1.Rhizosphere bacterial metabolism of plants growing in landfill cover soil regulates biodegradation of chlorobenzene.
Shangjie CHEN ; Li DONG ; Juan XIONG ; Baozhong MOU ; Zhilin XING ; Tiantao ZHAO
Chinese Journal of Biotechnology 2025;41(6):2451-2466
The regulation of rhizosphere bacterial community structure and metabolism by plants in municipal solid waste landfills is a key to enhancing the biodegradation of chlorobenzene (CB). In this study, we employed biodiversity and metabolomics methods to systematically analyze the mechanisms of different plant species in regulating the rhizosphere bacterial community structure and metabolic features and then improved the methane (CH4) oxidation and CB degradation capacity. The results showed that the rhizosphere soil of Rumex acetosa exhibited the highest CH4 oxidation and CB degradation capacity of 0.08 g/(kg·h) and 1.72×10-6 g/(L·h), respectively, followed by the rhizosphere soil of Amaranthus spinosus L., with the rhizosphere soil of Broussonetia papyrifera showing the weakest activity. Rumex acetosa promoted the colonization of Methylocaldum in the rhizosphere, and the small-molecule organic amine, such as triethylamine and N-methyl-aniline, secreted from the roots of this plant enhanced the tricarboxylic acid cycle and nicotinamide metabolism, thereby increasing microbial activity and improving CH4 and CB degradation efficiency. Conversely, cinnamic acid and its derivatives secreted by Broussonetia papyrifera acted as autotoxins, inhibiting microbial activity and exacerbating the negative effects of salt stress on key microbes such as methanotrophs. This study probed into the mechanisms of typical plants growing in landfill cover soil in regulating bacterial ecological functions, offering theoretical support and practical guidance for the plant-microbe joint control of landfill gas pollution.
Biodegradation, Environmental
;
Rhizosphere
;
Soil Microbiology
;
Waste Disposal Facilities
;
Chlorobenzenes/metabolism*
;
Bacteria/metabolism*
;
Soil Pollutants/metabolism*
;
Methane/metabolism*
;
Plant Roots/microbiology*
;
Amaranthus/microbiology*
;
Soil
2.Real world research on prognosis and associated risk factors of postoperative radiotherapy in breast cancer patients undergoing postmastectomy breast reconstruction
Haonan HAN ; Hailing HOU ; Baozhong ZHANG ; Jing WANG ; Yuanjie CAO ; Jinqiang YOU ; Zhongjie CHEN ; Jie CHEN ; Bailin ZHANG ; Li ZHU ; Xiangpan LI ; Ping WANG ; Liming XU
Chinese Journal of Radiation Oncology 2025;34(5):453-460
Objective:To evaluate the impact of postoperative radiotherapy (RT) and associated risk factors on the prognosis of patients undergoing postmastectomy breast reconstruction (PMBR) for breast cancer.Methods:A retrospective analysis was conducted on 1593 breast cancer patients who underwent PMBR at Tianjin Medical University Cancer Institute & Hospital between January 2010 and October 2023. Patients were divided into an RT group ( n = 351) and a non-RT group ( n =1242) based on whether postoperative radiotherapy was administered. The primary endpoints were overall survival (OS) and progression-free survival (PFS), and the secondary endpoint was the incidence of revision surgery. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were used for pairing. Continuous variables were compared between the two groups using the independent samples t-tests, while categorical variables were compared using chi-square tests, and survival analysis was performed using the Kaplan-Meier method. Cox proportional hazards model was used to analyze survival influencing factors, and include propensity factors with P<0.2 in univariate analysis into multivariate analysis. Results:In the RT group, there were 3 deaths (0.9%) and 21 cases of disease progression (6.0%); in the non-RT group, 7 patients died (0.56%) and 40 experienced disease progression (3.22%). The median OS was 20.1 months (range: 0.1-164.9), and the median PFS was 19.5 months (range: 0.1-160.9). Pregnancy-associated breast cancer and higher N stage were identified as significant risk factors for OS, while neoadjuvant therapy, absence of adjuvant chemotherapy or endocrine therapy, and higher T stage were significant risk factors affecting patients' PFS. Radiotherapy significantly reduced the survival risk for PMBR patients with pregnancy-associated breast cancer or those receiving neoadjuvant therapy ( P=0.019, 0.027). Compared with other reconstruction methods, implant-based reconstruction was associated with a lower incidence of postmastectomy revision surgery(10.5% vs. 17.0%, P<0.001). Even after radiotherapy, the revision surgery incidence for implant-based reconstruction remained lower than that of other methods (12.2% vs. 14.2%, P=0.591). Compared with other reconstruction types, expander-based reconstruction was associated with an increased incidence of revision surgery (31.9% vs. 10.9%, P<0.001). Conclusions:Postmastectomy radiotherapy can reduce survival risk in PMBR patients with pregnancy-associated breast cancer or who received neoadjuvant therapy, showing positive effects on OS and PFS in high-risk patients. Pregnancy, higher T/N stage, and specific treatment strategies are critical factors influencing the prognosis of PMBR patients. Implant-based reconstruction is associated with a lower incidence of revision surgery, which remains low even after RT, whereas expander-based reconstruction may increase the long-term risk of revision surgery.
