1.Advances in the research and application of neurokinin-1 receptor antagonists
HONG XIANGYU ; MA JUNJIE ; ZHENG SHANSHAN ; ZHAO GUANGYU ; FU CAIYUN
Journal of Zhejiang University. Science. B 2024;25(2):91-105
Recently,the substance P(SP)/neurokinin-1 receptor(NK-1R)system has been found to be involved in various human pathophysiological disorders including the symptoms of coronavirus disease 2019(COVID-19).Besides,studies in the oncological field have demonstrated an intricate correlation between the upregulation of NK-1R and the activation of SP/NK-1R system with the progression of multiple carcinoma types and poor clinical prognosis.These findings indicate that the modulation of SP/NK-1R system with NK-1R antagonists can be a potential broad-spectrum antitumor strategy.This review updates the latest potential and applications of NK-1R antagonists in the treatment of human diseases and cancers,as well as the underlying mechanisms.Furthermore,the strategies to improve the bioavailability and efficacy of NK-1R antagonist drugs are summarized,such as solid dispersion systems,nanonization,and nanoencapsulation.As a radiopharmaceutical therapeutic,the NK-1R antagonist aprepitant was originally developed as radioligand receptor to target NK-1R-overexpressing tumors.However,combining NK-1R antagonists with other drugs can produce a synergistic effect,thereby enhancing the therapeutic effect,alleviating the symptoms,and improving patients'quality of life in several diseases and cancers.
2.Predictive value of preoperative frailty for pulmonary complications after cardiac surgery in elderly patients
Guanglei FAN ; Guangyu MA ; Wei XU ; Shuyang FU ; Shuchi LIN ; Mingzhu ZHENG ; Tianchi SHAN ; Wenjing ZHAO
The Journal of Clinical Anesthesiology 2023;39(12):1255-1259
Objective To investigate the predictive value of preoperative frailty for pulmonary com-plications(PPCs)after cardiac surgery in elderly patients.Methods A total of 162 elderly patients,109 males and 53 females,aged 65-83 years,BMI 18-36 kg/m2,ASA physical status Ⅱ-Ⅳ,underwent elec-tive open heart surgery from July 2022 to January 2023 were collected.The patients were divided into two groups according to the occurrence of PPCs:the PPCs group(n=57)and the non-PPCs group(n=105).General information,smoking history,alcohol consumption history,EuroSCORE Ⅱ,frailty,chronic comorbidities(hypertension,diabetes mellitus,myocardial infarction,pulmonary hypertension,chronic ob-structive pulmonary disease,sleep apnea syndrome,etc.),Hb,creatinine,albumin,pulmonary function indices,left ventricular ejection fraction,type of surgery,duration of surgery,aortic clamping time,and cardiopulmonary bypass time were collected.Factors with P<0.2 and clinically significant in the univariate regression analysis were included in the multivariate logistic regression analysis,and the predictive efficacy of the Fried frailty scale and EuroSCORE Ⅱ for PPCs were compared by the area under the ROC curve(AUC).Results PPCs occurred in 57 patients(35.2%).Multifactorial Logistic regression analysis showed that frailty(OR=3.14,95%CI 1.05-9.37,P<0.05)and EuroSCORE Ⅱ(OR=2.16,95%CI 1.01-4.60,P<0.05)were risk factors for the development of PPCs.The predictive power of Fried frailty scale(AUC=0.76,95%CI 0.68-0.82)was significantly higher than that of EuroSCORE Ⅱ(AUC=0.65,95%CI 0.57-0.72)(P<0.05).Conclusion Preoperative frailty is the independent risk factors for pulmonary complications after cardiac surgery in elderly patients,and the Fried frailty scale has a better predictive efficacy compared to EuroSCORE Ⅱ,a traditional risk predictor.
