1.Qualitative and quantitative analysis of chemical components of different processed products of Corni Fructus by UPLC-Q-TOF-MS and UPLC-QqQ-MS/MS.
Li-Qiang ZHANG ; Guo-Shun SHAN ; Yi-Dan HONG ; Si-Han LIU ; Guo-Wei XU ; Hui GAO ; Wei WANG ; Cheng-Guo JU
China Journal of Chinese Materia Medica 2025;50(8):2145-2158
Qualitative and quantitative analysis methods for chemical components of different processed products of Corni Fructus were established to systematically characterize and identify these components, and the content of the main differential components was determined. The chemical components of different processed products of Corni Fructus were collected using ultra-high performance liquid chromatography-quadrupole time-of-flight tandem mass spectrometry(UPLC-Q-TOF-MS). Through analysis of self-built databases, literature, and reference standards, a total of 93 components were obtained, including 19 iridoids, 15 flavonoids, 16 organic acids, eight triterpenoids, eight tannins, four amino acids, two polysaccharides, five olefins, and 16 other compounds. Additionally, by using multivariate statistical methods, the differential components between different processed products of Corni Fructus were screened under the conditions of VIP>1.0 and FC<0.5 or FC>2.0 and P<0.05. The PCA and OPLS-DA results showed differences in the chemical components between different processed products of Corni Fructus. A total of 21 differential components were screened, including tartaric acid, morroniside, and rutin. On this basis, ultra-high performance liquid chromatography-triple quadrupole tandem mass spectrometry(UPLC-QqQ-MS/MS) was used to determine the content of 10 main common differential components, including gallic acid, morroniside, ursolic acid, loganin, swertiamarin, rutin, 5-hydroxymethylfurfural, cornuside Ⅰ, quercetin, and oleanolic acid. The above 10 components showed a good linear relationship within the determined concentration range, with the precision, stability, repeatability, and sample recovery rate all meeting the requirements. Compared with that in Corni Fructus, the content of iridoid glycosides in wine-prepared Corni Fructus and wine-and honey-prepared Corni Fructus decreased, while the content of gallic acid, rutin, quercetin, 5-hydroxymethylfurfural, ursolic acid, and oleanolic acid increased. Compared with wine-prepared Corni Fructus, wine-and honey-prepared Corni Fructus showed varying degrees of increase in all other components, except for a slight decrease in gallic acid content. In summary, this study clarified the influence of different processing methods on the chemical components of Corni Fructus, providing a theoretical basis for the scientific connotation, overall quality evaluation, and clinically rational application of Corni Fructus processing in the future.
Tandem Mass Spectrometry/methods*
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Chromatography, High Pressure Liquid/methods*
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Cornus/chemistry*
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Drugs, Chinese Herbal/chemistry*
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Fruit/chemistry*
2.Study on the efficacy of automatic-controlled pressure cupping for lumbar disc herniation.
Bo-Chen PENG ; Min-Shan FENG ; Li LI ; Gui-Ju REN ; Yi-Zhen YUAN ; Li-Jie CHANG ; Shu-Ying REN ; Liu ZENG ; Guang-Wei LIU ; Li-Guo ZHU ; Na YUAN
China Journal of Orthopaedics and Traumatology 2025;38(11):1133-1138
OBJECTIVE:
To observe the clinical efficacy and safety of automatic pressure-controlled pressure cupping in patients with lumbar disc herniation, and compare it with traditional cupping.
METHODS:
A total of 100 patients diagnosed with lumbar disc herniation from January 2022 to August 2024 were selected and divided into two groups:the automatic pressure-controlled pressure cupping group (controlled pressure cupping group) and the traditional cupping group (control group), 50 cases in each group. In the controlled pressure cupping group, there were 18 males and 32 females, with an age of (51.98±12.69) years;in the control group, there were 16 males and 34 females, with an age of (51.32±12.05) years. The visual analogue scale(VAS), comfort score, and lumbar range of motion were observed before treatment and after the 1st, 3rd, and 7th treatments to evaluate the efficacy and safety.
