1.Clinical efficacy of combination therapy with continuous intravenous pumping of Endostar and SOX regimen in advanced primary carcinoma of the liver
Jin SU ; Xinhua XU ; Kezhi SHI ; Fang YI ; Yang LIU
The Journal of Practical Medicine 2016;32(17):2908-2911
Objective To evaluate the efficacy and safety of combination therapy of Endostar and oxaliplatin plus S-1 ( SOX regimen) in patients with advanced Primary carcinoma of the liver. Methods 32 advanced primary liver cancer patients admitted from February 2012 to August 2014 were assigned to SOX regimen as systemic chemotherapy: oxaliplatin 130 mg/m2 iv d1; S-1 (80 ~ 120 mg, twice-daily) for 14 days; 150 mg Endostar which was dissolved in 210 mL normal saline for 120 h durative transfusion. Treatment was repeated every 21 days. Objective clinical efficacy and adverse effect was assessed every 2 cycles. Serum alpha fetoprotein (AFP) level was also monitored according to the schedule. Results All 32 patients were available to be assessed, the objective response rate (ORR), disease control rate (DCR) ,the clinical benefit response rates (CBR), 1 year survival rate was 15.6%, 46.9%, 56.3%, 58.3% respectively. The serum AFP respond rate was 19.4%. Major adverse effects were myelosuppression and fatigue , mostly graded at 1 ~ 2. There were no treatment-related death. Conclusions These preliminary results suggest that continuous intravenous pumping of Endostar combined with SOX regimen could provide survival benefits with tolerable adverse effects.
2.Clinical Observation of S-1 Capsules Combined with Recombinant Human Endostatin in the Treatment of Middle and Advanced Primary Liver Carcinoma
Jin SU ; Kezhi SHI ; Yang LIU ; Ying QIAN ; Xinhua XU
China Pharmacy 2017;28(11):1496-1499
OBJECTIVE:To observe therapeutic efficacy and safety of S-1 capsules combined with recombinant human end-ostatin in the treatment of middle and advanced primary liver carcinoma. METHODS:Totally 94 patients with middle and advanced primary liver carcinoma in the First College of Clinical Medical Science of China Three Gorges university during Feb. 2012-Dec. 2014 were divided into combination group(48 cases)and control group(46 cases)according to random number table. Both groups were given S-1 capsules 40-60 mg orally within 30 min after breakfast and supper. Combination group additionally received Recom-binant human endostatin injection 150 mg added into 0.9%Sodium chloride injection 210 mL with portable micro pump for continu-ous pump of 120 h. A course involved 14 d treatment and 7 d interval. Short-term objective therapeutic efficacy,clinical benefit re-sponse (CBR) and ADR were evaluated after 2 courses. Disease progression time and average survival period were compared be-tween 2 groups. RESULTS:Objective response rate,disease control rate,disease progression time and average survival period of combination group were 14.6%,66.7%,(5.5 ± 1.3) months,(10.7 ± 3.8) months;those of control group were 8.7%,45.6%, (4.8±1.2)months,(8.9±3.3)months,with statistical significance between 2 groups(P<0.05). CBR rate of combination group (79.2%)was significantly higher than control group(52.2%),with statistical significance(P<0.05). There was no statistical sig-nificance in the incidence of ADR between 2 groups (P>0.05). CONCLUSIONS:S-1 combined with recombinant human end-ostatin show good therapeutic efficacy and tolerance for patients with middle and advanced primary liver carcinoma,and do not in-crease the incidence of ADR.
