1.Preliminary experience of robotic-assisted kidney transplantation in a single center
Mingxiao ZHANG ; Zhenshan DING ; Jianfeng WANG ; Ying ZHAO ; Tianyu ZHANG ; Chuanzhen CAO ; Yisen DENG ; Xiaofeng ZHOU
Organ Transplantation 2024;15(3):422-428
Objective To evaluate the safety, effectiveness and feasibility of robotic-assisted kidney transplantation (RAKT). Methods Clinical data of 16 patients who underwent kidney transplantation were collected. Among them, 8 recipients received RAKT (RAKT group) and 8 cases underwent open kidney transplantation (OKT) with the contralateral kidney from the same donor (OKT group). Perioperative status and the recovery of renal allograft function were compared between two groups. Results All patients successfully completed the surgery. In the RAKT group, no patient was converted to open surgery. The operation time in the RAKT group was longer than that in the OKT group (P=0.015). No significant differences were observed in the serum creatinine levels before surgery and upon discharge between two groups (both P>0.05). In the OKT group, one recipient developed delayed graft function (DGF), and the remaining recipients did not experience perioperative complications. No significant difference was noted in the short-term recovery of renal allograft function between two groups (P>0.05). Conclusions Postoperative recovery of the recipients in the RAKT group is equivalent to that of their counterparts in the OKT group. RAKT is a safe and effective procedure for the team expertise in kidney transplantation.
2.Application values of fixed tube current based on head circumference in children's head CT examinations
Jian ZHANG ; Chuanzhen BIAN ; Xiaojun ZHANG
Journal of Practical Radiology 2024;40(1):115-118
Objective To explore the application values of fixed tube current based on head circumference(HC)in children's head CT examinations.Methods A total of 573 children's head CT imaging data were collected retrospectively,the tube current and HC were recorded.Pearson's correlation analysis was used to determine the relationship of tube current with HC,counted the median tube current values of each group based on HC and used them as the prefixed tube current.Seventy-two children were prospectively collected.According to the random number table method,the children were divided into the control group and the experimental group,with 35 cases in the control group and 37 cases in the experimental group.The control group used automatic exposure control(AEC)technology for tube current,while the experimental group used the median value of tube current corresponding to HC group-ing.The difference in radiation doses and image qualities between the two groups was compared.Results Pearson analysis of 573 retrospec-tive cases showed that the correlation between HC and tube current was considerably strong(r=0.95,P<0.001).The median tube current values of each group based on HC were 70-130 mAs.There were statistically significant differences in CTDIvol.16 and SSDEDW based on water equivalent diameter(DW)between the two groups(t=-11.27,2.81,P<0.05).Compared with the control group,CTDIvol.16 and SSDEDW in the experimental group decreased by 10.83%and 12.59%respectively.There were no statistically signifi-cant differences in signal-to-noise ratio(SNR)between the two groups(t=-1.26,P>0.05)and there were also no statistically significant differences in the subjective evaluation of images(Z=-0.45,P>0.05).Conclusion Measuring children's HC before examination and setting the fixed tube current corresponding to HC grouping can reduce radiation doses while maintaining image qualities.
3.Research status and progress of nuclear factor κappa B signaling pathway in Beh?et disease
Chuanzhen ZHENG ; Xiaomin ZHANG
Chinese Journal of Ocular Fundus Diseases 2023;39(10):862-867
Behcet's Disease (BD) is a multisystem vasculitis characterized by disease alternated with recurrent episodes and remissions, involving genital, oral, ocular uvea, cutaneous, and articular manifestations. The nuclear factor (NF)-κB signaling pathway paly an important role in the BD progression. It encompasses diverse gene, protein, and cellular regulatory mechanisms operating across various levels, alongside microbiological and experimental studies involving animals and cells. At the protein research findings, activation of the NF-κB pathway in BD patients is marked by elevated plasma levels of soluble CD40 ligand, which stimulates neutrophils to release reactive oxygen species and extracellular traps, thereby promoting inflammation. At the cellular research findings, macrophages in BD patients polarize towards classically activated macrophages phenotype through the NF-κB pathway, exacerbating the inflammatory response. The activation of NF-κB is associated with increased expression of anti-apoptotic proteins in T cells, leading to prolonged inflammation. Microbiological investigations reveal that the decreased gut microbiota diversity in BD patients compromises intestinal barrier integrity. NF-κB pathway involvement in regulating neutrophil and type 1 helper T cell (Th) 1/Th17 cell function worsens inflammation. Genetically, BD patients exhibit polymorphisms in immune regulatory genes, which contribute to inflammation through the NF-κB pathway. Mutations in NF-κB-associated genes elevate the risk of BD, while mutations in the endogenous inhibitor A20 lead to abnormal NF-κB activity, sustaining inflammation. Animal experiments and in vitro experiments corroborate the efficacy of NF-κB inhibitors in attenuating inflammation. Targeting upstream inflammatory factors within the NF-κB pathway yields positive outcomes in BD patients. In summary, the NF-κB signaling pathway plays a pivotal role in the development of BD. Developing NF-κB inhibitors may open new avenues for treating BD. Further research is necessary to comprehensively elucidate the precise mechanisms by which NF-κB operates in the pathogenesis of BD, as well as its potential clinical applications in therapy.
