Publications by authors named "Zeming Liu"

88 Publications

Delivery of manganese carbonyl to the tumor microenvironment using Tumor-Derived exosomes for cancer gas therapy and low dose radiotherapy.

Biomaterials 2021 Jul 18;274:120894. Epub 2021 May 18.

Department of Electronic Science and Technology, School of Physics and Technology, Wuhan University, Wuhan, 430072, China.

The development of novel radiosensitizer with high selectivity and controllability is highly desirable. CO gas could cause damage to mitochondria and thus enhance RT effect. Controlled delivery of CO in tumor is important both to achieve high-efficiency of CO gas therapy and to decrease the risk of CO poisoning. In this study, manganese carbonyl (MnCO) loaded exosome nano-vesicles (MMV) to overcome this conundrum for tumor therapy is developed. After administration, MMV showed its admirable performance in active tumor-targeting, mitochondria damage and radiosensitization therapy. These MMV nanoparticles were able to facilitate robust CO evolution and consequent ROS generation in response to X-ray irradiation both in vitro and in vivo. Significantly, MMV could facilitate a 90% inhibition effect of tumor growth under very low dose (only 2Gy) RT, which is better than high dose (6Gy) radiotherapy. Overall, this study highlights a novel and practical approach to enhancing the efficacy of tumor RT, underscoring the value of future research in the field of CO medicine.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.biomaterials.2021.120894DOI Listing
July 2021

Short uncemented femoral component for hip revision: prognosis and risk factors associated with failure.

BMC Surg 2021 Apr 13;21(1):192. Epub 2021 Apr 13.

Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, Hebei, People's Republic of China.

Background: The application of short femoral stems is partially restricted in revision surgery. This study will demonstrate the therapeutic effect and unsuitable situation for short stem revision.

Methods: Demographic characteristics of all patients were recorded in detail (Table 1). Anteroposterior view radiographic examinations of proximal femur are necessary before and after the operation for patients. The primary outcome of interest was the survival rate of the femoral stem at the final follow-up. Risk factors for failure were also investigated. The secondary outcomes of interest included the Harris hip score, excellent to good rate and incidence of complications. The Mann-Whitney U test was performed for comparisons between continuous variables. The chi-square test was performed for comparisons between categorical variables. Cox regression analysis was used to assess the association between potential risk factors and the failure of revision surgery.

Results: A total of 381 patients with short stems were retrospectively reviewed. There were 188 males and 193 females. The average age and body mass index before revision surgery were 58.85 ± 13.46 years and 23.72 ± 3.40 kg/m, respectively. The mid-term survival rate of the short femoral component was 94.23%. The prognosis and complications of patients between the two groups were compared. There was no significant difference between the two groups in the Harris score, complication incidence or survival rate of the femoral component. The strongest risk factor in this study was intraoperative periprosthetic femoral fracture during revision surgery (HR = 5.477, 95% CI = 2.156-13.913).

Conclusion: Three risk factors for failure were identified: ageing, osteoporosis and intraoperative periprosthetic femoral fracture during revision surgery. Therefore, a short femoral stem should be implanted in patients with these risk factors with additional caution.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12893-021-01196-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8045178PMC
April 2021

Comparing the Value of Cystatin C and Serum Creatinine for Evaluating the Renal Function and Predicting the Prognosis of COVID-19 Patients.

Front Pharmacol 2021 22;12:587816. Epub 2021 Mar 22.

Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, China.

Coronavirus disease- (COVID-19-) related renal function abnormality is associated with poor prognosis. However, the clinical significance of dynamic changes in renal function indicators has not been studied, and no studies have evaluated the renal function in COVID-19 patients by cystatin C. This study aimed to evaluate the effect of abnormal renal function on admission on prognosis of COVID-19 patients and the prognostic value of various renal function indicators. A total of 1,764 COVID-19 patients without a history of chronic kidney disease were categorized into two groups, an elevated cystatin C group and a normal cystatin C group, based on the results of renal function tests on admission. The clinical characteristics were compared between the two groups, and logistic or Cox regression analyses were performed to explore the associations between elevated cystatin C/serum creatinine levels and disease severity and survival. We also performed receiver operating characteristic (ROC) curve, Kaplan-Meier survival, and curve fitting analyses. When adjusted for several significant clinical variables, elevated cystatin C levels on admission were independent predictors of disease severity ( < 0.001), and elevated creatinine levels were independent predictors of death ( = 0.020). Additionally, the ROC curve analysis shows that elevated cystatin C levels [area under the curve (AUC): 0.656] have a better predictive value for disease severity than elevated creatinine levels (AUC: 0.540). The survival curves of patients with elevated cystatin C/creatinine levels show a sharper decline than those of patients with normal cystatin C/creatinine levels ( < 0.001). The curve fitting analysis revealed that, compared to the flat curves of cystatin C and creatinine levels for patients who survived, the curves for patients who died kept rising, and cystatin C levels rose above the normal range earlier than creatinine. Elevated cystatin C, which occurs earlier than serum creatinine, is useful for the early detection of renal function abnormality and might have better predictive value for disease severity in COVID-19 patients, while elevated serum creatinine may have a better predictive value for risks of death.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fphar.2021.587816DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8019901PMC
March 2021

Refusal of cancer-directed surgery in male breast cancer.

Medicine (Baltimore) 2021 Apr;100(13):e25116

Department of Plastic Surgery.

Abstract: It has been reported that some male breast cancer patients may refuse the recommended surgery, but the incidence rate in the United States is not clear. The purpose of this study was to identify the incidence, trends, risk factors, and eventual survival outcomes associated with the rejection of such cancer-directed surgery.We collected data on 5860 patients with male breast cancer (MBC) from the Surveillance, Epidemiology, and End Results database, including 50 patients refusing surgery as recommended. Kaplan-Meier survival analysis and Cox proportional hazard regression were used to identify the effects of refusing surgery on cancer-specific survival (CSS) and overall survival (OS). The association between acceptance or rejection of surgery and mortality were estimated by nested Cox proportional hazards regression models with adjustment for age, race, clinical characteristics, and radiation.Of the 5860 patients identified, 50 (0.9%) refused surgery. Old age (≥65: hazard ratio [HR]: 3.056, 95% confidence interval [CI]: 1.738-5.374, P < .0001), higher AJCC stage (III: HR: 3.283, 95% CI: 2.134-5.050, P < .0001, IV: HR: 14.237, 95% CI: 8.367-24.226, P < .0001), progesterone receptor status (negative: HR: 1.633, 95% CI: 1.007-2.648, P = .047) were considered risk factors. Compared with the surgery group, the refusal group was associated with a poorer prognosis in both OS and CSS (χ2 = 94.81, P < .001, χ2 = 140.4, P < .001). Moreover, significant differences were also observed in OS and CSS among 1:3 matched groups (P = .0002, P < .001).Compared with the patients undergoing surgery, the patients who refused the cancer-directed surgery had poor prognosis in the total survival period, particularly in stage II and III. The survival benefit for undergoing surgery remained even after adjustment, which indicates the importance of surgical treatment before an advanced stage for male breast cancer patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/MD.0000000000025116DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8021363PMC
April 2021

Novel Engineered Bacterium/Black Phosphorus Quantum Dot Hybrid System for Hypoxic Tumor Targeting and Efficient Photodynamic Therapy.

