1.Research advancement of the application of artificial intelligence deep learn-ing in the diagnosis and treatment of orbital diseases and ocular tumors
Zhangjun REN ; Jinhai YU ; Zexi SANG ; Yaohua WANG ; Hongfei LIAO
Recent Advances in Ophthalmology 2024;44(2):163-168
In recent years,deep learning,a pivotal subset of artificial intelligence machine learning,has achieved noteworthy advancements in the medical domain.It facilitates precise detection,diagnosis and prognostic assessment of various diseases through the analysis of medical images.Within ophthalmology,deep learning techniques have found wide-spread application in the diagnosis and prediction of thyroid-related eye diseases,orbital blowout fracture,melanoma,bas-al cell carcinoma,orbital abscess,lymphoma,retinoblastoma and other diseases.Leveraging images from computed tomo-graphy,magnetic resonance imaging and even pathological sections,this technology demonstrates a capacity to diagnose,differentiate and stage orbital diseases and ocular tumors with a high level of accuracy comparable to that of expert clini-cians.The promising prospects of this technology are expected to enhance the diagnosis and treatment of related diseases,concurrently reducing the time and cost associated with clinical practices.This review consolidates the latest research pro-gress on the application of artificial intelligence deep learning in orbital diseases and ocular tumors,aiming to furnish clini-cians with up-to-date information and developmental trends in this field,thereby furthering the clinical application and widespread adoption of this technology.
2.Expert consensus on surgical treatment of oropharyngeal cancer
China Anti-Cancer Association Head and Neck Oncology Committee ; China Anti-Cancer Association Holistic Integrative Oral Cancer on Preventing and Screen-ing Committee ; Min RUAN ; Nannan HAN ; Changming AN ; Chao CHEN ; Chuanjun CHEN ; Minjun DONG ; Wei HAN ; Jinsong HOU ; Jun HOU ; Zhiquan HUANG ; Chao LI ; Siyi LI ; Bing LIU ; Fayu LIU ; Xiaozhi LV ; Zheng-Hua LV ; Guoxin REN ; Xiaofeng SHAN ; Zhengjun SHANG ; Shuyang SUN ; Tong JI ; Chuanzheng SUN ; Guowen SUN ; Hao TIAN ; Yuanyin WANG ; Yueping WANG ; Shuxin WEN ; Wei WU ; Jinhai YE ; Di YU ; Chunye ZHANG ; Kai ZHANG ; Ming ZHANG ; Sheng ZHANG ; Jiawei ZHENG ; Xuan ZHOU ; Yu ZHOU ; Guopei ZHU ; Ling ZHU ; Susheng MIAO ; Yue HE ; Jugao FANG ; Chenping ZHANG ; Zhiyuan ZHANG
Journal of Prevention and Treatment for Stomatological Diseases 2024;32(11):821-833
With the increasing proportion of human papilloma virus(HPV)infection in the pathogenic factors of oro-pharyngeal cancer,a series of changes have occurred in the surgical treatment.While the treatment mode has been im-proved,there are still many problems,including the inconsistency between diagnosis and treatment modes,the lack of popularization of reconstruction technology,the imperfect post-treatment rehabilitation system,and the lack of effective preventive measures.Especially in terms of treatment mode for early oropharyngeal cancer,there is no unified conclu-sion whether it is surgery alone or radiotherapy alone,and whether robotic minimally invasive surgery has better func-tional protection than radiotherapy.For advanced oropharyngeal cancer,there is greater controversy over the treatment mode.It is still unclear whether to adopt a non-surgical treatment mode of synchronous chemoradiotherapy or induction chemotherapy combined with synchronous chemoradiotherapy,or a treatment mode of surgery combined with postopera-tive chemoradiotherapy.In order to standardize the surgical treatment of oropharyngeal cancer in China and clarify the indications for surgical treatment of oropharyngeal cancer,this expert consensus,based on the characteristics and treat-ment status of oropharyngeal cancer in China and combined with the international latest theories and practices,forms consensus opinions in multiple aspects of preoperative evaluation,surgical indication determination,primary tumor re-section,neck lymph node dissection,postoperative defect repair,postoperative complication management prognosis and follow-up of oropharyngeal cancer