RESULTS:
All patients completed the treatment intervention, with complete follow-up data collected. No adverse reactions or complications occurred during treatment and follow-up. After the 3rd treatment, the VAS score of the controlled pressure cupping group was (2.38±0.49), which was lower than that of the control group (2.94±0.68), with a statistically significant difference (P<0.001). In the controlled pressure cupping group, the VAS scores after the 1st, 3rd, and 7th treatments were significantly better than those before treatment (P=0.026);in the control group, the VAS scores after the 3rd and 7th treatments were better than those before treatment, but the difference was not statistically significant(P=0.182). Repeated-measures analysis of variance (ANOVA) on VAS scores at different time points in both groups showed that there were statistically significant differences in inter-group, time, and interaction effects (P<0.05). After the 1st treatment, in the controlled pressure cupping group, 0 patients felt comfortable, 42 patients (84%) felt mild discomfort, and 8 patients (16%) felt moderate discomfort;in the control group, 0 patients felt comfortable, 28 patients (56%) felt mild discomfort, and 22 patients(44%) felt moderate discomfort;the difference between the two groups was statistically significant(P=0.005). After the 3rd treatment, in the controlled pressure cupping group, 30 patients(60%) felt comfortable, 20 patients (40%) felt mild discomfort, and 0 patients felt moderate discomfort; in the control group, 9 patients (18%) felt comfortable, 41 patients (82%) felt mild discomfort, and 0 patients felt moderate discomfort;the difference between the two groups was statistically significant(P<0.001). There was no statistically significant difference in comfort between the two groups after the 7th treatment(P>0.001). There was no statistically significant difference in lumbar range of motion between the two groups before and after treatment(P>0.05);compared with before treatment, the lumbar range of motion of both groups after treatment was significantly improved, with statistically significant differences (P<0.001).
CONCLUSION
Automatic pressure-controlled pressure cupping can effectively relieve symptoms in patients with lumbar disc herniation, with excellent safety.
Humans
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Female
;
Male
;
Intervertebral Disc Displacement/physiopathology*
;
Middle Aged
;
Adult
;
Lumbar Vertebrae/physiopathology*
;
Cupping Therapy/methods*
;
Pressure
;
Aged
;
Treatment Outcome
3.HFA-ICOS score in predicting cancer therapy-related cardiac dysfunction among breast cancer and lymphoma patients
Chang SHAN ; Mingyue JU ; Mei YANG ; Yanli ZHANG ; Xinxin ZHANG ; Xuefu CHEN ; Jia LI ; Fengqi FANG ; Xiuli SUN ; Yunlong XIA ; Ying LIU
Chinese Journal of Cardiology 2025;53(8):882-890
Objective:To explore the predictive efficacy of the HFA-ICOS score for cancer therapy-related cardiac dysfunction (CTRCD) in Chinese patients with breast cancer and lymphoma.Methods:This study was a single-center retrospective cohort study which included patients with breast cancer and lymphoma who were treated with anthracyclines from February 2018 to February 2025 at the First Affiliated Hospital of Dalian Medical University. Patients were evaluated at baseline with cardiac biomarkers and echocardiography, including left ventricular ejection fraction and global longitudinal strain of the left ventricle. After anthracycline therapy, they were followed up at 1, 3, 6, and 12 months. Data involved biomarkers and echocardiography were collected to determine whether CTRCD had occurred. The patients were categorized into low-risk, intermediate-risk, high-risk, and very-high-risk groups using the HFA-ICOS scoring model. The cumulative probability of CTRCD under different HFA-ICOS risk stratification was analyzed using Kaplan-Meier survival curves. The effect of HFA-ICOS risk stratification on CTRCD was assessed using an univariate Cox proportional hazards regression model. The predictive efficacy of the HFA-ICOS model