1.The efficacy of neoadjuvant therapy for esophageal cancer: A network meta-analysis
Xin GAO ; Shuolian WANG ; Shuai XU ; Wenwen MA ; Ziang XU ; Gawei HU ; Qingxin LI
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2024;31(07):1035-1042
Objective To explore the best neoadjuvant treatment strategy for esophageal cancer and provide a theoretical basis for clinical formulation of neoadjuvant treatment plan. Methods PubMed, EMbase, The Cochrane Library, Web of Science, CNKI, Wanfang, and VIP were searched from inception to May 2022. Two researchers independently performed literature screening and data extraction. The quality of the studies was evaluated by the Cochrane risk of bias tool, and data analysis was performed in RStudio environment using R3.6.3 software. Results A total of 24 studies were included, covering 5 286 patients treated with surgery alone, neoadjuvant chemotherapy (NCT), neoadjuvant radiotherapy (NRT), or neoadjuvant chemoradiotherapy (NCRT) followed by combined surgical treatment. The risk of bias of the studies was low. The results of the network meta-analysis showed that combined surgical treatments after NCRT [HR=0.77, 95%CI (0.70, 0.85)] and NCT [HR=0.89, 95%CI (0.81, 0.98)] were effective methods to improve patients' overall survival (OS) compared with surgery alone. In addition, NCRT could significantly reduce the incidence of local recurrence [OR=0.43, 95%CI (0.30, 0.58)] and distant metastasis [OR=0.71, 95%CI (0.52, 0.93)] in patients with esophageal cancer. However, NCRT [RR=1.30, 95%CI (0.77, 2.20)] increased the mortality rate of patients at 30 d after surgery. Conclusion The available evidence suggests that NCRT combined with surgery is the best option for treating patients with resectable esophageal cancer, but this treatment carries the risk of increased 30 d postoperative mortality. Future studies should focus on optimizing the NCRT regimen with the aim of improving patients’ OS while effectively reducing postoperative mortality. In addition, more high-quality randomized controlled trials are needed to support the results of the study.
2.Evaluation of a stent system based on "PETTICOAT" technique in distal aortic remodeling for type B aortic dissection: a multi-center "Matching" comparative study
Chengkai HU ; Jue YANG ; Wei WANG ; Xiangchen DAI ; Xinwu LU ; Youfei QI ; Hongpeng ZHANG ; Yuchong ZHANG ; Shouji QIU ; Genmao CAO ; Enci WANG ; Peng LIN ; Fandi MO ; Shiyi LI ; Zheyun LI ; Ziang ZUO ; Yi SI ; Weiguo FU ; Lixin WANG
Chinese Journal of General Surgery 2024;39(5):350-356
Objective:To compare the aortic remodeling of the Fabulous stent system and standard thoracic aortic endovascular repair (TEVAR) on distal aorta type B aortic dissection (TBAD). Methods:The prospective data collected between Dec 2017 and Oct 2019 from 134 patients with type B aortic dissection (TBAD) who underwent treatment with the "Fabulous" stent system, and retrospective data from 159 TBAD patients receiving standard TEVAR from corresponding multicenter. By using propensity score matching analysis, we compared the prognosis and aortic remodeling outcomes in patients undergoing Fabulous and standard TEVAR treatments during a 1-year postoperative follow-up.Results:In this study, 62 patients in Fabulous group and 62 patients in standard TEVAR were included.There were no significant statistical differences in baseline characteristics between the two groups. In terms of aortic remodeling in bare stent region, Fabulous group had better change trends of diameter of true lumen [10.6 (4.4, 14.5) mm vs. 4.7 (0.9, 10.7) mm, P=0.001] and false lumen [-24.2 (-30.5, -4.9) mm vs. 0.7 (-11.8, 2.3) mm, P<0.001] than those in the standard TEVAR group. The rate of complete false lumen thrombosis was also higher in the Fabulous group (62.9% vs. 37.1%, P=0.042). Conclusion:The Fabulous stent system, when compared to standard TEVAR surgery, demonstrates good aortic remodeling outcomes in the distal aorta.
