1.Establishment and Validation of a Platinum Resistance Recurrence Prediction Model for Advanced Epithelial Ovarian Cancer
Yaping JIANG ; Haohan WANG ; Xianling NING ; Zujiao YANG ; Wenyan WANG ; Zhoumei LIU ; Xielan YANG
Journal of Practical Obstetrics and Gynecology 2024;40(5):374-380
Objective:To analyze the influencing factors of platinum resistant recurrence in advanced epithelial ovarian cancer(AEOC),establish a nomogram model to predict platinum-resistant recurrence of AEOC,and inter-nally validate it.Methods:The clinicopathological data of 577 AEOC patients who achieved complete remission af-ter initial treatment in the Department of Gynecology,Yunnan Cancer Hospital from June 1,2013 to December 31,2021 were collected.According to whether the platinum free interval(PFI)was less than 6 months,the patients were divided into platinum-resistant recurrence group(130 cases)and non-platinum-resistant group(447 cases,including patients with platinum-sensitive recurrence and no recurrence after 6 months of follow-up).Multivariate Logistic regression analysis was used to screen for the independent risk factors affecting the recurrence of plati-num-resistant patients.Based on the independent risk factors,a nomogram prediction model was established,and Bootstrap method was used for internal verification.The area under the ROC curve(AUC),calibration curve and decision curve(DCA)were used to evaluate the performance of the model.Results:①There were statistically sig-nificant differences in age,bilateral ovarian invasion,FIGO staging,menopause,neoadjuvant chemotherapy(NACT),chemotherapy interval(TTC),platelet count(PLT),platelet count/lymphocyte count ratio(PLR),fibrino-gen/lymphocyte count ratio(FLR),prognostic nutritional index(PNI),albumin(ALB),CA125 level,ascites volume,residual lesions,perioperative chemotherapy frequency,and CA125 half-life between the two groups(P<0.05).②Multivariate Logistic regression analysis showed that bilateral ovarian invasion,FIGO stage Ⅳ,TTC>16 days,ini-tial ascites volume>1000ml,perioperative chemotherapy frequency>9 times,surgery with R2 resection,CA125 half-life>52 days were independent risk factors for recurrence of platinum-resistant AEOC patients(OR>1,P<0.05).③The AUC of the nomogram model constructed based on the above 7 indicators was 0.791(95%Cl 0.747-0.835),and the calibration curve and ideal curve fitted well.DCA showed that the net benefit interval of the model was 0.037-0.800.Conclusions:The nomogram prediction model based on independent risk factors for the recurrence of platinum-resistance of AEOC patients has good discrimination,calibration and clinical appli-cability,which can better predict the recurrence risk of platinum-resistance in AEOC patients after the initial treat-ment.
2.Application of Global Leadership Initiative on Malnutrition criteria in patients with liver cirrhosis
Minjie JIANG ; Juan CHEN ; Muchen WU ; Jing WU ; Xiaotong XU ; Juan LI ; Can LIU ; Yaping ZHAO ; Xin HUA ; Qinghua MENG
Chinese Medical Journal 2024;137(1):97-104
Background::The Global Leadership Initiative on Malnutrition (GLIM) criteria were published to build a global consensus on nutritional diagnosis. Reduced muscle mass is a phenotypic criterion with strong evidence to support its inclusion in the GLIM consensus criteria. However, there is no consensus regarding how to accurately measure and define reduced muscle mass in clinical settings. This study aimed to investigate the optimal reference values of skeletal muscle mass index for diagnosing sarcopenia and GLIM-defined malnutrition, as well as the prevalence of GLIM-defined malnutrition in hospitalized cirrhotic patients.Methods::This retrospective study was conducted on 1002 adult patients with liver cirrhosis between January 1, 2018, and February 28, 2022, at Beijing You-An Hospital, Capital Medical University. Adult patients with a clinical diagnosis of liver cirrhosis and who underwent an abdominal computed tomography (CT) examination during hospitalization were included in the study. These patients