1.Intravenous Tenecteplase for Acute Ischemic Stroke Within 4.5–24 Hours of Onset (ROSE-TNK): A Phase 2, Randomized, Multicenter Study
Lu WANG ; Ying-Jie DAI ; Yu CUI ; Hong ZHANG ; Chang-Hao JIANG ; Ying-Jie DUAN ; Yong ZHAO ; Ye-Fang FENG ; Shi-Mei GENG ; Zai-Hui ZHANG ; Jiang LU ; Ping ZHANG ; Li-Wei ZHAO ; Hang ZHAO ; Yu-Tong MA ; Cheng-Guang SONG ; Yi ZHANG ; Hui-Sheng CHEN
Journal of Stroke 2023;25(3):371-377
Background:
and Purpose Intravenous tenecteplase (TNK) efficacy has not been well demonstrated in acute ischemic stroke (AIS) beyond 4.5 hours after onset. This study aimed to determine the effect of intravenous TNK for AIS within 4.5 to 24 hours of onset.
Methods:
In this pilot trial, eligible AIS patients with diffusion-weighted imaging (DWI)-fluid attenuated inversion recovery (FLAIR) mismatch were randomly allocated to intravenous TNK (0.25 mg/kg) or standard care within 4.5–24 hours of onset. The primary endpoint was excellent functional outcome at 90 days (modified Rankin Scale [mRS] score of 0–1). The primary safety endpoint was symptomatic intracranial hemorrhage (sICH).
Results:
Of the randomly assigned 80 patients, the primary endpoint occurred in 52.5% (21/40) of TNK group and 50.0% (20/40) of control group, with no significant difference (unadjusted odds ratio, 1.11; 95% confidence interval 0.46–2.66; P=0.82). More early neurological improvement occurred in TNK group than in control group (11 vs. 3, P=0.03), but no significant differences were found in other secondary endpoints, such as mRS 0–2 at 90 days, shift analysis of mRS at 90 days, and change in National Institutes of Health Stroke Scale score at 24 hours and 7 days. There were no cases of sICH in this trial; however, asymptomatic intracranial hemorrhage occurred in 3 of the 40 patients (7.5%) in the TNK group.
Conclusion
This phase 2, randomized, multicenter study suggests that intravenous TNK within 4.5–24 hours of onset may be safe and feasible in AIS patients with a DWI-FLAIR mismatch.
2.Age-Based Grouping Criteria in Medicine.
Acta Academiae Medicinae Sinicae 2023;45(2):285-289
Age,a basic marker of the population,is an indispensable demographic characteristic in medicine.However,the grouping in medicine according to age have problems such as inconsistent grouping criteria and ambiguous definition of age-related terms.Therefore,this article reviews the age-based grouping criteria and the application of related terms in medicine.
3.Research progress on chemical constituents and pharmacological activities of Potentilla.
Jia WU ; Zai-Qi ZHANG ; Huang-He YU ; Fei-Bing HUANG ; Zhu-Liang CHEN ; Ling-Ling CHU ; Bin LI ; Wei WANG
China Journal of Chinese Materia Medica 2022;47(6):1509-1538
There are 200-500 species of Potentilla(Rosaceae) worldwide, among which 90 species are widely distributed in China and have a long history of ethnic medicinal use. According to our statistics, a total of 367 compounds have been isolated and identified from plants of this genus, including terpenoids, flavonoids, phenolic acids, tannins, and phenylpropanoids. The medicinal materials made from these plants mainly have antioxidative, blood sugar-lowering, anti-inflammatory, anti-tumor, cardiovascular system-protecting, neuroprotective, and hepatoprotective activities. This study systematically reviews the research progress on chemical constituents and pharmacological activities of Potentilla plants to provide a basis for further research and clinical application.
Anti-Inflammatory Agents/pharmacology*
;
Antioxidants/pharmacology*
;
Drugs, Chinese Herbal/pharmacology*
;
Plant Extracts/pharmacology*
;
Potentilla
4.Prognostic values of stromal tumor-infiltrating lymphocytes and lymphocyte-activation gene-3 in advanced gastric adenocarcinoma.