3.Biocompatibility of rat’ s nature decellularized pancreatic biological scaffolds
Yingkuan SHAO ; Xialin YAN ; Zhiheng RAO ; Gaojian HUANG ; Jiawei LI ; Junjie HUANG ; Jin MEI ; Kezhi LIN
Acta Anatomica Sinica 2014;(4):561-568
Objective To harvest pancreatic tissues from rats , prepare decellularized bio-derived pancreatic scaffolds ( DBPS) , and to examine the integrity and biocompatibility of the scaffolds .Methods Normal pancreases were harvested from healthy adult SD rats .DBPS was prepared by perfusing SDS and Triton X-100 through bile duct and the portal vein, respectively.After decellularization, normal pancreatic tissue and DBPS were compared via HE staining , and transmission electron microscopy ( TEM ) . Abdominal wall and subcutaneous implantations were used to compare biocompatibility , and the remain quantity of residual protein and growth factors were determined via enzyme linked immunosorbent assay(ELISA).MTT assay was used to test the scaffolds’ cytotoxicity.The scaffolds were co-cultured with endotheliocyte .Results HE staining and TEM study indicated no residual cells in the DBPS as well as preservation of the complete extracellular matrix .The remain quantity of residual protein and growth factors in ECM was high .The abdominal wall and subcutaneous implantation revealed that DBPS triggered a lower immune response as compared to the control group.MTT assay showed little cytotoxicity .Endotheliocyte assembled and growed with the scaffolds together .Conclusion DBPS are completely decellularized , and exhibit a higher level of biocompatibility in vivo.Using the way of vessels can make the integrity of extracellular matrix to be fully preserves and contain more growth factors .So using vessels way is better than bile duct .
4.Clinical efficacy of bevacizumab for the treatment of serious peritumorous brain edema
Jin SU ; Ying QIAN ; Kezhi SHI ; Yang LIU ; Fang YI ; Xinhua XU
Chinese Journal of Clinical Oncology 2016;43(23):1045-1048
Objective:To investigate the efficacy of bevacizumab on the treatment of serious peritumorous brain edema. Methods:A total of 16 patients with malignant brain tumors and serious peritumorous brain edema, (13 cases of lung cancer, 2 cases of breast can-cer, and 1 case of recurrent glioblastoma) were analyzed. Treatment with glucocorticoids, osmotic dehydration, and other convention-al approaches were not effective for these patients. Bevacizumab was administered at a dose of 5 mg/kg at least once every three or four weeks. The Karnofsky performance score (KPS) and the changes in cerebral edema symptoms, such as cerebral edema volume, tu-mor volume, edema index (EI), and changes in magnetic resonance imaging (MRI) were compared before and after treatment. The t-test and least-significant difference method were used to compare treatment groups. Results:All bevacizumab-treated patients had re-duced symptoms. The KPS after treatment was significantly higher than that before treatment (P<0.001). The cerebral edema vol-umes, tumor volumes, and EI of 16 patients were significantly decreased (P<0.05). Bevacizumab caused mild clinical side effects. Con-clusion:Preliminary results showed that treatment of serious peritumorous brain edema with bevacizumab was safe and effective.
5.Research progress on health effect of occupational exposure to radar
Shanghai Journal of Preventive Medicine 2022;34(7):712-718
Radar uses electromagnetic waves to detect, track and locate objects at certain distances, which is widely used in military, meteorological, navigation and other fields. Radar emits electromagnetic waves outward and produces non-ionizing radiation, which may be considered as a physical occupational hazard. Epidemiological surveys found that long-term exposure to radar is associated with various adverse health effects, which may be correlated to transmitted power and frequency of radar, location of radar antenna, position of workers, and shielding effectiveness of cabins where work station is located. Based on radar frequency and electromagnetic radiation intensity, this study summarizes the health effects of radar on occupational population exposed to radar.
