1.Association between the magnitude of systolic blood pressure reduction after successful endovascular thrombectomy with outcomes and post-procedure symptomatic intracranial hemorrhage in acute large vessel occlusion stroke patients
Xianjun HUANG ; Hao WANG ; Junfeng XU ; Xianhui DING ; Yapeng GUO ; Xiangjun XU ; Ke YANG ; Qian YANG ; Zhiming ZHOU
Chinese Journal of Cerebrovascular Diseases 2024;21(3):145-155
Objective To explore the association of the magnitude of systolic blood pressure reduction(SBPr)with post-procedure 24 h symptomatic intracranial hemorrhage(sICH)and 90-day clinical outcomes in patients with successful endovascular thrombectomy(EVT).Methods Consecutively registered patients with EVT caused by anterior circulation large vessel occlusion stroke(LVOS)in the First Affiliated Hospital of Wannan Medical College(Yijishan Hospital)between July 2015 and April 2023 and patients with successful reperfusion were analyzed.Demographic data,medical history(hypertension,diabetes),the trial of Org 10172 in acute stroke treatment(TOAST)classification,the baseline National Institutes of Health Stroke Scale(NIHSS)score and the baseline Alberta stroke early CT(ASPECT)score of patients were collected.And procedure related parameters(including time from onset to puncture,time from onset to reperfusion,occluded site[internal carotid artery,M1 segment of middle cerebral artery,M2 segment of middle cerebral artery],collateral circulation status[determined based on preoperative occluded angiography showing the range of collateral circulation in the occluded vessel area,defined as good collateral circulation with a reflux range of ≥ 50%and poor collateral circulation with a reflux range of<50%]),immediate postoperative reperfusion status(evaluated using the modified thrombolysis for cerebral infarction[mTICI]grading,successful reperfusion defined as mTICI grading of 2b-3),24 hours sICH,and 90 days clinical outcomes(evaluated using the modified Rankin scale score at 90days after EVT,with a score ≤ 2indicating a good prognosis and a score>2indicating a poor prognosis).SBPr was defined as(baseline SBP-mean SBP)/baseline SBP x 100%.According to the the magnitude of SBPr,SBPr is divided into 5 categories(<-10%,-10%-10%,>10%-20%,>20%-30%and>30%).Based on the clinical outcomes at 90 days and the occurrence of sICH at 24 hours after EVT,patients were divided into a good prognosis group and a poor prognosis group,as well as an sICH group and a non-sICH group.The relationship between SBPr and postoperative 90 days clinical prognosis or sICH was analyzed using a binary Logistic regression model.Subgroup analysis was conducted based on a history of hypertension(yes and no),continuous intravenous hypotensive therapy(yes and no),baseline ASPECT scores(3-5 and 6-10),and collateral circulation status(good and bad).Using a restricted cubic plot to depict the relationship between SBPr and sICH and clinical prognosis at 90days.Results(1)In total,731 patients were included.The median age was 71(62,77)years and 424(58.0%)were men.The median baseline NIHSS score was 14(12,18),the median baseline ASPECT was 9(7,10),405(55.4%)patients achieved 90-day modified Rankin scale score 0-2,and 35 patients(4.8%)developed sICH.(2)Multivariate analysis showed that the older age(OR,1.036,95%CI 1.017-1.056),the higher baseline NIHSS score(OR,1.095,95%CI1.049-1.144),the lower baseline ASPECT score(OR,0.704,95%CI 0.636-0.780),diabetes(OR,1.729,95%CI 1.084-2.758),bad collateral circulation(good collateral circulation vs.bad collateral circulation,OR,0.481,95%CI 0.332-0.696)and SBPr>30%(SBPr-10%-10%as a reference,OR,2.238,95%CI 1.230-4.071),the higher the risk of poor clinical outcomes at 90 days(all P<0.05).Continuous intravenous hypotensive therapy is a risk factor for postoperative 24 h sICH(OR,2.278,95%CI 1.047-4.953;P=0.038),while SBPr 20%-30%is associated with a lower risk of postoperative 24 h sICH(SBPr-10%-10%as a reference,OR,0.362,95%CI0.131-0.998;P=0.049).(3)The restrictive cube plot shows that there is a U-shaped relationship between SBPr after EVT and poor clinical outcomes at 90 days,while there is a nearly linear relationship with the occurrence of sICH.The more SBP reduction,the lower the incidence of sICH.