patients.The key points include:① Before the treatment of oropharyngeal cancer,the expression of P16 protein should be detected to clarify HPV status;② Perform enhanced magnetic resonance imaging of the maxillofacial region before surgery to evaluate the invasion of oropharyngeal cancer and guide precise surgical resec-tion of oropharyngeal cancer.Evaluating mouth opening and airway status is crucial for surgical approach decisions and postoperative risk prediction;③ For oropharyngeal cancer patients who have to undergo major surgery and cannot eat for one to two months,it is recommended to undergo percutaneous endoscopic gastrostomy before surgery to effectively improve their nutritional intake during treatment;④ Early-stage oropharyngeal cancer patients may opt for either sur-gery alone or radiation therapy alone.For intermediate and advanced stages,HPV-related oropharyngeal cancer general-ly prioritizes radiation therapy,with concurrent chemotherapy considered based on tumor staging.Surgical treatment is recommended as the first choice for HPV unrelated oropharyngeal squamous cell carcinoma(including primary and re-current)and recurrent HPV related oropharyngeal squamous cell carcinoma after radiotherapy and chemotherapy;⑤ For primary exogenous T1-2 oropharyngeal cancer,direct surgery through the oral approach or da Vinci robotic sur-gery is preferred.For T3-4 patients with advanced oropharyngeal cancer,it is recommended to use temporary mandibu-lectomy approach and lateral pharyngotomy approach for surgery as appropriate;⑥ For cT1-2N0 oropharyngeal cancer patients with tumor invasion depth>3 mm and cT3-4N0 HPV unrelated oropharyngeal cancer patients,selective neck dissection of levels ⅠB to Ⅳ is recommended.For cN+HPV unrelated oropharyngeal cancer patients,therapeutic neck dissection in regions Ⅰ-Ⅴ is advised;⑦ If PET-CT scan at 12 or more weeks after completion of radiation shows intense FDG uptake in any node,or imaging suggests continuous enlargement of lymph nodes,the patient should undergo neck dissection;⑧ For patients with suspected extracapsular invasion preoperatively,lymph node dissection should include removal of surrounding muscle and adipose connective tissue;⑨ The reconstruction of oropharyngeal cancer defects should follow the principle of reconstruction steps,with priority given to adjacent flaps,followed by distal pedicled flaps,and finally free flaps.The anterolateral thigh flap with abundant tissue can be used as the preferred flap for large-scale postoperative defects.
3.Efficacy and safety of mitoxantrone hydrochloride liposome injection in treatment of peripheral T-cell lymphomas: a multicenter, non-interventional, ambispective cohort, real-world study (MOMENT)
Huiqiang HUANG ; Zhiming LI ; Lihong LIU ; Liang HUANG ; Jie JIN ; Hongyan TONG ; Hui ZHOU ; Zengjun LI ; Zhenqian HUANG ; Wenbin QIAN ; Kaiyang DING ; Quande LIN ; Ming HOU ; Yunhong HUANG ; Jingbo WANG ; Pengcheng HE ; Xiuhua SUN ; Xiaobo WANG ; Zunmin ZHU ; Yao LIU ; Jinhai REN ; Huijing WU ; Liling ZHANG ; Hao ZHANG ; Liangquan GENG ; Jian GE ; Ou BAI ; Liping SU ; Guangxun GAO ; Xin LI ; Yanli YANG ; Yijian CHEN ; Aichun LIU ; Xin WANG ; Yi WANG ; Liqun ZOU ; Xiaobing HUANG ; Dongping HUANG ; Shujuan WEN ; Donglu ZHAO ; Jun MA
Journal of Leukemia & Lymphoma 2023;32(8):457-464
Objective:To evaluate the efficacy and safety of mitoxantrone hydrochloride liposome injection in the treatment of peripheral T-cell lymphoma (PTCL) in a real-world setting.Methods:This was a real-world ambispective cohort study (MOMENT study) (Chinese clinical trial registry number: ChiCTR2200062067). Clinical data were collected from 198 patients who received mitoxantrone hydrochloride liposome injection as monotherapy or combination therapy at 37 hospitals from January 2022 to January 2023, including 166 patients in the retrospective cohort and 32 patients in the prospective cohort; 10 patients in the treatment-na?ve group and 188 patients in the relapsed/refractory group. Clinical characteristics, efficacy and adverse events were summarized, and the overall survival (OS) and progression-free survival (PFS) were analyzed.Results:All 