1.Chemotherapy initiation with single-course methotrexate alone or combined with dactinomycin versus multi-course methotrexate for low-risk gestational trophoblastic neoplasia: a multi-centric randomized clinical trial.
Lili CHEN ; Ling XI ; Jie JIANG ; Rutie YIN ; Pengpeng QU ; Xiuqin LI ; Xiaoyun WAN ; Yaxia CHEN ; Dongxiao HU ; Yuyan MAO ; Zimin PAN ; Xiaodong CHENG ; Xinyu WANG ; Qingli LI ; Danhui WENG ; Xi ZHANG ; Hong ZHANG ; Quanhong PING ; Xiaomei LIU ; Xing XIE ; Beihua KONG ; Ding MA ; Weiguo LU
Frontiers of Medicine 2022;16(2):276-284
		                        		
		                        			
		                        			We aimed to evaluate the effectiveness and safety of single-course initial regimens in patients with low-risk gestational trophoblastic neoplasia (GTN). In this trial (NCT01823315), 276 patients were analyzed. Patients were allocated to three initiated regimens: single-course methotrexate (MTX), single-course MTX + dactinomycin (ACTD), and multi-course MTX (control arm). The primary endpoint was the complete remission (CR) rate by initial drug(s). The primary CR rate was 64.4% with multi-course MTX in the control arm. For the single-course MTX arm, the CR rate was 35.8% by one course; it increased to 59.3% after subsequent multi-course MTX, with non-inferiority to the control (difference -5.1%,95% confidence interval (CI) -19.4% to 9.2%, P = 0.014). After further treatment with multi-course ACTD, the CR rate (93.3%) was similar to that of the control (95.2%, P = 0.577). For the single-course MTX + ACTD arm, the CR rate was 46.7% by one course, which increased to 89.1% after subsequent multi-course, with non-inferiority (difference 24.7%, 95% CI 12.8%-36.6%, P < 0.001) to the control. It was similar to the CR rate by MTX and further ACTD in the control arm (89.1% vs. 95.2%, P =0.135). Four patients experienced recurrence, with no death, during the 2-year follow-up. We demonstrated that chemotherapy initiation with single-course MTX may be an alternative regimen for patients with low-risk GTN.
		                        		
		                        		
		                        		
		                        			Antineoplastic Combined Chemotherapy Protocols/adverse effects*
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		                        			Dactinomycin/adverse effects*
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		                        			Female
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		                        			Gestational Trophoblastic Disease/drug therapy*
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		                        			Humans
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		                        			Methotrexate/therapeutic use*
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		                        			Pregnancy
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		                        			Retrospective Studies
		                        			
		                        		
		                        	
2.Clinical characteristics of vascular neuro-ophthalmology in patients with central retinal artery occlusion
Qingli LU ; Zhongzhong LIU ; Jing WANG ; Pei LIU ; Qiaoqiao CHANG ; Yan LIU ; Guozheng LIU ; Xuemei LIN ; Fang WANG ; Songdi WU
Chinese Journal of Ocular Fundus Diseases 2021;37(10):775-779
		                        		