(4)In the subgroup analyses,in the non-hypertension history and the good collateral circulation group,SBPr>30%has a higher risk of poor clinical outcomes compared to SBPr-10%-10%(OR and 95%CI were 2.921[1.000-8.528]and 2.363[1.078-5.183],respectively,with P=0.05 or P<0.05);After EVT,the group receiving continuous intravenous hypotensive therapy and the baseline ASPECT score 6-10 groups showed a significant correlation between SBPr>30%and poor clinical outcomes at 90 days(SBPr-10%-10%as a reference,OR and 95%CI were 2.646[1.168-5.993]and 2.481[1.360-4.527],respectively,with P<0.05).The correlation between SBPr and lower incidence of sICH was only found in the subgroup of poor collateral circulation(SBPr-10%-10%as a reference,SBPr>20%-30%:OR,0.133,95%CI 0.027-0.652;SBPr>30%:OR,0.104,95%CI 0.013-0.864;all P<0.05).Conclusions Among patients who achieved successful reperfusion with EVT,SBPr might be related to a worse functional outcome at 90 days and sICH 24 h after operation.However,the relationship may exhibit significant heterogeneity across different subgroups.Baseline ASPECT score,history of hypertension,collateral circulation,and the use of continuous venous hypertension after EVT have been highlighted in individualized blood pressure management after EVT.
2.Epidemic characteristics of female breast cancer in cancer registration areas of Gansu province in 2019 and trend analysis from 2010 to 2019
Haiyan YIN ; Zhiming CHUN ; Qiaojun MA ; Han CHENG ; Gaoheng DING ; Haiyan ZHANG ; Yuqin LIU
Practical Oncology Journal 2024;38(3):141-148
Objective The objective of this study was to analyze the incidence and mortality of female breast cancer in canc-er registration areas of Gansu province in 2019 and the change trend of female breast cancer incidence and mortality from 2010 to 2019,so as to provide data support for the prevention and treatment of breast cancer.Methods The incidence and mortality data of breast cancer and related demographic data in all cancer registration areas in Gansu province from 2010 to 2019 were collected.The incidence,mortality,age-standardized incidence by Chinese standard population(ASIRC),age-standardized mortality by Chinese standard population(ASMRC),age-standardized incidence by World standard population(ASIRW)and age-standardized mortality by World standard population(ASMRW),cumulative incidence and other key indicators of female breast cancer in each cancer registra-tion area were calculated according to urban and rural distribution and age groups.Joinpoint linear regression was used to analyze the annual change trend of incidence and mortality of female breast cancer in cancer registration areas in Gansu province from 2010 to 2019.Results In 2019,the number of new cases from female breast cancer in the cancer registration areas of Gansu province was 1,502 cases,accounting for 13.14%of all new malignant tumors in women.The incidence was 33.00/100,000,ASIRC and ASIRW were 23.83/100,000 and 23.81/100,000,respectively,and a cumulative rate of 0-74 years old was 2.34%.The incidence of breast cancer in urban and rural areas was 22.25/100,000 and 26.59/100,000,respectively.In 2019,the number of female breast cancer deaths in the cancer registration areas of Gansu province was 254,accounting for 5.61%of all female malignant tumor deaths.The crude mortality was 5.58/100,000,ASMRC and ASMRW were 3.70/100,000 and 3.90/100,000,respectively.The cumulative rate of 0-74 years old was 0.39%.The ASMRC of breast cancer in urban and rural areas was 3.63/100,000 and 3.79/100,000,respec-tively.The annual change trend in the ASIRC of female breast cancer in the province from 2010 to 2019 was not statistically significant(APC=-0.35%,P=0.81),while ASMRC decreased by an average of 9.85%per year(APC=-9.85%,P=0.03).Conclusion Breast cancer is a high incidence malignant tumor that threatens the physical and mental health of female residents in Gansu province,and it is a kind of cancer that women focus on.We should actively screen the risk group of women.