3.Predicting response to non-small cell lung cancer immunotherapy using pre-treatment contrast-enhanced CT texture-based classification
Leilei SHEN ; Guangyu TAO ; Hongchao FU ; Xuemei LIU ; Xiaodan YE ; Jianding YE
Chinese Journal of Oncology 2021;43(5):541-545
Objective:To explore the value of pre-treatment contrast-enhanced computed tomography (CT)-based texture analysis in predicting response to non-small cell lung cancer (NSCLC) immunotherapy.Methods:From January to July 2018, a total of 51 lesions from 42 patients with advanced non-small cell lung cancer receiving immunotherapy at Shanghai Chest Hospital were selected in this retrospective study. Pre-treatment contrast-enhanced CT-based texture features were extracted by MaZda software. Ten optimal texture features were chosen based on three different methods: Fisher coefficient, mutual information measure (MI) and minimization of classification error probability combined average correlation coefficients(POE+ ACC), respectively. According to the efficacy of the first immunotherapy, 51 lesions were divided into non-progressive disease (non-PD, n=26) and progressive disease (PD, n=25). The differences were tested in each texture feature set between the two groups. The immunotherapy effects of target lesions were analyzed by principal component analysis(PCA), linear discriminant analysis (LDA) and nonlinear discriminant analysis (NDA). The sensitivity, specificity, accuracy, positive-predictive value (PPV) and negative-predictive value (NPV) were calculated. The area under the curve (AUC) was used to quantify the predictive accuracy of the three analysis models for each texture feature set and compare them with the actual classification results. Results:In all of three texture feature sets, the texture parameter differences of Perc.50%, Perc.90%, "S(5, 5)SumEntrp" and "S(4, 4)SumEntrp" were higher in PD group than those in non-PD group (all P<0.05). The classification result of texture feature set chosen by POE+ ACC and analyzed by NDA was identified as the best model (AUC=0.802, 95% CI: 0.674-0.930), and its sensitivity, specificity, accuracy, PPV and NPV were 72%, 88.5%, 80.4%, 85.7%, 76.7%, respectively. Conclusion:Pre-treatment contrast-enhanced CT-based texture characteristics of NSCLC may function as non-invasive biomarkers for the evaluation of response to immunotherapy.
4.Predicting response to non-small cell lung cancer immunotherapy using pre-treatment contrast-enhanced CT texture-based classification
Leilei SHEN ; Guangyu TAO ; Hongchao FU ; Xuemei LIU ; Xiaodan YE ; Jianding YE
Chinese Journal of Oncology 2021;43(5):541-545
Objective:To explore the value of pre-treatment contrast-enhanced computed tomography (CT)-based texture analysis in predicting response to non-small cell lung cancer (NSCLC) immunotherapy.Methods:From January to July 2018, a total of 51 lesions from 42 patients with advanced non-small cell lung cancer receiving immunotherapy at Shanghai Chest Hospital were selected in this retrospective study. Pre-treatment contrast-enhanced CT-based texture features were extracted by MaZda software. Ten optimal texture features were chosen based on three different methods: Fisher coefficient, mutual information measure (MI) and minimization of classification error probability combined average correlation coefficients(POE+ ACC), respectively. According to the efficacy of the first immunotherapy, 51 lesions were divided into non-progressive disease (non-PD, n=26) and progressive disease (PD, n=25). The differences were tested in each texture feature set between the two groups. The immunotherapy effects of target lesions were analyzed by principal component analysis(PCA), linear discriminant analysis (LDA) and nonlinear discriminant analysis (NDA). The sensitivity, specificity, accuracy, positive-predictive value (PPV) and negative-predictive value (NPV) were calculated. The area under the curve (AUC) was used to quantify the predictive accuracy of the three analysis models for each texture feature set and compare them with the actual classification results. Results:In all of three texture feature sets, the texture parameter differences of Perc.50%, Perc.90%, "S(5, 5)SumEntrp" and "S(4, 4)SumEntrp" were higher in PD group than those in non-PD group (all P<0.05). The classification result of texture feature set chosen by POE+ ACC and analyzed by NDA was identified as the best model (AUC=0.802, 95% CI: 0.674-0.930), and its sensitivity, specificity, accuracy, PPV and NPV were 72%, 88.5%, 80.4%, 85.7%, 76.7%, respectively. Conclusion:Pre-treatment contrast-enhanced CT-based texture characteristics of NSCLC may function as non-invasive biomarkers for the evaluation of response to immunotherapy.
