1.Introduction to the 9 th edition of TNM classification for lung cancer
Bo ZHANG ; Wentao FANG ; Hua ZHONG
Chinese Journal of Oncology 2024;46(3):206-210
		                        		
		                        			
		                        			Lung cancer is the second commonly diagnosed cancer and remained the leading cause of cancer-related death, with an estimated 1.8 million deaths in 2020. The identification of driver gene mutation and administration of corresponding tyrosine kinase inhibitor have improved overall survival and quality of life in advanced lung cancer patients. Check point inhibitor has revolutionized treatment strategy of driver gene negative advanced NSCLC patients. TNM staging system is the most widely used classification method, providing an international common language during academic communication and important tool for predicting prognosis and subsequent treatment decision making. Accumulating knowledge about prognostic factors in lung cancer promotes the update of TNM classification. In the World Conference on Lung Cancer (WCLC) held in Singapore, September, 2023, International Association for Study of Lung Cancer (IASLC) released the forthcoming 9 th edition of TNM classification for lung cancer, which is supposed to be adopted at January, 2024. The manuscript discussed the history, data resource and limitation of the TNM staging system.
		                        		
		                        		
		                        		
		                        	
2.Introduction to the 9 th edition of TNM classification for lung cancer
Bo ZHANG ; Wentao FANG ; Hua ZHONG
Chinese Journal of Oncology 2024;46(3):206-210
		                        		
		                        			
		                        			Lung cancer is the second commonly diagnosed cancer and remained the leading cause of cancer-related death, with an estimated 1.8 million deaths in 2020. The identification of driver gene mutation and administration of corresponding tyrosine kinase inhibitor have improved overall survival and quality of life in advanced lung cancer patients. Check point inhibitor has revolutionized treatment strategy of driver gene negative advanced NSCLC patients. TNM staging system is the most widely used classification method, providing an international common language during academic communication and important tool for predicting prognosis and subsequent treatment decision making. Accumulating knowledge about prognostic factors in lung cancer promotes the update of TNM classification. In the World Conference on Lung Cancer (WCLC) held in Singapore, September, 2023, International Association for Study of Lung Cancer (IASLC) released the forthcoming 9 th edition of TNM classification for lung cancer, which is supposed to be adopted at January, 2024. The manuscript discussed the history, data resource and limitation of the TNM staging system.
		                        		
		                        		
		                        		
		                        	
3.A phase Ⅱ clinical study of the efficacy and safety of antaitasvir phosphate combined with yiqibuvir for the treatment of chronic hepatitis C in adults
Lai WEI ; Hongxin PIAO ; Jinglan JIN ; Shufen YUAN ; Xuan AN ; Jia SHANG ; Wenhua ZHANG ; Jiabao CHANG ; Tong SUN ; Yujuan GUAN ; Bo NING ; Jing ZHU ; Wentao GUO ; Qingwei HE ; Lin LUO ; Yulei ZHUANG ; Hongming XIE ; Yingjun ZHANG
Chinese Journal of Hepatology 2024;32(7):637-642
		                        		
		                        			
		                        			Objective:To evaluate the efficacy and safety of antaitasvir phosphate 100 mg or 200 mg combined with yiqibuvir for 12 weeks in patients with various genotypes of chronic hepatitis C, without cirrhosis or compensated stage cirrhosis.Methods:Patients with chronic hepatitis C (without cirrhosis or compensated stage cirrhosis) were randomly assigned to the antaitasvir phosphate 100 mg+yiqibuvir 600 mg group (100 mg group) or the antaitasvir phosphate 200 mg+yiqibuvir 600 mg group (200 mg group) in a 1∶1 ratio. The drugs were continuously administered once a day for 12 weeks and observed for 24 weeks after drug withdrawal. The drug safety profile was assessed concurrently with the observation of the sustained virological response (SVR12) in the two patient groups 12 weeks following the drug cessation. The intention-to-treat concept was used to define as closely as possible a full analysis set, including all randomized cases who received the experimental drug at least once. The safety set was collected from all subjects who received the experimental drug at least once (regardless of whether they participated in the randomization group) in this study. All efficacy endpoints and safety profile data were summarized using descriptive statistics. The primary efficacy endpoint was SVR12. The primary analysis was performed on a full analysis set. The frequency and proportion of cases were calculated in the experimental drug group (antaitasvir phosphate capsules combined with yiqibuvir tablets) that achieved "HCV RNA
4.Features of Henle fiber layer by spectral domain optical coherence tomography in central serous chorioretinopathy
Weiwei LIU ; Wentao CHEN ; Bo ZHANG ; Nan LI ; Chao ZHAO ; Rui HU
Chinese Journal of Experimental Ophthalmology 2023;41(1):35-41
		                        		
