1.Application of real-time continuous glucose monitoring in outpatient management system for type 1 diabetes mellitus
Yanjun SHEN ; Yaqiang TIAN ; Ming LI ; Ying LI ; Honggang DUAN ; Lanbo PENG ; Shaoxia LU ; Xiaoqin TIAN ; Xinchen LI
Chinese Journal of Endocrinology and Metabolism 2017;33(5):367-371
Objective To evaluate the effect of continuous glucose monitoring system(CGMS) in improving the current status of type 1 diabetes mellitus(T1DM) control and reducing the economic burden of the patients.Methods One hundred and fifteen patients with T1DM were randomly assigned to the CGMS group and the self-monitoring of blood glucose(SMBG) group respectively.The patients in CGMS group were on 72 h CGMS every 6 months, while SMBG group only with SMBG to guide the insulin dose adjustment.The levels of blood glucose and the statistics of the number of hypoglycemia and diabetic ketoacidosis were taken as the main observational indexes every 6 months.The chronic complication and the statistics of the number of hospitalizations and the total cost of treatment were made as the secondary observational index every 12 months.Results 2 h postprandial plasma glucose(2hPG) and mean blood glucose(MBG) in the CGMS group were lower than those in the SMBG group [(10.7±1.9 vs 11.5±2.7) mmol/L, (9.7±0.5 vs 10.6±0.7) mmol/L, P<0.05] in the clinical follow-up visit after 6 months.The per capita number of hypoglycaemia in the CGMS group was lower than that in the SMBG group[(7.9±2.6 vs 9.2±3.4) times, P<0.05].In the outpatient follow-up re-visit to the patients after 6 months, fasting plasma glucose(FPG), 2hPG, MBG, and HbA1C of the patients in the CGMS group were lower than those in the SMBG group(t=4.71~9.75, P<0.05), the per capita numbers of hypoglycemia and DKA in the CGMS group were lower than those in the SMBG group(t=3.61~4.37, P<0.05).Conclusion The application of real-time continuous glucose monitoring in T1DM outpatient management may reduce the whole-day blood glucose of the patients, decrease the incidence risk of hypoglycemia, and improve the compliance of the treatment while without increasing the economic burden of the disease.
2.Structural feature of type I CRISPR-Cas system and its application in gene editing
Yuwen ZHANG ; Chenlin YU ; Xinchen DAI ; Yibei XIAO ; Meiling LU
Journal of China Pharmaceutical University 2021;52(6):675-683
The CRISPR-Cas (clustered regularly interspaced short palindromic repeats and CRISPR-associated) system is an "adaptive immune system" found in the genomes of bacteria and archaea which is mediated by RNA and resists foreign nucleic acid invasion.Take advantage of specific recognition of target nucleic acid, CRISPR-Cas system can efficiently edit their target site or accurately regulate gene expression, and now have been developed into a powerful tool for gene editing.According to the different compositions of the effector complex, the system has been divided into two categories: class 1 (type I, type IV, and type III) and class 2 (type II, type V, and type VI).Class 2 system, like the CRISPR-Cas9, is widely used in basic research due to the earliest discovery and best research.However, class 1 has not been maturely developed and utilized though it makes up 90% of the entire CRISPR-Cas system.In this essay, the classification of subtype, the assembly of Cascade complex, the cleavage and degradation mechanism of Cas3, and the application in gene editing of class 1 type I CRISPR-Cas system will be discussed and summarized to provide new ideas and methods for further mechanism studying and application of this category.