5.Effect of integrated care on sense of coherence and relocation stress in family members of severe neurological disease patients after ICU transfer
Chinese Journal of Practical Nursing 2020;36(19):1496-1501
Objective:To investigate the effect of nurse-led integrated care on sense of coherence and relocation stress in family members of severe neurological disease patients after ICU transfer.Methods:A total of 78 severe neurological disease patients and family members were divided into study group and control group with 39 cases each by random digits table method. Participants in the control group received routine nursing, while the study group carried out nurse-led integrated care program. The scores of relocation stress and sense of coherence were assessed by Family Relocation Stress Scale (RFSS) and Sense of Coherence-29 (SOC-29), respectively.Results:After transfertion, the scores of preparation for relocation, family burden, satisfaction with the relocation process and total RFSS scores were (17.49 ± 3.57), (11.38 ± 1.93), (4.59 ± 0.59), (47.05 ± 4.72) points in the study group, and (13.79 ± 2.92), (9.51 ± 2.26), (3.51 ± 0.64), (39.44 ± 4.10) points in the control group, the difference was statistically significant ( t values were 3.937-7.675, P<0.05). After transfertion, the scores of comprehensibility, manageability, meaningfulness and total SOC-29 scores were (23.97 ± 2.61), (29.49 ± 4.55), (21.13 ± 3.73), (74.49 ± 6.77) points in the study group, and (21.49 ± 2.88), (27.23 ± 4.02), (17.05 ± 3.85), (65.79 ± 6.09) points, the difference was statistically significant ( t values were 2.321-5.960, P<0.05 or 0.01). Conclusions:Nurse-led integrated care can promote sense of coherence and alleviate relocation stress of family members of severe neurological disease patients after ICU transfer.
6.Clinical application of 18 F-FDOPA PET/CT imaging in the diagnosis of pheochromocytoma/para-ganglioma
Zhiwei GUAN ; Guangyu MA ; Xiaojun ZHANG ; Huaping FU ; Li ZANG ; Jinming ZHANG ; Baixuan XU
Chinese Journal of Nuclear Medicine and Molecular Imaging 2019;39(8):468-472
Objective To explore the efficiency of 6-18 F-fluoro-L-3,4-dihydroxyphenylalanine (18 F-FDOPA) PET/CT imaging in the diagnosis of pheochromocytoma/paraganglioma (PPGLs). Methods Twenty-six patients (15 males, 11 females;age:13-76 years) who were suspected of PPGLs with adrenal or retro-peritoneal mass were enrolled into this prospective study. All patients underwent 18 F-FDOPA PET/CT ima-ging. The clinical data, laboratory data and imaging results were collected. Region of interest ( ROI) was drawn on the liver and lesions, and the mean standardized uptake value ( SUVmean ) of the liver and the max-imum standardized uptake value ( SUVmax ) of lesions were calculated, as well as the ratio of tumor/lesion ratio ( T/L) . Based on the pathological results considered as the gold standard, the diagnostic efficiency of 18 F-FDOPA PET/CT imaging in PPGLs was calculated and compared with that of CT/MR. Besides, receiv-er operating characteristic ( ROC) curve analysis of T/L was used. Results Twenty-five patients were path-ologically confirmed, including 12 patients with PPGLs and 13 patients with non-PPGLs. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of 18 F-FDOPA PET/CT ima-ging was 11/12, 12/13, 92.00%(23/25), 11/12 and 12/13, respectively. The area under the ROC curve of T/L was 0.978, with the cut-off value of 1.55. 18 F-FDOPA PET/CT imaging totally detected 29 positive foci, including 12 of pheochromocytoma (PCC) and 17 of paraganglioma (PGL). Among those 18F-FDOPA positive PGL foci, 11 were detected by CT/MR, while 6 with diameter less than 1 cm were missed. Conclu-sion 18 F-FDOPA PET/CT imaging can detect more small PGL lesions than CT/MR, suggesting that it may be a proper imaging modality of PPGLs.
