Publications by authors named "Ran Chu"

9 Publications

  • Page 1 of 1

Progress in the management of ovarian granulosa cell tumor: A review.

Acta Obstet Gynecol Scand 2021 May 24. Epub 2021 May 24.

Department of Obstetrics and Gynecology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.

Ovarian granulosa cell tumor (GCT) is a rare, low-grade malignant tumor that accounts for 70% of the sex cord-stromal tumors, it has two histopathological types with different clinical and biological features: adult GCT and juvenile GCT. Most women diagnosed with the adult GCT have a favorable prognosis, with a 5-year survival rate of 97-98%, but adult GCT has a feature of late relapse, the recurrence time could be more than 20 years after diagnosis. Juvenile GCT had a survival rate of 97% in stage I and a 5-year survival rate of 0%-22% in advanced stage with earlier relapse than adult GCT. Consequently, the scenario emphasizes the need for early diagnosis, standardized treatment protocols and long-term follow-up. However, there is a lack of consensus regarding accurate diagnosis of GCT and adjuvant treatment. Furthermore, GCT tends to occur in young women, which emphasizes the viability of fertility-sparing surgery. The current review performed a systematic literature review of 60 articles in order to summarize the latest advancements of GCT, with an emphasis on the molecular pathogenesis and survival after fertility-sparing surgery. We found that young women with fertility-sparing surgery had a desirable reproductive and survival outcome compared to radical surgery.
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http://dx.doi.org/10.1111/aogs.14189DOI Listing
May 2021

Hyperemesis gravidarum induced refeeding syndrome causes blood cell destruction: a case report and literature review.

BMC Pregnancy Childbirth 2021 May 9;21(1):366. Epub 2021 May 9.

Department of Obstetrics Gynecology, Cheeloo College of Medicine, Qilu Hospital, Shandong University, Shandong, 250012, Jinan, China.

Background: Hyperemesis gravidarum (HG) is a common complication during pregnancy, however, HG associated simultaneous onset of blood cell destruction due to electrolyte abnormalities is rare. In this case, a woman with refeeding syndrome (RFS) secondary to electrolyte abnormalities caused by severe HG was diagnosed and managed in our hospital.

Case Presentation: A 29-year old woman was sent to the local hospitals because of severe HG with appetite loss, weight reduction, general fatigue, and she was identified to have severe electrolyte abnormalities. However, the electrolyte abnormalities were not corrected promptly, and then she had the symptoms of stillbirth, altered mental status, visual hallucination, hemolytic anemia and thrombocytopenia. After transferred to our hospital, we continued to correct the electrolyte abnormalities and the labor induction was performed as soon as possible. The symptoms of blood cell destruction were relieved obviously, and the patient discharged four days later. The electrolyte disturbances and physio-metabolic abnormalities caused by HG helped us diagnose this case as RFS.

Conclusions: This case emphasizes that patients with RFS should be diagnosed appropriately and intervened promptly in order to prevent electrolyte imbalance induced blood cell destruction.
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http://dx.doi.org/10.1186/s12884-021-03821-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8108454PMC
May 2021

Development and validation of nomograms for predicting blood loss in placenta previa with placenta increta or percreta.

Ann Transl Med 2021 Feb;9(4):287

Department of Obstetrics and Gynecology, Qilu Hospital, Shandong University, Jinan, China.

Background: To develop the risk prediction model of intraoperative massive blood loss in placenta previa with placenta increta or percreta.

Methods: This study included 260 patients, of whom 179 were allocated to the development group and 81 to the validation group. Univariate and multivariate logistic regression analyses were used to identify characteristics that were associated with massive blood loss (≥2,500 mL) during cesarean section. A nomogram was constructed based on regression coefficients. Receiver-operating characteristic curve, calibration curve, and decision curve analyses were applied to assess the discrimination, calibration, and performance of the model.

Results: Two models were constructed. The preoperative feature model (model A) consisted of vascular lacunae within the placenta and hypervascularity of the uterine-placental margin, uterine serosa-bladder wall interface, and cervix. The preoperative and surgical feature model (model B) consisted of an emergency cesarean section, no preoperative balloon placement of the abdominal aorta, and the previously mentioned four ultrasound signs. Model B had better discrimination than model A (area under the curve: development group: 0.839 0.732; validation group: 0.829 0.736). Model B showed a higher area under the decision curve than model A in both the training and validation groups.