and its utility in clinical decision-making were assessed with receiver operating characteristic (ROC) curves, calibration curves, and decision curves at each time point.Results:A total of 286 patients, aged 55 (44, 61) years, were enrolled, of whom 33 (11.5%) cases were male. And 113 (39.5%) patients developed CTRCD during a median follow-up time of 111 (70, 210) days. HFA-ICOS risk stratification showed that 228 (79.7%) were low-risk, 49 (17.1%) were intermediate-risk, and a total of 9 (3.1%) were high-risk and very high-risk. The difference in the occurrence of CTRCD over time between patients with different HFA-ICOS risk stratification was statistically significant ( Plog-rank<0.001). Cox proportional regression hazards analysis showed an increased risk of CTRCD development in intermediate-risk ( HR=1.95, 95% CI 1.22-3.00, P=0.006) and high-risk and very high-risk patients ( HR=4.12, 95% CI 1.66-8.54, P=0.004) compared with low-risk patients. The ROC curves showed that the area under the curve of the HFA-ICOS model predicting CTRCD was 0.532, 0.597, 0.600 and 0.577 at 1, 3, 6 and 12 months, respectively. The calibration curves indicated Brier scores of 0.041 (95% CI 0.013-0.067), 0.144 (95% CI 0.115-0.173), 0.232 (95% CI 0.215-0.249) and 0.236 (95% CI 0.220-0.251) at 1, 3, 6 and 12 months, correspondingly. The clinical decision curve suggested that clinical intervention may have a net benefit when the risk threshold is between 0.15 and 0.18 at 1 month, between 0.10 and 0.50 at 3 months, and between 0.30 and 0.70 at 6 and 12 months. Conclusion:The HFA-ICOS score could predict the occurrence of CTRCD in patients with breast cancer and lymphoma treated with anthracycline drugs, although its predictive efficacy is limited, and the prediction model requires further validation in a larger population.
4.Effectiveness evaluation of the construction of "mosquito-free village" in Fuling District
WANG Ling ; JU Denghui ; XIANG Yu ; YU Shan ; LI Jiwen
Journal of Preventive Medicine 2025;37(7):714-717,721
Objective:
To evaluate the effectiveness for the construction of the "mosquito-free village" in Jinzishan Village, Fuling District, Chongqing Municipality, so as to provide references for improving mosquito control practices in hilly and mountainous rural areas.
Methods:
The "mosquito-free village" initiative in Fuling District was launched in April 2023. Mosquito density monitoring was conducted annually from April to October. Larval mosquito density was monitored using the path method and scoop-catch method, and adult mosquito density was monitored using human-baited landing catch. One hundred and fifty-two villagers were randomly conducted before the "mosquito-free village" construction (April 2023) and one hundred and sixty-seven villagers were randomly conducted after the construction (November 2024). Knowledge awareness rate and correct behavioral practices regarding mosquito control among villagers were assessed. The satisfaction among villagers were evaluated in November 2024. The effectiveness of the initiative was evaluated based on mosquito density data, health education outcomes from 2023 to 2024, and satisfaction.
Results:
The average larval mosquitoes path index in Jinshanzi Village decreased from 1.50 spots/km in 2023 to 0.07 spots/km in 2024 (P<0.05). The average sampling spoon index of larval mosquitoes decreased from 3.43% in 2023 to 0 in 2024. The average landing rate index of adult mosquitoes decreased from 3.90 mosquitoes/(person·time) in 2023 to 0.38 mosquitoes/(person·time) in 2024 (P<0.05). The awareness rate of mosquito control knowledge and the formation rate of correct behaviors among villagers increased from 59.87% and 57.24% in 2023 to 92.22% and 90.42% in 2024, respectively (both P<0.05). In 2024, the satisfaction of villagers was 92.81%.
Conclusion
The mosquito density, health education effectiveness, and satisfaction of villagers in Jinzishan Village have all met the evaluation criteria for a "mosquito-free village", providing a replicable model for promotion in hilly and mountainous rural areas.
