The Prognostic Value of Treatment-Related Lymphopenia in Nasopharyngeal Carcinoma Patients

Li-Ting Liu,Qiu-Yan Chen,Lin-Quan Tang,Shan-Shan Guo,Ling Guo,Hao-Yuan Mo,Ming-Yuan Chen,Chong Zhao,Xiang Guo,Chao-Nan Qian,Mu-Sheng Zeng,Jin-Xin Bei,Jing Tan,Shuai Chen,Ming-Huang Hong,Jian-Yong Shao 대한암학회 2018 Cancer Research and Treatment Vol.50 No.1

Purpose This study was conducted to evaluate the prognostic value of treatment-related lymphopenia in patients with nasopharyngeal carcinoma (NPC). Materials and Methods A total of 413 consecutive stage II-IVb NPC patients treated with concurrent chemoradiotherapy (CCRT) were enrolled. The overall survival (OS), progression-free survival (PFS), and distant metastasis-free survival (DMFS) were calculated with the Kaplan-Meier method, and differences were compared using the log-rank test. Results A minimum (mini)–absolute lymphocyte counts (ALC) of < 390 cells/μL or ALC after 3 months of CCRT (post3m-ALC) < 705 cells/μL was significantly associated with worse outcome than mini-ALC ! 390 cells/μL (OS, p=0.002; PFS, p=0.005; DMFS, p=0.004) or post3m-ALC ! 705 cells/μL (OS, p < 0.001; PFS, p < 0.001; DMFS, p=0.001). Patients with lymphopenia (mini-ALC < 390 cells/μL and post3m-ALC < 705 cells/μL) had a worse prognosis than those without lymphopenia (mini-ALC ! 390 cells/μL and post3m-ALC ! 705 cells/μL) (OS, p < 0.001; PFS, p < 0.001; DMFS, p < 0.001). Multivariate analysis revealed that post3m-ALC was an independent prognostic factor for OS (hazard ratio [HR], 1.76; 95% confidence interval [CI], 1.12 to 2.78; p=0.015), PFS (HR, 1.86; 95% CI, 1.23 to 2.82; p=0.003), and DMFS (HR, 1.87; 95% CI, 1.13 to 3.08; p=0.014). Multivariate analysis also revealed that patients with lymphopenia had a high risk of death (HR, 3.79; 95% CI, 1.75 to 8.19; p=0.001), disease progression (HR, 2.93; 95% CI, 1.59 to 5.41; p=0.001), and distant metastasis (HR, 3.89; 95% CI, 1.67 to 9.10; p=0.002). Multivariate analysis performed with time dependent Cox regression demonstrated ALC was an independent prognostic factor for OS (HR, 0.995; 95% CI, 0.991 to 0.999; p=0.025) and PFS (HR, 0.993; 95% CI, 0.988 to 0.998; p=0.006). Conclusion Treatment-related lymphopenia was a poor prognostic factor in NPC patients.

Evaluation of the Geometric Accuracy of Anatomic Landmarks as Surrogates for Intrapulmonary Tumors in Image-guided Radiotherapy

Li, Hong-Sheng,Kong, Ling-Ling,Zhang, Jian,Li, Bao-Sheng,Chen, Jin-Hu,Zhu, Jian,Liu, Tong-Hai,Yin, Yong Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.5

Objectives: The purpose of this study was to evaluate the geometric accuracy of thoracic anatomic landmarks as target surrogates of intrapulmonary tumors for manual rigid registration during image-guided radiotherapy (IGRT). Methods: Kilovolt cone-beam computed tomography (CBCT) images acquired during IGRT for 29 lung cancer patients with 33 tumors, including 16 central and 17 peripheral lesions, were analyzed. We selected the "vertebrae", "carina", and "large bronchi" as the candidate surrogates for central targets, and the "vertebrae", "carina", and "ribs" as the candidate surrogates for peripheral lesions. Three to six pairs of small identifiable markers were noted in the tumors for the planning CT and Day 1 CBCT. The accuracy of the candidate surrogates was evaluated by comparing the distances of the corresponding markers after manual rigid matching based on the "tumor" and a particular surrogate. Differences between the surrogates were assessed using 1-way analysis of variance and post hoc least-significant-difference tests. Results: For central targets, the residual errors increased in the following ascending order: "tumor", "bronchi", "carina", and "vertebrae"; there was a significant difference between "tumor" and "vertebrae" (p = 0.010). For peripheral diseases, the residual errors increased in the following ascending order: "tumor", "rib", "vertebrae", and "carina"; There was a significant difference between "tumor" and "carina" (p = 0.005). Conclusions: The "bronchi" and "carina" are the optimal surrogates for central lung targets, while "rib" and "vertebrae" are the optimal surrogates for peripheral lung targets for manual matching of online and planned tumors.

