Park S.-J.,University of Ulsan |
Ahn J.-M.,University of Ulsan |
Kim Y.-H.,University of Ulsan |
Park D.-W.,University of Ulsan |
And 21 more authors.
New England Journal of Medicine | Year: 2015
BACKGROUND: Most trials comparing percutaneous coronary intervention (PCI) with coronaryartery bypass grafting (CABG) have not made use of second-generation drug-eluting stents. METHODS: We conducted a randomized noninferiority trial at 27 centers in East Asia. We planned to randomly assign 1776 patients with multivessel coronary artery disease to PCI with everolimus-eluting stents or to CABG. The primary end point was a composite of death, myocardial infarction, or target-vessel revascularization at 2 years after randomization. Event rates during longer-term follow-up were also compared between groups. RESULTS: After the enrollment of 880 patients (438 patients randomly assigned to the PCI group and 442 randomly assigned to the CABG group), the study was terminated early owing to slow enrollment. At 2 years, the primary end point had occurred in 11.0% of the patients in the PCI group and in 7.9% of those in the CABG group (absolute risk difference, 3.1 percentage points; 95% confidence interval [CI], -0.8 to 6.9; P = 0.32 for noninferiority). At longer-term follow-up (median, 4.6 years), the primary end point had occurred in 15.3% of the patients in the PCI group and in 10.6% of those in the CABG group (hazard ratio, 1.47; 95% CI, 1.01 to 2.13; P = 0.04). No significant differences were seen between the two groups in the occurrence of a composite safety end point of death, myocardial infarction, or stroke. However, the rates of any repeat revascularization and spontaneous myocardial infarction were significantly higher after PCI than after CABG. CONCLUSIONS: Among patients with multivessel coronary artery disease, the rate of major adverse cardiovascular events was higher among those who had undergone PCI with the use of everolimus-eluting stents than among those who had undergone CABG. Copyright © 2015 Massachusetts Medical Society.
Hu Y.-Y.,Sir Run Run Shaw Hospital |
Dong X.-Q.,Hangzhou Municipal Peoples Hospital |
Yu W.-H.,Hangzhou Municipal Peoples Hospital |
Zhang Z.-Y.,Hangzhou Municipal Peoples Hospital
Shock | Year: 2010
S100B has been described as a marker of brain injury. However, not much is known regarding change in plasma S100B and its relation with mortality after spontaneous intracerebral hemorrhage (ICH).Thus, we sought to investigate change in plasma S100B level after ICH and to evaluate its relation with disease outcome. Thirty healthy controls and 86 patients with acute ICH were included. Plasma samples were obtained on admission and at days 1, 2, 3, 5, and 7 after ICH. Its concentration was measured by enzyme-linked immunosorbent assay. After ICH, plasma S100B level in patients increased during the 6-h period immediately, peaked in 24 h, plateaued at day 2, decreased gradually thereafter, and was substantially higher than that in healthy controls during the 7-day period. Plasma S100B levels were highly associated with Glasgow Coma Scale scores, ICH volumes, presences of intraventricular hemorrhage, and survival rates (all P < 0.05). Multivariate analysis showed baseline plasma S100B level as a good predictor for 1-week mortality (odds ratio, 1.046; 95%confidence interval, 1.014-1.078; P = 0.004). A receiver operating characteristic curve identified plasma S100B cutoff level (192.5 pg/mL) that predicted 1-week mortality with the high sensitivity (93.8%) and specificity (70.4%) values (P < 0.001). The differences between areas under curves of plasma S100B levels and those of Glasgow Coma Scale scores and ICH volumes were not statistically significant (both P > 0.05). Increased S100B level is found after ICH and may contribute to the inflammatory process of ICH, in association with a poor clinical outcome. © 2010 by the Shock Society.
Wang Z.,Sir Run Run Shaw Hospital |
Wang C.,Zhejiang University |
Huang X.,Zhejiang University |
Shen Y.,Zhejiang Medical College |
And 2 more authors.