3.Effects of SP600125 on Proliferation and Invasion of Human Cervical Cancer HeLa Cells
Yanxiu MO ; Feihong YAO ; Juntong LIU ; Ziang HU ; Mulan LI
Cancer Research on Prevention and Treatment 2022;49(4):304-313
Objective To investigate the effect of SP600125 on the proliferation, cell cycle, apoptosis and invasion of human cervical cancer HeLa cells. Methods CCK-8 method was used to detect the proliferation of HeLa cells treated with different concentrations of SP600125 at different time points. The 20 μmol/L of SP600125 was determined for subsequent experiments. Cell proliferation ability was detected using plate clone formation assay; nuclear morphology was observed by DAPI staining; cell cycle and apoptosis were measured by flow cytometry; cell migration and invasion were detected by cell scratch and Transwell methods; the mRNA and protein levels of p53, Mad2L1 and CDC20 were measured by qRT-PCR and Western blot after SP600125 treatment at different time points. Results Compared with control group (0.1%DMSO), cells proliferative activity were reduced by 10, 20, 30, 40 and 50 μmol/L SP600125 treatment for 24h. Compared with control group, the rate of apoptosis was significantly increased in SP600125 treatment groups, and the cell proportion in G2/M phase increased (
4.Association between maternal parenting stress and sleep problems among first grade primary students
AMAERJIANG Nubiya, XIAO Huidi, ZUNONG Jiawulan, LI Menglong, LI Ziang, HU Yifei
Chinese Journal of School Health 2022;43(5):668-670
Objective:
To investigate the sleeping status of the first grade primary students aged 6-8 in Beijing, to investigate the association between maternal parenting stress and children s sleep, and to inform intervention of addressing sleep problems among children in Beijing.
Methods:
Online survey was conducted based on the child cohort study designed to study puberty, obesity, and cardiovascular risk (PROC). The Children s Sleep Habits Questionnaire (CSHQ) and Parenting Stress Index Short Form (PSI-SF) were completed by parents, and 1 136 school aged children and their mothers were included as study participants. Logistic regression models were used to determine the association between maternal parenting stress and children s sleep.
Results:
The prevalence of sleep problems among first grade primary students was 78.52%. Among the children who received PSI-SF, the score of children with sleeping problems(86.66±17.31) was higher than that of the children with no sleeping problems(78.59±17.75)( t =6.42, P <0.01). After adjusting sociodemographic characteristics, multivariable logistic regression results showed children of mothers with parenting stress were more likely to have sleep problems ( OR =2.52, 95% CI =1.55-4.11, P <0.01). Taking 3 dimensions in PSI-SF as independent variables, the analysis indicated that compared with the children having mothers free from parental stress and difficult children, the children with mothers with parental stress were more likely to suffer from the sleeping problems( OR = 1.66 ,1.76, P <0.05).
Conclusion
Sleep problems are prevalent among first grade primary students, and it underscores providing psychological support to alleviate maternal parenting stress to address children s sleep problems.
5.Sex differences in the growth and physical development of Beijing school aged children and adolescents
Chinese Journal of School Health 2021;42(4):510-514
Objective:
The study aimed to explore sex differences in the growth and physical development of Beijing school-aged children and adolescents.
Methods:
Data obtained from regular health examinations of 94 122 school-aged children and adolescents aged 6-18 years old were collected from primary and high schools in Shunyi District from 2009 to 2018, and a longitudinal dataset was compiled with complete anthropometric parameters including height, weight, and BMI levels after linkage of individuallevel information. The age-specific growth rate was calculated and a linear mixed-effects model was used to identify sex differences according to chronological or relative age to peak height velocity (PHA).
Results:
Height, weight, and BMI levels increased with age in both boys and girls. Girls were taller than boys in the 10-11 year-old age group, catch-up growth in height was observed in boys at age 12, whose height surpassed that of girls thereafter. Boys had a higher weight and BMI than girls in all age groups (P<0.01). Sex differences were found in the growth rates of height, weight, and BMI levels(t=-67.56,-47.46,3.22,P<0.01), which was demonstrated by the interaction effect of sex and age in the linear mixed-effects model. The PHA in boys was 12 years old, which was two years later than the PHA in girls. Boys reached peak weight velocity at 12 years old, lagging one year behind girls who reached their peak at 11 years old. The curves of the BMI growth rate with age showed double peaks in boys and the first peak appeared at 10 years, which was one year earlier than girls. The change in weight was highly synchronized in time with the increase in height, after adjusting for the growth rate of weight by PHA. Weight velocity increased with age before the onset of puberty until PHA, and then it declined; boys presented with obvious fat accumulation before the onset of puberty.
Conclusion
Sex differences in the growth and physical development of school-aged children and adolescents were persistent and apparent, and the change in weight was highly synchronized in time with the increase in height.
