1.Exercise intervention prescription for postmenopausal women with nonalcoholic fatty liver disease and related comorbidities
Jie JU ; Xing WANG ; Xinge ZHANG ; Changyu YANG ; Peng LIU
Journal of Clinical Hepatology 2024;40(6):1248-1254
The prevalence rate of nonalcoholic fatty liver disease(NAFLD)in postmenopausal women is significantly higher than that in premenopausal women and even exceeds that in men of the same age group,and exercise intervention remains an effective method for the prevention and treatment of NAFLD in postmenopausal women.In addition,postmenopausal women with NAFLD often have comorbidities such as sarcopenia,osteoporosis,cardiovascular diseases,and diabetes,which requires targeted exercise prescriptions and proactive intervention for potential comorbidities.Through a literature review,this article provides targeted recommendations for exercise intervention prescriptions in postmenopausal women with NAFLD and related comorbidities.
2.Evaluation of the operational efficiency of oncology department in a multi-campus public hospital based on the super efficiency DEA-Malmquist index model
Changyu QU ; Juming LIU ; Yusha GONG ; Qin YANG ; Yongxiang GONG ; Tiemei HE ; Xiaodong LIU ; Tienan YI ; Chunrong HUANG
Chinese Journal of Hospital Administration 2024;40(5):387-392
Objective:To analyze the operational efficiency of the oncology department in multi-campus hospital, providing reference for rational resource allocation and efficiency enhancement.Methods:A certaion tertiary grade A Hospital is a multi-campus public hospital with integrated management. This study focused on its oncology department, with 9 wards located in different campus as decision-making units. Data from 2020 to 2022 were extracted from the hospital′s medical records management system, disease diagnosis-related groups management system, and hospital information system. The super-efficiency DEA model and Malmquist index model were used to evaluate efficiency variations of the oncology department in different time slots and decision-making units. Identifying input redundancies and output deficiencies in wards not achieving constant returns to scale through projection value analysis. Selecting the total number of medical staff and the actual total number of bed-days occupied as input indicators, while bed utilization rate, discharge rate, and case mix index as output indicators.Results:From 2020 to 2022, the wards with a DEA super-efficiency value greater than 1 were 0, 2, and 4, respectively, showing a gradual increase in overall efficiency. In 2022, wards S3, S4, S7, and S9 achieved constant returns to scale with super-efficiency values of 1.001, 1.005, 1.113, and 1.112, respectively. The other five wards had zero input redundancy, but some suffered from insufficient outputs. For example, wards S5 and S8 should increase their bed utilization rates by 5% and 4%, respectively. Wards S1 and S8 needed to increase their annual discharge numbers by 24% and 1%, respectively, while wards S2 and S6 should increase their annual case mix index by 21% and 20%, respectively. From 2020 to 2021, the Malmquist index of the oncology department was 0.959, while from 2021 to 2022 it rose to 1.030, and the Malmquist index of each ward was greater than 1.Conclusions:By implementing integrated management across multiple campus, the operational efficiency of the oncology department has been comprehensively improved. The use of the super efficient DEA-Malmquist index model to evaluate the operational efficiency of departments has practical significance.
3.Adjuvant chemotherapy versus adjuvant concurrent chemoradiotherapy after radical surgery for early-stage cervical cancer: a randomized, non-inferiority, multicenter trial.