were randomly divided into a modeling group (cohort 1, 667 patients) and a validation group (cohort 2, 335 patients). In cohort 1, optimal cut-off values of skeletal muscle index at the third lumbar skeletal muscle index (L3-SMI) were determined using receiver operating characteristic analyses against in-hospital mortality in different gender groups. Next, patients in cohort 2 were screened for nutritional risk using the Nutritional Risk Screening 2002 (NRS-2002), and malnutrition was diagnosed by GLIM criteria. Additionally, the reference values of reduced muscle mass in GLIM criteria were derived from the L3-SMI values from cohort 1. Multivariate logistic regression analysis was used to analyze the association between GLIM-defined malnutrition and clinical outcomes.Results::The optimal cut-off values of L3-SMI were 39.50 cm 2/m 2 for male patients and 33.06 cm 2/m 2 for female patients. Based on the cut-off values, 31.63% (68/215) of the male patients and 23.3% (28/120) of the female patients had CT-determined sarcopenia in cohort 2. The prevalence of GLIM-defined malnutrition in cirrhotic patients was 34.3% (115/335) and GLIM-defined malnutrition was an independent risk factor for in-hospital mortality in patients with liver cirrhosis ( Wald = 6.347, P = 0.012). Conclusions::This study provided reference values for skeletal muscle mass index and the prevalence of GLIM-defined malnutrition in hospitalized patients with liver cirrhosis. These reference values will contribute to applying the GLIM criteria in cirrhotic patients.
3.Study on the Mechanism of the Flavonoids from the New
Liang GAO ; Yalin ZHANG ; Yuhan WU ; Jiahui SHAO ; Hui ZHANG ; Yidan SHAO ; Yaping XU ; Jianping JIANG
Chinese Journal of Modern Applied Pharmacy 2024;41(2):166-176
OBJECTIVE
To explore the mechanisms of the flavonoids from new "Zhe Eight Flavors" Quzhou Fructus Aurantii(PTFC) against hepatocellular carcinoma based on the prediction of network pharmacology and experimental verification.
METHODS
From TCMSP, TCMID, ETCM, BATMAN-TCM and SwissTargetPrediction databases, the potential target proteins of PTFC, including naringin, narirutin and neohesperidin were collected. Based on the GeneCards, CTD, Disgenet, and OMIM databases, a set of target proteins for hepatocellular carcinoma was constructed. Taking the intersection of potential target proteins of PTFC and target proteins of hepatocellular carcinoma, key target proteins were obtained and a protein-protein interaction network was established. Besides, GO function and KEGG pathway enrichment analysis on the core target proteins was performed and a Compounds-Targets-Pathways-Disease network was constructed. Through proliferation, cloning, wound healing, and migration experiments, the effects of PTFC on the viability of HepG2 liver cancer cells were analyzed. Using fluorescence probe staining the impacts of PTFC on the mitochondrial membrane potential and apoptosis of HepG2 were observed. Finally, the validation of the regulatory effect of PTFC on the key predicted target PRKCA were carried out through RT-qPCR.
RESULTS
Based on network pharmacology, a total of 217 potential target proteins for PTFC were screened, with 59 intersecting target proteins related to diseases, including ALB, ESR1, PRKCA, and others. GO functional and KEGG pathway enrichment analysis revealed that the PTFC target proteins were involved in 193 biological processes and 13 cancer-related signaling pathways. Experimental results demonstrated that PTFC could impact the proliferation, cloning, wound healing, and migration abilities of liver cancer cells, leading to a decrease in mitochondrial membrane potential and promoting cell apoptosis. The results of RT-qPCR confirmed a significant downregulation of PRKCA expression by PTFC, validating the predictions made by network pharmacology analysis.
CONCLUSION
This study has revealed the potential molecular mechanism of PTFC treating hepatocellular carcinoma via the PRKCA target, laying the foundation for clinical application of PTFC.