ACS Appl Mater Interfaces 2021 Mar 19;13(8):10564-10573. Epub 2021 Feb 19.

Department of Molecular Pathology, Application Center for Precision Medicine, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China.

Intratumoral hypoxia significantly constrains the susceptibility of solid tumors to oxygen-dependent photodynamic therapy (PDT), and effort to reverse such hypoxia has achieved limited success to date. Herein, we developed a novel engineered bacterial system capable of targeting hypoxic tumor tissues and efficiently mediating the photodynamic treatment of these tumors. For this system, we genetically engineered to express catalase, after which we explored an electrostatic adsorption approach to link black phosphorus quantum dots (BPQDs) to the surface of these bacteria, thereby generating an engineered /BPQDs (EB) system. Following intravenous injection, EB was able to target hypoxic tumor tissues. Subsequent 660 nm laser irradiation drove EB to generate reactive oxygen species (ROS) and destroy the membranes of these bacteria, leading to the release of catalase that subsequently degrades hydrogen peroxide to yield oxygen. Increased oxygen levels alleviate intratumoral hypoxia, thereby enhancing BPQD-mediated photodynamic therapy. This system was able to efficiently kill tumor cells in vivo, exhibiting good therapeutic efficacy. In summary, this study is the first to report the utilization of engineered bacteria to facilitate PDT, and our results highlight new avenues for BPQD-mediated cancer treatment.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1021/acsami.0c20254DOI Listing
March 2021

Decreased CO Levels as Indicators of Possible Mechanical Ventilation-Induced Hyperventilation in COVID-19 Patients: A Retrospective Analysis.

Front Public Health 2020;8:596168. Epub 2021 Jan 8.

Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, China.

Six months since the outbreak of coronavirus disease (COVID-19), the pandemic continues to grow worldwide, although the outbreak in Wuhan, the worst-hit area, has been controlled. Thus, based on the clinical experience in Wuhan, we hypothesized that there is a relationship between the patient's CO levels and prognosis. COVID-19 patients' information was retrospectively collected from medical records at the Leishenshan Hospital, Wuhan. Logistic and Cox regression analyses were conducted to determine the correlation between decreased CO levels and disease severity or mortality risk. The Kaplan-Meier curve analysis was coupled with the log-rank test to understand COVID-19 progression in patients with decreased CO levels. Curve fitting was used to confirm the correlation between computed tomography scores and CO levels. Cox regression analysis showed that the mortality risk of COVID-19 patients correlated with decreased CO levels. The adjusted hazard ratios for decreased CO levels in COVID-19 patients were 8.710 [95% confidence interval (CI): 2.773-27.365, < 0.001], and 4.754 (95% CI: 1.380-16.370, = 0.013). The adjusted odds ratio was 0.950 (95% CI: 0.431-2.094, = 0.900). The Kaplan-Meier survival curves demonstrated that patients with decreased CO levels had a higher risk of mortality. Decreased CO levels increased the mortality risk of COVID-19 patients, which might be caused by hyperventilation during mechanical ventilation. This finding provides important insights for clinical treatment recommendations.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fpubh.2020.596168DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7874065PMC
February 2021

Rethinking the 8th AJCC System: Is It Suitable for Patients Aged <55 Years With Stage T4N1M0 Follicular Variant of Papillary Thyroid Carcinoma to Be Placed in Stage I?

Front Oncol 2020 11;10:543055. Epub 2020 Dec 11.

Department of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China.

Purpose: The newest (8th) edition of the TNM staging system published in 2017. In this edition, some significant changes happened from the previous edition. As a result, down-staging appeared in nearly one third of DTC patients. However, we don't know whether the new system predicts the survival of FVPTC patients accurately. Therefore, it is necessary to thoroughly evaluate the correlation between the new system and survival prediction in terms of FVPTC.

Methods: We enrolled 17,662 FVPTC patients from the Surveillance, Epidemiology, and End Results database. Factors associated with survival were identified by Cox regression analyses. The mortality rates per 1,000 person-years were calculated and compared. Cox proportional hazards regression quantified the risk of survival, and survival curves were produced by Kaplan-Meier analyses using log-rank tests.

Results: Age at diagnosis, race, T-stage at diagnosis, distant metastasis, radiation therapy, and surgery were independent factors associated with cancer-specific survival. Patients aged <55 years with stage T4N1M0 FVPTC had higher mortality rates per 1,000 person-years than patients in the same stage according to the 8th AJCC System. Cox proportional hazards regression reflected that patients aged <55 years with stage T1-3, any N, M0 or T4N0M0 disease (p=0.001) and patients aged ≥55 years with T1-2N0M0 disease (p=0.004) had significantly lower risks of cancer-specific survival (CSS) than those aged <55 years with stage T4N1M0 disease. The CSS curve of patients aged <55 years with stage T4N1M0 disease showed a decline on comparison with others belonging to stage I (p<0.001); and the curve was even not different from patients in stage II and stage III (p>0.05).

Conclusion: Patients aged <55 years with stage T4N1M0 FVPTC had worse survival than patients in stage I; no difference was seen on comparison with stage II patients. We recommend this group of patients be upstaged in the 8th AJCC system.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fonc.2020.543055DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7794009PMC
December 2020

Transcription factor EB‑mediated autophagy promotes dermal fibroblast differentiation and collagen production by regulating endoplasmic reticulum stress and autophagy‑dependent secretion.

Int J Mol Med 2021 02 9;47(2):547-560. Epub 2020 Dec 9.

Department of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, P.R. China.