3.Randomized controlled clinical study of Yifei Sanjie Decoction in the treatment of multiple pulmonary nodules
Mengqian LI ; Xiaomei ZHANG ; Baozhong LI ; Yuxin LAI ; Yanni LI ; Tianshu YANG ; Xinlei TAN ; Yunlong SUN
Journal of Beijing University of Traditional Chinese Medicine 2025;48(11):1519-1530
Objective To observe the efficacy and safety of Yifei Sanjie Decoction in the treatment of multiple pulmonary nodules.Methods A prospective randomized controlled clinical study was conducted to select 189 patients with multiple pulmonary nodules who saught medical attention at the Pulmonary Nodule Diagnosis and Treatment Center of Dongfang Hospital,Beijing University of Chinese Medicine and the Department of Thoracic Surgery of Beijing Shijitan Hospital Affiliated to Capital Medical University from January 2023 to March 2025.According to the random number table method,126 cases were randomly divided into the trial group and 63 cases in the blank control group at a ratio of 2∶1.The trial group was treated with modified Yifei Sanjie Decoction,and the blank control group was only followed up without intervention.The course of treatment was 3 months.The patients in the two groups were reexamined with lung CT after 3 months.The efficacy was evaluated by the area reduction rate of the major pulmonary nodules and the cumulative multiple pulmonary nodules in patients with multiple pulmonary nodules combined with the average diameter and malignant signs.According to the property of the major pulmonary nodules,we divided the patients into ground glass,solid,and mixed ground glass subgroups to evaluate the efficacy of different types of pulmonary nodules.We evaluated the change of malignant risk of pulmonary nodules according to the change of Mayo score.We evaluated the safety of the treatment medicine by blood routine,urine routine,and liver and kidney function.Results A total of 175 patients completed the study,117 in the trial group and 58 in the blank control group.The total effective rates of the major pulmonary nodules and the cumulative multiple pulmonary nodules in the trial group were 41.03%and 42.74%,respectively,the total effective rate of nodule number change was 29.91%which were significantly higher than those in the blank control group(P<0.05).In the trial group,the total effective rates of the major pulmonary nodules in the ground glass(72 cases),solid(28 cases),and mixed ground glass(17 cases)subgroups were 40.28%,32.14%,and 58.82%,respectively,the total effective rates of the cumulative multiple pulmonary nodules were 38.89%,42.86%,and 58.82%,respectively,which were significantly higher than those in corresponding subgroups of ground glass(37 cases),solid(14 cases),and mixed ground glass(7 cases)of the blank control(P<0.05).After treatment,the average diameter,area,and Mayo score of the major pulmonary nodules and the cumulative multiple pulmonary nodules in the trial group were significantly lower than those in the blank control group and before treatment(P<0.05),the average diameter,area,and Mayo score of the major pulmonary nodules and the cumulative multiple pulmonary nodules in the ground glass,solid,and mixed ground glass subgroups were lower than those in corresponding subgroups of the blank control group,and significantly lower than those before treatment(P<0.05).The number of nodules and malignant signs in the trial group were lower than before,while those in the blank control group were higher than before.There were no serious adverse events in the two groups during the study.Conclusion Yifei Sanjie Decoction can effectively treat the major pulmonary nodules and the cumulative multiple pulmonary nodules in patients with multiple pulmonary nodules,reduce the average diameter and area of nodules,reduce the Mayo score,and reduce the malignant signs and number of nodules.In the ground glass,solid,and mixed ground glass groups,the curative effect is well,and the safety is high,it can be used for the clinical treatment of multiple pulmonary nodules.
