1.Relationship between acute radiation reactions and doses of total body irradiation before hematopoietic stem cell transplantation
Yanchuan SHI ; Shuzhuang LYU ; Yazhao LIU ; Weitao NIU ; Rongxiao WANG ; Jingya ZHANG ; Yuhui PANG ; Jianying LI ; Gengshen SU
Journal of Leukemia & Lymphoma 2021;30(2):82-86
Objective:To investigate the relationship of the acute radiation reactions of totalbody irradiation before hematopoietic stem cell transplantation with the different total and fractionated doses of irradiation.Methods:The clinical data of 48 patients who underwent 6 MV X-ray total body irradiation pretreatment from May 2015 to December 2019 in Shijiazhuang Ping'an Hospital before undergoing hematopoietic stem cell transplantation were retrospectively analyzed. The patients were divided into 8 Gy group (12 cases), 10 Gy group (31 cases) and 12 Gy group (5 cases) according to the total radiation dose, and divided into 4 Gy/f group (17 cases) and 5 Gy/f group (31 cases) according to the fractionated radiation dose. Acute radiation reactions in the oral mucosa, pharynx, salivary glands, upper gastrointestinal tract, lower gastrointestinal tract and lung of patients in each group after radiotherapy were summarized and compared.Results:Acute pharyngeal reaction in the total radiation dose of 8 Gy group showed that 11 cases (91.7%) were grade 0 and 1 case (8.3%) was grade 1; in the total radiation dose of 10 Gy group, 10 cases (32.3%) were grade 0, 13 cases (41.9%) were grade 1, 4 cases (12.9%) were grade 2, 3 cases (9.7%) were grade 3, and 1 case (3.2%) was grade 4; in the total radiation dose of 12 Gy group, 2 cases (40.0%) were grade 0, 1 case (20.0%) was grade 1, 1 case (20.0%) was grade 2, and 1 case (20.0%) was grade 3. The severity of acute pharyngeal radiation reaction in the total radiation dose of 8 Gy group was better than that in the 10 Gy and 12 Gy groups, and the difference was statistically significant ( χ2 = 11.338, P = 0.003); there was no significant difference in the incidence of acute radiation reactions in other parts (all P > 0.05). Acute pharyngeal radiation reaction in the fractionated radiation dose of 4 Gy/f group showed that 13 cases (76.5%) were grade 0, 2 case (11.8%) was grade 1, 1 case (5.9%) was grade 2, and 1 case (5.9%) was grade 3; in the 5 Gy/f group, 10 cases (32.3%) were grade 0, 13 cases (41.9%) were grade 1, 4 cases (12.9%) were grade 2, 3 cases (9.7%) were grade 3, and 1 case (3.2%) was grade 4. The severity of acute pharyngeal radiation reaction in the fractionated radiation dose 4 Gy/f group was better than that in the 5 Gy/f group, and the difference was statistically significant ( Z = -2.606, P = 0.009); there was no significant difference in the incidence of acute radiation reactions in other parts (all P > 0.05). Conclusion:The total dose of 8 Gy and fractionated dose of 4 Gy/f in the total body irradiation before hematopoietic stem cell transplantation can alleviate the acute pharyngeal radiation reaction.
2.A comparision between two different local resections for the treatment of duodenal stromal tumors
Jingya YUAN ; Yanyan SHI ; Yuntao BING ; Dianrong XIU
Chinese Journal of General Surgery 2021;36(12):915-918
Objective:To investigate the safety and clinical efficacy of laparoscopy dominated approaches to two different local resections for duodenal stromal tumors.Methods:From May 2015 to May 2021 25 duodenal stromal tumors cases were allocated to wedged resection group (8 cases) and segmental resection (17cases).Results:Compared with the segmental resection group, the operative time in the wedge resection group was significantly shorter [(202±43) min vs. (299±128) min, t=-2.814, P=0.010]. The intraoperative blood loss was 20 (10-50) ml in the wedge resection group and 30 (15-100) ml in the segmental resection group ( t=-1.128, P>0.05). Patients in the wedge resection group had a significantly shorter postoperative hospital stay, 7(9-11) days vs. 14 (10-28) days, t=-2.66, P=0.008. There was no difference in the incidence of postoperative complications and gastric emptying disorders between the two groups ( P>0.05). Conclusion:In spite of laparoscopic,robotic or open approaches, wedge resection and segmental resection based on anatomic location for duodenal stromal tumors are both safe and satisfactory.