Autophagy is reported to be involved in the formation of skin hypertrophic scar (HTS). However, the role of autophagy in the process of fibrosis remains unclear, therefore an improved understanding of the molecular mechanisms associated with autophagy may accelerate the development of effective therapeutic strategies against HTS. The present study evaluated the roles of autophagy mediated by transcription factor EB (TFEB), a pivotal regulator of lysosome biogenesis and autophagy, in transforming growth factor‑β1 (TGF‑β1)‑induced fibroblast differentiation and collagen production. Fibroblasts were treated with TGF‑β1, TGF‑β1 + tauroursodeoxycholic acid (TUDCA) or TGF‑β1 + TFEB‑small interfering RNA (siRNA). TGF‑β1 induced phenotypic transformation of fibroblasts, as well as collagen synthesis and secretion in fibroblasts in a dose‑dependent manner. Western blotting and immunofluorescence analyses demonstrated that TGF‑β1 upregulated the expression of autophagy‑related proteins through the endoplasmic reticulum (ER) stress pathway, whereas TUDCA reversed TGF‑β1‑induced changes. Reverse transcription‑quantitative PCR (RT‑qPCR), western blotting and RFP‑GFP‑LC3 double fluorescence analyses demonstrated that knockdown of TFEB by TFEB‑siRNA decreased autophagic flux, upregulated the expression of proteins involved in the apoptotic pathway, such as phosphorylated‑α subunit of eukaryotic initiation factor 2, C/EBP homologous protein and cysteinyl aspartate specific proteinase 3, and also downregulated the expression of α‑smooth muscle actin and collagen I (COL I) in fibroblasts. Immunofluorescence confocal analyses and enzyme‑linked immunosorbent assay indicated that TGF‑β1 increased the colocalization of COL I with lysosomal‑associated membrane protein 1 and Ras‑related protein Rab‑8A, a marker of secretory vesicles, in fibroblasts, as well as the secretion of pro‑COL Iα1 in culture supernatants. Meanwhile, these effects were abolished by TFEB knockdown. The present results suggested that autophagy reduced ER stress, decreased cell apoptosis and maintained fibroblast activation not only through degradation of misfolded or unfolded proteins, but also through promotion of COL I release from the autolysosome to the extracellular environment.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3892/ijmm.2020.4814DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7797452PMC
February 2021

D-Dimer as a Prognostic Indicator in Critically Ill Patients Hospitalized With COVID-19 in Leishenshan Hospital, Wuhan, China.

Front Pharmacol 2020 21;11:600592. Epub 2020 Dec 21.

Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, China.

D-dimer is a small protein fragment and high levels of D-dimer have been associated with increased mortality in patients presenting to emergency departments with infection. Previous studies have reported increased levels of D-dimer in COVID-19; however, it is unclear whether an increased D-dimer level provides early warning of poor prognosis. Therefore, this study aimed to assess the usefulness of D-dimer as an early indicator of prognosis in patients with coronavirus disease (COVID-19). We conducted a retrospective study of patients with COVID-19 admitted to Leishenshan Hospital in Wuhan, China, from February 15 to March 30, 2020. The final date of follow-up was April 11, 2020. Of the 1,643 patients with COVID-19, 691 had elevated D-dimer levels. Their median age was 65 years. Of the patients with elevated D-dimer levels, 45% had comorbidities, with cardiovascular disease (205 [29.7%]) being the most common. Patients with elevated D-dimer were more likely to require treatment with high-flow oxygen, anticoagulation, antibiotics, and admission to the intensive care unit They were also more likely to have increased interleukin-6, monocytes, and lymphocytes. Patients with elevated D-dimer levels had significantly higher mortality than those with normal or low D-dimer levels. In patients with COVID-19, elevated D-dimer was associated with abnormal immunity, underlying disease, increased disease severity, and increased mortality. Taken together, D-dimer may be a marker for the early warning of disease severity and increased risk of death. These findings provide insights into the potential risk of elevated D-dimer in patients with COVID-19.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fphar.2020.600592DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7779604PMC
December 2020

Elevated α-hydroxybutyrate dehydrogenase as an independent prognostic factor for mortality in hospitalized patients with COVID-19.

ESC Heart Fail 2021 02 17;8(1):644-651. Epub 2020 Dec 17.

Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Donghu Road 169, Wuhan, 430071, China.

Aims: Many studies have explored the clinical characteristics of patients with coronavirus disease (COVID-19), especially patients with cardiovascular disease. However, associated mechanisms and markers remain to be further investigated. This study aimed to investigate the effect of α-hydroxybutyrate dehydrogenase (α-HBDH) levels on disease progression and prognosis of patients with COVID-19.

Methods And Results: One thousand seven hundred and fifty-one patients from the Leishenshan hospital in Wuhan were divided into elevated and normal groups by α-HBDH level, and the clinical information between the two groups was compared retrospectively. The main outcome evaluation criteria included in-hospital death and disease severity. Univariate and multivariate regression analyses, survival curves, logistic regression, and receiver operating characteristic curve models were performed to explore the relationship between elevated α-HBDH and the two outcomes. Besides, curve fitting analyses were conducted to analyse the relationship between computed tomography score and survival. Among 1751 patients with confirmed COVID-19, 15 patients (0.87%) died. The mean (SD) age of patients was 58 years in normal α-HBDH group and 66 years in elevated α-HBDH group (P < 0.001). The mortality during hospitalization was 0.26% (4 of 1559) for patients with normal α-HBDH levels and 5.73% (11 of 192) for those with elevated α-HBDH levels (P < 0.001). Multivariate Cox analysis confirmed an association between elevated α-HBDH levels and higher risk of in-hospital mortality [hazard ratio: 4.411, 95% confidence interval (95% CI), 1.127-17.260; P = 0.033]. Multivariate logistic regression for disease severity and α-HBDH levels showed significant difference between both groups (odds ratio = 3.759; 95% CI, 1.895-7.455; P < 0.001). Kaplan-Meier curves also illustrated the survival difference between normal and elevated α-HBDH patients (P < 0.001).

Conclusions: Our study found that serum α-HBDH is an independent risk factor for in-hospital mortality and disease severity among COVID-19 patients. α-HBDH assessment may aid clinicians in identifying high-risk individuals among COVID-19 patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/ehf2.13151DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7835619PMC
February 2021

Bilirubin Levels as Potential Indicators of Disease Severity in Coronavirus Disease Patients: A Retrospective Cohort Study.

Front Med (Lausanne) 2020 9;7:598870. Epub 2020 Nov 9.

Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, China.