Zhi Da WU ; Jian Chao WANG ; He Jun ZHANG ; Jie Qiong LIN ; Zai Zeng WU ; Xiong Wei ZHENG ; Gang CHEN
Chinese Journal of Pathology 2022;51(10):1007-1012
Objective: To analyze density of stromal tumor-infiltrating lymphocytes (sTIL) and expression of lymphocyte-activation gene-3 (LAG-3) protein in advanced gastric adenocarcinomas, and to investigate the correlation of sTIL and LAG-3 with the prognosis in patients with advanced gastric adenocarcinoma. Methods: The clinicopathological characteristics and follow-up data of 260 patients with advanced gastric adenocarcinoma were collected at Fujian Cancer Hospital, from January 2011 to December 2014. The percentage of sTILs was reported semi-quantitatively using histological section evaluation, the LAG-3 protein was detected using immunohistochemistry, and the expression was correlated with the clinicopathological features and patient outcomes. Results: Among the 260 cases, high density of sTIL was detected in 173 cases (66.5%) while LAG-3 high expression was observed in 160 cases (61.5%). These cases were divided into four groups. Group Ⅰ: 48 cases (18.5%) were sTIL low/LAG-3 low; group Ⅱ: 52 cases (20.0%) were sTIL high/LAG-3 low; group Ⅲ: 39 cases (15.0%) were sTIL low/LAG-3 high; group Ⅳ: 121 cases (46.5%) were sTIL high/LAG-3 high. Kaplan-Meier survival analyses showed that patient prognoses were related to age, tumor size, tumor location, Lauren classification, perineural invasion, vascular invasion, TNM staging, postoperative adjuvant chemotherapy and molecular classification (P<0.05). Meanwhile, higher densities of sTIL and higher expression of LAG-3 were associated with better prognosis. Multivariate survival analysis showed age, tumor size, Lauren classification and postoperative adjuvant chemotherapy were independent prognostic factors for patient survival. The results showed a poor prognosis in low-sTIL/low-LAG-3 patients. Conclusions: Compared with low density of sTIL and low expression of LAG-3, high density of sTIL and high expression of LAG-3 are associated with better outcomes in patients with advanced gastric adenocarcinoma, respectively. Combined detecton of sTIL and LAG-3 may be more useful in gastric cancer than using either alone. Age, tumor size, Lauren classification and postoperative adjuvant chemotherapy are independent prognostic factors for patients with advanced gastric adenocarcinoma.
Adenocarcinoma/pathology*
;
Humans
;
Immunohistochemistry
;
Lymphocytes, Tumor-Infiltrating/metabolism*
;
Neoplasm Staging
;
Prognosis
;
Retrospective Studies
;
Stomach Neoplasms/pathology*
5.Chemical constituents of Cassia occidentalis.
Zai ZHANG ; Shao-Wei NI ; Xue XU ; Wen-Zhong HUANG ; Shan-Shan WANG ; Hong ZHU ; Xue-Mei GAO
China Journal of Chinese Materia Medica 2021;46(15):3873-3876
Compounds(1-6) were isolated and identified from 90% ethanol extract of the stems and leaves of Cassia occidentalis through column chromatography with silica gel, ODS, and Sephadex LH-20. These compounds were identified as 7-hydroxy-5-(3-hydroxy-2-oxopropyl)-2-methyl-4H-chromen-4-one(1), saccharonol A(2), S-6-hydroxymullein(3), 2-methyl-5-acetonyl-7-hydroxy-chromone(4), 2-(2'-hydroxypropyl)-5-methyl-7-hydroxychromone(5) and 7,4'-dihydroxyflavone(6) based on their physicochemical and spectroscopic data. Among them, compound 1 was a new compound, and all the compounds were isolated from this plant for the first time. DPPH method was employed to determine the antioxidant activities of these compounds in vitro. Six compounds exhibited weak antioxidant activities.