4.Randomized controlled clinical study of Yifei Sanjie Decoction in the treatment of multiple pulmonary nodules
Mengqian LI ; Xiaomei ZHANG ; Baozhong LI ; Yuxin LAI ; Yanni LI ; Tianshu YANG ; Xinlei TAN ; Yunlong SUN
Journal of Beijing University of Traditional Chinese Medicine 2025;48(11):1519-1530
Objective To observe the efficacy and safety of Yifei Sanjie Decoction in the treatment of multiple pulmonary nodules.Methods A prospective randomized controlled clinical study was conducted to select 189 patients with multiple pulmonary nodules who saught medical attention at the Pulmonary Nodule Diagnosis and Treatment Center of Dongfang Hospital,Beijing University of Chinese Medicine and the Department of Thoracic Surgery of Beijing Shijitan Hospital Affiliated to Capital Medical University from January 2023 to March 2025.According to the random number table method,126 cases were randomly divided into the trial group and 63 cases in the blank control group at a ratio of 2∶1.The trial group was treated with modified Yifei Sanjie Decoction,and the blank control group was only followed up without intervention.The course of treatment was 3 months.The patients in the two groups were reexamined with lung CT after 3 months.The efficacy was evaluated by the area reduction rate of the major pulmonary nodules and the cumulative multiple pulmonary nodules in patients with multiple pulmonary nodules combined with the average diameter and malignant signs.According to the property of the major pulmonary nodules,we divided the patients into ground glass,solid,and mixed ground glass subgroups to evaluate the efficacy of different types of pulmonary nodules.We evaluated the change of malignant risk of pulmonary nodules according to the change of Mayo score.We evaluated the safety of the treatment medicine by blood routine,urine routine,and liver and kidney function.Results A total of 175 patients completed the study,117 in the trial group and 58 in the blank control group.The total effective rates of the major pulmonary nodules and the cumulative multiple pulmonary nodules in the trial group were 41.03%and 42.74%,respectively,the total effective rate of nodule number change was 29.91%which were significantly higher than those in the blank control group(P<0.05).In the trial group,the total effective rates of the major pulmonary nodules in the ground glass(72 cases),solid(28 cases),and mixed ground glass(17 cases)subgroups were 40.28%,32.14%,and 58.82%,respectively,the total effective rates of the cumulative multiple pulmonary nodules were 38.89%,42.86%,and 58.82%,respectively,which were significantly higher than those in corresponding subgroups of ground glass(37 cases),solid(14 cases),and mixed ground glass(7 cases)of the blank control(P<0.05).After treatment,the average diameter,area,and Mayo score of the major pulmonary nodules and the cumulative multiple pulmonary nodules in the trial group were significantly lower than those in the blank control group and before treatment(P<0.05),the average diameter,area,and Mayo score of the major pulmonary nodules and the cumulative multiple pulmonary nodules in the ground glass,solid,and mixed ground glass subgroups were lower than those in corresponding subgroups of the blank control group,and significantly lower than those before treatment(P<0.05).The number of nodules and malignant signs in the trial group were lower than before,while those in the blank control group were higher than before.There were no serious adverse events in the two groups during the study.Conclusion Yifei Sanjie Decoction can effectively treat the major pulmonary nodules and the cumulative multiple pulmonary nodules in patients with multiple pulmonary nodules,reduce the average diameter and area of nodules,reduce the Mayo score,and reduce the malignant signs and number of nodules.In the ground glass,solid,and mixed ground glass groups,the curative effect is well,and the safety is high,it can be used for the clinical treatment of multiple pulmonary nodules.