198 patients were treated with mitoxantrone hydrochloride liposome injection for a median of 3 cycles (range 1-7 cycles); 28 cases were treated with mitoxantrone hydrochloride liposome injection as monotherapy, and 170 cases were treated with the combination regimen. Among 188 relapsed/refractory patients, 45 cases (23.9%) were in complete remission (CR), 82 cases (43.6%) were in partial remission (PR), and 28 cases (14.9%) were in disease stabilization (SD), and 33 cases (17.6%) were in disease progression (PD), with an objective remission rate (ORR) of 67.6% (127/188). Among 10 treatment-na?ve patients, 4 cases (40.0%) were in CR, 5 cases (50.0%) were in PR, and 1 case (10.0%) was in PD, with an ORR of 90.0% (9/10). The median follow-up time was 2.9 months (95% CI 2.4-3.7 months), and the median PFS and OS of patients in relapsed/refractory and treatment-na?ve groups were not reached. In relapsed/refractory patients, the difference in ORR between patients with different number of treatment lines of mitoxantrone hydrochloride liposome injection [ORR of the second-line, the third-line and ≥the forth-line treatment was 74.4% (67/90), 73.9% (34/46) and 50.0% (26/52)] was statistically significant ( P = 0.008). Of the 198 PTCL patients, 182 cases (91.9%) experienced at least 1 time of treatment-related adverse events, and the incidence rate of ≥grade 3 adverse events was 66.7% (132/198), which was mainly characterized by hematologic adverse events. The ≥ grade 3 hematologic adverse events mainly included decreased lymphocyte count, decreased neutrophil count, decreased white blood cell count, and anemia; non-hematologic adverse events were mostly grade 1-2, mainly including pigmentation disorders and upper respiratory tract infection. Conclusions:The use of mitoxantrone hydrochloride liposome injection-containing regimen in the treatment of PTCL has definite efficacy and is well tolerated, and it is a new therapeutic option for PTCL patients.
4.Analysis of Chemical Components as Coumarin in Saposhnikovia divaricata by UPLC-Q-TOF-MS
Xiaolei REN ; Jinhai HUO ; Guodong SUN ; Wenfeng WEI ; Weiming WANG
China Pharmacy 2019;30(3):349-354
OBJECTIVE: To analyze chemical components as coumarin in Saposhnikovia divaricata, and to provide reference for comprehensive analysis of pharmacodynamic material base in S. divaricata. METHODS: UPLC-Q-TOF-MS method was adopted. Chromatographic condition: the determination was performed on ACQUITY UPLC BEH C18 column with mobile phase consisted of 0.1% formic acid water-0.1% formic acid acetonitrile (gradient elution) at the flow rate of 0.3 mL/min. The column temperature was 35 ℃, and sample size was 3 μL. MS condition: ESI, in positive and negative ion mode, ESI+/ESI- 5 500 V/-4 500 V, declustering potential of 80--80 V, auxiliary heating gas pressure of 55.00 psi, atomizing gas pressure of -55 psi, curtain gas pressure of -35.00 psi, desolvent temperature of 550 ℃, collision activation scanning energy of 15 eV, collision voltage of 35 psi. Component analysis was performed by comparing with the related literature data and the standard chromatogram control combined with accurate relative molecular mass of compounds provided by UPLC-Q-TOF-MS. RESULTS: Totally 135 chemical components were analyzed in ESI+ mode, and the 105 chemical components were analyzed in ESI- mode. 11 chemical components as coumarin were identified in ESI+ mode, such as isoimperatorin, umbelliferone, scopolamine, xanthotoxin, psoralen, Ostenol, fraxidin, isoimperatorin, 5-hydroxyl-8-methoxypsoralen, phellopterin, decursin. CONCLUSIONS: The method is accurate and rapid, and can be used for the analysis of chemical components as coumarin in S. divaricata.
5.Effects of heat-reinforcing acupuncture on urine metabolites in rheumatoid arthritis rabbits.
Xiaozheng DU ; Bo YUAN ; Jinhai WANG ; Xinghua ZHANG ; Liang TIAN ; Chaozhan REN ; Huazong ZENG
Chinese Acupuncture & Moxibustion 2017;37(1):55-60
OBJECTIVETo compare the effects of different acupuncture methods on urine metabolites in rheumatoid arthritis (RA) rabbits, and to explore the specificity mechanism of heat-reinforcing acupuncture for RA.