5.Mechanism underlying the effect of formononetin on interleukin-1beta-induced chondrocyte injury
Jixin SHAN ; Ruibin YE ; Shaohua JU ; Qiang WANG
Chinese Journal of Tissue Engineering Research 2025;29(12):2484-2491
BACKGROUND:Formononetin is an isoflavonoid compound widely found in red clover,astragalus,and chickweed,which has the ability to inhibit oxidative stress,inflammatory factor release,and apoptosis. OBJECTIVE:To investigate the effect of formononetin on interleukin-1β-induced chondrocyte injury and its mechanism. METHODS:(1) Cartilage tissues from patients with osteoarthritis and patients with simple meniscus injury were collected,and real-time quantitative PCR was used to detect miR-135b-5p expression. (2) Human chondrocytes were cultured in vitro,and then divided them into nine groups:cells in normal control group were cultured for 48 hours with no treatment;cells in interleukin-1β group were treated with interleukin-1β for 48 hours;cells in interleukin-1β+low-dose formononetin group were treated with 25 μmol/L formononetin for 24 hours followed by treatment with interleukin-1β for 48 hours;cells in interleukin-1β+middle-dose formononetin group were treated with 50 μmol/L formononetin for 24 hours followed by treatment with interleukin-1β for 48 hours;cells in interleukin-1β+high-dose formononetin group were treated with 100 μmol/L formononetin for 24 hours followed by treatment with interleukin-1β for 48 hours;cells in interleukin-1β+miR NC group were treated with miR NC for 6 hours followed by treatment with interleukin-1β for 48 hours;cells in interleukin-1β+miR-135b-5p group were treated with miR-135b-5p mimics for 6 hours followed by treatment with interleukin-1β for 48 hours;cells in interleukin-1β+high dose formononetin+anti-miR-NC group were treated with anti-miR-NC for 6 hours,then treated with 100 μmol/L formononetin for 24 hours,and finally treate with interleukin-1β for 48 hours;cells in interleukin-1β+high-dose formononetin+anti-miR-135b-5p group were treated with anti-miR-135b-5p for 6 hours,the treated with 100 μmol/L formononetin for 24 hours,and finally treated with interleukin-1β for 48 hours. Relevant tests are performed after treatment. RESULTS AND CONCLUSION:The expression level of miR-135b-5p in cartilage tissue of patients with osteoarthritis was significantly lower than that of patients with simple meniscus injury (P<0.05). Compared with the normal control group,the expression level of miR-135b-5p,proliferative ability,activity of superoxid dismutase,and expression levels of collagenase Ⅱ protein and Bcl-2 protein in chondrocytes were lower in the interleukin-1β group (P<0.05),while apoptotic rate,lactate dehydrogenase activity,malondialdehyde level,levels of proinflammatory factors,and expression levels of matrix metalloproteinase-13 protein and Bax protein were higher in the interleukin-1β group (P<0.05). Formononetin inhibited chondrocyte damage caused by interleukin-1β in a concentration-dependent manner. Transfection of miR-135b-5p mimics elevated miR-135b-5p expression in the interleukin-1β group and inhibited chondrocyte damage induced by interleukin-1β;transfection of anti-miR-135b-5p decreased miR-135b-5p expression in the interleukin-1β+high-dose formononetin group and inhibited the effect of formononetin on chondrocytes. To conclude,the protective effect of formononetin on chondrocyte injury induced by interleukin-1β may be related to the regulation of miR-135b-5p expression.
