1.The safety and efficacy of boron neutron capture therapy (BNCT) in the treatment of recurrent malignant tumors
Junqiang HONG ; Xiaoyi LIN ; Youqun LAI ; Ye CAO ; Xiangquan KONG ; Yuanhao LIU ; Shuiying LUO ; Zhicheng XIONG ; Mei GONG ; Yalai LIN ; Qiaoyun CHEN ; Mingang YING ; Li HUO ; Xiaohua ZHU ; Xiaoping SUN ; Yiqiao DENG ; Diyun SHU ; Haige ZHANG ; Cheng HUANG ; Jianji PAN
Chinese Journal of Radiation Oncology 2025;34(10):985-992
Objective:To evaluate the safety and efficacy of accelerator-based boron neutron capture therapy (AB-BNCT) in the treatment of recurrent and refractory malignant tumors.Methods:The data of 14 patients admitted to Xiamen Humanity Hospital from September 2022 to April 2023 were prospectively collected, including 7 patients with primary brain malignancies and 7 patients with locally recurrent inoperable head and neck malignancies. All patients received intravenous infusion of boron drug (NBB-001, p-dihydroxyborylphe nylalanine, a patented freeze-dried formulation) at a total nominal dosage of 500 mg/kg (11 patients) or 750 mg/kg (3 patients), and were irradiated with neutrons (operating with NeuPex system). Adverse events after treatment were recorded and assessed. The primary efficacy endpoint was the 90 d objective response rate (ORR), while the secondary endpoints included progression-free survival (PFS) and complete response rate (CRR). Data were compiled and analyzed by SAS 9.4 software. The rate and 95% CI were calculated using Clopper-Pearson method. Results:The median dose delivered to 80% of the target volume (D 80%) was 16.80 GyE (range: 8.93-23.79 GyE). The most common adverse reactions were hyperamylasemia, alopecia, and hyperprolactinemia. Five patients experienced 8 cases of grade 3 or above adverse events, including 1 case of grade 4 acute kidney injury and 7 cases of grade 3 adverse events. All adverse events were recovered after observation or treatment. At 90 d after treatment, the ORR of all patients was 9/14 (64%, 95% CI: 35%-87%), disease control rate (DCR) was 10/14 (71%, 95% CI: 42%-92%), CRR was 2/14 (14%, 95% CI: 2%-42%); and the best overall response during the entire course included an ORR of 10/14 (71% ,95% CI: 42%-92%), DCR of 13/14 (93%, 95% CI: 66%-100%), and CRR of 3/14 (21% ,95% CI: 5%-51%). The 1-year survival rate for head and neck malignancies was 71.4%, and the 2-year survival rate was 42.8%. The 1-year survival rate for recurrent brain malignancies was 42.8%. Conclusion:AB-BNCT demonstrates favorable safety and promising efficacy in treating primary brain malignancies and recurrent/refractory head and neck malignancies, representing a potential therapeutic option.
