1.Analysis of the safety and efficacy of neoadjuvant immunotherapy combined with chemotherapy for radical resection of locally advanced gastric cancer: a two-center propensity-matched study
Chenbin LYU ; Jun LU ; Binbin XU ; Hongda PAN ; Qiuxian CHEN ; Jie CHEN ; Yuqin SUN ; Yongbin ZHANG ; Lisheng CAI ; Fenglin LIU
Chinese Journal of Surgery 2025;63(10):952-961
Objective:To investigate the impact of neoadjuvant immunotherapy combined with chemotherapy on the safety and efficacy of radical resection in patients with cT3-4NxM0 gastric cancer.Methods:A retrospective cohort study method was used. The clinicopathological data of 515 patients who underwent radical gastrectomy after neoadjuvant treatment at Second Department of Gastric Surgery,Fudan University Shanghai Cancer Center and Department of Gastric Surgery,Zhangzhou Hospital Affiliated to Fujian Medical University from January 2020 to June 2023 were collected. Among them,379 patients received neoadjuvant chemotherapy alone(chemotherapy group),and 136 patients received neoadjuvant immunotherapy combined with chemotherapy(immunotherapy group). There were 382 males and 133 females,with an age of (58.4±10.9)years(range:26 to 85 years). To reduce the influence of potential confounding factors,a 1∶1 propensity score matching method was adopted,and the clamp value was 0.02. The peri-operative safety,imaging and postoperative pathological tumor regression,and prognosis were compared by independent sample t-test, Mann-Whitney U test, χ 2 test or Fisher exact probability method between the two groups. The Kaplan-Meier method was used to draw survival curves, and the differences between groups were compared by Log-rank test. Results:After matching, there were 101 patients in each of the chemotherapy group and the immunotherapy group. The baseline data of the patients in the two groups were evenly distributed (all P>0.05). According to the RECIST 1.1 criteria, the complete response rate (11.9% (12/101) vs. 4.0% (4/101)), partial response rate(68.3%(69/101) vs. 53.4%(54/101)), stable disease rate (17.8%(18/101) vs. 39.6%(40/101)) and disease progression rate (2.0%(2/101) vs. 3.0%(3/101)) between the immunotherapy group and the chemotherapy group were no statistical defferences ( χ2=14.374, P=0.002), and objective response rate (80.2%(81/101) vs. 57.4%(58/101), χ2=12.203, P<0.01) in the immunotherapy group was higher than that in the chemotherapy group. The results of postoperative pathological examination showed that the immunotherapy group had a higher complete response rate (16.8%(17/101) vs. 6.9% (7/101), χ2=4.728, P=0.030) and major pathological response rate (42.6%(43/101) vs. 23.8% (24/101), χ2=8.062, P=0.005). For the two groups, the operation time (175.0(76.0)minutes vs. 160.0 (30.0)minutes, Z=-0.059, P=0.953), intraoperative blood loss (110.0 (150.0)ml vs. 100.0 (120.0)ml, Z=-0.370, P=0.712), overall incidence of postoperative complications (20.8%(21/101) vs. 18.8%(19/101), χ2=0.125, P=0.724) and incidence of severe complications (5.0%(5/101) vs. 3.0%(3/101), χ2=0.130, P=0.718) were comparable. The median follow-up time of all patients was 46 months(range: 19 to 61 months). The 3-year overall survival rate (63.2% vs. 54.4%, P=0.035) and progression-free survival rate (59.1% vs. 45.6%, P=0.022) of the immunotherapy group were higher than those of the chemotherapy group. Meanwhile, there were no statistically significant differences in the incidence of neoadjuvant-treatment-related adverse events (48.5%(49/101) vs. 40.6% (41/101), χ2=1.283, P=0.411) and the incidence of severe adverse reactions of grade 3 or above (13.9% (14/101) vs. 10.9% (11/101), χ2=0.257, P=0.522) between the two groups. Conclusion:Neoadjuvant immunotherapy combined with chemotherapy can significantly improve the imaging and postoperative pathological tumor response rates and 3-year survival rate of patients with locally advanced gastric cancer,without increasing the incidence of postoperative complications and neoadjuvant treatment-related adverse event.