Chromones
;
Plant Leaves
;
Senna Plant
;
Spectrum Analysis
6.Addition and Subtraction Therapy of Buyang Huanwutang Combined with Si Junzitang to Poststroke Fatigue and Antioxidant and Anti-inflammatory with Syndrome of Qi Deficiency and Blood Stasis
Yan-zhen WANG ; Wei-feng WANG ; Yu-lan AN ; Hui-fang ZHAO ; PENG ZHANG ; Zai-wei ZHANG ; Jun-qin ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2020;26(23):131-136
Objective:To evaluate effect of addition and subtraction therapy of Buyang Huanwutang combined with Si Junzitang and acupuncture to poststroke fatigue (PSF) and syndrome of Qi deficiency and blood stasis, at the same time we studied the antioxidant and anti-inflammatory effects. Method:One hundred and forty-four patients were randomly divided into control group and observation group (1∶1) by random number table. 66 patients in control group completed the therapy (4 patients were falling off or missing visit, 2 patients were eliminate), 67 patients in observation group completed the therapy (2 patients were falling off or missing visit, 3 patients were eliminate). In control group, patinets got acupuncture, 1 time/day, 6 times/week, they also got Geqi Tongmai grain, 10 g/time, 3 times/day. Patients in observation group got acupuncture (the same as which in control group), and addition and subtraction therapy of Buyang Huanwutang combined with Si Junzitang, 1 dose/day, and courses of treatment in two groups were 4 weeks. Before and after treatment, fatigue severity scale (FSS), NIH stroke scale (NIHSS), syndrome of Qi deficiency and blood stasis, stroke specific quality of life scale (SS-QOL), and scores of ability of daily life (ADL) were recorded. And levels of superoxide dismutase (SOD), malondialdehyde (MDA), glutathione peroxidase (GSH-Px), homocysteine (Hcy), interleukin-1
7.Secukinumab demonstrates high efficacy and a favorable safety profile over 52 weeks in Chinese patients with moderate to severe plaque psoriasis.
Lin CAI ; Jian-Zhong ZHANG ; Xu YAO ; Jun GU ; Quan-Zhong LIU ; Min ZHENG ; Shi-Fa ZHANG ; Jin-Hua XU ; Cheng-Xin LI ; Hao CHENG ; Qing GUO ; Wei-Li PAN ; Shen-Qiu LI ; Ruo-Yu LI ; Zai-Pei GUO ; Zhi-Qi SONG ; Shan-Shan LI ; Xiu-Qin DONG ; Linda WANG ; Rong FU ; Pascaline REGNAULT ; Pascal CHAREF ; Rafal MAZUR ; Manmath PATEKAR
Chinese Medical Journal 2020;133(22):2665-2673
BACKGROUND:
Psoriasis is a chronic inflammatory skin disease, affecting about 0.6% of the Chinese population. Many patients are not well controlled by conventional treatments, thus there is need for new treatment regimens. In this study, we assessed the efficacy and safety of secukinumab in Chinese patients with moderate to severe plaque psoriasis.
METHODS:
This study was a 52-week, multicentre, randomized, double-blind, placebo-controlled, parallel-group, Phase 3 trial. A sub-population of study participants (≥18 years) of Chinese ethnicity were randomized to receive subcutaneous injections of 300 or 150 mg secukinumab, or placebo. The co-primary endpoints were psoriasis area severity index (PASI) 75 and Investigator's Global Assessment (IGA) 0/1 at Week 12.
RESULTS:
A total of 441 Chinese patients were enrolled in this study. Co-primary outcomes were achieved; 300 and 150 mg secukinumab were superior to placebo as shown in the proportion of patients that achieved PASI 75 (97.7% and 87.2% vs. 3.7%, respectively; P < 0.001), and IGA 0/1 (82.3% and 69.7% vs. 2.7%; P < 0.001) at Week 12. Treatment efficacy was maintained until Week 52. There was no increase in overall adverse events with secukinumab relative to placebo throughout the 52-week period.
CONCLUSION:
Secukinumab is highly effective and well tolerated in Chinese patients with moderate to severe plaque psoriasis.
TRIAL REGISTRATION
ClinicalTrials.gov, NCT03066609; https://clinicaltrials.gov/ct2/show/record/NCT03066609.
Antibodies, Monoclonal/therapeutic use*
;
Antibodies, Monoclonal, Humanized
;
China
;
Double-Blind Method
;
Humans
;
Psoriasis/drug therapy*
;
Severity of Illness Index
;
Treatment Outcome
8.Analysis of special ehealth service for corona virus disease 2019 (COVID-19) pneumonia.
Wen FENG ; Liang Nan ZHANG ; Jing Yuan LI ; Tian WEI ; Ting Ting PENG ; Dong Xu ZHANG ; Zai Xin GUO ; Wei Song WANG
Journal of Peking University(Health Sciences) 2020;52(2):302-307
OBJECTIVE:
To analyze how governments, hospitals and information technology(IT) companies use Internet technology to provide online health services during the early stage of corona virus disease 2019 (COVID-19) epidemic in January 2020 in China, and then provide suggestions and coping strategies for the later stage and post-epidemic time.