Danhui WENG ; Huihua XIONG ; Changkun ZHU ; Xiaoyun WAN ; Yaxia CHEN ; Xinyu WANG ; Youzhong ZHANG ; Jie JIANG ; Xi ZHANG ; Qinglei GAO ; Gang CHEN ; Hui XING ; Changyu WANG ; Kezhen LI ; Yaheng CHEN ; Yuyan MAO ; Dongxiao HU ; Zimin PAN ; Qingqin CHEN ; Baoxia CUI ; Kun SONG ; Cunjian YI ; Guangcai PENG ; Xiaobing HAN ; Ruifang AN ; Liangsheng FAN ; Wei WANG ; Tingchuan XIONG ; Yile CHEN ; Zhenzi TANG ; Lin LI ; Xingsheng YANG ; Xiaodong CHENG ; Weiguo LU ; Hui WANG ; Beihua KONG ; Xing XIE ; Ding MA
Frontiers of Medicine 2023;17(1):93-104
We conducted a prospective study to assess the non-inferiority of adjuvant chemotherapy alone versus adjuvant concurrent chemoradiotherapy (CCRT) as an alternative strategy for patients with early-stage (FIGO 2009 stage IB-IIA) cervical cancer having risk factors after surgery. The condition was assessed in terms of prognosis, adverse effects, and quality of life. This randomized trial involved nine centers across China. Eligible patients were randomized to receive adjuvant chemotherapy or CCRT after surgery. The primary end-point was progression-free survival (PFS). From December 2012 to December 2014, 337 patients were subjected to randomization. Final analysis included 329 patients, including 165 in the adjuvant chemotherapy group and 164 in the adjuvant CCRT group. The median follow-up was 72.1 months. The three-year PFS rates were both 91.9%, and the five-year OS was 90.6% versus 90.0% in adjuvant chemotherapy and CCRT groups, respectively. No significant differences were observed in the PFS or OS between groups. The adjusted HR for PFS was 0.854 (95% confidence interval 0.415-1.757; P = 0.667) favoring adjuvant chemotherapy, excluding the predefined non-inferiority boundary of 1.9. The chemotherapy group showed a tendency toward good quality of life. In comparison with post-operative adjuvant CCRT, adjuvant chemotherapy treatment showed non-inferior efficacy in patients with early-stage cervical cancer having pathological risk factors. Adjuvant chemotherapy alone is a favorable alternative post-operative treatment.
Female
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Humans
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Uterine Cervical Neoplasms/drug therapy*
;
Prospective Studies
;
Quality of Life
;
Neoplasm Staging
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Chemoradiotherapy
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Chemotherapy, Adjuvant/adverse effects*
;
Adjuvants, Immunologic
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Antineoplastic Combined Chemotherapy Protocols/therapeutic use*
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Retrospective Studies
4.Th2 cells infiltrating high-grade serous ovarian cancer: a feature that may account for the poor prognosis
Hao SU ; Yueqi JIN ; Changyu TAO ; Hua YANG ; Ence YANG ; Wei-Guang ZHANG ; Fengzhi FENG
Journal of Gynecologic Oncology 2023;34(4):e48-
Objective:
We aimed to investigate the differences of transcriptome profile between 2 groups of high-grade serous ovarian cancer (HGSOC) patients with distinct outcomes and identify potential biomarkers for recurrence.
Methods:
RNA sequencing was performed in 2 groups of HGSOC patients with similar demographic characteristics but exhibiting distinct progression-free survival (PFS). Transcriptome data of poor response (PR; PFS ≤6 months) and good response (GR; PFS ≥12 months) group were compared. We employed xCell to evaluate the abundance of 63 cells in tumor microenvironment. The predictive value of recurrence-related tumor infiltration cells was validated in cohort data from Gene Expression Omnibus (GEO) and The Cancer Genome Atlas (TCGA) dataset. The weighted correlation network analysis was performed to identify the genes related to cell infiltration.
Results:
PR patients exhibited a distinct tumor infiltration immune cells-related transcriptional profile compared to GR patients, such as lower signatures of leukocyte differentiation, activation and chemotaxis. The fraction of T-helper 2 (Th2) cells infiltration was significantly higher in PR group than in GR group. High infiltration of Th2 was significantly associated with unfavorable prognosis in the GEO cohort (area under the curve=0.84 at 6 months recurrence) and TCGA cohort (p=0.008). Genes enriched to extracellular matrix organization and integrin binding were relevant to Th2 infiltration.
Conclusion
Patients with HGSOC having shorter PFS exhibited a distinct gene signature that related to tumor-infiltrating immune cells. The level of Th2 infiltration could facilitate patient recurrence risk stratification and may be a promising biomarker for prognosis prediction and immune-related treatment.