METHODSA total of 40 clean purple-blue rabbits were randomly allocated to a normal group, a model group, a mild reinforcing-reducing needling (MRRN) group, a twirling-reinforcing needling (TRN) group and a heat-reinforcing needling (HRN) group, 8 rabbits in each one. Except the normal group, the rabbits in the remaining groups were treated with ovalbumin and freezing to establish RA model. The rabbits in the MRRN group, TRN group and HRN group were treated with MRRN, TRN and HRN at "Zusanli" (ST 36), respectively, 30 min per treatment, once a day for seven days. After treatment, 24-h urine was collected. The rabbits were sacrificed to collect synovial tissues of knee to perform morphology observation; the liquid chromatography quadrupole time-of-flight mass spectrometry (LC-Q/TOF-MS) was applied to measure urine metabolites. All the data were analyzed by principal component analysis (PCA) and partial least squares discriminant analysis (PLS-DA).
RESULTSCompared with the normal group, the leucine-related metabolites, as main urine metabolites, were decreased in the model group (<0.05), while the purine-related metabolites and tryptophane-related metabolites were increased (<0.05). Compared with the model group, the leucine-related metabolites, as main urine metabolites, were increased in the three needling groups after treatment (<0.05), while the tryptophan-related metabolites andpurine-related metabolites were decreased (<0.05), moreover, the leucine-related metabolites in the HRN group were obviously higher than those in the MRRN group and TRN gruop (<0.05).
CONCLUSIONSMRRN, TRN and HRN can regulate the pathway of leucine metabolism (energy metabolism), purine metabolism (oxidative damage) and tryptophane metabolism (immune regulation) for RA, The specificity of HRN for RA focuses on regulation of leucine metabolism (energy metabolism).
6.Influence of autophagy inhibited by chloroquine in apoptosis of myelogenous leukemia cells promoted by decitabine
Lina XING ; Jinhai REN ; Ying WANG ; Fuxu WANG ; Shengxin CAI
Journal of Jilin University(Medicine Edition) 2017;43(5):937-942
Objective:To study the influence of chloroquine combined with decitabine in the apoptosis of leukemia K562 cells and KG-1a1Aor1a cells,to explore the effect of autophagy on the leukemia cell apoptosis induced by decitabine,and to clarify its mechanism.Methods:The leukemia K562 and KG-1a1Aor1a cells were cultivated in vitro and divided into blank control group,decitabine group (10 μmol · L 1) and chloroquine (50 μmol · L 1) combined with decitabine group (combined group).The leukemia cells in combined group were pre-treated with chloroquine for 6 h before experiment.After treatment with drugs for 24 and 48 h,the number of cells was detected and by CCK-8 method the inhibitory rates of proliferation cells were calculated;the apoptotic rates and mitochondrial membrane potential were detected by flow cytometry.Q-PCR method was carried out to determine the gene expression levels of Atg7 and Atg12,and Western blotting was used to test the protein expression of LC3.Results:After treatment for 24 and 48 h,the number of K562 and KG-1a1Aor1a cells in decitabine group and combined group were decreased compared with blank control group (P<0.05 or P<0.01);the apoptotic rates and mitochondrial membrane potential were remarkably increased (P<0.05 or P<0.01).Compared with decitabine group,the number of K562 and KG-1a1Aor1a in combined group was significantly decreased,and the apoptotic rates were remarkably increased (P<0.05).After treatment for 24 h,the expression levels of Atg7,Atg12 and LC3-Ⅱ/LC3-Ⅰ in the leukemia K562 and KG-1a1Aor1a cells in decitabine group were significantly increased compared with blank control group (P<0.05 or P<0.01);the expression levels of Atg7,Atg12 and LC3-Ⅱ/LC3-Ⅰ in the leukemia K562 and KG-1a1Aor1a cells in combined group were significantly decreased compared with decitabine group (P<0.05 or P<0.01).Conclusion:Decitabine could promote the apoptosis of leukemia cells,and the inhibition of autophagy by chloroquine can promote the apoptosis induced by decitabine.
