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PubMed | Peoples Hospital of Jiangsu Province, Shanghai Putuo District Central Hospital, Pizhou Traditional Chinese Medicine Hospital and Shanghai University
Type: Journal Article | Journal: Biomedical chromatography : BMC | Year: 2016

The aim of this study was to investigate the effects of verapamil on the pharmacokinetics of pristimerin in rats. A sensitive and reliable LC-MS/MS method was developed and applied for the determination of pristimerin in rat plasma. The pharmacokinetics of orally administered pristimerin with and without verapamil pretreatment was investigated. The results indicated that, when the rats were pretreated with verapamil, the peak concentration of pristimerin increased from 189.13 to 277.53ng/mL (46.7%), and the AUC0-t increased by approximately 82.0%. Additionally, the effects of verapamil on the absorption and metabolic stability of pristimerin were investigated using the Caco-2 cell transwell model and rat liver microsomes. A markedly higher transport of pristimerin across the Caco-2 cells was observed in the basolateral-to-apical direction and was abrogated in the presence of the P-gp inhibitor, verapamil. These results indicated that P-gp might be involved in the absorption of pristimerin. Of note, the metabolic half-life of pristimerin was prolonged by the pretreatment with verapamil. In conclusion, verapamil could affect the pharmacokinetics of pristimerin, and it might work through increasing the absorption of pristimerin by inhibiting P-gp, or through slowing down the metabolism of pristimerin in the rat liver. Copyright 2015 John Wiley & Sons, Ltd.


Du G.,East China Normal University | Jiang Z.,Shanghai JiaoTong University | Yao Y.,Shanghai No 6 Peoples Hospital | Diao X.,Shanghai Putuo District Central Hospital
Journal of Medical Systems | Year: 2013

In order to improve the standard of management in hospitals and effectively control the cost of clinical treatments, this research primarily focuses on optimizing the scheduling of clinical pathways (CPs). A mathematical model for CP scheduling is constructed, and the hybrid genetic algorithm (HGA, combining a genetic algorithm with particle swarm optimization) is proposed for solving this problem so as to distribute medical resources and schedule the treatments of patients reasonably and effectively. The optimal search space can be further enlarged by introducing a new mutation mechanism, which allows a more satisfactory solution to be found. In particular, the relative patient waiting time and relative time efficiency are used as measure indexes, which are more scientific and effective than the usual indexes of absolute time and absolute time efficiency. After comparing absolute waiting time, relative waiting time, utilization of absolute waiting time, and utilization of relative waiting time waiting respectively, the conclusion can confidently be drawn that task scheduling obviously enhances patients' time efficiency, reduces time wastage and therefore promotes patient satisfaction with medical processes. Moreover, the patients can to a certain degree move away from their usual passive role in medical processes by using this scheduling system. In order to further validate the rationality and validity of the proposed method, the heuristic rules for CP scheduling are also tested using the same case. The results demonstrate that the proposed HGA achieves superior performance, in terms of precision, over those heuristic rules for CP scheduling. Therefore, we utilize HGA to optimize CP scheduling, thus providing a decision-making mechanism for medical staff and enhancing the efficiency of medical processes. This research has both theoretical and practical significance for electronic CP management, in particular. © 2013 Springer Science+Business Media New York.


Wang L.,Shanghai Putuo District Central Hospital | Wu L.-X.,Shanghai JiaoTong University
Journal of Shanghai Jiaotong University (Medical Science) | Year: 2015

Mycoplasma pneumoniae is one of major pathogens causing respiratory tract infection of children and is usually treated with macrolides. Since 2001, reported macrolide resistant isolates of Mycoplasma pneumoniae has increased worldwide, especially in East Asia. This paper reviews the current situation and mechanisms of macrolide resistance of Mycoplasma pneumoniae and clinical characteristics of pediatric patients infected by macrolide resistant Mycoplasma pneumoniae, and discusses the best approach to deal with this situation. ©, 2015, Editorial Department of Journal of Shanghai Second Medical University. All right reserved.


Du G.,Shanghai JiaoTong University | Jiang Z.,Shanghai JiaoTong University | Diao X.,Shanghai Putuo District Central Hospital | Ye Y.,Shanghai JiaoTong University | Yao Y.,Shanghai No 6 Peoples Hospital
Journal of Medical Systems | Year: 2012

Clinical pathways' variances present complex, fuzzy, uncertain and high-risk characteristics. They could cause complicating diseases or even endanger patients' life if not handled effectively. In order to improve the accuracy and efficiency of variances handling by Takagi-Sugeno (T-S) fuzzy neural networks (FNNs), a new variances handling method for clinical pathways (CPs) is proposed in this study, which is based on T-S FNNs with novel hybrid learning algorithm. And the optimal structure and parameters can be achieved simultaneously by integrating the random cooperative decomposing particle swarm optimization algorithm (RCDPSO) and discrete binary version of PSO (DPSO) algorithm. Finally, a case study on liver poisoning of osteosarcoma preoperative chemotherapy CP is used to validate the proposed method. The result demonstrates that T-S FNNs based on the proposed algorithm achieves superior performances in efficiency, precision, and generalization ability to standard T-S FNNs, Mamdani FNNs and T-S FNNs based on other algorithms (CPSO and PSO) for variances handling of CPs. © Springer Science+Business Media, LLC 2010.