5.Application of MRI WARP sequence in periprosthetic joint infection
Changyu HUANG ; Xinyu FANG ; Yang CHEN ; Jian MEI ; Zida HUANG ; Chaofan ZHANG ; Wenbo LI ; Wenming ZHANG
Chinese Journal of Orthopaedic Trauma 2021;23(8):663-668
Objective:To explore whether MRI WARP sequence can provide clearer musculoskeletal images to guide the operation for patients with periprosthetic joint infection (PJI) by comparing MRI WARP sequence images with conventional sequence images.Methods:The data were analyzed retrospectively of 23 PJI patients who had been diagnosed and treated at Department of Orthopedics, The First Affiliated Hospital to Fujian Medical University from January 2020 to February 2021. They were 13 females and 10 males, with an average age of 62.8 years (from 32 to 88 years). According to the MRI sequences, they were divided into a WARP group ( n=14) subjected to MRI scanning by WARP sequence and a conventional group ( n=9) subjected to MRI scanning by conventional sequence. The gender, age, erythrocyte sedimentation rate (ESR) and C-reaction protein (CRP) were recorded for both groups. The signal-to-noise ratios were compared between the 2 sequences and 2 experts evaluated the clarity and surgical guidance of the images. Results:There was no significant difference in gender, age, CRP or ESR between the 2 groups, showing comparability ( P>0.05). The 2 experts showed consistency in evaluation of image sharpness and surgical guidance ( P<0.05). The WARP group was significantly better than the conventional group in image sharpness score [2.25(2.0, 2.6) versus 1.00 (0.5, 1.0)], surgical guidance score [2.00(1.5, 2.5) versus 0.50(0, 0.8)], and signal-to-noise ratio [47.28 (32.8, 74.3) versus 21.67(13.5, 31.4)] ( P<0.05). Conclusion:MRI WARP sequence can provide clearer musculoskeletal images than conventional MRI sequence to better guide the operation for PJI patients.
6.Protective effect of α-asarone and β-asarone on Aβ -induced inflammatory response in PC12 cells and its.
Jianhong SHI ; Ruizhi LI ; Yuanxiao YANG ; Liting JI ; Changyu LI
Journal of Zhejiang University. Medical sciences 2021;50(5):591-600
To investigate effects of α-asarone and β-asarone on induced PC12 cell injury and related mechanisms. Aβ toxic injury cell model was induced by Aβ in PC12 cells. PC12 cells were divided into blank control group, model control group, α-asarone group (0.5, 1.0, β-asarone group (6.3, 12.5, vasoactive intestinal peptide (VIP) group, and VIP antagonist control group. Cell survival rate was detected by CCK-8 kit; cell apoptosis rate was detected by flow cytometry. The levels of inflammatory cytokines interleukin (IL)-1, , tumor necrosis factor (TNF)-α, oxidation-related inducible nitric oxide synthase (iNOS), nitric oxide (NO), apoptosis factors caspase-3 and p53 were detected by ELISA method. The expressions of C-Jun N-terminal kinase (JNK) and p38 mitogen-activated protein kinase (p38MAPK) were detected by Western blotting. Compared with model control group, cell survival rates of group, β-asarone group and VIP group increased; the cell apoptosis rate decreased; levels of apoptosis-related factors caspase-3, p53, inflammatory factors IL-1, TNF-α decreased; IL-10 level increased; levels of oxidization-related factors iNOS and NO decreased; the expression of JNK and p38MAPK protein decreased (all <0.05). After VIP antagonist intervention, the survival rate of β-asarone group decreased; apoptosis rate increased; apoptosis related factors caspase-3, p53, inflammatory factors IL-1, TNF-α increased; IL-10 decreased; oxidation related factors iNOS and NO increased; the expression of JNK and p38MAPK protein increased (all <0.05); while there were no significant changes in these indicators of α-asarone group (all >0.05). α-asarone and β-asarone have protective effects on PC12 cell injury induced by Aβ. β-asarone may inhibit inflammatory factors and oxidation-related factors through promoting VIP secretion, regulating JNK/MAPK pathway, and reducing PC12 cell apoptosis; however, the effect of α-asarone may be not related to VIP secretion.