4.Ferroptosis is involved in testicular injury induced by TDCIPP in adolescent male mice
Chuanzhen XIONG ; Ling ZHANG ; Yang ZHANG ; Ruiwen LI ; Yu SUN ; Yunhao LIU
Chinese Journal of Industrial Hygiene and Occupational Diseases 2023;41(8):562-568
Objective:To investigate the role of ferroptosis in testicular injury in adolescent male mice induced by TDCIPP.Methods:In December 2021, 30 healthy 3-week-old male C57BL/6 mice, with a body weight of (13±2) g, were selected and fed adaptive for one week. They were divided into control group, low-dose group, medium-dose group, high-dose group and iron death inhibitor group according to a random number table, with 6 mice in each group. Mice in low, medium and high dose groups were treated with 5, 25 and 125 mg/ (kg·d) TDCIPP for 28 days, respectively, while the control group was treated with the same amount of corn oil for 28 days. The iron death inhibitor group was given 125 mg/ (kg·d) TDCIPP intragastric administration for 28 days, and 30 mg/kg DFO saline solution was intraperitoneally injected three times a week. After the treatment, the mice were killed, the epididymis was separated, and sperm count was performed. HE staining was used to observe the morphological changes of mouse testis, and iron content in testis was detected by tissue iron detection kit. The level of reactive cxygen species, MDA content, and the mitochondrial membrane potential level of mice were detected. Western blot analysis of testicular glutathione peroxidase (GPX4) and internal cyclooxygenase-2 (COX2) protein expression.Results:Compared with the control group, the spermatogenic cells in the testes of mice treated with medium-and high-dose of TDCIPP were disorderly arranged, showing a vacuolar structure. the number of sperm in the epididymis was significantly reduced ( P=0.009, 0.004), while the sperm deformity rate was significantly increased ( P=0.010, 0.000). Moreover, the content of ROS, iron ion and MDA in the testes increased significantly ( P<0.05), and the mitochondrial membrane potential of mouse testicular cells decreased significantly ( P<0.05). The expression of GPX4 proteins decreased ( P<0.05). while the expression of COX2 increased significantly ( P<0.01). Compared with high-dose group group, spermatogenic cells in ferroptosis inhibitor group were closely arranged and normal, and ROS and Fe contents in testicular tissue were significantly decreased ( P<0.01) ; GPX4 protein expression was significantly increased while COX2 protein expression was significantly decreased ( P<0.05) . Conclusion:Ferroptosis is involved in TDCIPP-induced testicular damage in male pubertal mice.