3.Comparison of clinical efficacy and prognosis of intensity-modulated radiotherapy and three dimensional conformal radiotherapy in patients with stage Ⅱ/m esophageal cancer: a multi-center retrospective analysis in Beijing, Tianjin and Hebei province (3JECROG R-06)
Yonggang XU ; Xin WANG ; Chen LI ; Lan WANG ; Chun HAN ; Junqiang CHEN ; Wencheng ZHANG ; Xiaomin WANG ; Xiaolin GE ; Wenbin SHEN ; Miaomiao HU ; Qianqian YUAN ; Chongli HAO ; Ling LI ; Zhiguo ZHOU ; Shuai QIE ; Na LU ; Qingsong PANG ; Ping WANG ; Yidian ZHAO ; Xinchen SUN ; Kaixian ZHANG ; Xueying QIAO ; Miaoling LIU ; Yadi WANG ; Shuchai ZHU ; Dazhi CHEN ; Qinhong WU ; Hong GAO ; Xia XIU ; Gaofeng LI ; Zefen XIAO
Chinese Journal of Radiation Oncology 2019;28(6):405-411
Objective To compare the therapeutic effects between three-dimensional conformal radiotherapy (3DCRT) and intensity-modulated radiotherapy (IMRT) in patients with stage Ⅱ/Ⅲ esophageal cancer and investigate the prognostic factors.Methods Medical record of 2 132 patients with stage Ⅱ/Ⅲ esophageal cancer who underwent definitive radiotherapy with/without chemotherapy in 10 hospitals from January 2002 to December 2016 from were retrospectively analyzed.Among these patients,37.9% of them were aged ≥ 70 years,33.9% with neck and upper esophageal tumors and 66.1% with middle and lower esophageal and borderline tumors.The median gross tumor volume (GTV) and lymph node gross tumor volume (GTVnd) was 41.6 cm3.Among them,32% were stage Ⅱ] and 68% were stage Ⅲ.A total of 723 patients received 3DCRT and 1 409 cases received IMRT.Patients received an equivalent dose in 2 Gy (EQD2) ≥ 60 Gy accounted for 86.1%,and 41.1% of them received concurrent chemoradiotherapy.Results The median follow-up time was 60.8 months.The 1-,3-and 5-year overall survival (OS) of all patients was 73.9%,41.7% and 32.6%,and the 1-,3-and 5-year progression-free survival (PFS) was 62.2%,37.3% and 32%,respectively.Multivariate analysis demonstrated that age,primary tumor location,clinical stage,tumor target volume,EQD2 and concurrent chemoradiotherapy were the independent prognostic factors for OS.Age,primary tumor location,clinical stage,tumor target volume and EQD2 were the independent prognostic factors for PFS.The OS and PFS did not significantly differ among the low-risk,low-/moderate-risk,moderate-/high-risk and high-risk groups according to age≥70 years,tumor diameter>5 cm,tumor volume ≥41.6 cm3 and stage Ⅲ (P<0.001).After the propensity score matching (PSM) method,neither 3DCRT nor IMRT yielded significant advantages in OS or PFS (P=0.971;P=0.658).However,IMRT tended to yield survival benefits in low-risk patients (P=0.125).Conclusions Both 3DCRT and IMRT yield relatively high OS rate in patients with stage Ⅱ/Ⅲ esophageal cancer.The prognosis model established in this investigation can properly predict the survival of patients.Low-risk patients tend to obtain survival benefits from IMRT.
4.Effect of tumor length on clinical stage for non-operative esophageal squamous cell carcinoma patients——multicenter retrospective data analysis (3JECROG R-01D)
Zhiguo ZHOU ; Xin WANG ; Lan WANG ; Junqiang CHEN ; Wencheng ZHANG ; Xiaomin WANG ; Xiaolin GE ; Wenbin SHEN ; Miaomiao HU ; Qianqian YUAN ; Yonggang XU ; Chongli HAO ; Shuai QIE ; Na LU ; Qingsong PANG ; Ping WANG ; Yidian ZHAO ; Xinchen SUN ; Kaixian ZHANG ; Gaofeng LI ; Ling LI ; Miaoling LIU ; Yadi WANG ; Chen LI ; Shuchai ZHU ; Zefen XIAO ; Chun HAN ; Xueying QIAO
Chinese Journal of Radiation Oncology 2019;28(7):490-494
Objective To retrospectively analyze the effect of tumor length on the prognosis in stage Ⅱ/Ⅲ esophageal squamous cell carcinoma (ESCC) patients treated with definitive radiotherapy and to evaluate the role of tumor length in clinical stage for non-operative ESCC patients.Methods The data of 2 086 ESCC patients who were treated with definitive radiotherapy from 2002 to 2016 in 10 hospitals (3JECROG) were analyzed.The effect of tumor length on overall survival (OS) was analyzed and stratified analysis of tumor length was done in different stages of ESCC.Results The median OS and median progression-free survival (PFS) time of the whole group were 25.6 months and 18.2 months respectively.The Cox multivariate analysis showed that treatment moda,aga,alinical stage and tumor length were independent prognostic factors.The median,1-,3-,and 5-year OS were 28.9 months,77.3%,45.0%,and 36.3% versus 21.9 months,69.9%,37.9%,and 28.1% for patients with ≤ 5 cm and patients > 5 cm respectively (P<0.05).For stage Ⅱ patienta,abe median OS were 42.1 and 38.9 months respectively in ≤ 5 cm group and>5 cm group (P=0.303).And for stage Ⅲ patienta,abe median OS were 23.9 and 19.3 months respectively in ≤5 cm group and>5 cm group (P<0.001).The median OS with N1was 24.1 and 18.4 montha,aespectively in ≤5 cm group and>5 cm group (P<0.001).Conclusions The tumor length was an independent prognostic factor for stage Ⅱ/Ⅲ patients treated definitive radiotherapy.The tumor length may be helpful in clinical staging of ESCa,aspecially for stage Ⅲ and N1.
