus using murine models.
RESULTS:
The mAb 6-137 was able to recognize a panel of H7 HAs with high affinity but not HA of other subtypes, including H1N1 and H3N2. The mAb 6-137 can efficiently inhibit the HA activity in the inactivated H7N9 virus and neutralize 100 tissue culture infectious dose 50 (TCID50) of H7N9 virus (influenza A/Nanjing/1/2013) in vitro, with neutralizing activity as low as 78 ng/mL. In addition, the mAb 6-137 protected the mice against the lethal challenge of H7N9 prophylactically and therapeutically.
CONCLUSION
The mAb 6-137 could be an effective antibody as a prophylactic or therapeutic biological treatment for the H7N9 exposure or infection.
Animals
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Antibodies, Monoclonal/therapeutic use*
;
Antibodies, Neutralizing/therapeutic use*
;
Antibodies, Viral
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Hemagglutinins
;
Humans
;
Influenza A Virus, H1N1 Subtype
;
Influenza A Virus, H3N2 Subtype
;
Influenza A Virus, H7N9 Subtype
;
Influenza Vaccines
;
Influenza in Birds
;
Influenza, Human/prevention & control*
;
Mice