2.Analysis of the safety and efficacy of neoadjuvant immunotherapy combined with chemotherapy for radical resection of locally advanced gastric cancer: a two-center propensity-matched study
Chenbin LYU ; Jun LU ; Binbin XU ; Hongda PAN ; Qiuxian CHEN ; Jie CHEN ; Yuqin SUN ; Yongbin ZHANG ; Lisheng CAI ; Fenglin LIU
Chinese Journal of Surgery 2025;63(10):952-961
Objective:To investigate the impact of neoadjuvant immunotherapy combined with chemotherapy on the safety and efficacy of radical resection in patients with cT3-4NxM0 gastric cancer.Methods:A retrospective cohort study method was used. The clinicopathological data of 515 patients who underwent radical gastrectomy after neoadjuvant treatment at Second Department of Gastric Surgery,Fudan University Shanghai Cancer Center and Department of Gastric Surgery,Zhangzhou Hospital Affiliated to Fujian Medical University from January 2020 to June 2023 were collected. Among them,379 patients received neoadjuvant chemotherapy alone(chemotherapy group),and 136 patients received neoadjuvant immunotherapy combined with chemotherapy(immunotherapy group). There were 382 males and 133 females,with an age of (58.4±10.9)years(range:26 to 85 years). To reduce the influence of potential confounding factors,a 1∶1 propensity score matching method was adopted,and the clamp value was 0.02. The peri-operative safety,imaging and postoperative pathological tumor regression,and prognosis were compared by independent sample t-test, Mann-Whitney U test, χ 2 test or Fisher exact probability method between the two groups. The Kaplan-Meier method was used to draw survival curves, and the differences between groups were compared by Log-rank test. Results:After matching, there were 101 patients in each of the chemotherapy group and the immunotherapy group. The baseline data of the patients in the two groups were evenly distributed (all P>0.05). According to the RECIST 1.1 criteria, the complete response rate (11.9% (12/101) vs. 4.0% (4/101)), partial response rate(68.3%(69/101) vs. 53.4%(54/101)), stable disease rate (17.8%(18/101) vs. 39.6%(40/101)) and disease progression rate (2.0%(2/101) vs. 3.0%(3/101)) between the immunotherapy group and the chemotherapy group were no statistical defferences ( χ2=14.374, P=0.002), and objective response rate (80.2%(81/101) vs. 57.4%(58/101), χ2=12.203, P<0.01) in the immunotherapy group was higher than that in the chemotherapy group. The results of postoperative pathological examination showed that the immunotherapy group had a higher complete response rate (16.8%(17/101) vs. 6.9% (7/101), χ2=4.728, P=0.030) and major pathological response rate (42.6%(43/101) vs. 23.8% (24/101), χ2=8.062, P=0.005). For the two groups, the operation time (175.0(76.0)minutes vs. 160.0 (30.0)minutes, Z=-0.059, P=0.953), intraoperative blood loss (110.0 (150.0)ml vs. 100.0 (120.0)ml, Z=-0.370, P=0.712), overall incidence of postoperative complications (20.8%(21/101) vs. 18.8%(19/101), χ2=0.125, P=0.724) and incidence of severe complications (5.0%(5/101) vs. 3.0%(3/101), χ2=0.130, P=0.718) were comparable. The median follow-up time of all patients was 46 months(range: 19 to 61 months). The 3-year overall survival rate (63.2% vs. 54.4%, P=0.035) and progression-free survival rate (59.1% vs. 45.6%, P=0.022) of the immunotherapy group were higher than those of the chemotherapy group. Meanwhile, there were no statistically significant differences in the incidence of neoadjuvant-treatment-related adverse events (48.5%(49/101) vs. 40.6% (41/101), χ2=1.283, P=0.411) and the incidence of severe adverse reactions of grade 3 or above (13.9% (14/101) vs. 10.9% (11/101), χ2=0.257, P=0.522) between the two groups. Conclusion:Neoadjuvant immunotherapy combined with chemotherapy can significantly improve the imaging and postoperative pathological tumor response rates and 3-year survival rate of patients with locally advanced gastric cancer,without increasing the incidence of postoperative complications and neoadjuvant treatment-related adverse event.
3.Research progress on wearable physiological parameter monitoring and its clinical applications.
