1.Clinical study of 34 patients with extranodal NK/T cell lymphoma-nasal type.
Xianling REN ; Quanfan JIA ; Guangming XIANG ; Zeyu ZHAO ; Kailun XU ; Wen DU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2007;21(8):361-362
OBJECTIVE:
To explore the clinical feature, the reason of misdiagnosis and mistreatment, influential factor of prognosis in patients with extranodal NK/T cell lymphoma-nasal type.
METHOD:
A retrospective study was made on the clinical data of 34 patients with extranodal NK/T cell lymphoma-nasal type. Among them, 10 cases were staged I(E) intra-cavity, 15 cases were I(E) ex-cavity, 6 cases were II(E) and 3 cases were IV(E). Among them, 29 cases were in nasal cavity, 5 cases were outside nasal cavity; 14 cases were treated with single chemotherapy or radiation therapy, 20 cases were treated with radiation therapy add chemotherapy.
RESULT:
The total rate of misdiagnosis and mistreatment were 58.8% (20/34), 52.3% (18/34), respectively. The 5-year survival rate of the I(E) intra-cavity group were 60.0% (6/10), and those of I(E) ex-cavity group were 26.7% (4/15), and those of II(E) group and IV(E) group were 16.7% (1/6), 0% (0/3), respectively There was significant difference between 3 groups by statistical analysis (P < 0.01). The 5-year survival rate of I(E) ex-cavity group treated with single therapy were 0% (0/6), and those of I(E)-cavity group treated with combined therapy were 50% (1/2).
CONCLUSION
The early clinical manifestation of extranodal NK/T tell lymphoma-nasal type is atypical and which is hard to diagnose and treat. Diagnosis depends on pathologic biopsy and immunohistochemistry, there are many factors that influence the prognosis of this disease, in which the clinical stage is a major factor. It is crucial for diagnosing and treating early.
Adolescent
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Adult
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Aged
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Diagnostic Errors
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Female
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Humans
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Lymphoma, Extranodal NK-T-Cell
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diagnosis
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therapy
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Male
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Middle Aged
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Nose Neoplasms
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diagnosis
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therapy
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Retrospective Studies
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Survival Rate
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Young Adult
2.Research progress on the pathogenesis of immune checkpoint inhibitor-associated myocarditis
Zeyu WEN ; Huili CAO ; Yajing ZHAO ; Chengmei YANG ; Songshan LI ; Huwei DAI ; Kang ZENG ; Bin YANG
Chinese Journal of Geriatrics 2023;42(12):1489-1494
Immune checkpoint inhibitors(ICIs)have become the most widely used drugs in tumor immunotherapy, with ipilimumab and nivolumab as their representatives.However, the use of immune checkpoint inhibitors has brought about many immune-related adverse events, of which myocarditis is one of the most fatal adverse reactions.The pathogenesis of immune checkpoint inhibitor-associated myocarditis is not fully understood, mainly involving autoimmune T lymphocyte infiltration, regulatory T-cell dysfunction, cytokines, autoantibody production, genetic factors, the gut microbiome, etc.The treatment and management of immune checkpoint inhibitor-associated myocarditis require concerted efforts of multidisciplinary experts.
