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Clinical Practice of Evidence-Based PDCA Cycle Management Model in Accelerated Recovery of Lung Cancer Patients

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Journal of Cancer Therapy 2024年第4期15卷 130-140页

作者： Lu Kang Juan Yuan Dandan Liu Bo Deng sun yat-sen university Cancer Center Guangzhou China

Objective: To explore the nursing effect of evidence-based PDCA cycle management mode in accelerated rehabilitation of patients undergoing thoracoscopic lung cancer radical surgery. Methods: 104 patients who underwent thoracoscopic lung cancer radical surgery in our hospital from June 2022 to February 2023 were randomly divided into control group and intervention group, with 52 cases in each group. The control group implemented evidence-based ERAS clinical pathway management, while the intervention group implemented evidence-based PDCA cycle quality management. The postoperative recovery of the two groups of patients was compared. Results: The postoperative recovery of the intervention group was significantly better than that of the control group. The first time to get out of bed, the first time to eat, the duration of chest drainage tube placement, and the length of hospital stay were significantly shorter than those of the control group. The incidence of postoperative chest complications and hospitalization costs were significantly lower than those of the control group, and patient satisfaction was significantly higher than that of the control group (P Conclusion: Evidence-based PDCA cycle quality management mode can effectively improve the implementation quality of accelerated rehabilitation nursing for patients undergoing thoracoscopic lung cancer radical surgery, and it is worthy of clinical promotion.

关键词： Evidence-Based PDCA Cycle Thoracoscopic Lung Cancer Radical Surgery Accelerated Rehabilitation

Radiomics models to predict bone marrow metastasis of neuroblastoma using CT

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Cancer Innovation 2024年第5期3卷 71-83页

作者： Xiong Chen Qinchang Chen Yuanfang Liu Ya Qiu Lin Lv Zhengtao Zhang Xuntao Yin Fangpeng Shu Department of Paediatric Urology Guangzhou Women and Children's Medical CenterGuangzhou Medical UniversityGuangzhouChina Department of Paediatric Surgery Guangzhou Institute of PaediatricsGuangzhou Medical UniversityGuangzhouChina Department of Pediatric Cardiology Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangdong Cardiovascular InstituteGuangdong Provincial Key Laboratory of Structural Heart DiseaseGuangzhouChina Department of Radiology Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina Department of Radiology the First People's Hospital of Kashi PrefectureKashiChina Medical School Sun Yat‐sen UniversityGuangzhouChina Department of Radiology Guangzhou Women and Children's Medical CenterGuangzhouChina

Background:Bone marrow is the leading site for metastasis from neuroblastoma and affects the prognosis of patients with ***,the accurate diagnosis of bone marrow metastasis is limited by the high spatial and temporal heterogeneity of *** analysis has been applied in various cancers to build accurate diagnostic models but has not yet been applied to bone marrow metastasis of ***:We retrospectively collected information from 187 patients pathologically diagnosed with neuroblastoma and divided them into training and validation sets in a ratio of 7:3.A total of 2632 radiomics features were retrieved from venous and arterial phases of contrastenhanced computed tomography(CT),and nine machine learning approaches were used to build radiomics models,including multilayer perceptron(MLP),extreme gradient boosting,and random *** also constructed radiomics‐clinical models that combined radiomics features with clinical predictors such as age,gender,ascites,and lymph gland *** performance of the models was evaluated with receiver operating characteristics(ROC)curves,calibration curves,and risk decile ***:The MLP radiomics model yielded an area under the ROC curve(AUC)of 0.97(95%confidence interval[CI]:0.95–0.99)on the training set and 0.90(95%CI:0.82–0.95)on the validation *** radiomics‐clinical model using an MLP yielded an AUC of 0.93(95%CI:0.89–0.96)on the training set and 0.91(95%CI:0.85–0.97)on the validation ***:MLP‐based radiomics and radiomics‐clinical models can precisely predict bone marrow metastasis in patients with neuroblastoma.