		                        			
		                        			Objective:To investigate the clinical characteristics of vascular neuro-ophthalmology in patients with central retinal artery occlusion (CRAO).Methods:A single-center, prospective clinical study. From January 2018 to December 2020, 49 eyes of 49 CRAO patients of The Neuro-ophthalmology Department of Xi'an First Hospital were included in the study. Data on patient demographic characteristics, vascular risk factors, disease characteristics, digital subtraction angiography (DSA) imaging characteristics of internal carotid arteries, treatment, treatment-related adverse events, and 1-month follow-up vascular events were collected. All patiens were examined by visual acuity, head CT and or magnetic resonance imaging. At the same time, 35 cases of internal carotid artery vascular DSA were examined; 14 cases of head and neck CT angiography were examined. The anatomical variation of the extracranial segment of the internal carotid artery was divided into tortuous, tortuous, and coiled; the aortic arch was divided into type Ⅰ , type Ⅱ , type Ⅲ, and bovine type. Intravenous thrombolysis, arterial thrombolysis, conservative treatment were performed. The follow-up time was1 month after treatment. Functional vision was defined as vision ≥20/100. Vascular events were strokes, cardiovascular events, deaths and neovascular glaucoma during follow-up.Results:Among 49 eyes of 49 cases, 40 eyes were male (81.6%, 40/49), and 9 eyes were female (18.4%, 9/49); the average age was 60.7±12.9 years. There were 33, 17, and 16 cases with hypertension, type 2 diabetes, and cerebrovascular disease, respectively; 27 and 34 cases had a history of smoking and tooth loss, respectively. Taking antihypertensive, hypoglycemic, antiplatelet aggregation/anticoagulation, and hypolipidemic drugs were 15, 5, 8, and 5 patients, respectively. There were 11 cases of transient amaurosis before the onset, and 17 cases of CRAO after waking up. There were 33 cases (67.3%, 33/49) with infarction of the affected side of the brain tissue. DSA was performed in 35 cases, and the stenosis rate of the internal carotid artery on the affected side was 70%-99% and 100% were 3 (8.6%, 3/35) and 4 (11.4%, 4/35) cases, respectively. The ophthalmic artery on the affected side originated from the external carotid artery in 5 cases (14.3%, 5/35). There were 17 (54.8%, 17/31) and 2 (6.5%, 2/31) cases of tortuousity and kinking in the extracranial segment of the internal carotid artery. There were 15 (42.9%, 15/35), 6(17.1%, 6/35), and 2 (5.7%, 2/35) cases of aortic arch type Ⅱ, type Ⅲ, and bovine type, respectively. Intravenous thrombolysis and arterial thrombolysis were performed in 13 and 29 cases, respectively. Complications occurred in 2 cases during treatment; 3 cases of symptoms fluctuated after treatment, and 10 cases of asymptomatic new infarcts occurred in imaging studies. Forty-eight cases were treated with antiplatelet aggregation/anticoagulation and hypolipidemic treatment. At discharge and 1 month after treatment, the recovery of functional vision was 7 and 17 cases, respectively. One month after treatment, 1 case died because myocardial infarction; 2 cases of neovascular glaucoma occurred.Conclusion:The proportion of CRAO patients with vascular risk factors and internal carotid artery abnormalities on the affected side is relatively high; the prognosis is relatively good after intravenous thrombolysis and/or arterial thrombolysis and secondary stroke prevention.
		                        		
		                        		
		                        		
		                        	
3.Functional outcome and recurrence 1 year after first-ever ischemic stroke in non-diabetic patients
Qingli LU ; Pei LIU ; Jing WANG ; Qiaoqiao CHANG ; Yan LIU ; Zhongzhong LIU ; Xuemei LIN ; Fang WANG ; Yaling SHI ; Songdi WU
International Journal of Cerebrovascular Diseases 2020;28(9):667-673
		                        		
