1.Relationship between triglycerides polyunsaturated fatty acid composition and visceral fat in patients with metabolic syndrome
Weikun GONG ; Hongzhang TONG ; Mengda CHEN ; Xiaofang GUO ; Jingyan HU ; Jingbo LAI
Chinese Journal of Health Management 2014;8(3):150-154
Objective Essential polyunsaturated fatty acids(PUFA) can not been synthesized by the body-self.Serum triglycerides n-6 and n-3 PUFAs directly or indirectly reflect the corresponding unsaturated fatty acids intake from meals.This study was to investigate the relationship of serum triglycerides polyunsaturated fatty acid composition with the ratio of n-6 to n-3 PUFA(n-6/n-3 PUFA) and magnetic resonance imaging measured intra-abdominal fat(MRI-IAF) with other body fat parameters of patients with metabolic syndrome.Methods Thirty-six patients with metabolic syndrome and 41 healthy controls were enrolled in this investigation.The relevance of serum triglycerides polyunsaturated fatty acids with MRI-IAF was observed.A stepwise regression analysis was applied to determine which kind of triglycerides polyunsaturated fatty acid could predict MRI-IAF,waist circumference and body mass index (BMI) more potent.Results In the metabolic syndrome group,blood sugar,lipid profiles,blood pressure,visceral fat accumulation-related parameters and serum triglycerides polyunsaturated fatty acid composition was worse than those in the control group.Compared with the healthy controls,n-6/n-3 PUFA was significantly increased(t=8.564,P<0.05),although C18∶3 n-3,C20∶5 n-3(EPA),C22∶6 n-3(DHA) and n-3PUFA were significantly declined(t=-2.920,-7.034,all P<0.05) in metabolic syndrome group.The difference of n-6 PUFA showed no statistically significant difference(t=-0.957,-1.494,P>0.05).n-6/n-3 PUFA,n-3 PUFA,EPA and DHA were associated with MRI-IAF(r=-0.377,0.565,all P<0.05); n-6/n-3 PUFA was correlated with the waist circumference(r=0.400,P=0.016) and BMI(r=0.357,P=0.033),while n6 PUFA showed no correlation with body fat parameters.N-6/n-3 PUFA was more potent to predict MRIIAF,waist circumference and BMI(adjusted R2=0.102,0.299,all P<0.05) than other polyunsaturated fatty acids.Conclusions The ratio of n-6/n-3 PUFA and n-3 PUFA may be positively correlated with EPA and DHA could be inversely associated with MRI-IAF and other body fat-related parameters in patients with metabolic syndrome,while n-6 PUFA did not show such a relationship.The ratio of n-6/n-3 PUFA might be more potent to predict MRI-IAF and other body fat-related parameters.
2.Long term follow-up of children with neuroblastoma without chemotherapy and radiotherapy
Jie ZHAO ; Ci PAN ; Min XU ; Min ZHOU ; Yijing GAO ; Wenting HU ; Jingyan TANG
Journal of Clinical Pediatrics 2017;35(9):678-681
Objectives To analyze the clinical features and long-term follow-up results of neuroblastoma (NB) without chemotherapy and radiotherapy, and to provide evidence for further improvement of treatment. Methods The clinical data of children diagnosed with NB who received operation during January 2005 to December 2015 was retrospectively analyzed, and the long-term follow-up results were evaluated. Results In 57 cases of NB, 43 cases (81.1%) were in stage 1, 8 cases were in stage 2 and 2 cases were in stage 4S. The median age at diagnose was 7 months (11 days - 10 years and 11 months). There were 47/51 cases had the pathological type with a good prognosis (accounting for 92.2%). FISH was detected in 1/49 case which had the amplification at greater than 10 copies. 56/57 cases underwent surgical resection of the primary tumor, 50 cases of which were completely resected, and 3 cases had very good partial remission after tumor resection. The abdominal mass was found in the uterus in 1 case, and surgical operation was not performed and the imaging was regularly checked for follow-up , and the mass subsided completely at 7-month-old. The median follow-up time was 36 months (4 - 99 months). Five children were lost to follow-up and the median time of follow-up was 19 months (4 - 45 months). One child in stage 4S relapsed at 1 year of follow-up, 2 cases in stage 1 relapsed at 6 months of follow-up. Five years event free survival rates (EFS) in all patients were 94.6%, and overall survival rate (OS) of the 5 years was 100%. Conclusions Children younger than 18 months without MYCN amplification in the stages 1 and 2 are safe by surgical treatment alone with good prognosis. Simple surgical treatment can also be extended to all age groups of NB without MYCN amplification in the stages 1 or 2.
