1.Analysis of risk factors for 1-year survival rate in patients with spinal metastasis secondary to lung cancer
Bingshan YAN ; Jingyu ZHANG ; Yancheng LIU ; Xiuchun YU ; Guochuan ZHANG ; Zhaoming YE ; Guowen WANG ; Yu ZHANG ; Yongcheng HU
Chinese Journal of Orthopaedics 2024;44(6):409-418
		                        		
		                        			
		                        			Objective:To investigate the risk factors for 1-year survival rate in patients with spinal metastasis secondary to lung cancer.Methods:The data of 343 patients with spinal metastases secondary to lung cancer from January 2011 to December 2018 were retrospectively studied. There were 188 males (54.8%) and 155 females (45.2%) with an average age of 59.47±10.21 years old (range 23-91 years). The patients were divided into operation group (150 cases, 43.7%) and non operation group (193 cases, 56.3%). The demographics, types of primary tumor, non spinal metastasis, visceral metastasis, spinal metastasis and segments, pathological fractures of vertebra, Frankel classification, physical function status (Karnofsky performance scale, KPS), visual analogue score (VAS), the spinal instability neoplastic score (SINS) were recorded and analyzed. The impact of different treatments on the survival prognosis of patients with spinal metastasis was evaluated. The independent factors affecting survival in those patients were analyzed by Cox proportional hazards regression model.Results:The peak incidence of spinal metastases was found in the age group of 46-60 years (43.7%, 150/343). 38.5% (132/343) of the patients had pathological fractures of the involved vertebral body. 58.3% (200/343) of the patients had extraspinal bone metastasis. 36.2% (124/343) of the patients had visceral metastasis. Among the primary tumors, adenocarcinoma was the most common tpye (61.5%, 211/343), followed by large cell lung cancer (12.5%, 43/343), small cell lung cancer (6.4%, 22/343), squamous cell cancer (6.1%, 21/343) and mixed cell lung cancer (5.3%, 18/343). The type of lung cancer cells in about 8.2 (28/343) patients was unknown. Among the surgical patients, 21 patients underwent minimally invasive surgery (14.0%), 28 patients underwent simple decompression surgery (18.7%), 76 patients underwent separation surgery (50.7%), and 25 patients underwent radical surgery (16.6%). 59.3% (89/150) of the patients had a better neurological function than before surgery. The average survival time of all patients was 9.88 months with the median survival time of 8 (5,14) months. The survival rates were 62.1% (213/343), 30.0% (103/343), and 3.8% (13/343) at 6, 12, and 24 months, respectively. The average survival time of patients in the operation group was 10.24 months with the median survival time of 9 (5, 15) months, and the average survival time of patients in the non operation group was 9.41 months with the median survival time of 7 (5, 13) months with no significant difference between the groups (χ 2=0.300, P=0.584). Multivariate Cox proportional hazard regression model analysis showed that radiotherapy [ HR=1.913, 95% CI(1.471, 2.488), P<0.001], chemotherapy [ HR=1.313, 95% CI(1.040, 1.658), P=0.022], targeted drug therapy [ HR=1.683, 95% CI(1.221, 2.319), P=0.001], KPS [ HR=1.593, 95% CI(1.140, 2.225), P=0.006] and pathological type (non-small cell lung cancer) were independent factors affecting the 1-year survival rate of patients with spinal metastasis secondary to lung cancer [ HR=0.322, 95% CI(0.225, 0.460), P<0.001] with significant difference. Conclusion:Surgical treatment can improve both the neurological function and general status of patients with spinal metastasis. Treatments of radiotherapy, chemotherapy, and targeted drug therapy can significantly improve 1-year survival rate, while a KPS less than 50 points and a primary lung cancer other than adenocarcinoma were independent risk factors reducing 1-year survival rate.
		                        		