6.Mechanism underlying the effect of formononetin on interleukin-1beta-induced chondrocyte injury
Jixin SHAN ; Ruibin YE ; Shaohua JU ; Qiang WANG
Chinese Journal of Tissue Engineering Research 2025;29(12):2484-2491
BACKGROUND:Formononetin is an isoflavonoid compound widely found in red clover,astragalus,and chickweed,which has the ability to inhibit oxidative stress,inflammatory factor release,and apoptosis. OBJECTIVE:To investigate the effect of formononetin on interleukin-1β-induced chondrocyte injury and its mechanism. METHODS:(1) Cartilage tissues from patients with osteoarthritis and patients with simple meniscus injury were collected,and real-time quantitative PCR was used to detect miR-135b-5p expression. (2) Human chondrocytes were cultured in vitro,and then divided them into nine groups:cells in normal control group were cultured for 48 hours with no treatment;cells in interleukin-1β group were treated with interleukin-1β for 48 hours;cells in interleukin-1β+low-dose formononetin group were treated with 25 μmol/L formononetin for 24 hours followed by treatment with interleukin-1β for 48 hours;cells in interleukin-1β+middle-dose formononetin group were treated with 50 μmol/L formononetin for 24 hours followed by treatment with interleukin-1β for 48 hours;cells in interleukin-1β+high-dose formononetin group were treated with 100 μmol/L formononetin for 24 hours followed by treatment with interleukin-1β for 48 hours;cells in interleukin-1β+miR NC group were treated with miR NC for 6 hours followed by treatment with interleukin-1β for 48 hours;cells in interleukin-1β+miR-135b-5p group were treated with miR-135b-5p mimics for 6 hours followed by treatment with interleukin-1β for 48 hours;cells in interleukin-1β+high dose formononetin+anti-miR-NC group were treated with anti-miR-NC for 6 hours,then treated with 100 μmol/L formononetin for 24 hours,and finally treate with interleukin-1β for 48 hours;cells in interleukin-1β+high-dose formononetin+anti-miR-135b-5p group were treated with anti-miR-135b-5p for 6 hours,the treated with 100 μmol/L formononetin for 24 hours,and finally treated with interleukin-1β for 48 hours. Relevant tests are performed after treatment. RESULTS AND CONCLUSION:The expression level of miR-135b-5p in cartilage tissue of patients with osteoarthritis was significantly lower than that of patients with simple meniscus injury (P<0.05). Compared with the normal control group,the expression level of miR-135b-5p,proliferative ability,activity of superoxid dismutase,and expression levels of collagenase Ⅱ protein and Bcl-2 protein in chondrocytes were lower in the interleukin-1β group (P<0.05),while apoptotic rate,lactate dehydrogenase activity,malondialdehyde level,levels of proinflammatory factors,and expression levels of matrix metalloproteinase-13 protein and Bax protein were higher in the interleukin-1β group (P<0.05). Formononetin inhibited chondrocyte damage caused by interleukin-1β in a concentration-dependent manner. Transfection of miR-135b-5p mimics elevated miR-135b-5p expression in the interleukin-1β group and inhibited chondrocyte damage induced by interleukin-1β;transfection of anti-miR-135b-5p decreased miR-135b-5p expression in the interleukin-1β+high-dose formononetin group and inhibited the effect of formononetin on chondrocytes. To conclude,the protective effect of formononetin on chondrocyte injury induced by interleukin-1β may be related to the regulation of miR-135b-5p expression.
7.Guideline for assessment and maintenance of intrinsic capacity in older adults
Wenjing LIU ; Zhiwen WANG ; Yuelin YU ; Xin REN ; Hui JU ; Hong CHEN ; Junxin WANG ; Shan-shan CHEN ; Jia ZHOU ; Mo YI ; Wenxia WANG ; Lingjuan ZHANG ; Siye CHEN ; Yufan YANG ; Xiaomeng WANG ; Hong SUN
Chinese Journal of Nursing 2025;60(3):261-265
Objective This study aims to develop a guideline for assessing and maintaining intrinsic capacity in older adults,offer recommendations to professionals regarding these assessments,and encourage the implementation of evidence-based clinical practices across various settings,including communities,hospitals,nursing homes,and other geriatric care environments.Methods An evidence-based approach guided the collection of questions through a lit-erature review.Preliminary recommendations were developed through a systematic search of domestic and interna-tional guideline networks,professional association websites,and comprehensive databases.Subsequently,the recom-mendations were revised,and the consensus was achieved through a round of expert consensus meetings and 3 rounds of expert correspondence,culminating in the formation of the guidelines.Results The developed guideline encompasses 2 aspects and 5 dimensions of assessment and maintenance,comprising a total of 28 questions and 39 recommendations.Specifically,6 questions and 9 recommendations were formulated for the cognitive dimension,5 questions and 7 recommendations for the locomotion dimension,6 questions and 7 recommendations for the vitality dimension,6 questions and 9 recommendations for the psychological dimension,and 5 questions and 7 recommenda-tions for the sensory dimension.Among these,34 are classified as strong recommendations,while 5 are categorized as weak recommendations.Conclusion The guideline offers scientifically robust,acceptable,and comprehensible rec-ommendations that equip the professionals with a foundation for decision-making aiming at preserving the intrinsic capacity of older adults.
