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Additional value of metabolic parameters to PET/CT-based radiomics nomogram in predicting lymphovascular invasion and outcome in lung adenocarcinoma
Nie, P; Yang, GJ; Wang, N; Yan, L; Miao, WJ; Duan, YL; Wang, YL; Gong, AD; Zhao, YJ; Wu, J; Zhang, CT; Wang, ML; Cui, JJ; Yu, MM; Li, DC; Sun, YQ; Wang, YY; Wang, ZG
EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING 2021年 48卷1期 页码:217-230
STAGE-I; PROGNOSTIC-SIGNIFICANCE; MICROVASCULAR INVASION; PATHOLOGICAL STAGE; CANCER; SIGNATURE; INDICATOR; SURVIVAL; FEATURES; IMPACT
Purpose Lymphovascular invasion (LVI) impairs surgical outcomes in lung adenocarcinoma (LAC) patients. Preoperative prediction of LVI is challenging by using traditional clinical and imaging parameters. The purpose of this study was to investigate the value of the radiomics nomogram integrating clinical factors, CT features, and maximum standardized uptake value (SUVmax) to predict LVI and outcome in LAC and to evaluate the additional value of the SUVmax to the PET/CT-based radiomics nomogram. Methods A total of 272 LAC patients (87 LVI-present LACs and 185 LVI-absent LACs) with PET/CT scans were retrospectively enrolled, and 160 patients with SUVmax >= 2.5 of them were used for PET radiomics analysis. Clinical data and CT features were analyzed to select independent LVI predictors. The performance of the independent LVI predictors and SUVmax was evaluated. Two-dimensional (2D) and three-dimensional (3D) CT radiomics signatures (RSs) and PET-RS were constructed with the least absolute shrinkage and selection operator algorithm and radiomics scores (Rad-scores) were calculated. The radiomics nomograms, incorporating Rad-score and independent clinical and CT factors, with SUVmax (RNWS) or without SUVmax (RNWOS) were built. The performance of the models was assessed with respect to calibration, discrimination, and clinical usefulness. All the clinical, PET/CT, pathologic, therapeutic, and radiomics parameters were assessed to identify independent predictors of progression-free survival (PFS). Results CT morphology was the independent LVI predictor. SUVmax provided better discrimination capability compared with CT morphology in the training set (P < 0.001) and test set (P = 0.042). A total of 1409 CT and PET radiomics features were extracted and reduced to 8, 8, and 10 features to build the 2D CT-RS, 3D CT-RS, and the PET-RS, respectively. There was no significant difference in AUC between the 2D-RS and 3D-RS (P > 0.05), and 2D CT-RS showed a relatively higher AUC than 3D CT-RS. The CT-RS, the CT-RNWOS, and the CT-RNWS showed good discrimination in the training set (AUC [area under the curve], 0.799, 0.796, and 0.851, respectively) and the test set (AUC, 0.818, 0.822, and 0.838, respectively). There was significant difference in AUC between the CT-RNWS and CT-RNWOS (P = 0.044) in the training set. Decision curve analysis (DCA) demonstrated the CT-RNWS outperformed the CT-RS and the CT-RNWOS in terms of clinical usefulness. Furthermore, DCA showed the PETCT-RNWS provided the highest net benefit compared with the PET-RNWS and CT-RNWS. PFS was significantly different between the pathologic and RNWS-predicted LVI-present and LVI-absent patients (P < 0.001). Carbohydrate antigen 125 (CA125), carcinoembryonic antigen (CEA), neuron-specific enolase (NSE), pathologic LVI, histologic subtype, and SUVmax were independent predictors of PFS in the 244 CT-RNWS-predicted cohort; and CA125, NSE, pathologic LVI, and SUVmax were the independent predictors of PFS in the 141 PETCT-RNWS-predicted cohort. Conclusions The radiomics nomogram, incorporating Rad-score, clinical and PET/CT parameters, shows favorable predictive efficacy for LVI status in LAC. Pathologic LVI and SUVmax are associated with LAC prognosis.
