1.Current progress of iron metabolism and tumor development
Journal of Medical Postgraduates 2017;30(9):998-1003
Iron is an essential nutrient that not only participates in cell oxidative phosphorylation, DNA synthesis and replication, but also regulates cancer associated genes through hypoxia-inducible factor (HIF).In the process of cancerization, cells change the way of iron metabolism resulting in a high consumption of iron.In this case, pathways of iron acquisition, efflux, storage and regulation are perturbed.Therefore, iron can significantly contribute to tumor growth, cell survival and metastasis.In this paper, we summarize the iron changes in cancer cells and the relationship between the changes and tumorigenesis.We also briefly state the potential problems of current clinical using iron chelating agents in oncotherapy.Targeting iron metabolic pathways may provide new tools for cancer prognosis and therapy.
2.Effect of Restraint and Watered Stress of Different Durations on Gastric Empting in Rats
Dan ZHANG ; Zhiwei XIA ; Yajing HAN
Acta Laboratorium Animalis Scientia Sinica 2009;17(6):415-418
Objective To study the effect of restraint and watered stress of different durations on the gastric empting in rats. Methods 48 male SD rats (weight ±150 g) were divided randomly into 6 groups with 8 in each. The experimental rats were restrained and watered in 23℃ water box for 1 h/d, while the controls were free. The body weight, general conditions and behavioral indexes of the rats were observed and recorded. The gastric empting rate was measured in rats with semi-solid diet after 3 d,7 d and 28 d during the statistically significant differences among different groups of different stress groups,and between the 3 d test group and 3 d control group. The gastric empting rate was higer in the 7-day test than in 7 d controlled group, lower in the 28 d test group than 28 d control group. Conclusion Different chronic stress can cause changes of gastric empting rate. With the prolonging of stress time, the empting rate is rising and then decending.
3.A survey of nonsteroidal anti-inflammatory drugs and aspirin associated peptic ulcer bleeding in hospitals
Zhiwei XIA ; Linlin MA ; Wei YAO
Chinese Journal of Internal Medicine 2011;50(2):111-115
Objective To investigate the clinical characteristic and prognosis of nonsteroidal antiinflammatory drugs( NSAIDs)and aspirin associated peptic ulcer bleeding. Method All patients with peptic ulcer bleeding were studied by the same researcher after admission and discharge. Results Fifty-one cases with NSAIDs and aspirin medication of the total peptic ulcer bleeding patients ( 147 cases) were included (34. 7% ). Compared with patients not associated with NSAIDs and aspirin medication, they are older [(41.2 ± 1. 9 ) years vs ( 59.4 ± 2. 2 ) years, P < 0. 001], more commonly associated with hypertension ( 10. 4% vs 39. 2% ,P <0. 001 ), coronary heart disease ( 10. 4% vs 17.6% ,P <0. 001 ) ,diabetes (4. 2%vs 19. 6%, P = 0. 005 ); and had more severe anemia (7. 3% vs 23. 5%, P = 0. 008 ). Fewer patients in NSAIDs group had epigastric pain (61.5% vs 27.5%, P < 0. 001 ), while there was more re-bleeding (9.4% vs 15.7%, P = 0.034). In all bleeding patients, factors associated with re-bleeding, surgical intervention and death included NSAIDs and aspirin medication, and low platelet count. In patients with NSAIDs and aspirin medication, re-bleeding was associated with previous ulcer history ( P < 0. 05 ).Conclusion Peptic ulcer bleeding patients with NSAIDs and aspirin medication were more severe ill, and less likely to present with epigastric pain.
4.Effect of Formula Granule of Siwu Drugs on Sex Hormone and Its Receptor in Bone Marrow Depressed Mice
Mingzhao JIA ; Qing XIA ; Zhiwei CHEN
Tianjin Medical Journal 2009;37(7):578-580
Objective: To investigate the effect of abstracted formula granule of Siwu drugs on the sex hormones and expressions of androgen receptor (AR)and estrogen receptor (ER) in bone marrow depressed mice. Methods: One hundred and eighty mice (90 male and 90 female) were randomly divided into 6 groups. The effects of the formula granule of Siwu on sex hormones and expressions of AR and ER were explored by SABC method in bone marrow of depressed mice. Results: For the male rats, the levels of androgen were increased in male of treatment groups compared with those of model groups (P<0.05), and the levels of estrogen were decreased in male of treatment groups compared with those of model groups (P<0.05).For the female rats, the levels of androgen were increased in female of treatment groups compared with those of model groups,but no significant differences (P>0.05), and the levels of estrogen were decreased in femal of treatment groups compared with those of model groups (P<0.05). There was a dose dependent manner between treatment groups. Conclusion: The results suggested that formula granule of Siwu drugs may play a role in the hematopoietic function to repair bone marrow depression by improving AR and the balance of estrogen / androgen in mice.