The coronavirus disease (COVID-19) pandemic has caused a large number of deaths. Some patients with severe or critical COVID-19 have been observed to have elevated bilirubin levels. Studies on the association of bilirubin level and mortality in patients with COVID-19 are limited. This study aimed to examine the role of bilirubin levels in COVID-19 severity and mortality. A retrospective cohort study was conducted in patients hospitalized with COVID-19 in Leishenshan Hospital in Wuhan, China. Cox regression analyses and logistic regression analyses were conducted to investigate the risks for mortality and disease severity, respectively. Kaplan-Meier analyses with log-rank tests were performed to assess the association between bilirubin level and survival. In total, 1,788 patients with COVID-19 were included in the analysis. 5.8% (4/69) of patients in the elevated serum total bilirubin (STB) group died, compared to 0.6% (11/1,719) of patients in the non-elevated STB group. The median alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities in the elevated STB group were 29 U/L [interquartile range (IQR): 16-45 U/L] and 22 U/L (IQR: 13-37 U /L), respectively, which were significantly higher than the median ALT (median: 23, IQR: 15-37) and AST (median: 20, IQR: 16-26) activities in the non-elevated STB group (both < 0.05). Patients with an elevated STB level showed increased mortality [hazard ratio (HR): 9.45, = 0.002], elevated conjugated bilirubin (CB) levels (HR: 4.38, = 0.03), and an elevated ratio of CB to unconjugated bilirubin (UCB, CB/UCB) (HR: 2.49, = 0.01). CB/UCB was positively correlated with disease severity (odds ratio: 2.21, = 0.01). COVID-19 patients with elevated STB and CB levels had a higher mortality, and CB/UCB was predictive of disease severity and mortality. Thus, it is necessary to pay special attention to COVID-19 patients with elevated bilirubin levels in clinical management.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fmed.2020.598870DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7680876PMC
November 2020

Novel analysis of prognosis of young patients with stage II differentiated thyroid cancer based on AJCC 8.0 and 6.0 criteria to implement the staging system.

Gland Surg 2020 Oct;9(5):1244-1257

Department of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China.

Background: The incidence of thyroid cancer among young adults is increasing; however, the clinical challenges specific to this population, such as diagnosis, reduced healthcare access, and inconsistent care, have received limited attention. Here, we conducted a subgroup analysis on a series of relatively young patients with differentiated thyroid carcinomas (DTCs), focusing on those with distant metastases at stage II, to obtain a deeper understanding of the factors influencing survival.

Methods: Information on <45- or <55-year-old patients at any T/N stage with distant metastasis (M1) was extracted from the SEER database according to the staging system in the 6 and 8 American Joint Committee on Cancer (AJCC) editions, respectively. Patient mortality was evaluated using Cox proportional hazards regression analyses and Kaplan-Meier analyses with log-rank tests.

Results: Both cancer-specific and all-cause mortality rates per 1,000 person-years for patients ≥35 years old significantly differed from those of patients <35 years old. DTC-specific survival curves also significantly differed between these age groups, according to both the AJCC 6.0 and 8.0-based analyses (P=0.0017 and P<0.001, respectively), as did patient survival curves (P=0.0003, P<0.001, respectively). The multivariate Cox regression model also revealed that poor OS was strongly predicted by race (P<0.001) in the analysis based on the criteria of 8 AJCC staging system.

Conclusions: Age is a risk factor for disease-specific and overall survival (OS) in young patients with stage II DTC, and young male patients exhibited poorer survival than females. Race also emerged as a potential risk factor for young patients in stage II. These findings offer guidance for improving the older and newer versions of the AJCC staging system.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.21037/gs-20-46DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7667068PMC
October 2020

Development of a novel oxidative stress-amplifying nanocomposite capable of supplying intratumoral HO and O for enhanced chemodynamic therapy and radiotherapy in patient-derived xenograft (PDX) models.

Nanoscale 2020 Nov;12(45):23259-23265

Department of Molecular pathology, Application Center for Precision Medicine, the Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, China.

Radiotherapy (RT) is a potent approach to cancer treatment, but the tumor microenvironment (TME) in solid tumors is often highly hypoxic and contains high levels of antioxidant enzymes, thereby reducing the RT efficacy. In this study, we developed an oxidative stress amplifier (termed CFM) capable of self-sufficient H2O2 and O2 delivery that can be used in concert with RT and chemodynamic therapy (CDT) to treat tumors in patient-derived xenograft (PDX) model systems. Upon exposure to the hypoxic and acidic TME, CFM undergoes rapid degradation that results in the release of Fe3+, Ca2+, O2, and H2O2. Glutathione can subsequently reduce Fe3+ to Fe2+, which is then able to react with H2O2via the Fenton reaction to yield high levels of hydroxyl radicals which subsequently damage mitochondria. CaO2-derived O2 also modulates intratumoral hypoxia, while excessive Ca2+ levels within mitochondria result in apoptotic cell death. Altogether, these properties sensitize PDX tumors to RT. Importantly, the Fe, Zn, and Ca generated by CFM degradation are essential elements in humans. Altogether, these properties make this approach to oxidative stress amplification a promising means of amplifying oxidative stress within tumors while overcoming hypoxia-related resistance to RT, thereby providing a framework for the design of potent radiosensitizing therapeutic approaches.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1039/d0nr06594cDOI Listing
November 2020

Analysis of the Risk Factors for Mortality in Adult COVID-19 Patients in Wuhan: A Multicenter Study.

Front Med (Lausanne) 2020 25;7:545. Epub 2020 Aug 25.

Department of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China.

An outbreak of coronavirus disease (COVID-19) in 2019 in Wuhan, China, has spread quickly worldwide. However, the risk factors associated with COVID-19-related mortality remain controversial. A total of 245 adult patients with laboratory-confirmed COVID-19 from two centers were analyzed. Chi-square, Fisher's exact, and the Mann-Whitney -tests were used to compare the clinical characteristics between the survivors and non-survivors. To explore the risk factors associated with in-hospital death, univariable and multivariable cox regression analyses were used. Of the 245 patients included in this study, 23 (9.4%) died in the hospital. The multivariate regression analysis showed increased odds of in-hospital deaths associated with age, D-dimer levels >1,000 ng/L, platelet count <125, and higher serum creatinine levels. We identified risk factors that show significant association with mortality in adult COVID-19 patients, and our findings provide valuable references for clinicians to identify high-risk patients with COVID-19 at an early stage.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fmed.2020.00545DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7479842PMC
August 2020

Synergic effects of histology subtype, lymph node metastasis, and distant metastasis on prognosis in differentiated thyroid carcinoma using the SEER database.

Gland Surg 2020 Aug;9(4):907-918

Department of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China.

Background: Differentiated thyroid carcinoma (DTC) is the most common clinical type of thyroid carcinoma. There are rare reports on the synergic effects of the different clinicopathological risk factors on the prognosis of it.

Methods: We retrospectively reviewed data on 86,032 DTC patients from the Surveillance, Epidemiology, and End Results (SEER) database. Univariate and multivariate Cox regression analyses were conducted to evaluate the correlation between clinicopathological factors and the prognosis of DTC. Relative excess risk (RERI) of synergic effect, attributable proportion (AP) of synergic effect, and synergy index (SI) were calculated to assess synergic effects. Kaplan-Meier analyses with log-rank tests was used to plot the survival curve affected by different risk factors.