Allylbenzene Derivatives
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Animals
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Anisoles/pharmacology*
;
Apoptosis
;
PC12 Cells
;
Rats
7.Effects of Nicorandil on the Proliferation ,Migration Ability and Hippo/YAP Signaling Pathway of Pulmonary Artery Smooth Muscle Cells
Fengnan CHEN ; Tingyuan LANG ; Changyu WU ; Xiaojun YU ; Xinmu SHI ; Kai SHEN ; Haiyan YANG
China Pharmacy 2020;31(22):2736-2740
OBJECTIVE:To evaluate the effects of nicorand il on the proliferation ,migration ability and Hippo/YAP signaling pathway of pulmonary artery smooth muscle cells (PASMCs). METHODS :Human primary PASMCs were divided into normal control group ,model group ,nicorandil low ,medium and high concentration groups (50,100,200 μmol/L),with 3 holes in each group. In addition to the normal control group ,the rest of the cells were inoculated on the gel coated medium to simulate the pulmonary hypertension environment ,so as to establish AS cell model. Then ,each drug group was added with corresponding drugs,and the normal control group and model group were added with the same volume of normal saline ,and cultured for 48 h. CCK-8 assay and Transwell assay were used for the examination of cell proliferation (by light density )and migration ability , respectively. mRNA expression of YAP target factors (CTGF and AREG )were examined by qRT-PCR. Western blotting assay was used to detect the protein expression of CTGF and AREG. RESULTS :Compared with normal control group ,light density of cells was increased significantly in model group ;the number of migration cells per field of view increased significantly ;mRNA and protein expression of CTGF and AREG were significantly increased (P<0.01). Compared with model group ,light density ,the number of migration cells per field of view ,mRNA and protein expression of CTGF and AREG in nicorandil low ,medium and high concentration groups were decreased significantly , in concentration-dependent manner (P<0.05 or P<0.01). CONCLUSIONS:Nicorandil can inhibit the proliferation and migration of PASMCs in AS model ,the mechanism of which cstc2019jscx-msxmX0174) may be associated with the Hippo/YAP signaling pathway.
8.Application strategy and effect of cuffed tracheostomy tube with inner cannula in the treatment of postoperative complications of laryngeal or hypopharyngeal cancer
Jinjin YUAN ; Dapeng LI ; Yehai LIU ; Kaile WU ; Yi ZHAO ; Jing WU ; Changyu YAO ; Yang WANG
Chinese Journal of Oncology 2020;42(11):976-979
Objective:To Investigate the application strategy and effect of cuffed tracheostomy tube with inner cannula in the treatment of postoperative complications of laryngeal and hypopharyngeal cancer.Methods:A total of 60 patients with laryngeal and hypopharyngeal cancer occurred serious postoperative complications, including 31 cases of severe postoperative neck infection, 8 cases of dyspnea, 5 cases of massive hemorrhage and 16 cases of seriously intractable aspiration. The tracheal cannula with inner cannula and outer cuff was immediately worn on these patients and the cuff was inflated. Different treatments were carried out according to different complications. The outer cuffs were inflated for patients with severe neck infections to prevent a large amount of neck secretions inhaled to the trachea. Patients with dyspnea immediately received ventilator-assisted ventilation. For those with massive hemorrhage on the wound, doctors should prevent bleeding and stop bleeding under general anesthesia. Patients with severely coughing should perform eating training to prevent food aspiration. The inner cannula was regularly replaced once a month for all of these patients.Results:Through targeted treatment, the complications of 60 patients with cuffed tracheostomy tube with inner cannula were effectively controlled. After dressing change, the neck wounds of 31 patients with neck infection were shrunk or healed. Finally, all of the patients were replaced with metal tracheal tubes. Eight cases with dyspnea were rescued with the symptomatic and related special treatment, and finally replace by metal tracheal tube. Five cases with massive bleeding in the neck wound were successfully rescued and replaced with metal tracheal cannula. Thirteen patients among 16 cases with intractable aspiration were removed the tracheal cannula and other 3 cases of old and severely ill were replaced with metal tracheal cannula.Conclusions:The cuffed tracheostomy tube with inner cannula is of great value in the treatment of severe postoperative complications of laryngeal or hypopharyngeal cancer. It is strongly recommended that the operators should fully understand and use it reasonably after the operation of laryngeal or hypopharyngeal cancer.
