1.Comparison between white light endoscopy and narrow-band imaging endoscopy in predicting histological healing of ulcerative colitis in remission
Tao HE ; Lingyu ZHU ; Peng PAN ; Lei LI ; Qiuye WANG ; Shilin QIU ; Liyan ZHANG ; Hui GAO ; Lianqiang SONG ; Shanming SUN
Chinese Journal of Digestive Endoscopy 2023;40(2):140-145
Objective:To investigate the predictive value of mucosal vascular pattern (MVP) under narrow-band imaging (NBI) enteroscopy in patients with ulcerative colitis (UC) in clinical remission for histological healing and clinical recurrence.Methods:A total of 142 patients with UC in clinical remission who visited the First Affiliated Hospital of Weifang Medical University from January 2018 to January 2021 were included in the study and underwent colonoscopy. The white light and NBI endoscopic images were collected and biopsies were obtained. The Mayo endoscopic score (MES) was calculated based on white light images, and MVP staging was evaluated based on mucosal vascular patterns under NBI. Nancy index (NI) was used to evaluate histological healing and patients were followed up for 1 year. The Spearman correlation coefficients of MES and MVP with histological healing and recurrence were calculated. The receiver operator characteristic (ROC) curve was plotted and the area under curve (AUC) was applied to evaluate the accuracy of white light and NBI endoscopy for predicting histological healing of UC in clinical remission.Results:According to the MVP criteria, 47 were defined as clear, 63 blurred, and 32 invisible. Spearman correlation analysis showed a significant correlation between MVP under NBI and histological healing ( r=0.549, P<0.001) and a moderate correlation between MES under white light and histological healing ( r=0.462, P<0.001). Spearman correlation analysis showed a moderate correlation between MVP under NBI and clinical recurrence ( r=0.451, P<0.001) and a moderate correlation between MES under white light and clinical recurrence ( r=0.352, P<0.001). AUC of NBI for diagnosing histological healing of UC in clinical remission was 0.809 (95% CI: 0.738-0.879), with a sensitivity of 84.6% (77/91) and specificity of 64.7% (33/51), superior to the white light endoscopy, of which AUC, sensitivity and specificity were 0.763 (95% CI: 0.678-0.848), 81.3% (74/91) and 66.7% (34/51). Conclusion:MVP staging under NBI could predict histological healing of UC patients in clinical remission and is superior to white light endoscopy.
2.Acute and chronic pain after subxiphoid versus transcostal thoracoscopic extended thymectomy: A propensity score matching study
Jianfei YANG ; Gaoxiang WANG ; Shanming TAO ; Liangdong XU ; Mingsheng WU ; Mingran XIE
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2023;30(06):842-847
Objective To compare and analyze the occurrence of acute and chronic pain after subxiphoid and transcostal thoracoscopic extended thymectomy. Methods A retrospective analysis was performed on 150 patients who underwent thoracoscopic extended thymectomy in our hospital from July 2020 to June 2022, among whome 30 patients received subxiphoid video-assisted thoracic surgery, and 120 patients received transcostal video-assisted thoracic surgery. The patients were matched by the propensity score matching method. Postoperative pain was evaluated by numeric rating scale (NRS). The intraoperative conditions and postoperative pain incidence were compared between the two groups. Results After matching, 60 patients were enrolled, 30 in each group, including 30 males and 30 females with an average age of 50.78±12.13 years. There was no difference in the general clinical data between the two groups (P>0.05), and no perioperative death. There were statistical differences in the intraoperative blood loss, postoperative drainage volume, postoperative catheter duration, postoperative hospital stay, postoperative pain on 1 d, 2 d, 3 d, 7 d, 3 months and 6 months after the surgery (P<0.05), but there was no statistical difference in the operation time or the postoperative 14 d NRS score (P>0.05). Further univariate and multivariate analyses for postoperative chronic pain showed that surgical method and postoperative 14 d NRS score were risk factors for chronic pain at the 3 months and 6 months after the surgery (P<0.05). Conclusion The subxiphoid thoracoscopic extended thymectomy has advantages over transcostal thoracoscopic surgery in the postoperative acute and chronic pain.