2.Clinical prognosis analysis of 177 cases bladder adenocarcinoma in a single center in China and comparison with SEER database
Tianxiang ZHANG ; Lu ZHANG ; Guoliang YANG ; Lianhua ZHANG ; Ming CAO ; Di JIN ; Ruiyun ZHANG ; Guanglei ZHUANG ; Yiran HUANG ; Wei XUE ; Haige CHEN
Chinese Journal of Urology 2025;46(3):166-172
Objective:To investigate the clinical and pathological characteristics, prognostic factors, and treatment outcomes of bladder adenocarcinoma.Methods:The data of 177 bladder adenocarcinoma patients treated at Renji Hospital, Shanghai Jiaotong University School of Medicine from January 2003 to December 2023, and 2 687 bladder adenocarcinoma patients from the SEER database (2000—2021) were reviewed retrospectively. The clinicopathological and prognostic characteristics were compared between the two cohorts. Patients with urachal adenocarcinoma or primary bladder adenocarcinoma were included, while metastatic bladder adenocarcinoma from other sites and urothelial carcinoma with glandular components were excluded. The Chi-square test was used for comparison of categorical data, and propensity score matching (1∶1) was applied to match baseline data between the Renji and SEER cohorts. Kaplan-Meier survival curves were generated, and log-rank tests were used for comparisons. Univariate and multivariate Cox regression analyses were performed using the survival R package, with P-values calculated via Wald tests. Results:The proportion of localized bladder adenocarcinoma was significantly higher in the Renji cohort than in the SEER cohort [61.0% (108/177) vs. 19.4% (521/2 687), P<0.001], and mucinous adenocarcinoma was more common in Renji cohort [33.3% (59/177) vs. 22.6% (607/2 687), P<0.001]. After matching for baseline factors, including SEER stage and pathological grade, survival analysis revealed that the Renji cohort patients had slightly better survival compared to the SEER cohort [median survival: 55.4 (24.1, 196.2) months vs. 39.2 (13.6, 137.4)months, P=0.033]. Multivariate Cox analysis identified SEER stage [Renji cohort: HR=3.83 (95% CI 1.62-9.07), P=0.002; SEER cohort: HR=3.67 (95% CI 3.13-4.31), P<0.001] and pathological grade [Renji cohort: HR = 2.76 (95% CI 1.54-4.95), P=0.001; SEER cohort: HR=1.46 (95% CI 1.29-1.65), P<0.001] as independent prognostic factors. In the Renji cohort, no significant differences were observed in the median progression-free survival [40.1 (19.5, 91.6) months vs. 40.9 (12.8, not reached)months, P=0.976] and overall survival [79.3 (37.1, 195.8) months vs. 53.9 (16.4, 129.5)months, P=0.374] between patients receiving adjuvant chemotherapy and those not receiving it. However, among patients with lymph node-positive bladder adenocarcinoma, adjuvant chemotherapy significantly improved both progression-free survival [40.1 (38.2, 75.4) months vs. 12.2 (3.1, 12.2)months, P=0.004] and overall survival [68.2 (46.2, 84.5)months vs. 28.1 (4.3, 28.3)months, P=0.006]. Conclusions:Bladder adenocarcinoma is rare and associated with poor prognosis. Compared to the SEER cohort, Renji cohort patients had more localized disease, with no significant differences in other features. SEER stage and pathological grade were independent prognostic factors in both cohorts. Lymph node-positive bladder adenocarcinoma patients in the Renji cohort benefited significantly from adjuvant chemotherapy.
3.Value of ultra high-frequency ultrasound measurement of artery intima thickness combined with monocyte to high-density lipoprotein cholesterol ratio in predicting the severity of coronary artery stenosis in premature coronary artery disease
Chenjing XU ; Jianjun YUAN ; Lixia WANG ; Yingjie CHU ; Xijun ZHANG ; Ming WU ; Yanyan GUO ; Haige YU ; Haohui ZHU
Chinese Journal of Ultrasonography 2025;34(2):114-121
Objective:To investigate the value of carotid,radial and podalic artery intima thickness(CIT,RIT,PIT)combined with monocyte to high-density lipoprotein ratio(MHR)in predicting the severity of coronary artery stenosis in patients with premature coronary artery disease(PCAD).Methods:A total of 80 patients with PCAD who received treatment in Henan Provincial People's Hospital from October 2023 to May 2024 were prospectively recruited,and they were divided into high group(≥41 score,40 cases)and low group(<41 score,40 cases)according to the median dichotomy of Gensini score. Thirty-four gender,age and body mass index(BMI)-matched healthy volunteers were selected as the control group. The CIT,RIT,PIT,media and intima media thickness of carotid,radial artery and podalic artery(CMT,RMT,PMT,CIMT,RIMT,PIMT)were measured using 24 MHz ultra-high frequency ultrasound probe,and the ratio of intima to media thickness(CIT/CMT,RIT/RMT,PIT/PMT)was calculated. The differences of general clinical data,laboratory indexes and ultrasonic parameters among the