4.Evaluation of Effectiveness of Pharmaceutical Care Model for Patients with Hepatitis B Cirrhosis Based on Medication Therapy Management Combined with PCNE Classification System
Lu XU ; Mengying LI ; Xingbei ZHOU ; Yaping JIANG ; Yuan WEI ; Danjuan XU ; Ningxun ZOU
Herald of Medicine 2024;43(6):987-992
Objective To provide pharmaceutical care for patients with hepatitis B cirrhosis by using the medication therapy management(MTM)model combined with Pharmaceutical Care Network Europe(PCNE),and to analyze the effectiveness of pharmaceutical care from clinical efficacy,safety,humanistic effect and drug-related problems(DRPs).Methods Patients with hepatitis B cirrhosis were randomly divided into the pharmaceutical care group and the control group who received only conventional treatment.Clinical pharmacists used MTM combined with PCNE to provide pharmaceutical care in the pharmaceutical care group.Economic effects,clinical indicators,safety,medication compliance and quality of life were compared between the two groups during the treatment and follow-up period.DRPs were analyzed in the pharmaceutical care group.Results The cost-utility ratio and clinical indicators in the pharmaceutical care group were better than those in the control group,and the adverse drug reactions of the former were statistically significant compared with the latter at the three months follow-up,and medication compliance and quality of life were statistically significant after intervention and during follow-up(P<0.05).There were 52 DRPs in the pharmaceutical care group,mainly in the category of poor treatment outcome.The main reasons were poor drug selection and excessive usage and dosage.There were 46 DRPs accepted by intervention,and 45 DRPs were completely and partially solved.Conclusion The pharmaceutical care model of MTM combined with PCNE classification system for patients with hepatitis B cirrhosis played a positive role in the treatment and follow-up period.
5.Mechanism study of ATOX1 promoting biological behavior of hepatocellular carcinoma cells through JAK2/STAT3 pathway
Jiajia MA ; Yaping ZHANG ; Bin YANG ; Meiqi ZHAO ; Lu JIANG ; Xiaoyu HUANG ; Luchang FAN ; Fengmei WANG
Tianjin Medical Journal 2024;52(9):907-912
Objective To investigate the clinical significance of the expression of antioxidant 1 copper chaperone protein(ATOX1)in hepatocellular carcinoma(HCC)and its relationship with tumor proliferation,migration and invasion.Methods The expression of ATOX1 mRNA in HCC cancer tissue and normal liver tissue was analyzed using the Human Genome Atlas database.Immunohistochemical experiment was used to detect the expression of ATOX1 in 15 cases of HCC cancer tissue and adjacent tissue.Human HCC cell lines Hep3B and HepG2 were divided into the control group(NC),the ATOX1 knockdown group 1(si-ATOX1#1)and the ATOX1 knockdown group 2(si-ATOX1#2).The effects of ATOX1 knockdown on the malignant biological behavior of HCC cells were observed through CCK-8 cell proliferation experiment,scratch experiment and Transwell invasion experiments.A nude mouse xenograft tumor model was constructed to analyze the effect of ATOX1 knockdown on the quality and volume of transplanted tumors.Western blot assay was used to detect the relationship between ATOX1 and JAK2/STAT3 pathway protein expression.Results Bioinformatics analysis showed that expression of ATOX1 mRNA in HCC cancer tissue was higher than that in adjacent normal tissue(P<0.05).The immunohistochemical staining results showed that the positive rate of ATOX1 protein was higher in HCC cancer tissue than that in adjacent tissue(93.33%vs.13.33%,P<0.01).In vitro experimental results showed that siRNA knockdown of ATOX1 protein expression in Hep3B and HepG2 cells significantly reduced the proliferation,migration and invasion abilities of cancer cells(P<0.05).In vivo experiments in mice showed that the volume and weight of subcutaneous xenograft tumors were significantly smaller in the sh-ATOX1 group than those in the sh-con group(P<0.05).The expression levels of JAK2/STAT3 pathway-related proteins p-JAK2,p-STAT3,CyclinD1 and MMP2 were significantly lower in the subcutaneous transplanted tumor tissue of the sh-ATOX1 group than that of the sh-con group(P<0.05).Conclusion ATOX1 can promote the proliferation,migration and invasion of HCC through JAK2/STAT3 pathway,which can potentially become a potential tumor marker and therapeutic target.