7.Protective role and mechanism of orexin A in cell viability of Alzheimer's disease cell model PC12
Di ZUO ; Zhenquan HE ; Lin MA ; Na DING ; Xiaofan REN ; Chun ZHANG ; Jinhai GU ; Fang XU
Chinese Journal of Neuromedicine 2017;16(12):1255-1258
Objective To study the role and mechanism of orexin A in cell viability of Alzheimer's disease (AD) cell model PC12. Methods PC12 cells were treated with 0, 10, 20, 30, 40 and 50 μmol/L Aβ25-35 for 24 h, and then, cell viability was measured by MTT to confirm which concentration was the suitable one to establish the AD cell models. (1) AD cell models were treated with 0, 0.01, 0.1, 1 and 2μmol/L orexin A for 24 h, and then, 30μmol/L Aβ25-35 was added for 24 h; MTT assay was used to determine the cell viability to conform the suitable concentration of orexin A. (2) Inverted phase contrast microscope was employed to observe the morphology changes of PC12 cells from the control group, 30 μmol/L Aβ25-35 treatment group, and 0.01 μmol/L orexin A+30 μmol/L Aβ25-35 treatment group. (3) The PC12 cells were given pretreatment of orexin A receptor inhibitor SB408124 for 2 h, and cell viability was detected. Results (1) Aβ25-35 at concentration 30μmol/L was the suitable one to establish the AD cell models;after being pretreated with different concentrations of orexin A, the cell viability showed significant differences (F=27.120, P=0.000), and 0.01μmol/L orexin A was the suitable concentration. (2) Some of the cells from the 30μmol/L Aβ25-35 treatment group had breaking-off of protuberance and damaged soma;cells from 0.01μmol/L orexin A+30μmol/L Aβ25-35 treatment group had breaking-off of protuberance, and the degree of damaged soma was eased as compared with that in the 30μmol/L Aβ25-35 treatment group. (3) If the cell viability of the control group was 100%, cell viability of orexin A receptor inhibitor group was 109.10%±0.36%, which was significantly decreased as compared with that in the 0.01 μmol/L orexin A pretreated group (117.24%±2.72%, P<0.05). Conclusion Orexin A can improve the cell viability via combination of its specific receptor; orexin A and its specific receptor may be new targets for prevention and cure of AD.
9.Effects of allogeneic compact bone derived-mesenchymal stem cell on proliferation,differentiation and chemokine receptor expression of T cells
Shukai QIAO ; Xiaonan GUO ; Jinhai REN ; Xiaoling GUO ; Yujie GUO ; Shengxin CAI
Chinese Journal of Immunology 2016;(1):37-41
Objective:To observe the effects of allogeneic compact bone derived-mesenchymal stem cells ( CB-MSCs) on pro-liferation and differentiation of T cells,and investigate the molecular mechanisms of the immunosuppressive ability.Methods:With an established co-culture system of CB-MSCs and mouse spleen lymphocytes ( SP) in vitro,we observed the effects of CB-MSCs on prolif-eration,apoptosis and cell cycle of SP by MTS/PES assay and flow cytometry.Also,we measured the effects of CB-MSCs on regulatory T cells ( Treg) ratio and expressions of CCR5,CCR7 and CXCR3 in SP.Results:CB-MSCs could obviously inhibit the PHA-stimulated SP proliferation with a dose-dependent manner;MSCs could significantly inhibit the spontaneous apoptosis of SP and induce SP cell cycle G0/G1 phase arrest.After co-culture with SP,CB-MSCs could obviously increase the proportion of Treg in SP,down-regulate the expression of CXCR3 and CCR5,as well as up-regulate the expression of CCR7.Conclusion: Allogeneic CB-MSCs can significantly inhibit cell proliferation of SP,the mechanisms mainly involved the G0/G1 cell cycle arrest rather than apoptosis induction.In addition, CB-MSCs can exert immunomodulatory effects by increasing the Treg ratio,regulating the expressions of chemokine receptors.
10.Problems in the treatment of acute promyelocytic leukemia
Fengru LIN ; Xiaonan GUO ; Jinhai REN
Journal of Leukemia & Lymphoma 2011;20(1):11-14
Acute promyelocytic leukemia (APL), a subtype of acute myeloid leukemia, is characterized by rapid progress, prone to developing DIC, and high mortality. Typical chromosome translocation with PMLRARα fusion gene occurs in more than 95% of APL cases. Since 1986, the outcome of APL has been significantly improved in our country by firstly using ATRA and ATO for treating APL, making APL of AML curable by chemotherapy only. Based on our limited experiences, we discussed the related problems in the treatment of APL.


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