1.Relationship between serum soluble CD155, soluble CD163 and chemotherapy efficacy and prognosis in patients with diffuse large B-cell lymphoma
Jinjie FU ; Xiaojun MA ; Keming SHENG ; Xiaoyang WANG ; Gaofeng FAN ; Huihui DONG ; Xiuying LI ; Yongfang LIU
Journal of Chinese Physician 2024;26(10):1519-1524
Objective:To investigate the relationship between serum soluble CD155 (sCD155), soluble CD163 (sCD163) and chemotherapy efficacy and prognosis in patients with diffuse large B-cell lymphoma (DLBCL).Methods:A total of 126 patients with DLBCL admitted to Handan Central Hospital from May 2018 to May 2020 (DLBCL group) and 126 healthy subjects (control group) were prospectively selected to compare serum sCD155 and sCD163 levels. According to the chemotherapy effect of DLBCL patients, they were divided into effective group and ineffective group, and the serum sCD155 and sCD163 levels were compared before and after treatment. The effective rate of chemotherapy in patients with different serum sCD155 and sCD163 levels was compared. Kaplan-Meier method was used to analyze the relationship between serum sCD155 and sCD163 levels and 3-year overall survival (OS) and progression-free survival (PFS) of DLBCL patients. Cox proportional risk regression model was used to analyze the prognostic factors of DLBCL patients.Results:The serum levels of sCD155 and sCD163 in DLBCL group were higher than those in control group before treatment (all P<0.05). The effective rate of chemotherapy in 126 DLBCL patients in this group was 69.8%(88/126). Compared with the effective group, the serum levels of sCD155 and sCD163 were higher in the ineffective group before and after treatment (all P<0.05). Compared with before treatment, serum sCD155 and sCD163 levels in the effective group were decreased after treatment (all P<0.05). The effective rate of DLBCL patients in sCD155 and sCD163 high level groups was lower than that in sCD155 and sCD163 low level groups (all P<0.05). Kaplan-Meier analysis showed that the 3-year OS and PFS of DLBCL patients in the low level group of sCD155 and sCD163 were higher than those in the high level group (all P<0.05). The high level of sCD155 and sCD163 were independent risk factors for 3-year PFS and OS in DLBCL patients (all P<0.05). Conclusions:Abnormal levels of serum sCD155 and sCD163 in DLBCL patients may reduce the efficacy of chemotherapy and lead to poor prognosis.
2.Chinese expert consensus on surgical treatment of aortic valve disease in children
Hao ZHANG ; Keming YANG ; Xinxin CHEN ; Nianguo DONG ; Shoujun LI
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2024;31(11):1560-1566
The consensus was authored by National Society of Congenital Heart Diseases. After employing the Delphi process and incorporating literature reviews and expert discussions, seven recommendations were ultimately formulated. The consensus provides a detailed elaboration on the pathoanatomy, pathophysiology, clinical manifestations, diagnostic methods, and surgical treatment approaches for aortic valve diseases in children. It emphasizes that the treatment of aortic valve diseases in children should take into account the needs of growth and development, and recommends surgical strategies for different age groups and types of lesions, including valve plasty, Ross procedure, valve replacement, and balloon dilation. Specifically, aortic valve plasty is recommended for neonates and infants, while surgical options for older children are more diversified. The consensus only discusses isolated aortic valve disease and does not cover cases complicated with other heart malformations
3.The long-term durability of valved homograft conduit in right ventricular outflow tract reconstruction after Ross surgery and non-Ross surgery
Yaojun DUN ; Dong ZHAO ; Zhongdong HUA ; Jun YAN ; Shoujun LI ; Keming YANG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2023;30(06):884-889
Objective To compare the long-term durability of valved homograft conduit (VHC) in patients with Ross and non-Ross right ventricular outflow tract (RVOT) reconstruction. Methods Patients who underwent RVOT reconstruction using VHC in Fuwai Hospital from January 2008 to October 2020 were retrospectively included. Patients who received Ross RVOT reconstruction were allocated to a Ross group and patients who received non-Ross RVOT reconstruction were allocated to a non-Ross group. The survival and reintervention-free rates of the two groups were evaluated with the Kaplan-Meier survival curve and log-rank test. The propensity score matching analysis was performed on the patients who completed ultrasound