Survival Benefit of Tamoxifen in Estrogen Receptor-Negative and Progesterone Receptor-Positive Low Grade Breast Cancer Patients

Li-Heng Yang,Hsin-Shun Tseng,Che Lin,Li-Sheng Chen,Shou-Tung Chen,Shou-Jen Kuo,Dar-Ren Chen 한국유방암학회 2012 Journal of breast cancer Vol.15 No.3

Purpose: This study aimed to analyze the efficacy and prognostic significance of adjuvant tamoxifen in breast cancer patients with various hormone receptor statuses. Methods: Typically, 1,260 female breast cancer patients were recruited in this study. The correlation between estrogen receptor (ER)/progesterone receptor (PR) phenotypes and clinical characteristics was investigated, and the survival rate was assessed after 5-year follow-up. Results: The 5-year overall survival (85%) was better in women under the age of 50 years. Patients with ER+/PR+ tumors had a better 5-year survival rate (94%); those with ER-/PR- tumors experienced the worst outcome (74% survival rate); whereas singlepositive cases were in between. In 97 out of 128 patients with ER-/PR+ tumors, tamoxifen was given as adjuvant hormonal therapy, and it increased the survival benefit in the lower grade group in terms of overall survival and disease-free survival (p=0.01 and p=0.03, respectively). Conclusion: For high-grade tumors with ER-/PR+, adjuvant tamoxifen therapy may have no survival benefit, whereas for the patients with low-grade ER-/PR+ tumors, adjuvant tamoxifen therapy is highly suggestive.

Diagnostic Value of Endorectal Ultrasound in Preoperative Assessment of Lymph Node Involvement in Colorectal Cancer: a Meta-analysis

Li, Li,Chen, Shi,Wang, Ke,Huang, Jiao,Liu, Li,Wei, Sheng,Gao, Hong-Yu Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.8

Background: Nodal invasion by colorectal cancer is a critical determinant in estimating patient survival and in choosing appropriate preoperative treatment. The present meta-analysis was designed to evaluate the diagnostic value of endorectal ultrasound (EUS) in preoperative assessment of lymph node involvement in colorectal cancer. Materials and Methods: We systematically searched PubMed, Web of Science, Embase, and China National Knowledge Infrastructure (CNKI) databases for relevant studies published on or before December 10th, 2014. The sensitivity, specificity, likelihood ratios, diagnostic odds ratio (DOR) and area under the summary receiver operating characteristics curve (AUC) were assessed to estimate the diagnostic value of EUS. Subgroup analysis and meta-regression were performed to explore heterogeneity across studies. Results: Thirty-three studies covering 3,016 subjects were included. The pooled sensitivity and specificity were 0.69 (95%CI: 0.63-0.75) and 0.77 (95%CI: 0.73-0.82), respectively. The positive and negative likelihood ratios were 3.09 (95%CI: 2.52-3.78) and 0.39 (95%CI: 0.32-0.48), respectively. The DOR was 7.84 (95%CI: 5.56-11.08), and AUC was 0.80 (95%CI: 0.77-0.84). Conclusions: This meta-analysis indicated that EUS has moderate diagnostic value in preoperative assessment of lymph node involvement in colorectal cancer. Further refinements in technology and diagnostic criteria are necessary to improve the diagnostic accuracy of EUS.