6.International research hotspots and trend on immigrant health from 2017 to 2022
Journal of Environmental and Occupational Medicine 2023;40(9):1024-1032
Background Immigrant health is an key node in achieving the goal of universal health coverage proposed by 2030 Agenda for Sustainable Development. The shock of severe public health emergency may exacerbate the original health-related contradictions of this group and bring more negative health effects. Objective To identify academic research hotspots and directions of immigrant health, and to examine trends in research hotspots before and after the public health emergency, so as to provide references to study immigrant health and response to public health emergency in the future. Methods Articles (document type) included in Web of Science core collection from 2017-01-01 to 2022-12-31 were retrieved. Microsoft Excel 2019 was used for descriptive analysis of included papers. VOSviewer 1.6.19 and CiteSpace 6.1.R6 were combined to draw cooperation maps of authors, institutions, and countries/areas to understand their cooperation and communication, and to draw keywords co-occurrence map, keywords clusters map, and keywords burst map to examine the hotspots and trends of immigrant health research before and after public health emergency. Results A total of 5997 papers pertaining to immigrant health from 2017 to 2022 were included, and the number of publications every year were overall on the rise generating a group of productive core authors. Institutions from the United States, Canada, and Northern Europe not only tightly cooperated within their countries/areas, but also cooperated frequently among countries/areas, forming an international cooperation network with the United States as its core. The keywords co-occurrence map showed that from 2017 to 2022, the research hotspots of immigrant health mainly focused on target groups of women, children, and refugees, and the study topics of mental health, acculturation, and care. The results of cluster analysis and further extraction found that the research topics in this field were divided into five categories: maternal and child health care, acculturation and mental health, health services, health equity, and chronic disease. The keywords burst map revealed that the research hotspots shifted from ethnic group, risk behavior, and sexes to COVID-19, health equity, social isolation, and victimization under the impact of public health emergency. Conclusion The cooperation and communication among study teams, institutions, and countries/areas have promoted the development of immigrant health study. Public health emergency has exacerbated the existing vulnerability of immigrants, and the topics related to health equity and social isolation of immigrants have raised attention becoming the research forefront. It is suggested that under the impact of public health emergency, corresponding public health policies are needed to mitigate health inequities and social support is also required for immigrants to ensure their physical and mental health.
7.The mediating effect of fear-avoidance beliefs in neck pain and quality of life among nursing staff in a hospital in Shanghai
Siyi WANG ; Guilan WU ; Ying SHEN ; Kezhi JIN
Chinese Journal of Practical Nursing 2020;36(23):1825-1830
Objective:To test whether the fear-avoidance beliefs (FAB) of nursing staff in a hospital in Shanghai have a mediating effect between neck pain and quality of life.Methods:The cross-sectional survey method was used to obtain the general information, neck pain, FAB and quality of life scores of the subjects. The mediating effect analysis was used to verify potential mediating effect of FAB on neck pain and quality of life.Results:A total of 103 valid questionnaires were collected, 60 (58.25%,60/103) in the neck pain group and 43 (41.75%, 43/103) in the pain-free group. The independent sample T test found that the FABQ score was higher in the pain group than in the pain-free group ( P<0.05). The quality of life score was lower in the pain-free group, and the between-group difference of physical component summary (PCS) was statistically significant ( P < 0.05). The results of pearson correlation analysis showed a negative correlation between FABQ and quality of life scores ( rFABQ1-PCS=-0.32, rFABQ2-PCS=-0.34, rFABQ1-MCS=-0.20, rFABQ2-MCS=-0.32, P<0.05). Both Physical Activity Fear Avoidance Belief (FABQ-1) and Work Fear Avoidance Belief (FABQ-2) have a complete mediating effect between neck pain and PCS. The mediating effect magnitude of FABQ-1 was 0.575, and the mediating effect of FABQ-2 was 0.552. The mediating effect magnitude of FABQ-1 was enlarged and FABQ-2 was reduced after adding age as a covariate in the mediating effect analysis. The mediating effect of FABQ-1 was 0.601, and the mediating effect magnitude of FABQ-2 was 0.501. Conclusion:The fear avoidance belief of nursing staff in a hospital in Shanghai presents a complete mediating effect between neck pain and quality of life, and the mediating effect of Physical Activity Fear Avoidance Belief is stronger with age but the mediating effect of Work Fear Avoidance Belief is weaker.