		                        			
		                        			Objective:To observe the features of Henle fiber layer (HFL) in eyes with central serous chorioretinopathy (CSC) using spectral domain optical coherence tomography (SD-OCT).Methods:A cross-sectional study was conducted.Thirty-five CSC patients (35 eyes) treated in the Third People's Hospital of Qingdao from January 2017 to November 2021 were enrolled.The subjects included 23 males (23 eyes) and 12 females (12 eyes), aged 24 to 60 years old, with an average age of (41.14±8.19) years, and had a CSC duration ranged from 1 day to 6 months.SD-OCT was performed on all eyes with a line scan through the central fovea horizontally.The features of HFL over subretinal fluid (SRF) area were analyzed and summarized.The study protocol adhered to the Declaration of Helsinki and was approved by the Ethics Committee of the Third People's Hospital of Qingdao (No.2022Y0403001).Results:In 26 eyes with regular dome-shaped neurosensory retinal detachment, HFL appeared to be delimited type 1 in 25 eyes, accounting for 96.15%, delimited type 2 in 7 eyes, accounting for 26.92%, bright in 17 eyes, accounting for 65.38% over SRF area.In 21 eyes with CSC duration≤21 days, HFL all showed delimited type 1 and some presented bright or delimited type 2 at the same time.In 5 eyes with CSC duration>21 days, HFL all showed bright and some were delimited type 1 or delimited type 2 in the meantime.In 15 eyes with symmetrical nasal and temporal retinal detachment, HFL showed symmetrical reflectivity over SRF area in horizontal OCT images in 6 eyes, and showed brighter reflectivity over nasal SRF in nasal elevated OCT images in 3 eyes and over temporal SRF in temporal elevated OCT images in 6 eyes.In 11 eyes with asymmetrical nasal and temporal retinal detachment, HFL showed brighter reflectivity over temporal SRF with larger retinal detachment range on temporal side in horizontal OCT images in 3 eyes.Of the 4 eyes with nasal elevated OCT images, the retinal detachment range was larger on temporal side and HFL showed symmetrical reflectivity over SRF area in 3 eyes, and HFL was brighter over nasal SRF area with larger retinal detachment range on nasal side in 1 eye.Of the 4 eyes with temporal elevated OCT images, the retinal detachment range was larger on nasal side and HFL showed symmetrical reflectivity over SRF area in 3 eyes, and HFL was brighter over nasal SRF area with larger retinal detachment range and higher height on nasal side in 1 eye.In 9 eyes with irregular neurosensory retinal detachment, HFL appeared to be delimited type 1 in 7 eyes, accounting for 77.78%, delimited type 2 in 5 eyes, accounting for 55.56%, bright in 6 eyes, accounting for 66.67%, dark in 4 eyes, accounting for 44.44%, and indistinct in 2 eyes, accounting for 22.22%.The detached neurosensory retina was not smooth in 7 eyes, and the phenotypes of HFL changed with the directions of detached neurosensory retina.In 2 eyes with only low neurosensory retinal detachment, HFL reflectivity on the raised side was slightly weaker than that on the lowered side.Conclusions:HFL appears to be delimited type 1 and bright mostly over SRF area in CSC in SD-OCT images.The phenotypes of HFL vary regularly with the tilt directions of OCT images, CSC duration, and the symmetry, range, height, directional characteristics of detached neurosensory retina.
		                        		