6.Expert consensus on odontogenic maxillary sinusitis multi-disciplinary treatment
Lin JIANG ; Wang CHENGSHUO ; Wang XIANGDONG ; Chen FAMING ; Zhang WEI ; Sun HONGCHEN ; Yan FUHUA ; Pan YAPING ; Zhu DONGDONG ; Yang QINTAI ; Ge SHAOHUA ; Sun YAO ; Wang KUIJI ; Zhang YUAN ; Xian MU ; Zheng MING ; Mo ANCHUN ; Xu XIN ; Wang HANGUO ; Zhou XUEDONG ; Zhang LUO
International Journal of Oral Science 2024;16(1):1-14
Odontogenic maxillary sinusitis(OMS)is a subtype of maxillary sinusitis(MS).It is actually inflammation of the maxillary sinus that secondary to adjacent infectious maxillary dental lesion.Due to the lack of unique clinical features,OMS is difficult to distinguish from other types of rhinosinusitis.Besides,the characteristic infectious pathogeny of OMS makes it is resistant to conventional therapies of rhinosinusitis.Its current diagnosis and treatment are thus facing great difficulties.The multi-disciplinary cooperation between otolaryngologists and dentists is absolutely urgent to settle these questions and to acquire standardized diagnostic and treatment regimen for OMS.However,this disease has actually received little attention and has been underrepresented by relatively low publication volume and quality.Based on systematically reviewed literature and practical experiences of expert members,our consensus focuses on characteristics,symptoms,classification and diagnosis of OMS,and further put forward multi-disciplinary treatment decisions for OMS,as well as the common treatment complications and relative managements.This consensus aims to increase attention to OMS,and optimize the clinical diagnosis and decision-making of OMS,which finally provides evidence-based options for OMS clinical management.
7.Expert consensus on the diagnosis and therapy of endo-periodontal lesions
Chen BIN ; Zhu YANAN ; Lin MINKUI ; Zhang YANGHENG ; Li YANFEN ; Ouyang XIANGYING ; Ge SONG ; Lin JIANG ; Pan YAPING ; Xu YAN ; Ding YI ; Ge SHAOHUA ; Chen FAMING ; Song ZHONGCHEN ; Jiang SHAOYUN ; Sun JIANG ; Luo LIJUN ; Ling JUNQI ; Chen ZHI ; Yue LIN ; Zhou XUEDONG ; Yan FUHUA
International Journal of Oral Science 2024;16(3):381-389
Endo-periodontal lesions(EPLs)involve both the periodontium and pulp tissue and have complicated etiologies and pathogenic mechanisms,including unique anatomical and microbiological characteristics and multiple contributing factors.This etiological complexity leads to difficulties in determining patient prognosis,posing great challenges in clinical practice.Furthermore,EPL-affected teeth require multidisciplinary therapy,including periodontal therapy,endodontic therapy and others,but there is still much debate about the appropriate timing of periodontal therapy and root canal therapy.By compiling the most recent findings on the etiology,pathogenesis,clinical characteristics,diagnosis,therapy,and prognosis of EPL-affected teeth,this consensus sought to support clinicians in making the best possible treatment decisions based on both biological and clinical evidence.