Du G.,Shanghai JiaoTong University | Jiang Z.,Shanghai JiaoTong University | Diao X.,Shanghai Putuo District Central Hospital | Yao Y.,Shanghai No 6 Peoples Hospital
Journal of Medical Systems | Year: 2012

Although the clinical pathway (CP) predefines predictable standardized care process for a particular diagnosis or procedure, many variances may still unavoidably occur. Some key index parameters have strong relationship with variances handling measures of CP. In real world, these problems are highly nonlinear in nature so that it's hard to develop a comprehensive mathematic model. In this paper, a rule extraction approach based on combing hybrid genetic double multi-group cooperative particle swarm optimization algorithm (PSO) and discrete PSO algorithm (named HGDMCPSO/DPSO) is developed to discovery the previously unknown and potentially complicated nonlinear relationship between key parameters and variances handling measures of CP. Then these extracted rules can provide abnormal variances handling warning for medical professionals. Three numerical experiments on Iris of UCI data sets, Wisconsin breast cancer data sets and CP variances data sets of osteosarcoma preoperative chemotherapy are used to validate the proposed method. When compared with the previous researches, the proposed rule extraction algorithm can obtain the high prediction accuracy, less computing time, more stability and easily comprehended by users, thus it is an effective knowledge extraction tool for CP variances handling. © Springer Science+Business Media, LLC 2010.


Xu K.,Shanghai Putuo District Central Hospital | Hai J.,Shanghai Tongji Hospital
Cell Biochemistry and Biophysics | Year: 2014

The objective of this study is to investigate the operative methods and therapeutic effects of stereotactic-guided microsurgical resection of hypertensive cerebral hemorrhage lesions in functional region. 18 cases of intracranial lesions (diameter 1.5-3 cm) were studied using a Leksell-G stereotactic system. Guided by the CT or MR, a small incision was made and the skull was opened with an annular drill. Electrophysiological stimulation was applied along the non-functional areas. 100 patients with cerebral hemorrhage were randomized into two groups of 50 cases each. One of the groups was treated using microsurgery, while the other group was treated using stereotactic technique. A comparative study was carried out between the two treatment methods for hypertensive intracerebral hemorrhage using the recent (1 month) and long-term (6 months) treatment. Using a Leksell-G system for precise positioning of microsurgery, 100 % of the lesion was fully removed. Neurological function was well protected without mortality or neurological deficiency. The use of stereotactic microsurgery for hypertensive intracerebral hemorrhage is successful compared with traditional methods. There is a significant clinical effect on the recovery of neurological function in patients. Stereotactic microsurgical resection of the lesion along with Ribbon treatment of hypertensive cerebral hemorrhage is an accurate, minimally invasive, safe, and effective surgical method. © 2013 Springer Science+Business Media New York.


Weng W.,Tongji University | Wang M.,Shanghai Putuo District Central Hospital | Xie S.,Shanghai Yangpu District Central Hospital | Long Y.,Shanghai Yangpu District Central Hospital | And 4 more authors.
Oncology Reports | Year: 2014

Renal cell carcinoma (RCC) is a common urological malignancy. It remains unclear, however, whether Yin Yang 1 (YY1) plays a functional role in the development of human RCC. In the present study, we demonstrated that levels of YY1 were significantly increased in primary RCC tissues when compared to these levels in the matched healthy tissues. YY1 knockdown inhibited cell growth, migration and invasion of RCC cells. Additionally, we highlighted a positive feedback-loop pathway resulting in YY1 upregulation. We observed that overexpression of YY1 caused repression of C/EBPα and the inhibition of C/EBPα led to the suppression of miR-34a. Since YY1 is a direct target of miR-34a, the low level of miR-34a increased the expression of YY1, promoting the aggressiveness of RCC cells. Furthermore, this feedforward mechanism was found in RCC tissues. We observed that miR-34a was downregulated in the pools of cancer tissues when compared to that of the normal tissues. The expression of miR-34a displayed an inverse correlation with YY1, but a positive correlation with C/EBPα. In conclusion, our study highlights the importance of a novel regulatory circuitry for YY1 activation in maintaining the aggressive phenotypes of RCC.