6.A longitudinal study on sex difference in weight growth and systolic blood pressure change among children and adolescents in Beijing
Chinese Journal of School Health 2021;42(5):652-655
Objective:
To explore sex differences between weight and systolic blood pressure (SBP) changes among school-age children and adolescents in Beijing, and to provide a basis for priority intervention to control the rapid growth of body weight and blood pressure.
Methods:
Anthropometric measurement data of 70 288 children and adolescents from primary and high schools in Shunyi District were collected from 2009 to 2018, and a longitudinal dataset with complete data related to weight and BP after individual data linkage was compiled. The age-specific weight and SBP growth rates were calculated, and a linear mixed-effects model was used to identify sex differences in chronological growth rates.
Results:
Weight and SBP increased with age in both boys and girls, and the mean weight and SBP were higher in boys than in girls across all age groups. The result of the linear mixed-effects model indicated apparent sex differences in weight and SBP growth rates, with an age and sex interaction term(β=-0.35, -0.40, P<0.01). The age at peak weight velocity (PWA) was 12 years old and the age at peak SBP velocity was 13 years old in boys, which occurred one and three years later than for girls, respectively. In addition, the peak weight and SBP velocity were higher in boys than in girls. The curves of the SBP growth rate adjusted for the PWA, showed that the peak SBP velocity occurred two years before PWA and the second peak SBP velocity occurred at the PWA, which indicated "double peaks" in both boys and girls. The SBP growth rate was always higher in boys than in girls, and the rates declined after PWA.
Conclusion
Sex differences in weight and SBP growth rates were persistent and obvious in school-age children and adolescents in Beijing and the change in SBP was highly time synchronized with the increase in weight.
7.Association between visceral adiposity index and nonalcoholic fatty liver among overweight and obese children in Beijing
LI Yindong, LI Menglong, DUAN Junwei, SHU Wen, LI Ziang, ZHEN Guoxin, ZHAO Ruilan, HU Yifei
Chinese Journal of School Health 2021;42(5):659-662
Objective:
To examine the association between the visceral adiposity index (VAI) and nonalcoholic fatty liver disease (NAFLD) in the pediatric population in order to improve risk stratification and prevention systems for chronic liver disease.
Methods:
A total of 510 overweight/obese children aged 6-8 years old were enrolled from the child cohort which was designed to study puberty, obesity, and cardiovascular risk (PROC), and complete data from liver ultrasounds and the VAI were obtained. Used Spearman s rank correlation coefficient, Chi-square tests, and Logistic regression analyses to explore the association between the VAI and NAFLD.
Results:
The detection rates of NAFLD for boys and girls were 25.9% and 11.1%, respectively. VAI for normal group and the NAFLD group were 0.43(0.31, 0.61) and 0.61(0.44, 0.87) in boys, and 0.74(0.56, 1.07) and 1.08(0.67, 1.51) in girls, respectively. Spearman s correlation coefficient analysis showed that triglycerides(TG), VAI, and the third quintile VAI group were positively correlated with NAFLD in both boys and girls(r=0.19,0.26,0.29;0.16,0.16,1.18,P<0.05), and high-density lipoprotein-cholesterol (HDL-C) was negatively correlated with NAFLD in boys (r=-0.21, P<0.05). With advancing tertiles of VAI, the increasing trend in the NAFLD detection rate was statistically significant in boys and girls(Chi-square for trend were 21.77,7.66, P<0.01). The results of univariate and multivariable Logistic regression showed that, by taking the first tertile of VAI as a reference, the risk of NAFLD among boys was higher in the second tertile (cOR=2.59, 95%CI=1.15-5.86; aOR=2.33, 95%CI=1.01-5.36) and in the third tertile(cOR=5.73, 95%CI=2.62-12.53; aOR=4.87, 95%CI=2.15-11.03), where as the risk among girls was higher in the third tertile(cOR=4.43, 95%CI=1.40-14.00).
Conclusion
VAI is positively correlated with pediatric NAFLD. Higher tertiles of VAI were associated with an increased risk of NAFLD in overweight and obese children, which indicates that VAI can be used as an early predictor of NAFLD.