5.Relationship of body mass index with hiatal hernia and reflux esophagitis
Bingxia GAO ; Liping DUAN ; Kun WANG ; Zhiwei XIA
Chinese Journal of Digestive Endoscopy 2011;28(6):316-319
Objective To investigate the relationship of body mass index with hiatal hernia (HH) and reflux esophagitis (RE).Methods Two hundreds and twenty seven gastroesophageal reflux disease (GERD) patients with typical acid regurgitation and heartburn were enrolled and categorized into three groups according to body mass index (BMI, kg/m2) as normal weight (18.5≤BMI <24), overweight (24≤BMI<28), and obesity (BMI≥28).RE, non-erosive reflux disease (NERD) and HH were diagnosed by gastroscopy.All the patients underwent ambulatory 24-hour pH monitoring and the pathological acid reflux was considered when the DeMeester score≥15.Effects of BMI on RE and HH were estimated by using logistic regression analysis.Results The percentages of RE and HH were 30.0%(68/227) and 5.7%(13/227), respectively.76.9% (10/13) HH patients had RE. Proportions of RE and HH increased significantly with increasing BMI (P<0.05), so was that of RE above grade B in three groups (6.4%, 16.9% and 31.6%,P=0.003).DeMeester scores of the three groups were 15.9, 19.8 and 36.9, respectively (P<0.05).The average 24-hour intra-esophagus pH value of overweight group, was significantly lower than that of normal weight patients in the afternoon and midnight (P<0.01).Multivariate analysis showed obesity was a risk factor for HH with OR 7.058 (95% CI: 1.294~38.488, P=0.024), male (OR: 2.537, 95% CI: 1.350~4.766, P=0.004), overweight (OR: 1.921, 95% CI: 1.005~3.670, P=0.048), obesity (OR: 3.305, 95% CI: 1.123~9.724, P=0.030) and HH (OR: 6.879, 95% CI: 1.695~27.913, P=0.007) were risk factors for RE.Conclusion BMI has a significant association with HH and RE, obesity is a common risk factor for both HH and RE, HH may induce the development of RE.
6.Clinical manifestations and endoscopic findings of congenital prepyloric membrane
Fenglin LIU ; Xiaohua XU ; Zhiwei XIA ; Shuhong ZHANG ; Yu ZHAO
Chinese Journal of Digestive Endoscopy 2008;25(4):173-177
Objective To study gastroscopic features and clinical diagnosis of prepyloric mem-brane. Methods Clinical characteristics,gastroscopic manifestation and operational findings of 18 pa-tients,whose prepyloric membrane have been confirmed by operations,were retrospectively reviewed. Results Gastroscopie findings showed that all the 1 8 patients suffered gastric retention and pyloric obstruc-tion to some degree,with 4 cases of esophageal erosion and/or esophageal ulcer,five cases of erosive hemor-rhagic gastritis,one case of ulcer at gastric antrum,gastric comer and pylorus respectively. There were 2 ca-ses of aperture like narrowing in prepyloric region. And there were 9 cases that showed obvious congestion and edema in the prepyloric mucus,with uniform circular mucusal protrusion around the stenosing stoma,and volcano-like depression in the middle,three cases of which showed mucosal membrane standing out to the gastric cavity. The membrane found in the above 11 cases located in pyloric exit or tube,and they under-went membrane excision and py|oroplasty. The other 7 cases showed thick mucosal folds at the distal antrum with radial arrangement. Round or irregular stenosing stoma were observed. These cases proved to be antral membrane,1-3 cm away from the duodenum and pylorus,and underwent simple membrane resection. Conclusion Congenital prepyloric membrane is rare and it likely mis-diagnosed. The onset and the degree of symptoms depend on the diameter of aperture of the membrane. Early endoscopy,in addition to barium contrast,should be performed on those children who have intermittent bilious vomiting,where false-positive radiological findings can be avoided,therefore,to facilitate right diagnosis and appropriate operation.