PubMed | Shanghai Putuo District Central Hospital
Type: Journal Article | Journal: Tumour biology : the journal of the International Society for Oncodevelopmental Biology and Medicine | Year: 2014

Lung cancer (LC) is one of the most prevalent causes of cancer death with a high mortality rate worldwide. While various sets of microRNAs (miRNAs) have been found to be highly sensitive and specific biomarkers for the early diagnosis of LC (the first word of abstract), conflicting results on their diagnostic accuracy are still present in individual studies. Thus, we aimed to conduct a systematic review and meta-analysis of the published literature to comprehensively assess the diagnostic value of miRNAs for predicting LC. The sensitivity and specificity of each included study were used to plot the summary receiver operator characteristic (SROC) curve and to calculate the area under the SROC curve (AUC). All analyses were performed using the Stata 12.0 software. Twenty-six articles were involved in our meta-analysis, 18 of which focused on single miRNA assays and 15 on multiple miRNA assays. For single miRNA profiling, the pooled parameters calculated from all studies are as follows: sensitivity (SEN), 0.72; specificity (SPE), 0.74; positive likelihood ratio (PLR), 2.7; negative likelihood ratio (NLR), 0.39; and diagnostic odds ratio (DOR), 7. For multiple miRNA profiling, the pooled estimates for the overall studies are as follows: SEN, 0.81; SPE, 0.84; PLR, 4.9; NLR, 0.23; and DOR, 22, which are significantly better than the diagnostic performance of the single miRNA profiling. In addition, subgroup analyses based on sample types suggested that blood-based multiple miRNA assays were more accurate than non-blood-based studies. In conclusion, the current meta-analysis shows that multiple miRNA assays were more accurate in diagnosing LC than single miRNA assays. However, further large-scale investigations are urgently needed to confirm our results and verify the feasibility of routine clinical utilization.


Guo Z.,Shanghai Putuo District Central Hospital | Zhao C.,Shanghai Putuo District Central Hospital | Wang Z.,Shanghai Putuo District Central Hospital
Tumor Biology | Year: 2014

Lung cancer (LC) is one of the most prevalent causes of cancer death with a high mortality rate worldwide. While various sets of microRNAs (miRNAs) have been found to be highly sensitive and specific biomarkers for the early diagnosis of LC (the first word of abstract), conflicting results on their diagnostic accuracy are still present in individual studies. Thus, we aimed to conduct a systematic review and meta-analysis of the published literature to comprehensively assess the diagnostic value of miRNAs for predicting LC. The sensitivity and specificity of each included study were used to plot the summary receiver operator characteristic (SROC) curve and to calculate the area under the SROC curve (AUC). All analyses were performed using the Stata 12.0 software. Twenty-six articles were involved in our metaanalysis, 18 of which focused on single miRNA assays and 15 on multiple miRNA assays. For single miRNA profiling, the pooled parameters calculated from all studies are as follows: sensitivity (SEN), 0.72; specificity (SPE), 0.74; positive likelihood ratio (PLR), 2.7; negative likelihood ratio (NLR), 0.39; and diagnostic odds ratio (DOR), 7. For multiple miRNA profiling, the pooled estimates for the overall studies are as follows: SEN, 0.81; SPE, 0.84; PLR, 4.9; NLR, 0.23; and DOR, 22, which are significantly better than the diagnostic performance of the single miRNA profiling. In addition, subgroup analyses based on sample types suggested that blood-based multiple miRNA assays were more accurate than non-blood-based studies. In conclusion, the current metaanalysis shows that multiple miRNA assays were more accurate in diagnosing LC than single miRNA assays. However, further large-scale investigations are urgently needed to confirm our results and verify the feasibility of routine clinical utilization. © International Society of Oncology and BioMarkers (ISOBM) 2014.


PubMed | Shanghai Putuo District Central Hospital
Type: Journal Article | Journal: Cell biochemistry and biophysics | Year: 2014

The objective of this study is to investigate the operative methods and therapeutic effects of stereotactic-guided microsurgical resection of hypertensive cerebral hemorrhage lesions in functional region. 18 cases of intracranial lesions (diameter 1.5-3 cm) were studied using a Leksell-G stereotactic system. Guided by the CT or MR, a small incision was made and the skull was opened with an annular drill. Electrophysiological stimulation was applied along the non-functional areas. 100 patients with cerebral hemorrhage were randomized into two groups of 50 cases each. One of the groups was treated using microsurgery, while the other group was treated using stereotactic technique. A comparative study was carried out between the two treatment methods for hypertensive intracerebral hemorrhage using the recent (1 month) and long-term (6 months) treatment. Using a Leksell-G system for precise positioning of microsurgery, 100 % of the lesion was fully removed. Neurological function was well protected without mortality or neurological deficiency. The use of stereotactic microsurgery for hypertensive intracerebral hemorrhage is successful compared with traditional methods. There is a significant clinical effect on the recovery of neurological function in patients. Stereotactic microsurgical resection of the lesion along with Ribbon treatment of hypertensive cerebral hemorrhage is an accurate, minimally invasive, safe, and effective surgical method.

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