METHODS:
We searched for information on ehealth services related to the outbreak of COVID-19 in China. The sources of information were mainstream search engines such as Baidu and the popular interactive social platforms such as Webchat. The keywords were "Internet+pneumonia", "Internet clinic", "pneumonia online clinic" and so on. The time of information was from January 20 to February 3, 2020. The key information was extracted and encoded by two persons back-to-back. The coding information included: name of organization provider, launching time, location of provider, service items, user, health workers engaging in the service, and so on. The coded information was entered and analyzed with SPSS 24.0 and Excel.
RESULTS:
There were totally 57 projects launched by local governments, hospitals and IT companies. Most of them were launched from January 24th to 27th, the hospital and government projects services regionally, especially in eastern provinces. In this study, 90.48% of the enterprises and 100.00% of the hospitals had online fever clinic and consultation services for COVID-19, 66.67% of the enterprises and 37.04% of the hospitals serviced derivative health problems. Only a few projects provided tele-medical consultation. There were individual projects that provided online health management for home quarantine people. Physicians were the main force of various projects. In some hospital projects, there were also nurses, pharmacists and professional technicians to provide featured consultation.
CONCLUSION
Ehealth is useful and helpful for the health care system to rapidly cope with health demand during instantaneous and post epidemic time. Regional distribution of ehealth is unbalanced. There are institutional and technical feasibilities for the emergency application of Internet technology. However, community health centers seldom provide ehealth or connect with tertiary hospitals with Internet. Therefore, all kinds of providers within healthcare system should promote emergence ehealth. Tele-medical diagnosis and referral should be developed by local governments during COVID-19. The application of "Internet+medical treatment" in community medical institutions and synergy among various institutions should be promoted.
Betacoronavirus
;
COVID-19
;
China
;
Coronavirus Infections
;
Humans
;
Pandemics
;
Pneumonia, Viral
;
SARS-CoV-2
;
Telemedicine
9.Application of apparent diffusion coefficient in children aged 2-12 years with intellectual disability/global developmental delay who have normal conventional brain MRI findings.
Lin LI ; Jian-She ZHAO ; Zai-Fen GAO ; Chang-You MA ; Chun-Hua DONG ; Hong-Wei ZHANG
Chinese Journal of Contemporary Pediatrics 2019;21(6):541-546
OBJECTIVE:
To study the value of fast spin-echo diffusion weighted imaging (TSE-DWI) apparent diffusion coefficient (ADC) in children aged 2-12 years with intellectual disability (ID)/global developmental delay (GDD) who have normal conventional brain MRI findings.
METHODS:
A total of 578 children with normal conventional brain MRI findings who met the diagnostic criteria for ID/GDD and 375 normal children were enrolled. Their imaging and clinical data were collected. All children underwent scanning with brain TSE-DWI sequence and routine sequence. ADC values of each brain region were compared between normal children with different ages, as well as between children with different degrees of ID/GDD in each age group. The influence of Adaptive Behavior Assessment System-II (ABAS-II) score on ADC values of each brain region was analyzed.
RESULTS:
For the normal children, the ADC values of the frontal and temporal white matter, the corpus callosum, the inner capsule, the centrum semiovale, the cerebellar dentate nucleus, the optic radiation, the thalamus, the lenticular nucleus, and the caudate nucleus gradually decreased with age (P<0.05). ADC values of the deep white matter, the shallow white matter, the deep gray matter nuclei, and the shallow gray matter increased with the increase in the degree of ID/GDD in the ID/GDD children aged 4-6 years (P<0.05). In the children with ID/GDD, the ADC values of the deep white matter, the shallow white matter, and the deep gray matter nuclei decreased with age (P<0.05). The ADC values of the children with ID/GDD decreased with the increase in ABAS-II score (P<0.05).
CONCLUSIONS
ADC can reflect the subtle structural changes of brain regions in children with ID/GDD who have normal conventional brain MRI findings. It may be associated with social adaptation. It can provide an objective basis for the quantitative diagnosis of ID/GDD in children.
Brain
;
Child
;
Child, Preschool
;
Diffusion Magnetic Resonance Imaging
;
Humans
;
Intellectual Disability
;
diagnostic imaging
;
Magnetic Resonance Imaging
;
White Matter
10.Statistical Prediction in Pathological Types of Chronic Kidney Disease.
Mei-Fang SONG ; Zong-Wei YI ; Xue-Jing ZHU ; Xue-Ling QU ; Chang WANG ; Zai-Qi ZHANG ; Lin SUN ; Fu-You LIU ; Yuan YANG
Chinese Medical Journal 2018;131(22):2741-2742

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