关键词： bone marrow metastasis machine learning neuroblastoma radiomics

Continuous Expression of Interferon Regulatory Factor 4 Sustains CD8^(+)T Cell Immunity against Tumor

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Research 2024年第3期2023卷 433-444页

作者： Anze Yu Jinfei Fu Zheng Yin Hui Yan Xiang Xiao Dawei Zou Xiaolong Zhang Xiongbing Zu Xian C.Li Wenhao Chen Immunobiology and Transplant Science Center Department of SurgeryHouston Methodist Research Institute and Institute for Academic MedicineHouston Methodist HospitalHoustonTXUSA Department of Urology First Affiliated HospitalSun Yat-sen UniversityGuangzhouGuangdongChina Systems Medicine and Bioengineering Department Houston Methodist Neal Cancer CenterHoustonTXUSA Department of Radiology Houston Methodist HospitalWeill Cornell MedicineHoustonTXUSA Department of Urology Xiangya HospitalCentral South UniversityChangshaHunanChina Department of Surgery Weill Cornell MedicineCornell UniversityNew YorkNYUSA.

T-cell-based immunotherapy is gaining momentum in cancer treatment;however,our comprehension of the transcriptional regulation governing T cell antitumor activity remains *** objective of this study was to explore the function of interferon regulatory factor 4(IRF4)in antitumor CD8^(+)T cells using the TRAMP-C1 prostate cancer and B16F10 melanoma *** achieve this,we generated an Irf4^(GFP-DTR) mouse strain and discovered that CD8^(+)tumor-infiltrating lymphocytes(TILs)expressing high levels of *** exhibited a more differentiated PD-1high cell *** administering diphtheria toxin to tumor-bearing Irf4^(GFP-DTR) mice,we partially depleted ***^(+)TILs and observed an accelerated tumor *** specifically explore the function of IRF4 in antitumor CD8^(+)T cells,we conducted 3 adoptive cell therapy(ACT)***,depleting ***^(+)CD8^(+)TILs derived from ACT significantly accelerated tumor growth,emphasizing their crucial role in controlling tumor ***,deleting the Irf4 gene in antitumor CD8^(+)T cells used for ACT led to a reduction in the frequency and effector differentiation of CD8^(+)TILs,completely abolishing the antitumor effects of ***,we performed a temporal deletion of the Irf4 gene in antitumor CD8^(+)T cells during ACT,starting from 20 days after tumor implantation,which significantly compromised tumor ***,sustained expression of IRF4 is essential for maintaining CD8^(+)T cell immunity in the melanoma model,and these findings carry noteworthy implications for the advancement of more potent immunotherapies for solid tumors.

关键词： sustained immunity implantation

Impact of baseline steroids on the efficacy of neoadjuvant immunochemotherapy in locally advanced esophageal squamous cell carcinoma

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World Journal of Gastrointestinal Oncology 2024年第9期16卷 3887-3897页

作者： Yuan-Heng Huang Guo-Zhen Yang Hui-Guo Chen Xiao-Jun Li Yong-Hui Wu Kai Zhang Jian-Nan Xu Jian Zhang Department of Cardiothoracic Surgery The Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhou 510630Guangdong ProvinceChina State Key Laboratory of Oncology in South China Collaborative Innovation Center of Cancer MedicineGuangzhou 510060Guangdong ProvinceChina Guangdong Esophageal Cancer Institute Guangzhou 510060Guangdong ProvinceChina

BACKGROUND Immunochemotherapy involving the combination of programmed cell death 1/programmed cell death ligand 1 inhibitors with chemotherapy has advanced the treatment of locally advanced esophageal squamous cell carcinoma(ESCC).The use of corticosteroids as pretreatment might reduce immunotherapy *** To investigate the impact of baseline corticosteroid use on neoadjuvant immunochemotherapy(nIC)outcomes in locally advanced ESCC *** Patients with locally advanced ESCC who received nIC at sun yat-sen university Cancer Center and the Third affiliated hospital of sun yat-sen university were *** were divided into dexamethasone and antihistamine groups on the basis of the administered *** efficacy and safety were evaluated,as well as its impact on short-term efficacy[complete pathological response(pCR),major pathological response(MPR)]and long-term efficacy[overall survival(OS),progression-free survival(PFS)]of *** From September 2019 to September 2023,142 patients were *** severe treatment-related adverse events or deaths were *** occurrence was greater in the antihistamine group(P=0.014).Short-term efficacy was not significantly different:The pCR rates were 29.9%and 40.0%,and the MPR rates were 57.9%and 65.7%in the dexamethasone and antihistamine groups,*** long-term efficacy was not significantly different:The 2 years OS rates were 95.2%and 93.5%,and the 2 years PFS rates were 90.3%and 87.8%.Subgroup analysis revealed no difference in OS between the 20 mg dexamethasone group and the<20 mg dexamethasone group,but PFS was significantly greater in the 20 mg dexamethasone group(93.9%vs 56.4%,P=0.001).CONCLUSION Dexamethasone or antihistamines can be used before nIC in locally advanced ESCC without affecting short-or long-term *** 20 mg dexamethasone before nIC may improve PFS in ESCC.