8.Establishment and Validation of a Platinum Resistance Recurrence Prediction Model for Advanced Epithelial Ovarian Cancer
Yaping JIANG ; Haohan WANG ; Xianling NING ; Zujiao YANG ; Wenyan WANG ; Zhoumei LIU ; Xielan YANG
Journal of Practical Obstetrics and Gynecology 2024;40(5):374-380
Objective:To analyze the influencing factors of platinum resistant recurrence in advanced epithelial ovarian cancer(AEOC),establish a nomogram model to predict platinum-resistant recurrence of AEOC,and inter-nally validate it.Methods:The clinicopathological data of 577 AEOC patients who achieved complete remission af-ter initial treatment in the Department of Gynecology,Yunnan Cancer Hospital from June 1,2013 to December 31,2021 were collected.According to whether the platinum free interval(PFI)was less than 6 months,the patients were divided into platinum-resistant recurrence group(130 cases)and non-platinum-resistant group(447 cases,including patients with platinum-sensitive recurrence and no recurrence after 6 months of follow-up).Multivariate Logistic regression analysis was used to screen for the independent risk factors affecting the recurrence of plati-num-resistant patients.Based on the independent risk factors,a nomogram prediction model was established,and Bootstrap method was used for internal verification.The area under the ROC curve(AUC),calibration curve and decision curve(DCA)were used to evaluate the performance of the model.Results:①There were statistically sig-nificant differences in age,bilateral ovarian invasion,FIGO staging,menopause,neoadjuvant chemotherapy(NACT),chemotherapy interval(TTC),platelet count(PLT),platelet count/lymphocyte count ratio(PLR),fibrino-gen/lymphocyte count ratio(FLR),prognostic nutritional index(PNI),albumin(ALB),CA125 level,ascites volume,residual lesions,perioperative chemotherapy frequency,and CA125 half-life between the two groups(P<0.05).②Multivariate Logistic regression analysis showed that bilateral ovarian invasion,FIGO stage Ⅳ,TTC>16 days,ini-tial ascites volume>1000ml,perioperative chemotherapy frequency>9 times,surgery with R2 resection,CA125 half-life>52 days were independent risk factors for recurrence of platinum-resistant AEOC patients(OR>1,P<0.05).③The AUC of the nomogram model constructed based on the above 7 indicators was 0.791(95%Cl 0.747-0.835),and the calibration curve and ideal curve fitted well.DCA showed that the net benefit interval of the model was 0.037-0.800.Conclusions:The nomogram prediction model based on independent risk factors for the recurrence of platinum-resistance of AEOC patients has good discrimination,calibration and clinical appli-cability,which can better predict the recurrence risk of platinum-resistance in AEOC patients after the initial treat-ment.
9.Establishment and Validation of a Platinum Resistance Recurrence Prediction Model for Advanced Epithelial Ovarian Cancer
Yaping JIANG ; Haohan WANG ; Xianling NING ; Zujiao YANG ; Wenyan WANG ; Zhoumei LIU ; Xielan YANG
Journal of Practical Obstetrics and Gynecology 2024;40(5):374-380
Objective:To analyze the influencing factors of platinum resistant recurrence in advanced epithelial ovarian cancer(AEOC),establish a nomogram model to predict platinum-resistant recurrence of AEOC,and inter-nally validate it.Methods:The clinicopathological data of 577 AEOC patients who achieved complete remission af-ter initial treatment in the Department of Gynecology,Yunnan Cancer Hospital from June 1,2013 to December 31,2021 were collected.According to whether the platinum free interval(PFI)was less than 6 months,the patients were divided into platinum-resistant recurrence group(130 cases)and non-platinum-resistant group(447 cases,including patients with platinum-sensitive recurrence and no recurrence after 6 months of follow-up).Multivariate Logistic regression analysis was used to screen for the independent risk factors affecting the recurrence of plati-num-resistant patients.Based on the independent risk factors,a nomogram prediction model was established,and Bootstrap method was used for internal verification.The area under the ROC curve(AUC),calibration curve and decision curve(DCA)were used to evaluate the performance of the model.Results:①There were statistically sig-nificant differences in age,bilateral ovarian invasion,FIGO staging,menopause,neoadjuvant chemotherapy(NACT),chemotherapy interval(TTC),platelet count(PLT),platelet count/lymphocyte count ratio(PLR),fibrino-gen/lymphocyte count ratio(FLR),prognostic nutritional index(PNI),albumin(ALB),CA125 level,ascites volume,residual lesions,perioperative chemotherapy frequency,and CA125 half-life between the two groups(P<0.05).