1.Effects of perinatal risk factors on bronchopulmonary dysplasia and retinopathy in preterm infants and their possible relationship
Yanan LI ; Qiannan JIANG ; Meng LYU ; Xueyi BAO ; Xiuxiang LIU
Chinese Journal of Perinatal Medicine 2024;27(2):111-117
Objective:To investigate the perinatal risk factors and correlation between bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP).Methods:A retrospective analysis was performed on 173 preterm infants born at less than 32 weeks' gestation with BPD who were admitted to the neonatal intensive care unit (NICU) of the Women and Children's Hospital of Qingdao University from June 2017 to July 2022. According to the diagnostic criteria for ROP, these preterm infants were divided into the ROP group ( n=64) and the non-ROP group ( n=109). Chi-square test, two independent samples t-test, and Mann-Whitney U test were used to compare the general data, treatment, and the incidence of complications between the two groups. Multivariate logistic stepwise regression analysis was used to analyze the independent risk factors of ROP in preterm infants with BPD and the receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of independent risk factors on ROP. The correlation between the severity of BPD and the incidence of ROP was analyzed. Results:The gestational age at birth [(28.0±1.1) vs. (28.8±1.2) weeks, t=4.01], the birth weight [(1 075.9±141.4) vs. (1 143.2±168.6) g, t=2.68], the partial pressure of carbon dioxide [42.5 mmHg (1 mmHg=0.133 kPa) (34.0-51.0 mmHg) vs. 47.0 mmHg (39.0-54.0 mmHg), Z=-2.31], and the total fluid intake on the first day of birth [80.0 ml (72.3-88.7 ml) vs. 83.6 ml (76.6-92.8 ml), Z=-2.28] in the ROP group were all lower than those in the non-ROP group (all P<0.05). While the prothrombin time [15.7 s (14.1-17.7 s) vs. 14.6 s (13.1-16.7 s), Z=-2.17], activated partial thromboplastin time [64.7 s (52.9-77.9 s) vs. 55.8 s (48.4-68.9 s), Z=-2.12], the proportion of patients treated with pulmonary surfactant [71.9% (46/64) vs. 49.5% (54/109), χ 2=8.25], the total duration of oxygen supplementation [50.5 d (40.0-64.0 d) vs. 45.0 d (37.0-52.0 d), Z=-2.77], the duration of invasive ventilation [5.0 d (1.0-11.0 d) vs. 1.0 d (0.0-5.0 d), Z=-4.03], the duration of noninvasive ventilation or high-flow oxygen therapy [(31.7±12.7) vs. (26.4±13.1) d, t=-2.59], and the incidence of neonatal respiratory distress syndrome [76.6% (49/64) vs. 57.8% (63/109), χ 2=6.22] were increased in the ROP group (all P<0.05). There was no significant difference in the proportion of BPD treated with corticosteroids between the ROP and non-ROP groups [60.3% (38/63) vs. 74.3% (81/109), χ 2=3.67, P=0.055]. Multivariate logistic stepwise regression analysis showed that smaller gestational age ( OR=1.599, 95% CI: 1.126-2.272, P=0.009), less fluid intake on the first day ( OR=1.033, 95% CI: 1.004-1.062, P=0.024), and longer duration of invasive ventilation ( OR=1.076, 95% CI:1.017-1.138, P=0.011) were independent risk factors for ROP in BPD infants, while glucocorticoid treatment was an independent protective factor ( OR=0.378, 95% CI:0.173-0.827, P=0.015). Most patients with mild or moderate BPD did not develop ROP [64.6% (73/113) and 66.7% (34/51)], while those with severe BPD were more likely to be complicated by ROP (7/9) ( χ 2=6.84, P=0.033). Conclusions:BPD infants with smaller gestational age, longer duration of invasive ventilation, and less fluid intake on the first day of birth are more likely to develop ROP, while glucocorticoid therapy can reduce the incidence of ROP in this population. Severe BPD may increase the risk of ROP in infants.