5.Real world research on prognosis and associated risk factors of postoperative radiotherapy in breast cancer patients undergoing postmastectomy breast reconstruction
Haonan HAN ; Hailing HOU ; Baozhong ZHANG ; Jing WANG ; Yuanjie CAO ; Jinqiang YOU ; Zhongjie CHEN ; Jie CHEN ; Bailin ZHANG ; Li ZHU ; Xiangpan LI ; Ping WANG ; Liming XU
Chinese Journal of Radiation Oncology 2025;34(5):453-460
Objective:To evaluate the impact of postoperative radiotherapy (RT) and associated risk factors on the prognosis of patients undergoing postmastectomy breast reconstruction (PMBR) for breast cancer.Methods:A retrospective analysis was conducted on 1593 breast cancer patients who underwent PMBR at Tianjin Medical University Cancer Institute & Hospital between January 2010 and October 2023. Patients were divided into an RT group ( n = 351) and a non-RT group ( n =1242) based on whether postoperative radiotherapy was administered. The primary endpoints were overall survival (OS) and progression-free survival (PFS), and the secondary endpoint was the incidence of revision surgery. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were used for pairing. Continuous variables were compared between the two groups using the independent samples t-tests, while categorical variables were compared using chi-square tests, and survival analysis was performed using the Kaplan-Meier method. Cox proportional hazards model was used to analyze survival influencing factors, and include propensity factors with P<0.2 in univariate analysis into multivariate analysis. Results:In the RT group, there were 3 deaths (0.9%) and 21 cases of disease progression (6.0%); in the non-RT group, 7 patients died (0.56%) and 40 experienced disease progression (3.22%). The median OS was 20.1 months (range: 0.1-164.9), and the median PFS was 19.5 months (range: 0.1-160.9). Pregnancy-associated breast cancer and higher N stage were identified as significant risk factors for OS, while neoadjuvant therapy, absence of adjuvant chemotherapy or endocrine therapy, and higher T stage were significant risk factors affecting patients' PFS. Radiotherapy significantly reduced the survival risk for PMBR patients with pregnancy-associated breast cancer or those receiving neoadjuvant therapy ( P=0.019, 0.027). Compared with other reconstruction methods, implant-based reconstruction was associated with a lower incidence of postmastectomy revision surgery(10.5% vs. 17.0%, P<0.001). Even after radiotherapy, the revision surgery incidence for implant-based reconstruction remained lower than that of other methods (12.2% vs. 14.2%, P=0.591). Compared with other reconstruction types, expander-based reconstruction was associated with an increased incidence of revision surgery (31.9% vs. 10.9%, P<0.001). Conclusions:Postmastectomy radiotherapy can reduce survival risk in PMBR patients with pregnancy-associated breast cancer or who received neoadjuvant therapy, showing positive effects on OS and PFS in high-risk patients. Pregnancy, higher T/N stage, and specific treatment strategies are critical factors influencing the prognosis of PMBR patients. Implant-based reconstruction is associated with a lower incidence of revision surgery, which remains low even after RT, whereas expander-based reconstruction may increase the long-term risk of revision surgery.
6.A study on the NORAD-induced autophagy promotes oxaliplatin resistance in adenocarcinoma of the esophagogastric junction
Shoumiao LI ; Zhiqiang LIU ; Heng CAO ; Zhiyong NIE ; Hui LI ; Baozhong LI
Chinese Journal of Digestion 2024;44(4):266-273
Objective:To investigate the effects and molecular mechanism of non-coding RNA-activated DNA damage(NORAD)induced autophagy on oxaliplatin resistance in adenocarcinoma of esophagogastric junction (AEG).Methods:Four pairs of surgical samples of AEG and para-carcinoma normal tissues from patients with advance AEG treated in Anyang Tumor Hospital from January to June 2023 were collected. The expression of NORAD in AEG and para-carcinoma tissues was analyzed by long non-coding RNA microarray chip. The primary tumor cell line of AEG (PDC) was derived from fresh AEG tissues. Oxaliplatin-resistant cell lines of PDC and AEG cell line OE19 (PDC-R and OE19-R) were established. NORAD expression knockdown PDC-R and OE19 cell lines (shNORAD PDC-R and shNORAD OE19-R) were prepared by transfection. The target of NORAD, the correlation and interaction between microRNA-433-3p (miR-433-3p) and NORAD were predicted using Starbase v3.0 and DIANA-lncBase v3.0. PDC, PDC-R, OE19 and OE19-R cells were co-transfected with miR-144-3p and wild-type NORAD (NORAD-WT) or mutant NORAD (NORAD-Mut) plasmid, respectively. Dual-luciferase reporter assay was used to verify the correlation between NORAD and miR-433-3p. The expression levels of NORAD and miR-433-3p in normal gastric mucosal cell line GES-1 and AEG cell lines PDC, PDC-R, shNORAD PDC-R, OE19, OE19-R and shNORAD OE19-R were detected by real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR). The expression of p62 protein and microtubule-associated protein 1 light chain 3B-Ⅱ (LC3B-Ⅱ) was determined by Western blotting. The half inhibitory concentration (IC 50) of PDC, PDC-R, shNORAD PDC-R, OE19, OE19-R and shNORAD OE19-R cells was measured by cell counting kit-8 (CCK-8) assay. Independent sample t-test was used for statistical analysis. Results:The results of microarray analysis showed that NORAD was significantly up-regulated in AEG compared with that in para-carcinoma tissues (fold change≥2.0, P<0.05). Bioinformatics studies found that miR-433-3p was the potential target of NORAD. The results of dual-luciferase reporter assay indicated that the relative luciferase activity of the NORAD-WT group was lower than that of NORAD-Mut group in PDC and PDC-R cells (0.441±0.104 vs. 0.928±0.204, 0.449±0.112 vs. 0.947±0.201), and the differences were statistically significant ( t=-14.74 and -14.94, both P<0.001). The results of dual-luciferase reporter assay of OE19 and OE19-R cell lines were the same as those of PDC cell lines. The results of qRT-PCR showed that the expression of NORAD in GES-1 cells (1.016±0.213) was lower than that of PDC cells (2.194±0.322) and PDC-R cells (4.040±0.336), and the differences were statistically significant ( t=-14.94 and -37.21, both P<0.001). Furthermore, the expression level of NORAD in PDC was also found to be lower than that in PDC-R cells, and the difference was statistically significant ( t=-19.43, P<0.001). Additionally, shNORAD PDC-R cells exhibited lower expression level of NORAD (0.290±0.165) compared with PDC-R cells, and the difference was statistically significant ( t=-49.05, P<0.001). The expression level of miR-433-3p in GES-1 cells (1.017±0.248) was higher than that in PDC cells (0.470±0.156) and PDC-R cells (0.203±0.045), and the differences were statistically significant ( t=9.15 and 15.85, both P<0.001). Moreover, the expression level of miR-433-3p was found to be higher in PDC cells compared with PDC-R cells, and the difference was statistically significant ( t=8.11, P<0.001). Additionally, the expression level of miR-433-3p in shNORAD PDC-R cells (0.699±0.256) was also higher than that in PDC-R cells ( t=9.37, P<0.001). The results of Western blotting showed that the expression of LC3B-Ⅱ in PDC-R was higher than that in PDC cells (0.426±0.060 vs. 0.212±0.041), the expression of LC3B-Ⅱ in shNORAD PDC-R cells (0.155±0.029) was lower than that in PDC cells, and the differences were statistically significant ( t=8.70 and -79.45, both P<0.001). However the expression of p62 protein in each cell line showed an opposite trend, with a lower relative expression in PDC-R than PDC (0.205±0.031 vs. 0.311±0.400), and the expression in shNORAD PDC-R (0.504±0.084) was higher than that in PDC, and the differences were statistically significant ( t=-31.19 and 62.80, both P<0.001). The expression patterns of NORAD, miR-433-3p, LC3B-Ⅱ and p62 proteins in OE19, OE19-R and shNORAD OE19-R cells were similar to those in PDC. The results of CCK-8 assessment of target cell viability showed that the IC 50 values of PDC, PDC-R and shNORAD PDC-R cell lines were 14.28, 22.27 and 2.51 μg/mL, respectively; and the IC 50 values of OE19, OE19-R and shNORAD PDC-R cell lines were 3.95, 8.12 and 1.89 μg/mL, respectively. Conclusions:NORAD is highly expressed in AEG tissues and cells. NORAD is overexpressed in oxaliplatin-resistant cell lines and increase the autophagy activity of cells. After NORAD is knockdown, autophagy activity is inhibited and the sensitivity of AEG cells to oxaliplatin is significantly enhanced.