Chenbin MA ; Haoran XU ; Deyu LI ; Zhengbo ZHANG
Journal of Biomedical Engineering 2021;38(3):583-593
Wearable physiological parameter monitoring devices play an increasingly important role in daily health monitoring and disease diagnosis/treatment due to their continuous dynamic and low physiological/psychological load characteristics. After decades of development, wearable technologies have gradually matured, and research has expanded to clinical applications. This paper reviews the research progress of wearable physiological parameter monitoring technology and its clinical applications. Firstly, it introduces wearable physiological monitoring technology's research progress in terms of sensing technology and data processing and analysis. Then, it analyzes the monitoring physiological parameters and principles of current medical-grade wearable devices and proposes three specific directions of clinical application research: 1) real-time monitoring and predictive warning, 2) disease assessment and differential diagnosis, and 3) rehabilitation training and precision medicine. Finally, the challenges and response strategies of wearable physiological monitoring technology in the biomedical field are discussed, highlighting its clinical application value and clinical application mode to provide helpful reference information for the research of wearable technology-related fields.
Monitoring, Physiologic
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Wearable Electronic Devices
4.Diagnosis and surgical treatment of symptomatic lumbar spinal epidural liposis.
Shi-Rong GU ; Ming ZHANG ; Hui CHENBIN ; Pei-Ming SANG ; Hai-Ming FANG
China Journal of Orthopaedics and Traumatology 2021;34(5):458-461
OBJECTIVE:
To explore diagnosis and surgical treatment of symptomatic lumbar spinal epidural lipoplasia.
METHODS:
A retrospective analysis of 19 patients with symptomatic lumbar spinal epidural hyperplasia treated with hemilaminectomy and interbody fusion and internal fixation from February 2012 to November 2018 were performed, including 7 males and 12 females, aged from 48 to 72 years old with an average of (57.6±1.2) years old;the course of disease ranged from 6 to 60 months with an average of (18.6±5.1) months;plane requiring decompression:L
RESULTS:
All patients were followed up from 12 to 37 months with an average of (16.3±3.8) months. Ninteen patients were successfully completed operation, and all adipose tissues in the compressed segment of the spinal canal were removed. Operation time was from 125 to 260 min with an average of (186± 15) min, and blood bleeding was from 150 to 500 ml with an average of (280±46) ml. Two patients occurred partial incision fat liquefaction and exudate did not heal, the incision was opened to remove effusion, the dressing was changed and anti-inflammatory treatments were performed. No complications such as cauda equina injury, cerebrospinal fluid leakage, and broken nails occurred. Preopertaive VAS of back pain and leg pain were 5.3±0.7 and 6.8±0.8, respectively, while 2.1±0.4 and 2.3±0.5 respectively at 6 months after opertaion, there were statisticalsignificant difference between 6 months after operation and before operation (
CONCLUSION
Patients with symptomatic lumbar spinal epidural lipoplasia undergo hemilaminectomy and internal fixation of compression segment could relieve compression of dura mater and cauda equina, and achieve good clinical results.
Back Pain
;
Child, Preschool
;
Female
;
Humans
;
Infant
;
Lumbar Vertebrae/surgery*
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Male
;
Retrospective Studies
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Spinal Fusion
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Treatment Outcome
5. Reconstruction of philtrum using Muscle Tension Lines Group in microform cleft lip
Chenbin DONG ; Jun LI ; Xiangqi LIU ; Shuai ZHANG
Chinese Journal of Plastic Surgery 2019;35(1):28-30
Objective:
This study is to investigate the effectiveness of philtrum repairment for-microform cleft lip, using muscle tension line group reconstruction.
Methods:
This is a retrospective study of 19 consecutively primary microform cleft lip repairment patients, from January 2015 to December 2017. All the patients were provided muscle tension line reconstruction (group 1) or traditional muscle repairment by horizontal mattress sutures (group 2). The philtral ridge and dimple were evaluated by scores. The statistical analyses were performed using unpaired
6. The clinical application of the location of euryon in nonsyndromic sagittal synostosis
Xiangqi LIU ; Jun LI ; Shuai ZHANG ; Chenbin DONG
Chinese Journal of Plastic Surgery 2019;35(2):128-131
Objective:
In clinical, cephalic index is the most common method to evaluate scaphocephaly. However, cephalic index alone is not sufficient to describe the nuances of skull shape. The authors hypothesize that the location of euryon could be a valuable and practical index as the supplement of cephalic index to better describe the skull.