9.Application strategy and effect of cuffed tracheostomy tube with inner cannula in the treatment of postoperative complications of laryngeal or hypopharyngeal cancer
Jinjin YUAN ; Dapeng LI ; Yehai LIU ; Kaile WU ; Yi ZHAO ; Jing WU ; Changyu YAO ; Yang WANG
Chinese Journal of Oncology 2020;42(11):976-979
Objective:To Investigate the application strategy and effect of cuffed tracheostomy tube with inner cannula in the treatment of postoperative complications of laryngeal and hypopharyngeal cancer.Methods:A total of 60 patients with laryngeal and hypopharyngeal cancer occurred serious postoperative complications, including 31 cases of severe postoperative neck infection, 8 cases of dyspnea, 5 cases of massive hemorrhage and 16 cases of seriously intractable aspiration. The tracheal cannula with inner cannula and outer cuff was immediately worn on these patients and the cuff was inflated. Different treatments were carried out according to different complications. The outer cuffs were inflated for patients with severe neck infections to prevent a large amount of neck secretions inhaled to the trachea. Patients with dyspnea immediately received ventilator-assisted ventilation. For those with massive hemorrhage on the wound, doctors should prevent bleeding and stop bleeding under general anesthesia. Patients with severely coughing should perform eating training to prevent food aspiration. The inner cannula was regularly replaced once a month for all of these patients.Results:Through targeted treatment, the complications of 60 patients with cuffed tracheostomy tube with inner cannula were effectively controlled. After dressing change, the neck wounds of 31 patients with neck infection were shrunk or healed. Finally, all of the patients were replaced with metal tracheal tubes. Eight cases with dyspnea were rescued with the symptomatic and related special treatment, and finally replace by metal tracheal tube. Five cases with massive bleeding in the neck wound were successfully rescued and replaced with metal tracheal cannula. Thirteen patients among 16 cases with intractable aspiration were removed the tracheal cannula and other 3 cases of old and severely ill were replaced with metal tracheal cannula.Conclusions:The cuffed tracheostomy tube with inner cannula is of great value in the treatment of severe postoperative complications of laryngeal or hypopharyngeal cancer. It is strongly recommended that the operators should fully understand and use it reasonably after the operation of laryngeal or hypopharyngeal cancer.
10. Therapeutic effect of Jin Long capsule combined with neoadjuvant chemotherapy on invasive breast cancer and the expression change of multidrug resistance proteins
Tongyin YANG ; Wei YI ; Jing WEN ; Changyu GAN ; Yingchun YANG ; Ming DAI
Chinese Journal of Oncology 2019;41(2):118-123
Objective:
To investigate the therapeutic effect of Jin Long Capsule (JLC) combined with neoadjuvant chemotherapy on the invasive breast cancer, and to explore the mechanism of JLC in inhibiting multidrug resistance of breast cancer.
Methods:
200 patients were divided into experimental group and control group (100 cases per group). The control group used TEC regimen for neoadjuvant chemotherapy. And the experimental group was treated with TEC regimen combined with oral JLC. According to the Miller & Payne grading system (MP), the efficacy of neoadjuvant chemotherapy was evaluated based on histopathological changes of breast cancer after neoadjuvant chemotherapy. Adverse effect was evaluated according to the classification criteria of the National Cancer Institute of the United States-The Common Terminology Criteria for Adverse Events (CTCAE) version 3.0. The expression of P-glycoprotein (P-gp), glutathione thiol transferase (GST)-π and topoisomerase Ⅱα (TopoⅡα) in breast cancer tissues before and after neoadjuvant chemotherapy were detected by immunohistochemical staining.
Results:
There were 83 effective cases (83%) in the experimental group, which was higher than that in the control group (65.0%,

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