3.A prospective multicenter randomized controlled study on the efficacy and safety of pharyngeal spraying recombinant human interferon alpha 2b in the treatment of children with herpangina
Jiahua PAN ; Zeyu YANG ; Jiayan PAN ; Xiaohong WEN ; Min HAN ; Lirong YANG ; Xian′gao CHENG ; Yanling LI ; Haiqing LIN ; Chuanjing LI ; Chengming YAN
Chinese Journal of Applied Clinical Pediatrics 2020;35(4):279-284
Objective:To evaluate the efficacy and safety of pharyngeal spraying recombinant human interfe-ron alpha 2b (rhIFNα2b) in the treatment of herpangina in children.Method:s A prospective, multicenter, rando-mized, opened and controlled study was carried out in 11 hospitals in Anhui province from August 2018 to March 2019.According to the time of admission, 180 patients diagnosed as herpangina were prospectively and randomly divided into rhIFNα2b treatment group and Ribavirin control group.On the basis of giving both groups the heat-clearing, detoxifying and anti-infection treatment, the patients in treatment group received pharyngeal spraying rhIFNα2b 9 g/L saline solution[1 million IU/mL, 0.1 million IU/(0.1 mL·press)], and the patients in control group were treated by pharyngeal spraying Ribavirin (0.5 mg RBV/press, 150 press), 3 presses per time, 4 times per day, continuous administration for 5 days for both groups.Those who recovered in advance were no longer given medication.All patients were observed to fully recover.The clinical efficacy and the disappearing time of symptoms and signs between two groups were compared, and the safety of pharyngeal spraying rhIFNα2b for patients was evaluated.Result:s All of the 180 patients completed the study, including 90 cases in the treatment group and 90 cases in the control group.There was no statistically significant difference in terms of gender, age, weight and course of illness before treatment between the two groups (all P>0.05), which had clinical comparability.The apparent efficiency of the treatment group [63.3% (57/90 cases)] was significantly higher than that in the control group [38.9% (35/90 cases)] and the difference was statistically significant( χ2=10.934, P=0.004); no significant difference in the total efficiency between the treatment group [96.7% (87/90 cases)]and the control group [92.2% (83/90 cases)]was observed ( χ2=2.924, P=0.169). The duration of fever[(32.59±20.73) h vs.(45.72±26.96) h], hyperemia[(76.48±23.12) h vs.(92.44±24.31) h], herpes[(72.99±25.77) h vs.(85.09± 26.62) h], salivation[(45.44±24.96) h vs.(54.42±31.20) h] and anorexia[(62.70±23.99) h vs.(78.71±30.54) h] in the treatment group were significantly shorter than those in the control group, and the differences were statistically significant(all P<0.05). Before treatment, the serum levels of tumor necrosis factor α(TNF-α) [(13.02±4.41) ng/L vs.(13.57±9.27) ng/L], interleukin-6(IL-6) [(26.48±11.31) ng/L vs.(30.15±15.55) ng/L] and C-reactive protein(CRP)[(19.34±14.11) mg/L vs.(19.83±14.57) mg/L]were not significantly different between the two groups (all P>0.05). After treatment, the serum levels of TNF-α and IL-6 were(7.26±1.99) ng/L and (2.42±0.73) ng/L in the treatment group, which were significantly lower than those in the control group [(12.09±6.39) ng/L and (7.32±11.51) ng/L](all P<0.05), but no significant difference in serum levels of CRP between the two groups was observed ( P>0.05). The comparison on positive rate of virus in pharyngeal swab between the treatment group [65.3% (32/49 cases) and 40.6% (13/32 cases) respectively] and the control group[66.7%(36/54 cases) and 41.0% (16/39 cases), respectively]before and after therapy showed no significant difference (all P>0.05). During the treatment, no serious adverse reactions were observed in the two groups.The incidence of adverse reactions was 1.1% (1/90 cases) in the treatment group and 5.6% (5/90 cases) in the control group.In addition, the serum hemoglobin level of children in the control group after treatment was significantly lower than that before treatment and that in the treatment group (all P<0.05). Conclusions:Compared with pharyngeal spraying ribavirin, pharyngeal spraying rhIFNα2b can greatly improve the clinical efficiency, accelerate the disappearance of clinical symptoms and signs, and shorten the total course of disease, and is more safe and worthy of clinical application.