		                        		
		                        		
		                        	
2.The clinical value of the New England spinal metastases score system in predicting the survival of patients with spinal metastases
Bingshan YAN ; Jingyu ZHANG ; Yancheng LIU ; Hong ZHANG ; Li YANG ; Jikai LI ; Xiuchun YU ; Guochuan ZHANG ; Guowen WANG ; Yu ZHANG ; Yongcheng HU
Chinese Journal of Orthopaedics 2022;42(20):1329-1339
		                        		
		                        			
		                        			Objective:To evaluate the clinical value of the New England spinal metastasis score (NESMS) in predicting the prognosis of patients with spinal metastases by retrospectively analyzing the medical records of multicenter spinal metastases in China.Methods:The data of 179 patients with spinal metastases from January 2008 to December 2018 were retrospectively collected. There were 108 males (60.3%) and 71 females (39.7%) with an average age of 59.79±10.88 years old (range 27-84 years). The patient demographic characteristics, primary tumor type, spinal metastases and segments, vertebral pathological fractures, neurological Frankel classification, physical function status, Karnofsky performance scale (KPS), visual analogue score (VAS), the spinal instability neoplastic score (SINS), modified Bauer score, NESMS score, Tomita score and modified Tokuhashi score were collected. The clinical value of NESMS score, Tomita score and modified Tokuhashi score in predicting the survival of patients with spinal metastases were compared. The independent factors affecting survival in these patients were analyzed by Cox proportional hazards regression model.Results:Among the 179 patients, the peak incidence of spinal metastases was in the age group of 61-75 years (45.3%, 81/179) of all patients. Lung cancer was the most common primary tumor (46.9%, 84/179). 40.8% (73/179) of patients had multi-segment metastasisand thoracic spine was the most common site with single-site metastasis (26.3%, 47/179). 28.5% (51/179) of the patients had visceral metastases and 52.0% (93/179) of the patients had extraspinal bone metastases. 31.3% (56/179) of the patients had pathological fractures of the involved vertebral bodies.114 patients received surgical treatment (63.4%). The mortality rates in 3-months, 6-months and 1-year were 22.4% (40/179), 51.4% (92/179) and 77.1% (138/179), respectively. The median survival time of patients with NESMS score of 0-3 was 3, 4, 8, and 10 months respectively with the mean survival time was 3.60±2.10, 6.77±3.39, 9.69±5.71 and 10.53±6.25 months. The 1-year mortality rates were 100% (13/13), 87.5% (42/48), 71.6% (63/88) and 66.7% (20/30) respectively. The consistency of NESMS score, Tomita score and modified Tokuhashi score in predicting survival of all patients was 0.63, 0.58 and 0.55, respectively. For patients with spinal metastases, the NESMS score was better than the Tomita score and modified Tokuhashi score in predicting survival at 3-months (AUC=1.00, 0.63, 0.42) and 6-months (AUC=0.71, 0.63, 0.45). But the accuracy of Tomita score was best in predicting survival at 1-year (AUC=0.66, 0.61, 0.38). Multivariate Cox proportional hazards regression model analysis showed that growth rate of primary tumor, neurological function Frankel score, albumin level and surgical treatment were independent factors affecting the survival time of patients with spinal metastases ( P<0.05). Conclusion:The consistency and accuracy of NESMS score in predicting survival of patients with spinal metastases are better than Tomita score and modified Tokuhashi score, especially in predicting 3- and 6-month survival. The growth rate of primary tumor, Frankel classification, albumin level and surgical treatment were independent factors affecting the survival time of patients with spinal metastases.
		                        		
		                        		
		                        		
		                        	
3.Rapid identification of phthalides and organic acids in Angelica sinensis based on UPLC-Q-TOF/MS
Qingqing ZHANG ; Yuan FENG ; Chunhua LI ; Guochuan LI ; Xingchao LIU ; Haoyue LI ; Hongfang WANG ; Li ZHOU ; Yixin ZHANG
China Pharmacy 2022;33(5):579-585
		                        		