2.Analysis of treatment modalities and prognosis of patients with gallbladder cancer in China from 2010 to 2017
Tai REN ; Yongsheng LI ; Yajun GENG ; Maolan LI ; Xiangsong WU ; Wenguang WU ; Xu′an WANG ; Yijun SHU ; Runfa BAO ; Ping DONG ; Wei GONG ; Jun GU ; Xuefeng WANG ; Jianhua LU ; Jiasheng MU ; Weihua PAN ; Xi ZHANG ; Xueli ZHANG ; Zhewei FEI ; Zaiyang ZHANG ; Yi WANG ; Hong CAO ; Bei SUN ; Yunfu CUI ; Chunfu ZHU ; Bing LI ; Linhui ZHENG ; Yeben QIAN ; Jun LIU ; Xueyi DANG ; Chang LIU ; Shuyou PENG ; Zhiwei QUAN ; Yingbin LIU
Chinese Journal of Surgery 2020;58(9):697-706
Objective:To evaluate the clinical characteristics and prognosis of gallbladder cancer (GBC) patients in China.Methods:This retrospective multicenter cohort study enrolled 3 528 consecutive GBC patients diagnosed between January 2010 to December 2017 in 15 hospitals from 10 provinces. There were 1 345 (38.12%) males and 2 183 (61.88%) females.The age of diagnosis was (63.7±10.8) years old (range: 26 to 99 years old) .There were 213 patients (6.04%) in stage 0 to Ⅰ, whereas 1 059 (30.02%) in stage Ⅱ to Ⅲ, 1 874 (53.12%) in stage Ⅳ, and 382 (10.83%) unavailable. Surgery was performed on 2 255 patients (63.92%) . Three hundred and thirty-six patients received chemotherapy or radiotherapy (9.52%; of which 172 were palliative); 1 101 (31.21%) received only supportive treatment.The patient source, treatment and surgery, pathology, concomitant gallstone, and prognosis were analyzed.Results:Among the 3 528 GBC patients, 959 (27.18%) were from East China, 603 (17.09%) from East-North China, 1 533 (43.45%) from Central China, and 433(12.27%) from West China. Among the 1 578 resectable tumor, 665 (42.14%) underwent radical surgery, 913 (57.86%) underwent surgery that failed to follow the guidelines.Eight hundred and ninety-one (56.46%) patients were diagnosed before surgery, 254 (16.10%) during surgery, and 381 (24.14%) after surgery (time point of diagnosis couldn′t be determined in 52 patients) .Among the 1 578 patients with resectable tumor, 759 (48.10%) had concomitant gallstone.Among the 665 patients underwent radical surgery, 69 (10.4%) showed positive resection margin, 510 (76.7%) showed negative resection margin, and 86 (12.9%) unreported margin status.The 5-year overall survival rate (5yOS) for the 3 528-patient cohort was 23.0%.The 5yOS for patients with resectable tumor was 39.6%, for patients with stage ⅣB tumor without surgery was 5.4%, and for patients with stage ⅣB tumor underwent palliative surgery was 4.7%.Conclusions:More than half GBC patients in China are diagnosed in stage Ⅳ.Curative intent surgery is valuable in improving prognosis of resectable GBC.The treatment of GBC needs further standardization.Effective comprehensive treatment for GBC is in urgent need.
3.Comparative efficacy of pharmacological treatments in the maintenance treatment of bipolar disorder: a systematic review and network Meta-analysis
Yaqi SUN ; Yumei WANG ; Tong LYU ; Ziyang WANG ; Xuan ZHAI ; Lu HAN ; Xiaoling QIAO ; Yu SU ; Yanping BAO ; Wei YAN ; Lin LU ; Xueyi WANG
Chinese Journal of Psychiatry 2020;53(6):527-536
Objective:Network meta-analyses (NMA) were used to evaluate and compare the effectiveness and acceptability of 20 maintenance treatment strategies for bipolar disorder (BD), such as lithium, imipramine, lithium+imipramine, carbamazepine, lithium+carbamazepine, valproic acid salt, lamotrigine, fluoxetine, olanzapine, aripiprazole, oxcarbazepine, quetiapine, lithium+valproic acid, risperidone long-acting injection, lamotrigine+valproic acid salt, aripiprazole+lamotrigine, paliperidone, ziprasidone, lurasidone, quetiapine sustained release.Methods:The Literatures were systematically searched from PubMed, EMBASE, PsycINFO, China national knowledge infrastructure (CNKI), Wanfang data (Wanfang), China biology medicine disc (CBMdisc) until 11/21/2019. Randomized controlled studies of the maintenance therapy with single or combination drugs for at least 12 weeks were selected. The primary outcome was the proportion of patients who got recurrence in the total number of patients. Efficacy of pharmacological treatments was assessed during the maintenance treatment treatments by using a random-effects network meta-analysis model within a Frequentists framework. Data analysis was performed in Stata 14.0 software.Results:40 studies covering with 10 431 patients were included, and 20 kinds of maintenance treatments for BD were performed. In terms of clinical efficacy, the top 5 treatments were lurasidone,quetiapine, olazanpine, lithium+carbamazepine, aripiprazole+lamotrigine.lithium ( RR:0.78, 95% CI: 0.62-0.97), olanzapine ( RR:0.51, 95% CI: 0.35-0.75), quetiapine ( RR:0.50, 95% CI: 0.33-0.74) and lurasidone ( RR:0.40, 95% CI: 0.19-0.83) were significantly superior to placebo. Conclusions:Lithium, olanzapine, quetiapine and lurasidone may be more effective than placebo,.but the efficaly of other monotherapy and combination therapy strategies need to be proven.
