1.Extraction,Separation and Hypoglycemic Activity Analysis of Polysaccharides from Brassica rapa
Mengyu HOU ; Ruina XU ; Qingsong LI ; Shaoxuan LI ; Xinying MA ; Yaohui YE
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(10):219-228
ObjectiveTo optimize the extraction method for polysaccharides from turnip(Brassica rapa), and analyze and evaluate the primary structure of the isolated and purified turnip polysaccharide fraction(BP-1) and its hypoglycemic effects in diabetic zebrafish. MethodsTaking polysaccharide yield as the evaluation index, a semi-bionic extraction method was employed. Single-factor experiments and Box-Behnken response surface methodology were used to investigate three factors of solid-to-liquid ratio, extraction time and extraction temperature, in order to optimize the extraction process. BP-1 was isolated and purified using the Sevage method and DEAE-52 cellulose column chromatography. Structural characterization of the turnip polysaccharides was performed using ultraviolet-visible spectrophotometry(UV), gas chromatography-mass spectrometry(GC-MS), Congo red assay, and Fourier-transform infrared spectroscopy(FT-IR) to determine purity, monosaccharide composition, triple-helix structure, and functional groups. The microstructure of the polysaccharides was observed using scanning electron microscopy(SEM) and atomic force microscopy(AFM). Zebrafish were divided into the blank group(adding E3 medium), and BP-1-1, BP-1-10, BP-1-50, BP-1-200, BP-1-1 000 groups(adding BP-1 solutions at concentrations of 1, 10, 50, 200, 1 000 mg·L-1, respectively), and zebrafish embryos were subjected to a 96-hour exposure experiment. The maximum tolerated concentration of BP-1 in zebrafish was determined by evaluating its effects on phenotype, survival rate, malformation rate, and heart rate. Experimental animals were randomly divided into the blank group, model group, BP-1-10 group(10 mg·L-1), BP-1-50 group(50 mg·L-1), and BP-1-200 group(200 mg·L-1). The blank group was cultured in E3 medium, the model and treatment groups were induced to establish a diabetic model in 4 day-post-fertilization(dpf) zebrafish embryos using 10 g·L-1 of glucose combined with 500 µmol·L-1 of alloxan. The treatment groups received corresponding doses of BP-1 solution, while the blank and model groups received an equal volume of saline. Glucose and insulin(INS) levels were measured using enzyme-linked immunosorbent assay(ELISA) kits, the effects on the liver were observed by hematoxylin-eosin(HE) histopathological sections. The mRNA expression levels of glucagon(Glucagon), insulin(Insa), and phosphoenolpyruvate carboxykinase 1(PCK1) were detected with real-time fluorescence quantitative polymerase chain reaction(Real-time PCR). ResultsThe optimized extraction conditions were determined as follows:solid-to-liquid ratio of 1∶40(g·mL-1), extraction time of 66 min, and extraction temperature of 79 ℃. Under these conditions, the yield of turnip polysaccharides was (10.34±0.96)%. UV analysis indicated that BP-1 contained no proteins or nucleic acids, GC-MS analysis revealed that BP-1 consisted of six monosaccharides(arabinose, rhamnose, ribose, mannose, galactose and glucose). Congo red assay indicated that the molecular conformation did not exhibit a triple-helix structure, FT-IR analysis showed the presence of α-glycosidic bonds and uronic acids, SEM analysis revealed an irregular flaky structure with a flat and smooth surface, AFM analysis suggested that the aggregated structure might be formed by the entanglement of molecular chains and intramolecular hydrogen bonding. The maximum tolerated concentration of BP-1 in zebrafish over 96 h was determined to be 200 mg·L-1. Pharmacodynamic results showed that, compared with the blank group, the model group exhibited significantly increased glucose levels and significantly decreased INS levels(P<0.01). Compared with the model group, the BP-1-50 group significantly reduced glucose levels and increased INS levels(P<0.05). Histopathological examination of liver tissue revealed that various doses of BP-1 had a certain reparative effect on damaged liver tissue. The liver tissue structure in the BP-1-200 group was nearly normal, with hepatocytes appearing plump. Real-time PCR results showed that, compared with the blank group, the model group exhibited significantly upregulated mRNA expressions of Glucagon and PCK1, and significantly downregulated mRNA expression of Insa(P<0.01). Compared with the model group, the BP-1-50 and BP-1-200 groups showed significantly downregulated mRNA expressions of Glucagon and PCK1, and significantly upregulated mRNA expression of Insa(P<0.01). ConclusionThe semi-bionic extraction method for turnip polysaccharides yields a high extraction rate, is simple to operate, has low costs, making it suitable for large-scale industrial production. BP-1 consists of six monosaccharides, contains α-glycosidic bonds and uronic acids, exhibits hypoglycemic activity, and provides a certain protective effect on the liver of alloxan-induced diabetic model zebrafish.