follow-up in the two groups, and the VHC dysfunction-free rate was compared between the two groups. Results A total of 243 patients were enrolled, including 142 males and 101 females, with a median age of 6 years (4 months to 56 years). There were 77 patients in the ROSS group and 166 patients (168 operations) in the non-ROSS group. The cardiopulmonary bypass time in the Ross group was shorter than that in the non-Ross group (175.4±45.6 min vs. 200.1±83.5 min, P=0.003). Five patients in the non-Ross group died early after the operation. The follow-up was available in 231 patients (93.1%), with the average follow-up time of 61.7±44.4 months. During the follow-up, 5 patients in the non-Ross group died. The 12-year survival rate was 100.0% in the Ross group and 93.2% in the non-Ross group (log-rank, P=0.026). In addition, 1 patient in the Ross group and 7 patients in the non-Ross group received VHC reintervention. There was no significant difference in the reintervention-free rate between the two groups (log-rank, P=0.096). Among the 73 patients in the Ross group and 147 patients in non-Ross group who were followed up by ultrasound after discharge, 45 patients (20.5%) developed VHC dysfunction. Before matching, the long-term durability of VHC in the Ross group was better than that in non-Ross group (10-year VHC dysfunction-free rate: 66.6% vs. 37.1%, log-rank, P=0.025). After the propensity score matching, 64 patients included in each group, and there was no statistical difference in the long-term durability of VHC between the two groups (10-year VHC dysfunction-free rate: 76.3% vs. 43.0%, log-rank, P=0.065). In the subgroup analysis, the 10-year VHC dysfunction-free rate in the Ross group was higher than that in the non-Ross group (71.0% vs. 20.0%, log-rank, P=0.032) among patients aged<6 years at surgery. However, there was no significant difference in the 10-year VHC dysfunction-free rate between the two groups (53.7% vs. 56.7%, log-rank, P=0.218) among patients aged ≥6 years at surgery. Conclusion After the propensity score matching analysis, the long-term durability of VHC has no significant difference between the Ross group and non-Ross group. The long-term durability of VHC after Ross surgery is superior to that of non-Ross surgery in patients aged<6 years at surgery.
4.Application status of right ventricular outflow tract reconstruction with valved homograft conduits: 13 years’ clinical analysis of a single center
Yaojun DUN ; Dong ZHAO ; Zhongdong HUA ; Jun YAN ; Shoujun LI ; Keming YANG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2023;30(07):1019-1024
Objective To evaluate the clinical outcome of valved homograft conduits (VHC) used for right ventricular outflow tract (RVOT) reconstruction in Fuwai Hospital in recent 13 years, and explore the factors influencing the long-term durability of VHC. Methods Clinical data of patients using VHC for RVOT reconstruction in Fuwai Hospital from November 2007 to October 2020 were retrospectively analyzed. The Kaplan-Meier survival curve was used to evaluate survival, VHC reintervention and VHC dysfunction. Cox proportional risk regression model was used to analyze the risk factors for VHC dysfunction. Results Finally 251 patients were enrolled, including 145 males and 106 females. The median age at surgery was 6.0 (0.3-67.0) years. Early death occurred in 5 (2.0%) patients. The follow-up was available for 239 (95.2%) patients, with the follow-up time of 0.3-160.0 (61.3±45.4) months. Five patients died during the follow-up, and the 1-year, 6-year, and 13-year survival rates were 96.6%, 95.5% and 95.5%, respectively. Eight patients received VHC reintervention during the follow-up, and freedom rates from VHC reintervention were 100.0%, 97.1% and 82.4% at 1 year, 6 years and 13 years, respectively. A total of 226 patients were followed up by echocardiography after discharge, with the follow-up time of 0.2-138.0 (48.5±40.5) months. During the follow-up, 46 (20.4%) patients developed VHC dysfunction, and freedom rates from VHC dysfunction at 1 year, 5 years, and 10 years were 92.6%, 79.6% and 59.3%, respectively. Univariate Cox regression analysis showed that age<6 years and VHC diameter<19 mm were risk factors for VHC dysfunction (P=0.029, 0.026), but multivariate regression analysis only indicated that age<6 years was an independent risk factor for VHC dysfunction (P=0.034). Conclusion The early and late outcomes of VHC used for RVOT reconstruction are satisfactory, and the long-term durability of VHC is also optimal. In addition, age<6 years is an independent risk factor for VHC dysfunction.