Biochimica et Biophysica Acta - Proteins and Proteomics | Year: 2012
The pleural effusion proteome has been found containing information that directly reflects pathophysiological status and represents a potential diagnostic value for pulmonary diseases. However, the variability in protein composition between malignant and benign effusions is not well understood. Herein, we investigated the changes of proteins in pleural effusions from lung adenocarcinoma and benign inflammatory disease (pneumonia and tuberculosis) patients by two-dimensional difference gel electrophoresis (2D-DIGE). Twenty-eight protein spots displayed significantly different expression levels were positively identified by MALDI-TOF-MS representing 16 unique proteins. Five identified protein candidates were further validated and analyzed in effusions, sera or tissues. Among them, hemopexin, fibrinogen gamma and transthyretin (TTR) were up-regulated in cancer samples. The effusion concentration of serum amyloid P component (SAP) was significantly lower in lung cancer patients than in benign inflammatory patients, but no differences were found in sera samples. Moreover, a Jumonji C (JmjC)-domain-containing protein, JMJD5, was observed to be down-regulated in malignant effusions, lung cancer tissues and cancer cells. These results shed light on the altered pleural effusion proteins as a useful and important complement to plasma or other routine clinical tests for pulmonary disease diagnosis. © 2012 Elsevier B.V. All rights reserved.
Hu X.-T.,Biomedical Research Center and Key Laboratory of Biotherapy of Zhejiang Province |
He C.,Sir Run Run Shaw Hospital
Chinese Journal of Cancer | Year: 2013
Gastric cancer is one of the most common malignancies and a leading cause of cancer mortality worldwide. The pathogenesis mechanisms of gastric cancer are still not fully clear. Inactivation of tumor suppressor genes and activation of oncogenes caused by genetic and epigenetic alterations are known to play significant roles in carcinogenesis. Accumulating evidence has shown that epigenetic silencing of the tumor suppressor genes, particularly caused by hypermethylation of CpG islands in promoters, is critical to carcinogenesis and metastasis. Here, we review the recent progress in the study of methylations of tumor suppressor genes involved in the pathogenesis of gastric cancer. We also briefly describe the mechanisms that induce tumor suppressor gene methylation and the status of translating these molecular mechanisms into clinical applications.
Lu H.,Sir Run Run Shaw Hospital |
Lu H.,Shaw University |
Li G.,Zhejiang University |
Liu L.,Sir Run Run Shaw Hospital |
And 3 more authors.
Autophagy | Year: 2013
Beyond its role in recycling intracellular components nonselectively to sustain survival in response to metabolic stresses, autophagy can also selectively degrade specific cargoes such as damaged or dysfunctional organelles to maintain cellular homeostasis. Mitochondria, known as the power plant of cells, are the critical and dynamic organelles playing a fundamental role in cellular metabolism. Mitophagy, the selective autophagic elimination of mitochondria, has been identified both in yeast and in mammalian cells. Moreover, defects in mitophagy may contribute to a variety of human disorders such as neurodegeneration and myopathies. However, the role of mitophagy in development and cancer remains largely unclear. in this review, we summarize our current knowledge of the regulation and function of mitophagy in development and cancer. © 2013 Landes Bioscience.
Guo Z.,Zhejiang Cancer Hospital |
Yu P.,Harvard University |
Liu Z.,Sir Run Run Shaw Hospital |
Liu Z.,University of Wisconsin - Madison |
And 2 more authors.
Clinical Endocrinology | Year: 2013
Background Conducting total thyroidectomy (TT) or subtotal thyroidectomy (ST) in patients with Graves' disease remains controversial. We performed a meta-analysis based on the published randomized controlled trials to evaluate the complications of TT vs ST. Methods We searched multiple electronic databases for prospective, randomized, controlled trials related to safety and effectiveness of TT vs ST. Relative risk (RR) was estimated with 95% confidence interval (CI) based on an intention-to-treat analysis. We considered the following outcomes: recurrent hyperthyroidism, ophthalmopathy progression, temporary and permanent hypoparathyroidism, temporary and permanent recurrent laryngeal nerve palsy (RLNP) and post-operative bleeding. Results Four trials with 674 patients (342 with TT, 332 with ST) were analysed. Although the overall rates of ophthalmopathy progression were similar between TT and ST (RR 0·92, 95% CI = 0·50-1·71; P = 0·80), TT was associated with a significant reduction in recurrent hyperthyroidism (RR 0·14, 95% CI = 0·05-0·41; P < 0·01). The pooled RR of post-operative bleeding for TT was similar to that for ST (RR 0·32, 95% CI = 0·05-1·96; P = 0·22). However, comparing with ST, the RR of temporary hypoparathyroidism was significantly higher for TT (RR 2·66, 95% CI = 1·89-3·73; P < 0·01). There was no significant difference in permanent hypoparathyroidism (RR 2·30, 95% CI = 0·78-6·76; P = 0·13), temporary (RR 1·08, 95% CI = 0·47-2·48; P = 0·85) and permanent RLNP (RR 1·54, 95% CI = 0·41-5·73; P = 0·52) between the two groups. Conclusions With regard to ophthalmopathy progression, post-operative bleeding, permanent hypoparathyroidism, temporary and permanent RLNP, TT is consistent with ST in patients with Graves' disease. However, TT is associated with a reduced incidence of recurrent hyperthyroidism and results in an increase in temporary hypoparathyroidism. Therefore, TT should be proposed for the treatment of Graves' disease. © 2013 John Wiley & Sons Ltd.