2.Extraction,Separation and Hypoglycemic Activity Analysis of Polysaccharides from Brassica rapa
Mengyu HOU ; Ruina XU ; Qingsong LI ; Shaoxuan LI ; Xinying MA ; Yaohui YE
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(10):219-228
ObjectiveTo optimize the extraction method for polysaccharides from turnip(Brassica rapa), and analyze and evaluate the primary structure of the isolated and purified turnip polysaccharide fraction(BP-1) and its hypoglycemic effects in diabetic zebrafish. MethodsTaking polysaccharide yield as the evaluation index, a semi-bionic extraction method was employed. Single-factor experiments and Box-Behnken response surface methodology were used to investigate three factors of solid-to-liquid ratio, extraction time and extraction temperature, in order to optimize the extraction process. BP-1 was isolated and purified using the Sevage method and DEAE-52 cellulose column chromatography. Structural characterization of the turnip polysaccharides was performed using ultraviolet-visible spectrophotometry(UV), gas chromatography-mass spectrometry(GC-MS), Congo red assay, and Fourier-transform infrared spectroscopy(FT-IR) to determine purity, monosaccharide composition, triple-helix structure, and functional groups. The microstructure of the polysaccharides was observed using scanning electron microscopy(SEM) and atomic force microscopy(AFM). Zebrafish were divided into the blank group(adding E3 medium), and BP-1-1, BP-1-10, BP-1-50, BP-1-200, BP-1-1 000 groups(adding BP-1 solutions at concentrations of 1, 10, 50, 200, 1 000 mg·L-1, respectively), and zebrafish embryos were subjected to a 96-hour exposure experiment. The maximum tolerated concentration of BP-1 in zebrafish was determined by evaluating its effects on phenotype, survival rate, malformation rate, and heart rate. Experimental animals were randomly divided into the blank group, model group, BP-1-10 group(10 mg·L-1), BP-1-50 group(50 mg·L-1), and BP-1-200 group(200 mg·L-1). The blank group was cultured in E3 medium, the model and treatment groups were induced to establish a diabetic model in 4 day-post-fertilization(dpf) zebrafish embryos using 10 g·L-1 of glucose combined with 500 µmol·L-1 of alloxan. The treatment groups received corresponding doses of BP-1 solution, while the blank and model groups received an equal volume of saline. Glucose and insulin(INS) levels were measured using enzyme-linked immunosorbent assay(ELISA) kits, the effects on the liver were observed by hematoxylin-eosin(HE) histopathological sections. The mRNA expression levels of glucagon(Glucagon), insulin(Insa), and phosphoenolpyruvate carboxykinase 1(PCK1) were detected with real-time fluorescence quantitative polymerase chain reaction(Real-time PCR). ResultsThe optimized extraction conditions were determined as follows:solid-to-liquid ratio of 1∶40(g·mL-1), extraction time of 66 min, and extraction temperature of 79 ℃. Under these conditions, the yield of turnip polysaccharides was (10.34±0.96)%. UV analysis indicated that BP-1 contained no proteins or nucleic acids, GC-MS analysis revealed that BP-1 consisted of six monosaccharides(arabinose, rhamnose, ribose, mannose, galactose and glucose). Congo red assay indicated that the molecular conformation did not exhibit a triple-helix structure, FT-IR analysis showed the presence of α-glycosidic bonds and uronic acids, SEM analysis revealed an irregular flaky structure