Dongfang, China
Dongfang, China

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Suo S.,Ren Ji Hospital | Chen X.,Ren Ji Hospital | Ji X.,Shanghai JiaoTong University | Zhuang Z.,Ren Ji Hospital | And 4 more authors.
Journal of Computer Assisted Tomography | Year: 2015

Objective: The objective of this study was to investigate the non- Gaussian water diffusion properties in bladder cancer and assess the efficacy of diffusion kurtosis imaging for estimating the histological grade of bladder cancer. Methods: Twenty-one patients with bladder cancer (high-grade, 12; lowgrade, 9) and 17 negative controls who underwent preoperative 3.0-T magnetic resonance imaging including multi-b value diffusion-weighted imaging (b values, 0, 500, 800, 1200, 1500, and 2000 s/mm2) were included. Besides apparent diffusion coefficient (ADC) maps, diffusion kurtosis imaging maps for diffusion coefficient (Dapp) and kurtosis (Kapp) were also obtained. Data were analyzed using the Mann-Whitney U test, Spearman correlation test, and receiver operating characteristic curves. Results: Bladder cancer showed significantly lower ADC values, lower Dapp values, and higher Kapp values compared with normal bladder wall (all P < 0.001). The Kapp values were significantly higher in high-grade than in low-grade tumors (P = 0.007). Significant correlations were found between Dapp and ADC (r = 0.901, P < 0001) as well as between Kapp and ADC (r = -0.910, P <0.001). The areas under the receiver operating characteristic curve were 0.843 and 0.796 for estimation of high-grade bladder cancer by using the Kapp values and ADC values, respectively. Conclusions: Diffusion in bladder cancer follows a non-Gaussian behavior. The new metric Kapp may potentially serve as a biomarker of grade of bladder cancer. © 2015 Wolters Kluwer Health, Inc.

Li J.,Shanghai JiaoTong University | Xu Y.,CAS Shanghai Institutes for Biological Sciences | Long X.-D.,Ren Ji Hospital | Long X.-D.,Youjiang Medical College for Nationalities | And 11 more authors.
Cancer Cell | Year: 2014

Cbx4 is a polycomb group protein that is also a SUMO E3 ligase, but its potential roles in tumorigenesis remain to be explored. Here, we report that Cbx4, but not other members of the Cbx family, enhances hypoxia-induced vascular endothelial growth factor (VEGF) expression and angiogenesis in hepatocellular carcinoma (HCC) cells through enhancing HIF-1α sumoylations at K391 and K477 in its two SUMO-interacting motifs-dependent mechanisms and increasing transcriptional activity of HIF-1. The Cbx4 expression is significantly correlated with VEGF expression, angiogenesis, and the overall survival of HCC patients and also in subcutaneously and orthotopically transplanted mice HCC models. Collectively, our findings demonstrate that Cbx4 plays a critical role in tumor angiogenesis by governing HIF-1α protein. © 2014 Elsevier Inc.

Wu B.,Shanghai JiaoTong University | Kun L.,Center for Monitoring of Linyi | Liu X.,Shanghai JiaoTong University | He B.,Ren Ji Hospital
Cardiovascular Drugs and Therapy | Year: 2014

Purpose: To compare the lifetime cost and effectiveness of five alternative chronic atrial fibrillation (AF) management strategies: rivaroxaban, warfarin, aspirin plus clopidogrel, aspirin and no prevention. Methods: An individual-level state-transition model was developed to track the lifetime disease course associated with AF. The clinical and utility data were derived from published studies. The cost data were estimated based on local charges and current Chinese practices. Sensitivity analyses were used to explore the impact of uncertainty on the results. Results: For base-case patients with a CHADS 2 score of 3, the cost per additional quality-adjusted life-years (QALYs) gained for rivaroxaban compared with no prevention, aspirin, aspirin plus clopidogrel and warfarin was $116,884, $153,944, $155,979 and $216,273, respectively. CHADS2 score had a substantial impact on the model outcomes for different prevention strategies. The time distribution of warfarin international normalised ratio (INR), stroke and intracranial haemorrhage (ICH) risks, cost of rivaroxaban and utility of warfarin therapy had substantial impacts on the results. Based on a willingness-to-pay threshold of $16,350/QALY, no prevention strategy was the preferred therapy for a patient with a low risk for stroke and a high risk for ICH; aspirin was preferred for patients with a moderate risk for stroke and ICH; and warfarin was preferred for patients with a high risk for stroke and a low risk of ICH. Conclusion: In the context of limited health resources, rivaroxaban is unlikely to be cost-effective, although it provided more health benefits comparing with other strategies. Additionally, warfarin with good INR control might be more suitable for AF patients in developing regions. © Springer Science+Business Media 2013.