3.Study on the clinical outcomes of children with stage Ⅳ malignant extracranial germ cell tumors
Qianghua YAN ; Jingyan TANG ; Ci PAN ; Qidong YE ; Min ZHOU ; Yijin GAO ; Wenting HU
Journal of Clinical Pediatrics 2017;35(5):321-324
Objective To evaluate the outcomes of children with stage Ⅳ malignant extracranial germ cell tumors. Methods Twenty-five patients were enrolled in the retrospective analysis. Event-free survival (EFS) and overall survival (OS) rates were estimated by Kaplan-Meier method with SPSS 13.0. Results Of the 25 children, there were 13 males and 12 females. The mean age at diagnosis was 2 years old (ranged 1 to 11). Five patients receiving chemotherapy in another hospital before (n=1), or giving up treatment after confirmed diagnosis (n=1), or giving up effective treatment after received less than 2 cycles (n=3) were excluded from this analysis. Of the 20 patients, 90.0% (18/20) achieved complete remission and 5.0% (1/20) achieved partial remission after treatment. The 5-year EFS rate and 5-year OS rate were 70.0%±10.2% and 82.4%±9.2% respectively. There was no death occurred due to complications. Conclusions The effect of this treatment program is positive. The cumulative dose of the drugs is not high, compared with other schemes such as PEB, but there are more drugs involved. Whether these drugs may cause long-term adverse reactions needs further research.
4.Establishment and Optimization of Guinea Pigs Model for Cholecystitis Based on Multi-index Evaluation
Jingyan HU ; Songli HUANG ; Xiaohui ZHOU
Journal of Medical Research 2023;52(12):45-49
Objective To investigate the establishment and optimization of guinea pigs model of cholecystitis,so as to provide the basis for further optimization of experimental design and research on the pathogenesis,treatment and mechanism of cholecystitis.Methods The guinea pigs model of cholecystitis was established by subcutaneous injection of lincomycin hydrochloride,the general condition,B-ultrasound of the gallbladder,blood routine indicators and hepatobiliary histology of the guinea pigs were observed to determine the stabili-ty and application prospect of the cholecystitis model.Results The general state observation showed that guinea pigs in the model group exhibited varying degrees of diet decrease,body weight loss,activity decrease,loose and lusterless hair,listlessness or irritability.B-ul-trasound results showed that,compared with the control group of guinea pigs,with the higher modeling dose,the thickness of the gallblad-der wall were more obvious(P<0.05).The blood routine index detection found that,with the higher modeling dose,the blood inflamma-tory indicators such as white blood cell count(WBC),lymphocyte(LYM),neutrophil(NEUT),monocyte(MONO)were increased sig-nificantly(P<0.05).The results of hematoxylin-eosin staining showed that,with the higher modeling dose,pathological changes such as structural changes of gallbladder and liver tissue structure,inflammatory cell infiltration,degeneration and necrosis of liver cells were more obvious.Conclusion In this study,the imaging indicators combined with blood and pathological indicators were used for multi-factor comprehensive evaluation of the modeling effect of cholecystitis and the stability of the inflammatory model,which was more intui-tive,accurate and low-cost than the conventional gallbladder pathological analysis method or combined with enzyme-linked immuno-sorptive assay,and provided a scientific and effective detection index for the evaluation of therapeutic effects of drugs.At the same time,the model with the dose of 120mg/kg lincomycin hydrochloride for guinea pigs cholecystitis was the most stable and difficult to self-heal.
5. Stratified treatment of non-distant metastatic rhabdomyosarcoma in children: an analysis of its efficacy and prognostic factors
Yali HAN ; Jingyan TANG ; Ci PAN ; Wenting HU ; Yijin GAO
Chinese Journal of Applied Clinical Pediatrics 2019;34(15):1146-1150
Objective:
To assess the efficacy of stratified treatment of pediatric non-distant metastatic rhabdomyosarcoma (RMS).
Methods:
A retrospective review was conducted in 129 pediatric patients with non-distant metastatic RMS between January 2005 and December 2016 at Shanghai Children′s Medical Center Affiliated to Shanghai Jiaotong University School of Medicine.According to their pathological types, TNM stages and postoperative pathologic staging, the 129 patients were grouped a low-risk group, an intermediate-risk group and a high-risk group.Multimodality therapies were applied to all patients including chemotherapy, surgery and radiotherapy.The overall survival (OS) and event-free survival (EFS) rates were analyzed by using the Kaplan-Meier method.