		                        		
		                        		
		                        	
5.Current progress and future directions of basic research on sepsis
Xiaoting ZHANG ; Wentao JI ; Lulong BO ; Jinjun BIAN ; Xiaoming DENG
Chinese Critical Care Medicine 2021;33(8):919-921
		                        		
		                        			
		                        			Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection, of which the pathogenesis is complex and the mortality rate is high. However, current basic research is facing the dilemma of high heterogeneity and difficult translation to clinical practice. In-depth basic research is one of the most important ways to break through the "bottleneck" of clinical diagnosis and treatment of sepsis. The purpose of this review is to analyze the current progress and challenges in the field of basic research on sepsis, and look forward to the potential research directions in the future. Cell function, energy metabolism, microbiota, epigenetics and recovery period of sepsis may be the research priorities.
		                        		
		                        		
		                        		
		                        	
6.Interpretation of surviving sepsis campaign: international guidelines for the management of sepsis and septic shock 2021
Wentao JI ; Yan MENG ; Lulong BO ; Xiaojian WAN ; Xiaoming DENG
Chinese Journal of Anesthesiology 2021;41(12):1409-1413
		                        		
		                        			
		                        			Sepsis is defined as life-threatening organ dysfunction secondary to a dysregulated host response to infection.It is considered a major cause of death and health loss worldwide.Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021, released in October 2021, included 93 total statements, which addressed screening and initial resuscitation, infection, hemodynamics, ventilation, additional therapies, and goals of care and long-term outcomes.This review interpreted the content ofthe guidelines and also analyzed the underlying issues.The guidelines provide a more accurate framework and guidance for the diagnosis and treatment of sepsis, and may also provide an opportunity to urge researchers in the field of sepsis worldwide to implement further individualized research.
		                        		
		                        		
		                        		
		                        	
7.Recurrence and prognosis of hepatocellular carcinoma after liver transplantation in different age qronps
Bo ZHANG ; Bo LI ; Tianfu WEN ; Hong WU ; Wentao WANG ; Li JIANG ; Jiayin YANG
Chinese Journal of Organ Transplantation 2021;42(3):141-146
		                        		
		                        			
		                        			Objective:To evaluate the long-term prognosis and recurrence of young liver transplant recipients with hepatocellular carcinoma(HCC).Methods:Based upon the database of liver transplantation center, clinical data were retrospectively reviewed for 39 young recipients(18~40 years)and 158 middle-aged and elderly recipients(over 40 years)from 2013 to 2017. The parameters of overall survival(OS), recurrence-free survival(RFS)and disease-specific survival(DSS)were compared between two groups.Cox's proportional hazard model was utilized for evaluating the prognostic factors.Results:Significant inter-group difference existed in recurrence rate of HCC. Kaplan-Meier analysis revealed no significant difference in OS rate(1/3-year OS, 82.1%, 66.7% and 86.1%, 74.7%, P>0.05)and DSS rate(1/3-year DSS, 94.9%, 82.1% and 99.4%, 91.1%, P=0.053); RFS rate(1/3-year RFS, 51.3%, 41.0% and 73.0%, 62.7%, P=0.008)showed significant differences; Cox multivariate analysis revealed that AFP>400 μg/L was an independent risk factor for OS, DSS and RFS; poorly differentiated tumors and positive micro-vascular invasion(MVI)were independent risk factor for DSS; poorly differentiated tumors and total tumor size >5 cm were independent risk factors for RFS. Conclusions:Although RFS of young adult group is worse than that in middle-aged and elderly group after LT, no significant inter-group difference exists in OS or DSS. And LT is still a quite effective treatment for young HCC patients.
		                        		
		                        		
		                        		
		                        	
8.Correlation analysis of single nucleotide polymorphisms in autophage-related 5 ( ATG[STHZ]5[STBZ] ) gene promoter with acute myocardial infarction
Yexin ZHANG ; Ruchao MA ; Wentao YANG ; Shuchao PANG ; Yinghua CUI ; Bo YAN
Chinese Journal of Clinical Laboratory Science 2019;37(2):87-91
		                        		
		                        			Objective:
		                        			To investigate the correlation of single nucleotide polymorphisms (SNPs) in autophage-related 5 ( ATG5 ) gene promoter with acute myocardial infarction (AMI).  
		                        		
