1.The effects of hypertension on the risk of recurrence among TOAST subtype of ischemic stroke
Jiamei LIU ; Siyuan QIN ; Lulu XIAO ; Lili XU ; Wen BAI ; Gelin XU
Journal of Medical Postgraduates 2014;(10):1052-1055
Objective The relationship between hypertension ( HTN) and ischemic stroke recurrence is unclear , but there may be different effects of HTN on the risk of recurrence .This study aims to explore whether HTN contributes differently to the recur-rence among subtypes of ischemic stroke ( IS) . Methods We eventually enrolled 1114 patients with ischemic stroke from Jul 2008 to Dec 2012 registered in Nanjing Stroke Registry Program (NSRP) in this study.All the patients were classified according to Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria: 315 (28.3%) patiwnts were classified as Large-artery atheroselerosis (LAA), 212 (19.0%) as cardioembolism (CE), 266 (23.9%) as small-artery occlusion (SAO), and 321 (28.8%) as other de-termined and undetermined etiologies ( Other) .The association between HTN and stroke recurrence in patients with different IS sub-types was analyzed using multivariate Cox regression analysis . Results The average follow-up duration was (19.4 ±10.3) months. Of 1114 patients with IS, 158 (14.2%) patients experienced a recurrent stroke .Patients with HTN had a significantly higher stroke recurrence rate than those without (16.5%vs 10.5%, P<0.05).Multivariate Cox regression analysis indicated that HTN increased the risk of ischemic stroke recurrence (HR=1.722, 95%CI:1.181-2.512, P=0.005).After stratification by TOAST subtypes, analysis revealed an association between HTN and stroke recurrence in LAA( HR=3 .767, 95%CI:1.866-7.585, P=0.001) and SAO (HR=3.530, 95%CI:1.156-12.740, P=0.028), but not in the other subtypes (CE: HR=0.773, 95%CI:0.370-1.615, P=0.493;Other:HR=1.498, 95%CI:0.590-3.807, P=0.395). Conclusion HTN is an independent risk factor for recurrent ischemic stroke and is related to the recurrent ischemic stroke in patients with large-artery and small-vessel disease .
2.Advances in research on the nephrotoxicity of uranium and its molecular mechanism
Jiamei BAI ; Xuhong DANG ; Yayi YUAN ; Ruifeng ZHANG
China Occupational Medicine 2024;51(5):581-585
With the extensive application of uranium in military, industrial and civil fields, the possibility of human exposure to uranium has become increasingly likely. When uranium is accidentally released into the environment, it can enter the human body by various pathways and accumulate in the kidneys, leading to proximal tubule epithelial cell damage or even death, and in severe cases, nephrotoxicity. Uranium exerts both chemical and radiological toxicity, with its kidney-damaging effects primarily attributed to chemical toxicity. Low-level uranium exposure causes mild kidney damage, while prolonged or high-level exposure alters kidney structure and biomarker level of uranium-induced nephrotoxicity (such as creatinine, urea nitrogen and kidney injury molecule-1, etc.). Uranium exposure also induces DNA damage and mutations, kidney inflammation, and renal cell autophagy. Current research on uranium nephrotoxicity primarily focuses on uranium-induced mitochondrial dysfunction, which leads to oxidative stress and apoptosis (mainly by mitochondrial and endoplasmic reticulum pathway), ultimately causing renal tissue damage. However, the molecular mechanisms underlying uranium-induced kidney toxicity remain incomplete. Future research on mechanism of uranium-induced cell damage, especially metabolism, intracellular distribution, and additional mechanisms, remains a long-term and challenging endeavor.