Results: Histology subtype, lymph node metastasis (LNM) status, and distant metastasis (DM) were independent risk factors for cancer-specific survival (CSS) and all-cause survival (ACS) in the multivariate analysis (all, P<0.001). Patients' age at diagnosis, sex, extrathyroidal extension, and radiation also influenced prognosis (all, P<0.001). The cancer-specific mortality (CSM) and all-cause mortality (ACM) rates per 1,000 person-years were higher in patients with follicular thyroid carcinoma (FTC) and in those with N1 stage and M1 stage disease. Furthermore, we observed a significant synergic effect between histology subtype and N stage, as well as histology subtype and M stage for the CSM of DTC (RERI =48.806, AP =0.853, SI =7.565; RERI =37.889, AP =0.430, SI =1.771, respectively). However, no synergic effect was observed in the case of the N stage and M stage for the CSM of DTC (RERI =7.928, AP =0.084, SI =1.093).

Conclusions: Patients with histology subtype of FTC and N1 stage, histology subtype of FTC and M1 stage had significant additive synergic effects on DTC prognosis for CSM.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.21037/gs-20-273DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7475367PMC
August 2020

Synergistic effect of clinicopathological factors on mortality risk in patients with differentiated thyroid cancer: An analysis using the SEER database.

Surg Oncol 2020 Sep 3;34:96-102. Epub 2020 Apr 3.

Department of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China. Electronic address:

Objectives: In this study, we analyzed the effects of histology subtypes, lymph node N-stages, and the presence of extrathyroidal extensions on cancer-specific survival (CSS) and overall survival (OS) in patients with differentiated thyroid cancer.

Materials And Methods: Cox proportional hazards regression analyses were carried out to evaluate the correlations between clinicopathological factors and CSS/OS. The combined effects of these factors on CSS and OS were then analyzed to determine the relative excess risk, attributable proportion, and synergy index. Kaplan-Meier curves were used to evaluate the mortality rate.

Results: A total of 86033 cases were included in the analysis. Histology subtype, N-stage, and extrathyroidal extension were all found to be risk factors for CSS (hazard ratio [HR] = 1.8, 95% confidence intervals [CI]: 1.4-2.3, p < 0.001; HR = 1.9, 95% CI: 1.6-2.3, p < 0.001; HR = 1.4, 95% CI: 1.0-1.9, p = 0.035, respectively). The risk factors for OS were histology subtype and N-stage (HR = 1.3, 95% CI; 1.2-1.5, p < 0.001; HR = 1. 4, 95% CI: 1.3-1.5, p < 0.001, respectively) but not extrathyroidal extension (HR = 1.1, 95% CI: 0.9-1.3, p = 0.228). Furthermore, histology subtype and N-stage, histology subtype and extrathyroidal extension, and N stage and extrathyroidal extension (relative excess risk, attributable proportion, and synergy index: 48.8, 0.9, 7.6; 50.2, 0.7, 3.9; 7.0, 0.3, 1.6; respectively) were found to have significant synergistic effects.

Conclusion: Patients with follicular thyroid carcinoma (FTC) and extrathyroidal extension or lymph node metastasis are at a higher risk of mortality. Histology subtype, N-stage, and extrathyroidal extension appear to have synergistic effects on the increased risk of poor CSS in patients. This result can in the further development of treatment guidelines to improve the outcome of FTC patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.suronc.2020.04.003DOI Listing
September 2020

Dynamic Interleukin-6 Level Changes as a Prognostic Indicator in Patients With COVID-19.

Front Pharmacol 2020 17;11:1093. Epub 2020 Jul 17.

Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, China.

Background: Interleukin-6 (IL-6), a proinflammatory cytokine, has been reported to be associated with disease severity and mortality in patients with coronavirus disease 2019 (COVID-19). Yet, dynamic changes in IL-6 levels and their prognostic value as an indicator of lung injury in COVID-19 patients have not been fully elucidated.

Objective: To validate whether IL-6 levels are associated with disease severity and mortality and to investigate whether dynamic changes in IL-6 levels might be a predictive factor for lung injury in COVID-19 patients.

Methods: This retrospective, single-center study included 728 adult COVID-19 patients and used data extracted from electronic medical records for analyses.

Results: The mortality rate was higher in the elevated IL-6 group than in the normal IL-6 group (0.16 5%). Cox proportional hazards and logistic regression analyses for survival (adjusted hazard ratio, 10.39; 95% confidence interval [CI], 1.09-99.23; = 0.042) and disease severity (adjusted odds ratio, 3.56; 95% CI, 2.06-6.19; < 0.001) revealed similar trends. Curve-fitting analyses indicated that patient computed tomography (CT) scores peaked on days 22 and 24. An initial decline in IL-6 levels on day 16 was followed by resurgence to a peak, nearly in tandem with the CT scores.

Conclusion: Increased IL-6 level may be an independent risk factor for disease severity and in-hospital mortality and dynamic IL-6 changes may serve as a potential predictor for lung injury in Chinese COVID-19 patients. These findings may guide future treatment of COVID-19 patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fphar.2020.01093DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7379481PMC
July 2020

Association Between Diabetes and COVID-19: A Retrospective Observational Study With a Large Sample of 1,880 Cases in Leishenshan Hospital, Wuhan.

Front Endocrinol (Lausanne) 2020 14;11:478. Epub 2020 Jul 14.

Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, China.

This study aimed to investigate the clinical courses and outcomes of diabetes mellitus patients with coronavirus disease 2019 (COVID-19) in Wuhan. This study enrolled 1,880 consecutive patients with confirmed COVID-19 in Leishenshan Hospital. We collected and analyzed their data, including demographic data, history of comorbidity, clinical symptoms, laboratory tests, chest computed tomography (CT) images, treatment options, and survival. The percentages of patients with diabetes among the severe and critical COVID-19 cases were higher than those among the mild or general cases (89.2%, 10.8 vs. 0%, = 0.001). However, patients with and without diabetes showed no difference in the follow-up period ( = 0.993). The mortality rate in patients with or without diabetes was 2.9% ( = 4) and 1.1% ( = 9), respectively ( = 0.114). Univariate and multivariate Cox regression analyses and the Kaplan-Meier curves did not show any statistically significant differences between patients with and without diabetes (all > 0.05). Our study results suggested that diabetes had no effect on the prognosis of COVID-19 patients but had a negative association with their clinical courses. These results may be useful for clinicians in the management of diabetic patients with COVID-19.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fendo.2020.00478DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7371935PMC
August 2020

Clinical characteristics of emergency surgery patients infected with coronavirus disease 2019 (COVID-19) pneumonia in Wuhan, China.