with a flat and smooth surface, AFM analysis suggested that the aggregated structure might be formed by the entanglement of molecular chains and intramolecular hydrogen bonding. The maximum tolerated concentration of BP-1 in zebrafish over 96 h was determined to be 200 mg·L-1. Pharmacodynamic results showed that, compared with the blank group, the model group exhibited significantly increased glucose levels and significantly decreased INS levels(P<0.01). Compared with the model group, the BP-1-50 group significantly reduced glucose levels and increased INS levels(P<0.05). Histopathological examination of liver tissue revealed that various doses of BP-1 had a certain reparative effect on damaged liver tissue. The liver tissue structure in the BP-1-200 group was nearly normal, with hepatocytes appearing plump. Real-time PCR results showed that, compared with the blank group, the model group exhibited significantly upregulated mRNA expressions of Glucagon and PCK1, and significantly downregulated mRNA expression of Insa(P<0.01). Compared with the model group, the BP-1-50 and BP-1-200 groups showed significantly downregulated mRNA expressions of Glucagon and PCK1, and significantly upregulated mRNA expression of Insa(P<0.01). ConclusionThe semi-bionic extraction method for turnip polysaccharides yields a high extraction rate, is simple to operate, has low costs, making it suitable for large-scale industrial production. BP-1 consists of six monosaccharides, contains α-glycosidic bonds and uronic acids, exhibits hypoglycemic activity, and provides a certain protective effect on the liver of alloxan-induced diabetic model zebrafish.
3.Expert consensus on digital restoration of complete dentures.
Yue FENG ; Zhihong FENG ; Jing LI ; Jihua CHEN ; Haiyang YU ; Xinquan JIANG ; Yongsheng ZHOU ; Yumei ZHANG ; Cui HUANG ; Baiping FU ; Yan WANG ; Hui CHENG ; Jianfeng MA ; Qingsong JIANG ; Hongbing LIAO ; Chufan MA ; Weicai LIU ; Guofeng WU ; Sheng YANG ; Zhe WU ; Shizhu BAI ; Ming FANG ; Yan DONG ; Jiang WU ; Lin NIU ; Ling ZHANG ; Fu WANG ; Lina NIU
International Journal of Oral Science 2025;17(1):58-58
Digital technologies have become an integral part of complete denture restoration. With advancement in computer-aided design and computer-aided manufacturing (CAD/CAM), tools such as intraoral scanning, facial scanning, 3D printing, and numerical control machining are reshaping the workflow of complete denture restoration. Unlike conventional methods that rely heavily on clinical experience and manual techniques, digital technologies offer greater precision, predictability, and efficacy. They also streamline the process by reducing the number of patient visits and improving overall comfort. Despite these improvements, the clinical application of digital complete denture restoration still faces challenges that require further standardization. The major issues include appropriate case selection, establishing consistent digital workflows, and evaluating long-term outcomes. To address these challenges and provide clinical guidance for practitioners, this expert consensus outlines the principles, advantages, and limitations of digital complete denture technology. The aim of this review was to offer practical recommendations on indications, clinical procedures and precautions, evaluation metrics, and outcome assessment to support digital restoration of complete denture in clinical practice.