Pooled analysis of the efficacy and safety of intraoperative dexmedetomidine on postoperative catheter-related bladder discomfort
Shi, HB; Zhang, HP; Pan, WZ; Lu, YY; Zhang, Y; Chen, LJ; Wei, CX; Cui, YS
LUTS-LOWER URINARY TRACT SYMPTOMS 2021年 13卷1期 页码:38-44
DOUBLE-BLIND; URINARY-TRACT; PREVENTION; ANTAGONISTS; RESECTION; INFUSION
Objectives The goal of the pooled analysis was to demonstrate the efficacy and safety of intraoperative dexmedetomidine in postoperative catheter-related bladder discomfort (CRBD). Methods MEDLINE, the Cochrane Central Register of Controlled Trials, and the Excerpta Medica Database (Embase) were used to pick out randomized controlled trials (RCTs) that used intraoperative dexmedetomidine in postoperative CRBD. This study was carried out using the preferred reporting items for systematic reviews and pooled analysis. We used RevMan version 5.3.0. to analyze the data. Results Seven RCTs involving 607 patients were brought into in the analysis. The incidence of CRBD and the incidence of moderate to severe CRBD were assessed at 0 hours, 0.5 or 1 hour, 2 or 3 hours, 6 hours, and 12 or 24 hours postoperatively. The analysis proved that both the incidence of CRBD (P < .00001) and the incidence of moderate to severe CRBD had a statistically significant reduction at 0 hours, 0.5 or 1 hours, 2 or 3 hours, and 6 hours postoperatively (P < .00001, P <.00001, P <.00001, P = .003, respectively). The postoperative pain score was lower in the dexmedetomidine group at 0 hours (P < .00001) and 1 hour (P = .002). Safety assessments indicated that there were no statistical differences between dexmedetomidine and control for side effects, mainly including dry mouth (P = .99) and postoperative vomiting and nausea (P = .77). Conclusions The pooled analysis demonstrates that intraoperative dexmedetomidine administration decreases the rate and severity of early postoperative CRBD without causing significant side effects.
Additional value of metabolic parameters to PET/CT-based radiomics nomogram in predicting lymphovascular invasion and outcome in lung adenocarcinoma (vol 33, pg 815, 2020)
Nie, P; Yang, GJ; Wang, N; Yan, L; Miao, WJ; Duan, YL; Wang, YL; Gong, AD; Zhao, YJ; Wu, J; Zhang, CT; Wang, ML; Cui, JJ; Yu, MM; Li, DC; Sun, YQ; Wang, YY; Wang, ZG
EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING 2021年 48卷1期 页码:325-327
Epidemiology of COVID-19: A systematic review and meta-analysis of clinical characteristics, risk factors, and outcomes
Li, J; Huang, DQ; Zou, BY; Yang, HL; Hui, WZ; Rui, FJ; Yee, NTS; Liu, CL; Nerurkar, SN; Kai, JCY; Teng, MLP; Li, XH; Zeng, H; Borghi, JA; Henry, L; Cheung, R; Nguyen, MH
JOURNAL OF MEDICAL VIROLOGY 2021年 93卷3期 页码:1449-1458
无关键词信息
Coronavirus disease 2019 (COVID-19) has become a pandemic, but its reported characteristics and outcomes vary greatly amongst studies. We determined pooled estimates for clinical characteristics and outcomes in COVID-19 patients including subgroups by disease severity (based on World Health Organization Interim Guidance Report or Infectious Disease Society of America/American Thoracic Society criteria) and by country/region. We searched Pubmed, Embase, Scopus, Cochrane, Chinese Medical Journal, and preprint databases from 1 January 2020 to 6 April 2020. Studies of laboratory-confirmed COVID-19 patients with relevant data were included. Two reviewers independently performed study selection and data extraction. From 6007 articles, 212 studies from 11 countries/regions involving 281 461 individuals were analyzed. Overall, mean age was 46.7 years, 51.8% were male, 22.9% had severe disease, and mortality was 5.6%. Underlying immunosuppression, diabetes, and malignancy were most strongly associated with severe COVID-19 (coefficient = 53.9, 23.4, 23.4, respectively, allP < .0007), while older age, male gender, diabetes, and hypertension were also associated with higher mortality (coefficient = 0.05 per year, 5.1, 8.2, 6.99, respectively;P = .006-.0002). Gastrointestinal (nausea, vomiting, abdominal pain) and respiratory symptoms (shortness of breath, chest pain) were associated with severe COVID-19, while pneumonia and end-organ failure were associated with mortality. COVID-19 is associated with a severe disease course in about 23% and mortality in about 6% of infected persons. Individuals with comorbidities and clinical features associated with severity should be monitored closely, and preventive efforts should especially target those with diabetes, malignancy, and immunosuppression.