5.Risk factors for recurrent left ventricular outflow tract obstruction after surgical repair for subaortic stenosis
Jie DONG ; Shun LIU ; Shuo DONG ; Mengxuan ZOU ; Chuhao DU ; Yangxue SUN ; Haitao XU ; Jiashu SUN ; Qiang WANG ; Shoujun LI ; Keming YANG ; Jun YAN
Chinese Journal of Thoracic and Cardiovascular Surgery 2023;39(10):599-604
Objective:To investigate the prognosis and risk factors for children diagnosed with all types of subaortic stenosis(SAS) who developed recurrent left ventricular outflow tract obstruction after surgical treatment.Methods:The study retrospectively included patients aged 0-18 years old who underwent open heart SAS surgery at Fuwai Hospital from 2016-2019. Children with hypertrophic obstructive cardiomyopathy were excluded. Detailed operative notes, medical records and ultrasound information, and follow-ups were extracted. Recurrent SAS was defined as left ventricular outflow tract gradient 30 mmHg(1 mmHg=0.133 kPa) 1 month after SAS surgical treatment.Results:A total of 137 children were included in this study. The medium age of children at the time of SAS surgery was 4.6 years old(3 months-17.8 years old). After a median follow-up of 4.36 years(3.2-5.7 years), a total of 30 patients developed recurrent LVOTO, with a recurrence rate of 21.9%, and 7(5.1%) underwent a second surgery. Compared to the non-recurrent group, children in the recurrent group were younger at the time of surgery( P=0.0443), had a smaller body surface area( P=0.0485), and a longer length of stay( P=0.0380). In Cox analysis, when only considering preoperative variables, the independent risk factor for LVOTO recurrence were a peak left ventricular outflow tract gradient higher than 50 mmHg( HR=5.25, P=0.001), a BSA less than 0.9( HR=2.5, P=0.023), and a length of SAS 5 mm( HR=2.29, P=0.050). When both preoperative and intraoperative variables were considered, preoperative peak left ventricular outflow tract gradient 50 mmHg( HR=4.91, P=0.002) and peeling from the aortic valve( HR=3.23, P=0.010) were independent risk factors for postoperative recurrence. Conclusion:Recurrent LVOTO after SAS surgical repair is common, and regular postoperative follow-up is crucial to evaluate whether a secondary intervention is required. Regular postoperative follow-up is needed for children at high risk.
6.Establishment and implementation of management information system for patients with stomas in cancer special hospital
Hong ZHANG ; Jie ZHANG ; Hong YANG ; Miaoning YOU ; Keming DONG ; Yuhan LU
Chinese Journal of Practical Nursing 2022;38(6):426-430
Objective:To establish and implement a management information system for patients with stomas based on the hospital information system.Methods:Relying on information system resources of Beijing Cancer Hospital, Beijing Institute for Cancer Research, the management information system for patients with stomas was developed by the Nursing Department and the Information Center from August 2018 according to the requirement of whole process management for patients with stomas.Results:A whole process management information system was constructed for patients with stomas including stoma construction, stoma care, management of complications and stoma closure. It was applied to 12 departments covering clinical departments and stoma clinics of the hospital, including 326 cases with stomas and 6 358 cumulative visits. 28 cases with skin complications around stoma were detected and the rate of complications was 8.59% (28/326) from May 2019 to October 2020.Conclusions:The management information system for patients with stomas can realize the whole-process management from stoma construction, stoma care, management of complications to stoma closure, and provide basis and guidance for nursing staff to implement professional nursing timely and accurately, which can also provide basis for continuously improving the quality of stoma care.
7.Evaluation of mid-term outcomes of pulmonary valve replacement surgery after repair of tetralogy of Fallot
Dong ZHAO ; Keming YANG ; Shoujun LI
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2021;28(04):404-408
Objective To evaluate mid-term outcomes of pulmonary valve replacement surgery after repair of tetralogy of Fallot. Methods A total of 73 patients with repaired tetralogy of Fallot who underwent pulmonary valve replacement surgery in our hospital from January 2010 to January 2020 were enrolled, including 42 males and 31 females. The median age was 3.9 (0.2-42.8) years at initial repair and 20.0 (2.0-50.0) years at pulmonary valve replacement. The clinical data of the patients were recorded and analyzed. Results There was no death in postoperative 30 d. The average follow-up time was 35.6±28.5 months, and no death occurred during the follow-up. One patient underwent a second reintervention after initial pulmonary valve replacement. The 1- and 5-year survival rates were both 100.0%, the 1- and 5-year reintervention-free rates were both 100.0%, and the 1- and 5-year valve failure-free rates were 100.0% and 67.1%. There was no significant difference in valve failure-free rates between different age groups (P=0.49) and different type of valve groups (P=0.74). The right (P=0.006) and left (P=0.002) ventricular ejection fractions were significantly improved, and the QRS duration was shortened after pulmonary valve replacement (P=0.006). Conclusion Mid-term outcomes of surgical pulmonary valve replacement were satisfactory in patients with repaired tetralogy of Fallot, while the long-term effects should be further emphasized in clinical practice.