three groups were compared. Risk factors affecting the severity of coronary stenosis in PCAD patients were explored by binary logistic regression. Subject working characteristic curves were plotted,area under the curve(AUC)was calculated,and the values of each ultrasound parameter and MHR in the independent and combined diagnosis of the severity of coronary artery stenosis in PCAD patients were evaluated.Results:①There were no statistically significant differences in age,gender,BMI,total cholesterol,CMT,RMT and PMT among the three groups(all P>0.05). There were no statistically significant differences in the comparison of smoking,hypertension,diabetes mellitus,systolic blood pressure,diastolic blood pressure,low-density lipoprotein cholesterol,total cholesterol,and triglycerides between the two subgroups of the PCAD(all P>0.05). ②CIT,CIMT,CIT/CMT,RIT,RIMT,RIT/RMT,PIT,PIMT,PIT/PMT were thickened in the high group compared with the low group,and MHR was higher than in the low group(all P<0.05),the differences in the above parameters remained statistically significant when comparing the PCAD group with the control group(all P<0.05). ③The AUC values for MHR,CIT,RIT and PIT alone to predict the severity of coronary stenosis in patients with PCAD were 0.781,0.767,0.780 and 0.722,respectively. The combined diagnostic efficiency of the four parameters was better than the independent diagnostic efficiency(AUC = 0.885). Conclusions:CIT,RIT and PIT are thicker in PCAD patients with high Gensini score and the combination of artery intima thickness and MHR has good efficacy in predicting the severity of coronary artery stenosis in PCAD patients.
4.Framework nucleic acid-based linear amplification platform for sensitive detection of bladder cancer-related miRNAs
Chenzhou MAO ; Ruiyun ZHANG ; Haige CHEN ; Fangfei YIN ; Xiaolei ZUO
Journal of Shanghai Jiaotong University(Medical Science) 2025;45(3):253-260
Objective·To construct a framework nucleic acid-based linear amplification platform for the sensitive and quantitative detection of bladder cancer-related microRNAs(miRNAs),facilitating early screening and accurate diagnosis of bladder cancer.Methods·This study combined a plasma fluorescence-enhanced chip with high-performance tetrahedral framework nucleic acid(tFNA)probes,targeting miRNAs as biomarkers,to construct a framework nucleic acid-based linear signal amplification platform for precise and high-throughput quantitative analysis of multiple targets.First,atomic force microscope(AFM)was used to verify the efficient synthesis of tFNA.The signal linear amplification capability of the reporter unit was verified by polyacrylamide gel electrophoresis(PAGE)and total internal reflection fluorescent microscope(TIRFM).The performance of the sensing interface substrates was compared,and the golden island chip with signal amplification was selected.The specificity of the detection system was verified by an interface specificity experiment.Five bladder cancer-related miRNAs were selected to construct standard curves for quantitative detection.Results·The efficient synthesis of tetrahedral monomer and dimer structures was verified by AFM.PAGE and TIRFM characterization verified the linear amplification of fluorescence signals from 1 to 6 valence fluorescence reporter units.In order to achieve further signal amplification,the plasma island chip and the traditional glass chip were compared.The results showed that the gold island chip exhibited a plasmonic effect,which significantly enhanced the near-infrared(NIR)fluorescence,with a signal amplification of up to 13.6 times compared to the glass chip.The specificity verification experiment showed that the signal-to-noise ratio of the system ranged from 7 to 10,demonstrating high specificity.Based on the high specificity of the system,along with the good interface regulation ability and linear amplification of the framework nucleic acid-based interface,dual-color parallel detection of the targets was finally realized.The working range was 100 fmol/L-10 nmol/L(R2≥0.991),and the detection limit was as low as 100 fmol/L.Conclusion·The establishment of this platform opens new avenues for highly sensitive quantitative analysis of biomarkers.Furthermore,the developed framework nucleic acid-based detection platform holds great potential for clinical diagnosis and prognosis of bladder cancer and other major diseases.Through early detection and precise subtype diagnosis,doctors can formulate more personalized treatment plans for patients,improving treatment efficacy and reducing unnecessary treatment plans and associated side effects.Therefore,this liquid biopsy technology not only provides new possibilities for early screening of bladder cancer but also serves as reference for research and clinical applications in other types of cancer.