Humans
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Denture, Complete
;
Computer-Aided Design
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Denture Design/methods*
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Consensus
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Printing, Three-Dimensional
4.Efficacy of bilateral facial muscle training combined with visual electromyography biofeedback in the treatment of idiopathic facial nerve palsy
Xinyue CAI ; Ling DING ; Yilan MA ; Shihong HU ; Huajun GU ; Longdian GU ; Yijie ZHU ; Jiakun YAN ; Yaoyao ZHENG ; Qingsong MA
Chinese Journal of Clinical Medicine 2025;32(6):1017-1023
Objective To explore the efficacy of bilateral facial muscle training combined with visual electromyography biofeedback on facial nerve function recovery in patients with idiopathic facial nerve palsy. Methods Patients with idiopathic facial nerve palsy admitted to Shanghai Fifth People’s Hospital, Fudan University from July 2022 to July 2024 were selected and randomly divided into a control group and an intervention group. The control group received conventional physical factor therapy, while the intervention group received bilateral facial muscle training combined with visual electromyography biofeedback therapy based on the control group’s regimen. After 20 treatment sessions, the total effective rate, the House-Brackmann (H-B) facial nerve grading system, the Sunnybrook Facial Grading System (SFGS) score, and the average value ratio of maximal amplitudes of bilateral frontalis and zygomaticus muscles were compared between the two groups. Results A total of 90 patients were included, 45 in each group. After 20 treatment sessions, the total effective rate was significantly higher in the intervention group than in the control group (84.4% vs 75.6%, P=0.003). Compared with the control group, the intervention group demonstrated a significantly lower H-B grade (P=0.003) and a higher SFGS score (P=0.001). The average value ratios of maximal amplitudes of the affected versus healthy side frontalis (P=0.013) and zygomatic (P=0.022) muscles were higher in the intervention group than in the control group. Conclusions Bilateral facial muscle training combined with visual electromyography biofeedback is an effective approach for treating idiopathic facial nerve palsy, effectively promoting the recovery of facial nerve function, and improving facial symmetry and facial muscle function.
5.A prospective randomized clinical study of folic acid in the intervention of radiation esophagitis induced by concurrent chemoradiotherapy in lung cancer
Hao ZHANG ; Yiying ZHU ; Weiwei OUYANG ; Shengfa SU ; Zhu MA ; Qingsong LI ; Yichao GENG ; Wengang YANG ; Xiaxia CHEN ; Bing LU
Chinese Journal of Radiation Oncology 2025;34(1):65-72
Objective:To investigate the efficacy of oral folic acid intervention in lung cancer patients with radiation esophagitis (RE) caused by concurrent chemoradiotherapy.Methods:In this randomized, controlled, single-center clinical trial, a total of 82 patients with stage N 2-N 3 lung cancer including small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC) admitted to the Affiliated Cancer Hospital of Guizhou Medical University from June 2022 to October 2023 were prospectively included. All enrolled patients were randomly divided into the experimental group (folic acid group) and control group according to 1 vs. 1 of simple random method, and patients in both groups were required to receive radiation therapy for lung lesions and mediastinal metastatic lymph nodes [≥2 cycles of chemotherapy were completed during the same period of radiotherapy (≥40 Gy / 20 F) or targeted drugs were given simultaneously]. The severity of RE was evaluated using the modified common terminology criteria for adverse events criteria of the National Cancer Institute in both groups weekly at the onset of radiation esophagitis symptoms and thereafter until 1 week after the end of radiotherapy. Conventional treatment of RE was delivered according to the grading criteria of the Radiation Therapy Oncology Group. Patients in the folic acid group were given with folic acid tablets 30 mg/d orally at the beginning of radiotherapy until the end of radiotherapy, while those in the control group did not receive any drug intervention. The onset time, severity and duration of RE, and changes in the severity of esophageal toxicity after conventional treatment were recorded and analyzed. Serum folate value, serum vitamin B 12 value and homocysteine value were measured before and after radiotherapy. For continuous quantitative variables, independent sample t-test or independent sample rank-sum test was used for comparison among different groups. For categorical data, Chi-square test or Fisher's exact probability method was used for comparison among different groups. Results:During the observation period, no grade 4 or above RE was reported between two groups. The incidence of grade 0, 1, 2 and 3 RE in the folic acid and control groups was 10% (4/40) and 5% (2/41), 70% (28/40) and 42% (17/41), 15% (6/40) and 51% (21/41), 5% (2/40) and 2% (1/41), respectively. The differences were not statistically significant between two groups ( P=0.456). However, the incidence of grade 0-1 RE in the folic acid group was significantly higher than that in the control group ( Z=2.72, P=0.006). The median time of RE in the folic acid group and control group was 12 d (range 7-52 d) and 15 d (range 11-56 d) after the start of radiotherapy, respectively, with no statistically significant difference ( χ2=-0.75, P=0.456). However, median duration of the individual's most severe RE was 12 d (range 4-36 d) and 21 d (range 7-38 d) in the folic acid group and control groups, respectively, and the differences were statistically significant ( χ2=2.10, P=0.039). In the folic acid group, the grades of swallowing with pain and dysphagia were significantly declined after folic acid intervention, especially at 2 weeks after the occurrence of RE ( P=0.001, P=0.002). The remission rate of RE after 1 week in the folic acid group was higher than that in the control group, and the difference was statistically significant ( χ2=7.36, P=0.012). Conclusion:Oral intake of folic acid during concurrent chemoradiotherapy for lung cancer cannot reduce the incidence of RE, but it may reduce its severity, shorten the duration of the most severe RE in individuals, and have a certain protective effect.