8. HIV and syphilis infection and related medical treatment status of low-fee female sex workers in three provinces of China, 2012-2015
Wei DONG ; Chu ZHOU ; Manhong JIA ; Yuejiao ZHOU ; Xi CHEN ; Jun KANG ; Ganggang FANG ; Chunwei QIN ; Jiayu WEI ; Xiaoling MI ; Yanbo WAN ; Zunyou WU ; Keming ROU
Chinese Journal of Preventive Medicine 2018;52(12):1239-1242
Objective:
To understand the HIV and syphilis infection and related treatment status of low-fee female sex workers (FSWs) in 3 provinces of China.
Methods:
Four cross-sectional survey data of low-fee FSWs from six cities (counties) in Guangxi, Yunnan and Hunan Province between October 2012 and July 2015 were obtained from the national science and technology major special project intervention study for reducing sexually transmitted diseases (STDs) and acquired immunodeficiency syndrome (AIDS) in low-fee FSWs' database, which included social demographic characteristics, sexual service characteristics and related medical care seeking behaviors, etc. A total of 2 050 subjects were included in the database.
Results:
The age of the subjects was (35.16±9.76) years old, with a minimum age of 15 and a maximum age of 67. Those who use condoms every time in commercial sex accounted for 58.9% (
9.Implementation of intervention programs on AIDS-related sexual transmission in China
Wei DONG ; Chu ZHOU ; Lin GE ; Dongmin LI ; Zunyou WU ; Keming ROU
Chinese Journal of Epidemiology 2015;36(12):1337-1340
Objective To analyze the implementation of intervention programs targeted on AIDS high risk sexual transmission groups since 2008,when the relative prevention and control information systems on HIV/AIDS were developed.Methods Data from both aggregated interventions and sentinel surveillance programs from 2008 to the end of 2014 were used.Descriptive statistics were performed to analyze the trends of implementation on high risk groups including men who have sex with men,female sex workers (FSW) and migrant workers.Results From 2008 to 2012,the monthly average numbers receiving intervention programs and the average monthly coverage rate on intervention for MSM,increased from 49000 to 252000,and from 8.6% to 78.5% respectively.The FSW related indicators increased from 329 000 to 625 000,and from 30.9% to 87.0% respectively.Above indexes on the two populations had dropped slightly in 2013 and 2014.Sentinel surveillance data showed that knowledge and behavior indicators observed from the MSM and FSW populations increased annually.The coverage of intervention programs on migrant workers increased from 4.7% to almost 10.0%,but the surveillance data on migrant men showed that the knowledge and behavior indicators were still lower than the other high-risk groups.Conclusion Intervention related to sexual transmission on HIV/AIDS among high-risk populations were effectively implemented,with some achievements seen.However,as sexual contact currently became the main route of AIDS epidemic,new challenges called for serious attention.
10.The comparative study of deficit/non-deficit schizophrenia serum proteins
Hui DONG ; Keming ZHU ; Xiaowei TANG ; Xiaobin ZHANG
International Journal of Laboratory Medicine 2015;(15):2131-2132
Objective To explore differently expressed proteins in serum samples obtained from Deficit Schizophrenia as well as Non‐Deficit Schizophrenia patients with proteomic techniques .Methods Make the comparative study of serum proteins between DS and NDS patients with two‐dimensional electrophoresis .The screened proteins were identified by mass spectrometer .Results Dur‐ing 18 differently expressed protein points screened in this study ,15 proteins were identified by mass spectrometer .Among of them , 12 proteins are up‐regulated while 3 proteins are down‐regulated in DS patients group .Conclusion It′s the first time to make the comparative study of serum protein profiles between DS and NDS patients by proteomic analysis .We expect that this study will contribute to better understanding of the pathophysiology of DS and explore the potential disease‐associated biomarker ,improve the future study for clinical medication of schizophrenia .

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