5.Impact of gamified behavior intervention based on mobile health on patients with coronary heart disease after percutaneous coronary intervention
Jie WANG ; Qingjuan GONG ; Haige ZHANG ; Mingming ZHANG
Chinese Journal of Practical Nursing 2025;41(19):1441-1448
Objective:To explore the effects of gamified behavior intervention based on mobile health on compliance, psychological status, and physical activity behavior of patients with coronary heart disease after percutaneous coronary intervention (PCI), providing a guidance for effectively improving the intervention effect of patients after PCI for coronary heart disease.Methods:The research plan was designed using a randomized, prospective, single blind, single center clinical research method. The patients with coronary heart disease who received treatment after PCI in the Second Affiliated Hospital of Air Force Medical University from January 2021 to November 2023 were selected as the study subjects by convenience sampling method and divided into the control group and the intervention group by the random number table method. The control group received routine intervention, while the intervention group received gamified behavior intervention based on mobile health on the basis of the control group. Both groups were intervened for 3 months and followed up for 3 months. The compliance, psychological status, physical activity behavior, and quality of life before intervention and after 3 months of follow-up, as well as the occurrence of adverse cardiovascular events during intervention and follow-up between two groups were compared.Results:A total of 88 patients with coronary heart disease after PCI were included, with 44 cases in both the control group and the intervention group. There were 23 males and 21 females in the control group with an age of (64.54 ± 4.32) years old. There were 24 males and 20 females in the intervention group with an age of (65.01 ± 4.36) years old. The scores of exercise, medication, diet, lifestyle compliance scores, physical activity behavior levels, the scores of social function, emotional function, physical function, role function, cognitive function after a 3-month follow-up in the intervention group were (95.32 ± 1.54) points, (95.07 ± 1.60) points, (93.43 ± 1.76) points, (95.03 ± 1.43) points, (1511.32 ± 113.54) metabolic equivalent/week, (94.03 ± 1.02) points, (93.42 ± 1.09) points, (92.21 ± 1.32) points, (93.42 ± 1.15) points, (88.54 ± 3.03) points, respectively, which were higher than the control group (77.43 ± 2.54) points, (78.31 ± 1.71) points, (74.32 ± 2.43) points, (75.14 ± 1.98) points, (1 432.65 ± 107.65) metabolic equivalent/week, (87.22 ± 1.21) points, (86.74 ± 1.30) points, (85.65 ± 3.43) points, (88.76 ± 1.09) points, (73.76 ± 3.43) points, the differences were statistical significant( t values were 3.34-54.02, all P<0.05). The scores of the Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) after a 3-month follow-up in the intervention group were (32.54 ± 1.85), (31.54 ± 0.87) points, respectively, which were lower than the control group (43.65 ± 2.03), (41.54 ± 1.23) points in the control group, the differences were statistical significant ( t=26.83, 44.03, both P<0.05). The incidence of adverse cardiovascular events during the intervention and follow-up period was 4.55% (2/44), which was lower than the control group 18.18% (8/44), the differences was statistical significant ( χ2=4.06, P<0.05). Conclusions:The nursing effect of gamified behavior intervention based on mobile health on patients with coronary heart disease after PCI was good, which could effectively improve compliance, promote the improvement of patients′ psychological state and physical activity behavior, reduce the occurrence of adverse cardiovascular events, further improve their quality of life.