3.Influencing factor of acute multivessel occlusion and its impact on prognosis of acute large vessel occlusion stroke patients after successful recanalization of endovascular treatment
Yuepei GAO ; Chenglei WANG ; Yapeng GUO ; Junfeng XU ; Xianhui DING ; Xiangjun XU ; Ke YANG ; Qian YANG ; Xianjun HUANG ; Zhiming ZHOU
Chinese Journal of Cerebrovascular Diseases 2024;21(11):767-777
Objective To investigate the influencing factors for acute multiple vessels occlusion(MVO)and its impact on the prognosis of patients with anterior circulation acute large vessel occlusion stroke(ALVOS)who achieved successful recanalization after endovascular treatment(EVT).Methods Patients with anterior circulation ALVOS who received successful EVT at the Yijishan Hospital of Wannan Medical College between July 2015 and April 2023 were retrospectively analyzed.Baseline data,including age,sex,onset-to-puncture time(OTP),onset-to-recanalization time(OTR),medical history(including atrial fibrillation,diabetes,hypertension),alcohol and smoking history,admission blood pressure(systolic and diastolic),Alberta stroke program early CT score(ASPECTS),National Institutes of Health stroke scale(NIHSS)score,trial of Org 10172 in acute stroke treatment(TOAST)classification(atherosclerotic type,cardioembolic type,and other etiology types),and 90-day modified Rankin scale(mRS)score were collected.Collateral circulation was assessed based on the degree of contrast agent reflux observed in the occluded arterial supply area during delayed DSA,and patients were classified into poor and good collateral circulation groups.Malignant cerebral edema was defined as a midline shift of ≥5 mm on the follow-up CT scan performed on day 3 post-surgery.The primary endpoint(efficacy indicator)was the 90-day mRS score,with mRS score≤ 2 considered as a good prognosis and mRS score>2 considered as a poor prognosis.The secondary endpoint(safety indicator)was the 90-day mortality rate.All patients were divided into MVO and non-MVO groups based on whether they had single or multiple intracranial vessel occlusions.Acute MVO was defined as the detection of acute occlusion of other large or medium vessels,in addition to the main vessels(internal carotid artery or M1/M2 segments of the middle crebral artery[MCA]),in CT angiography,MR angiography,or DSA,resulting in ischemia in brain regions distinct from the main occlusion area.Factors that showed statistically significant differences in univariate analysis were further analyzed using multivariate Logistic regression to identify the risk factors for the occurrence of acute MVO and the factors associated with the prognosis of ALVOS patients.Results A total of 846 patients with ALVOS were included,with ages ranging from 26 to 94 years(mean age[69±11]years).The proportion of male patients was 57.2%(484/846).The median admission ASPECTS was 8(7,9)and the median admission NIHSS score was 14(12,18).The incidence of malignant cerebral edema at 3 days post-surgery was 13.4%(112/835),and the 90-day mortality rate was 19.1%(162/846).(1)Among the 846 ALVOS patients,810(95.7%)were in the non-MVO group and 36(4.3%)were in the MVO group.Univariate analysis showed significant differences between the MVO and non-MVO groups in terms of atrial fibrillation,malignant cerebral edema,admission ASPECTS,admission NIHSS scores,TOAST classification,collateral circulation,rate of complete recanalization,and 90-day poor prognosis rate(all P<0.05).However,there was no statistically significant difference in 90-day mortality between the two groups(P=0.193).Multivariate Logistic regression analysis showed that TOAST classification of cardioembolic type(OR,16.089,95%CI 1.835-141.061,P=0.012)and other etiology types(OR,9.768,95%CI 1.078-88.540,P=0.043)were associated with the occurrence of MVO.