8.Contributing factors of health-related preventive behaviors among resident aliens in China
Jiayi LAI ; Huishuan WU ; Kezhi JIN
Journal of Environmental and Occupational Medicine 2024;41(5):505-511
Background The Belt and Road Initiative is promoting the growth of the cross-border population, and there is still a lack of study on modifiable factors associated with health-related preventive behaviors among resident aliens in China. Public health events may highlight the relevant factors. Objective To conduct a pilot study to preliminarily identify potential modifiable factors associated with preventive behaviors among resident aliens in China, and to explore possible mediating effects of positivity and self-efficacy on the relationship between satisfaction of health services and preventive behaviors, aiming to provide ideas for further research in this direction. Methods A cross-sectional survey was conducted among foreigners in a city of East China by using snowball sampling in July 2023. Based on the protection motivation theory, the Self-Efficacy Scale, Positivity Scale, Preventive Behaviors Scale, and Satisfaction of Health Services Scale were adopted in the survey. Cronbach's α coefficient was used to evaluate scale reliability. A structural equation model was constructed for validity test and path analysis. Maximum likelihood method was used for parameter estimation, and bias-corrected percentile Bootstrap method was used to verify mediating effect. Results A total of 187 resident aliens were approached and 180 of them returned valid questionnaires. The Cronbach's α coefficients of the Self-Efficacy Scale, Positivity Scale, and Preventive Behaviors Scale were 0.904, 0.784, and 0.821, respectively. The M (P25, P75) scores of self-efficacy, positivity, preventive behaviors, and satisfaction of health services were 32 (27, 35), 29 (25, 30), 17 (14, 20), and 4 (3, 5), respectively. Statistically significant differences in the scores of preventive behaviors were identified among the participants by religious belief, geographical location, and economy (P<0.05). The results of path analysis showed that satisfaction of health services, positivity, and self-efficacy had direct positive effects on preventive behaviors (P<0.05), and positivity and self-efficacy played multiple mediation roles in the relationship between satisfaction of health services and preventive behaviors. The results of mediating effect test showed that the indirect effects of the three identified paths mediated by positivity and self-efficacy were statistically significant, and the total size of indirect effect was 0.316 (95%CI: 0.180, 0.466) that accounted for 61.2% of the total effect size. The strongest mediating path was satisfaction of health services→positivity→preventive behaviors, with an indirect effect size of 0.167 (95%CI: 0.046, 0.335) that accounted for 32.4% of the total effect size. Conclusion Future studies and policy formulation on preventive behaviors of foreigners in China should focus on the social demographic factors such as geographical location of home country, religious belief, and cultural customs. At the same time, the study of path relationship of preventive behaviors should embrace environmental factors, emotional factors, and cognitive factors.
9.Multilevel analysis of factors influencing mental health of nursing staff in four provinces in China
Mengshuang LIU ; Kezhi JIN ; Siyi WANG ; Ying SHEN
Journal of Environmental and Occupational Medicine 2022;39(6):639-644
Background Nursing staff are often exposed to a variety of occupational risk factors in the working environment, such as long working hours and heavy workload, which associated with adverse mental health outcomes. And these factors may not be randomly distributed across different levels. Objective To explore mental health risk factors of nursing staff by multilevel analysis. Methods A cross-sectional survey of nursing staff in Shanghai Municipality, Zhejiang Province, Guangxi Zhuang Autonomous Region, and Xinjiang Uygur Autonomous Region was conducted through convenience sampling from 2018 to 2021. Data were collected by self-report questionnaires. The mental component summaries of 12-Iitem Short Form Health Survey were used to evaluate the mental health status of nursing staff, and related factors were collected atindividual level, including gender, body mass index (BMI), smoking status, drinking status, working years, pain intensity of musculoskeletal disorders, and working hours per week, and at regional level, including gross domestic product (GDP) level of each province. A two-level model was established by incorporating both individual and regional factors, and deviance was used to test the goodness of fit of the model. A traditional generalized linear model was also established, and then compared with the multilevel model. Results A total of 567 nurses participated in this study, and the valid rate of questionnaire was 80.08%. The results of the multilevel model showed that the regional factor contributed 12.1% to the mental component summaries. As to the regional factor, GDP was negatively correlated with mental health of nursing staff, the adjusted OR (AOR) was −0.53 (95%CI: −0.66-−0.28). Among the factors at individual level, the mental component summaries of females were lower than those of males (AOR=−3.25, 95%CI: −4.73-−0.35); the longer the working years, the higher the mental health score (AOR=0.11, 95%CI: 0.06-0.20); working hours per week (AOR=−0.10, 95%CI: −0.14-−0.03) and pain intensity of musculoskeletal disorders (AOR=−0.05, 95%CI: −0.06-−0.03) were negatively correlated with mental component summaries. The results of the generalized linear model included the same factors as the multilevel model, but the 95%CIs of AOR of the factors in the multilevel model were narrower, and the deviation value of the multilevel model was the smallest, indicating that the goodness of fit of the multilevel model was better than that of the traditional linear model. Conclusion The mental health of nursing staff is not only affected by individual level factors, but also affected by regional level factors. It suggests that combining different levels of intervention measures can upscale the effect of improving mental health in nursing staff.
