1.Long-term observation of structural integrity changes in the outer retina of macular edema with central retinal vein occlusion after initial combination therapy of anti-vascular endothelial growth factor and dexamethasone intravitreal implantation
Ya YE ; Zhen HUANG ; Ming YAN ; Guoren XU ; Yanping SONG
Chinese Journal of Ocular Fundus Diseases 2024;40(8):583-592
Objective:To observe the long-term effects of anti-vascular endothelial growth factor (VEGF) drug initiation combined with dexamethasone intravitreal implant (DEX) on the structural integrity of the outer macular region of the eye in patients with macular edema (ME) secondary to central retinal vein occlusion (CRVO).Methods:A retrospective clinical study. From February 2018 to August 2022, 54 patients diagnosed with CRVO combined with ME (CRVO-ME) in Department of Ophthalmology of Central Theater Command General Hospital were included in the study. Among them, there were 30 males and 24 females, all with monocular disease. According to different treatment regiments, patients were divided into anti-VEGF and DEX combination therapy group (initial combination group), anti-VEGF drug monotherapy group (monotherapy group) with 21 eyes and 33 eyes, respectively. Best corrected visual acuity (BCVA), optical coherence tomography (OCT) examination were performed in all eyes. The thickness of foveal retina (CRT) and the deficiency length of outer membrane (ELM), ellipsoid band (EZ) and chimaera band (IZ) in the 1 mm macular area were measured by OCT. The initiating combination group was treated with anti-VEGF agents or DEX as assessed on demand (PRN) after the combination therapy, and the monotherapy group received 3+PRN regimen. Relevant examinations were performed at 1 (V1), 6 (V6), 12 (V12) months and observation cut-off or the last visit (Vf) after treatment using the same equipment before treatment. The deletion length of ELM, EZ and IZ in V1, V6, V12 and Vf after treatment were compared between the two groups. Repeated measurement ANOVA was used to compare BCVA, CRT and deletion length of ELM, EZ and IZ at different follow-up times. Spearman rank correlation test was used to analyze the correlation between the two groups of continuous variables.Results:The follow-up time of patients in the initial combination group and monotherapy group was (18.05±5 .66) and (21.90±10.80) months, respectively, with no statistical significance ( F=13.430, P=0.229). Compared with baseline, the deletion lengths of ELM, EZ and IZ were significantly improved ( F=11.848, 10.880, 29.236), BCVA was increased ( F=10.541) and CRT was decreased ( F=52.278) in the initial combination group and the monotherapy group at different follow-up times after treatment. The differences were statistically significant ( P<0.001). At V1, EZ and IZ deletion lengths were (344.10±413.03), (593.33±372.96) μm and (354.71±321.75), (604.85±385.77) μm in the initial combination group and monotherapy group, respectively. The improvement of EZ and IZ deletion lengths in the initial combination group was better than that in the single drug group, and the difference was statistically significant ( F=5.272, 6.106; P=0.026, 0.017). The CRT of the initial combination group and the monotherapy group were (248.86±59.99) and (314.72±214.91) μm, respectively, and the CRT of the initial combination group was significantly lower than that of the monotherapy group, with statistical significance ( F=6.102, P=0.017). At V6, V12 and Vf, the deletion length of ELM, EZ and IZ and BCVA and CRT showed no statistical significance ( P>0.05). Correlation analysis showed that ELM, EZ, IZ were positively correlated with BCVA and CRT in the initial combination group and monotherapy group ( P<0.001). In V6, V12 and Vf, the number of anti-VEGF drug injections in the initial combination group and monotherapy group was (2.67±1.32), (4.43±2.27), (6.05±3.51), (4.58±0.90), (7.33±1.93), (11.33±6.10) times, respectively. The number of injections in the initial combination group was significantly lower than that in the monotherapy group, and the difference was statistically significant ( F=5.150, 0.646, 3.433; P<0.001). Conclusions:The improvement of BCVA and CRT in the initial combination group is similar to that in the monotherapy group. Compared with the monotherapy group, EZ and IZ deletion are improved more significantly in the initial combination group, and CRT decreased more rapidly and significantly. The initial combination group receives fewer anti-VEGF injections than the monocular group.
2.Prognostic Perspectives of STING and PD-L1 Expression and Correlation with the Prognosis of Epstein-Barr Virus-Associated Gastric Cancers
Qi SUN ; Yao FU ; Xiaobing CHEN ; Lin LI ; Hongyan WU ; Yixuan LIU ; Haojun XU ; Guoren ZHOU ; Xiangshan FAN ; Hongping XIA
Gut and Liver 2022;16(6):875-891
Background/Aims:
Epstein-Barr virus-associated gastric cancers (EBVaGCs) have unique molecular and clinicopathological characteristics. The cyclic GMP-AMP synthase-stimulator of interferon genes (STING) pathway is recently recognized as the critical innate immunity against pathogens and tumors. STING is also a master regulator in the cancer-immunity cycle and targeting STING could synergize with existing immune-checkpoint therapies. However, the role of STING in GC, especially in EBVaGC, and its correlation with programmed death-ligand 1 (PD-L1) remain largely unclear.
Methods:
We collected 78 cases of EBVaGCs and 210 cases of EBV-negative GC (EBVnGC) from a total of 1,443 cases of GC analyzed by EBV-encoded small RNA in situ hybridization. We investigated STING and PD-L1 expression and their concomitant prognostic value in EBVaGCs and EBVnGCs using tissue microarray and immunohistochemistry. The effects of STING and PD-L1 expression on the overall survival of patients with EBVaGC or EBVnGC were assessed by univariate and multivariate analysis.