Study on Enhancing Lightning Protection Scheme of Catenary in Subway Viaduct Section

Li, Rui-Fang,Chen, Kui,Chen, Li-Sheng,Cao, Xiao-Bin,Wu, Guang-Ning,Zhang, Xue-Qin The Korean Institute of Electrical Engineers 2017 Journal of Electrical Engineering & Technology Vol.12 No.2

Viaduct increases the height of subway catenary, namely magnifies lightning attraction scope that lead to higher possibility of suffering lightning stroke. Therefore, it is necessary to analyze performance of lightning striking to catenary of subway in viaduct section and propose an improving lightning protection scheme. In this paper, using ATP-EMTP simulation software to establish an associated model to evaluate lightning withstand level of catenary with existing lightning protection schemes including arrester and grounding point, an improving lightning protection scheme is proposed - every pillar ground earth and arresters are installed with some installing spacing between 200m to 400m based on lightning damage degree and reliability requirements - according to analyzing results: while lightning withstand level is lowest for lightning striking to the neutral pillar, lightning withstand level is greatest for lightning striking to the both-ends pillar that arrester and grounding point are both installed; grounding point could obviously improve lightning withstand level for lightning striking to ground wire while arrester could obviously improve the lightning withstand level for lightning striking to catenary; every pillar ground earth could enhance the lowest lightning withstanding level up to 2.5 times than of that pillar ground earth across every 200m.

Influence of Intravenous Contrast Medium on Dose Calculation Using CT in Treatment Planning for Oesophageal Cancer

Li, Hong-Sheng,Chen, Jin-Hu,Zhang, Wei,Shang, Dong-Ping,Li, Bao-Sheng,Sun, Tao,Lin, Xiu-Tong,Yin, Yong Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.3

Objective: To evaluate the effect of intravenous contrast on dose calculation in radiation treatment planning for oesophageal cancer. Methods: A total of 22 intravein-contrasted patients with oesophageal cancer were included. The Hounsfield unit (HU) value of the enhanced blood stream in thoracic great vessels and heart was overridden with 45 HU to simulate the non-contrast CT image, and 145 HU, 245 HU, 345 HU, and 445 HU to model the different contrast-enhanced scenarios. 1000 HU and -1000 HU were used to evaluate two non-physiologic extreme scenarios. Variation in dose distribution of the different scenarios was calculated to quantify the effect of contrast enhancement. Results: In the contrast-enhanced scenarios, the mean variation in dose for planning target volume (PTV) was less than 1.0%, and those for the total lung and spinal cord were less than 0.5%. When the HU value of the blood stream exceeded 245 the average variation exceeded 1.0% for the heart V40. In the non-physiologic extreme scenarios, the dose variation of PTV was less than 1.0%, while the dose calculations of the organs at risk were greater than 2.0%. Conclusions: The use of contrast agent does not significantly influence dose calculation of PTV, lung and spinal cord. However, it does have influence on dose accuracy for heart.

Use of Acupressure to Improve Gastrointestinal Motility in Women after Trans-abdominal Hysterectomy

Chen, Li-Li,Hsu, Sheng-Feng,Wang, Min-Hung,Chen, Chao-Ling,Lai, Jim-Shoung 경희대학교 2001 INTERNATIONAL SYMPOSIUM ON EAST-WEST MEDICINE Vol.2001 No.1

Objective : To evaluate the effectiveness of acupressure on the gastrointestinal motility (GI) in women after trans-abdominal hysterectomy(TAH). Methods : Forty-one women undergoing trans-abdominal hysterectomy were recruited and randomly assigned to two groups. Twenty-one patients were assigned to the experimental group while remaining 20 patients were assigned as controls. A single blinded test was used for this study. Patients were not informed as to the tripe of treatment they would receive. The experimental group received twice daily acupressure for 3 minutes at three meridian points, Neiguan(PC-6), Zusanli(ST-36) and Sanyinjiao(SP-6), beginning 4 hours after surgery and continuing for 3 days. Control group received 3 minutes acupressure on non-meridian points on the tibia or radial bone surface approximately 3 to 4 cm from the corresponding three meridian points. Acupressure was performed twice a day, one at 10 Am and another at 2 Pm. GI contractions was measured by stethoscope prior to and after afternoon acupressure during 2- minute observational period. Results : Results show that acupressure of these three meridian points significantly (p<0.05) increased GI motility in the experimental groups, but not in the control group (p>0.05). Conclusions : Results showed that non-invasive acupressure of these meridian points could significantly improve the GI motility and could be incorporated into the technical curriculum and clinical education program of nursing schools. Family members of the patient could be taught to continue this procedure at home to enhance GI motility in patients undergoing trans-abdominal hysterectomy.