6.Impact of gamified behavior intervention based on mobile health on patients with coronary heart disease after percutaneous coronary intervention
Jie WANG ; Qingjuan GONG ; Haige ZHANG ; Mingming ZHANG
Chinese Journal of Practical Nursing 2025;41(19):1441-1448
Objective:To explore the effects of gamified behavior intervention based on mobile health on compliance, psychological status, and physical activity behavior of patients with coronary heart disease after percutaneous coronary intervention (PCI), providing a guidance for effectively improving the intervention effect of patients after PCI for coronary heart disease.Methods:The research plan was designed using a randomized, prospective, single blind, single center clinical research method. The patients with coronary heart disease who received treatment after PCI in the Second Affiliated Hospital of Air Force Medical University from January 2021 to November 2023 were selected as the study subjects by convenience sampling method and divided into the control group and the intervention group by the random number table method. The control group received routine intervention, while the intervention group received gamified behavior intervention based on mobile health on the basis of the control group. Both groups were intervened for 3 months and followed up for 3 months. The compliance, psychological status, physical activity behavior, and quality of life before intervention and after 3 months of follow-up, as well as the occurrence of adverse cardiovascular events during intervention and follow-up between two groups were compared.Results:A total of 88 patients with coronary heart disease after PCI were included, with 44 cases in both the control group and the intervention group. There were 23 males and 21 females in the control group with an age of (64.54 ± 4.32) years old. There were 24 males and 20 females in the intervention group with an age of (65.01 ± 4.36) years old. The scores of exercise, medication, diet, lifestyle compliance scores, physical activity behavior levels, the scores of social function, emotional function, physical function, role function, cognitive function after a 3-month follow-up in the intervention group were (95.32 ± 1.54) points, (95.07 ± 1.60) points, (93.43 ± 1.76) points, (95.03 ± 1.43) points, (1511.32 ± 113.54) metabolic equivalent/week, (94.03 ± 1.02) points, (93.42 ± 1.09) points, (92.21 ± 1.32) points, (93.42 ± 1.15) points, (88.54 ± 3.03) points, respectively, which were higher than the control group (77.43 ± 2.54) points, (78.31 ± 1.71) points, (74.32 ± 2.43) points, (75.14 ± 1.98) points, (1 432.65 ± 107.65) metabolic equivalent/week, (87.22 ± 1.21) points, (86.74 ± 1.30) points, (85.65 ± 3.43) points, (88.76 ± 1.09) points, (73.76 ± 3.43) points, the differences were statistical significant( t values were 3.34-54.02, all P<0.05). The scores of the Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) after a 3-month follow-up in the intervention group were (32.54 ± 1.85), (31.54 ± 0.87) points, respectively, which were lower than the control group (43.65 ± 2.03), (41.54 ± 1.23) points in the control group, the differences were statistical significant ( t=26.83, 44.03, both P<0.05). The incidence of adverse cardiovascular events during the intervention and follow-up period was 4.55% (2/44), which was lower than the control group 18.18% (8/44), the differences was statistical significant ( χ2=4.06, P<0.05). Conclusions:The nursing effect of gamified behavior intervention based on mobile health on patients with coronary heart disease after PCI was good, which could effectively improve compliance, promote the improvement of patients′ psychological state and physical activity behavior, reduce the occurrence of adverse cardiovascular events, further improve their quality of life.