Results:
We found that both STING and PD-L1 exhibited significantly higher expression in the EBVaGCs than that in the EBVnGCs. The expression of STING was positively correlated with that of PD-L1 in EBVaGCs. Simultaneous negative expression of STING and PD-L1, and positive expression of STING were independent prognostic risk factors for EBVaGC and EBVnGC, respectively.
Conclusions
This is the first prognostic retrospective study of STING and PD-L1 expression and the prognosis among EBVaGC and EBVnGC. The expression and prognostic value of STING and PD-L1 are different in the two types of GCs. STING and PD-L1 are promising prognostic biomarkers and therapeutic targets for EBVaGC and EBVnGC.
3.Socialization character of the examinee in entrance examination of medical postgraduate
Xianghua ZHU ; Hailing LI ; Juan QIAO ; Houfeng ZHAO ; Tiejun XU ; Baojun GE ; Yan HU ; Xin LIU ; Guoren SUN ; Baorong SUN ; Deqin GENG
Chinese Journal of Behavioral Medicine and Brain Science 2010;19(6):541-543
Objective To study the socialization character of the examinee in entrance examination of medical postgraduate.Methods 48 examinee in physical fitness test and 496 examinee in entrance examination of medical postgraduate were investigated by applying minnesota multiphasic personality inventory ( MMPI ).Results ①Female postgraduate entrance examinee had higher scores of social responsibility and absence of social anxiety ( H1 ) than male ( 59.1 ± 9.0 vs 56.0 ± 8.5, 59.0 ± 10.1vs 57.3 ± 8.6, P < 0.05 ).Graduates had higher scores of absence of social anxiety( H1 ) (58.3 ±9.4 vs 52.1 ± 11.5, P<0.05 ), lower scores of alienation from the society(PD4A) and alienation from the society(S1 A) (44.2 ±7.6 vs 51.7 ±9.0, 39.6 ±7.4 vs 45.9 ±9.6,P<0.05) than junior college graduates.The unmarried persons had higher scores of alienation from the society (PD4A) than the married persons (44.7±7.7 vs 42.9±7.1,P<0.05).②After controlling the effect of gender,marital status and education level, covariance analysis demonstrated that postgraduate entrance examinee had higher scores of S1A (40.0 ±7.5 vs35.2 ±6.8, P<0.05).Conclusion There are significant differences of socialization character among postgraduate entrance examinee with the difference of genders, marital status and education level.Postgraduate entrance examinee prefers alienation from the society.
4.The prognostic significance of FDG PET-CT standardized uptake value in patients with non-small cell lung cancer
Xiaoqing XU ; Xindong SUN ; Guoren YANG ; Zheng FU ; Jinming YU ; Man HU
Chinese Journal of Radiation Oncology 2008;17(2):97-100
Objective To determine the prognostic value of standardized uptake value(SUV)of fluorodeoxyglucose(FDG)by positron emission tomography and computed tomography(PET-CT)in nonsmall cell lung cancer(NSCLC).Methods Forty-eight patients(39 male,9 female)with stage ⅢNSCLC were reviewed.All patients had at least two repeated FDG PET-CT scans either before and after therapy and the maximum standardized uptake value(SUVmax)of the primary lung lesion was calculated. Resuits Of the 45 eligible patients,after a median follow-up of 22.5 months(rang,13 to 35 months),24 patients had local and regional recurrenee or metastasis and 21 remain disease-free.The mean SUVmax of patients who had local recurrence or metastasis before and after treatment was 12.30±3.17 and 5.35±2.29,respectively.The mean SUVmax of patients who had no loeal recurrence or metastasis before and after treatment was 8.46±3.00 and 2.82±0.63,respectively.Significant differences(tbefore=4.15,Pbefore<0.01;Pafter=4.88,Pafter<0.01)in SUVmax were observed either before and after treatment.However,the percent change of SUVmax between pretreatment and post-treatment were not significiantly different(t=1.99,P>0.05).Using the SUVbefore of 9.0 yielded 92% sensitivity,62% specificity,73% positive predictive value and 87%negaffve Dredictive value in predicting regional recurrence or metastasis. While using the SUVafter of 4.3 yielded 71% sensitivity,100% specificity,100% positive predictive valne and 72% negative Dredictive value. Conclusions PET-CT may have the potientials to predict response to therapy and the SUVmax is a significant predictor for recurrent or metastasis in patients of NSCLC.
5.Detection of E-cadherin gene promoter hypermethylation in plasma of breast cancer patients
Jingjie ZHANG ; Tao OUYAN ; Guoren DENG ; Wenhui WAN ; Guangwei XU
Chinese Journal of General Surgery 2000;0(11):-
Objective To evaluate the feasibility in early diagnosis, predicting therapeutic effect, recurrence monitoring by examining promoter hypermethylation for cancer-associated genes E-cadherin in cancer tissue and peripheral blood of breast cancer patients. Methods The tumor tissue, paracancer- tissue and the paired plasma were examined for aberrant methylation of E-cadherin gene by methylation-specific PCR in 42 cases of breast cancer and 10 cases of breast benign diseases. Results The incidence of promoter hypermethylation of E-cadherin in tumor tissues was 52.4% and the paired plasma were 33.3%. E-cadherin hypermethylation in plasma samples and tumor samples significantly correlated with each other ( P

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