7.Meta analysis of 95 patients with Ménétrier disease in China
Ye LIU ; Zhiwei XIA ; Zhiqiang SONG ; Zhigang DING ; Liya ZHOU
Chinese Journal of Digestion 2009;29(12):816-820
Objective To summarize the clinical features, diagnosis and treatment of Ménétrier disease in China. Methods A systematic review of Ménétrier disease in China was performed. Four electronic databases were searched from 1993 to 2008 including CNKI and Wanfang seeking studies about pathologically performed Ménétrier disease. Results Data of 95 patients with Ménétrier disease from 62 studies was included. There were 74 males and 21 females. The mean age of onset in adults was (47.4± 5.3) years . The process of the disease was longer in male individuals that in female individals (47.5 months vs. 13.7 months, P<0.05). The main symptoms included abdominal pain (76.8%), weight loss (42.1%), anorexia (40.0%) and edema of lower extremities (36.8%), etc.Hypoproteinemia was accounted for 71.6 % and most of the patients had hypochlorhydria. The typical giant hyperplastic gastric fold was found in 88.4 % of the patients under endoscopy. The diffuse type was in predominance and mainly involved the greater curve of the stomach (55.3 %). Whereas 5.3 patients were accompanied with gastric cancer. The misdiagnostic rate of the disease was 31. 6%,which accounted for 50% in surgically treated patients. Conclusions In China, the Ménétrier disease is predominant in middle-aged males, and the process is longer in males than in females. Misdiagnosis is related to existence of weight loss and hypoproteinemia. Most of the patients with Ménétrier disease have a good prognosis even the disease process is long.
8.Trend analysis of endemic arsenism in the monitored areas of the disease in 2010 - 2012 in Inner Mongolia
Yajuan XIA ; Kegong WU ; Kuiying FANG ; Zhiwei GUO ; Na CUI
Chinese Journal of Endemiology 2016;(1):32-34
Objectives To monitor the residents prevalence of endemic arsenism in the disease affected areas in Inner Mongolia, so as to provide feasible suggestions for control of arsenism in the future. Methods Monitoring data were obtained from the Project of Endemic Disease Prevention Granted by Central Government in 2010 - 2012, and the conditions of arsenism patients from 38 endemic arsenic villages were analyzed among different year, age and gender. Results The detection rate of arsenism of the 38 surveillance villages was 7.38%(517/7 004) in 2010, 7.10%(482/6 784) in 2011 and 6.62% (431/6 514) in 2012. The arsenism patients of mild;moderate and severe cases from 2010 to 2012, accounted for 74.47% (385/517), 74.27% (358/482), 75.17% (324/431); 16.83% (87/517), 16.60% (80/482), 15.78% (68/431) and 8.7% (45/517), 9.13% (44/482), 9.05% (39/431), respectively. For skin lesions, the detection rates of keratosis, pigmentation and depigmentation from 2010 to 2012, were 8.08%(566/7 004), 7.90%(536/6 784), 7.77%(506/6 514);3.27%(229/7 004), 3.29%(223/6 784), 2.87%(187/6 514) and 6.68% (468/7 004), 6.63% (450/6 784), 5.82% (379/6 514), respectively, showed a declining trend. It also showed a declining trend with age, and the patients were mainly 40 years old people and older, and the highest detection rate was in the 60- 70 years old group[15.54%(143/920)、14.72%(135/917)、13.36%(136/1 018)]. For gender distribution, the detection rate of the three years was higher in male than female [male 8.24%(300/3 639), 7.99%(283/3 542), 7.71%(260/3 372);female 6.45%(217/3 365), 6.14%(199/3 242), 5.44%(171/3 142),χ2=8.24, 8.77, 13.54, all P〈0.01]. Conclusion There is no big change of arsenism conditions in 2010-2012, with a slight declining trend.
9.Prevention and handling of missing data in clinical trials.
Zhiwei JIANG ; Chanjuan LI ; Ling WANG ; Jielai XIA
Acta Pharmaceutica Sinica 2015;50(11):1402-7
Missing data is a common but unavoidable issue in clinical trials. It not only lowers the trial power, but brings the bias to the trial results. Therefore, on one hand, the missing data handling methods are employed in data analysis. On the other hand, it is vital to prevent the missing data in the trials. Prevention of missing data should take the first place. From the perspective of data, firstly, some measures should be taken at the stages of protocol design, data collection and data check to enhance the patients' compliance and reduce the unnecessary missing data. Secondly, the causes of confirmed missing data in the trials should be notified and recorded in detail, which are very important to determine the mechanism of missing data and choose the suitable missing data handling methods, e.g., last observation carried forward (LOCF); multiple imputation (MI); mixed-effect model repeated measure (MMRM), etc.
10.Importance of data management with statistical analysis set division.
Ling WANG ; Chanjuan LI ; Zhiwei JIANG ; Jielai XIA
Acta Pharmaceutica Sinica 2015;50(11):1464-9
Testing of hypothesis was affected by statistical analysis set division which was an important data management work before data base lock-in. Objective division of statistical analysis set under blinding was the guarantee of scientific trial conclusion. All the subjects having accepted at least once trial treatment after randomization should be concluded in safety set. Full analysis set should be close to the intention-to-treat as far as possible. Per protocol set division was the most difficult to control in blinded examination because of more subjectivity than the other two. The objectivity of statistical analysis set division must be guaranteed by the accurate raw data, the comprehensive data check and the scientific discussion, all of which were the strict requirement of data management. Proper division of statistical analysis set objectively and scientifically is an important approach to improve the data management quality.