(2)Among the 846 ALVOS patients,445 had a good prognosis at 90days,and 401 had a poor prognosis.Univariate analysis showed that,compared to the good prognosis group,the poor prognosis group had a lower proportion of males and smokers,and a higher proportion of patients with older age,higher baseline systolic blood pressure,hypertension,diabetes,and atrial fibrillation(all P<0.01).Additionally,the poor prognosis group had higher admission NIHSS scores(P<0.01),lower admission ASPECTS,lower rates of good collateral circulation and complete recanalization,higher rates of malignant cerebral edema and MVO,and statistically significant differences in TOAST classification distribution(all P<0.01).Multivariate Logistic regression analysis showed that MVO was associated with poor 90-day prognosis in ALVOS patients after EVT(OR,3.368,95%CI 1.149-9.878,P=0.027).Furthermore,older age(OR,1.045,95%CI 1.025-1.066),diabetes(OR,1.719,95%CI 1.080-2.734),higher baseline systolic blood pressure(OR,1.012,95%CI 1.004-1.019),lower admission ASPECTS(OR,0.746,95%CI 0.674-0.826),higher admission NIHSS score(OR,1.115,95%CI 1.070-1.162),without immediate postoperative complete recanalization(OR,0.413,95%CI 0.290-0.592),poor collateral circulation(OR,0.594,95%CI 0.415-0.851),and malignant cerebral edema(OR,6.191,95%CI 3.026-12.670)were all associated with poor 90-day prognosis after EVT in ALVOS patients(all P<0.05).Conclusions The TOAST classification of cardioembolic type and other etiology types is associated with MVO.MVO is a risk factor for poor outcomes after successful EVT in ALVOS patients.
4.Efficacy and safety of mitoxantrone hydrochloride liposome injection in treatment of peripheral T-cell lymphomas: a multicenter, non-interventional, ambispective cohort, real-world study (MOMENT)
Huiqiang HUANG ; Zhiming LI ; Lihong LIU ; Liang HUANG ; Jie JIN ; Hongyan TONG ; Hui ZHOU ; Zengjun LI ; Zhenqian HUANG ; Wenbin QIAN ; Kaiyang DING ; Quande LIN ; Ming HOU ; Yunhong HUANG ; Jingbo WANG ; Pengcheng HE ; Xiuhua SUN ; Xiaobo WANG ; Zunmin ZHU ; Yao LIU ; Jinhai REN ; Huijing WU ; Liling ZHANG ; Hao ZHANG ; Liangquan GENG ; Jian GE ; Ou BAI ; Liping SU ; Guangxun GAO ; Xin LI ; Yanli YANG ; Yijian CHEN ; Aichun LIU ; Xin WANG ; Yi WANG ; Liqun ZOU ; Xiaobing HUANG ; Dongping HUANG ; Shujuan WEN ; Donglu ZHAO ; Jun MA
Journal of Leukemia & Lymphoma 2023;32(8):457-464
Objective:To evaluate the efficacy and safety of mitoxantrone hydrochloride liposome injection in the treatment of peripheral T-cell lymphoma (PTCL) in a real-world setting.Methods:This was a real-world ambispective cohort study (MOMENT study) (Chinese clinical trial registry number: ChiCTR2200062067). Clinical data were collected from 198 patients who received mitoxantrone hydrochloride liposome injection as monotherapy or combination therapy at 37 hospitals from January 2022 to January 2023, including 166 patients in the retrospective cohort and 32 patients in the prospective cohort; 10 patients in the treatment-na?ve group and 188 patients in the relapsed/refractory group. Clinical characteristics, efficacy and adverse events were summarized, and the overall survival (OS) and progression-free survival (PFS) were analyzed.Results:All 198 patients were treated with mitoxantrone hydrochloride liposome injection for a median of 3 cycles (range 1-7 cycles); 28 cases were treated with mitoxantrone hydrochloride liposome injection as monotherapy, and 170 cases were treated with the combination regimen. Among 188 relapsed/refractory patients, 45 cases (23.9%) were in complete remission (CR), 82 cases (43.6%) were in partial remission (PR), and 28 cases (14.9%) were in disease stabilization (SD), and 33 cases (17.6%) were in disease progression (PD), with an objective remission rate (ORR) of 67.6% (127/188). Among 10 treatment-na?ve patients, 4 cases (40.0%) were in CR, 5 cases (50.0%) were in PR, and 1 case (10.0%) was in PD, with an ORR of 90.0% (9/10). The median follow-up time was 2.9 months (95% CI 2.4-3.7 months), and the median PFS and OS of patients in relapsed/refractory and treatment-na?ve groups were not reached. In relapsed/refractory patients, the difference in ORR between patients with different number of treatment lines of mitoxantrone hydrochloride liposome injection [ORR of the second-line, the third-line and ≥the forth-line treatment was 74.4% (67/90), 73.9% (34/46) and 50.0% (26/52)] was statistically significant ( P = 0.008). Of the 198 PTCL patients, 182 cases (91.9%) experienced at least 1 time of treatment-related adverse events, and the incidence rate of ≥grade 3 adverse events was 66.7% (132/198), which was mainly characterized by hematologic adverse events. The ≥ grade 3 hematologic adverse events mainly included decreased lymphocyte count, decreased neutrophil count, decreased white blood cell count, and anemia; non-hematologic adverse events were mostly grade 1-2, mainly including pigmentation disorders and upper respiratory tract infection. Conclusions:The use of mitoxantrone hydrochloride liposome injection-containing regimen in the treatment of PTCL has definite efficacy and is well tolerated, and it is a new therapeutic option for PTCL patients.
5.Identification of critical radioresistance genes in esophageal squamous cell carcinoma by whole exome sequencing
Zhiming CHEN ; Junjie CHEN ; Li LI ; Qian DING ; Yunan HAN ; Hongyu ZHAO
Journal of International Oncology 2023;50(10):592-599
Objective:To compare the genetic spectrums of esophageal squamous cell carcinoma (ESCC) patients with different prognosis after postoperative radiotherapy and to screen the genetic variants associated with radiotherapy resistance.Methods:A total of 32 ESCC patients who received radical surgery and postoperative adjuvant radiotherapy in Affiliated Hospital of Nantong University from January 2015 to December 2019 were selected as the study objects. According to whether there was any recurrence in the radiation field within 1 year, they were divided into a recurrence group (radiotherapy resistance group, n=16) and a stable group (radiotherapy sensitive group, n=16). Genomic DNA was extracted from patients and high-throughput sequencing was performed using whole exome sequencing (WES) technology. Biological information analysis software Trimmomatic, BWA and Picard were used to process the data and the alignment files were obtained by GATK comparison, then Vardict software was used to screen out various genetic variants from the sequencing data. The disease free survival (DFS) and overall survival (OS) were estimated by Kaplan-Meier method. Cox proportional hazard regression model was used to analyze the independent risk factors of DFS and OS of ESCC patients. Results:After quality control of the sample data, 26 patients were finally included in this study for follow-up analysis, 13 in each of the recurrence and stable groups. The median tumor mutation burden of non-silent tumors in the whole group was 0.95 mutations/Mb. The substitution types of mutant bases were mainly C>T conversion, followed by C>G transmutation. The genetic variants with the highest frequency were single nucleotide polymorphism (SNP) (75.1%), deletion mutation (13.7%) and insertion mutation (10.5%). The number of tumor-specific mutations in the recurrence group was slightly higher than that in the stable group (median mutation number was 36 and 34, respectively), and the top ten gene profiles of