Results:
Of 129 patients, 119 cases were included in this study.In 119 patients, the age of onset for the RMS ranged from 7 to 191 months, with the median onset age of 48 months.The median follow-up time was 40 months for event-free patients with RMS, and 36 months for all the 119 patients.The 5-year OS and EFS for all patients were (92.1±2.9)% and (76.5±4.4)%, respectively.While the 5-year EFS for patients in the low-risk group, intermediate-risk group and high-risk group were all above 70%, and the difference among the three groups was not statistically significant (
6.Application of simulation teaching method in promoting competency of undergraduate medical students of pediatrics
Liyuan HU ; Wenwei QIU ; Jianqing SHEN ; Wenhao ZHOU ; Jingyan WU
Chinese Journal of Medical Education Research 2021;20(8):922-925
In 2013, Shanghai Medical College of Fudan University restarted the enrollment of the undergraduate students in directional pediatrics. To cultivate medical talents in pediatrics, a serious of educational innovations and practices have been carried out guided by competency training, including training a team of teachers with simulated teaching skills and establishing a teaching platform for simulation teaching. Medical students can practice medicine and gain experience through the risk-free simulated scenarios, that is helpful to enhance their confidence in clinical skills and communications and decrease medical errors in their future careers.
7.Effects of Jiedu hugan granule on the inflammatory factor and tight junction protein of small intestine in rats with immunological liver injury
Saihua XU ; Jingna HU ; Jingyan MEI ; Weicheng MA
Chinese Journal of Clinical Pharmacology and Therapeutics 2017;22(12):1352-1357
AIM:To investigate the influence of Jiedu hugan granule on the inflammatory factor and tight junction protein of small intestine in rats with immunological liver injury.METHODS:Fifty SD rats were randomly divided into control group,model group,low,middle and high experimental group of Jiedu hugan granule (2.7,5.4,and 10.8 g/kg).All the groups excepted the control group received intraperitoneal injections of 0.5 mL pig serum for each to establish immunological liver injury model.The experimental group was irrigated ltime/d,continuous dosing for 14 d.The liver tissue and small intestinal tissue pathological changes were observed by HE staining,the serum alanine aminotransferase (ALT),aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) were detected,and the expression of liver tissue TNF-α and small intestine tissue occludin-5 were detected by immunohistochemical method.RESULTS:The model group liver tissue showed accumulation of fat cells,liver cells enlargement,disorganized liver and associated with inflammatory cells infiltration;the experimental group liver cell morphological ruled,hepatic cords in alignment and inflammatory cells infiltration significantly decrease.The model group small intestinal mucosa villi showed atrophy,fall off of epithelial cell,edema,large number of inflammatory cells infiltration;the experimental group showed closelyknitted small intestinal mucosa villi,relieve edema,and no obvious infiltration of inflammatory cells.The levels of ALT,AST,LDH and TNF-α in experimental group were statistically lower than the model group,and the levels were statistically reduce with the dose of jiedu hugan granule increased.The levels of occludin-5 in experimental group were statistically highter than those of the model group,and the levels of occludin-5 were statistically increase with the dose of Jiedu hugan granule increased,the differences were statistically significant (P < 0.05).CONCLUSION:Jiedu hugan granule can improve the organizational structure of liver and small intestine,protect the damage of liver,reduce inflammation,and maintain small intestine mucosal barrier function.
8. A long-term follow-up report of pediatric relapsed Wilms tumor after retreatment
Tianyi WANG ; Ci PAN ; Yijin GAO ; Wenting HU ; Qidong YE ; Min ZHOU ; Jingyan TANG
Chinese Journal of Pediatrics 2017;55(10):743-747
Objective:
To investigate the long-term efficacy and prognostic factors of pediatric relapsed Wilms tumor (WT) after retreatment.
Method:
Sixteen children in Shanghai Children′s Medical Center with relapsed Wilms tumor were enrolled consecutively in this study between April 2006 and June 2016. All patients were diagnosed according to pathology, imaging and medical and surgical oncologist′s assistance. Relapse treatment included surgical excision, chemotherapy and selective radiation therapy. The clinical features, long-term outcomes and prognostic factors of patients were analyzed retrospectively.Survival data were analyzed by Kaplan-Meier.Log-Rank analysis was used for univariate analysis.