6.A prospective study on clinical monitoring of early cardiac myocardial dysfunction by conventional radiotherapy in N 2-N 3 non-small cell lung cancer with lymph node metastases
Yiying ZHU ; Hao ZHANG ; Weiwei OUYANG ; Shengfa SU ; Yinxiang HU ; Zhu MA ; Sha LI ; Qingsong LI ; Wengang YANG ; Xiaxia CHEN ; Haijie JIN ; Jie LIU ; Fuhuan LUO ; Zhourui LIU ; Bing LU
Chinese Journal of Radiation Oncology 2025;34(7):664-670
Objective:To analyze the changes and significance in clinical cardiac indicators of early cardiac myocardial dysfunction and cardiac substructure dose during conventional radiotherapy for N 2-N 3 non-small cell lung cancer (NSCLC) with mediastinal lymph node metastases. Methods:The data of 34 NSCLC patients with lymph node metastases in regions 4-8 admitted to the Affiliated Cancer Hospital of Guizhou Medical University from June 2022 to August 2023 were observed and analyzed. All patients were treated with volumetric modulated arc therapy with a prescribed dose of 60-70 Gy. Cardiac troponin T (cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were measured at 6 time points: within 1 week before radiotherapy ( t0); when the cumulative radiotherapy dose reaches 20 Gy ( t20), 40 Gy ( t40), 60 Gy ( t60) during radiotherapy; within 1 week after radiotherapy ( tp); 1 month after radiotherapy( tp1). Left ventricular global longitudinal strain (LVGLS) and left atrial global longitudinal strain (LAGLS) were assessed at 4 time points: t0, t40, tp and tp1, respectively. The changes in cardiac indicators at different time points during radiotherapy and their correlation with substructure doses were analyzed using analysis of variance, linear regression analysis, and Pearson correlation. Results:The correlation between cardiac substructure dose and mean heart dose (MHD) in the study cohort in the descending order was as follows: left ventricle ( B=0.43, P<0.001), right ventricle ( B=0.37, P=0.002), left atrium ( B=0.16, P<0.001), and right atrium ( B=0.15, P=0.001). There were significant differences in the changes of LVGLS and LAGLS across different time points ( F=3.13, P=0.029; F=17.18, P<0.001). At 1 month after radiation, LAGLS was significantly decreased compared to pre-radiation levels ( P=0.009), whereas no significant difference was observed in LVGLS ( P=1.000). No significant differences were observed in the changes of cTnT and NT-proBNP across different time points (all P>0.05). Significant correlations were identified between cTnT and right ventricle mean dose at t40 ( r=0.38, P=0.025), as well as between NT-proBNP and right atrium mean dose at t60 and tp ( r=0.54, P=0.001; r=0.41, P=0.016). Conclusions:At present, there is no significant difference between the sensitive serum markers of myocardial injury and LVGLS in detecting early myocardial injury. LAGLS may hold substantial clinical value. There is uncertainty about radiation injury and repair of various cardiac substructures.