7.Analysis of risk factors for epididymitis after transurethral resection of prostate
Tao LI ; Chongde FU ; Guangyu CHEN ; Wuling JIN ; Ying ZHANG ; Mojia BI ; Qiaohong WEI ; Lin JIAO ; Yao TANG ; Shengtao XIE ; Xiaotong LIU ; Hui GAO
International Journal of Surgery 2018;45(9):588-591
Objective To investigate the risk factors associated with epididymitis after transurethral resection of prostate.Methods A retrospective analysis of 352 patients with benign prostatic hyperplasia (BPH) who underwent transurethral resection of prostate in X'an Aerospace General Hospital from January 2015 to December 2017 was performed.There were 14 cases of epididymitis and 338 cases of nonepididymitis.Measurement data were expressed as ((x) ± s),t test was used for comparison between groups;count data was expressed by rate (%),and chi-square test was used for comparison between groups.Univariate and multivariate logistic regression analyses were used for factors that may lead to post-urethral epididymitis.Results Univariate logistic regression analysis showed that preoperative leukocytic positive,urine glucose positive and prostate volume had significant effects on postoperative epididymitis (P < 0.05).Multivariate logistic regression analysis showed that prostate volume increased (OR =0.182,P =0.005)was an independent risk factor for postoperative epididymitis.Conclusion The enlargement of prostate volume is an independent risk factor for postoperative epididymitis.For large-volume prostate surgery,the purpose of relieving obstruction can be achieved.
8.Analysis and suggestion on application and approval of national natural science foundation of China based on the experience of Xiyuan hospital of China academy of Chinese medical sciences
Guangyu LIU ; Ran LI ; Na LANG ; Jianhua FU
International Journal of Traditional Chinese Medicine 2018;40(7):583-586
The excel statistical software and standard research methods were applied to account the application and approval rates of NSFC of Xiyuan Hospital of CACMS in the recent 3 years. The application and feedback issued by NSFC were collated and analyzed in this paper. From the foundation management, all departments had higher enthusiasm on project application, but departments applied were relatively centralized. The approval rates had risen steadily in the past 3 years. And approved projects mainly focused on departments of cardiovascular, hematology, spleen and stomach, geriatrics and basic medicine. However, no higher level projects were not supported successful by NSFC. And research awards for Xiyuan Hospital were mainly supported by the Ministry of Science and Technology and NSFC. In order to enhance successful rates of application and guarantee development of science research more sustainable, rapid and healthy, enthusiasm of researchers should be stimulated; quality of declaration should be improved; new mechanism of scientific research management need be perfected; and a good research environment should be built.