Neuroprotective effect of rhaponticin against Parkinson disease: Insights from in vitro BV-2 model and in vivo MPTP-induced mice model
Zhao, FF; Tian, HJ; Chinnathambi, A; Alharbi, SA; Yang, HG
JOURNAL OF BIOCHEMICAL AND MOLECULAR TOXICOLOGY 2021年 35卷1期
INFLAMMATORY RESPONSES; NEUROINFLAMMATION; NEURODEGENERATION; PROTECTS
Parkinson's disease (PD) is a complex neurodegenerative illness associated with the loss or damage to neurons of the dopaminergic system in the brain. Few therapeutic approaches and considerable side effects of conventional drugs necessitate a new therapeutic agent to treat patients with PD. Rhaponticin is a natural hydroxystilbene, found in herbal plants such asRheum rhaponticum, and known to have desirable biological activity including anti-inflammatory properties. However, the neuroinflammation on rhaponticin levels has only been investigated partially so far. So, the current study explored whether rhaponticin could ameliorate the pathophysiology observed in both the in vitro microglial BV-2 cells and the in vivo (1-methyl-4-phenyl-1,2,3,5-tetrahydropyridine [MPTP])-mediated PD model. The results show rhaponticin significantly attenuated lipopolysaccharide (LPS)-mediated microglial activation by suppressing nitric oxide synthase in conjunction with abridged reactive oxygen species production together with proinflammatory mediator reduction. In vivo rhaponticin treatment improves motor impairments as well as the loss of dopaminergic neurons in MPTP-treated mice possibly through suppression via mediators of inflammation. Taken together, these results offer evidence that rhaponticin exerts anti-inflammatory effects and neuroprotection in an LPS-induced microglial model and the MPTP-induced mouse models of PD.
Role of Gut Microbiome and Microbial Metabolites in Alleviating Insulin Resistance After Bariatric Surgery
Wang, MF; Li, LP; Chen, YZ; Lian, GD; Wang, JS; Zhang, JZ; Shan, KS; Shang, L; Tian, F; Jing, CQ
OBESITY SURGERY 2021年 31卷1期 页码:327-336
Y GASTRIC BYPASS; CHAIN FATTY-ACIDS; BILE-ACIDS; INTESTINAL MICROBIOTA; RECEPTOR SUBSTRATE-1; GLUCOSE-TOLERANCE; SERUM METABOLOME; BRANCHED-CHAIN; S-NITROSATION; AMINO-ACIDS
Insulin resistance (IR) is the most common pathophysiological change in patients with type 2 diabetes mellitus (T2DM). Several recent studies have suggested that the gut microbiome and microbial metabolites are involved in the pathogenesis of IR. Bariatric surgery, as an effective treatment for T2DM, can markedly alleviate IR through mechanisms that have not been elucidated. In this review, we summarize the current evidence on the changes in the gut microbiome and microbial metabolites (including lipopolysaccharide, short-chain fatty acids, branched-chain amino acids, aromatic amino acids, bile acids, methylamines, and indole derivatives) after bariatric surgery. Additionally, we discuss the mechanisms that correlate the changes in microbial metabolites with the postoperative alleviation of IR. Furthermore, we discuss the prospect of bariatric surgery as a treatment for T2DM.