Lin Q.,Zhejiang University |
Ding X.,Zhejiang University |
Qiu F.,Sir Run Run Shaw Hospital |
Song X.,Sir Run Run Shaw Hospital |
And 2 more authors.
Biomaterials | Year: 2010
The in-stent restenosis (ISR) and the late stent thrombosis (LAST) represent the most common failures of stent implantation and are both mediated at the injured endothelium. The natural endothelium healing mechanism provides an approach to achieve in situ endothelialization of the implant by stimulating the neighboring endothelial cells (ECs) migration or capturing the circulating endothelial cells (CEC) directly from the blood circulation. An anti-CD34 antibody functionalized multilayer of heparin/collagen is developed here via layer-by-layer assemble. The ellipsometry and QCM-D results demonstrate that the multilayer coatings with slight glutaraldehyde cross-linking are stable in static incubation and flushing conditions, respectively. The in vitro hemocompatibility tests and cell culture results indicate that both heparin/collagen multilayers with or without the anti-CD34 antibody functionalization not only preserve good hemocompatibility, but also promote cell attachment and growth notably. While the heparin/collagen multilayer coatings show no selectivity in promotion of ECs and smooth muscle cells (SMCs), the anti-CD34 antibody functionalized heparin/collagen multilayers can specifically promote the attachment and growth of the vascular ECs. The metabolic activity assessment and the NO secretion measurements further indicate that the adherent ECs on the anti-CD34 antibody functionalized heparin/collagen multilayer surface have better viability and possess the specific function of the natural vascular ECs. In vivo experiments indicate that the anti-CD34 antibody can enrich and accelerate the attachment of the vascular cells onto the stent and rapid endothelialization is realized. While no significant difference of neointimal hyperplasia is observed between the bare metal stents and heparin/collagen multilayer modified stents, the neointimal hyperplasia on the anti-CD34 antibody functionalized multilayer modified stents is significantly inhibited. The success of the anti-CD34 antibody functionalized heparin/collagen multilayer coating in rapid endothelialization and anti-restenosis might indicate that the immobilization of ECs specific ligand onto a cytocompatible matrix can be a good approach for in situ endothelialization and a possible solution to ISR. © 2010 Elsevier Ltd. All rights reserved.