Methods:
This is a retrospective study. CT scans of 17 scaphocephaly patients and 17 normal controls were included. Eight of 17 scaphocephaly patients have 6 months postoperative CT scan. The preoperative location of euryon of scaphocephaly patients was compared to that of the controls and postoperative. The horizontal location of euryon was defined as the ratio of the distance, from the most prominent point of forehead to euryon, to anteroposterior cranial length. The vertical location of euryon was defined as the ratio of the vertical distance, from the nasion to euryon, to cranial height.
Results:
Both the horizontal and vertical locations of euryon of preoperative scaphocephaly patients were significantly decreased compared to normals (46.50%±4.02% vs. 50.39%±2.21%,
7. Association study of genetic variations in SLCO1B3 gene with prognosis in breast cancer patients treated with neoadjuvant chemotherapy of TA regimen
Zhongli DU ; Chengshan XU ; Zhimin BIAN ; Mingting PENG ; Chenbin LI ; Ting FENG ; Xiaozhou XU ; Haijing LIU ; Bailin ZHANG
Chinese Journal of Oncology 2019;41(8):587-593
Objective:
To assess the association of single nucleotide polymorphisms (SNPs) in SLCO1B3 gene with prognosis of breast cancer (BC) patients treated with neoadjuvant chemotherapy of TA regimen (taxane and antharcycline drugs).
Methods:
439 female BC patients were recruited and treated with neoadjuvant chemotherapy of TA regimen. A blood sample (2 ml) of peripheral blood was collected from each patient before chemotherapy. Tagging SNPs (tag-SNPs) were selected. We investigated the association of tag-SNPs with prognosis, by Sequenom Mass ARRAY system platform, characterizing tag-SNPs. The hazard ratio (
8.Association study of genetic variations in SLCO1B3 gene with prognosis in breast cancer patients treated with neoadjuvant chemotherapy of TA regimen
Zhongli DU ; Chengshan XU ; Zhimin BIAN ; Mingting PENG ; Chenbin LI ; Ting FENG ; Xiaozhou XU ; Haijing LIU ; Bailin ZHANG
Chinese Journal of Oncology 2019;41(8):587-593
Objective To assess the association of single nucleotide polymorphisms ( SNPs) in SLCO1B3 gene with prognosis of breast cancer (BC) patients treated with neoadjuvant chemotherapy of TA regimen (taxane and antharcycline drugs). Methods 439 female BC patients were recruited and treated with neoadjuvant chemotherapy of TA regimen.A blood sample (2 ml) of peripheral blood was collected from each patient before chemotherapy. Tagging SNPs (tag?SNPs) were selected. We investigated the association of tag?SNPs with prognosis, by Sequenom Mass ARRAY system platform, characterizing tag?SNPs. The hazard ratio ( HR ) and 95% confidence interval ( CI ) for progression or death were calculated by multivariable?adjusted Cox regression model. Results Seven tag?SNPs ( rs11045689, rs200104106, rs3764006, rs3834935, rs4149117, rs7305323 and rs73241801) were selected for study. Compared with individuals carrying the rs11045689 GG genotype, individuals carrying rs11045689 AA genotype performed worse PFS and OS, with the HR (95% CI) for progression being 1.39 (1.11~1.75) and the HR (95% CI) for death being 1.38 ( 1.04~1.83). Compared with individuals carrying the rs73241801 CC genotype, individuals carrying rs73241801 TT genotype performed better OS (P=0.041), with the HR (95% CI) for death being 0.65 (0.44~0.94). The number of risk allele was significantly associated with PFS (P=0.012) and OS (P=0.017) of BC patients by accumulation analysis. Compared with individuals carrying one or less than one risk allele, individuals carrying four risk alleles performed worse PFS and OS, with the HR (95%CI) for progression being 1.37 (1.09~1.72) and the HR ( 95% CI) for death being 1.36 (1.02~1.81). Conclusion The variations of rs11045689 and rs73241801 in SLCO1B3 gene were significantly associated with prognosis of BC patients treated with neoadjuvant chemotherapy of TA regimen, which might serve as biomarkers for predicting prognosis of BC patients treated with neoadjuvant chemotherapy.