mutation frequency were significantly different between the two groups. In the recurrence group, 392 unique mutated genes were detected, and the top five were MUC19, NPIPA5, EPPK1, FLG and FOXG1. In the stable group, 192 unique mutation genes were detected, and the top five were TCHH, WNK1, AIM1L, COL6A5 and DPCR1. The median DFS and OS were 15.0 months (95% CI: 10.1 months-not reached) and 26.2 months (95% CI: 19.8 months-not reached) in the recurrence group respectively, and no recurrence or metastasis occurred in the stable group. Univariate analysis showed that GRIK2 ( χ2=6.81, P=0.009), MUC4 ( χ2=4.25, P=0.039), MUC5B ( χ2=4.03, P=0.045), PRRG1 ( χ2=5.15, P=0.023) gene mutations, 3p deletion ( χ2=4.16, P=0.041) and 14q deletion ( χ2=7.09, P=0.008) were correlated with DFS. FLG ( χ2=6.41, P=0.011), NPIPA5 ( χ2=4.57, P=0.033), PKD1L2 ( χ2=6.41, P=0.011), FOXG1 ( χ2=4.57, P=0.033) gene mutations, 3p deletion ( χ2=3.88, P=0.049), 14q deletion ( χ2=5.66, P=0.017) and 18p deletion ( χ2=3.85, P=0.050) were associated with OS. Multivariate analysis showed that 14q deletion ( HR=3.65, 95% CI: 1.18-11.32, P=0.025) was an independent risk factor for DFS of ESCC patients with postoperative adjuvant radiotherapy, and FLG ( HR=8.94, 95% CI: 1.52-52.74, P=0.016), NPIPA5 ( HR=6.36, 95% CI: 1.23-33.03, P=0.028) gene mutation and 14q deletion ( HR=3.82, 95% CI: 1.18-12.31, P=0.025) were independent risk factors for OS of ESCC patients with postoperative adjuvant radiotherapy. Conclusion:The WES results suggest that the types and rates of gene mutations of the ESCC patients with postoperative adjuvant radiotherapy in the recurrence and stable groups are basically the same, but the mutation spectrum of the two groups is significantly different. FLG, NPIPA5 gene mutations and 14q deletion can be used as molecular markers to predict the prognosis of ESCC patients treated with postoperative adjuvant radiotherapy.
6.Clinical guideline for spinal reconstruction of osteoporotic thoracolumbar fracture in elderly patients (version 2022)
Tao SUI ; Jian CHEN ; Zhenfei HUANG ; Zhiyi HU ; Weihua CAI ; Lipeng YU ; Xiaojian CAO ; Wei ZHOU ; Qingqing LI ; Jin FAN ; Qian WANG ; Pengyu TANG ; Shujie ZHAO ; Lin CHEN ; Zhiming CUI ; Wenyuan DING ; Shiqing FENG ; Xinmin FENG ; Yanzheng GAO ; Baorong HE ; Jianzhong HUO ; Haijun LI ; Jun LIU ; Fei LUO ; Chao MA ; Zhijun QIAO ; Qiang WANG ; Shouguo WANG ; Xiaotao WU ; Nanwei XU ; Jinglong YAN ; Zhaoming YE ; Feng YUAN ; Jishan YUAN ; Jie ZHAO ; Xiaozhong ZHOU ; Mengyuan WU ; Yongxin REN ; Guoyong YIN
Chinese Journal of Trauma 2022;38(12):1057-1066
Osteoporotic thoracolumbar fracture in the elderly will seriously reduce their quality of life and life expectancy. For osteoporotic thoracolumbar fracture in the elderly, spinal reconstruction is necessary, which should comprehensively consider factors such as the physical condition, fracture type, clinical characteristics and osteoporosis degree. While there lacks relevant clinical norms or guidelines on selection of spinal reconstruction strategies. In order to standardize the concept of spinal reconstruction for osteoporotic thoracolumbar fracture in the elderly, based on the principles of scientificity, practicality and progressiveness, the authors formulated the Clinical guideline for spinal reconstruction of osteoporotic thoracolumbar fracture in elderly patients ( version 2022), in which suggestions based on evidence of evidence-based medicine were put forward upon 10 important issues related to the fracture classification, non-operative treatment strategies and surgical treatment strategies in spinal reconstruction after osteoporosis thoracolumbar fracture in the elderly, hoping to provide a reference for clinical treatment.