Conclusions: The preoperative and surgical feature model for placenta previa with placenta increta or percreta can improve the early identification and management of patients who are at high risk of intraoperative massive blood loss.
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http://dx.doi.org/10.21037/atm-20-5160DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7944278PMC
February 2021

The complete mitochondrial genome of a Chinese endemic species, (Vaniot) N. Kilian (Cichorieae; Asteraceae).

Mitochondrial DNA B Resour 2020 Feb 11;5(1):1098-1099. Epub 2020 Feb 11.

School of Life Sciences, Zhengzhou University, Zhengzhou, China.

The first complete mitochondrial genome (mt) of (Vaniot) N. Kilian (Cichorieae; Asteraceae) was sequenced and successfully assembled in this study. The full length of the mt genome is 360,751 bp, containing 73 genes (33 protein-coding genes, 29 tRNA genes, 6 rRNA genes, and 5 protein-coding genes containing internal stop codons). There are two pairs of long (over 1000 bp) repeat regions in the mt genome of . . The phylogenetic analysis indicated that has a close relationship with other Lactucinae species.
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http://dx.doi.org/10.1080/23802359.2020.1726220DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7748815PMC
February 2020

Fresh versus frozen embryo transfer in women with thin endometrium: a retrospective cohort study.

Ann Transl Med 2020 Nov;8(21):1435

Department of Pathology, Reproductive Hospital Affiliated to Shandong University, Jinan, China.

Background: A thin endometrium affects embryo implantation. We designed a retrospective cohort study to analyze the differences of fertilization-intracytoplasmic sperm injection (IVF-ICSI) outcomes between fresh embryo transfer (ET) and frozen ET in patients with a thin endometrium.

Methods: The present study comprised of 1,110 patients with a thin endometrium undergoing IVF-ICSI between January 2013 and December 2017 in our unit. Propensity score matching (PSM) was used to balance the influence of intergroup confounding factors and to compare the pregnancy outcomes of the matched patients in the two groups. The fresh embryo group and frozen embryo group consisted of 632 and 478 women, respectively. After PSM, 173 patients were included in the two groups, respectively.

Results: The frozen embryo group showed a higher live birth rate (31% 18.4%, P<0.001; 30.6% 19.7%, P=0.019), clinical pregnancy rate (40% 26.4%, P<0.001; 38.7% 25.4%, P=0.008), and biochemical pregnancy rate (46.2% 32.9%, P<0.001; 44.5% 31.8%, P=0.020) than the fresh embryo group before and after PSM.

Conclusions: Our results demonstrated that for women with a thin endometrium who were undergoing IVF, the live birth rate, clinical pregnancy rate, and biochemical pregnancy rate after frozen ET were significantly higher than in the fresh ET group.
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http://dx.doi.org/10.21037/atm-20-3230DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7723638PMC
November 2020

Prognostic Assessment of Cervical Cancer Patients by Clinical Staging and Surgical-Pathological Factor: A Support Vector Machine-Based Approach.

Front Oncol 2020 5;10:1353. Epub 2020 Aug 5.

Department of Obstetrics and Gynecology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.