9.Association study of genetic variations in SLCO1B3 gene with prognosis in breast cancer patients treated with neoadjuvant chemotherapy of TA regimen
Zhongli DU ; Chengshan XU ; Zhimin BIAN ; Mingting PENG ; Chenbin LI ; Ting FENG ; Xiaozhou XU ; Haijing LIU ; Bailin ZHANG
Chinese Journal of Oncology 2019;41(8):587-593
Objective To assess the association of single nucleotide polymorphisms ( SNPs) in SLCO1B3 gene with prognosis of breast cancer (BC) patients treated with neoadjuvant chemotherapy of TA regimen (taxane and antharcycline drugs). Methods 439 female BC patients were recruited and treated with neoadjuvant chemotherapy of TA regimen.A blood sample (2 ml) of peripheral blood was collected from each patient before chemotherapy. Tagging SNPs (tag?SNPs) were selected. We investigated the association of tag?SNPs with prognosis, by Sequenom Mass ARRAY system platform, characterizing tag?SNPs. The hazard ratio ( HR ) and 95% confidence interval ( CI ) for progression or death were calculated by multivariable?adjusted Cox regression model. Results Seven tag?SNPs ( rs11045689, rs200104106, rs3764006, rs3834935, rs4149117, rs7305323 and rs73241801) were selected for study. Compared with individuals carrying the rs11045689 GG genotype, individuals carrying rs11045689 AA genotype performed worse PFS and OS, with the HR (95% CI) for progression being 1.39 (1.11~1.75) and the HR (95% CI) for death being 1.38 ( 1.04~1.83). Compared with individuals carrying the rs73241801 CC genotype, individuals carrying rs73241801 TT genotype performed better OS (P=0.041), with the HR (95% CI) for death being 0.65 (0.44~0.94). The number of risk allele was significantly associated with PFS (P=0.012) and OS (P=0.017) of BC patients by accumulation analysis. Compared with individuals carrying one or less than one risk allele, individuals carrying four risk alleles performed worse PFS and OS, with the HR (95%CI) for progression being 1.37 (1.09~1.72) and the HR ( 95% CI) for death being 1.36 (1.02~1.81). Conclusion The variations of rs11045689 and rs73241801 in SLCO1B3 gene were significantly associated with prognosis of BC patients treated with neoadjuvant chemotherapy of TA regimen, which might serve as biomarkers for predicting prognosis of BC patients treated with neoadjuvant chemotherapy.
10.Upper Gastrointestinal Tract pH Monitoring in Rats with Chronic Sleep Deprivation and High Fat Diet
Chenbin ZHANG ; Mu LI ; Yanping ZHANG ; Lina LI ; Xingwang JIANG ; Hui SONG ; Yao PAN ; Yangu GUO ; Bo FENG
Journal of Audiology and Speech Pathology 2018;26(1):68-72
Objective To investigate the relationship of chronic sleep deprivation and high fat diet with laryn-gopharyngeal reflux (LPRD) .Methods A total of 16 rats were randomly divided into the experimental group and control group .Modified multiplatform water surface method and high fat diet (containing 35% fat) were used in the experimental group rats .The rats in the control group had free sleep and normal feed .The upper gastrointestinal tract pH monitoring with double detectors was used to record the changes of pH in the both rats for 10 hours .The reflux index ,the times of re-flux with pH<4 and the longest duration of reflux were selected and converted into data of 24 hours .The three indexes of the experiment group were compared to those of the control group .Results There was no animal death during the model construction .The rats in the experimental group were irritable .There was no difference of rats weight in both groups before and after the experiment(P>0 .05) .The median of reflux index ,times of reflux with pH<4 and the longest duration of reflux of pharyngeal pH 2 detector in the rats of the experimental group were 21 .07 ,27 .25 and 61 .11 ,respectively .Those of the control group were 1 .25 ,0 .95 and 8 .44 ,respectively .Above three index of the experimental group increased obviously and the difference was statistically significant when compared to those of the control (P<0 .05) .It was suggested that LPRD might appear in the experimental group rats .The median of reflux index and the times of reflux with pH < 4 of esophageal pH1 detector in the rats of the experimental group were 15 .87 and 96 .67 ,displaying an increase when compared to those of the control group (26 .25 and 5 .6) .The differ-ences were statistically significant(P<0 .05);but the median of the longest duration of reflux in pH1 detector of the experimental group rats was 26 .25 ,failing to show statistical difference compared to that of the control group (5 .6) (P>0 .05) .Conclusion Chronic sleep deprivation and high fat diet may play an important role in the pathogenesis of LPRD .This animal model may be a new vector to study LPRD .

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