7.Long non‑coding RNA Linc‑pint mediates the progression of colorectal cancer by regulating miRNA‑21
Mengcheng LI ; Chengsheng DING ; Liguo LIU ; Zezhi SHAN ; Zhiming JIN
Shanghai Journal of Preventive Medicine 2022;34(8):728-735
ObjectiveTo investigate the biological function and molecular mechanism of long non-coding RNA Linc‑pint in colorectal cancer. MethodsQuantitative real‑time quantitative (qRT‑PCR) was performed to detect the expression level of Linc‑pint in 31 pairs of colorectal cancer tumor and adjacent normal tissues; correlation between the expression level of Linc‑pint and the clinicopathological characteristics was analyzed by the chi‑square test. Kaplan-Meier survival analysis was used to assess the relationship between Linc‑pint expression level and the prognosis of patients. Cox regression model was used to analyze the relationship between clinicopathological characteristics and the prognosis of patients. Expression level of Linc‑pint were detected by qRT‑PCR in 5 common colorectal cancer cell lines. Effect of Linc‑pint on cell proliferation, invasion and migration was measured by cell counting kit‑8 assay, Transwell assay and harvested xenografts from nude mice. qRT‑PCR was performed to detect the expression level of Linc‑pint's target gene micro RNA(miR)‑21 in 31 pairs of colorectal cancer tumor tissues and adjacent normal tissues. Pearson correlation coefficient was used to assess the correlation between Linc‑pint and miR‑21. qRT‑PCR was used to detect the expression of overexpression of Linc‑pint on miR‑21 in colorectal cancer cells. ResultsExpression level of Linc‑pint in normal tissues (3.95±1.16) was significantly higher than that in colorectal cancer tissues (2.74±0.95) (t=6.17, P<0.05). Overall survival rate of patients with high expression of Linc‑pint was 62.5%, which was significantly higher than that of patients with low expression of Linc‑pint (34.3%, P<0.05). The proliferation, invasion and migration of CRC cells were inhibited after overexpression of Linc‑pint. In colorectal cancer tumor and adjacent normal tissues, Linc‑pint and miR‑21 showed opposite expression in tumor tissues and were negatively correlated (r=-0.288 and -0.908, both P<0.05). ConclusionLinc‑pint acts as a tumor suppressor by down‑regulating the expression level of miR‑21 to inhibit the proliferation, invasion and migration of colorectal cancer.
8.Clinical features and outcomes of newly diagnosed follicular lymphoma concurrent with diffuse large B-cell lymphoma component
Zhijuan LIN ; Jie ZHA ; Shuhua YI ; Zhifeng LI ; Lingyan PING ; Xiaohua HE ; Haifeng YU ; Zhong ZHENG ; Wei XU ; Feili CHEN ; Ying XIE ; Biyun CHEN ; Huilai ZHANG ; Li WANG ; Kaiyang DING ; Wenyu LI ; Haiyan YANG ; Weili ZHAO ; Lugui QIU ; Zhiming LI ; Yuqin SONG ; Bing XU
Chinese Journal of Hematology 2022;43(6):456-462
Objective:To explore the clinical features and survival of newly diagnosed follicular lymphoma (FL) patients with diffuse large B-cell lymphoma (DLBCL) component.Methods:1845 newly diagnosed FL patients aged ≥ 18 years with grades 1-3a in 11 medical centers in China from 2000 to 2020 were included, and patients with DLBCL component were screened. The clinical data and survival data of the patients were retrospectively analyzed, and the prognostic factors were screened by univariate and multivariate analysis.Results:146 patients (7.9% ) with newly diagnosed FL had DLBCL component. The median age was 56 (25-83) years, 79 males (54.1% ) . The pathology of 127 patients showed the proportion of DLBCL component. Patients were divided into two groups according to whether the proportion of DLBCL component was ≥ 50% . The study found that patients with DLBCL component ≥ 50% had higher grade 3 ratio (94.3% vs 91.9% , P=0.010) , Ki-67 index ≥ 70% ratio (58.5% vs 32.9% , P=0.013) and PET-CT SUVmax ≥ 13 ratio (72.4% vs 46.3% , P=0.030) than patients with DLBCL component<50% . All patients received CHOP or CHOP like ± rituximab chemotherapy. The