The International Federation of Gynecology and Obstetrics (FIGO) staging system is considered the most powerful prognostic factor in patients with cervical cancer. In addition, other surgical-pathological risk factors have been demonstrated to have significance in predicting the prognosis of patients. Therefore, the purpose of this study was to investigate the effects of the FIGO staging system and surgical-pathological risk factors on the prognosis of cervical cancer patients. A retrospective study was performed on patients diagnosed with cervical cancer at FIGO stage IB1-IIA2. Kaplan-Meier, Cox proportional hazards regression analysis and the support vector machine (SVM) algorithm were used to assess and validate the high-risk factors related to recurrence and death. A total of 647 patients were included. Kaplan-Meier analysis showed that five high-risk factors, including FIGO stage, status of pelvic lymph node, parametrial involvement, tumor size, and depth of cervical cancer, had a significant effect on the prognosis of patients. In multivariate analysis, pelvic lymph node metastasis (hazard ratio [HR] 2.415, 95% confidence interval [CI] 1.471-3.965), parametrial involvement (HR 2.740, 95% CI 1.092-6.872) and >2/3 depth of cervical invasion (HR 2.263, 95% CI 1.045-4.902) were three independent risk factors of disease-free survival. Pelvic lymph node metastasis (HR 3.855, 95% CI 2.125-6.991) and parametrial involvement (HR 3.871, 95% CI 1.375-10.900) were two independent risk factors for overall survival. When all five high-risk factors were assembled and used for classification prediction through SVM, it achieved the highest prediction accuracy of recurrence (accuracy = 69.1%). The highest prediction accuracy for survival was 94.3% when only using the two independent predictors (the pathological status of lymph nodes and parametrium involvement) by SVM classifiers. Among the 13 groups of intermediate-risk factor, the combination of tumor size, histology and grade of differentiation was more accurate in predicting prognosis than the intermediate-risk factors in the Sedlis criteria (recurrence: 86.8% vs. 60.0%; death: 92.0% vs. 71.6%). The combination of FIGO stage and surgical-pathological risk factors can further enhance the prediction accuracy of the prognosis in patients with early-stage cervical cancer. Histology and grade of differentiation can further improve the prediction accuracy of intermediate-risk factors in the Sedlis criteria.
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http://dx.doi.org/10.3389/fonc.2020.01353DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7419674PMC
August 2020

Predicting the Risk of Adverse Events in Pregnant Women With Congenital Heart Disease.

J Am Heart Assoc 2020 07 14;9(14):e016371. Epub 2020 Jul 14.

Department of Obstetrics and Gynecology Qilu Hospital Cheeloo College of Medicine Shandong University Jinan Shandong China.

Background Women with congenital heart disease are considered at high risk for adverse events. Therefore, we aim to establish 2 prediction models for mothers and their offspring, which can predict the risk of adverse events occurred in pregnant women with congenital heart disease. Methods and Results A total of 318 pregnant women with congenital heart disease were included; 213 women were divided into the development cohort, and 105 women were divided into the validation cohort. Least absolute shrinkage and selection operator was used for predictor selection. After validation, multivariate logistic regression analysis was used to develop the model. Machine learning algorithms (support vector machine, random forest, AdaBoost, decision tree, k-nearest neighbor, naïve Bayes, and multilayer perceptron) were used to further verify the predictive ability of the model. Forty-one (12.9%) women experienced adverse maternal events, and 93 (29.2%) neonates experienced adverse neonatal events. Seven high-risk factors were discovered in the maternal model, including New York Heart Association class, Eisenmenger syndrome, pulmonary hypertension, left ventricular ejection fraction, sinus tachycardia, arterial blood oxygen saturation, and pregnancy duration. The machine learning-based algorithms showed that the maternal model had an accuracy of 0.76 to 0.86 (area under the receiver operating characteristic curve=0.74-0.87) in the development cohort, and 0.72 to 0.86 (area under the receiver operating characteristic curve=0.68-0.80) in the validation cohort. Three high-risk factors were discovered in the neonatal model, including Eisenmenger syndrome, preeclampsia, and arterial blood oxygen saturation. The machine learning-based algorithms showed that the neonatal model had an accuracy of 0.75 to 0.80 (area under the receiver operating characteristic curve=0.71-0.77) in the development cohort, and 0.72 to 0.79 (area under the receiver operating characteristic curve=0.69-0.76) in the validation cohort. Conclusions Two prenatal risk assessment models for both adverse maternal and neonatal events were established, which might assist clinicians in tailoring precise management and therapy in pregnant women with congenital heart disease.
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http://dx.doi.org/10.1161/JAHA.120.016371DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7660735PMC
July 2020

Rapid-Response, Low Detection Limit, and High-Sensitivity Capacitive Flexible Tactile Sensor Based on Three-Dimensional Porous Dielectric Layer for Wearable Electronic Skin.

ACS Appl Mater Interfaces 2019 Oct 21;11(43):40716-40725. Epub 2019 Oct 21.