Surgery 2020 09 19;168(3):398-403. Epub 2020 May 19.

Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, China. Electronic address:

Background: We aimed to investigate clinical symptoms and epidemiologic features of emergency surgery patients infected with the 2019 novel coronavirus disease (COVID-19). More than 5 million people worldwide have been diagnosed with COVID-19 since December 2019 to the time of this publication. Thousands of emergency operations have been carried out since December 2019. To date, however, no literature has focused on the clinical symptoms of emergency surgery patients with COVID-19 pneumonia.

Methods: We conducted a retrospective cohort study of 164 emergency surgery patients with or without COVID-19 pneumonia in Zhongnan Hospital of Wuhan University in Wuhan, China, from January 1, 2020, to January 20, 2020. For this report, the final date of follow-up was February 5, 2020. The associated clinical, laboratory, epidemiologic, demographic, radiologic, and outcome data were collected and analyzed.

Results: Of the 164 emergency surgery patients, the median age was 41 years (interquartile range, 29-89), and 136 (82.9%) were women. The associated main clinical symptom included fever (93 [56.7%]),dry cough (56 [34.2%]), fatigue (86 [52.4%]), nausea (78 [47.6%]), and dizziness (77 [47%]). Of 54 emergency surgery patients infected with COVID-19, the median age was 46 years (interquartile range: 25-89), and 45 (83.3%) were women. The pathologic clinical symptoms investigated included fever (54 [100%]), fatigue (48 [88.9%]), nausea (52 [96.3%]), dizziness (46 [85.2%]), and dry cough (44 [81.5%]). The lymphopenia (0.37 × 10/L [interquartile range: 0.23-0.65]) and increased C-reactive protein (24.7 × 10/L [interquartile range: 13.57-38]) were observed. The preoperative fever and postoperative fever in emergency surgery patients with or without COVID-19 pneumonia were analyzed in this study. Of 54 emergency surgery patients with COVID-19, 15 (27.8%) showed preoperative fever, 54 (100%) had postoperative fever. Of 110 emergency surgery patients without COVID-19, 5 (4.5%) had preoperative fever, 31 (28.2%) patients had postoperative fever. In emergency surgery patients with COVID-19, the fever lasted more than 7 days, markedly exceeded the length of time non-COVID-19 patients experienced fever (approximately 3 days). Furthermore, 43 health care workers were exposed to emergency surgery patients with COVID-19 pneumonia and were infected with COVID-19 pneumonia.

Conclusion: In our study, the clinical symptoms of emergency surgery patients infected with COVID-19 displayed marked differences from those reporting common COVID-19 pneumonia. In addition, the health care workers were suspected to have been exposed to a great risk when caring for emergency surgery patients with COVID-19 pneumonia. Management guidelines of emergency surgery patients are described in in this report.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.surg.2020.05.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7236668PMC
September 2020

New proposed tumor-node-metastasis staging system for medullary thyroid carcinoma based on the Surveillance, Epidemiology, and End Results database.

Am J Transl Res 2020 15;12(6):2703-2710. Epub 2020 Jun 15.

Department of Plastic Surgery, Zhongnan Hospital of Wuhan University Wuhan 430071, China.

Background: Medullary thyroid carcinoma (MTC) has been separated into its own chapter in the 8th edition of the American Joint Committee on Cancer (AJCC) staging system. However, controversies still exist for the staging of MTC. This study aimed to identify prognostic differences among patients with MTC to define a more accurate staging system.

Methods: Data on cancer-specific survival from the Surveillance, Epidemiology, and End Results database between 2010 and 2014 were used for this study. Kaplan-Meier (K-M) curves, Cox proportional hazards regression analysis, and mortality per 1000-person-years were used to evaluate the mortality rate to create the new staging system.

Results: A total of 960 cases were included in this analysis. The mortality rates of 24 different groups, which were classified using T stage (T1-4), N stage (N0-1b), and M stage (M0-1) were assessed using K-M curves. Cox proportional hazards regression analysis and mortality per 1000-person-years were used to classify patients, as stage I (T1-3N0-1aM0, 654, 68.34%), stage II (T1-3N1bM0, 181, 18.91%), stage III (T4N0-1bM0, 58, 6.06%), and stage IV (T1-4N0-1bM1, 64, 6.69%). The hazard ratios of stages II, III, and IV, using stage I as a reference, were 5.281 (95% confidence interval [CI], 1.236-22.562), 20.603 (95% CI, 4.400-96.467), and 55.717 (95% CI, 14.307-216.988), respectively. The mortality rates per 1000-person-years of stages I, II, III, and IV were 2.036 (95% CI, 0.657-6.312), 14.867 (95% CI, 6.679-33.092), 98.287 (95% CI, 54.432-177.478), and 224.199 (95% CI, 146.180-343.860), respectively.

Conclusions: Compared with the current AJCC tumor-node-metastasis (TNM) staging system for MTC, this new proposed TNM staging system, which is based on cancer-specific mortality rate analysis, provides more accurate risk stratification and can ensure more rational treatment measures.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7344094PMC
June 2020

Potential Prognostic Predictors and Molecular Targets for Skin Melanoma Screened by Weighted Gene Co-expression Network Analysis.

Curr Gene Ther 2020 ;20(1):5-14

Department of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China.

Aims And Objectives: Among skin cancers, malignant skin melanoma is the leading cause of death. Identification of gene markers of malignant skin melanoma associated with survival may provide new clues for prognosis prediction and treatment. This research aimed to screen out potential prognostic predictors and molecular targets for malignant skin melanoma.

Introduction: Information regarding gene expression in skin melanoma and patients' clinical traits was obtained from the Gene Expression Omnibus database. Weighted gene co-expression network analysis (WGCNA) was applied to build co-expression modules and investigate the association between the modules and clinical traits. Moreover, functional enrichment analysis was performed for clinically significant co-expression modules. Hub genes of these modules were validated via Gene Expression Profiling Interactive Analysis (GEPIA) and the Human Protein Atlas (http:// www.proteinatlas.org).

Methods: First, using WGCNA, 9 co-expression modules were constructed by the top 25% differentially expressed genes (4406 genes) from 77 human melanoma samples. Two co-expression modules (magenta and blue modules) were significantly correlated with survival months (r = -0.27, p = 0.02; r = 0.27, p = 0.02, respectively). The results of functional enrichment analysis demonstrated that the magenta module was mainly enriched in the cell cycle process and the blue module was mainly enriched in the immune response process. Additionally, the GEPIA and Human Protein Atlas results suggested that the hub genes CCNB2, ARHGAP30, and SEMA4D were associated with relapse-free survival and overall survival (all p-values < 0.05) and were differentially expressed in melanoma tumors and normal skin.