8.Guideline for assessment and maintenance of intrinsic capacity in older adults
Wenjing LIU ; Zhiwen WANG ; Yuelin YU ; Xin REN ; Hui JU ; Hong CHEN ; Junxin WANG ; Shan-shan CHEN ; Jia ZHOU ; Mo YI ; Wenxia WANG ; Lingjuan ZHANG ; Siye CHEN ; Yufan YANG ; Xiaomeng WANG ; Hong SUN
Chinese Journal of Nursing 2025;60(3):261-265
Objective This study aims to develop a guideline for assessing and maintaining intrinsic capacity in older adults,offer recommendations to professionals regarding these assessments,and encourage the implementation of evidence-based clinical practices across various settings,including communities,hospitals,nursing homes,and other geriatric care environments.Methods An evidence-based approach guided the collection of questions through a lit-erature review.Preliminary recommendations were developed through a systematic search of domestic and interna-tional guideline networks,professional association websites,and comprehensive databases.Subsequently,the recom-mendations were revised,and the consensus was achieved through a round of expert consensus meetings and 3 rounds of expert correspondence,culminating in the formation of the guidelines.Results The developed guideline encompasses 2 aspects and 5 dimensions of assessment and maintenance,comprising a total of 28 questions and 39 recommendations.Specifically,6 questions and 9 recommendations were formulated for the cognitive dimension,5 questions and 7 recommendations for the locomotion dimension,6 questions and 7 recommendations for the vitality dimension,6 questions and 9 recommendations for the psychological dimension,and 5 questions and 7 recommenda-tions for the sensory dimension.Among these,34 are classified as strong recommendations,while 5 are categorized as weak recommendations.Conclusion The guideline offers scientifically robust,acceptable,and comprehensible rec-ommendations that equip the professionals with a foundation for decision-making aiming at preserving the intrinsic capacity of older adults.
9.HFA-ICOS score in predicting cancer therapy-related cardiac dysfunction among breast cancer and lymphoma patients
Chang SHAN ; Mingyue JU ; Mei YANG ; Yanli ZHANG ; Xinxin ZHANG ; Xuefu CHEN ; Jia LI ; Fengqi FANG ; Xiuli SUN ; Yunlong XIA ; Ying LIU
Chinese Journal of Cardiology 2025;53(8):882-890
Objective:To explore the predictive efficacy of the HFA-ICOS score for cancer therapy-related cardiac dysfunction (CTRCD) in Chinese patients with breast cancer and lymphoma.Methods:This study was a single-center retrospective cohort study which included patients with breast cancer and lymphoma who were treated with anthracyclines from February 2018 to February 2025 at the First Affiliated Hospital of Dalian Medical University. Patients were evaluated at baseline with cardiac biomarkers and echocardiography, including left ventricular ejection fraction and global longitudinal strain of the left ventricle. After anthracycline therapy, they were followed up at 1, 3, 6, and 12 months. Data involved biomarkers and echocardiography were collected to determine whether CTRCD had occurred. The patients were categorized into low-risk, intermediate-risk, high-risk, and very-high-risk groups using the HFA-ICOS scoring model. The cumulative probability of CTRCD under different HFA-ICOS risk stratification was analyzed using Kaplan-Meier survival curves. The effect of HFA-ICOS risk stratification on CTRCD was assessed using an univariate Cox proportional hazards regression model. The predictive efficacy of the HFA-ICOS model and its utility in clinical decision-making were assessed with receiver operating characteristic (ROC) curves, calibration curves, and decision curves at each time point.Results:A total of 286 patients, aged 55 (44, 61) years, were enrolled, of whom 33 (11.5%) cases were male. And 113 (39.5%) patients developed CTRCD during a median follow-up time of 111 (70, 210) days. HFA-ICOS risk stratification showed that 228 (79.7%) were low-risk, 49 (17.1%) were intermediate-risk, and a total of 9 (3.1%) were high-risk and very high-risk. The difference in the occurrence of CTRCD over time between patients with different HFA-ICOS risk stratification was statistically significant ( Plog-rank<0.001). Cox proportional regression hazards analysis showed an increased risk of CTRCD development in intermediate-risk ( HR=1.95, 95% CI 1.22-3.00, P=0.006) and high-risk and very high-risk patients ( HR=4.12, 95% CI 1.66-8.54, P=0.004) compared with low-risk patients. The ROC curves showed that the area under the curve of the HFA-ICOS model predicting CTRCD was 0.532, 0.597, 0.600 and 0.577 at 1, 3, 6 and 12 months, respectively. The calibration curves indicated Brier scores of 0.041 (95% CI 0.013-0.067), 0.144 (95% CI 0.115-0.173), 0.232 (95% CI 0.215-0.249) and 0.236 (95% CI 0.220-0.251) at 1, 3, 6 and 12 months, correspondingly. The clinical decision curve suggested that clinical intervention may have a net benefit when the risk threshold is between 0.15 and 0.18 at 1 month, between 0.10 and 0.50 at 3 months, and between 0.30 and 0.70 at 6 and 12 months. Conclusion:The HFA-ICOS score could predict the occurrence of CTRCD in patients with breast cancer and lymphoma treated with anthracycline drugs, although its predictive efficacy is limited, and the prediction model requires further validation in a larger population.