7.Efficacy of autofluorescence point-spectral analysis combined with the immune colloidal gold technique for the detection of ectopic microscopic parathyroid glands to guide surgery for secondary hyperparathyroidism
Kun PENG ; Baozhong YAO ; Hongcun CHEN ; Jun ZHANG ; Wenzhong BAO ; Wenbo LI ; Weitao SONG ; Sailong SANG ; Li LIN ; Zhixing JIA ; Liang LI
The Journal of Practical Medicine 2024;40(20):2905-2912
Objective To evaluate the intraoperative identification of ectopic parathyroid tissue in the central neck region using autofluorescence point-spectral analysis(AFPSA)combined with immune colloidal gold technique(ICGT),for guiding total parathyroidectomy(TPTX)or clean parathyroidectomy(CPTX)in the management of secondary hyperparathyroidism(SHPT).Methods Retrospectively collected and compared the clinical data of 64 patients with SHPT from October 2019 to June 2023.In the observation group,TPTX was performed as the initial procedure in 36 cases,followed by sampling of suspicious targets using AFPSA in the central neck area and subsequent detection through ICGT.CPTX was then conducted if a positive result was obtained.On the other hand,the control group consisted of 28 cases where only TPTX was performed without any additional tests during surgery.The surgical data,parathyroid hormone(PTH)levels,blood calcium levels,blood phosphorus levels,alkaline phosphatase(ALP)levels,regression of clinical symptoms,changes in parathyroid function and occurrence of hypocalcemia were compared between these two groups.Results In the observation group,there were 9 cases of AFPSA-ICGT positivity,including 2 left-sided cases,4 right-sided cases,and 3 thymic cases;among these posi-tive cases,there were a total of 10 locations with mildly hyperplastic or nonhyperplastic microscopic parathyroid tissue.The difference in the number of total parathyroid glands removed(including ectopic)between the two groups was statistically significant(P<0.05).At both 3 and 6 months postoperatively,ALP levels in the observation group were significantly lower than those in the control group(P<0.01 and P<0.001 respectively);at 6 months postoperatively,differences in PTH and blood phosphorus levels between the two groups were also statistically significant(P<0.05 and P<0.001 respectively).Joint bone pain and skin itching recurred in some patients within the control group at six months after surgery(P<0.05),whereas recurrence of SHPT was less frequent within the observation group compared to controls(P<0.05);however,no statistically significant differences were observed regarding postoperative hypoparathyroidism or hyperparathyroidism as well as hypocalcemia between either groups.Conclusion The AFPSA-ICGT intraoperative test can be utilized to guide surgery for SHPT,enabling accurate and efficient identification as well as safe targeting of parathyroid tissues that may not exhibit obvious hyperplasia in the central cervical region.
8.Advances of anti-HER2 targeted drugs and combined therapeutic regimens for gastric and esophagogastic adenocarcinoma
Lili DENG ; Xingyu DUAN ; Baozhong LI
Journal of International Oncology 2023;50(12):751-757
Patients with human epidermal growth factor receptor 2 (HER2) overexpression or amplification in gastric and esophagogastic adenocarcinoma can significantly benefit from anti-HER2 therapies. Presently, various humanized monoclonal antibodies such as trastuzumab and pertuzumab, alongside diverse anti-HER2 antibody drug conjugates (trastuzumab emtansine, disitamab vedotin, trastuzumab deruxtecan, ARX788), and tyrosine kinase inhibitors (lapatinib, afatinib, pyrotinib), are employed either as monotherapy or in combination settings for advanced gastric and esophagogastic adenocarcinoma. These therapeutic modalities have demonstrated promising clinical efficacy in clinical trials, thereby ameliorating patients' prognosis and enhancing life quality. Further exploration on the efficacy and safety of novel HER2-targeted agents and combined therapeutic regimens in clinical practice holds the promise of furnishing more efficacious strategies for treating HER2-positive advanced gastric and esophagogastic adenocarcinoma.
9.Treatment of Patients with Mediate-Risk Pure Ground Glass Pulmonary Nodules Based on the State Theory:A Prospective Randomize-controlled Clinical Observation
Likun CHE ; Xiaomei ZHANG ; Baozhong LI ; Mengqian LI ; Jiarui HU ; Rui LI ; Xiaolin YU ; Qiuwen XU ; Ying JIN ; Yuxin LAI ; Liangduo JIANG
Journal of Traditional Chinese Medicine 2023;64(20):2109-2115