		                        			
		                        			OBJECTIVE To establish a comprehensive and rapid m ethod for the a nalysis of chemical constituents as phthalides and organic acids in Angelica sinensis ,and to provide scientific reference for the quality evaluation and pharmacodynamic substance research of A. sinensis . METHODS The 70% ethanol extract of A. sinensis was analyzed by ultra high performance liquid chromatography-quadrupole-time of flight tandem mass spectrometry (UPLC-Q-TOF/MS). The determination was performed on ACQUITY UPLC BEH-C 18 column with mobile phase consisted of 0.1% formic acid solution- acetonitrile(gradient elution )at the flow rate of 0.3 mL/min. The column temperature was set at 30 ℃,and sample size was 2 µL. The ion source was an electrospray ion source ,using positive ion scanning mode ,and the mass scanning range was m/z 50-1 000. Capillary voltage was 4 000 V; atomizer pressure was 35 psi;cracking voltage was 135 V and the taper hole voltage was 65 V;the temperature of dry gas was 320 ℃;the flow of dry gas was 10 L/min and the flow of sheath gas was 11 L/min;collision energy were 20 and 40 V. Qualitative Analysis 10.0 software was used to obtain the retention time of compounds ,the accurate mass number of excimer ion peaks and secondary fragments. The compounds were analyzed by comparing with the mass spectra of the reference substance ,combined with relevant literature ,mass spectrometry cleavage law and database such as Chemspider ,MassBank,PubChem. RESULTS A total of 72 compounds were identified or deduced from A. sinensis ,including 55 phthalides,13 organic acids and 4 other constituents. CONCLUSIONS The established method is rapid and accurate for the identification of chemical constituents from A. sinensis ,such as organic acids and phthalides ,which provides an efficient and rapid analytical method for the comprehensive characterization of its chemical constituents.
		                        		
		                        		
		                        		
		                        	
4.The trend of clinical and pathological characteristics and surgical treatment in patients with spinal metastases: A multicenter retrospective study
Bingshan YAN ; Yancheng LIU ; Hong ZHANG ; Li YANG ; Jikai LI ; Xiuchun YU ; Guochuan ZHANG ; Zhaoming YE ; Guowen WANG ; Yu ZHANG ; Yongcheng HU
Chinese Journal of Orthopaedics 2022;42(8):471-481
		                        		
		                        			
		                        			Objective:To retrospectively analyze the patients with spinal metastases who received surgical intervention and summarize the evolution of their clinical and pathological characteristics and surgical methods.Methods:The data of 703 patients with spinal metastases from January 2007 to December 2018 were collected retrospectively. There were 395 males (56.19%, 395/703) and 308 females (43.81%, 308/703) with an average age of 58.14±11.46 years (range 13-84 years). According to the degree of invasion and thoroughness of tumor resection, the surgical methods could be divided into minimally invasive surgery, decompression surgery, separation surgery, piecemeal resection and total en-bloc spondylectomy surgery. The operative methods were minimally invasive surgery in 89 cases (12.66%), decompression surgery in 96 cases (13.66%), separation surgery in 303 cases (43.10%), piecemeal resection in 182 cases (25.89%) and total en-bloc spondylectomy in 33 cases (4.69%). To analyze the trend of the clinical, pathological types and surgical treatment of patients with spinal metastases over the years, and determine the relevant factors affecting the decision-making of surgical methods by multivariate logistic regression.Results:The ratio of male to female was 1.28:1. 39.54% (278/703) of patients with single-segment involvement in 703 patients, 24.04% (169/703) of patients with double-segment metastasis and 36.42% (256/703) of patients with multi-segment metastasis. The most common type of primary tumor was lung cancer (34.57%, 243/703), followed by breast cancer (8.25%, 58/703), myeloma (8.11%, 57/703), gastrointestinal tumor (6.82%, 48/703) and renal malignant tumor (6.40%, 45/703). From 2007 to 2018, there was no significant difference in the percentage change of different age, gender and primary tumor source composition (age: χ 2=14.01, P=0.233; gender: χ 2=35.73, P=0.341; primary tumor: χ 2=120.09, P=0.074). The percentage of patients with sacrococcygeal metastasis decreased from 20.00% in 2008 to 1.89% in 2017 and the difference was statistically significant (χ 2=8.09, P=0.005). The percentage of patients with multi-level metastasis increased from 26.67% in 2008 to 52.83% in 2017, and the difference was statistically significant (χ 2=7.23, P=0.007). The percentage of patients with minimally invasive surgery decreased from 25.00% in 2007 to 5.88% in 2018, and the percentage of patients with segmented resection decreased from 53.33% in 2008 to 10.29% in 2018. The proportion of the two surgical methods showed a significant downward trend, and the differences were statistically significant (minimally invasive surgery: χ 2=1.46, P=0.026; segmented resection surgery: χ 2=19.56, P<0.001). The percentage of patients undergoing separation surgery increased from 13.33% in 2008 to 64.71% in 2018, and the proportion of patients undergoing total en-bloc spondylectomy increased from 0 in 2007 to 10.29% in 2018. Both surgical methods showed a significant growth trend and the differences were statistically significant (separation surgery: χ 2=27.09, P<0.001; χ 2=4.16, P=0.042). Multivariate Logistic regression analysis showed that age, metastatic site, number of metastatic segments, pathological vertebral fractures, Frankel grade, SINS score and VAS score were independent factors influencing surgical decision-making ( P<0.05). Conclusion:With different time and age, the invasiveness and thoroughness of surgery are increasing, which shows that the percentage of patients who underwent separation surgery and to-tal en-bloc spondylectomy is significantly increasing. Age, metastatic site, number of metastatic segments, pathological vertebral fractures, Frankel grade, SINS score and VAS score are independent factors affecting surgical decision-making.
		                        		