3. A phase II, single-arm, open-label, multicenter clinical study to evaluate the efficacy and safety of sofosbuvir combined with ribavirin in patients with genotype 2 chronic hepatitis C virus infection
Yinghui GAO ; Guangming LI ; Qinglong JIN ; Yingren ZHAO ; Zhansheng JIA ; Xiaorong MAO ; Yongfeng YANG ; Jia SHANG ; Gongchen WANG ; Wen XIE ; Shanming WU ; Mingxiang ZHANG ; Jinlin HOU ; Dongliang LI ; Yuemin NAN ; Yujuan GUAN ; Chunxia ZHU ; Yangzhou YUAN ; Lai WEI
Chinese Journal of Hepatology 2019;27(5):352-357
Objective:
To evaluate the efficacy and safety of sofosbuvir (Nanjing Zhengda Tianqing Pharmaceutical Co., Ltd.) combined with ribavirin in patients with genotype 2 chronic hepatitis C virus infection.
Methods:
Treatment-naïve or treatment experienced genotype 2 chronic hepatitis C patients from sixteen research centers of China were screened. All subjects received once-daily dose of sofosbuvir (400 mg) combined with ribavirin (body weight < 75 kg, 1 000 mg/day, 400 mg in the morning and 600 mg in the evening; body weight > 75 kg, 1 200 mg/d, 600 mg in the morning and 600 mg in the evening) for 12 weeks. Patients were followed-up for a period of 12 weeks after discontinuation of treatment. Continuous variables were expressed as mean ± standard deviation. The proportion of subjects with virologic response at different follow-up time points and 95% confidence intervals were estimated by maximum likelihood ratio and Clopper-Pearson interval.
Results:
132 cases with genotype 2 chronic hepatitis C virus infection from sixteen research centers of China were included, 12 cases of whom were associated with cirrhosis, and the remaining 120 cases were not associated with cirrhosis. One hundred and thirty-one cases completed the study, and one patient lost to follow-up at week 4 after the end of treatment. The sustained virological response rate was 96.2% (95% confidence interval: 92.37% - 99.16%) after 12 weeks of drug withdrawal. Virological relapse occurred in four cases. Of the 132 subjects enrolled in the study, 119 (90.2%) reported 617 adverse events during treatment, of which 359 (76.5%) were TEAE related to sofosbuvir and/or ribavirin. There were nine TEAEs of grade 3 and above, and six cases (4.5%) of them had six severe adverse events. Only one serious adverse event was associated with sofosbuvir and ribavirin (unstable angina pectoris). There were no adverse events leading to drug discontinuation or death.
Conclusion
Sofosbuvir combined with ribavirin has a high SVR rate in the treatment of genotype 2 chronic hepatitis C virus infection, and most of the adverse events occurred were mild with acceptable safety profile.
4.Analysis of Correlation of Insulin Resistance With Incidence and Recurrence of Colorectal Adenoma
Lei ZONG ; Wei WANG ; Shilin QIU ; Xinling ZHOU ; Shanming SUN
Chinese Journal of Gastroenterology 2018;23(10):606-610
Background:Reduction of incidence and recurrence rates of colorectal adenoma (CRA)are the keys for reducing the incidence of colorectal cancer. Studies have shown that insulin resistance is involved in this process. Aims:To investigate the correlation of insulin resistance with incidence and recurrence of CRA. Methods:Clinical data of 238 CRA patients were collected,and 200 patients with normal colonoscopy results were served as controls. Waist to hip ratio (WHR), fasting blood glucose (FPG),total cholesterol (TC),triglyceride (TG),high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C),adiponectin,fasting insulin (FINS),HOMA-IR were compared between the two groups. Correlation of insulin resistance with incidence and recurrence of CRA was analyzed. Results:WHR,FPG, TG,FINS,adiponectin and HOMA-IR were statistically different between CRA group and controls (P<0.05),however, no significant differences in BMI,DBP,TC,HDL-C,LDL-C were found between the two groups. Incidence rate of CRA (80.1% vs. 41.4%)and recurrence rate of CRA (62.4% vs. 46.3%)were significantly increased in patients with insulin resistance than those in patients without insulin resistance. Logistic regression analysis showed that family history, metabolic syndrome and HOMA-IR were independent risk factors for incidence of CRA (P <0. 05 ),and metabolic syndrome,family history of adenoma,adenoma number,adenoma size,pathological type and HOMA-IR were independent risk factors for recurrence of CRA (P<0.05). Conclusions:The incidence and recurrence rates of CRA are higher in patients with insulin resistance than those without insulin resistance.
