1.Lienal polypeptide injection for cancer adjuvant therapy: a Meta-analysis
Rong KANG ; Yuanting JIA ; Yimeng GUO
Cancer Research and Clinic 2019;31(5):336-342
Objective To systematically evaluate the efficacy of the lienal polypeptide injection combined with chemotherapy or radiotherapy on the short-term efficacy, Karnofsky score, immune function and adverse reactions in treatment of various cancers. Methods The databases of PubMed, Embase, Cochrane Library, CNKI, Wanfang and VIP were retrieved from database establishing time to January 2017, and the randomized controlled trials (RCT) about lienal polypeptide injection combined with radiotherapy or chemotherapy in the treatment of advanced cancer were collected. The quality assessment was conducted and eligible trials were included in the Meta-analysis. Results A total of 23 articles were included, involving 1658 patients. The patients were divided into treatment group (lienal polypeptide injection combined with chemotherapy or radiotherapy, 842 cases) and control group (chemotherapy or radiotherapy alone, 816 cases). Results of Meta-analysis showed that the short-term effective rate (RR = 1.20, 95% CI 1.07-1.33, P = 0.001), the improvement rate of Karnofsky score (RR = 1.77, 95% CI 1.43-2.19, P < 0.05) and immune function related indicators: CD3+ (MD = 9.48, 95% CI 6.76-12.20, P < 0.01), CD4+ (MD = 7.54, 95% CI 5.38-9.71, P < 0.01), NK cells (MD = 4.47, 95%CI 3.45-5.48, P < 0.01) and CD4 +/CD8 + (MD = 0.33, 95% CI 0.25-0.42, P < 0.01) in the treatment group were significantly higher than those in the control group, and the differences were statistically significant. The incidence of nausea and vomiting (RR = 0.51, 95% CI 0.35-0.73, P = 0.0002) and bone marrow suppression (RR = 0.41, 95% CI 0.25, 0.68, P = 0.0006) in the treatment group were significantly lower than those in the control group, and the differences were statisticallysignificant. There was no statistical difference in CD8+ level and the incidence of neurotoxicity, diarrhea, oral mucositis and hepatic injury between the two groups (all P > 0.05). Conclusion Lienal polypeptide injection combined with radiotherapy or chemotherapy is superior to conventional radiotherapy or chemotherapy alone in the treatment of cancer, which can improve the quality of life of patients with tumors, reduce the incidence of nausea and vomiting and bone marrow suppression induced by the treatment.
2.A preliminary methodology and precision study of producing 3D printing heart model by multimodel medical image fusion technology
Sikai CHEN ; Qing ZHOU ; Hongning SONG ; Qing DENG ; Dan JIA ; Yuanting YANG ; Jinling CHEN
Chinese Journal of Ultrasonography 2018;27(11):924-930
Objective To obtain abundant anatomical information using fusion of ultrasonic valve images and CT heart images and provide new methods of image processing for 3D heart printing . Methods Cardiac examinations of three-dimensional transesophageal echocardiography ( 3D-TEE) and DICOM images of 41 patients who had atrial fibrillation without structural cardiac diseases were analyzed retrospectively and the data afterward were processed by using Mimics software . For the single-mode image group ,only the heart CT were invoked as the data sources . For the multimodel image group ,CT and ultrasound images were invoked as the data sources . Valve structures of the 3D reconstructions were graded and the circumferences ,areas and other parameters of the two groups were measured . The images of two groups were overlapped ,and the angles between the two valve planes of each heart were evaluated and analysed . Results Score of valves reconstructed by ultrasound 3D construction was higher than those by CT reconstruction . Measurements of correlated parameters between the 3D-TEE group and the CT group showed no significant statistical difference ( P > 0 .05 ) , and the consistency was well . Ultrasound measurements of 3D reconstructed valves were well concordant with CT reconstructed valves by Bland-Altman analysis . Mean value and standard deviation of the angles between mitral valve annulus and aortic valve ring plane of each heart in the two group were ( 3 .15 ± 0 .88)°,( 2 .87 ± 0 .76)°,respectively . Conclusions Ultrasonic valve images can fuse precisely with CT images and it provides a better displayed morphology . This will help improving simulation quality of the 3D printed hearts .
3.Feasibility study of three-dimensional printing combined with mock circulatory system to make compliant mitral valve model for hemodynamic testing in vitro based on ultrasound image data
Hao WANG ; Bin ZHANG ; Hongning SONG ; Yuanting YANG ; Qing DENG ; Dan JIA ; Juan GUO ; Wei REN ; Qing ZHOU
Chinese Journal of Ultrasonography 2020;29(3):206-212
Objective:To explore the feasibility of three-dimensional(3D) printing combined with mock circulatory system of flexible mitral valve model for hemodynamic testing in vitro based on ultrasound image data, making the transformation of 3D printing valve model from static to dynamic and from anatomical to functional, as well as assisting surgical plan for mitral valve diseases. Methods:A total of 10 subjects underwent three-dimensional transesophageal echocardiography (3D-TEE) and proved to be without mitral diseases were collected as mitral normal group from February 2017 to December 2018 in Renmin Hospital of Wuhan University, 10 mitral stenosis patients were collected as mitral stenosis group, and 10 mitral regurgitation patients were collected as mitral regurgitation group. Hemodynamic parameters of velocity (peak E), pressure gradient were obtained by two-dimensional transthoracic echocardiography in three groups, and the degree of mitral valve stenosis and regurgitation were also evaluated. Then 3D-TEE was performed to obtain the 3D volume image of mitral valve. After image post-processing and 3D modeling, the valve mold was printed with soluble material polyvinyl alcohol (PVA). The mixture of human skin silicone, silicone oil, starch and curing agent were poured into the mitral valve mold in a certain proportion to make flexible silicone mitral valve model. Then, the compliant valve model was placed in mock circulatory system (MCS), regularly opening and closing as it in vivo in the heart cycle. The hemodynamic parameters of mitral valve were measured again in vitro and the degree of stenosis and regurgitation was also evaluated respectively. Paired t test was used for statistical analysis of in vivo and in vitro measurements in two groups, and the consistency test was performed. Results:The mitral valve 3D-TEE images of all patients were successfully post-processed, mitral valve molds were printed and flexible models were made. In vitro hemodynamic tests were all completed. The opening and closing state of the valve model in vitro was similar to that in vivo. Mitral valve regurgitation was detected in mitral regurgitation group in vitro, with degree to that in vivo. There were no statistically significant differences in hemodynamic parameters measured in vivo and in vitro models (all P>0.05), with a high consistency ( r=0.76). Among the 10 patients with mitral stenosis and 10 patients with mitral regurgitation, 18 patients were evaluated as same degree as in vivo. Conclusions:3D printing of compliant mitral valve model based on ultrasound image is feasible, which reproduced hemodynamic features of mitral valve in vitro, setting foundation for further surgery simulation and clinical decision-making.