		                        			Methods:
		                        			The SNPs of  ATG5 gene promoter were detected by polymerase chain reaction (PCR) and Sanger sequencing. The typing and correlation of SNPs in 378 AMI patients and 374 healthy controls were analyzed by Chi-square test, Logistic regression analysis and haplotype analysis.  
		                        		
		                        			Results:
		                        			Two SNPs of  ATG5 gene promoter, rs506027 (OR=1.4, 95% CI \[0.6-3.0\], P=0.411) and rs510432 (OR=1.6, 95% CI \[0.7-3.4\], P=0.275), were found. They didn′t increase the susceptibility of AMI, and the haplotype associated with AMI was not found in the two SNPs.  
		                        		
		                        			Conclusion
		                        			The polymorphism of  ATG5 gene promoter isn′t associated with the susceptibility of AMI.
		                        		
		                        		
		                        		
		                        	
9.Clinical efficacy and prognostic factors analysis of hepatectomy for hepatocellular carcinoma
Aixiang LIU ; Haiqing WANG ; Wentao BO ; Xielin FENG ; Lang TIAN ; Hui ZHANG ; Mingyi ZHANG ; Yong HU
Chinese Journal of Digestive Surgery 2019;18(4):368-374
		                        		
		                        			
		                        			Objective To investigate the clinical efficacy and prognostic factors of hepatectomy for hepatocellular carcinoma (HCC).Methods The retrospective case-control study was conducted.The clinicopathological data of 789 HCC patients who were admitted to the Sichuan Cancer Hospital Affiliated to School of Medicine of University of Electronic Science and Technology of China from January 2009 to January 2016 were collected.There were 669 males and 120 females,aged from 42 to 60 years,with a median age of 52 years.Surgical procedures were determined according to the preoperative and intraoperative comprehensive evaluations of patients.Observation indicators:(1) situations of surgical treatment;(2) postoperative pathological examinations of patients;(3) follow-up and survival situations;(4) prognostic factors analysis.Follow-up using outpatient examination and telephone interview was performed to detect patients' survival up to May 2017.Normality of measurement data was done using the K-S test.Measurement data with skewed distribution were represented as M (range).Count data were described as absolute number or percentage.The survival rate and survival curve were respectively calculated and drawn by the Kaplan-Meier method.The univariate analysis and multivariate analysis were done using the Log-rank test and COX regression model,respectively.Results (1) Situations of surgical treatment:all the 789 patients underwent successful hepatectomy,liver volume dissected accounting for 32.5% (range,17.0%-52.0%) of the total liver volume.Of the 789 patients,413 underwent anatomical hepatectomy including 116 of hepatic segmentectomy,136 of right hemihepatectomy,77 of left hemihepatectomy,57 of left lateral lobe hepatectomy,27 of central hepatectomy,376 underwent nonanatomical hepatectomy including 344 of partial hepatectomy,17 of extended right hemihepatectomy,15 of extended left hemihepatectomy.Volume of intraoperative blood loss was 400 mL (range,200-500 mL) in the 789 patients and 173 had intraoperative blood transfusion.Of the 789 patients,240 had postoperative complications (68 with postoperative severe complications),including 65 of liver insufficiency,37 of ascites and pleural effusion,37 of pulmonary complications,19 of infectious complications,17 of cardiovascular complications,17 of abdominal hemorrhage,11 of gastrointestinal complications,9 of neruologic complications,8 of postoperative bile leakage,10 of other complications,11 of death;the same patient can merge multiple complications.The 229 survival patients with complications were cured by symptomatic supportive treatment.Duration of postoperative hospital stay was 9 days (range,7-11 days).(2) Postoperative pathological examinations.Results of postoperative pathological examinations showed 17 patients with bile duct tumor thrombus,92 with naked eye tumor thrombus at portal vein branches and 167 with microvascular invasion.Of the 789 patients,High-,moderate-,low-differentiated carcinoma were detected in 19,678,92 patients,respectively.(3) Follow-up and survival situations:690 of the 789 patients were followed up for 1-96 months,with a median time of 21 months.The l,3,5-year overall survival rates were 82.1%,66.1%,59.2% in the 789 patients.(4) Prognostic factors analysis:results of univariate analysis showed that level of preoperative alphafetoprotein (AFP),Child grade of preoperative liver function,Barcelona clinic liver cancer staging,tumor diameter,surgical procedure of hepatectomy,volume of intraoperative blood loss,intraoperative blood transfusion,postoperative complications,postoperative severe complications,bile duct tumor thrombus,portal vein tumor thrombus,vascular invasion were related factors affecting prognosis of HCC patients after hepatectomy (x2 =8.603,8.864,39.970,28.978,6.376,26.144,8.955,6.596,9.910,7.288,37.566,19.183,P<0.05).Results of multivariate analysis showed that tumor diameter,volume of intraoperative blood loss,portal vein tumor thrombus were independent factors affecting prognosis of HCC patients after hepatectomy (hazard ratio =1.085,1.000,2.259,95% confidence interval:1.053-1.118,1.000-1.001,1.621-3.146,P<0.05).Conclusion Hepatectomy for HCC has a good safety,with satisfactory clinical efficacy.Tumor diameter,volume of intraoperative blood loss,portal vein tumor thrombus are independent factors affecting prognosis of HCC patients after hepatectomy.
		                        		
