1. Standardized treatment of chronic radiation-induced bowel injury
Lei WANG ; Tenghui MA ; Zhihang LIU ; Yanjiong HE
Chinese Journal of Gastrointestinal Surgery 2019;22(11):1021-1026
Radiation-induced bowel injury is a common complication of radiation therapy for pelvic malignancy. Given the huge number of patients diagnosed with pelvic malignancy, the number of patients diagnosed with radiation-induced bowel injury increased year by year, which put a great burden on the clinical diagnosis and treatment of radiation-induced bowel injury. In particular, chronic radiation-induced bowel injury, which is manifested in the process of prolonged, repeated and progressive aggravation, seriously affects the physical and mental health of patients and makes clinical diagnosis and treatment difficult. However, due to insufficient attention and understanding from doctors and patients, standardized diagnosis and treatment of radiation-induced bowel injury still have a long way to go. Radiation-induced bowel injury is self-limited but irreversible. During diagnosis, we should pay attention to overall evaluation of the stage of disease based on clinical symptoms, endoscopic examination, imaging examination, pathology and nutritional risk. The treatment methods include health education, drug therapy, enema therapy, formalin local treatment, endoscopic treatment and surgical treatment, etc. The treatment decision-making should be based on clinical symptoms, endoscopic or imaging findings to alleviate the clinical symptoms of patients as the primary goal and to improve the long-term quality of life of patients as the ultimate goal.
2.Research advances in the role of blood metabolic markers in the treatment response and prognosis prediction of primary liver cancer
Zhiying LIU ; Zhihang ZHOU ; Song HE
Journal of Clinical Hepatology 2023;39(10):2470-2475
Primary liver cancer is one of the most severe cancer burdens around the world. Metabolic reprogramming is one phenotype of cancer, and blood metabolic markers are closely associated with metabolic reprogramming and can predict the risk of recurrence and survival or assess the treatment response of liver cancer, with important significance in the stratified management of patients, the development of rational treatment strategies, and the improvement of patient prognosis. By reviewing the recent studies on blood metabolomics in assessing the treatment response or predicting the prognosis of liver cancer, this article summarizes the blood metabolites with predictive significance and their mechanism of action and analyzes the current research status, existing problems, and prospects of this field. It is believed that the metabolites, such as aromatic amino acids, lipids, and bile acids, have an important clinical value in predicting the prognosis of liver cancer, and metabolomics technology has great potential in finding useful metabolites, but there are still many issues to be solved, such as technical limitations, insufficient studies, and multiple influencing factors.
3.Clinical and endoscopic features of 179 cases of autoimmune gastritis
Zhiji CHEN ; Chao DENG ; Feng XU ; Junyu LU ; Zhihang ZHOU ; Suhua WU ; Song HE
Chinese Journal of Digestion 2023;43(8):531-536
Objective:To explore the clinical and endoscopic features of patients with autoimmune gastritis (AIG) and to improve the accuracy of clinical diagnosis of AIG.Methods:From January 3, 2020 to November 25, 2021, the general information (gender, age), laboratory examination indicators and endoscopic findings of 179 AIG patients diagnosed at the Second Affiliated Hospital of Chongqing Medical University were retrospectively analyzed. The laboratory examination indicators included hemoglobin, gastrin-17, pepsinogen (PG), anemia combination indicators (ferritin, vitamin B 12), thyroid function indicators (thyroid-stimulating hormone, thyroglobulin antibody and thyroid peroxidase antibody), Helicobacter pylori, and anti-parietal cell antibody and anti-intrinsic factor antibody. Descriptive methods were used for statistical analysis. Results:Among the 179 AIG patients, there were 42 males (23.5%) and 137 females (76.5%), with an average age of (55.23±12.04) years old. The gastrin-17 level of AIG patients was 195.31 ng/L (143.64 ng/L, 273.61 ng/L), PG Ⅰ level and PG Ⅰ/PG Ⅱ ratio were 12.40 μg/L (7.65 μg/L, 19.40 μg/L) and 1.03 (0.66, 1.52), respectively. There were 15.3% (18/118) of the AIG patients with iron deficiency anemia, and 16.1% (19/118) with megaloblastic anemia. The positive rate of anti-parietal cell antibody was 71.8% (51/71), and the positive rate of anti-intrinsic factor antibody was 25.4% (18/71). The serum thyroid-stimulating hormone level increased in 27.3% (15/55) of the patients, and the positive rates of thyroglobulin antibody and thyroid peroxidase antibody were 31.6% (12/38) and 47.4% (18/38), respectively. The positive rate of Helicobacter pylori was 29.7% (38/128). The endoscopic appearance of AIG indicated reverse atrophy, characterized by obvious atrophy in gastric fundus and gastric body mucosa, however the atrophy of gastric antrum was not obvious. Under endoscopy yellow-white turbid mucus, which was difficult to be washed, was found in 67.0% (120/179) of the patients, and under endoscopy the residual gastric fundus glands could be seen in 19.6% (35/179) of the patients. Among 179 AIG patients, 7 cases (3.9%) of neuroendocrine tumor (NET), 7 cases (3.9%) of early gastric adenocarcinoma (including 1 case of poorly differentiated adenocarcinoma), 1 case (0.6%) of adenoma, and 14 cases (7.8%) of hyperplastic polyps were found. Except for the case of poorly differentiated adenocarcinoma undergoing surgery, the others were treated with endoscopic resection. Conclusions:When unexplained iron deficiency anemia, megaloblastic anemia, or reverse atrophy is found, AIG should be considered. AIG patients are at high risk for gastric cancer and NET, and should be closely followed up, and active treatment should be given before anemia and neurological symptoms appear.