关键词： Esophageal squamous cell carcinoma Neoadjuvant immunochemotherapy Dexamethasone Antihistamines Treatment efficacy

Validation and performance of three scoring systems for predicting primary non-function and early allograft failure after liver transplantation

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Hepatobiliary & Pancreatic Diseases International 2024年第5期23卷 463-471页

作者： Yu Nie Jin-Bo Huang Shu-Jiao He Hua-Di Chen Jun-Jun Jia Jing-Jing Li Xiao-Shun He Qiang Zhao General Surgery Center Department of Hepatobiliary Surgery IIResearch Center for Artificial Organ and Tissue EngineeringGuangzhou Clinical Research and Transformation Center for Artificial LiverInstitute of Regenerative MedicineZhujiang HospitalSouthern Medical UniversityGuangzhou 510515China Organ Transplant Center the First Affiliated HospitalSun Yat-sen UniversityGuangzhou 510080China Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology Guangzhou 510080China Guangdong Provincial International Cooperation Base of Science and Technology Guangzhou 510080China Division of Hepatobiliary Pancreatic Surgery the First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China

Background: Primary non-function(PNF) and early allograft failure(EAF) after liver transplantation(LT) seriously affect patient outcomes. In clinical practice, effective prognostic tools for early identifying recipients at high risk of PNF and EAF were urgently needed. Recently, the Model for Early Allograft Function(MEAF), PNF score by King's College(King-PNF) and Balance-and-Risk-Lactate(BAR-Lac) score were developed to assess the risks of PNF and EAF. This study aimed to externally validate and compare the prognostic performance of these three scores for predicting PNF and EAF. Methods: A retrospective study included 720 patients with primary LT between January 2015 and December 2020. MEAF, King-PNF and BAR-Lac scores were compared using receiver operating characteristic(ROC) and the net reclassification improvement(NRI) and integrated discrimination improvement(IDI) analyses. Results: Of all 720 patients, 28(3.9%) developed PNF and 67(9.3%) developed EAF in 3 months. The overall early allograft dysfunction(EAD) rate was 39.0%. The 3-month patient mortality was 8.6% while 1-year graft-failure-free survival was 89.2%. The median MEAF, King-PNF and BAR-Lac scores were 5.0(3.5–6.3),-2.1(-2.6 to-1.2), and 5.0(2.0–11.0), respectively. For predicting PNF, MEAF and King-PNF scores had excellent area under curves(AUCs) of 0.872 and 0.891, superior to BAR-Lac(AUC = 0.830). The NRI and IDI analyses confirmed that King-PNF score had the best performance in predicting PNF while MEAF served as a better predictor of EAD. The EAF risk curve and 1-year graft-failure-free survival curve showed that King-PNF was superior to MEAF and BAR-Lac scores for stratifying the risk of EAF. Conclusions: MEAF, King-PNF and BAR-Lac were validated as practical and effective risk assessment tools of PNF. King-PNF score outperformed MEAF and BAR-Lac in predicting PNF and EAF within 6 months. BAR-Lac score had a huge advantage in the prediction for PNF without post-transplant variables. Proper use

关键词： Primary non-function Early allograft failure Risk predicting model Liver transplantation

Assessment of the Respiratory Disease Mortality Risk from Single and Composite Exposures to PM_(2.5)and Ozone—Guangzhou City,Guangdong Province,China,2018-2021

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China CDC weekly 2024年第34期6卷 857-861,I0001-I0006页