		                        			
		                        			Objective:To investigate the risk factors for poor outcome and recurrence at 1 year after first-ever ischemic stroke in non-diabetic patients.Methods:Using Xi'an Stroke Registry Research Database, the clinical data of patients with non-diabetic first-ever ischemic stroke diagnosed in 4 tertiary A hospitals in Xi'an from January to December 2015 were collected. The National Institute of Health Stroke Scale (NIHSS) was used to evaluate the severity of stroke. Prognosis (functional outcome and recurrence) was followed up at 1 year after diagnosis. Functional outcome was assessed using the modified Rankin scale. 0-2 was defined as good outcome and >2 as poor outcome. Recurrence was defined as new focal neurological dysfunction caused by cerebral infarction or cerebral hemorrhage events during follow-up and confirmed by cranial CT or MRI. Multivariable logistic regression analysis was used to identify the independent influencing factors of clinical outcomes at 1 year. Multivariable Cox proportional hazard model was used to identify the independent influencing factors of recurrence within 1 year. Results:A total of 1 214 non-diabetic patients with first-ever ischemic stroke were included. One year follow-up showed that 210 patients (17.3%) had a poor outcome, 88 (7.2%) of them died, and 47 (3.9%) had recurrence. Multivariate logistic regression analysis showed that age (odds ratio [ OR] 1.065, 95% confidence interval [ CI] 1.042-1.090; P<0.001), atrial fibrillation ( OR 3.170, 95% CI 1.588-6.327; P=0.001), white blood cell count ( OR 1.106, 95% CI 1.006-1.216; P=0 037), baseline NIHSS score ( OR 1.210, 95% CI 1.147-1.277; P<0.001), and stroke associated-pneumonia (SAP; OR 3.677, 95% CI 1.451-9.316; P=0.006) were independently associated with poor outcomes. Multivariate Cox proportional hazards regression analysis showed that baseline NIHSS score (hazard ratio [ HR] 1.055, 95% CI 1.003-1.109; P=0.036) and SAP ( HR 7.067, 95% CI 3.154-15.836; P<0.001) were independently associated with recurrence. Kaplan-Meier survival curve analysis showed that the 1-year recurrence rate of patients with severe stroke was significantly higher than that of patients with mild to moderate stroke (log-rank test, P<0.001), and the 1-year recurrence rate of patients with SAP was significantly higher than that of patients without SAP (log-rank test, P<0.001). Conclusion:Age, atrial fibrillation, white blood cell count, baseline NIHSS score and SAP are the independent predictors of poor outcomes at 1 year after first-ever ischemic stroke in non-diabetic patients. Baseline NIHSS score and SAP are the independent predictors of recurrence within 1 year after first-ever ischemic stroke in non-diabetic patients.
		                        		
		                        		
		                        		
		                        	
4. Clinical efficacy of radical resection for stage T3 gallbladder cancer and prognostic analysis
Hongying HE ; Guangtao LI ; Qingli LI ; Xiaochen MA ; Yangfan ZHANG ; Lu CHEN ; Feng FANG ; Tianqiang SONG
Chinese Journal of Digestive Surgery 2019;18(10):966-978
		                        		
		                        			 Objective:
		                        			To investigate the clinical efficacy of radical resection for stage T3 gallbladder cancer and prognostic factors.
		                        		
		                        			Methods:
		                        			The retrospective case-control study was conducted. The clinico-pathological data of 87 patients with T3 gallbladder cancer who were admitted to Tianjin Medical University Cancer Institute and Hospital from January 2005 to June 2016 were collected. There were 44 males and 43 females, aged 29-79 years, with a median age of 61 years. According to the different preoperative pathological classification and intraoperative exploration of gallbladder cancer, corresponding surgeries were performed. Observation indicators: (1) surgical and postoperative conditions; (2) clinical efficacy of stage T3 gallbladder cancer and prognostic factors analysis; (3) clinical efficacy of stage T3 gallbladder adenocarcinoma and prognostic factors analysis; (4) clinical efficacy of stage T3 gallbladder adenosquamous carcinoma and prognostic factors analysis. Follow-up by outpatient examination or telephone interview was performed to detect the postoperative survival of patients up to June 2018. Measurement data with skewed distribution were represented as 
		                        		
		                        	
5.Construction of lung cancer cell model overexpressing human MutS homologue 2(hMSH2)
Bichao LU ; Qingli SHEN ; Wenli LI ; Juan LI ; Hui CHEN ; Yumei DAI ; Wei HE
Basic & Clinical Medicine 2017;37(7):929-934
		                        		