Water-soluble fraction of particulate matter < 2.5 mu m promoted lung epithelia cells apoptosis by regulating the expression of caveolin-1 and Kruppel-like factor 5
Wei, W; Wang, Y; Li, M; Yang, M
JOURNAL OF APPLIED TOXICOLOGY 2021年 41卷3期 页码:410-420
GENE-EXPRESSION; KAPPA-B; PM2.5; A549; EXPOSURE
Ambient fine particulate matter of <2.5 mu m (PM2.5) has been linked to morbidity and mortality from respiratory and cardiovascular diseases. Lung epithelial cells bear the brunt of PM2.5 exposure. In the present study, we found that exposure of A549 cells to the water-soluble fraction of PM2.5 (WS-PM2.5) promoted the expression and internalization of caveolin-1. Caveolin-1 knockdown restrained the endocytosis of WS-PM2.5. In addition, WS-PM2.5 accumulation in the cells induced the phosphorylation of serine/threonine protein kinase B (AKT) and nuclear factor kappa-light-chain enhancer of activated B cells (NF kappa B), as well as the expression of Kruppel-like factor 5 (KLF5). Inhibiting activation of AKT and NF kappa B also partly reduced WS-PM2.5 concentration in cells, but KLF5 knockdown did not affect the intracellular accumulation of WS-PM2.5. KLF5 knockdown suppressed cytochrome P450 family 1 subfamily A member 1 (CYP1A1) expression and activated caspase 3. Luciferase reporter assay and chromatin immunoprecipitation assay showed that KLF5 positively regulated the transcription of KLF5. These results suggested that caveolin-1 was required for the endocytosis of WS-PM2.5. Intracellular accumulation of WS-PM2.5 activated AKT and NF kappa B, which facilitated WS-PM2.5 endocytosis. WS-PM2.5 accumulation also induced KLF5 expression, increasing the transcriptional expression of CYP1A1, which contributed to activate caspase 3.
Second-generation cryoballoon vs. contact-force sensing radiofrequency catheter ablation in atrial fibrillation: a meta-analysis of randomized controlled trials
Wang, Y; Wang, W; Yao, JM; Chen, LH; Yi, SL
JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY 2021年 60卷1期 页码:9-19
PULMONARY VEIN ISOLATION
Objectives It is imperative to understand the influence of second-generation cryoballoon (CB-2) and contact-force sensing radiofrequency ablation (CF-RF) on clinical outcomes in atrial fibrillation (AF). This updated meta-analysis of randomized controlled trials (RCTs) examined the efficacy and safety of CB-2 vs. CF-RF in patients with AF. Methods RCTs on the use of CB-2 vs. CF-RF in patients with AF were included. The primary outcome was the recurrence of AF, and the key secondary outcomes included serious complications, acute pulmonary vein isolation (PVI), procedure duration, and fluoroscopy time. Results A total of 261 articles were identified, and five studies with a total of 845 participants were included in the study. A total of 93% of participants had paroxysmal AF, 7% of participants had persistent AF, and none of participants had permanent AF. There were 499 participants in the CB-2 arm and 346 in the CF-RF arm. AF recurrence was comparable in the CB-2 group (30.3%) and the CF-RF group (29.2%) (OR = 0.93; 95%CI = 0.56-1.54;P = 0.79;I-2 = 48%). There were no statistical differences in acute PVI (P = 0.92;I-2 = 0%) and serious complications (P = 0.87;I-2 = 47%) between the two groups. The procedure duration was shorter in the CB-2 group than in the CF-RF group (MD = - 13.39; 95%CI = - 15.58, - 7.19;P < 0.0001;I-2 = 59%). Conclusion Our study demonstrated that CB-2 and CF-RF had comparable recurrences of AF and similar incidences of serious complications in AF patients during the ablation process.