7.A prospective randomized clinical study of folic acid in the intervention of radiation esophagitis induced by concurrent chemoradiotherapy in lung cancer
Hao ZHANG ; Yiying ZHU ; Weiwei OUYANG ; Shengfa SU ; Zhu MA ; Qingsong LI ; Yichao GENG ; Wengang YANG ; Xiaxia CHEN ; Bing LU
Chinese Journal of Radiation Oncology 2025;34(1):65-72
Objective:To investigate the efficacy of oral folic acid intervention in lung cancer patients with radiation esophagitis (RE) caused by concurrent chemoradiotherapy.Methods:In this randomized, controlled, single-center clinical trial, a total of 82 patients with stage N 2-N 3 lung cancer including small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC) admitted to the Affiliated Cancer Hospital of Guizhou Medical University from June 2022 to October 2023 were prospectively included. All enrolled patients were randomly divided into the experimental group (folic acid group) and control group according to 1 vs. 1 of simple random method, and patients in both groups were required to receive radiation therapy for lung lesions and mediastinal metastatic lymph nodes [≥2 cycles of chemotherapy were completed during the same period of radiotherapy (≥40 Gy / 20 F) or targeted drugs were given simultaneously]. The severity of RE was evaluated using the modified common terminology criteria for adverse events criteria of the National Cancer Institute in both groups weekly at the onset of radiation esophagitis symptoms and thereafter until 1 week after the end of radiotherapy. Conventional treatment of RE was delivered according to the grading criteria of the Radiation Therapy Oncology Group. Patients in the folic acid group were given with folic acid tablets 30 mg/d orally at the beginning of radiotherapy until the end of radiotherapy, while those in the control group did not receive any drug intervention. The onset time, severity and duration of RE, and changes in the severity of esophageal toxicity after conventional treatment were recorded and analyzed. Serum folate value, serum vitamin B 12 value and homocysteine value were measured before and after radiotherapy. For continuous quantitative variables, independent sample t-test or independent sample rank-sum test was used for comparison among different groups. For categorical data, Chi-square test or Fisher's exact probability method was used for comparison among different groups. Results:During the observation period, no grade 4 or above RE was reported between two groups. The incidence of grade 0, 1, 2 and 3 RE in the folic acid and control groups was 10% (4/40) and 5% (2/41), 70% (28/40) and 42% (17/41), 15% (6/40) and 51% (21/41), 5% (2/40) and 2% (1/41), respectively. The differences were not statistically significant between two groups ( P=0.456). However, the incidence of grade 0-1 RE in the folic acid group was significantly higher than that in the control group ( Z=2.72, P=0.006). The median time of RE in the folic acid group and control group was 12 d (range 7-52 d) and 15 d (range 11-56 d) after the start of radiotherapy, respectively, with no statistically significant difference ( χ2=-0.75, P=0.456). However, median duration of the individual's most severe RE was 12 d (range 4-36 d) and 21 d (range 7-38 d) in the folic acid group and control groups, respectively, and the differences were statistically significant ( χ2=2.10, P=0.039). In the folic acid group, the grades of swallowing with pain and dysphagia were significantly declined after folic acid intervention, especially at 2 weeks after the occurrence of RE ( P=0.001, P=0.002). The remission rate of RE after 1 week in the folic acid group was higher than that in the control group, and the difference was statistically significant ( χ2=7.36, P=0.012). Conclusion:Oral intake of folic acid during concurrent chemoradiotherapy for lung cancer cannot reduce the incidence of RE, but it may reduce its severity, shorten the duration of the most severe RE in individuals, and have a certain protective effect.