9.Clinical significance of seven serum markers in the diagnosis of preoperative and postoperative ;gastric cancer
Yunkai KANG ; Xuewei WU ; Xiaoqin SHI ; Yongjun MIAO ; Qingyue LU ; Hai QU ; Guangyu FU ; Min. WANG
Chinese Journal of Laboratory Medicine 2017;40(1):60-63
Objective To investigate the clinical significance of serum CEA , CA19-9, CA72-4, CA242, CA50, PGⅠand PGR ( PGⅠ/PGⅡ) in the Diagnosis of preoperative and postoperative gastric cancer.Methods Retrospective study.The levels of CEA , CA19-9, CA72-4, CA242, CA50, PGⅠand PGⅡin serum of 41 patients with gastric cancer preoperative and postoperative and 60 healthy people were detected by AutoLumo A2000 chemiluminescence immunoassay and compared.Statistical analysis was performed using Rank-sum test by SPSS 17.0.Results The median of CEA, CA19-9, CA72-4, CA242, CA50, PGI, PGII and PGR in postoperative gastric cancer group were 3.79 ng/ml, 17.85 U/ml, 3.50 U/ml, 14.52 U/ml, 17.62 U/ml, 32.81 ng/ml, 11.48 ng/ml, 3.35.The postoperative gastric cancer group were 1.67 ng/ml, 7.76 U ml, 1.73 U/ml, 6.30 U/ml, 7.57 U/ml, 20.56 ng/ml, 5.71 ng/ml, 2.94.The healthy group were 1.53 ng /ml, 7.59 U/ml, 1.47 U/ml, 6.08 U/ml, 5.68 U/ml, 90.86 ng/ml, 14.85 ng/ml, 6.67.There were statistical differences in the serum levels of CEA , CA19-9, CA72-4, CA242, CA50, PGⅠ, PGⅡand PGR among different groups (chi-squared values were 79.108, 20.678, 20.374, 7.252, 56.73, 131.212, 20.38, 86.37, P<0.05).By the Mann-Whitney rank sum test,the serum levels of CEA , CA19-9, CA72-4, CA242 and CA50 in patients with preoperative gastric cancer were significantly higher than those in healthy controls (Z values were -8.598, -4.425, -4.365, -2.000,-7.420, P<0.05).The level of postoperative group was significantly lower than that of preoperative group (Z value were -4.641, -2.383, -2.459, -2.399, -2.903, P<0.05).The serum PGⅠ, PGⅡand PGR levels in patients with preoperative gastric cancer were significantly lower than those in healthy controls (Z values were -10.309, -2.695, 8.637, P<0.05).The PGⅠlevel in the postoperative group was significantly lower than that in the preoperative group (Z value was -2.109, P<0.05).PGⅡ,PGR levels of postoperative group were lower than those of preoperative group , but the difference were not statistically significant.(Z values were -1.506,-0.838, P values were 0.132,0.402).Conclusion The detection of the seven serum markers can help to preoperative diagnosis and postoperative monitoring of gastric cancer .
10.18 F-FDG PET/CT in staging and metabolic activity assessment of multiple myeloma
Lijuan DI ; Jianhua ZHANG ; Rongfu WANG ; Zhanli FU ; Yan FAN ; Xuchu ZHANG ; Guangyu ZHAO ; Yonggang CUI ; Meng LIU ; Lei KANG ; Xuhe LIAO ; Yanfu WANG
Chinese Journal of Nuclear Medicine and Molecular Imaging 2017;37(1):35-38
Objective To investigate the clinical value of 18 F?FDG PET/CT in staging multiple myeloma ( MM) and evaluating the glucose metabolic activity of MM. Methods A total of 25 MM patients ( 13 males, 12 females, age:39-67 years) from May 2010 to April 2015 were enrolled in this retrospective study. The SUVmax of each patient was recorded. D?S plus staging according to 18 F?FDG PET/CT was com?pared with the traditional D?S staging. The SUVmax and the percentage of plasmacytes of bone marrow of phase Ⅲ and non?phase Ⅲ ( phaseⅠand Ⅱ) according to D?S plus staging were compared. Two?sample t test and Wilcoxon rank sum test were used to analyze the data. Results In 25 MM patients, the range of SUVmax of lesions was 1.8-12?0 and the mean value was 5.15±2.74. According to D?S staging, the numbers of patients with phase Ⅰ,Ⅱ andⅢwere 7, 4 and 14, respectively. While the numbers were 3, 1 and 21 by D?S plus staging. Based on the D?S plus staging system, stages of 7 patients ( 28%, 7/25 ) were changed. According to the D?S plus staging system, the SUVmax between phaseⅢand non?phaseⅢpatients was significantly different (5.75±2.54 vs 3.00±0?70; t=2.12, P<0.05), while the percentage of plasma?cytes of bone marrow between the 2 groups had no significant difference ( 17. 50%( 4. 25%-41. 75%) vs 11?15%(10.25%-36.57%);z=0.05, P>0.05). Conclusion 18F?FDG PET/CT is of clinical importance for MM staging and metabolic activity assessment of MM.

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