overall response rate (ORR) was 88.2% , and the complete response (CR) rate was 76.4% . In the groups with different proportions of DLBCL component, there was no significant difference in the remission rate after induction treatment and the incidence of disease progression within 2 years after initiation of treatment (POD24) ( P<0.05) . The overall estimated 5-year progression free survival (PFS) rate was 58.9% , and the 5-year overall survival (OS) rate was 90.4% . The 5-year OS rate of POD24 patients was lower than that of non POD24 patients (70.3% vs 98.5% , P<0.001) . Compared with non maintenance treatment of rituximab, maintenance treatment of rituximab could not benefit the 5-year PFS rate (57.7% vs 58.8% , P=0.543) , and the 5-year OS rate had a benefit trend, but the difference was not statistically significant (100% vs 87.8% , P=0.082) . Multivariate analysis showed that failure to reach CR after induction treatment was an independent risk factor for PFS ( P=0.006) , while LDH higher than normal was an independent risk factor for OS ( P=0.031) . Conclusion:FL patients with DLBCL component ≥50% have more invasive clinical and pathological features. CHOP/CHOP like ± rituximab regimen can improve the clinical efficacy of patients. Rituximab maintenance therapy can not benefit the PFS and OS of patients. Failure to reach CR after induction therapy was the independent unfavorable factor for PFS.
9.The key points of development trend and clinical practice of global donation after cardiac death
Xiaoliang WU ; Gang CHEN ; Donghua ZHENG ; Zhiming DING ; Wenshi JIANG
Organ Transplantation 2020;11(1):93-
Organ transplantation has brought hope for healing of patients with end-stage organ failure. However, the shortage of human organs has become one of the important factors that severely restrict the development of human organ transplantation. Donation after cardiac death (DCD) is a safe way to expand the source of donors. While trying to make extensive effort to increase the quantity of donation after brain death (DBD), countries attempt to grasp the opportunity of DCD when conditions permit. In this article, the historical background and global development trend of DCD, fundamental conditions for the implementation of controllable DCD, key issues and ethical review in the practice of controllable DCD were discussed.
10.Children pertussis IgG antibody levels analysis
Fang LIU ; Xiaoben WU ; Tingting HOU ; Yixiao YIN ; Jie DING ; Miao YU ; Zhiming LU
International Journal of Laboratory Medicine 2018;39(3):319-321
Objective In order to know the changes of serum pertussis IgG antibody level and the percent-age of white blood cells and lymphocytes in blood routine of children with IgG antibody positive,it is easy to diagnose and treat according to the clinical symptoms and examination results of children.Methods 485 cases of children in Shangdong Provincial Hospital were randomly enrolled as the test subjects,and pertussis anti-body IgG(PT -IgG)detection and blood cell detection were carried out.Results The levels of Pertussis IgG antibody were positive in 90 cases,the positive rate was 18.6%,pertussis IgG antibody level of children aged 8- <10 years old was the highest,2- <4 years old took the second place,10-14 years old were with the low-est levels.Among the patients with positive pertussis antibody levels,white blood cells in total were more than 20×109/L and lymphocyte percentage reached more than 60% in 19 cases,the positive rate was 21.1%,of which 6- <8 years old the highest positive rate was 10-14,the lowest.Conclusion IgG antibody of pertussis incidence is higher in children under 10 years old,the changes of white blood cells and lymphocytes mainly in children under the age of 8,the general course of the disease can be up to 2-3 months,so the need for early diagnosis and treatment,strengthen the immunity of pertussis vaccine is very necessary for children.

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