5.Ferroptosis is involved in testicular injury induced by TDCIPP in adolescent male mice
Chuanzhen XIONG ; Ling ZHANG ; Yang ZHANG ; Ruiwen LI ; Yu SUN ; Yunhao LIU
Chinese Journal of Industrial Hygiene and Occupational Diseases 2023;41(8):562-568
Objective:To investigate the role of ferroptosis in testicular injury in adolescent male mice induced by TDCIPP.Methods:In December 2021, 30 healthy 3-week-old male C57BL/6 mice, with a body weight of (13±2) g, were selected and fed adaptive for one week. They were divided into control group, low-dose group, medium-dose group, high-dose group and iron death inhibitor group according to a random number table, with 6 mice in each group. Mice in low, medium and high dose groups were treated with 5, 25 and 125 mg/ (kg·d) TDCIPP for 28 days, respectively, while the control group was treated with the same amount of corn oil for 28 days. The iron death inhibitor group was given 125 mg/ (kg·d) TDCIPP intragastric administration for 28 days, and 30 mg/kg DFO saline solution was intraperitoneally injected three times a week. After the treatment, the mice were killed, the epididymis was separated, and sperm count was performed. HE staining was used to observe the morphological changes of mouse testis, and iron content in testis was detected by tissue iron detection kit. The level of reactive cxygen species, MDA content, and the mitochondrial membrane potential level of mice were detected. Western blot analysis of testicular glutathione peroxidase (GPX4) and internal cyclooxygenase-2 (COX2) protein expression.Results:Compared with the control group, the spermatogenic cells in the testes of mice treated with medium-and high-dose of TDCIPP were disorderly arranged, showing a vacuolar structure. the number of sperm in the epididymis was significantly reduced ( P=0.009, 0.004), while the sperm deformity rate was significantly increased ( P=0.010, 0.000). Moreover, the content of ROS, iron ion and MDA in the testes increased significantly ( P<0.05), and the mitochondrial membrane potential of mouse testicular cells decreased significantly ( P<0.05). The expression of GPX4 proteins decreased ( P<0.05). while the expression of COX2 increased significantly ( P<0.01). Compared with high-dose group group, spermatogenic cells in ferroptosis inhibitor group were closely arranged and normal, and ROS and Fe contents in testicular tissue were significantly decreased ( P<0.01) ; GPX4 protein expression was significantly increased while COX2 protein expression was significantly decreased ( P<0.05) . Conclusion:Ferroptosis is involved in TDCIPP-induced testicular damage in male pubertal mice.
6.Meta-analysis of the relationship between the intake of fruits and vegetables and the risk of prostate cancer
Chuanzhen XIONG ; Ling ZHANG ; Jun XIANG ; Silong CAI
Journal of Public Health and Preventive Medicine 2022;33(2):128-133
Objective To systematically evaluate the relationship between the intake of fruits and vegetables and the risk of prostate cancer, so as to provide relevant evidence for formulating the prevention strategies of prostate cancer. Methods Pubmed, Embase, and Web of Science databases were searched by computer for cohort studies and related literatures evaluating the relationship between vegetable and/or fruit intake and prostate cancer risk. The quality of the included literature was rated, and meta-analysis was carried out using R software (4.0. 3 version). Results A total of 20 cohort studies were included. Four studies only reported the relationship between fruit intake and the risk of prostate cancer, 4 studies only reported the relationship between vegetable intake and the risk of prostate cancer, and 12 studies reported the relationship between fruit and vegetable intake and the risk of prostate cancer. Meta-analysis results indicate that although dietary intake of vegetables in the high-intake group may reduce the risk of prostate cancer, the difference was not statistically significant (RR, 0.97; 95% CI (0.94, 1.01), P=0.11); I2=21.3%, P=0.21). There was no significant correlation between fruit intake and the risk of prostate cancer (RR, 1.00; 95% CI (0.96, 1.04) , P=0.99). Conclusion There is no significant correlation between the intake of vegetables and/or fruits and the risk of prostate cancer.