作者： Hongwei Tu Yijun Hu Keqi Hu Peipei Dong Yue Wen Jing Jiang Xuedan Xu Jinxu Huang Jiemin Zhu Changyun He Qiuxia Chen Yongying Liu Guangdong Provincial Center for Disease Control and Prevention Guangzhou CityGuangdong ProvinceChina Jinan university Guangzhou CityGuangdong ProvinceChina Department of Science and Education Guangdong Second Provincial General HospitalGuangzhou CityGuangdong ProvinceChina sun yat-sen university Guangzhou CityGuangdong ProvinceChina

Summary What is already known about this topic?Fine particulate matter(PM_(2.5))and ozone(O_(3))are prevalent pollutants in the atmosphere,which threaten human health,especially the respiratory ***,people are exposed to a mixture of various pollutants in the ***,the single and combined effects of both pollutants need to be investigated.

关键词： environment. ozone Guangdong

Matrix stiffening promotes chondrocyte senescence and the osteoarthritis development through downregulating HDAC3

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Bone Research 2024年第2期12卷 438-452页

作者： Bowen Fu Jianlin Shen Xuenong Zou Nian sun Ze Zhang Zengping Liu Canjun Zeng Huan Liu Wenhua Huang Guangdong Medical Innovation Platform for Translation of 3D Printing Application The Third Affiliated HospitalSouthern Medical UniversityGuangzhou 510630 GuangdongChina Guangdong Engineering Research Center for Translation of Medical 3D Printing Application Guangdong Provincial Key Laboratory of Digital Medicine and BiomechanicsNational Key Discipline of Human AnatomySchool of Basic Medical SciencesSouthern Medical UniversityGuangzhou 510145 GuangdongChina Department of Foot and Ankle Surgery Center for Orthopedic SurgeryThe Third Affiliated HospitalSouthern Medical UniversityGuangzhou 510630 GuangdongChina Department of Orthopedics Affiliated Hospital of Putian UniversityPutian 351100 FujianChina Central Laboratory Affiliated Hospital of Putian UniversityPutian 351100 FujianChina Guangdong Provincial Key Laboratory of Orthopedics and Traumatology Department of Spinal SurgeryThe First Affiliated Hospital of Sun Yat-sen UniversityGuangzhou 510080 GuangdongChina Nanfang hospital Southern Medical UniversityGuangzhou 510515 GuangdongChina Guangzhou Blood Center Guangzhou 510095 GuangdongChina Department of Orthopedics The Affiliated Traditional Chinese Medicine HospitalSouthwest Medical UniversityLuzhou 646000 SichuanChina

Extracellular matrix(ECM)stiffening is a typical characteristic of cartilage aging,which is a quintessential feature of knee osteoarthritis(KOA).However,little is known about how ECM stiffening affects chondrocytes and other molecules *** study mimicked the physiological and pathological stiffness of human cartilage using polydimethylsiloxane(PDMS)*** demonstrated that epigenetic Parkin regulation by histone deacetylase 3(HDAC3)represents a new mechanosensitive mechanism by which the stiffness matrix affected chondrocyte *** found that ECM stiffening accelerated cultured chondrocyte senescence in vitro,while the stiffness ECM downregulated HDAC3,prompting Parkin acetylation to activate excessive mitophagy and accelerating chondrocyte senescence and osteoarthritis(OA)in ***,intra-articular injection with an HDAC3-expressing adeno-associated virus restored the young phenotype of the aged chondrocytes stimulated by ECM stiffening and alleviated OA in *** findings indicated that changes in the mechanical ECM properties initiated pathogenic mechanotransduction signals,promoted the Parkin acetylation and hyperactivated mitophagy,and damaged chondrocyte *** results may provide new insights into chondrocyte regulation by the mechanical properties of ECM,suggesting that the modification of the physical ECM properties may be a potential OA treatment strategy.