5.Difference analysis of imported malaria characteristics in Pudong New Area of Shanghai before and after COVID-19
Qi LU ; Xinchen LU ; Xuyue CAI ; Siyu YU ; Hanzhao LIU ; Suzhen CHEN ; Anmei SHEN
Shanghai Journal of Preventive Medicine 2023;35(10):1011-1015
ObjectiveTo describe the differences in imported malaria cases before and after the COVID-19 pandemic in Pudong New Area, Shanghai, to explore the possible impact of isolation measures during the pandemic on malaria, and to provide a basis for formulation of malaria control strategies during the prevention and control of major infectious diseases in the future. MethodsInformation on malaria cases reported in Pudong New Area from 2017 to 2022 was collected and divided into two groups: cases before the COVID-19 pandemic (2017‒2019) and cases after the COVID-19 pandemic (2020‒2022). Analysis was conducted on information such as gender, age, parasite species, country of infection, place of onset, time of onset, time of first diagnosis, time of confirmed diagnosis, hospitalization, and duration of treatment for both groups. ResultsThe pre-COVID group consisted of 21 cases, and post-COVID group consisted of 28 cases, with male and falciparum malaria predominating in both groups. There were statistically significant differences between the two groups in terms of Shanghai residency status, use of preventive measures, and adherence to standardized treatment (P<0.05). The time interval from symptom onset to first diagnosis was longer in the pre-COVID group than that in the post-COVID group (Z=-2.617, P<0.05 ). The interval from the first diagnosis to the confirmed diagnosis and duration of treatment were shorter in the pre-COVID group than that in the post-COVID group (Z=-3.381, P<0.05; Z=-4.148, P<0.05). There was no significant difference in gender, age, malaria classification, source of infection, onset area, length of hospital stay, complications, severe cases, and interval between onset and diagnosis between the two groups (P>0.05). ConclusionAfter the outbreak of COVID-19, the medical priority plan prolongs the treatment time of malaria patients, increasing the risk of severe illness and death.
6.Clinical efficacy of dose escalation in 3-dimensional radiotherapy for patients with esophageal squamous cell carcinoma-multicenter retrospective analysis (3JECROG R-03)
Jingjing ZHAO ; Wencheng ZHANG ; Hualei ZHANG ; Weiming HAN ; Xin WANG ; Chen LI ; Junqiang CHEN ; Xiaomin WANG ; Yidian ZHAO ; Xueying QIAO ; Zhiguo ZHOU ; Chun HAN ; Shuchai ZHU ; Wenbin SHEN ; Lan WANG ; Xiaolin GE ; Xinchen SUN ; Kaixian ZHANG ; Miaomiao HU ; Ling LI ; Chongli HAO ; Gaofeng LI ; Yonggang XU ; Yadi WANG ; Na LU ; Miaoling LIU ; Shuai QIE ; Zefen XIAO ; Qingsong PANG ; Ping WANG
Chinese Journal of Radiation Oncology 2020;29(11):941-947