7.Current state and progress of intravitreal injection of chemotherapeutic agents for the treatment of vitreoretinal lymphoma
Chuanzhen ZHENG ; Xinjun REN ; Xiaomin ZHANG
Chinese Journal of Ocular Fundus Diseases 2021;37(9):731-736
Primary vitreoretinal lymphoma (PVRL) is one of the most common type of primary intraocular lymphoma. The current treatment options include local ocular radiotherapy (radiotherapy), systemic chemotherapy (chemotherapy), local ocular chemotherapy, and combination therapy. The treatment options are different at different stages of PVRL, however, there is no uniform treatment guideline. Local ocular chemotherapy can make the drug reach effective therapeutic concentration in the eye, and it can be repeated many times. At the same time, it can avoid the adverse reactions caused by systemic medication or radiotherapy. It is an ideal choice for relieving ocular symptoms. At present, the mainstream ocular local chemotherapeutics are methotrexate (MTX) and rituximab (RTX). The basic consensus about the intravitreal injection of MTX (IVM) is the induction-consolidation-maintenance model, however, the time of each stage and frequency of IVM are diverse. The time interval of intravitreal injection of RTX is also variable, ranging from 1 time/week to 1 time/months and so on. Corneal epithelial lesions caused by frequent MTX injections and the higher recurrence rate after RTX treatment are the main reasons for changing the treatment plan. For patients with primary central nervous system lymphoma and PVRL, combined treatment with neurology department is necessary to save patient's lives, ophthalmology treatment relieves ocular symptoms and improves the patient's quality of life. For patients with PVRL alone without central nervous system involvement, ophthalmology treatment is necessary to control patient's eye symptoms, and close follow-up should be followed to find the involvement of the central nervous system in time, and then combined with neurological treatment to save patient’s lives.
8.Neoadjuvant Chemotherapy–Guided Bladder-Sparing Treatment for Muscle-Invasive Bladder Cancer: Results of a Pilot Phase II Study
Hongzhe SHI ; Wen ZHANG ; Xingang BI ; Dong WANG ; Zejun XIAO ; Youyan GUAN ; Kaopeng GUAN ; Jun TIAN ; Hongsong BAI ; Linjun HU ; Chuanzhen CAO ; Weixing JIANG ; Zhilong HU ; Jin ZHANG ; Yan CHEN ; Shan ZHENG ; Xiaoli FENG ; Changling LI ; Yexiong LI ; Jianhui MA ; Yueping LIU ; Aiping ZHOU ; Jianzhong SHOU
Cancer Research and Treatment 2021;53(4):1156-1165
Purpose:
Reduced quality of life after cystectomy has made bladder preservation a popular research topic for muscle-invasive bladder cancer (MIBC). Previous research has indicated significant tumor downstaging after neoadjuvant chemotherapy (NAC). However, maximal transurethral resection of bladder tumor (TURBT) was performed before NAC to define the pathology, impacting the real evaluation of NAC. This research aimed to assess real NAC efficacy without interference from TURBT and apply combined modality therapies guided by NAC efficacy.
Materials and Methods:
Patients with cT2-4aN0M0 MIBC were confirmed by cystoscopic biopsy and imaging. NAC efficacy was assessed by imaging, urine cytology, and cystoscopy with multidisciplinary team discussion. Definite responders (≤ T1) underwent TURBT plus concurrent chemoradiotherapy. Incomplete responders underwent radical cystectomy or partial cystectomy if feasible. The primary endpoint was the bladder preservation rate.
Results:
Fifty-nine patients were enrolled, and the median age was 63 years. Patients with cT3-4 accounted for 75%. The median number of NAC cycles was three. Definite responders were 52.5%. The complete response (CR) was 10.2%, and 59.3% of patients received bladder-sparing treatments. With a median follow-up of 44.6 months, the 3-year overall survival (OS) was 72.8%. Three-year OS and relapse-free survival were 88.4% and 60.0% in the bladder-sparing group but only 74.3% and 37.5% in the cystectomy group. The evaluations of preserved bladder function were satisfactory.
Conclusion
After stratifying MIBC patients by NAC efficacy, definite responders achieved a satisfactory bladder-sparing rate, prognosis, and bladder function. The CR rate reflected the real NAC efficacy for MIBC. This therapy is worth verifying through multicenter research.