7.Framework nucleic acid-based linear amplification platform for sensitive detection of bladder cancer-related miRNAs
Chenzhou MAO ; Ruiyun ZHANG ; Haige CHEN ; Fangfei YIN ; Xiaolei ZUO
Journal of Shanghai Jiaotong University(Medical Science) 2025;45(3):253-260
Objective·To construct a framework nucleic acid-based linear amplification platform for the sensitive and quantitative detection of bladder cancer-related microRNAs(miRNAs),facilitating early screening and accurate diagnosis of bladder cancer.Methods·This study combined a plasma fluorescence-enhanced chip with high-performance tetrahedral framework nucleic acid(tFNA)probes,targeting miRNAs as biomarkers,to construct a framework nucleic acid-based linear signal amplification platform for precise and high-throughput quantitative analysis of multiple targets.First,atomic force microscope(AFM)was used to verify the efficient synthesis of tFNA.The signal linear amplification capability of the reporter unit was verified by polyacrylamide gel electrophoresis(PAGE)and total internal reflection fluorescent microscope(TIRFM).The performance of the sensing interface substrates was compared,and the golden island chip with signal amplification was selected.The specificity of the detection system was verified by an interface specificity experiment.Five bladder cancer-related miRNAs were selected to construct standard curves for quantitative detection.Results·The efficient synthesis of tetrahedral monomer and dimer structures was verified by AFM.PAGE and TIRFM characterization verified the linear amplification of fluorescence signals from 1 to 6 valence fluorescence reporter units.In order to achieve further signal amplification,the plasma island chip and the traditional glass chip were compared.The results showed that the gold island chip exhibited a plasmonic effect,which significantly enhanced the near-infrared(NIR)fluorescence,with a signal amplification of up to 13.6 times compared to the glass chip.The specificity verification experiment showed that the signal-to-noise ratio of the system ranged from 7 to 10,demonstrating high specificity.Based on the high specificity of the system,along with the good interface regulation ability and linear amplification of the framework nucleic acid-based interface,dual-color parallel detection of the targets was finally realized.The working range was 100 fmol/L-10 nmol/L(R2≥0.991),and the detection limit was as low as 100 fmol/L.Conclusion·The establishment of this platform opens new avenues for highly sensitive quantitative analysis of biomarkers.Furthermore,the developed framework nucleic acid-based detection platform holds great potential for clinical diagnosis and prognosis of bladder cancer and other major diseases.Through early detection and precise subtype diagnosis,doctors can formulate more personalized treatment plans for patients,improving treatment efficacy and reducing unnecessary treatment plans and associated side effects.Therefore,this liquid biopsy technology not only provides new possibilities for early screening of bladder cancer but also serves as reference for research and clinical applications in other types of cancer.
8.Clinical prognosis analysis of 177 cases bladder adenocarcinoma in a single center in China and comparison with SEER database
Tianxiang ZHANG ; Lu ZHANG ; Guoliang YANG ; Lianhua ZHANG ; Ming CAO ; Di JIN ; Ruiyun ZHANG ; Guanglei ZHUANG ; Yiran HUANG ; Wei XUE ; Haige CHEN
Chinese Journal of Urology 2025;46(3):166-172
Objective:To investigate the clinical and pathological characteristics, prognostic factors, and treatment outcomes of bladder adenocarcinoma.Methods:The data of 177 bladder adenocarcinoma patients treated at Renji Hospital, Shanghai Jiaotong University School of Medicine from January 2003 to December 2023, and 2 687 bladder adenocarcinoma patients from the SEER database (2000—2021) were reviewed retrospectively. The clinicopathological and prognostic characteristics were compared between the two cohorts. Patients with urachal adenocarcinoma or primary bladder adenocarcinoma were included, while metastatic bladder adenocarcinoma from other sites and urothelial carcinoma with glandular components were excluded. The Chi-square test was used for comparison of categorical data, and propensity score matching (1∶1) was applied to match baseline data between the Renji and SEER cohorts. Kaplan-Meier survival curves were generated, and log-rank tests were used for comparisons. Univariate and multivariate Cox regression analyses were performed using the survival R package, with P-values calculated via Wald tests. Results:The proportion of localized bladder adenocarcinoma was significantly higher in the Renji cohort than in the SEER cohort [61.0% (108/177) vs. 19.4% (521/2 687), P<0.001], and mucinous adenocarcinoma was more