3.Analysis of prognostic factors in patients with non-small cell lung cancer treated by surgery and chemotherapy
Liwen XIONG ; Aiqin GU ; Hao BAI ; Hao JI ; Dajiang QI ; Meilin LIAO ; Yunzhong ZHOU ; Jiamei ZHAO ; Baohui HAN
China Oncology 2001;0(03):-
Background and Purpose:Lung cancer is the most malignant tumour in the world.Its incidence is growing and NSCLC is predominent(80%) in lung cancer.Most patients with lung cancer were diagnosed in late stages.The tumour could be shrunk by neoadjuvant chemotherapy when the case with stage Ⅲ NSCLC was considered not possible for radical operated neoadjuvant chemotherapy may lead to the following,operation could be improved,micrometastasis could be annihilated and survival could be extended.Objective of this paper was to analyse the prognostic factors for survival in patients treated by surgery and chemotherapy for NSCLC.Methods:98 cases of neoadjuvant chemotherapy combined with surgery for NSCLC,stageⅠ~Ⅲ,were collected retrospectively in our hospital from 1995 to 1997.35 cases were stageⅠ.21 cases were stage Ⅱ.42 cases were stage Ⅲ.83 cases had 1 cycle of chemotherapy pre-operatively.15 cases had 2 cycles chemotherapy pre-operatively.Regimes of chemotherapy were MVP,MOP and MAP et al.Response rate(RR) of chemotherapy was:45 cases had partial response(PR) and 53 cases were stable disease(SD).Operative mode was lobectomy and pneumectomy with lymph nodes dissection.Pathologic type was squamous,adeno,adeno-squamous and others.All the patients were treated by chemotherapy for two or three cycles after surgery except for the patients in stageⅠin 1996~1997.After being followed-up for more than 5 years,data were examined using life table,KaplanMeier method,Log Rank statistic and Cox-mantel test.The possible factors affecting survival were tested with univariate and multivariate analysis.Results:The median followed-up time of 98 cases for NSCLC was 41.2 months.36 cases were alive.62 cases were dead.The 1-,3-,5-year survival rate of 98 cases for NSCLC was 88.78%、49.63% and 18.46%.The 5-year survival rates of stageⅠ、ⅡandⅢ were 33.23%、20.26% and 5.52% respectively(P=0.0002).The 5-year survival rates of N_(0)、N_(1)、N_(2) were 35.49%、19.08% and 4.90% respectively(P=0.0004).In the 98 cases of NSCLC,better prognosis was correlated with earlier stage.The prognosis was better if the period from last chemotherapy before operation to operation was no more than 1 month. The prognosis of lobectomy,lung hila activity,thorax lymph nodes negativity and squamous cancer was better.The prognosis was poorer if the tumor had invaded big vessels,viscera,chest wall,pericardium and quantity bleeding during≥400ml.The prognosis was better if the tumor was fibrotic.The prognosis of 2 cycles of chemotherapy pre-operatively might be better than 1 cycle.The prognosis of tumor necrosis was poorer and the prognosis of chemotherapy post-operatively was better.Conclusions:The main prognostic factors affecting survival in patients treated by surgery and chemotherapy for NSCLC was stage,the period from last chemotherapy before operation to operation,operation mode,lung hila activity,thorax lymph nodes,site of tumor invasion,bleeding quantity,pathologic type,tumor fibrosis and necrotis,cycles chemotherapy pro-operation and chemotherapy post-operation.
4.Effect of folic acid supplementation in childbearing aged women during pregnancy on neonate birth weight in Shaanxi province
Jiamei LI ; Pengfei QU ; Shaonong DANG ; Shanshan LI ; Ruhai BAI ; Bowen QIN ; Hong YAN
Chinese Journal of Epidemiology 2016;37(7):1017-1020
Objective To investigate the effect of folic acid supplementation in childbearing aged women during pregnancy on the birth weight of newborns in Shaanxi province.Methods A questionnaire survey was conducted among the childbearing aged women selected through multistage stratified random sampling in Shaanxi during 2010-2013,all of these childbearing aged women were in pregnancy or had definite pregnancy outcomes.The birth weight of newborns and folic acid supplementation during pregnancy were used as the dependent variables and independent variables respectively in multiple linear regression model and quantile regression model and confounding factors were controlled.Results Multiple linear regression analysis showed that the birth weight of newborns whose mothers had folic acid supplementation during pregnancy were significantly higher than those whose mothers had no folic acid supplementation during pregnancy,an average increase of 29.56 g (B=29.56,t=4.69 and P<0.01).Quantile regression analysis showed from very low to higher percentiles (q=0-0.55,q=0.65,q=0.75-0.80),the birth weights of newborns whose mothers supplemented folic acid were higher than those whose mother did not supplement folic acid,the difference was significant,but the increase varied.As the increase of the percentiles of birth weight,the body weight increase declined gradually in those whose mothers had folic acid supplementation compared with those whose mothers had no folic acid supplementation.Conclusion Folic acid supplementation during pregnancy can increase the birth weight of newborns,the influence was greater in newborns with lower body weight than in newborns with higher body weight.