9.Application of cervical anterior flexion in CT examination of neck for preschool children with Dose Right technique
Chuanzhen BIAN ; Jian ZHANG ; Ying WANG ; Jie LIU
Chinese Journal of Radiological Medicine and Protection 2020;40(3):241-246
Objective:To analyze the influence on radiation dose and image quality of children neck CT with anterior flexion of cervical spine using self-made sponge pad with DoseRight technique.Methods:A total of 125 children aged 1-5 years who underwent neck CT examination were consecutively collected prospectively. The patients were divided into control group and test group with computer random number method . The control group was supine on the scanning bed and fixed in the CT skull stent. The test group was supine on the scanning bed with a self-made sponge cushion under the neck to extend the head and droop the shoulder. The data was acquired with Philips Brilliance iCT and CTDI VOL was obtained from the dose report. SSDE ED and SSDE WD were calculated seperately.The image quality by measuring the noise value and signal-to-noise ratio of the paravertebral muscle area at the middle level of the third cervical vertebra and thyroid area. Subjective evaluation of image quality by 5-point scoring systemwas performed. Results:The noise values of paravertebral muscles and thyroid regions in the test group were lower than those in the control group( t=-6.93, -7.41, P<0.05), and the signal-to-noise ratios were higher than those in the control group ( t=5.74, 6.14, P<0.05). The subjective score of the test group (4.32±0.70) was better than that of the control group (3.70±0.66), and the difference was statistically significant ( Z=-4.27, P<0.05). The jaw-pharynx angle and the number of vertebra displayed of the test group were higher than those of the control group ( t=4.94, 5.09, P<0.05). CTDI VOL, and in the control group were 22.1%, 26.0% and 27.1% higher than those in the test group ( t=6.17, 5.11, 4.35, P<0.01). Conclusions: is more accurate to indicate the CT radiation dose of children. The self-made sponge pad keeping the cervical spine in anterior flexion can reduce radiation dose and improve image quality.
10.Intravitreal injection of conbercept after operation in the treatment of proliferatived diabetic retinophathy complicated with vitreous hemorrhage
Jinping ZHANG ; Xinjun REN ; Chuanzhen ZHENG ; Dejia WEN ; Xiaorong LI ; Xiaomin ZHANG
Chinese Journal of Ocular Fundus Diseases 2020;36(2):105-109
Objective:To observe the efficacy and safety of intravitreal injection of conbercept in the treatment of proliferatived diabetic retinophathy (PDR) complicated with vitreous hemorrhage by minimally invasive vitreoretinal surgery.Methods:Prospective clinical study. A total of 50 patients with PDR complicated with vitreous hemorrhage clinically diagnosed in Tianjin Medical University Eye Hospital who needed vitrectomy were recruited in this study. According to the principle of informed consent, the patients were divided into two groups: postoperative injection group and the control group. Twenty-five eyes of 25 patients in each group were examined before operation. No significant proliferative changes in the posterior pole and traction retinal detachment were observed. There was significant difference of age between two groups ( t=-24.697, P=0.030), but no significant difference of sex ( χ2=0.330, P=0.564), duration of diabetes ( t=-1.144, P=0.258), logMAR BCVA ( t=-0.148, P=0.883), lens state ( χ2=0.397, P=0.529), panretinal laser photocoagulation ( χ2=1.333, P=0.248). The postoperative injection group was treated with intravitreous injection of 0.05 ml conbercept (10 mg/ml) immediately after 27G minimally invasive vitrectomy. The other treatment and follow-up were the same as those in the postoperative injection group except for conbercept injection. All patients underwent routine slit-lamp examination, indirect ophthalmoscope and B-ultrasound examination before operation. The main outcome measure included the time of operation, the incidence rate of iatrogenic retinal holes and silicone oil filling. The recurrence of vitreous hemorrhage, BCVA, intraocular pressure, central retinal thickness (CRT), postoperative complications and progression were recorded 1 week, 1 month, 3 months and 6 months after operation. Results:At 1 week and 1, 3, 6 months after operation, there was significant difference of logMAR BCVA between the two groups ( t=-4.980, -4.840, -4.892, -5.439; P<0.001). At 3 and 6 months after operation, the recurrence of vitreous hemorrhage in the postoperative injection group was lower than that in the control group, but there was no statistical difference between two groups ( χ2=3.030, 4.153; P=0.192, 0.103). At 1 week and 1, 3, 6 months after operation, the CRT in the postoperative injection group was lower than that in the control group, the difference was significant ( t=-2.622, -2.638, -3.613, -3.037; P=0.012, 0.010, 0.001, 0.004, 0.005). There was no complications such as choroid detachment, proliferative vitreoretinopathy, retinal detachment, iris redness and neovascular glaucoma in all the eyes after operation. Conclusions:Intravitreal injection of conbercept in the treatment of PDR after operation is safe and effective. It can reduce the recurrence of vitreous hemorrhage after vitrectomy, improve the BCVA.


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