10.Evaluation of Malignancy Risk of Ampullary Tumors Detected by Endoscopy Using 2- 18FFDG PET/CT
Pei-Ju CHUANG ; Hsiu-Po WANG ; Yu-Wen TIEN ; Wei-Shan CHIN ; Min-Shu HSIEH ; Chieh-Chang CHEN ; Tzu-Chan HONG ; Chi-Lun KO ; Yen-Wen WU ; Mei-Fang CHENG
Korean Journal of Radiology 2024;25(3):243-256
Objective:
We aimed to investigate whether 2-[ 18F]fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (2-[ 18F]FDG PET/CT) can aid in evaluating the risk of malignancy in ampullary tumors detected by endoscopy.
Materials and Methods:
This single-center retrospective cohort study analyzed 155 patients (79 male, 76 female; mean age, 65.7 ± 12.7 years) receiving 2-[ 18F]FDG PET/CT for endoscopy-detected ampullary tumors 5–87 days (median, 7 days) after the diagnostic endoscopy between June 2007 and December 2020. The final diagnosis was made based on histopathological findings. The PET imaging parameters were compared with clinical data and endoscopic features. A model to predict the risk of malignancy, based on PET, endoscopy, and clinical findings, was generated and validated using multivariable logistic regression analysis and an additional bootstrapping method. The final model was compared with standard endoscopy for the diagnosis of ampullary cancer using the DeLong test.
Results:
The mean tumor size was 17.1 ± 7.7 mm. Sixty-four (41.3%) tumors were benign, and 91 (58.7%) were malignant. Univariable analysis found that ampullary neoplasms with a blood-pool corrected peak standardized uptake value in earlyphase scan (SUVe) ≥ 1.7 were more likely to be malignant (odds ratio [OR], 16.06; 95% confidence interval [CI], 7.13–36.18;P < 0.001). Multivariable analysis identified the presence of jaundice (adjusted OR [aOR], 4.89; 95% CI, 1.80–13.33; P = 0.002), malignant traits in endoscopy (aOR, 6.80; 95% CI, 2.41–19.20; P < 0.001), SUVe ≥ 1.7 in PET (aOR, 5.43; 95% CI, 2.00–14.72; P < 0.001), and PET-detected nodal disease (aOR, 5.03; 95% CI, 1.16–21.86; P = 0.041) as independent predictors of malignancy. The model combining these four factors predicted ampullary cancers better than endoscopic diagnosis alone (area under the curve [AUC] and 95% CI: 0.925 [0.874–0.956] vs. 0.815 [0.732–0.873], P < 0.001). The model demonstrated an AUC of 0.921 (95% CI, 0.816–0.967) in candidates for endoscopic papillectomy.
Conclusion
Adding 2-[ 18F]FDG PET/CT to endoscopy can improve the diagnosis of ampullary cancer and may help refine therapeutic decision-making, particularly when contemplating endoscopic papillectomy.


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