3. Gene mutations from 511 myelodysplastic syndromes patients performed by targeted gene sequencing
Bing LI ; Jingya WANG ; Jinqin LIU ; Zhongxun SHI ; Shuailing PENG ; Huijun HUANG ; Tiejun QIN ; Zefeng XU ; Yue ZHANG ; Liwei FANG ; Hongli ZHANG ; Naibo HU ; Lijuan PAN ; Shiqiang QU ; Zhijian XIAO
Chinese Journal of Hematology 2017;38(12):1012-1016
Objective:
To study the characteristics of gene mutations in Chinese myelodysplastic syndromes (MDS) patients.
Methods:
A total of 511 Chinese patients with MDS performed 112-gene targeted sequencing were retrospectively analyzed.
Results:
Eighty-three distinct mutant genes were found in 511 patients with MDS. Amongst these, the most frequent mutations was associated with epigenetics (50%) , followed by spliceosome (37%) , signal transduction (34%) , transcription factors (24%) and cell cycle/apoptosis (17%) . 439 subjects (86%) had at least one gene mutation. The mean number of mutations in refractory anemia with unilineage dysplasia (RCUD) was 1.25, refractory anemia with multilineage dysplasia (RCMD) was 1.73, refractory anemia with ring sideroblasts (RARS) was 2.79, refractory anemia with excess blasts-1 (RAEB-1) was 2.22, RAEB-2 was 2.34, MDS with isolated 5q- was 2.67, MDS, unclassified (MDS-U) was 2.00. U2AF1 mutant subjects were more likely to have isolated+8[
4.Sitagliptin compared with glimepiride combined with metformin as an initial therapy in newly diagnosed diabetes patients with severe hyperglycaemia: A randomized controlled non-inferiority study
Mingqian HE ; Jingya WANG ; Mei DENG ; Bingyin SHI ; Jing SUI
Journal of Xi'an Jiaotong University(Medical Sciences) 2021;42(1):86-92,98
【Objective】 To investigate the efficacy and safety of sitagliptin combined with metformin versus glimepiride combined with metformin in newly diagnosed type 2 diabetes patients with severe hyperglycaemia. 【Methods】 A randomized controlled and non-inferiority trial was carried out. A total of 129 newly diagnosed type 2 diabetes patients with severe hyperglycaemia [FPG≥200 mg/mL (11.1 mmol/L) and HbA1c≥9.0%] were enrolled and numerally randomly assigned to two groups. The patients received sitagliptin combined with metformin (n=66) or glimepiride combined with metformin (n=63) for 4 weeks and then metformin alone for another 8 weeks. Glycaemic control, weight changes and β-cell insulin secretory capacity were investigated to demonstrate the efficacy and safety of these two treatments. 【Results】 Mean HbA1c reduction was 4.03% in sitagliptin group and 4.13% in glimepiride group after 3 months of treatment. The lower boundary of the two-sided 95% confidence intervals of the mean HbA1c reduction difference between the two groups was -0.648%, which was more than -0.65%, suggesting that the predefined statistical criterion for non-inferiority was achieved. FPG decreased significantly after one month of intervention in both groups (P<0.05). Significant reduction in the time of reaching euglycemia, FPG and weight decrease was observed in sitagliptin group than glimepiride group (P<0.05). The FPG control rate FPG<110 mg/mL (6.1 mmol/L) was higher in sitagliptin group than in glimepiride group (P<0.05). After the 3-month follow-up, FPG, HbA1c and incidence of hypoglycemia showed no significant differences in the two groups, while weight loss and BMI changes showed significant differences in sitagliptin group compared with glimepiride group (P<0.05). No significant differences in β-cell insulin secretory indexes were observed in the two therapy groups (P>0.05). 【Conclusion】 Our study provided evidence that sitagliptin combined with metformin in newly diagnosed diabetes patients with severe hyperglycaemia showed better outcomes in glycaemic remission compared with glimepiride for those who refused insulin injection.