Results And Conclusion: The results provided the framework of co-expression gene modules of skin melanoma and screened out CCNB2, ARHGAP30, and SEMA4D associated with survival as potential prognostic predictors and molecular targets of treatment.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2174/1566523220666200516170832DOI Listing
January 2020

Comparison of Bone Remodeling Between Collum Femoris-Preserving Stems and Ribbed Stems in 1-Stage Bilateral Total Hip Arthroplasty.

Med Sci Monit 2020 May 15;26:e924668. Epub 2020 May 15.

Department of Orthopedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland).

BACKGROUND This study examined a cohort of patients who underwent bilateral THAs. CFP prostheses and ribbed prostheses were each used on both sides. We assessed the midterm clinical, radiological, and bone remodeling outcomes around prosthesis of these patients. MATERIAL AND METHODS From January 2009 to January 2013, 53 patients were enrolled in our study. We clinically evaluated all patients by recording Harris hip and Oxford hip scores. Some radiological indicators of the femoral prosthesis position were measured. Periprosthetic bone remodeling was assessed via bone mineral density (BMD) measurements. RESULTS The mean preoperative HHS of the CFP group and ribbed group were no significantly different (P=0.570). The neck-shaft angle in the ribbed group was significantly greater than in the CFP group (P<0.001). The CFP group had a greater offset (P<0.001). There was no significant difference in leg-length discrepancy (P=0.727) or Engh score between the 2 groups at the last follow-up (P=0.858). The preoperative BMD was increased at the last follow-up in Gruen zones 3 and 5 (P<0.05) and decreased in Gruen zones 1 and 7 (P<0.05) on the CFP side. BMD was increased in Gruen zone 4 (P=0.007) on the ribbed side. Pearson correlations and rate of complications were not significantly different. CONCLUSIONS Both the CFP and ribbed stem significantly improved the preoperative HHSs and OHSs. The bone remodeling of the CFP stem was more concentrated in the middle and distal regions of the prosthesis, while that of the ribbed stem was more concentrated in the proximal portion of the prosthesis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.12659/MSM.924668DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7245061PMC
May 2020

Is a simplified TNM staging system more clinically relevant than the American Joint Committee on Cancer system for the follicular variant of papillary thyroid cancer?

Ann Transl Med 2020 Apr;8(7):463

Department of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.

Background: Despite the recent release of the 8th edition of the American Joint Committee on Cancer (AJCC) staging manual, risk stratification for the follicular variant of papillary thyroid cancer (FVPTC), which is the second common variant of papillary thyroid carcinoma (PTC) after classical PTC, remains controversial. This study aimed to develop a more accurate and relevant staging system specifically for FVPTC.

Methods: Patients with FVPTC who were included in the Surveillance, Epidemiology, and End Results (SEER) open database between 2010 and 2015 were divided into 47 groups according to their TNM classifications and age. Subsequently, these 47 groups were categorized into appropriate stages based on Kaplan-Meier survival curves, mortality analyses, a Cox proportional hazards model, and clinical considerations.

Results: Our retrospective analysis of 17,628 cases yielded the following new staging classification: stage I, defined as age <55 years and any T/N/M or age ≥55 years and T1-3/any N/M0 (n=17,427, 98.85%); stage II, age ≥55 and T4/any N/M0 or age ≥55 and any T/N0/M1 (n=173, 0.99%); and stage III, age ≥55 and any T/N1/M1 (n=28, 0.16%). The overall mortality rates per 1,000-person-years were 4.135 [95% confidence interval (CI): 3.653-4.681], 71.193 (95% CI: 51.354-98.697), and 199.744 (95% CI: 115.983-343.997) for our new stages I, II, and III, respectively. The hazard ratios for the new stages II and III (reference: stage I) were 5.081 (95% CI: 3.110-8.301) and 21.690 (95% CI: 11.402-41.258), respectively.

Conclusions: Compared to the 8th edition of the AJCC staging system, our newly proposed system provided more accurate risk stratification for patients with FVPTC, as demonstrated by actual survival and mortality outcomes. This new model may thus help guide more personalized treatment for these patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.21037/atm.2020.03.111DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7210171PMC
April 2020

Exploring the structure-property relationship of three-dimensional hexagonal boron nitride aerogels with gyroid surfaces.

Nanoscale 2020 May;12(18):10180-10188

International Center for Applied Mechanics, State Key Laboratory for Strength and Vibration of Mechanical Structures, School of Aerospace, Xi'an Jiaotong University, Xi'an 710049, China.

Three-dimensional hexagonal boron nitride aerogels (hBNAGs) are novel porous materials with many promising applications such as energy storage, thermal insulation and sensing. However, the structure-property relationships of hBNAGs in complicated thermo-mechanical coupled environments are still not clear. In this study, we employed a binary phase-field crystal (PFC) model to construct the atomic structures of hBNAGs, upon which the mechanical and thermal behaviors of hBNAGs were systematically investigated using large-scale atomistic simulations. It is found that the hBNAG geometry and topological defects strongly affect the mechanical and thermal properties. For example, the Young's modulus and tensile strength follow the scaling laws of mass density with a power factor of about 1.4 and 1.2, respectively, indicating that the stretching and bending combine toward tensile deformation. In addition, cracks nucleate around the octagon defects, indicating that the tensile strength is also influenced by the topological defects. Under compression, complicated crumpled deformations and ridges in the entire region are observed and the compression strength follows the scaling law of mass density with a power factor above 2.0, which means that a large portion of the hBNAGs do not contribute to the compression load bearing. We find that hBNAGs have a very low thermal conductivity of about two orders of magnitude lower than that of a hBN sheet. Also, the thermal conductivity of hBNAGs increases with increasing mass density, which also follows a scaling law. The power of the scaling law is about 0.5, indicating that the thermal conductivity has a strong nonlinear dependence on the mass density. Our work provides a deep understanding of the structure-property relationships of hBNAGs, which is useful for the engineering applications of hBNAGs.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1039/d0nr01055cDOI Listing
May 2020

Injectable Hydrogel for NIR-II Photo-Thermal Tumor Therapy and Dihydroartemisinin-Mediated Chemodynamic Therapy.

Front Chem 2020 7;8:251. Epub 2020 Apr 7.

Department of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China.