Ping P.,Ren Ji Hospital | Gu B.-H.,Shanghai Pudong District Traditional Chinese Medicine Hospital | Li P.,Ren Ji Hospital | Li P.,Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics | And 3 more authors.
Asian Journal of Andrology | Year: 2014

Testicular cancer (TC) is the most curable type of cancer, with a survival rate of more than 95%. Oncologists are faced with the challenge that gonadotoxic cancer treatments can compromise future fertility, either temporarily or permanently. Our aim was to investigate the long-term effects of TC treatments on male fertility and on the offspring of patients who had received these treatments. Between January 1996 and December 2010, 125 eligible patients, ranging from 18 to 54 years (median age 36.3 ± 15.7), with unilateral TC underwent surgery, chemotherapy or radiotherapy at our center. Some of these patients had their semen samples cryopreserved in the Shanghai Human Sperm Bank. The clinical data were evaluated, and questionnaire and telephone follow-up surveys were given to all patients. The data were analyzed to determine the patients' fertility status pre-and posttreatment. Of the 125 eligible patients, 93.6% (117/125) were accessible and were evaluated. Among 81 men who were married before diagnosis, 21 had conceived successfully before diagnosis and six reported azoospermia. Posttreatment conception was attempted by 73 men; of these, 16 conceived naturally and 19 conceived by artificial reproductive techniques, resulting in 37 healthy babies with no congenital malformations. Of the patients who had not conceived before treatment, 21.9% (21/96) banked their sperm and 23.8% of these patients (5/21) subsequently used the banked sperm. Retroperitoneal lymph node dissection, chemotherapy and radiotherapy were the most highly correlated with lack of conception post-TC treatment. Sperm banking should be recommended to TC patients with the desire for biological conception. There is no evidence to suggest that TC treatments are associated with birth defects or childhood malignancies. © 2014 AJA, SIMM & SJTU. All rights reserved.

Xu W.,Molecular Cell Laboratory for Kidney Disease | Shao X.,Molecular Cell Laboratory for Kidney Disease | Tian L.,Molecular Cell Laboratory for Kidney Disease | Gu L.,Molecular Cell Laboratory for Kidney Disease | And 8 more authors.
Journal of Pharmacology and Experimental Therapeutics | Year: 2014

Apoptosis of renal tubular cells plays a crucial role in renal fibrosis. Astragaloside IV (AS-IV), a compound extracted from Radix Astragali, has been shown to inhibit renal tubular cell apoptosis induced by high glucose, but its role in preventing chronic renal fibrosisaswellasthe underlying molecular mechanisms involved still remain obscure. In this study, human kidney tubular epithelial cells induced by transforming growth factor-β1 (TGF-β1) were used to investigate the protective role of AS-IV in antifibrosis. As an in vivo model, mice subjected to unilateral ureteral obstruction (UUO) were administered AS-IV (20 mg/kg) by intraperitoneal injection for 7 days. AS-IV significantly alleviated renal mass loss and reduced the expression of α-smooth muscle actin, fibronectin, and collagen IV both in vitro and in vivo, suggesting that this compound functions in the inhibition of renal tubulointerstitial fibrosis. Furthermore, transferase-mediated dUTP nick-end labeling assay results both in vivo and in vitro showed that AS-IV significantly attenuated both UUO and TGF-β1-induced cell apoptosis and prevented renal tubular epithelial cell injury in a dose-dependent manner. Western blotting results also revealed that the antiapoptotic effect of AS-IV was reflected in the inhibition of caspase-3 activation, which might be mediated primarily by the downregulation of mitogen-activated protein kinase effectors phospho-p38 and phospho-c-Jun N-terminal kinase. These data infer that AS-IV effectively attenuates the progression of renal fibrosis after UUO injury and may have a promising clinical role as a potential antifibrosis treatment in patients with chronic kidney disease. Copyright © 2014 by The American Society for Pharmacology and Experimental Therapeutics.