		                        			
		                        			Objective To construct human lung cancer cell model with human MutS homologous protein 2 (hMSH2) overexpression for exploring the effect of hMSH2 molecule in the cytotoxicity of γδ T cell against lung cancer cells.Methods hMSH2 coding sequence was cloned by PCR for construction of recombinant vector which over expressed hMSH2-EGFP fusion protein using homologous recombination.The recombinant vector was transfected to lung cancer cell line NCI-H520 to construct human lung cancer cell model overexpressing hMSH2 molecule.The expression of hMSH2 molecule in NCI-H520 was detected by Western blot.The expression of hMSH2 on the cell membrane was measured by flow cytometry.Cytotoxicity of expanded γδ T cells from peripheral blood mononuclear cells against NCI-H520 cells was detected by LDH release assay in vitro.Results hMSH2 coding sequence (2805 bp) was cloned and the result of restriction endonuclease digestion of Fugw-hMSH2 recombinant vector was accordance with the anticipated objective strip size.Exogenous hMSH2-EGFP fusion protein was expressed in NCIH520 cells.The level of hMSH2 molecule on the surface of NCI-H520 cells with overexpression of hMSH2 was significantly increased (P<0.001).Cytotoxicity of γδ T cells against NCI-H520 cells with overexpression of hMSH2 was significantly increased compared to the wild type NCI-H520 cells (P<0.05).Conclusions Lung cancer cell model that overexpresses hMSH2 molecule is successfully constructed,hMSH2 molecule on the cell membrane is increased and the cytotoxicity of γδ T cells against lung cancer cells is enhanced.
		                        		
		                        		
		                        		
		                        	
6.Differential expression of autophagy-related genes in melanocytes under oxidative stress
Qingli GONG ; Xue LI ; Gaozhong DING ; Yuting LING ; Wen'e ZHAO ; Xixi XIONG ; Yan LU ;
Chinese Journal of Dermatology 2017;50(8):547-552
		                        		
		                        			
		                        			Objective To evaluate the effect of hydrogen peroxide (H2O2) on autophagy in melanocytes,and to explore its possible regulatory mechanisms.Methods Normal human melanocytes at exponential growth phase were divided into several groups:blank control group receiving no treatment,positive control group treated with 100 nmol/L sirolimus solution,and experiment groups treated with H2O2 solution at different volume fractions of 10-7-10-3 respectively.After 4-hour treatment,cell counting kit-8 (CCK-8) assay and flow cytometry were performed to evaluate the cellular proliferative activity and detect apoptosis of melanocytes respectively.Acridine orange staining was performed to detect autophagosome formation,transmission electron microscopy to observe ultrastructural changes of autophagosomes,and Western blot analysis to measure the expression of autophagy-specific protein Beclin 1 and microtubuleassociated protein 1 light chain 3B (LC3B).A total of 84 autophagy-related genes were analyzed by RT2 Profiler PCR Array,so as to screen differentially expressed autophagy-related genes.Results After the treatment with H2O2 at different volume fractions of 10-3,5 × 10-4,10-4,5 × 10-5,10-5,5 × 10-6 and 10-6,experiment groups showed significantly decreased cellular proliferative activity,but significantly increased apoptosis rate compared with the blank control group (F =286.95,301.23,respectively,both P < 0.05).With the increase in volume fractions of H2O2,the cellular proliferative activity was significantly gradually decreased (P < 0.05),while the apoptosis rate showed an opposite trend (P < 0.05),except that the 5 ×10-6 H2O2 group showed no significant differences in the apoptosis rate compared with the 10-5 H2O2 group and 10-6 H2O2 group.Acridine orange staining and electron microscopy showed autophagosome formation in the 10-5 H2O2 group,10-6 H2O2 group and positive control group.Western blot analysis revealed that Beclin1 expression and LC3B-Ⅱ/LC3B-Ⅰ ratio were significantly higher in the 10-5 H2O2 group,10-6 H2O2 group and positive control group than in the blank control group (all P < 0.05).RT2 Profiler PCR Array showed significant up-regulation of ATG12,ATG3,ULK1,PIK3CG,PTEN and PIK3C3 genes and significant downregulation of EIF2AK3 gene in the 10-5 H2O2 group,10-6 H2O2 group and positive control group compared with the blank control group.In the 10-5 H2O2 group and positive control group,the mTOR gene was significantly up-regulated,and the ULK2 gene was significantly down-regulated.The 10-6 H2O2 group showed no obvious changes in the expression of mTOR gene,but significant up-regulation of AMPK and JNK1 genes.Conclusion H2O2 at volume fractions of 10-5 and 10-6 can induce autophagy in melanocytes,likely by influencing the expression of some related signaling molecules.
		                        		