Result:
One case was excluded because of giving up the therapy even though no disease progress was identified. A total of 15 cases (5 males and 10 females) were included in this study. The median age at diagnosis was 3.8 years (range 0.5-9.1 years). The tumor staging at diagnosis included one case of stageⅠ, 7 cases of stageⅡand 7 cases of stage Ⅲ. Among cases of stage Ⅲ, 6 cases had radiation therapy history. The pathology of all patients′ recurrent tumor was favorable histology (FH). The median follow-up time was 34.6 months (range 12.5-132.7 months) until March 21, 2017. The time from initial diagnosis to relapse was 7.9 months (range 3.1-17.9 months). Four cases experienced local recurrence, 9 cases relapsed with metastases (6 cases in lungs, 2 in livers, 1 in mediastinum) and 2 cases relapsed in both local site and with metastases. Except to 2 cases received irregular retreatment, 13 cases received regimen I (doxorubicin, vincristine, epoposide and cyclophosphamide for 25 weeks) as relapsed chemotherapy. Five cases received autologous bone marrow transplantation (ABMT). Until the last follow-up, 8 cases achieved continuous complete remission (range 6.7-104.3 months), 3 cases had relapse again or progressing and 4 cases died. The estimated 5-year overall survival (OS) rate and event free survival (EFS) rate were (70±15)% and (52±15)%. According to whether received ABMT or not, the 5-year EFS rate were 51% and 53%. According to whether relapsed within 6 months after diagnosis or not, the 5-year EFS rate were 38% and 56% respectively.
Conclusion
The 5-year EFS rate of pediatric relapsed FH WT have reached above 50% by multi-disciplinary treatment in our experience and we encourage patients and doctors to receive retreatment.
9. Long-term follow-up of neuroblastoma in children less than 18 months of age
Jie ZHAO ; Ci PAN ; Min XU ; Min ZHOU ; Yijin GAO ; Wenting HU ; Jingyan TANG
Chinese Journal of Pediatrics 2017;55(10):754-759
Objective:
To assess the clinical features and long-term outcomes of neuroblastoma (NB) in children less than 18 months of age, so as to provide evidence for further improvement of treatment.
Method:
Clinical data(sex, age, stage, risk group, treatment response, follow-up, etc.) of 155 NB patients under age of 18 months from June 2000 to December 2015 in Shanghai Children′s Medical Center were analyzed retrospectively. The clinical features were summarized and the long-term follow-up results were evaluated. The overall survival (OS) and event-free survival (EFS) were analyzed by using Kaplan-Meier method. Factors including age, stage, risk group, bone marrow and bone metastasis, N-MYC status and dehydrogenase(LDH) level were analyzed by Log-Rank test.
Result:
Totally 155 eligible patients (96 males, 59 females) were included. The median age of disease onset was 7 months (11 days to 18 months). There were 31 cases of stage 1, 19 cases of stage 2, 45 cases of stage 3, 38 cases of stage 4 and 21 cases of stage 4S. The median follow-up time was 36 months (range 4 to 189 months), the 3-year and 5-year EFS rate were 89.6% and 85.2% respectively and the 3-year and 5-year OS rate were 96.2% and 94.1%, respectively. A total of 15 recurrent or progressed cases were observed. The median time to first recurrence was 11 months (range 3 to 39 months), 6 cases eventually died. Second malignancy occurred in one patient. The patients who had relapsed disease within 12 months from initial diagnosis have much lower 3-year OS rate than those in whom the disease recurred 12 months later (25.7%
10. A follow-up report of childhood hepatoblastoma from 74 cases in a single center
Tianyi WANG ; Ci PAN ; Jingyan TANG ; Qidong YE ; Min ZHOU ; Yijing GAO ; Wenting HU
Chinese Journal of Pediatrics 2017;55(5):364-368
Objective:
To investigate the efficacy and the prognostic factors in pediatric hepatoblastoma according to the standard diagnostic and therapeutic regimen.
Method:
Eighty-four consecutive patients were enrolled in this study between June 2000 and June 2015. Diagnosis and staging was decided by the multi-disciplinary team including oncologists, surgeons, pathologists and sub-specialized radiologists refering to protocol of Children′s Oncology Group(COG) and International Society of Pediatric Oncology Liver Tumor Study Group (SIOPEL) in a case observational study. Univariate analysis was tested by the log-rank and multivariate analysis by COX regression. All consecutive cases were divided into low risk group and high risk group according to grouping criteria. Complete remission was defined as both imaging negative and α fetoprotein (AFP) normalization. Retrospective analysis was performed in clinical features, long-term outcomes and prognostic factors.
Result:
Ten patients were excluded because of giving up after less than or equal to three cycles of treatment. A total of 74 cases were included in this study; 45 males and 29 females. The median age at diagnosis was 1.7 years(range 0.2-14.8 years). Untill August 30, 2016, the median follow-up time was 24.2 months (range 4.1-135.3 months); 59 cases achieved complete remission.The estimated five years overall survival (OS) and event free survival(EFS) were 90%(68/74)and 72%(58/74). AFP could be normalized after 5 circles of treatment or 2 circles of postoperation.In univariate analysis , the five years OS and EFS in low risk group were both 100%(18/18), and those in high risk group were 88%(50/56)and 68%(40/56), respectively. The five years OS rates were 75%(15/19) and 95%(53/55) in patients with or without distant metastasis (