关键词： chondrocyte osteoarthritis stiffness

Down-regulation of microRNA-23a promotes pancreatic ductal adenocarcinoma initiation and progression by up-regulation of FOXM1 expression

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Genes & Diseases 2024年第5期11卷 456-469页

作者： Lixin Liang Tian Cai Xiaojia Li Jianhong An sen Yu Yang Zhang Fengjie Guo Fang Wei Jie He Keping Xie Tingting Jiang Center for Pancreatic Cancer Research South China University of Technology School of MedicineGuangzhouGuangdong 510006China Department of Laboratory Medicine The Sixth Affiliated Hospital and Nanhai People’s HospitalSouth China University of Technology School of MedicineFoshanGuangdong 528200China The Second affiliated hospital and Guangzhou First People’s hospital South China University of Technology School of MedicineGuangzhouGuangdong 510006China

Transcriptional factor Forkhead box M1(FOXM1)plays an important role in pancreatic ductal adenocarcinoma(PDAC)development and *** molecular mechanisms underlying its dysregulation remain *** identified and functionally validated the microRNAs(miRNAs)that critically regulate FOXM1 expression in *** expression levels of miRNA-23a(miR-23a-3p and-5p)were altered in PDAC cell lines and their effects on FOXM1 signaling and cell proliferation and migration and tumorigenesis were examined in vitro and in vivo using mouse PDAC *** with non-tumor pancreatic tissues,PDAC tissues and cell lines exhibited significantly reduced levels of miR-23a *** miR-23a expression and concomitant increase in FOXM1 expression were also observed in acinar-toductal metaplasia and pancreatic intraepithelial neoplasia,the major premalignant lesions of *** expression of miR-23a reduced the expression of FOXM1 and suppressed cell proliferation and migration in PDAC cells,whereas the inhibitors of miR-23a did the *** or reduced levels of miR-23a increased the levels of FOXM1 expression,while increased expression of FOXM1 down-regulated miR-23a expression,suggesting that miR-23a and FOXM1 were mutual negative regulators of their expression in PDAC ***,the miR-23a/FOXM1 signaling axis is important in PDAC initiation and progression and could serve as an interventional or therapeutic target for patients with early or late stages of PDAC.

关键词： FOXM1 Gene expression Gene regulation MicroRNA Pancreatic cancer Targeted therapy

Clinical features and possible pathogenesis of multiple evanescent white dot syndrome with different retinal diseases and events:a narrative review

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International Journal of Ophthalmology(English edition) 2024年第3期17卷 583-595页

作者： Chun-Li Chen Yi-Zhe Cheng Zhi-Han Zhang Ge Wang Xiao-Yan Peng Department of Ophthalmology Beijing Tongren HospitalCapital Medical UniversityBeijing 100730China Beijing Ophthalmology and Visual Science Key Laboratory Beijing 100730China State Key Laboratory of Ophthalmology Zhongshan Ophthalmic CenterSun Yat-sen UniversityGuangzhou 510600Guangdong ProvinceChina

●Multiple evanescent white dot syndrome(MEWDS)is a rare fundus disease,characterized by acute vision loss and visual field *** previous studies have explained the possible pathogenesis and clinical features of primary ***,as the number of reported cases increases,secondary MEWDS occurs in other related retinal diseases and injuries,exhibiting some special *** associated retinal diseases include multifocal choroiditis/punctate inner choroidopathy(MFC/PIC),acute zonal occult outer retinopathy,best vitelliform macular dystrophy,pseudoxanthoma elasticum,and ocular *** related retinal injury is laser photocoagulation,surgery,and *** primary MEWDS often have a self-limiting course,secondary MEWDS may require treatment in some cases,according to the severity of concomitant diseases and ***,MEWDS secondary to MFC/PIC that is prone to forming choroidal neovascularization and focal choroidal excavation,needs positive treatment with *** possible underlying pathogenesis of secondary MEWDS is the exposure of choroidal antigen after the disruption of Bruch’s *** MEWDS-related features in secondary MEWDS are still evanescent under most *** prognosis and treatment depend on the severity of *** studies propose that the etiology is associated with immune factors,including viral infection,inflammation in choroid and Bruch’s membrane,and antigen exposure caused by retinal and/or choroidal *** pathogenic studies should be conducted in the *** diagnosis for secondary MEWDS could benefit patients in aspects of management and prognosis.

关键词： multiple evanescent white dot syndrome punctate inner choroidopathy multifocal choroiditis secondary multiple evanescent white dot syndrome