10.Disease burden of low back pain attributable to ergonomic risk factors in selected Chinese occupational groups
Fang ZHOU ; Mengshuang LIU ; Jiayi LAI ; Kezhi JIN
Journal of Environmental and Occupational Medicine 2022;39(12):1319-1328
Background As traditional chemical and physical hazards as well as associated adverse health outcomes in workplace were wildly controlled in the past half century, the prevalence and disease burden of low back pain (LBP) have drawn more and more attention and become one of the important public health problems in the world. Objective To analyze the health loss and attributable disease burden of ergonomic risk factors for LBP in two major categories of occupations in China, aiming to provide evidence for formulating effective prevention and control policies of LBP in the workplace. Methods Based on the methodological framework of the Global Burden of Disease Study (GBD), a meta-analysis was firstly applied to summarize relevant literature results and estimate the prevalence of LBP in two occupational groups (including technicians and associate professionals and machine operators and assemblers) by different age groups in China. Then important epidemiologic parameters (including disability weight, remission rate, and incidence) from GBD 2019 were used to estimate mean duration of disease and age at onset using DisMod II software, and to calculate health loss indexes in the selected occupational groups in China in 2013, such as years lived with disability (YLD) and disability-adjusted life year (DALY) of LBP and its attributable fractions by ergonomic risk factors, which were compared to the outcome of GBD 2013. Results After the adjustment by DisMod II, the prevalence rate of LBP was 13.00% in technicians and associate professionals (11.25% for males and 14.84% for females) and 14.80% in machine operators and assemblers (13.56% for males and 16.10% for females) in 2013, which increased with age. The DALY rate of LBP was 8.02‰ in technicians and associate professionals (7.68‰ for males and 8.33‰ for females) and 10.34‰ in machine operators and assemblers (10.30‰ for males and 10.44‰ for females), which also showed an overall increasing trend with age. In 2013, the population attributable fraction (PAF) of ergonomic risk factors to LBP was 11.42% in technicians and associate professionals and 29.17% in machine operators and assemblers. The DALY of LBP attributable to ergonomics risk factors was 4498 person-years (2108 person-years for males), with the highest DALY in the 45-49 year group (951 person-years), and the attributable DALY rate was 0.92‰ in technicians and associate professionals. The DALY of LBP attributable to ergonomics risk factors was 48529 person-years (33046 person-years for males), with the highest DALY in the 40-44 year group (10852 person-years), and the attributable DALY rate was 3.02‰ in machine operators and assemblers. Regarding LBP-associated DALY rate, in the 20 years of age and above group, both occupational groups (technicians and associate professionals: 8.06‰, machine operators and assemblers: 10.66‰) showed higher values than the general population (3.55‰). In the 20 years of age and above group, the DALY rates attributable to ergonomic risk factors with the order from high to low were machine operators and assemblers (3.11‰), general population (1.10‰) and technicians and associate professionals (0.92‰). Conclusion The LBP-associated disease burden is heavier in the two Chinese occupational groups than in general population. Reducing the disease burden of LBP by interventions targeting ergonomic risk factors in machine operators and assemblers is more effective than that in technicians and associate professionals as the results of attributable burden of disease suggest.