ObjectiveTo observe the clinical efficacy and safety of treating mediate-risk pure ground glass pulmonary nodules (pGGNs) based on the state theory. MethodsA prospective clinical randomized controlled trial was used. Totally 141 cases of mediate-risk pGGNs were divided into treatment group (92 cases) and control group (49 cases) according to the random table method. The treatment group was given the basic Sanjie Formula (基础散结方) orally with modification according to the identification of traditional Chinese medicine (TCM) state, 1 dose per day, 3 months as a course of treatment.Three months after the treatment patients were checked by CT. Patients who were clinically judged as cure, moderate to low risk, and turned to surgical resection do not carry out a second course of treatment,and the rest of the patients continued to complete the second courses. Patients in the control group did not receive any treatment and were only followed up periodically. Patients in both groups received a CT review 3 months and 6 months after enrolled. Comprehensive curative effect was evaluated according to the reduction rate of the area of pulmonary nodules shown in chest CT, to further explore the clinical effective difference for patients at different TCM state; the risk of malignancy index (Mayo score) was calculated by Mayo model at enrollment and 3 months and 6 months after enrolled. Adverse events were monitored continuously during the study. ResultsDuring the follow-up, 8 cases in the treatment group and 7 cases in the control group were lost. A total of 126 cases completed the whole process, including 84 cases in the treatment group and 42 cases in the control group. The total effective rates at 3 months and 6 months of the treatment group were 46.15% (30/65) and 45.71% (32/70) in the treatment group, while the total effective rates at 3 months and 6 months in the control group were 12.5% (4/32) and 10.00% (4/40). Compared with the control group, the comprehensive curative effect of 3 months and 6 months of enrollment in treatment group was significantly better than that in corresponding control group (P<0.01). The pulmonary nodule area and Mayo score in the treatment group decreased after 3 and 6 months of enrollment (P<0.01). In contrast, there was no statistically significant difference in nodule area between pre- and post-enrollment time points in the control group (P>0.05), and probability of Mayo risk increased in the control group after 6 months of enrollment compared to pre-enrollment (P<0.05). Among the 84 patients in the treatment group, there were 15 cases of qi deficiency state, 7 cases of yin deficiency state, 5 cases of yang deficiency state, 20 cases of qi depression state, 32 cases of damp-heat state, and 5 cases of harmonious state; the difference in the distribution of the total clinical effective rate of the patients with different TCM states after treatment was statistically significant (P<0.05), and the total effective rate of two-by-two comparison of qi depression state was higher (13/20,65.00%) than that of the total effective rate of damp-heat state (8/32,25.00%, P<0.00833). There were no significant changes in blood routine, urine routine, liver function and kidney function in both groups, and no adverse events occurred. ConclusionTreating mediate-risk pGGNs based on the state theory can effectively reduce the area of pulmonary nodules and inhibit the growth of malignant risk of pulmonary nodules.
10.Predictive value of serum neurofilament light chain on neurologic function in out-of-hospital cardiac arrest patients
Fengmei YANG ; Baozhong MA ; Qiang SUN ; Nan LI ; Ying LIU ; Wenjie WANG
Chinese Journal of Emergency Medicine 2023;32(3):371-376
Objective:To determine the predictive value of serum neurofilament light chain (NfL) on neurologic function in out-of-hospital cardiac arrest (OHCA) patients.Methods:The clinical data of 96 OHCA patients admitted to Cangzhou Central Hospital from January 2018 to March 2022 were retrospectively analyzed. According to the Glasgow-Pittsburgh cerebral performance category (CPC) upon hospital discharge, the patients were divided into the favorable neurologic function (grade 1-2) and poor neurologic function (grade 3-5) groups. The difference of serum NfL was compared between the two groups, and the relationship between serum NfL and neurologic function was assessed using correlation analysis and logistic regression analysis. The area under the curve (AUC), sensitivity, and specificity of serum Nfl were calculated by receiver operating characteristic (ROC) curve. Hanley & McNeil method test was used to compare the difference of AUCs between serum NfL and neuron specific enolase (NSE).Results:Twenty-six percent (25/96) patients were discharged with favorable neurologic function. Serum NfL in the favorable neurological function group was significantly lower than that in the poor neurologic function group (47.6 pg/mL vs. 261.4 pg/mL, P<0.001). Correlation analysis showed that serum NfL was positively correlated with neurologic function ( r=0.69, P<0.001). Logistic regression analysis showed that serum NfL was independently associated with neurological function ( OR=0.92, 95% CI: 0.86-0.98; P=0.010). ROC curve indicated that the AUC of serum NfL in predicting poor neurologic function was 0.95 (95% CI: 0.92-0.99), with a sensitivity of 84.5% and a specificity of 100% at the cutoff value of 80.0 pg/mL. The AUC of serum NSE in predicting poor neurologic function was 0.79 (95% CI: 0.69-0.89), with a sensitivity of 67.6% and a specificity of 80.0% at the cutoff value of 45.1 ng/mL. A pairwise comparison using Hanley & McNeil method showed that the AUC of serum NfL in predicting poor neurologic function was higher than that of NSE ( Z=3.22, P=0.001). Conclusions:Serum NfL is helpful for clinician to predict neurologic function in OHCA patients.

Result Analysis
Print
Save
E-mail