		                        		
		                        		
		                        	
7.The clinical, radiological and prognostic factor analysis of medullary infarction
Aping SUN ; Xiangyi LIU ; Qingli SUN ; Lu CHEN ; Xiaolu LIU ; Dongsheng FAN
Chinese Journal of Internal Medicine 2016;55(5):361-365
		                        		
		                        			
		                        			Objective To investigate the clinical and radiological features of medullary infarction (MI), and to compare the clinical characteristics of lateral medullary infarction (LMI) and medial medullary infarction (MMI).Methods Patients diagnosed as acute MI who were treated from January 2009 to December 2014 in Department of Neurology, Peking University Third Hospital, were retrospectively enrolled in the study and data were analyzed including risk factors, clinical features, laboratory findings, radiological characteristics, etiology and outcomes.Results A total of 62 cases of MI were enrolled with 48 cases of LMI and 14 cases of MMI , including 2 cases of bilateral MMI.The mean onset age of LMI and MMI was 60.2 ± 12.3 and 56.9 ± 14.2, respectively.The frequently affected location of LMI was the middle and upper part of medulla [40 cases (83.3%)].The common symptoms and signs of LMI were dizzy (38 cases ,79.2%), sensory disturbance (33 cases ,68.8%), dysarthria (32 cases ,66.7%), dysphagia (30 cases ,62.5%), diminished pharyngeal reflex (30 cases, 62.5%), Homer's sign (29 cases, 60.4%), ataxia (26 cases, 54.2%) and nausea or vomiting (25 cases, 52.1%).The frequently affected location of MMI was the upper part of medulla (13 cases, 92.9%).The common symptoms and signs of MMI were motor dysfunction (12 cases, 85.7%), sensory disturbances (11 cases, 78.6%), dizzy (10 cases, 71.4%) and dysarthria (10 cases, 71.4%).Infarctions caused by atherosclerosis were found in 35 cases of LMI (72.9%) and 12 cases of MMI (85.7%).Five cases (10.4%) of LMI died in hospital, while 1 case (7.1%) of MMI died in hospital.No lesion was found in 16 cases (25.8%) by MRI-DWI within the first 24 hours of onset.Conclusions Our study showes that the mean onset age of LMI is older than that of MMI.The lesion of LMI is frequently located in the upper and middle medulla, whereas the lesion of MMI is mostly in the upper medulla.The prognosis of LMI is worse than that of MMI.Atherosclerosis of the vertebral arteries is the predominant vascular pathology in MI.
		                        		
		                        		
		                        		
		                        	
8.Evaluation of efficacy of glucocorticoids and intravenous immunoglobulin for the treatment of toxic epidermal necrolysis
Jie SUN ; Jin LIU ; Qingli GONG ; Gaozhong DING ; Liwen MA ; Lichao ZHANG ; Yan LU
Chinese Journal of Dermatology 2015;(9):633-636
		                        		
		                        			
		                        			Objective To evaluate the efficacy of systemic glucocorticoids and intravenous immunoglobulin (IVIG)for the treatment of toxic epidermal necrolysis (TEN). Methods Clinical data on TEN inpatients treated with systemic glucocorticoids alone or in combination with IVIG were collected from the Department of Dermatology, First Affiliated Hospital of Nanjing Medical University from January 2006 to December 2012. Therapeutic outcomes were evaluated in these patients. Statistical analysis was carried out by using a multiple linear regression analysis, binary logistic regression analysis and Cox regression analysis with the SPSS 16.0 software. Results A total of 48 inpatients with TEN were included in this study. Multiple linear regression analysis showed that the maximum daily dose of glucocorticoids for disease control was decreased gradually over years (β=-0.461, P=0.004). However, binary logistic regression analysis revealed no obvious changes in the frequency of administration of IVIG over years. Cox regression analysis showed that both hospitalization duration (RR=0.351, 95.0%CI:0.150-0.825)and the time required for the control of skin lesions (RR=0.492, 95.0%CI:0.245-0.986)decreased with the increase in the frequency of IVIG administration. In addition, with the increase in the maximum daily dose of glucocorticoids for disease control, the time required for the control of skin lesions was also shortened (RR=0.997, 95.0%CI:0.994 -1.000), while no obvious changes were observed in hospitalization duration. Conclusions IVIG shows superiority in controlling lesions, reducing complications and improving the prognosis of TEN. Compared with systemic glucocorticoids, IVIG shows better therapeutic efficacy and less adverse effects, and may be preferentially selected.
		                        		