Objective:To evaluate the effect of definitive radiotherapy with different doses on overall survival (OS) and identify the prognostic factors of patients with non-metastatic esophageal squamous cell carcinoma (ESCC).Methods:Clinical data of 2 344 ESCC patients treated with definitive radiotherapy (RT) alone or chemoradiotherapy from 2002 to 2016 in 10 hospitals were collected and analyzed retrospectively. After the propensity score matching (PSM)(1 to 2 ratio), all patients were divided into the low-dose group (equivalent dose in 2 Gy fractions, EQD 2Gy<60 Gy; n=303) and high-dose group (EQD 2Gy≥60 Gy; n=606) based on the dose of radiation. Survival analysis was conducted by Kaplan- Meier method. Multivariate prognostic analysis was performed by Cox′s regression model. Results:The median follow-up time was 59.6 months. After the PSM, the 1-, 3- and 5-year overall survival (OS) rate was 66.5%, 34.7%, 27.2% in the low-dose group, 72.9%, 41.7% and 34.7% in the high-dose group, respectively ( P=0.018). The 1-, 3-and 5-year progression-free survival rate was 52.2%, 27.2%, 23.1% in the low-dose group, 58.3%, 38.1% and 33.9% in the high-dose group, respectively ( P=0.001). The outcomes of univariate analysis indicated that cervical/upper esophagus location, early (stage Ⅱ) AJCC clinical stage, node negative status, tumor length ≤5 cm, receiving intensity-modulated radiation therapy (IMRT), receiving concurrent chemotherapy and EQD 2Gy≥60 Gy were closely associated with better OS (all P<0.05). Multivariable analysis demonstrated that tumor location, regional lymph node metastasis, concurrent chemotherapy and EQD 2Gy were the independent prognostic factors for OS (all P<0.05). Conclusion:Three-dimensional conformal or IMRT with EQD 2Gy≥60 Gy yields favorable survival outcomes for patients with locally advanced ESCC.
7.Population and chigger mite infection of rodents in Pudong New Area, Shanghai
Xinchen LU ; Xuyue CAI ; Chen LIN ; Jun LIU ; Siyu YU ; Yongting YUAN ; Hanzhao LIU
Shanghai Journal of Preventive Medicine 2023;35(12):1218-1222
ObjectiveTo investigate the population and chigger mite infection of rodents in Pudong District, Shanghai, so as to provide the scientific basis for the prevention and control of rodents and chigger transmitted diseases. MethodsThe monitoring work was conducted in four points including Xuanqiao, Hangtou, Laogang and Nanhui New Town with night trapping method from 2020 to 2022. Habitats as farmland, wasteland, rural residential areas, and parks were selected. The rodent species were identified and rodent density was calculated. All chigger mites were collected from the earlaps and auricular fossae of the rodents. The species of chigger mites were identified and the chigger mite index was calculated. ResultsA total of 222 rodents were captured. They belonged to 5 species, 4 genera, 2 families and 2 orders, including 4 species, 3 genera, and 1 family of Rodentia and 1 species of Insectivora. M. musculus was the dominant species, with a composition ratio of 54.05%. Total 80 chigger mites were captured, with a detection rate of 36.03%. The total chigger index was 0.36 and Rattus tanezumi held the highest (6.00), followed by M. musculus (0.48). There were 3 species of chigger mites, L.deliense, L.scutellare, and L.gaohuense. L.deliense was the dominant specie, accounting for 55.00%. ConclusionThere is a risk of chigger-borne disease transmission in Pudong New Area with M. musculus as the dominant host and L. deliense as the dominant species.