4.Effect of individualized rehabilitation extended nursing on activities of daily living in children with cerebral palsy
Qian ZHANG ; Wanpei LIANG ; Li WEN ; Xiayu YANG ; Xiaodong KANG ; Lidan MA ; Yi LIAO ; Zeyu ZHAO
Chinese Journal of Practical Nursing 2018;34(36):2828-2832
Objective To evaluate the effect of individualized rehabilitation extended nursing on activities of daily living (ADL) in children with cerebral palsy. Methods A total of 156 cases of non-operative children with severe disorder of cerebral palsy from January to December 2017 in Sichuan 81 Rehabilitation Center, of 101 males and 55 females, aged 2-7 years with weighting 9 to 21 kg, were divided into 2 groups according to the time sequence, of which 70 cases of January to June 2017 before extension nursing as control group and 86 cases of July to December 2017 after extension nursing as observation group. The control group was received routine nursing according to the ADL rating scale, and the observation group was adopted the extended nursing method, according to the ADL rating scale to evaluate and judge the barrier grade, and chosen the suitable measures for rehabilitation nursing according to the individualized principle.The rehabilitation assessment was carried out before extended nursing (W0), the second week after extended nursing (W2), fourth week (W4), sixth week (W6), eighth week (W8), tenth week (W10), and twelfth week (W12) respectively. Results There was no significant difference in gender, age, weight and ADL scores at the time point of W0between the two groups (P>0.05). The ADL scores of the two groups were increased with the treatment time, and the increase of the observation group was greater than that of the control group. Compared with the control group, the ADL scores of the observation group were increased significantly at the time of W4to W12(P<0.01).After 12 weeks of treatment, there were 25 cases of mild disorders (29% ), 46 cases of moderate disorder (53.5% ) and 15 cases of severe disorder (17.5% ) in the observation group, and 3 cases of mild disorders (4.3% ), 38 cases of moderate disorder (54.3% ) and 29 cases of severe disorder (41.4% ) in the control group, and the observation group was obviously better than that of the control group (χ2=21.083,P<0.01). Conclusion Individualized rehabilitation extended nursing can improve ADL in children with cerebral palsy.
5.Risk stratification and treatment progress of smoldering multiple myeloma
Zeyu LIN ; Guangzhong YANG ; Tongtong WANG ; Wenming CHEN ; Wen GAO
Journal of Leukemia & Lymphoma 2021;30(10):626-629
Smoldering multiple myeloma is a kind of heterogeneous asymptomatic plasma cell disease. Some patients have a high risk of developing symptomatic multiple myeloma. However, the starting point and options of treatment for smoldering multiple myeloma patients are still unclear. This article reviews the risk stratification and treatment progress of smoldering multiple myeloma.
6.Predictive value of 18F-FDG PET/CT metabolic parameters combined with inflammatory markers for medium-term outcome in patients with primary gastrointestinal diffuse large B cell lymphoma
Zeyu ZHANG ; Chao CHENG ; Jiannan WEN ; Zhenyong GU ; Juanli MAO ; Yingying ZHANG ; Siyu LIANG ; Mingxin WANG ; Changjing ZUO
Chinese Journal of Nuclear Medicine and Molecular Imaging 2023;43(2):85-90
Objective:To explore the predictive value of 18F-FDG PET/CT metabolic parameters combined with inflammatory markers for the medium-term efficacy of chemotherapy in patients with primary gastrointestinal diffuse large B cell lymphoma (PGI-DLBCL). Methods:From April 2011 to May 2020, 67 patients (37 males, 30 females, age: 28-85 years) with PGI-DLBCL examined by 18F-FDG PET/CT before chemotherapy in Changhai Hospital, Navy Medical University were retrospectively analyzed. All patients were treated with cyclophosphamide+ doxorubicin+ vincristine+ prednisone (CHOP) or rituximab+ CHOP (R-CHOP) regimens, and the medium-term efficacy was evaluated after 2-4 cycles of chemotherapy. The effect outcome was divided into complete remission (CR) group and non-CR (NCR) group based on the Lugano lymphoma response evaluation criteria. Mann-Whitney U test was used to compare the differences of SUV max, peak of SUV (SUV peak), metabolic tumor volume (MTV), total lesion glycolysis (TLG), platelet/lymphocyte ratio (PLR) and neutrophil/lymphocyte ratio (NLR) between two groups. The independent risk factors of NCR were analyzed by multivariate logistic regression and the binary logistic regression model was established according to the results. The model was tested with external validation data ( n=15). Results:Of 67 PGI-DLBCL patients, 28(41.8%) were CR and 39(58.2%) were NCR. SUV peak, MTV, TLG, PLR and NLR in NCR group (17.3(12.3, 28.1), 73.8(42.9, 141.7) cm 3, 887.5(300.9, 2 075.3) g, 203.9(155.7, 297.1), 3.9(3.0, 4.9)) were significantly higher than those in CR group (9.5(6.2, 15.2), 11.3(4.7, 23.2) cm 3, 85.2(35.5, 214.6) g, 149.3(102.8, 173.1), 2.2(1.8, 4.6); z values: from -6.41 to -2.33, all P<0.05). The logistic regression model was as follows: P=1/(1+ e - x), x=0.100×MTV+ 0.024×PLR-8.064. The prediction accuracy for NCR risk was 86.57%(58/67), with the accuracy of 13/15 tested by external validation data. Conclusion:MTV combined with PLR has a good predictive value for medium-term efficacy of CHOP/R-CHOP chemotherapy in patients with PGI-DLBCL.