		                        		
		                        		
		                        	
10.Extrahepatic bile duct resection in patients with hepatocellular carcinoma with bile duct tumor thrombi
Aixiang LIU ; Haiqing WANG ; Wentao BO ; Xielin FENG ; Lang TIAN ; Hui ZHANG ; Mingyi ZHANG ; Yong HU
Chinese Journal of Hepatobiliary Surgery 2018;24(6):395-399
		                        		
		                        			
		                        			Objective To review the role of extrahepatic bile duct resection in patients with hepatocellular carcinoma with bile duct tumor thrombi.Methods The Pubmed,Wan Fang and China Science and Technology Journal Database were reviewed systematically.Any case reports or studies involving treatment of hepatocellular carcinoma with bile duct tumor thrombi were included in this literature search.Two authors independently assessed the studies for inclusion and extracted the data.Univariate analysis was used to compare the baseline characteristics and the Kaplan-Meier method was used for analyzing survival and diseasefree survival outcomes.Results Using predetermined inclusion criteria,16 studies which included 170 patients entered into this study.All these patients underwent surgical resection of hepatocellular carcinoma and bile duct tumor thrombi.Based on the Satoh classification,45 patients were type Ⅰ,107 patients type Ⅱ and 18 patients type Ⅲ.Twenty-four patients underwent liver resection combined with extrahepatic bile duct resection.The remaining 146 patients underwent liver resection combined with thrombectomy.The 1-,3-,and 5-year survival rates of all the patients were 73.4%,41.5% and 21.8%,and the corresponding recurrences free survival rates were 62.5%,29.2% and 13.1%,respectively.On Kaplan-Meier analysis,there were no significant differences in the survival outcomes between the 2 groups of patients,(P > 0.05).The 1-,3-,and 5-year survival rates of the extrahepatic bile duct resection group were 66.7%,41.7% and 12.5%,and those of the thrombectomy group were 74.6%,41.3% and 23.8%,respectively.On subgroup analysis (Satoh type Ⅱ and Ⅲ),no significant differences were observed between the two groups (P >0.05).The 1-,3-,and 5-year survival rates of the extrahepatic bile duct resection group were 65.2%,38.0% and 13.0%,and those of the thrombectomy group were 72.8%,39.5% and 20.9%,respectively.Conclusion Extrahepatic bile duct resection did not improve the overall survival of patients with hepatocellular carcinoma with bile duct tumor thrombi.
		                        		
		                        		
		                        		
		                        	
            
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