Mobile Social Helping Platform of LBS

Chen Yuefeng,Li Bingquan,Gao sheng,Peng Linxi 보안공학연구지원센터 2015 International Journal of Smart Home Vol.9 No.1

Mobile Internet grows with demands of location information of mobile users . In order to overcome the limitation of sociality, we develop Mobile social helping platform (MSH) of LBS, which realize the sharing of sociality. First, we analyze the requirement of MSHP platform, then design its architecture and database, and finally discuss the key technologies of MSHP. The platform makes use of open source technology, implements and optimizes LBS service. The simulation results show the system has good portability and maintainability, which is easy to be commercialized.

Prediction Model for unfavorable Outcome in Spontaneous Intracerebral Hemorrhage Based on Machine Learning

Shengli Li,Jianan Zhang,Xiaoqun Hou,Yongyi Wang,Tong Li,Zhiming Xu,Feng Chen,Yong Zhou,Weimin Wang,Mingxing Liu 대한신경외과학회 2024 Journal of Korean neurosurgical society Vol.67 No.1

Objective : The spontaneous intracerebral hemorrhage (ICH) remains a significant cause of mortality and morbidity throughout the world. The purpose of this retrospective study is to develop multiple models for predicting ICH outcomes using machine learning (ML). Methods : Between January 2014 and October 2021, we included ICH patients identified by computed tomography or magnetic resonance imaging and treated with surgery. At the 6-month check-up, outcomes were assessed using the modified Rankin Scale. In this study, four ML models, including Support Vector Machine (SVM), Decision Tree C5.0, Artificial Neural Network, Logistic Regression were used to build ICH prediction models. In order to evaluate the reliability and the ML models, we calculated the area under the receiver operating characteristic curve (AUC), specificity, sensitivity, accuracy, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR). Results : We identified 71 patients who had favorable outcomes and 156 who had unfavorable outcomes. The results showed that the SVM model achieved the best comprehensive prediction efficiency. For the SVM model, the AUC, accuracy, specificity, sensitivity, PLR, NLR, and DOR were 0.91, 0.92, 0.92, 0.93, 11.63, 0.076, and 153.03, respectively. For the SVM model, we found the importance value of time to operating room (TOR) was higher significantly than other variables. Conclusion : The analysis of clinical reliability showed that the SVM model achieved the best comprehensive prediction efficiency and the importance value of TOR was higher significantly than other variables.

Excessive mechanical strain accelerates intervertebral disc degeneration by disrupting intrinsic circadian rhythm

Ding Sheng-Long,Zhang Tai-Wei,Zhang Qi-Chen,Ding Wang,Li Ze-Fang,Han Guan-Jie,Bai Jin-Song,Li Xi-Lei,Dong Jian,Wang Hui-Ren,Jiang Li-Bo 생화학분자생물학회 2021 Experimental and molecular medicine Vol.53 No.-

Night shift workers with disordered rhythmic mechanical loading are more prone to intervertebral disc degeneration (IDD). Our results showed that circadian rhythm (CR) was dampened in degenerated and aged NP cells. Long-term environmental CR disruption promoted IDD in rats. Excessive mechanical strain disrupted the CR and inhibited the expression of core clock proteins. The inhibitory effect of mechanical loading on the expression of extracellular matrix genes could be reversed by BMAL1 overexpression in NP cells. The Rho/ROCK pathway was demonstrated to mediate the effect of mechanical stimulation on CR. Prolonged mechanical loading for 12 months affected intrinsic CR genes and induced IDD in a model of upright posture in a normal environment. Unexpectedly, mechanical loading further accelerated the IDD in an Light-Dark (LD) cycle-disrupted environment. These results indicated that intrinsic CR disruption might be a mechanism involved in overloading-induced IDD and a potential drug target for night shift workers.