Endoclips as novel fiducial markers in trimodality bladder-preserving therapy of muscle-invasive bladder carcinoma: feasibility and patient outcomes
Shahbaz, M; Ammar, A; Wang, YL; Farhaj, Z; Qiao, L; Niu, J
INTERNATIONAL BRAZ J UROL 2021年 47卷1期 页码:93-99
LONG-TERM OUTCOMES; MODALITY THERAPY; CANCER INCIDENCE; RADIOTHERAPY
Hypothesis: Endoclip can be used as fiducial marker in urology. Objective: To assess the feasibility, cost effectiveness and reliability of endoclips as novel fiducial markers in precision radiotherapy, as part of a trimodality bladder-preserving treatment (TBPT) of muscle-invasive bladder carcinoma. Materials and Methods: This retrospective study was performed at Weifang People's Hospital (Weifang, China) from January 2015 to June 2018. A total of 15 patients underwent TBPT. Endoclips were applied to healthy edges of the resected bladder wall as novel fiducial markers. Radio-sensitizing chemotherapy and routine precision radiotherapy were given. The number and position of the endoclips during radiotherapy sessions were monitored. Complications and tumor recurrence were analyzed. esults: The mean age (+/- standard deviation) of the patients was 67 +/- 10 years (range 46-79). There were 3 females and 12 males. Forty-nine endoclips were applied in all patients (3.3 +/- 0.8). The tumor was completely visibly resected in all patients. The number of endoclips remained the same through the planned last radiotherapy session (3.3 +/- 0.8), i.e., none were lost. All endoclips were removed after the last radiotherapy session. The average number of follow-up months was 38.9 +/- 13.2 (range 11-52). There were no procedure-related complications at discharge or follow-up. At one-year, overall recurrence-free survival was 93.3%. Two patients had recurrences at 18 months and 10 months after TBPT, respectively, and salvage radical cystectomy was performed with no further recurrences. Another patient died due to metastasis 9 months after the completion of therapy. Conclusions: Endoclips are reliable, safe and cost-effective as novel fiducial markers in precision-radiotherapy post-TBPT.
A targeted and redox/pH-responsive chitosan oligosaccharide derivatives based nanohybrids for overcoming multidrug resistance of breast cancer cells
Jia, LJ; Li, ZY; Zheng, DD; Li, ZY; Zhao, ZX
CARBOHYDRATE POLYMERS 2021年 251卷
ACID MODIFIED CHITOSAN; INTRACELLULAR DRUG; DELIVERY; IMMUNOTHERAPY; CHEMOTHERAPY; APOPTOSIS; MICELLES
A novel folic acid mediated chitosan oligosaccharide-grafted disulfide-containing polyethylenimine copolymer-based silica nanohybrids were fabricated for co-delivering paclitaxel and P-shRNA. These nanoparticles could efficiently protect P-shRNA against degradation, and exhibited well redox-responsive P-shRNA release and pH-responsive drug release behaviors. Folic acid as the targeting head, could improve cellular uptake of nanoparticles by multidrug-resistant breast cancer cells. Moreover, these nanoparticles showed excellent delivery P-shRNA into cells and displayed high gene silencing efficiency at the targeted mRNAs to downregulate the expression of P-gp which induced up to 63% decrease. Finally, nanoparticles could completely reverse the resistance of breast cancer cells to paclitaxel and the resistance reversion index was 50.59. These results suggested that our nanoparticles could efficiently co-deliver paclitaxel and P-shRNA into cancer cells to exert its synergistic antitumor effect, and opened up a new avenue for overcoming multidrug resistance.
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