8.Varicose epidural plexus, a neglected cause of low back pain
Na ZHAO ; Weiyu NI ; Yi LIANG ; Ziang HU
Chinese Journal of Orthopaedics 2021;41(2):123-128
The epidural venous plexus is considered as a cause of low back and leg pain but has been neglected for a long time. As an auxiliary drainage system of the vena cava, the epidural venous plexus plays an important role in the circulation of body fluids, and its tortuous expansion may lead to clinical symptoms similar to a herniated disc or spinal stenosis, by compressing nerve roots or dura. Due to the lack of specificity of imaging findings, it is difficult to distinguish accurately from disc herniation or spinal stenosis. The epidural venous plexus is tortuous and thin-walled, which is easy to be broken during the operation that resulted in obscuring the surgical field and leading to other complications such as postoperative hematoma. Despite researches of epidural venous plexus have been carried out for years, details are still left unknow. We hereby reviewed the latest research progress of the epidural venous plexus including anatomical structure, morphological characteristics, clinical significance and imaging examination.
9.Prognostic nomogram incorporating radiological features for predicting overall survival in patients with AIDS-related non-Hodgkin lymphoma.
Xueqin LI ; Ziang PAN ; Xing WANG ; Tianli HU ; Wen YE ; Dongmei JIANG ; Wen SHEN ; Jinxin LIU ; Yuxin SHI ; Shuang XIA ; Hongjun LI
Chinese Medical Journal 2021;135(1):70-78
BACKGROUND:
Acquired immune deficiency syndrome (AIDS)-related non-Hodgkin lymphoma (AR-NHL) is a high-risk factor for morbidity and mortality in patients with AIDS. This study aimed to determine the prognostic factors associated with overall survival (OS) and to develop a prognostic nomogram incorporating computed tomography imaging features in patients with acquired immune deficiency syndrome-related non-Hodgkin lymphoma (AR-NHL).
METHODS:
A total of 121 AR-NHL patients between July 2012 and November 2019 were retrospectively reviewed. Clinical and radiological independent predictors of OS were confirmed using multivariable Cox analysis. A prognostic nomogram was constructed based on the above clinical and radiological factors and then provided optimum accuracy in predicting OS. The predictive accuracy of the nomogram was determined by Harrell C-statistic. Kaplan-Meier survival analysis was used to determine median OS. The prognostic value of adjuvant therapy was evaluated in different subgroups.
RESULTS:
In the multivariate Cox regression analysis, involvement of mediastinal or hilar lymph nodes, liver, necrosis in the lesions, the treatment with chemotherapy, and the CD4 ≤100 cells/μL were independent risk factors for poor OS (all P < 0.050). The predictive nomogram based on Cox regression has good discrimination (Harrell C-index = 0.716) and good calibration (Hosmer-Lemeshow test, P = 0.620) in high- and low-risk groups. Only patients in the high-risk group who received adjuvant chemotherapy had a significantly better survival outcome.
CONCLUSION
A survival-predicting nomogram was developed in this study, which was effective in assessing the survival outcomes of patients with AR-NHL. Notably, decision-making of chemotherapy regimens and more frequent follow-up should be considered in the high-risk group determined by this model.
Acquired Immunodeficiency Syndrome
;
Humans
;
Lymphoma, Non-Hodgkin
;
Neoplasm Staging
;
Nomograms
;
Prognosis
;
Retrospective Studies
10.Prevalence of childhood asthma in China from 2011 to 2018: a Meta-analysis
XIAO Huidi, SHU Wen, LI Menglong, LI Ziang, YAN Han, HU Yifei
Chinese Journal of School Health 2020;41(8):1208-1211
Objective:
To understand the epidemiological characteristic of the prevalence of aasthma in children in China, and to provide clues for the prevention and treatment of asthma in China.
Methods:
A systematical literature retrieval on children asthma prevalence from CNKI, WanFang Data, VIP and PubMed databases was performed. Random effects model was used to calculate the combined prevalence of asthma and its 95% confidence interval (CI) with Stata 16.0 software, the subgroup analysis was conducted according to sex, age and region.
Results:
A total of 26 studies were included, including 213 729 children, 112 169 boys and 101 560 girls. Meta-analysis showed that the combined prevalence of asthma in children aged 14 and under in China was 3.3%(95%CI=2.7%-4.0%). The subgroup analysis showed that the prevalence of asthma in boys was higher than that in girls(Q=11.42, P=0.01). The prevalence of asthma in preschool children aged 4-6 was higher than that in infants aged 0-3 and school children aged 7-14(Q=8.03, P=0.02). And there was no significant discrepancy of the asthma prevalence among children between the north and south(Q=0.72, P>0.05).
Conclusion
The prevalence of childhood asthma in China presented an increasing trend. Our findings underscore more efforts to control and prevent asthma among children.


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