In traditional Chinese medicine, dihydroartemisinin (DHA) is the focus of extensive attention because of its unique activity with Fe to produce reactive oxygen species (ROS) and promote apoptosis. In this work, we designed a newfangled [email protected] containing FeCl, traditional Chinese ink (Hu Kaiwen ink), and agarose hydrogel to create a synergistic activity with DHA in the treatment of cancer. When the system is irradiated under 1,064 nm for a few minutes, the ink in the [email protected] converts the light to heat and hyperthermia causes the reversible hydrolysis of hydrogel. Then, Fe quickly diffuses from the hydrogel to the tumor microenvironment and is reduced to Fe to break the endoperoxide bridge in pre-injected DHA, which results in the release of free radicals for a potent anticancer action. To our knowledge, this is the first report of a hydrogel tumor therapy system that induces a photo-thermal response in the second near infrared window (NIR-II). experiments also showed a significant effect of DHA-Fe in chemodynamic therapy (CDT) and in photo-thermal therapy. This hydrogel platform provided an encouraging idea for synergistic tumor therapy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fchem.2020.00251DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7154176PMC
April 2020

Heptazoline exerts antiproliferative effects on human melanoma cells by inducing apoptosis, cell cycle arrest and targeting MAPK signalling pathway.

J BUON 2020 Jan-Feb;25(1):479-484

Department of Plastic Surgery, Zhongnan Hospital of Wuhan University , Wuhan , Hubei , 430071, China.

Purpose: Melanoma is one of the prevalent types of cancer and ranks 6th major cause of cancer associated mortality. In this study the anticancer effects of the carbazole alkaloid Heptazoline were investigated against a panel of melanoma cells.

Methods: The normal BJ-5TA and melanoma cell lines MEL-CLS-1M MEL-CLS-2, MEL-CLS-3 were used in this study. MTT and colony formation assays were used to determine the proliferation rate of melanoma cells Aciridine orange (AO)/ ethidium bromide (EB) and annexin V/propidium iodide (PI) staining were used to check the apoptotic cell death. Cell cycle analysis was performed by flow cytometry and protein expression was checked by western blotting.

Results: Heptazoline inhibited the growth of all the melanoma cell lines, exhibiting an IC50 of 15 to 40 µM against the melanoma cells. However, the normal skin cells had IC50 125 µM. The anticancer effects were found to be due to induction of apoptotic cell death which was associated with the upregulation of Bax, cleaved caspase 3, 9 and PARP and downregulation of Bcl-2. Furthermore, Heptazoline also triggered the G0/G1 arrest of melanoma cells. The effects of Heptazoline on the MAPK signalling pathway revealed that this molecule could inhibit the expression of p-p38 concentration-dependently.

Conclusion: Taken together, Heptazoline may prove a lead molecule in the development of systemic therapy of melanoma.
View Article and Find Full Text PDF

Download full-text PDF

Source
December 2020

Innovative analysis of distant metastasis in differentiated thyroid cancer.

Oncol Lett 2020 Mar 15;19(3):1985-1992. Epub 2020 Jan 15.

Department of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, P.R. China.

Differentiated thyroid cancer (DTC) is the most common thyroid cancer with a relatively high survival rate. The association between certain risk factors of distant metastasis (DM) remains uncertain. In order to assess the prognosis of patients with DTC better, the present study aimed to investigate the synergistic effects between histologic subtype, tumor size, lymph node metastasis (LNM) status and extrathyroidal extension (ETE) on the incidence of DM in DTC. Data of 96,788 patients with DTC were obtained from the Surveillance, Epidemiology and End Results database. The association between clinicopathological factors and DM was evaluated by univariate and multivariate analyses. The synergistic effects of relevant factors were determined by measuring the relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP) and synergy index (SI). The results demonstrated that tumor size, LNM status, histologic subtype and ETE were independent risk factors for DM [odds ratio (OR)=2.433; P<0.001; OR=3.998; P<0.001; OR=6.266; P<0.001; and OR=3.873; P<0.001, respectively]. In addition, a significant additive synergistic effect on DM was identified between ETE and histologic subtype, ETE and LNM status, as well as between ETE and tumor size (RERI=34.097; AP=0.706; SI=3.585; RERI=6.425; AP=0.410; SI=1.781; and RERI=76.973; AP=0.864; SI=7.930, respectively). Therefore, the results of this study revealed that ETE with follicular thyroid histology, N1 stage or large tumor size may have a synergistic effect on the risk of DM in patients with DTC. These results suggested that individualized treatment may benefit patients with DTC, and when ETE coexists with one of the identified risk factors, radical treatments may be required.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3892/ol.2020.11304DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7039098PMC
March 2020

Comparison of Clinical Outcomes, Radiological Outcomes and Bone Remodeling Outcomes Between Proximal Coated Single-Wedge New Stem and Full Coated Dual-Wedge Classic Stem in 1-Stage Bilateral Total Hip Arthroplasty.

Med Sci Monit 2020 Jan 31;26:e921847. Epub 2020 Jan 31.

Department of Osteonecrosis and Hip Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland).

BACKGROUND This retrospective study investigated the clinical outcomes, radiological outcomes, and bone remodeling patterns associated with a Medial/Lateral Taper (M/L Taper) stem and Link Classic Uncemented (LCU) stem in 1-stage bilateral total hip arthroplasty (THA). MATERIAL AND METHODS The results of 52 patients who underwent 1-stage bilateral THA with a M/L Taper stem on one side and an LCU stem on the other between January 2012 and February 2015 were retrospectively compared. Patients were clinically assessed by the Harris hip score (HHS), visual analogue score (VAS) and incidence of complications. Radiological indicators were measured. Periprosthetic bone remodeling was assessed via bone mineral density (BMD) measurements. RESULTS The mean follow-up time was 5.2 years. At each follow-up, there was no difference in the HHS and VAS between the 2 groups. The neck-shaft angle, offset, vertical height of the rotational center and limb lengthening were lower in the M/L Taper group than in the LCU group (P<0.001). The Engh total score was lower in the LCU group (P=0.039). Significantly higher (P<0.001) BMDs were observed in the M/L Taper group in Gruen zones 1, 2, and 6. significantly lower (P<0.001) BMDs were observed in the M/L Taper group in Gruen zones 3 and 5. CONCLUSIONS Due to the increased postoperative neck-shaft angle, the full coated dual-wedge classic stem was prone to cause lower limb lengthening. The proximal coated single-wedge new stem patients were more likely to have an insufficient postoperative neck length. The new stem achieved load transfer and proximal fixation, leading to better proximal femoral bone preservation is more in line with human biomechanical characteristics.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.12659/MSM.921847DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7006600PMC
January 2020