5.Optimization of Extraction Technology of Total Triterpenes from the Leaves of Cornus officinalis by Box-Behnken Design-response Surface Methodology
Denghui ZHU ; Jingke ZHANG ; Meng LI ; Jingya SHI ; Juanjuan LIU ; Junjun WEI ; Xiaoke ZHENG ; Weisheng FENG
China Pharmacy 2021;32(1):46-50
OBJECTIVE:To optimize the extraction technology for total triterpenes from the leaves of Cornus officinalis . METHODS:Based on the full swelling of the leaves of C. officinalis ,total triterpenes was extracted with heating reflux method. The effects of ethanol concentration ,liquid-solid ratio ,extraction time and extraction times on the contents of total triterpenes from the leaves of C. officinalis were investigated by single factor test. Using oleanolic acid as control ,the contents of total triterpenes were detected by UV spectrometry. On the basis of single factor test ,fixing the times of extraction a s 3 times,taking the contents of total triterpenes as response value ,using ethanol volume fraction ,solid-liquid ratio and extraction time as factors , Box-Behnken design-response methodology was used to optimize the extraction technology of total triterpenes from the leaves of C. officinalis,and the optimized extraction technology was validated. RESULTS :The optimal extraction technology of total triterpenes from the leaves of C. officinalis were as follows as ethanol concentration of 73%,liquid-to-material ratio of 38 ∶ 1(mL/g), extraction time of 60 min. Results of 3 validation tests showed that the contents of total triterpenes from the leaves of C. officinalis were 6.92%,6.91%,6.84%;the average content was 6.89%(RSD=0.63%),relative error of which with the predicted value (7.28%)was 5.36%. CONCLUSIONS :The optimized technology is stable and reliable ,and can be used for the extraction of total triterpenes from leaves of C. officinalis .
6.Methodology for Developing Rapid and Living Guidelines of Traditional Chinese Medicine (RALIG-TCM) (Part 2): Development Process and Key Steps during Preparation Stage
Yujing ZHANG ; Lijiao YAN ; Ziteng HU ; Yaxin CHEN ; Xiaoling LI ; Qianzi CHE ; Jingya WANG ; An LI ; Nannan SHI ; Yanping WANG ; Ning LIANG
Journal of Traditional Chinese Medicine 2024;65(3):275-280
It is necessary to develop rapid and living guidelines in order to improve the evidence translation and guidance for clinical practice in emergency situations, and to enhance the participation of traditional Chinese medicine (TCM) in management of emergencies. This paper introduced the process of developing rapid and living guidelines of TCM and divided it into three stages, that is preparation, rapid development and dynamic updating, which highlights the features of rapid development, high quality, and dynamic updating and the integration with the predominance of TCM. By comparing with general guidelines on composition, personnel number, timing to formulate and communication patterns of the guideline working groups, as well as the content and number of clinical questions, this paper mainly gave suggestions on how to formulate a concise but authoritative team during the preparation stage, how to efficiently manage the guideline team and promote the development process from conflict of interest management, working and communication mode adjustment, and how to formulate and update the important and prioritized clinical questions, all of which may provide reference for the development of TCM rapid and living guidelines.
7.Methodology for Developing Rapid and Living Guidelines of Traditional Chinese Medicine (RALIG-TCM) (Part 3): Rapid Evidence Collection, Integration and Recommendation Formation
Ziteng HU ; Lijiao YAN ; Yujing ZHANG ; Yaxin CHEN ; Xiaoling LI ; Haili ZHANG ; Huizhen LI ; Jingya WANG ; An LI ; Zhao CHEN ; Ning LIANG ; Nannan SHI ; Yanping WANG
Journal of Traditional Chinese Medicine 2024;65(3):281-286
The lack of direct evidence is an important problem faced in the formation of recommendations in rapid living guidelines of traditional Chinese medicine under public health emergencies, and the supplementation of indirect evidence can be a key method to solve this problem. For the collection of evidence, the type of evidence required, including direct and indirect evidence, should be clarified, and ‘direct first’ principle for selecting evidence can be set to standardize and accelerate the guideline development. When integrating evidence, recommendations can be formed directly if there is sufficient direct evidence, while regarding insufficient direct evidence, recommendations need to be supplemented and improved by integrating indirect evidence. In addition, when the body of evidence contains evidence from multiple sources, it is suggested to rate the evidence according to “higher rather than lower” principle. Finally, when forming recommendations, the level of evidence, safety and economic efficiency should be taken into consideration to determine the strength of the recommendation.