1.Clinical and electrocardiographic characteristics of carriers with SCN5A mutations and non-SCN5A mutations in fever-induced Brugada syndrome
Keqin SHEN ; Zhonghe ZHANG ; Ganxiao CHEN ; Xiaoxiong LIU ; Guohua FAN ; Jinqiu LIU ; Hao XIA ; Hong JIANG ; Dan HU
Chinese Journal of Cardiology 2024;52(12):1377-1382
Objective:To investigate the differences in clinical and electrocardiographic characteristics between carriers of SCN5A mutations and non-SCN5A mutations in fever-induced Brugada syndrome.Methods:This study is a retrospective cohort study. A total of 263 patients with fever-induced Brugada syndrome who were admitted to Renmin Hospital of Wuhan University from January 2000 to December 2023 were selected. Their clinical manifestations, electrocardiographic characteristics, and major adverse cardiovascular events (MACE) at the time of diagnosis and during the follow-up period were collected. Among them, 200 patients underwent next-generation sequencing. Based on the genetic variation results, after excluding other mutations, they were divided into SCN5A mutation group, non-SCN5A sodium-related mutation group, potassium/calcium mutation group, and no mutation group. Comparisons were made among these groups in terms of their clinical and electrocardiographic characteristics.Results:Among the 263 patients with fever-induced Brugada syndrome, the mean age was (41.9±17.6) years, with 80.6% (212/263) being male. The median follow-up duration was 53.0 months, and 13.7% (36/263) of the patients experienced MACE. The rate of SCN5A mutation was 34.5% (69/200), while the rates of non-SCN5A sodium-related mutations and potassium/calcium-related mutations were 4.5% (9/200) and 3.5% (7/200), respectively. The SCN5A mutation group was younger than the non-SCN5A sodium-related mutation group and the no mutation group (ages were (33.8±14.7), (49.8±11.6), (44.6±15.7) years, respectively, P<0.001). The SCN5A mutation group also had a longer PR interval than the no mutation group ((176.8±32.3) ms vs. (163.9±28.6) ms, P=0.034). The incidence of MACE was higher in the non-SCN5A sodium-related mutation group than that in the no mutation group (55.6% (5/9) vs. 9.1% (9/99), P=0.002). Conclusions:Fever-induced Brugada syndrome patients carrying non-SCN5A mutations exhibit distinct clinical and electrocardiographic characteristics compared to those with SCN5A mutations. These differences warrant attention in clinical practice.
2.TNFSF14 mediates ischemia/reperfusion-induced acute kidney injury in mice by promoting mitochondrial fission
Ximing CHEN ; Quanyou ZHENG ; Quilian XU ; Keqin ZHANG
Immunological Journal 2024;40(1):26-32
This study was designed to investigate the effects of TNFSF14 on mitochondrial function in ischemia/reperfusion-induced acute kidney injury(I/R-AKI)and its mechanism.TNFSF14-/-and TNFSF14+/+mice underwent renal ischemia-reperfusion operation to establish I/R-AKI models,and their histopathology changes were compared by using Periodic Acid-Schiff stain,transmission electron microscopy.Immunohistochemistry(IHC)was used to detect levels of TNFSF14,HVEM,LT[3R,mitochondrial activity related proteins(Dpr1 and Mfn2)and inflammatory cells infiltration in kidney tissues of mice and relevant patients.In vitro cell experiments,immunofluorescence and immunoblotting were used to observe the effects of exogenous recombinant TNFSF14 factor on the damage and mitochondrial activity of renal tubular epithelial cell line HK-2 cells.Data showed that the expression of TNFSF14 and its receptors were significantly increased in kidney tissues of I/R-AKI mice and clinical human renal tissues of acute tubular injury.Compared with the sham group,I/R mice showed significantly higher levels of renal tubular injury score,inflammatory cells infiltration,cell apoptosis,mitochondrial damage,and Drp1 expression,while knocking out the TNFSF14 gene,the above indicators were significantly reduced.In vitro,exogenous TNFSF14 stimulation could aggravate the hypoxia-induced apoptosis and the decrease of mitochondrial membrane potential in HK-2 cells,while increasing phosphorylation of Drp1 at Se616 to promote its transfer from cytoplasm to mitochondria,leading to an abnormal increase in mitochondrial fission.In conclusions,TNFSF14 may mediate the pathological process of I/R-AKI by promoting mitochondrial damage.
3.The value of preoperative MRI texture analysis in guiding postoperative prognosis of glioma
Huixi CHEN ; Yunchang LIU ; Keqin LIU ; Wenbo WANG ; Zhizhu PENG
Journal of Practical Radiology 2024;40(5):817-820,840
Objective To investigate the correlation between different grade glioma and MRI image texture parameters and the guiding value of texture analysis for postoperative prognosis.Methods A total of 107 glioma patients were selected,and the texture parameters of MRI images were recorded.The correlation between the grade of glioma and the texture parameters of MRI images was analyzed.The risk factors affecting postoperative adverse effects of glioma patients were analyzed,and the diagnostic efficacy of each texture parameter in predicting glioma grade and postoperative good condition was evaluated.Results Comparison of MRI image tex-ture parameters between patients with low-grade glioma and patients with high-grade glioma showed no significant differences in kur-tosis,skewness,standard deviation,contrast and uniformity,but significant differences in correlation,entropy,consistency and gap distance.Correlation,entropy,consistency and gap distance were significantly correlated with glioma grade.The diagostic efficiency of entropy in predicting glioma grade was significantly higher than that of correlation,consistency and gap distance.The combination of the four predicted glioma patients with good postoperative diagnostic efficacy was the highest.Conclusion The correlation,entropy,consistency and gap distance of MRI image texture parameters can effectively diagnose the grade of glioma,and the combination of the four parameters is more beneficial to the postoperative evaluation of glioma patients.