		                        		
		                        		
		                        	
5.Outcome of patients with osteosarcoma after recurrence and analysis of factors affecting the long-term survival——A long-term follow-up study of recurrent patients by multicenter
Xiaozhou LIU ; Yiyang YU ; Xin SHI ; Guangxin ZHOU ; Zhiwei HE ; Weibin ZHANG ; Yang DONG ; Guochuan ZHANG ; Sujia WU ; Yongcheng HU ; Xiuchun YU ; Zhen WANG
Chinese Journal of Orthopaedics 2018;38(18):1089-1096
		                        		
		                        			
		                        			Objective To investigate the outcome and affecting factors of patients with osteosarcoma after recurrence.Methods Retrospective analysis was used to analyze the achieved data and prognosis-related factors of 72 patients with extremity osteosarcoma after recurrence from June 2000 to September 2012 through multicenter joint treatment.37 males and 35 females were included.The overall age was 7 to 61 years old (average age22.2 years old).Classification based on the tumor recurrent parts:42 cases (58.3%) on femur,18 cases (25%) on tibia,7 cases (9.7%) on humerus and 5 cases (6.9%) on fibula.Classification based on metastases:14 cases of simple recurrence (19.4%),58 cases (80.6%) of recurrence with metastasis:29 cases (40.3%) of recurrence occurred first,9 cases (12.5%) of metastasis occurred firstly,20 cases (27.8%) of simultaneous recurrence with metastasis;12/14 patients (16.7%) of simple recurrence had long-term survival,but 2 died (2.8%).Six of 58 patients (8.3%) of recurrence with metastasis had long-term survival but 52 died (72.2%).Results The overall 10-year postrelapse survival rate of the 72 patients was 25%.Kaplan-Meier univariate analysis revealed that postrelapse survival was significantly influenced by the continued treatment after recurrence and the number of postoperative chemotherapy,but it was not significantlyinfluenced by age,gender and the number of preoperative chemotherapy.Multivariate analysis revealed that the continued treatment after recurrence and the number of postoperative chemotherapy were independent prognostic factors (P=0.002,P=0.007).At the same time,according to the survival curve grouped by different indicators,the number of chemotherapy after recurrence has no significant effect on TFS.However,the continued treatment after recurrence has obvious statistical significance on improving TFS and OS of patients (P=0.026,P=0.002).Conclusion Resection and standard postoperative chemotherapy had significant effects on the postrelapse survival in patients with osteosarcoma.There are good prospects for further multimodal therapy and multicenter cooperation for osteosarcoma after recurrence.
		                        		
		                        		
		                        		
		                        	
6.Review and analysis of the treatment of polycentric osteosarcoma in China
Wenjian WANG ; Xiuchun YU ; Jia HAN ; Kai ZHENG ; Ming XU ; Yongcheng HU ; Feng WANG ; Sujia WU ; Xiaozhou LIU ; Yang YAO ; Wenxi YU ; Zhen WANG ; Minghui LI ; Guochuan ZHANG ; Ming ZHAO ; Yiyang YU ; Weibin ZHANG ; Qiyuan BAO
Chinese Journal of Orthopaedics 2018;38(18):1097-1107
		                        		