Key Laboratory of Microelectronic Devices & Integrated Technology , Institute of Microelectronics, Chinese Academy of Sciences , Beijing 100029 , P. R. China.

Three-dimensional (3D) porous conductive composites explored in highly sensitive tactile sensors have attracted extensive close attention in recent years owing to their peculiar porous structure and unique physical properties in terms of excellent mechanical flexibility, high relative dielectric permittivity, and good elastic property. Herein, we report an practical, efficient, and macroscopic dip-coating process to manufacture rapid-response, low detection limit, high-sensitivity, and highly sensitive capacitive flexible tactile sensors. The fabrication process, tactile perception mechanism, and sensing performance of the developed devices are comparatively investigated. The homogeneous 3D hybrid network constructed by graphene nanoplatelets/carboxyl-functionalized multiwalled carbon nanotubes/silicone rubber composites anchored on polyurethane sponge skeletons exhibits a significantly improved dielectric property, resulting in a high-performance capacitive flexible tactile sensor with a fast response time (∼45 ms), an extremely low-pressure detection limit of ∼3 Pa, excellent sensitivity (∼0.062 kPa), and excellent durability and stability over 2000 cycles. Importantly, the flexible devices can be used as the wearable electronic skin and successfully mounted on human skin or a soft-bodied robot to achieve the capability of physiological stimuli monitoring, micropressure monitoring, soft grabbing, etc. Our rapid-response, low detection limit, and high-sensitivity capacitive flexible tactile sensor with a novel 3D porous dielectric layer could be a prospective candidate for the wearable applications in real-time and high-accuracy portable healthcare monitoring devices, advanced human-machine interfaces, and intelligent robot perception systems.
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http://dx.doi.org/10.1021/acsami.9b16511DOI Listing
October 2019

Diagnostic accuracy of frozen section analysis of borderline ovarian tumors: a meta-analysis with emphasis on misdiagnosis factors.

J Cancer 2018 16;9(16):2817-2824. Epub 2018 Jul 16.

Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Ji'nan city, Shandong province, China.

First, to evaluate the sensitivity and positive predictive value (PPV) of intra-operative frozen section (FS) diagnosis in borderline ovarian tumors (BOTs), and to explore the factors affecting the diagnostic accuracy. Second, to assess the clinical outcomes of misdiagnosed BOT patients. We performed a retrospective study of all patients diagnosed as BOT through FS or paraffin section (PS) at Qilu Hospital between January 2005 and December 2015. Clinical and pathologic data were extracted. Univariate analysis was performed using standard two-sided statistical tests. We also performed a meta-analysis to further validate the findings. In our retrospective study, 155 patients were included. Agreement between FS and PS diagnosis was observed in 127/155 (81.9%) patients, yielding a sensitivity of 92.7% and a PPV of 87.6%. Under-diagnosis and over-diagnosis occurred in 22 cases (14.2%) and 6 cases (3.9%), respectively. In our univariate analysis of our retrospective study, tumor size (=0.048) and surgery approach (=0.024) were significantly associated with misdiagnosis. The pooled analysis of 13 studies including 1,577 patients indicated that the accuracy (69.2%), sensitivity (82.5%), and PPV (81.1%) were low; also under-diagnosis (20.2%) and over-diagnosis (10.5%) were frequent. The meta-analysis results showed that mucinous histology ( 0.0001, OR=2.03 [1.47-2.81]) and unilateral tumors (=0.001, OR=2.39 [1.41-4.06]) were associated with the misdiagnosis of BOT. In our retrospective study, there was no statistical significance of clinical outcome such as extent of surgery (=0.838), recurrence (=0.586), fertility (=0.560), death (=0.362) between misdiagnosed and accurately diagnosed BOT patients. FS analysis of BOTs has low accuracy, sensitivity, and PPV. Under-diagnosis and over-diagnosis are frequent. Meta-analysis results verify that mucinous histology and unilateral tumors are associated with misdiagnosis of FS. Nevertheless, misdiagnosed patients have a good clinical outcome despite the high frequency of misdiagnosis through FS.
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http://dx.doi.org/10.7150/jca.25883DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6096369PMC
July 2018