Fan S.,Sir Run Run Shaw Hospital |
Hu Z.,Sir Run Run Shaw Hospital |
Hong H.,Sir Run Run Shaw Hospital |
Zhao F.,Sir Run Run Shaw Hospital
Spine | Year: 2012
STUDY DESIGN.: The Roland-Morris Disability Questionnaire (RMDQ) was translated and then adapted and validated. OBJECTIVE.: Translation of the RMDQ into simplified Chinese characters (SCRMDQ), and its cross-cultural adaptation and validation in patients with low back pain with or without radicular leg pain. SUMMARY OF BACKGROUND DATA.: The RMDQ is used worldwide and versions in traditional Chinese characters are available in Hong Kong and Taiwan. But there is no version in simplified Chinese characters for use in Mainland China. METHODS.: The original version of the RMDQ was translated and back-translated, and then cross-cultural adaptation of the simplified Chinese version was performed following published guidelines. The SCRMDQ was validated in 150 patients, 30 of whom finished the prefinal SCRMDQ and helped determine the final version. The remaining 120 patients were asked to complete the final SCRMDQ, simplified Chinese Oswestry Disability Index (SCODI), and visual analogue scale. Reliability was assessed with the final version using internal consistency by the Cronbach α coefficient and intraclass correlation coefficient; structural validity was evaluated by correspondence analysis. Then comparison of SCRMDQ and SCODI was performed. RESULTS.: A total of 116 patients in the final validation study finished the questionnaires completely. Their mean age was 52.17 ± 11.95 years (range, 22-78 yr) and the mean low back pain duration was 42.04 ± 60.94 months (range, 2-480 mo). The average time taken was 4.11 ± 1.48 minutes (range, 2-9 min) on SCRMDQ and 7.37 ± 3.98 minutes (range, 3-30 min) on SCODI. The mean SCRMDQ, SCODI, and visual analogue scale scores were 14.07 ± 4.79 (range, 2-24), 23.98 ± 10.38 (range, 2-47), and 57.17 ± 20.72 (range, 0-95), respectively. In the final test, the Cronbach α for internal consistency was 0.826 and intraclass correlation coefficient was 0.947; both showed adequate acceptance. Positive and statistically significant correlations were found between SCRMDQ and SCODI (r = 0.791, P < 0.01) and visual analogue scale (r = 0.493, P < 0.01), indicating sufficient structural validation. Most patients preferred SCRMDQ to SCODI, because it was simpler to understand and easier to finish. CONCLUSION.: The SCRMDQ was reliable and valid as a low back pain measurement tool in patients with or without radicular leg pain in Mainland China. The further use and research with the questionnaire were recommended. Copyright © 2012 Lippincott Williams &Wilkins.
Ip Y.-T.,Queen Elizabeth Hospital |
Yuan J.-Q.,Sir Run Run Shaw Hospital |
Cheung H.,Caritas Medical Center |
Chan J.K.C.,Queen Elizabeth Hospital
American Journal of Surgical Pathology | Year: 2010
Hemangioblastoma is a benign tumor that can occur sporadically, or in association with von Hippel-Lindau disease in approximately one-quarter of the cases. Only exceptionally does it occur outside the central nervous system. This report describes 2 cases of sporadic renal hemangioblastoma, with 1 patient presenting with hematuria and polycythemia, and the other low back pain. Histologically, the tumors were circumscribed, and composed of sheets of large polygonal cells traversed by arborizing thin-walled blood vessels. Many of the tumor cells showed pleomorphic nuclei, but the mitotic figures were rare. The cytoplasm was eosinophilic, and occasionally finely vacuolated indicating the presence of lipid. The diagnosis of hemangioblastoma was confirmed by negative immunostaining for cytokeratin, and positive staining for α-inhibin, S100, and neuron-specific enolase. This benign neoplasm which can be mistaken for various malignancies such as renal cell carcinoma, epithelioid angiomyolipoma, adrenal cortical carcinoma, and paraganglioma, deserves wider recognition for its occurrence as a primary renal tumor. © 2010 by Lippincott Williams & Wilkins.
Hu J.B.,Sir Run Run Shaw Hospital
Oncology research and treatment | Year: 2014
The optimal radiotherapy technique and combination with systemic therapy in locally advanced gastric cancer patients are far from being resolved despite the fact that radiochemotherapy is becoming more attractive in contemporary clinical practice. 40 patients with locally advanced gastric cancer received intensity-modulated radiotherapy (IMRT) at a dosage of 45-50.4 Gy concurrent with chemotherapy using S-1 solely or with a combination of oxaliplatin. Surgery was recommended for those who were evaluated as resectable. Sequential chemotherapy with various regimens was adopted based on the efficacy and tolerance of radiochemotherapy. The overall response rate was 75% according to Response Evaluation Criteria in Solid Tumors and Japanese Gastric Cancer Association criteria. 24 finally underwent surgery, with 22 (91.7%) receiving an R0 resection (resection for cure or complete remission). The overall pathological response rate was 37.5% (9/24). Patients receiving an R0 resection had a higher 2-year overall survival rate (64.7 vs. 16.2%, p = 0.001) and local relapse-free survival rate (90.2 vs. 29.3%, p = 0.000), while there was no difference in distant metastasis-free survival rate (66.1 and 48.1% p = 0.231). Hematological and gastrointestinal toxicities of grade 1 or grade 2 were relatively common. The high rate of R0 resections and low rate of locoregional recurrence suggest that IMRT combined with S-1-based chemotherapy is an effective treatment for locally advanced gastric cancer patients.