		                        			
		                        			Objective To investigate the clinical and epidemiological characteristics of osteosarcoma in China and analyze the incidence and clinical treatment of osteosarcoma.Methods The clinical data of 1 593 patients with osteosarcoma in 7 bone cancer treatment centers from January 2000 to February 2017 were analyzed.We retrieved large samples of documents in the database,extracted the relevant data and compared the data with this study.SPSS 13 software was used for statistical analysis and each factor was tested by x2.Results Of 1 593 patients,984 were males and 609 were females.The ratio of male to female was 1.62∶ 1.The average age was 23.2 years (range from 3-80 years).The peak age of onset was 11-20 years (52.4%).There were 217 elderly patients (> 40 years old).The tumors occurred in 1 524 limbs and 69 in axial bone.The most common sites of disease were distal femur 706 cases,proximal tibia 375 cases,distal humerus 117 cases and others 395 cases.There were 1 154 cases (71%) around the knee joint.The axial bone included 18 cases of spine,49 cases of pelvis and 2 cases of rib.Preoperative biopsy was performed in 1 111 cases and incisional biopsy in 280 cases.Preoperative diagnosis could be made in 1 345 cases (84.4% of all patients,accounting for 96.7% of biopsy patients).There were 79 cases with metastasis at first visit,accounting for 5%.Preoperative chemotherapy was performed in 1 185 cases (74.4%).With the DIA preoperative chemotherapy 271 cases,DIA+MTX 251 cases,AP 149 cases.220 cases of tumor cell necrosis rate was evaluated after operationaccording to the Huvos classification.There were78 cases of grade Ⅰ,105 cases of Ⅱ grade,35 cases of Ⅲ and 2 cases of grade Ⅳ.There were 1 299 cases undergoingpostoperative chemotherapy (81.5%),1 306 patients undergoinglimb salvage surgery (82%).Thespecific operation with prosthetic replacement is the most common (911 cases,69.8%).The postoperative chemotherapy included DIA+MTX regimen 471 cases,DIA regimen 266 cases and AP regimen 98 cases.Before and after the operation,379 cases were treated with the same chemotherapy regimen and 666 cases were changed.A total of 18 large sample documents were retrieved in Chinese data base (5 684 cases).The sex ratio,age range,peak incidence and location of the disease were similar to those of this study.The average age was 1-2 years old younger.The percentage of lung metastases associated with initial visits washigher.The rate of preoperative and postoperative chemotherapy and limb salvage waslowand the rate of tumor necrosis wasbetter after chemotherapy.A total of 22 large sample literatures were searched in foreign database (12 850 cases).The ratio of men and women is 1.30∶1 and the proportion of women is higher than the domestic data.The average age was 1-2 years older.The ratio of the knee joint was lower.The percentage of lung metastases associated with initial visits washigher.The rate of preoperative and postoperative chemotherapy and limb salvage were similar to that of this study and the rate of tumor necrosis was better after chemotherapy.Conclusion The general situation of the incidence of osteosarcoma (sex,age,location of the disease) is not significantly different from the previous reports both at home and abroad.In the treatment,preoperative and postoperative chemotherapy rate and limb salvage surgery rate have improved significantly compared with the past.The chemotherapy program from the coexistence of various programs,gradually to the DIA+MTX and DIA program as the mainstream program.
		                        		
		                        		
		                        		
		                        	
7.Effects of Zhige Oral Liquid on Lipid Metabolism in Rats with Alcoholic Liver Disease
LiJun CAI ; Youping LIU ; Zhi LI ; Bo LI ; Guochuan YANG ; Mei WEI
World Science and Technology-Modernization of Traditional Chinese Medicine 2018;20(6):929-934
		                        		
		                        			
		                        			Objective: To observe the effects of Zhige oral liquid on lipid metabolism in rats with alcoholic liver disease.Methods: Alcoholic liver disease rats were induced by alcoholic gavage plus normal diet. The intervention group was given different doses of Zhige oral liquid at the same time. The control group was given alcohol and oral administration of Jiejiuling oral liquid. After 12 weeks, the rats were sacrificed and serum ALT, AST, TC, TG and liver TC and TG levels were measured. Results: Compared with the normal group, the liver index, serum ALT, AST, TC, TG and liver TC and TG levels were significantly higher in the groups except the high dose group (P < 0.01 or 0.05), among which the model group and the low dose group had the most significant increase (P < 0.01) . Compared with the model group, the above indicators were decreased in the high, medium and low dose groups and the control group, and the decreasing trend was the same.That is, the high dose of the Zhige oral liquid was the most significant (P < 0.01), followed by the middle dose group and the control group (P < 0.05) . The decrease in the low dose group was the least significant. Compared with the control group, there were significant differences in the high-dose groups (P < 0.05) . Conclusion: A certain dose of Zhige oral liquid can inhibit or reduce the occurrence of alcoholic liver disease by improving lipid metabolism disorder.
		                        		