common in Renji cohort [33.3% (59/177) vs. 22.6% (607/2 687), P<0.001]. After matching for baseline factors, including SEER stage and pathological grade, survival analysis revealed that the Renji cohort patients had slightly better survival compared to the SEER cohort [median survival: 55.4 (24.1, 196.2) months vs. 39.2 (13.6, 137.4)months, P=0.033]. Multivariate Cox analysis identified SEER stage [Renji cohort: HR=3.83 (95% CI 1.62-9.07), P=0.002; SEER cohort: HR=3.67 (95% CI 3.13-4.31), P<0.001] and pathological grade [Renji cohort: HR = 2.76 (95% CI 1.54-4.95), P=0.001; SEER cohort: HR=1.46 (95% CI 1.29-1.65), P<0.001] as independent prognostic factors. In the Renji cohort, no significant differences were observed in the median progression-free survival [40.1 (19.5, 91.6) months vs. 40.9 (12.8, not reached)months, P=0.976] and overall survival [79.3 (37.1, 195.8) months vs. 53.9 (16.4, 129.5)months, P=0.374] between patients receiving adjuvant chemotherapy and those not receiving it. However, among patients with lymph node-positive bladder adenocarcinoma, adjuvant chemotherapy significantly improved both progression-free survival [40.1 (38.2, 75.4) months vs. 12.2 (3.1, 12.2)months, P=0.004] and overall survival [68.2 (46.2, 84.5)months vs. 28.1 (4.3, 28.3)months, P=0.006]. Conclusions:Bladder adenocarcinoma is rare and associated with poor prognosis. Compared to the SEER cohort, Renji cohort patients had more localized disease, with no significant differences in other features. SEER stage and pathological grade were independent prognostic factors in both cohorts. Lymph node-positive bladder adenocarcinoma patients in the Renji cohort benefited significantly from adjuvant chemotherapy.
9.Value of ultra high-frequency ultrasound measurement of artery intima thickness combined with monocyte to high-density lipoprotein cholesterol ratio in predicting the severity of coronary artery stenosis in premature coronary artery disease
Chenjing XU ; Jianjun YUAN ; Lixia WANG ; Yingjie CHU ; Xijun ZHANG ; Ming WU ; Yanyan GUO ; Haige YU ; Haohui ZHU
Chinese Journal of Ultrasonography 2025;34(2):114-121
Objective:To investigate the value of carotid,radial and podalic artery intima thickness(CIT,RIT,PIT)combined with monocyte to high-density lipoprotein ratio(MHR)in predicting the severity of coronary artery stenosis in patients with premature coronary artery disease(PCAD).Methods:A total of 80 patients with PCAD who received treatment in Henan Provincial People's Hospital from October 2023 to May 2024 were prospectively recruited,and they were divided into high group(≥41 score,40 cases)and low group(<41 score,40 cases)according to the median dichotomy of Gensini score. Thirty-four gender,age and body mass index(BMI)-matched healthy volunteers were selected as the control group. The CIT,RIT,PIT,media and intima media thickness of carotid,radial artery and podalic artery(CMT,RMT,PMT,CIMT,RIMT,PIMT)were measured using 24 MHz ultra-high frequency ultrasound probe,and the ratio of intima to media thickness(CIT/CMT,RIT/RMT,PIT/PMT)was calculated. The differences of general clinical data,laboratory indexes and ultrasonic parameters among the three groups were compared. Risk factors affecting the severity of coronary stenosis in PCAD patients were explored by binary logistic regression. Subject working characteristic curves were plotted,area under the curve(AUC)was calculated,and the values of each ultrasound parameter and MHR in the independent and combined diagnosis of the severity of coronary artery stenosis in PCAD patients were evaluated.Results:①There were no statistically significant differences in age,gender,BMI,total cholesterol,CMT,RMT and PMT among the three groups(all P>0.05). There were no statistically significant differences in the comparison of smoking,hypertension,diabetes mellitus,systolic blood pressure,diastolic blood pressure,low-density lipoprotein cholesterol,total cholesterol,and triglycerides between the two subgroups of the PCAD(all P>0.05). ②CIT,CIMT,CIT/CMT,RIT,RIMT,RIT/RMT,PIT,PIMT,PIT/PMT were thickened in the high group compared with the low group,and MHR was higher than in the low group(all P<0.05),the differences in the above parameters remained statistically significant when comparing the PCAD group with the control group(all P<0.05). ③The AUC values for MHR,CIT,RIT and PIT alone to predict the severity of coronary stenosis in patients with PCAD were 0.781,0.767,0.780 and 0.722,respectively. The combined diagnostic efficiency of the four parameters was better than the independent diagnostic efficiency(AUC = 0.885). Conclusions:CIT,RIT and PIT are thicker in PCAD patients with high Gensini score and the combination of artery intima thickness and MHR has good efficacy in predicting the severity of coronary artery stenosis in PCAD patients.