5.Moderating effects of gender on relationship between love relationship satisfaction and empathy in college students
Chinese Mental Health Journal 2017;31(7):573-576
Objective:To explore the moderating effect of gender between love relationship satisfaction and empathy in college students.Methods:Totally 175 pairs of college couples were enrolled.They were assessed with the Quality of Relationship Index (QRI) and Interpersonal Reactivity Index-C (IRI-C) to evaluate love relationship satisfaction and empathy.IRI-C included 4 dimensions named perspective taking (PT),personal distress (PD),fantasy (FS) and empathetic concern (EC).Multiple regression analysis was used to investigate the moderating effects of gender on relationship between love relationship satisfaction and empathy in college students.Results:The scores of QRI and PT were higher in the males than in the females,but the PD scores were lower in the males [(36.6 ±5.9) vs.(35.2 ±6.0),(10.9 ±3.4) vs.(9.9 ± 3.4),(6.0 ±4.1) vs.(8.1 ±4.3),Ps <0.01].The QRI scores were the lowest in the students who were in love for less than 3 months (33.1 ±7.1).The PT scores positively predicted the QRI scores (3 =-0.19),the PD scores multiplied by gender negatively predicted the QRI scores (β =-0.17),and the EC scores multiplied by gender positively predicted the QRI scores (β =-0.21).Conclusion:Male students may experience higher love relationship satisfaction than females.The gender plays a moderating role to the influence of empathy on love relationship satisfaction in college students.
6.Mediating effect of marital attitude on relationship between self-esteen and romantic satisfaction in college students
Chinese Mental Health Journal 2017;31(8):654-658
Objective:To investigate the mediating effect of marital attitude on the relation between self-esteem and romantic relationship satisfaction in college students.Methods:Totally 342 college students in love were assessed with the Self-esteem Scale (SES),Marital Attitude Scale (MAS) and Quality of Relationship Index (QRI).The Bootstrap method was used to explore the mediating roles of marital attitude between self-esteem and romantic relationship satisfaction.Results:There were significantly positive correlations among the scores of SES,MAS and QRI (r =022-0.95,Ps < 0.01).Self-esteem could directly predict college students'romantic relationship satisfaction (β =0.45,95 % CI:0.27-0.63),and had significant positive predictability to college students romantic relationship satisfaction when the marital attitude was controlled (β =0.17,95% CI:0.08-0.29).Conclusion:It suggests that marital attitude may have a partial mediating effect between self-esteem and romantic relationship satisfaction in college students.
7.Meta-Analysis of Chinese Medicine Combined with Chemotherapy in Preventing StageⅡ-ⅢColorectal Cancer Patients from Postoperative Recurrence and Metastasis
Kaibo GUO ; Qingying YAN ; Shanming RUAN ; Yingying WANG ; Minhe SHEN
Journal of Guangzhou University of Traditional Chinese Medicine 2017;34(4):617-622
Objective To systematically evaluate the effectiveness of Chinese medicine(CM) combined with chemotherapy in preventing stageⅡ-Ⅲ colorectal cancer patients from postoperative recurrence and metastasis. Methods Databases of PubMed, EMBase, Cochrane Library, China National Knowledge Information(CNKI), VIP Database, Wanfang Database, and SinoMed were retrieved to collect randomized controlled trials(RCTs) of CM combined with chemotherapy in preventing stageⅡ-Ⅲ colorectal cancer patients from postoperative recurrence and metastasis. And then the quality of the included RCTs was evaluated systematically. Results Seven RCTs involving 700 cases of stageⅡ-Ⅲ colorectal cancer patients were included, 355 patients in treatment group were treated with CM combined with chemotherapy, and 345 patients in control group were treated with chemotherapy alone. The results of Meta-analysis showed that treatment group was superior to the control group in preventing the recurrence and metastasis of colorectal cancer one , 2 and 3 year(s) after the radical surgery, showing statistically significant differences(P < 0.05), while the difference of five-year recurrence and metastasis rate was not statistically significant between the two groups(P > 0.05). At the same time, CM combined with chemotherapy had better effect than chemotherapy alone on prolonging the time for recurrence and metastasis, improving performance status and relieving the symptoms, the difference being significant(P<0.05). Conclusion CM combined with chemotherapy exerts better effect than chemotherapy alone in preventing stageⅡ-Ⅲ colorectal cancer patients from postoperative recurrence and metastasis and onimproving the quality of life of the patients. However, for the low methodological quality of the included trials, the conclusion still needs more large-size sample, multiple-center, and high-quality clinical trials to be confirmed.