8.A prospective study on clinical monitoring of early cardiac myocardial dysfunction by conventional radiotherapy in N 2-N 3 non-small cell lung cancer with lymph node metastases
Yiying ZHU ; Hao ZHANG ; Weiwei OUYANG ; Shengfa SU ; Yinxiang HU ; Zhu MA ; Sha LI ; Qingsong LI ; Wengang YANG ; Xiaxia CHEN ; Haijie JIN ; Jie LIU ; Fuhuan LUO ; Zhourui LIU ; Bing LU
Chinese Journal of Radiation Oncology 2025;34(7):664-670
Objective:To analyze the changes and significance in clinical cardiac indicators of early cardiac myocardial dysfunction and cardiac substructure dose during conventional radiotherapy for N 2-N 3 non-small cell lung cancer (NSCLC) with mediastinal lymph node metastases. Methods:The data of 34 NSCLC patients with lymph node metastases in regions 4-8 admitted to the Affiliated Cancer Hospital of Guizhou Medical University from June 2022 to August 2023 were observed and analyzed. All patients were treated with volumetric modulated arc therapy with a prescribed dose of 60-70 Gy. Cardiac troponin T (cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were measured at 6 time points: within 1 week before radiotherapy ( t0); when the cumulative radiotherapy dose reaches 20 Gy ( t20), 40 Gy ( t40), 60 Gy ( t60) during radiotherapy; within 1 week after radiotherapy ( tp); 1 month after radiotherapy( tp1). Left ventricular global longitudinal strain (LVGLS) and left atrial global longitudinal strain (LAGLS) were assessed at 4 time points: t0, t40, tp and tp1, respectively. The changes in cardiac indicators at different time points during radiotherapy and their correlation with substructure doses were analyzed using analysis of variance, linear regression analysis, and Pearson correlation. Results:The correlation between cardiac substructure dose and mean heart dose (MHD) in the study cohort in the descending order was as follows: left ventricle ( B=0.43, P<0.001), right ventricle ( B=0.37, P=0.002), left atrium ( B=0.16, P<0.001), and right atrium ( B=0.15, P=0.001). There were significant differences in the changes of LVGLS and LAGLS across different time points ( F=3.13, P=0.029; F=17.18, P<0.001). At 1 month after radiation, LAGLS was significantly decreased compared to pre-radiation levels ( P=0.009), whereas no significant difference was observed in LVGLS ( P=1.000). No significant differences were observed in the changes of cTnT and NT-proBNP across different time points (all P>0.05). Significant correlations were identified between cTnT and right ventricle mean dose at t40 ( r=0.38, P=0.025), as well as between NT-proBNP and right atrium mean dose at t60 and tp ( r=0.54, P=0.001; r=0.41, P=0.016). Conclusions:At present, there is no significant difference between the sensitive serum markers of myocardial injury and LVGLS in detecting early myocardial injury. LAGLS may hold substantial clinical value. There is uncertainty about radiation injury and repair of various cardiac substructures.
9.Clinical characteristics and prognostic analysis of carbapenem-resistant Enterobacteriaceae bloodstream infections in patients with hematologic diseases
Lining ZHANG ; Yuqing CUI ; Qingsong LIN ; Chunhui XU ; Jiali SUN ; Yigeng CAO ; Wenbin CAO ; Chen LIANG ; Xin CHEN ; Weihua ZHAI ; Qiaoling MA ; Rongli ZHANG ; Jialin WEI ; Donglin YANG ; Aiming PANG ; Yi HE ; Erlie JIANG ; Mingzhe HAN ; Sizhou FENG
Chinese Journal of Hematology 2024;45(11):1022-1027
Objectives:This study aimed to analyze the clinical and molecular characteristics of carbapenem-resistant Enterobacteriaceae (CRE) bloodstream infection (BSI) in patients with hematological diseases and to explore prognostic risk factors.Methods:This retrospective study included patients with hematologic diseases with CRE BSI at the Institute of Hematology and Blood Diseases Hospital from January 2015 to December 2022. The clinical features, carbapenemase test results, antimicrobial treatments, and outcomes were analyzed.Results:A total of 120 patients developed CRE BSI. Escherichia coli (58/120, 48.3%) was the most prevalent Enterobacteriaceae, followed by Klebsiella