10.The safety and efficacy of boron neutron capture therapy (BNCT) in the treatment of recurrent malignant tumors
Junqiang HONG ; Xiaoyi LIN ; Youqun LAI ; Ye CAO ; Xiangquan KONG ; Yuanhao LIU ; Shuiying LUO ; Zhicheng XIONG ; Mei GONG ; Yalai LIN ; Qiaoyun CHEN ; Mingang YING ; Li HUO ; Xiaohua ZHU ; Xiaoping SUN ; Yiqiao DENG ; Diyun SHU ; Haige ZHANG ; Cheng HUANG ; Jianji PAN
Chinese Journal of Radiation Oncology 2025;34(10):985-992
Objective:To evaluate the safety and efficacy of accelerator-based boron neutron capture therapy (AB-BNCT) in the treatment of recurrent and refractory malignant tumors.Methods:The data of 14 patients admitted to Xiamen Humanity Hospital from September 2022 to April 2023 were prospectively collected, including 7 patients with primary brain malignancies and 7 patients with locally recurrent inoperable head and neck malignancies. All patients received intravenous infusion of boron drug (NBB-001, p-dihydroxyborylphe nylalanine, a patented freeze-dried formulation) at a total nominal dosage of 500 mg/kg (11 patients) or 750 mg/kg (3 patients), and were irradiated with neutrons (operating with NeuPex system). Adverse events after treatment were recorded and assessed. The primary efficacy endpoint was the 90 d objective response rate (ORR), while the secondary endpoints included progression-free survival (PFS) and complete response rate (CRR). Data were compiled and analyzed by SAS 9.4 software. The rate and 95% CI were calculated using Clopper-Pearson method. Results:The median dose delivered to 80% of the target volume (D 80%) was 16.80 GyE (range: 8.93-23.79 GyE). The most common adverse reactions were hyperamylasemia, alopecia, and hyperprolactinemia. Five patients experienced 8 cases of grade 3 or above adverse events, including 1 case of grade 4 acute kidney injury and 7 cases of grade 3 adverse events. All adverse events were recovered after observation or treatment. At 90 d after treatment, the ORR of all patients was 9/14 (64%, 95% CI: 35%-87%), disease control rate (DCR) was 10/14 (71%, 95% CI: 42%-92%), CRR was 2/14 (14%, 95% CI: 2%-42%); and the best overall response during the entire course included an ORR of 10/14 (71% ,95% CI: 42%-92%), DCR of 13/14 (93%, 95% CI: 66%-100%), and CRR of 3/14 (21% ,95% CI: 5%-51%). The 1-year survival rate for head and neck malignancies was 71.4%, and the 2-year survival rate was 42.8%. The 1-year survival rate for recurrent brain malignancies was 42.8%. Conclusion:AB-BNCT demonstrates favorable safety and promising efficacy in treating primary brain malignancies and recurrent/refractory head and neck malignancies, representing a potential therapeutic option.

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