1.Research on the relations of intraventricular pressure gradients determined by echocardiography and left ventricular cardiotoxicity in the early stage of anthracycline chemotherapy
Mengxiao HAN ; Jian ZHANG ; Manchen YANG ; Qunling ZHANG ; Xianhong SHU ; Zheng LI ; Leilei CHENG
Chinese Journal of Cardiology 2025;53(8):891-897
Objective:To preliminarily explore the relationship between intraventricular pressure gradients (IVPG) measured by ultrasound hemodynamic analysis and left ventricular cardiotoxicity after anthracycline chemotherapy.Methods:This was a retrospective cohort study. Patients with diffuse large B-cell lymphoma (DLBCL) who completed 6 cycles of R-CHOP chemotherapy at Fudan University Shanghai Cancer Center from 2014 to 2015 were included. Echocardiography was performed at baseline (T0), after 2 cycles of chemotherapy (T1), after 4 cycles of chemotherapy (T2), and after all chemotherapy cycles (T3). Left ventricular global longitudinal strain (LVGLS), left ventricular global circumferential strain (LVGCS), and left ventricular ejection fraction (LVEF) were analyzed using speckle-tracking imaging technology, and IVPG was measured using hemodynamic analysis technology, including IVPG of long-axis (IVPG-LA) and IVPG of short-axis. The change rate of each index from T0 to T2 was marked as Δ. Left ventricular cardiotoxicity was defined as a decrease in LVEF of ≥10% from the baseline level or LVEF ≤50%. Univariate logistic regression analysis was used to explore the related factors of left ventricular myocardial toxicity, and the receiver operating characteristic curve was drawn to analyze their evaluation efficiency for left ventricular myocardial toxicity.Results:A total of 55 patients were included, including 28 males (51%), aged (46.5±11.7) years. Twelve patients (22%) developed left ventricular cardiotoxicity. Compared with T0, IVPG-LA decreased at T1 ((10.73±2.51)% vs. (11.52±3.62)%, P=0.037); while LVGLS, LVGCS, and LVEF only decreased at T3 (all P<0.05). Univariate logistic regression analysis showed that ΔIVPG-LA and ΔLVGLS were related factors for left ventricular myocardial toxicity in patients with DLBCL receiving chemotherapy (all P<0.05). The receiver operating characteristic curve showed that the area under the curve of ΔLVGLS was 0.702, with an optimal cut-off value of 13.15% (sensitivity 66.7%, specificity 62.8%); the area under the curve of ΔIVPG-LA was 0.812, with an optimal cut-off value of 20.74% (sensitivity 75.0%, specificity 90.7%). Conclusions:Hemodynamic analysis technology shows promise clinical application value in evaluating subclinical changes in left ventricular function in tumor patients after anthracycline chemotherapy; the change rate of IVPG-LA could be used as an early indicator of left ventricular toxicity after anthracycline chemotherapy.
2.Research on the relations of intraventricular pressure gradients determined by echocardiography and left ventricular cardiotoxicity in the early stage of anthracycline chemotherapy
Mengxiao HAN ; Jian ZHANG ; Manchen YANG ; Qunling ZHANG ; Xianhong SHU ; Zheng LI ; Leilei CHENG
Chinese Journal of Cardiology 2025;53(8):891-897
Objective:To preliminarily explore the relationship between intraventricular pressure gradients (IVPG) measured by ultrasound hemodynamic analysis and left ventricular cardiotoxicity after anthracycline chemotherapy.Methods:This was a retrospective cohort study. Patients with diffuse large B-cell lymphoma (DLBCL) who completed 6 cycles of R-CHOP chemotherapy at Fudan University Shanghai Cancer Center from 2014 to 2015 were included. Echocardiography was performed at baseline (T0), after 2 cycles of chemotherapy (T1), after 4 cycles of chemotherapy (T2), and after all chemotherapy cycles (T3). Left ventricular global longitudinal strain (LVGLS), left ventricular global circumferential strain (LVGCS), and left ventricular ejection fraction (LVEF) were analyzed using speckle-tracking imaging technology, and IVPG was measured using hemodynamic analysis technology, including IVPG of long-axis (IVPG-LA) and IVPG of short-axis. The change rate of each index from T0 to T2 was marked as Δ. Left ventricular cardiotoxicity was defined as a decrease in LVEF of ≥10% from the baseline level or LVEF ≤50%. Univariate logistic regression analysis was used to explore the related factors of left ventricular myocardial toxicity, and the receiver operating characteristic curve was drawn to analyze their evaluation