8. Clinical effect and safety of 144-week treatment with entecavir capsules in treatment-naïve HBeAg-positive patients with chronic hepatitis B
Dachuan CAI ; Chen PAN ; Weihua YU ; Shuangsuo DANG ; Jia LI ; Shanming WU ; Nan JIANG ; Maorong WANG ; Zhaohua ZHANG ; Feng LIN ; Shaojie XIN ; Yongfeng YANG ; Baoshen SHEN ; Hong REN
Chinese Journal of Hepatology 2017;25(8):597-600
Objective:
To investigate the clinical effect and safety of entecavir capsules in the treatment of treatment-naïve HBeAg-positive patients with chronic hepatitis B (CHB).
Methods:
A total of 158 HBeAg-positive CHB patients were given oral entecavir capsules at a dose of 0.5 mg/time once a day for 144 weeks. Clinical outcome and safety were evaluated at baseline and at 24, 48, 72, 96, 120, and 144 weeks of treatment respectively. The Fisher’s exact test was used for the analysis of categorical data.
Results:
After 144 weeks of treatment, 90.91% of all patients achieved virologic response (< 69 IU/ml), the normalization rate of alanine aminotransferase was 88.18%, the clearance rate of HBeAg was 33.33%, and the seroconversion rate of HBeAg was 24.07%. Of all patients, 2 dropped out due to adverse events and 5 experienced serious adverse reactions.
Conclusion
Entecavir capsules can inhibit viral replication and have good safety in treatment-naïve HBeAg-positive CHB patients.
9.Analysis of risk factors for perioperative heart failure following hip fracture surgery in the aged patients
Tiezhou WANG ; Shanming WANG ; Caimai WANG ; Liwu JIANG ; Haiming LANG
Chinese Journal of Geriatrics 2016;35(9):978-981
Objective To analyze risk factors for the perioperative heart failure following hip fracture surgery in the aged patients.Methods The present study included 186 elderly patients(≥ 65 years)who had received hip fracture surgery from August 2009 to Janurary 2014 in our department.Their clinical data were analyzed to define risk factors for perioperative heart failure.Results Factors significantly affecting the perioperative heart failure included age,gender,hypertension,time from injury to operation,general health before injury,pain score,perioperative blood transfusion,perioperative human serum albumin transfusion,fluid infusion during operation,perioperative balance between daily fluid intake and output,perioperative temperature changing and heart diseases.A multivariate Logistic regression analysis revealed that the independent risk factors for perioperative heart failure included general health before injury (OR =21.967,P=0.000),perioperative balance between daily fluid intake and output (OR =19.349,P =0.005),heart diseases (OR =6.009,P =0.006).Conclusions In aged patients undergoing hip fracture repair operations the independent risk factors for perioperative heart failure include general health before injury,perioperative balance between daily fluid intake and output,heart diseases.Perioperative risk assessment and prevention are the keys of better prognosis.
10.Chemical constituents of Adina rubella
Lei ZHANG ; Ying GAO ; Yuntao JIANG ; Shanming RUAN ; Minhe SHEN ; Hao WANG
Journal of China Pharmaceutical University 2015;(5):556-560
From the ethanol extract of Adina rubella;twelve compounds were isolated by silica gel and ODS col-umn chromatography.Their structures were identified by spectroscopic analysis as:5;7-dihydroxy-2-methyl-chromone-7-O-β-D-glucopyranoside(1);scopolin(2);(+)-lyoniresinol-3a-O-β-D-glucopyranoside(3);(6S;7R;8R)-7a-[(β-D-glucopyranosyl)oxy]lyoniresinol(4);harman-3-carboxylic acid(5);lyaloside(6);3-oxoquinovid acid(7);oleanolic acid(8);3-acetyl oleanolic acid(9);quinovic acid 3-O-β-D-glucopyranosyl-28-O-β-L-rham-nopyranosyl ester(10);quinovic acid 3-O-β-D-glucopyranosiyl-28-O-β-D-glucopyranosyl ester(11)and pyrocin-cholic acid 3-O-α-L-rhamnopyranosyl-28-[β-D-glucopyranosyl-(1 →6)-O-β-D-glucopyranosyl]ester(12). Compounds 3;4;6;8-10 were isolated from this plant for the first time.

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