4.SARS-CoV-2 reactive memory T cell immunity in healthy individuals
Chen LUO ; Yonghua YIN ; Yudi XIE ; Zhihang HE ; Ling LI ; Zhong LIU ; Jue WANG ; Qiang CHEN
Chinese Journal of Blood Transfusion 2022;35(5):504-508
【Objective】 To understand the memory phenotype and function of SARS-CoV-2 reactive CD4+ T cells in healthy individuals. 【Methods】 In this study, SARS-CoV-2-derived peptides were used to stimulate PBMC from participants.SARS-CoV-2 reactive memory T cells were detected by intracellular staining and flow cytometry, and memory phenotype analysis was performed.CBA was used to detect cytokine secretion after SARS-CoV-2-derived peptides stimulation to evaluate the function of SARS-CoV-2 reactive memory T cells. 【Results】 We found that SARS-CoV-2 reactive CD4+ memory T cells could be detected in 40% (6/15) healthy donors.Phenotypic analysis of memory showed that these T cells were mainly composed of central memory T cells(82.2%), and other memory cells accounted for 17.8%.Compared with negative control, IL-10 was significantly decreased after stimulation of SARS-CoV-2-derived peptides (P<0.05), while the secretion of IFNγ, TNFα, IL-2 and IL-4 showed no significant difference. 【Conclusions】 SARS-CoV-2 reactive CD4+ memory T cells are present in healthy individuals from China.
5.Double-negative T cells: a promising avenue of adoptive cell therapy in transplant oncology.
Zhihang HU ; Modan YANG ; Hao CHEN ; Chiyu HE ; Zuyuan LIN ; Xinyu YANG ; Huigang LI ; Wei SHEN ; Di LU ; Xiao XU
Journal of Zhejiang University. Science. B 2023;24(5):387-396
Tumor recurrence is one of the major life-threatening complications after liver transplantation for liver cancer. In addition to the common mechanisms underlying tumor recurrence, another unavoidable problem is that the immunosuppressive therapeutic regimen after transplantation could promote tumor recurrence and metastasis. Transplant oncology is an emerging field that addresses oncological challenges in transplantation. In this context, a comprehensive therapeutic management approach is required to balance the anti-tumor treatment and immunosuppressive status of recipients. Double-negative T cells (DNTs) are a cluster of heterogeneous cells mainly consisting of two subsets stratified by T cell receptor (TCR) type. Among them, TCRαβ+ DNTs are considered to induce immune suppression in immune-mediated diseases, while TCRγδ+ DNTs are widely recognized as tumor killers. As a composite cell therapy, healthy donor-derived DNTs can be propagated to therapeutic numbers in vitro and applied for the treatment of several malignancies without impairing normal tissues or being rejected by the host. In this work, we summarized the biological characteristics and functions of DNTs in oncology, immunology, and transplantation. Based on the multiple roles of DNTs, we propose that a new balance could be achieved in liver transplant oncology using them as an off-the-shelf adoptive cell therapy (ACT).
Humans
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T-Lymphocytes
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Immunotherapy, Adoptive
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Neoplasm Recurrence, Local
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Transplantation, Homologous
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Cell- and Tissue-Based Therapy
6.Study on RHD and RHCE gene mRNA based on three generation sequencing technology
Xiaoyu GUAN ; Xin JI ; Ling LI ; Haixia XU ; Li TIAN ; Qi REN ; Zhihang HE ; Jue WANG ; Zhong LIU
Chinese Journal of Blood Transfusion 2023;36(2):115-120
【Objective】 To establish RH gene mRNA sequencing method based on nanopores sequencing and to explore the RHD and RHCE mRNA transcripts in D positive and Del individuals. 【Methods】 From March 2021 to May 2022, 5 RhD positive samples and 5 Del samples screened out by hospitals in Chengdu were sent to our laboratory for futher examination. The erythrocytes and buff coat were isolated, then DNA and RNA were extracted.All 10 samples were genotyped by PCR-SSP. After the mRNA was reversely transcribed into cDNA, the full-length mRNA of RHD and RHCE genes were simultaneously amplified by a pair of primers. Sanger sequencing and third-generation sequencing technology based on Nanopore were used to sequence the amplified products, and the types and expressions of different splices of RHD and RHCE gene mRNA transcripts were analyzed. 【Results】 The method established in this study can simultaneously amplify the full length transcripts of RHD and RHCE. Ten different RHD gene mRNA transcripts and nine RHCE gene mRNA transcripts were detected in 10 samples. RHD full-length transcript (RHD-201) can be detected in RhD Del type, but the expression amount was significantly lower than that in RhD positive samples. The expression amount of transcript RHD-207 (Del789) in Del samples was significantly higher than that in RhD positive samples. The transcript RHD-208 (Del8910+ 213) was only detected in RhD Del type individuals, and no significant difference was found between other RHD transcripts and all RHCE transcripts in the two phenotypes. 【Conclusion】 In this study, an analytical method for sequencing full-length transcript isomers of RHD and RHCE mRNA via the third generation was successfully established, and complex alternative splicing patterns were found in RHD and RHCE genes, providing a new method for the study of alternative splicing of blood group gene variants mRNA.