②Multivariate Logistic regression analysis showed that bilateral ovarian invasion,FIGO stage Ⅳ,TTC>16 days,ini-tial ascites volume>1000ml,perioperative chemotherapy frequency>9 times,surgery with R2 resection,CA125 half-life>52 days were independent risk factors for recurrence of platinum-resistant AEOC patients(OR>1,P<0.05).③The AUC of the nomogram model constructed based on the above 7 indicators was 0.791(95%Cl 0.747-0.835),and the calibration curve and ideal curve fitted well.DCA showed that the net benefit interval of the model was 0.037-0.800.Conclusions:The nomogram prediction model based on independent risk factors for the recurrence of platinum-resistance of AEOC patients has good discrimination,calibration and clinical appli-cability,which can better predict the recurrence risk of platinum-resistance in AEOC patients after the initial treat-ment.
10.Establishment and Validation of a Platinum Resistance Recurrence Prediction Model for Advanced Epithelial Ovarian Cancer
Yaping JIANG ; Haohan WANG ; Xianling NING ; Zujiao YANG ; Wenyan WANG ; Zhoumei LIU ; Xielan YANG
Journal of Practical Obstetrics and Gynecology 2024;40(5):374-380
Objective:To analyze the influencing factors of platinum resistant recurrence in advanced epithelial ovarian cancer(AEOC),establish a nomogram model to predict platinum-resistant recurrence of AEOC,and inter-nally validate it.Methods:The clinicopathological data of 577 AEOC patients who achieved complete remission af-ter initial treatment in the Department of Gynecology,Yunnan Cancer Hospital from June 1,2013 to December 31,2021 were collected.According to whether the platinum free interval(PFI)was less than 6 months,the patients were divided into platinum-resistant recurrence group(130 cases)and non-platinum-resistant group(447 cases,including patients with platinum-sensitive recurrence and no recurrence after 6 months of follow-up).Multivariate Logistic regression analysis was used to screen for the independent risk factors affecting the recurrence of plati-num-resistant patients.Based on the independent risk factors,a nomogram prediction model was established,and Bootstrap method was used for internal verification.The area under the ROC curve(AUC),calibration curve and decision curve(DCA)were used to evaluate the performance of the model.Results:①There were statistically sig-nificant differences in age,bilateral ovarian invasion,FIGO staging,menopause,neoadjuvant chemotherapy(NACT),chemotherapy interval(TTC),platelet count(PLT),platelet count/lymphocyte count ratio(PLR),fibrino-gen/lymphocyte count ratio(FLR),prognostic nutritional index(PNI),albumin(ALB),CA125 level,ascites volume,residual lesions,perioperative chemotherapy frequency,and CA125 half-life between the two groups(P<0.05).②Multivariate Logistic regression analysis showed that bilateral ovarian invasion,FIGO stage Ⅳ,TTC>16 days,ini-tial ascites volume>1000ml,perioperative chemotherapy frequency>9 times,surgery with R2 resection,CA125 half-life>52 days were independent risk factors for recurrence of platinum-resistant AEOC patients(OR>1,P<0.05).③The AUC of the nomogram model constructed based on the above 7 indicators was 0.791(95%Cl 0.747-0.835),and the calibration curve and ideal curve fitted well.DCA showed that the net benefit interval of the model was 0.037-0.800.Conclusions:The nomogram prediction model based on independent risk factors for the recurrence of platinum-resistance of AEOC patients has good discrimination,calibration and clinical appli-cability,which can better predict the recurrence risk of platinum-resistance in AEOC patients after the initial treat-ment.


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