Xu Q.,Ren Ji Hospital | Cao W.-W.,Ren Ji Hospital | Mi J.-H.,Ren Ji Hospital | Yu L.,Ren Ji Hospital | And 2 more authors.
European Neurology | Year: 2014

Background and Purpose: To assess the validity of the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE) in the detection of vascular mild cognitive impairment (VaMCI) in patients with subcortical ischemic vascular disease (SIVD). Methods: Among 102 SIVD patients, both cutoff scores of the MMSE and MoCA for differentiating VaMCI from no cognitive impairment (NCI) or differentiating VaMCI from vascular dementia (VaD) were determined by the receiver operator characteristic (ROC) analysis. Optimal sensitivity with specificity of cutoff scores was obtained after the raw scores were adjusted for education. Results: After adjusting for education, the MoCA cutoff score for differentiating VaMCI from NCI was at 24/25 and that for differentiating VaMCI from VaD was at 18/19. After applying the adjusted MoCA scores from 19 to 24 to identify VaMCI in all SIVD patients, sensitivity was at 76.7% and specificity was at 81.4% (κ = 0.579). The adjusted cutoff score of the MMSE for differentiating VaMCI from NCI was at 28/29 and that for differentiating VaMCI from VaD was at 25/26. The sensitivity and specificity of the adjusted MMSE was at 58.1 and 71.2%, respectively, when using the score from 26 to 28 to identify VaMCI in SIVD patients (κ = 0.294). Conclusions: The MoCA detected subcortical VaMCI better than the MMSE. © 2013 S. Karger AG, Basel.

To evaluate the efficacy of the endovascular intervention for transatlantic inter society consensus (TASC) type C and type D femoropopliteal artery disease. We conducted a retrospective analysis on 95 cases (98 lower limbs) with TASC type C and type D femoropopliteal artery arteriosclerosis lesion treated by percutaneous transluminal angioplasty and/or primary stent implantation from January 2007 to April 2009. We used ankle brachial index (ABI), Fontaine stages, limb salvage percentage and primary patency to evaluate the efficacy of the endovascular intervention therapy. The technical success rate of the 98 limbs was 94.9%, the perioperation mortality was 4.2% and the total amputation rate was 5.1%. 81 cases (84 limbs) were followed-up for a mean time of (13 ± 7) months, whose average ABI in dorsalis pedis artery and posterior tibial artery were 0.58 ± 0.22 and 0.60 ± 0.21 and increased 0.14 ± 0.25 and 0.13 ± 0.22 respectively than the ABI before intervention therapy. The statistical analysis showed a significant difference in ABI. The limbs of critical limb ischemia (CLI) were of 16.4% in the follow-up period and of 73.5% before the intervention therapy. The statistical results showed a significant difference in the percentage of CLI. Percutaneous endovascular intervention is an effective and minimally invasive method, and has a curative clinical efficacy to treat TASC type C and type D femoropopliteal artery disease.

Lu H.,Ren Ji Hospital | Zhang W.,Ren Ji Hospital | Graham D.Y.,Baylor College of Medicine
European Journal of Gastroenterology and Hepatology | Year: 2013