8.Prognostic analysis of definitive three-dimensional radiotherapy for non-surgically resectable esophageal squamous cell carcinoma:a multi-center retrospective study ( 3JECROG R-01)
Xin WANG ; Lan WANG ; Junqiang CHEN ; Wencheng ZHANG ; Xiaomin WANG ; Xiaolin GE ; Wenbin SHEN ; Miaomiao HU ; Qianqian YUAN ; Yonggang XU ; Chongli HAO ; Zhiguo ZHOU ; Shuai QIE ; Na LU ; Qingsong PANG ; Yidian ZHAO ; Xinchen SUN ; Kaixian ZHANG ; Gaofeng LI ; Ling LI ; Xueying QIAO ; Miaoling LIU ; Yadi WANG ; Lei DENG ; Wenqing WANG ; Nan BI ; Tao ZHANG ; Wei DENG ; Chen LI ; Wenjie NI ; Xiao CHANG ; Weiming HAN ; Zongmei ZHOU ; Jun LIANG ; Qinfu FENG ; Lvhua WANG ; Dongfu CHEN ; Jima LY ; Shuchai ZHU ; Chun HAN ; Zefen XIAO
Chinese Journal of Radiation Oncology 2018;27(11):959-964
Objective To evaluate the survival and prognostic factors of esophageal cancer treated with definitive ( chemo ) radiotherapy by applying novel radiation techniques including three-dimensional conformal radiotherapy (3DCRT) or intensity-modulated radiotherapy (IMRT). Methods Clinical data of 2762 patients with non-operated esophageal squamous cell carcinoma who underwent definitive ( chemo ) radiotherapy from 2002 to 2016 in 10 hospitals were retrospectively analyzed.The prognostic factors were also identified and analyzed. Results The median follow-up time was 60. 8 months. The 1-, 2-, 3-and 5-year overall survival (OS) of all patients was 71. 4%,48. 9%,39. 3%,and 30. 9%,respectively.The 1-,2-,3-and 5-year progression-free survival (PFS) was 59.5%,41.5%,35.2%,and 30%,respectively.The median survival was 23 months.The median time to progression was 17. 2 months.Multivariate analysis demonstrated that age, primary tumor location, clinical stage, tumor target volume, EQD2 and treatment mode were the independent prognostic factors for OS.Primary tumor location,clinical stage,tumor target volume and EQD2 were the independent prognostic factors for PFS. Conclusions In this first large-scale multi-center retrospective analysis of definitive ( chemo) radiotherapy for esophageal squamous cell carcinoma in China, the 5-year OS of patients with esophageal squamous cell carcinoma is significantly improved by 3DCRT, IMRT combined with chemotherapy drugs. However, the findings remain to be validated by prospective clinical trials with high-level medical evidence.
9. Prognostic analysis of definitive radiotherapy for early esophageal carcinoma(T1-2N0M0): a multi-center retrospective study of Jing-Jin-ji Esophageal and Esophagogastric Cancer Radiotherapy Oncology Group
Na LU ; Xin WANG ; Chen LI ; Lan WANG ; Junqiang CHEN ; Wencheng ZHANG ; Xiaomin WANG ; Xiaolin GE ; Wenbin SHEN ; Miaomiao HU ; Qianqian YUAN ; Yonggang XU ; Chongli HAO ; Zhiguo ZHOU ; Shuai QIE ; Zefen XIAO ; Shuchai ZHU ; Chun HAN ; Xueying QIAO ; Qingsong PANG ; Ping WANG ; Yidian ZHAO ; Xinchen SUN ; Kaixian ZHANG ; Ling LI ; Gaofeng LI ; Miaoling LIU ; Yadi WANG
Chinese Journal of Oncology 2020;42(2):139-144
Objective:
To evaluate the prognostic factors of T1-2N0M0 esophageal squamous cell carcinoma (ESCC) treated with definitive radiotherapy.
Methods:
The clinical data of 196 patients with T1-2N0M0 ESCC who were treated with definitive radiotherapy in 10 hospitals were retrospectively analyzed. All sites were members of Jing-Jin-Ji Esophageal and Esophagogastric Cancer Radiotherapy Oncology Group (3JECROG). Radiochemotherapy were applied to 78 patients, while the other 118 patients received radiotherapy only. 96 patients were treated with three-dimensional conformal radiotherapy (3DCRT) and 100 treated with intensity-modulated radiotherapy (IMRT). The median dose of plan target volume(PTV) and gross target volume(GTV) were both 60 Gy. The median follow-up time was 59.2 months. Log rank test and Cox regression analysis were used for univariat and multivariate analysis, respectively.
Results:
The percentage of normal lung receiving at least 20 Gy (V20) was (18.65±7.20)%, with average dose of (10.81±42.05) Gy. The percentage of normal heart receiving at least 30 Gy (V30) was (14.21±12.28)%. The maximum dose of exposure in spinal cord was (39.65±8.13) Gy. The incidence of radiation pneumonia and radiation esophagitis were 14.80%(29/196) and 65.82%(129/196), respectively. The adverse events were mostly grade 1-2, without grade 4 toxicity. Median overall survival (OS) and progression-free survival (PFS) were 70.1 months and 62.3 months, respectively. The 1-, 3- and 5-year OS rates of all patients were 75.1%、57.4% and 53.2%, respectively. The 1-, 3- and 5-year PFS rates were 75.1%、57.4% and 53.2%, respectively. Multivariate analysis demonstrated that patients′age (