7.Analysis on Children's Health Equity in Countries along the"Belt and Road"Based on Concentration Index and Thiel Index
Linhong LI ; Zeyu TAN ; Xinyi ZHANG ; Zixuan WEN ; Tongtong GUO ; Zewen XU ; Qi JING ; Wengui ZHENG
Chinese Health Economics 2024;43(2):49-52
Objective:To analyze and evaluate the equity of children's health in countries along the"the Belt and Road",promote further attention to children's health in countries along the route,and promote cooperation and exchanges on children's health between China and countries along the"the Belt and Road".Methods:Using concentration index and concentration curve to measure overall equity,and using the Thiel index for intraregional and interregional euqity measurement.Results:The under-five mortality concentration index is 0.349 7,the concentration curve is below the absolute fair line.The Thiel index shows that inequality in low-income countries,lower-middle-income countries,upper-middle-income countries and high-income countries is the leading cause of child health inequities in the"the Belt and Road"countries.Conclusion:There is inequity in the health of children in countries along"the Belt and Road Initiative",countries along the"the Belt and Road"should take comprehensive measures to reduce the under-five mortality rate,at the same time strengthen international cooperation to further promote equity in children's health in"Belt and Road"countries.
8.Informed LASSO machine learning method in postoperative survival analysis of supra-cardiac total anomalous pulmonary venous connection
Xiaobing LIU ; Furong LIU ; Zeyu CHEN ; Guangzheng XU ; Hailong QIU ; Erchao JI ; Xiaohua LI ; Shusheng WEN ; Tao LIU ; Jian ZHUANG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2022;29(07):848-853
Objective To characterize surgical outcomes of supra-cardiac total anomalous pulmonary venous connection (TAPVC), investigate risk factors for postoperative death, and explore informed LASSO machine learning methods to solve "small sample size problem" in research of rare congenital heart diseases. Methods A retrospective analysis of 241 patients with supra-cardiac TAPVC who underwent surgical repair in Guangdong Provincial People's Hospital from 2009 to 2019 was conducted, including 179 males and 62 females with a median surgical age of 71 (33, 232) d. Detailed clinical data of the postoperative death-related factors were extracted. Univariable Cox proportional hazard models were used to initially screen potential risk factors for postoperative death. Factors with P鈮?.05 were retained. To solve the limitation of small sample size and the "P>n" problem, we proposed a novel LASSO method for conducting multivariable Cox regression analysis that was capable of bringing in findings of related studies to improve analysis power and to reduce false-negative findings. Results 聽 聽Univariable Cox analyses showed several potential clinical risk factors, among which highly significant factors (P<0.001) included: surgical weight鈮?.5 kg (HR=16.00), main pulmonary artery diameter (HR=0.78), prolonged cardiopulmonary bypass time (HR=1.21), aortic block time (HR=1.28), and postoperative ventilator-assisted time (HR=1.13/d). LASSO multivariable analysis revealed that independent risk factors for postoperative death included cardiopulmonary bypass time (aHR=1.308/30 min), age (aHR=0.898), postoperative ventilator-assisted time (aHR=1.023/d), weight鈮?.5 kg (aHR=2.545), right vertical venous return (aHR=1.977), preoperative pulmonary venous obstruction (aHR=1.633) and emergency surgery (aHR=1.383). Conclusion 聽 聽Our proposed informed LASSO method can use previous studies' results to improve the power of analysis and effectively solve the "P>n" and small sample size limitation. Cardiopulmonary bypass time, surgical age, postoperative ventilator-assisted time, weight, right vertical venous return, preoperative pulmonary venous obstruction, and emergency surgery are risk factors for postoperative death of supra-cardiac TAPVC.