efficiency for left ventricular myocardial toxicity.Results:A total of 55 patients were included, including 28 males (51%), aged (46.5±11.7) years. Twelve patients (22%) developed left ventricular cardiotoxicity. Compared with T0, IVPG-LA decreased at T1 ((10.73±2.51)% vs. (11.52±3.62)%, P=0.037); while LVGLS, LVGCS, and LVEF only decreased at T3 (all P<0.05). Univariate logistic regression analysis showed that ΔIVPG-LA and ΔLVGLS were related factors for left ventricular myocardial toxicity in patients with DLBCL receiving chemotherapy (all P<0.05). The receiver operating characteristic curve showed that the area under the curve of ΔLVGLS was 0.702, with an optimal cut-off value of 13.15% (sensitivity 66.7%, specificity 62.8%); the area under the curve of ΔIVPG-LA was 0.812, with an optimal cut-off value of 20.74% (sensitivity 75.0%, specificity 90.7%). Conclusions:Hemodynamic analysis technology shows promise clinical application value in evaluating subclinical changes in left ventricular function in tumor patients after anthracycline chemotherapy; the change rate of IVPG-LA could be used as an early indicator of left ventricular toxicity after anthracycline chemotherapy.
3.Effect of nursing model based on nursing quality evaluation system in patients with severe acute pancreatitis
Manchen ZHU ; Lina ZHU ; Ying YANG
Chinese Journal of Modern Nursing 2022;28(4):538-540
Objective:To explore the effect of nursing model based on nursing quality evaluation system in patients with severe acute pancreatitis.Methods:From July 2019 to June 2020, convenience sampling was used to select 80 patients with severe acute pancreatitis admitted to the Affiliated Hospital of Jining Medical College as the research object. According to the random number table method, the patients were divided into the observation group and the control group, with 40 cases in each group. The control group implemented the conventional nursing model, and the observation group conducted the nursing model based on the nursing quality evaluation system on this basis. The treatment compliance and nursing satisfaction of the two groups of patients were compared.Results:The treatment compliance and nursing satisfaction of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The nursing model based on the nursing quality evaluation system can improve the treatment compliance of patients with severe acute pancreatitis and their satisfaction with nursing work, and it is worthy of clinical application.
4.Construction of C-shaped cartilage with electrospun gelatin/polycaprolactone nanofibrous membranes and 3D printed supporter
Hengyi ZHANG ; Bei FENG ; Yang GE ; Manchen GAO ; Jie BAI ; Wei FU ; Zhiwei XU
Journal of Shanghai Jiaotong University(Medical Science) 2017;37(7):896-900
Objective·To construct C-shaped cartilage rings by rabbit auricular cartilage-derived chondrocytes combing with both electrospun gelatin/ polycaprolactone(GT/PCL) nanofibrous membranes and 3D printed supporters for repairing tracheal cartilage defects.Methods·Primary chondrocytes were isolated from rabbit auricular cartilage with methods of trypsin enzyme digestion and collagenase enzyme digestion.After proliferation in vitro,the chondrocytes of passage 2 were harvested for further experiments.Ultrafine composite fibers of GT/PCL were fabricated via electrospinning.The electrospun GT/PCL membranes were tailored into rectangle shape,the length of which is 12 cm and the width is 2.5 cm.Chondrocytes were seeded on membrane at a density of 1 × 108 cells/mL.Then the membrane were rolled onto a 3D printed supporter of poly(DL-lactide-ε-caprolactone) (PLCL) material to construct a C-shaped cartilage-like complex.After 8 weeks of subcutaneous incubation in vivo,gross inspection and paraffin section staining were applied for evaluation.Results·After 8 weeks of culture in vivo,mature cartilage-like tissue were formed with open-cylindrical bellow appearance and pecific mechanical property.C-shaped rings arranged at regular intervals on the inner surface of tissue,which were similar to the normal structure of tracheal cartilages.Histological and immunohistological staining showed a large number of typical lacunar structures and extracellular matrix secretions.Conclusion·It is feasible to construct tissue engineered C-shaped cartilage tissue by combing chondrocytes with GT/PCL membrane and 3D printed PLCL supporter for tracheal cartilage repair.

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