4.Analysis of treatment modalities and prognosis of patients with gallbladder cancer in China from 2010 to 2017
Tai REN ; Yongsheng LI ; Yajun GENG ; Maolan LI ; Xiangsong WU ; Wenguang WU ; Xu′an WANG ; Yijun SHU ; Runfa BAO ; Ping DONG ; Wei GONG ; Jun GU ; Xuefeng WANG ; Jianhua LU ; Jiasheng MU ; Weihua PAN ; Xi ZHANG ; Xueli ZHANG ; Zhewei FEI ; Zaiyang ZHANG ; Yi WANG ; Hong CAO ; Bei SUN ; Yunfu CUI ; Chunfu ZHU ; Bing LI ; Linhui ZHENG ; Yeben QIAN ; Jun LIU ; Xueyi DANG ; Chang LIU ; Shuyou PENG ; Zhiwei QUAN ; Yingbin LIU
Chinese Journal of Surgery 2020;58(9):697-706
Objective:To evaluate the clinical characteristics and prognosis of gallbladder cancer (GBC) patients in China.Methods:This retrospective multicenter cohort study enrolled 3 528 consecutive GBC patients diagnosed between January 2010 to December 2017 in 15 hospitals from 10 provinces. There were 1 345 (38.12%) males and 2 183 (61.88%) females.The age of diagnosis was (63.7±10.8) years old (range: 26 to 99 years old) .There were 213 patients (6.04%) in stage 0 to Ⅰ, whereas 1 059 (30.02%) in stage Ⅱ to Ⅲ, 1 874 (53.12%) in stage Ⅳ, and 382 (10.83%) unavailable. Surgery was performed on 2 255 patients (63.92%) . Three hundred and thirty-six patients received chemotherapy or radiotherapy (9.52%; of which 172 were palliative); 1 101 (31.21%) received only supportive treatment.The patient source, treatment and surgery, pathology, concomitant gallstone, and prognosis were analyzed.Results:Among the 3 528 GBC patients, 959 (27.18%) were from East China, 603 (17.09%) from East-North China, 1 533 (43.45%) from Central China, and 433(12.27%) from West China. Among the 1 578 resectable tumor, 665 (42.14%) underwent radical surgery, 913 (57.86%) underwent surgery that failed to follow the guidelines.Eight hundred and ninety-one (56.46%) patients were diagnosed before surgery, 254 (16.10%) during surgery, and 381 (24.14%) after surgery (time point of diagnosis couldn′t be determined in 52 patients) .Among the 1 578 patients with resectable tumor, 759 (48.10%) had concomitant gallstone.Among the 665 patients underwent radical surgery, 69 (10.4%) showed positive resection margin, 510 (76.7%) showed negative resection margin, and 86 (12.9%) unreported margin status.The 5-year overall survival rate (5yOS) for the 3 528-patient cohort was 23.0%.The 5yOS for patients with resectable tumor was 39.6%, for patients with stage ⅣB tumor without surgery was 5.4%, and for patients with stage ⅣB tumor underwent palliative surgery was 4.7%.Conclusions:More than half GBC patients in China are diagnosed in stage Ⅳ.Curative intent surgery is valuable in improving prognosis of resectable GBC.The treatment of GBC needs further standardization.Effective comprehensive treatment for GBC is in urgent need.
5.Comparative efficacy of pharmacological treatments in the maintenance treatment of bipolar disorder: a systematic review and network Meta-analysis
Yaqi SUN ; Yumei WANG ; Tong LYU ; Ziyang WANG ; Xuan ZHAI ; Lu HAN ; Xiaoling QIAO ; Yu SU ; Yanping BAO ; Wei YAN ; Lin LU ; Xueyi WANG
Chinese Journal of Psychiatry 2020;53(6):527-536
Objective:Network meta-analyses (NMA) were used to evaluate and compare the effectiveness and acceptability of 20 maintenance treatment strategies for bipolar disorder (BD), such as lithium, imipramine, lithium+imipramine, carbamazepine, lithium+carbamazepine, valproic acid salt, lamotrigine, fluoxetine, olanzapine, aripiprazole, oxcarbazepine, quetiapine, lithium+valproic acid, risperidone long-acting injection, lamotrigine+valproic acid salt, aripiprazole+lamotrigine, paliperidone, ziprasidone, lurasidone, quetiapine sustained release.Methods:The Literatures were systematically searched from PubMed, EMBASE, PsycINFO, China national knowledge infrastructure (CNKI), Wanfang data (Wanfang), China biology medicine disc (CBMdisc) until 11/21/2019. Randomized controlled studies of the maintenance therapy with single or combination drugs for at least 12 weeks were selected. The primary outcome was the proportion of patients who got recurrence in the total number of patients. Efficacy of pharmacological treatments was assessed during the maintenance treatment treatments by using a random-effects network meta-analysis model within a Frequentists framework. Data analysis was performed in Stata 14.0 software.Results:40 studies covering with 10 431 patients were included, and 20 kinds of maintenance treatments for BD were performed. In terms of clinical efficacy, the top 5 treatments were lurasidone,quetiapine, olazanpine, lithium+carbamazepine, aripiprazole+lamotrigine.lithium ( RR:0.78, 95% CI: 0.62-0.97), olanzapine ( RR:0.51, 95% CI: 0.35-0.75), quetiapine ( RR:0.50, 95% CI: 0.33-0.74) and lurasidone ( RR:0.40, 95% CI: 0.19-0.83) were significantly superior to placebo. Conclusions:Lithium, olanzapine, quetiapine and lurasidone may be more effective than placebo,.but the efficaly of other monotherapy and combination therapy strategies need to be proven.

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