		                        		
		                        		
		                        	
9.Analysis on Anti-platelet Aggregation Effectors from Gardenia Jasminoides Extract with Employment of Platelet Affinity Extraction Method Coupled with HPLC
Qingli GUO ; Shouying DU ; Yang LU ; Pengyue LI ; Pan XU ; Zhen WANG ; Yiwang GUO ; Kexin SHANG ; Yanke CHENG
World Science and Technology-Modernization of Traditional Chinese Medicine 2014;(9):1891-1895
		                        		
		                        			
		                        			This study was aimed to search anti-platelet aggregation effectors from Gardenia jasminoides extract with the employment of platelet affinity extraction method coupled with HPLC, in order to provide pharmacological experi-mental evidences of the selected effectors to verify its feasibility. Under physiological conditions, washed rat platelets were added into G. jasminoides extract and then a mixture was gained. Consequently, some components from G. jas-minoides extract were combined to the platelets in the mixture while some were not owing to their special chemical structures and properties. Firstly, the uncombined components were washed off from the mixture. Secondly, the com-bined components in the leftover was washed down and collected, respectively, right after destroying the occupied platelets' structures. Thirdly, different collected eluents were analyzed, respectively, by HPLC established in the pre-vious work to search the effectors. Fourthly, pharmacological experiments were implemented for confirmation. The re-sults showed that dominant effective components from G. jasminoides extract acting on anti-platelet aggregation were identified as geniposide. Further evident was provided as well by pharmacological experiment that geniposide exhibit-ed significant inhibitory effect on anti-platelet aggregation in rats induced by ADP, rat tail collagen and thrombin(P< 0.01). It was concluded that the platelet affinity extraction-HPLC method proposed in this paper can be utilized to analyze the correlation of effectors from G. jasminoides extract and its pharmacological effects. Moreover, there are some correlations between screened chemical substances and their pharmacological effects.
		                        		
		                        		
		                        		
		                        	
10.Analysis of disease and health risk factors among teachers in one university of Chongqing
Xiaohong YANG ; Shanbi ZHOU ; Youhong XIE ; Qiongwu YU ; Hao LIU ; Zongliang LU ; Yu QIN ; Qingli HE ; Mantian MI
Chongqing Medicine 2014;(25):3325-3328
		                        		
		                        			
		                        			Objective To understand the teachers′health status of one university in Chongqing to provide the basis for the healthcare of this group.Methods The teachers′health examination information in1 303 cases of physical healthy examination was retrospectively analyzed.The data were analyzed by the SPSS17.0 statistical software.Results The main detected diseases were conj unctivitis,fatty liver,cataract,refractive error,eyeground arteriosclerosis and hypertension.The top-5 health risk factors includ-ed dyslipidemia,overweight,hyperpiesia,increased uric acid and fasting blood glucose abnormality.The detection rates of conj uncti-vitis,fatty liver,eyeground arteriosclerosis,overweight,hyperpiesia,increased uric acid,fasting blood glucose abnormality examined in males were obviously higher than those in females(P<0.05),while which of cataracts,refractive errors,hypertension and dyslip-idimia were not relevant to gender(P>0.05).Apart from the increased uric acid(P=0.740),the morbidity and risk factors in dif-ferent ages were markedly different(P<0.01).The case rate of diabetes and hypertension was lower than the national average. Conclusion The eye health status of teachers in this university is not optimistic;there were many health risk factors.The health knowledge education of overweight,dyslipidemia,pathoglycemia and hyperpiesia should be carried out aiming at this group.
		                        		
		                        		
		                        		
		                        	
            
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