pneumoniae (52/120, 43.3%). A total of 93 CRE strains were tested for carbapenemase, of which 75 strains produced carbapenemase (metalloenzyme: 51 strains; serine enzyme: 24 strains). The 30-day mortality rate after BSI was 24.2% (29/120). Univariate analysis revealed significantly lower mortality in patients treated with the ceftazidime-avibactam-containing regimen than in those treated with other antibiotics (7.8% vs 36.2%, P<0.001). Moreover, initiating active therapy within 24 h of BSI onset significantly reduced mortality (15.0% vs 33.3%, P=0.019). The proportion of patients with CRE colonization receiving active therapy within 12 and 24 h was significantly higher compared with patients without colonization (12 h: 14.5% vs 34.1%, P=0.012; 24 h: 40.8% vs 65.9%, P=0.008). Multivariate analysis revealed that septic shock ( HR=24.436, 95% CI 4.148 - 143.966, P<0.001) and pulmonary infection ( HR=9.346, 95% CI 2.718-32.140, P<0.001) were independent risk factors for death within 30 days. Appropriate therapy was initiated within 24 h ( HR=0.225, 95% CI 0.059 - 0.851, P=0.028), and treatment with the ceftazidime-avibactam-containing regimen ( HR=0.082, 95% CI 0.018-0.362, P=0.001) significantly reduced mortality. Conclusion:The prognosis of CRE BSI in patients with hematological diseases is poor. Timely, appropriate therapy and receipt of a ceftazidime-avibactam-containing regimen can improve survival and prognosis.
10.Differential diagnosis of post-thrombectomy high-density shadow within the brain parenchyma displayed on early plain CT scan in patients with ischemic stroke
Yuan MA ; Peicheng LI ; Qingsong LI ; Huijuan SHI ; Yizhi LIU ; Long CHEN
Journal of Interventional Radiology 2024;33(8):829-833
Objective To differentiate cerebral parenchymal hemorrhage from contrast extravasation based on the imaging characteristics of a high-density shadow within the brain parenchyma,which is demonstrated on early(within 24 hours)plain CT scan in patients with acute ischemic stroke after receiving mechanical thrombectomy(MT).Methods The clinical data of 77 patients with ischemic stroke caused by acute large-vessel occlusion,who received MT and whose early plain CT scan(performed within 24 hours after MT)showed a high-density shadow within the brain parenchyma,were retrospectively analyzed.According to the results of CT reexamination performed at 24-48 hours after treatment,the patients were divided into parenchymal hemorrhage group(n=38,43 sites)and pure contrast extravasation group(n=39,47 sites).The direct signs(including location distribution,maximum CT value,volume,mixed density sign)and the indirect signs(including local space-occupying effect,intraventricular high density,subarachnoid high density)of the post-thrombectomy intraparenchymal high-density(PTIH)shadow displayed on early CT images after MT were analyzed.The differences in imaging characteristics between the two groups were analyzed by using t-test,Mann-Whitney rank sum test,chi-square test,Fisher exact test and multivariate logistic regression analysis.Results The space-occupying effect(28/38 versus 9/39,P=0.003)and intraventricular high density lesion(5/38 versus 0/39,P=0.025)were more likely to occur in the parenchymal hemorrhage group than in the pure contrast extravasation group.The newly-developed 90 PTIH lesions included 43 parenchymal hemorrhage foci and 47 contrast extravasation foci.Multivariate logistic regression analysis showed that the differences in the PTIH volume and mixed density sign between the two groups were statistically significant(both P<0.05,OR=2.93 and OR=9.24 respectively).The optimal critical value of PTIH volume for diagnosing cerebral parenchymal hemorrhage was 9.3 cm3.Conclusion The space-occupying effect and intraventricular high density are the indirect signs for judging a newly-developed PTIH to be a cerebral parenchymal hemorrhage.PTIH volume ≥9.3 cm3 and mixed density sign are the direct signs for judging a newly-developed PTIH to be a cerebral parenchymal hemorrhage.

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