Antimicrobial resistance has continued to undermine many popular anti-Helicobacter pylori therapies. Antibiotic resistance to commonly used anti-H. pylori drugs in China has increased markedly, making China an ideal site to identify regimens that remain effective despite widespread antimicrobial resistance. Bismuth is one of the few antimicrobials to which resistance does not develop. Factors contributing to H. pylori treatment success include host factors (e.g. genetic differences in the metabolism of the drugs used), bacterial factors (e.g. susceptibility), and details of the regimen (e.g. doses, dosing interval, dosing in relation to meals, formulation, etc.). We reviewed the recent experience in China with bismuth-containing quadruple therapies. The experience consists of 16 studies with 25 arms involving 1971 patients to identify successful regimens (defined as reliably obtaining 90% or greater eradication per protocol) deserving further study. Despite high rates of resistance to commonly used antimicrobials, several regimens could achieve high success. These were characteristically 14-day regimens containing a proton pump inhibitor and either tetracycline and metronidazole or furazolidone and amoxicillin. We propose approaches for further development including for optimization and simplification related to convenience and side effects (e.g. twice rather than three or four times daily or administration at the noon and evening meal instead of at breakfast and evening) while maintaining effectiveness of at least 90%. Studies in China identified regimens that were highly effective despite the high prevalence of resistance to metronidazole, fluoroquinolones, and macrolides. Multicenter randomized studies will be required to confirm which is the best. © 2013 Wolters Kluwer Health | Lippincott Williams and Wilkins.

Xu H.,Ren Ji Hospital | Ke K.,Ren Ji Hospital | Zhang Z.,Ren Ji Hospital | Luo X.,Ren Ji Hospital | And 3 more authors.
Journal of Craniofacial Surgery | Year: 2013

Background: Growth factors contained in platelet-rich plasma (PRP) have been reported to induce osteoblast differentiation in certain studies, while in others, osteogenesis has not been shown clinically. The aim of the present study was toverify the effect of PRP and its combination with rhBMP-2 as a controlled delivery system during sagittal suture distraction osteogenesis. Methods: Thirty-six-week male New Zealand white rabbits were randomly assigned to sagittal suture distraction osteogenesis groups treated with (1) PRP gel alone; and (2) PRP gel mixed with 10 Kg rhBMP-2 (PRP/rhBMP-2), and a control group untreated. A heavy 200-g continuous mechanical force was applied for 33 days using a nickel titanium open spring to distract the suture between 2 miniscrew implants. The suture morphology was evaluated radio-graphically and histologically after sacrifice. Results: The amount of suture separation in the control group and the PRP gel group were statistically greater (P < 0.05) than in the PRP/rhBMP-2 gel group. Compared to the control group, the micro-CTand histologic analysis showed that the local application of PRP gel not only stimulates the new bone formation between the suture gap but accelerates the suture wound healing during distraction without suture fusion. There was a percent of total suture height 15.3 ± 9.5% fusion in PRP/rhBMP-2 gel group and the average thickness of cranium bone in the PRP/rhBMP-2 gel group was statistically greater (P < 0.05) than in the control group and the PRP gel group. Conclusions: In this animal model, both PRP gel and PRP/rhBMP-2 gel are effective in improving new bone formation in suture distraction osteogenesis. PRP gel induces suture bone formation without suture fusion and accelerates the suture wound healing, while the PRP/rhBMP-2 gel group, in which the sutures fused prematurely, showed powerful bone formation ability aided by rhBMP-2. PRP can be alternatively use as a controlled release system for rhBMP-2, but caution should be used before proceeding with the application of high-dose growth factors around the growing craniofacial sutures. Copyright © 2013 by Mutaz B. Habal, MD.

Wang J.,Ren Ji Hospital | Qian J.,Ren Ji Hospital | Hu Y.,Ren Ji Hospital | Kong X.,Ren Ji Hospital | And 8 more authors.
Nature Communications | Year: 2014

Covalent modification adding acetyl groups to the C terminus of the p53 protein has been suggested to be required for its functional activation as a tumour suppressor. However, it remains largely unknown how p53 acetylation is deregulated in colorectal cancer (CRC), which is the third most commonly diagnosed cancer worldwide. Here we show that ArhGAP30, a Rho GTPase-activating protein, is a pivotal regulator for p53 acetylation and functional activation in CRC. ArhGAP30 binds to p53 C-terminal domain and P300, facilitating P300-mediated acetylation of p53 at lysine 382. ArhGAP30 expression is required for p53 activation upon DNA damage stress, and the level of ArhGAP30 correlates with p53 acetylation and functional activation in CRC tissues. Moreover, low level of ArhGAP30 expression associates with poor survival of CRC patients. In summary, ArhGAP30 is required for p53 acetylation and functional activation in CRC, and the expression of ArhGAP30 is a potential prognostic marker for CRC. © 2014 Macmillan Publishers Limited.

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