		                        		
		                        		
		                        	
8.Dynamic change of cystathionine β-synthase during cerebral ischemia-reperfusion and its effect in rats
Xiaolu ZHOU ; Guochuan WANG ; Anchao TAN ; Jielin LIU ; Hua ZHANG
Chinese Journal of Immunology 2016;32(8):1141-1144
		                        		
		                        			
		                        			Objective:To observe the dynamic change of cystathionine β-synthase during cerebral ischemia-reperfusion and its effect in rats.Methods:The ischemic model was established with line embolism to block the middle cerebral artery .The reverse tran-scription-polymerase chain reaction ( RT-PCR) and Western blot assay were used to assess the expression of cystathionine β-synthase (CBS) in SHAM group,I group,and IR group.ELISA assay was performed to detected the homocysteine (HCY) level in plasma.After treating with the inhibitor of cystathionine β-synthase called hydroxyla mine(HA),the expression of hemeoxygenase 1(HO-1) and the pathologic change of the brain was evaluated .Results:As compared to sham group ,the expression of CBS was significantly up-regulated in ischemia-reperfusion group at 12 h post-reperfusion.Meanwhile,it existed the lowest level of HCY at 12 h post-reperfusion,comparing to sham grouzp ( 5.73 ±1.17 vs 2.88 ±0.93 , F=25.56 , P=0.001 ) .When inhibited the activity of CBS via using HA , the down-regulation of HO-1 protein and further damage in neuron were observed .Conclusion:Cystathionine β-synthase serves as an protective factor during cerebral ischemia-reperfusion.
		                        		
		                        		
		                        		
		                        	
9.A new method of designing genechip probe for frontier port detection of pathogenic microorganism.
Lin LU ; Guochuan LIU ; Huiyuan ZHANG ; Fujun SUN ; Guangquan CHEN
Journal of Biomedical Engineering 2009;26(3):643-652
		                        		
		                        			
		                        			In the process of designing genechip probe for detecting pathogenic microorganism, the selection of single nucleotide polymorphism (SNP) combination is of great importance. At present, there is no automatic design method. This work is hard and the result is not always well. A new approach for selecting SNP combination is presented in this paper. Genetic algorithm is used to search optimal solution on the basis of classification ability of SNP combination, which is evaluated by the rough set theory. Other related experimental parameters are also incorporated. Experimental results show that the method can find out the best SNP combination pattern efficiently and accurately, thus demonstrating the reliability of this new method for designing the genechip probe.
		                        		
		                        		
		                        		
		                        			Algorithms
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		                        			Base Sequence
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		                        			Brucella
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		                        			isolation & purification
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		                        			Humans
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		                        			Molecular Sequence Data
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		                        			Oligonucleotide Array Sequence Analysis
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		                        			methods
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		                        			Polymorphism, Single Nucleotide
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		                        			Salmonella enterica
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		                        			isolation & purification
		                        			
		                        		
		                        	
10.The research advance of analytical methodology for detecting bovine spongiform encephalopathy.
Chuanzhong WEI ; Guochuan LIU ; Guiping MA ; Xuelong TIAN ; Ping JIN ; Chenglin PENG
Journal of Biomedical Engineering 2005;22(1):211-213
		                        		
		                        			
		                        			Bovine spongiform encephalopathy (BSE) is an infectious disease which can threaten animal husbandry and human health seriously. The disease mainly violates the central neural system. This article selectively reviewed current researches on the analytical detection of BSE and transmissible spongiform encephalopathy (TSE).
		                        		
		                        		
		                        		
		                        			Animals
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		                        			Cattle
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		                        			Encephalopathy, Bovine Spongiform
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		                        			diagnosis
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		                        			transmission
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		                        			virology
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		                        			Humans
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		                        			Prions
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		                        			isolation & purification
		                        			
		                        		
		                        	
            
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