4.Construction and validation of a nomogramdiagnostic model for osteosarcopenia in maintenance hemodialysis patients
Haoyong ZHANG ; Kun ZHANG ; Xin LI ; Xiaojing WANG ; Chen YU ; Keqin ZHANG ; Fanglei XU
Chinese Journal of Modern Nursing 2024;30(24):3242-3249
Objective:To explore the risk factors of osteosarcopenia in maintenance hemodialysis patients, construct a diagnostic nomogram model and verify the effect.Methods:Usingthe convenient sampling method, a total of 697 patients who underwent regular hemodialysis in six hospitals in Shanghai from July 2020 to April 2021 were selected as the modeling set, and 132 patients who underwent regular hemodialysis in Tongji Hospital in Shanghai in November 2020 were selected as the validation set. General information, laboratory indicators, human parameters, physical functions, nutritional status, physical activity, cognitive function, and depression were collected. Logistic regression was used to analyze the risk factors of osteosarcopenia in maintenance hemodialysis patients and to construct a nomogram model. The effect of the model was evaluated by the area under the receiver operating characteristic curve, calibration curve, and decision curve.Results:A total of 697 maintenance hemodialysis patients were included in the modeling set, including 171 patients with osteosarcopenia, with an incidence rate of 24.53% (171/697). The results of the binomial logistic regression analysis showed that age, body mass index, physical activity intensity, and Charlson Comorbidity Index (CCI) were the influencing factors for the occurrence of osteosarcopenia in maintenance hemodialysis patients ( P<0.05). The area under the receiver operating characteristic curve in the modeling set, ten-fold cross-validation, and validation set were 0.835, 0.827, and 0.851, respectively. The calibration curves of the modeling and validation sets fitted well. The decision curve showed that the clinical utility of the nomogram was good. Conclusions:Maintenance hemodialysis patients are prone to osteosarcopenia. Old age, low body mass index, high Charlson Comorbidity Index, and low-intensity physical activity are risk factors for osteosarcopenia in maintenance hemodialysis patients. A nomogramdiagnostic model based on the above-mentioned influencing factors can help medical staff identify high-risk populations early and develop prevention and treatment measures.
5.Investigation on a family cluster of COVID-19 in Ningbo
LI Hui ; DUAN Donghui ; CHEN Bingbing ; SUN Jialu ; DING Keqin ; YI Bo ; YUAN Weiwei ; Weiwei Hu ; ZHANG Dongliang ; LI Ning ; LEI Song ; CUI Jun
Journal of Preventive Medicine 2020;32(9):895-898
Objective:
To report an investigation of a family cluster of coronavirus disease 2019 ( COVID-19 ) in Ningbo, so as to provide reference for the prevention and control measures.
Methods:
According to the COVID-19 Prevention and Control Program ( fourth version ) , an epidemiological investigation was conducted to collect the demographic information, clinical features and exposure history, to find the close contacts, and to figure out the source and route of infection.
Results:
Twelve confirmed cases and one asymptomatic case were reported. The attack rate was 16.05%. Among them, five were males and eight were females; the age ranged from 11 to 85 years old, with a median of 39 years old; most had mild symptoms. The incubation period was 2-13 days, with a median of 6.5 days. The first case ( Case 1 ) developed the symptoms on January 22, and had close contact with Zhang, an asymptomatic case, on January 20. Zhang was related to a cluster in the Buddhist assembly on January 19. Case 1, who caused the spread of the epidemic among family members, participated in several family visits and dinners from January 22 to 27 with other 24 families, resulting in six secondary cases and six third-generation cases. There were 54 close contacts except the family members, no infection was found.
Conclusion
This family cluster may result from the close contact with an asymptomatic case, and then spread within families through having dinners and living together.
6.Epidemiological characteristics of coronavirus disease 2019 in Ningbo
ZHANG Dongliang ; YI Bo ; CHEN Yi ; DING Keqin ; WANG Haibo ; DONG Hongjun ; XU Guozhang ; WANG Aihong ; MA Xiao ; ZHANG Yan ; FANG Ting
Journal of Preventive Medicine 2020;32(4):330-333
Objective:
To analyze the epidemiological characteristics of coronavirus disease 2019 (COVID-19) cases reported in Ningbo from January 22 to February 22, 2020, so as to provide guidance for the prevention and control of the COVID-19 epidemic.
Methods:
The confirmed cases of COVID-19 reported by Ningbo were selected from National Diseases Prevention and Control Information System to analyze the epidemiological characteristics by descriptive epidemiological method, including time, spatial and population distribution, clinical symptoms and exposure history.
Results:
A total of 157 confirmed cases of COVID-19 were reported and there was no death. The first confirmed case was reported on January 22. On the incidence curve, the peak was from January 22 to February 4, with a maximum of 15 cases in a single day. The incidence curve presented sustained human-to-human transmission. The number of the cases showed a declining trend from February 5. The confirmed cases were reported in all 10 counties(cities or districts),among which 69(43.95%)cases were reported in Haishu District. The confirmed cases were mainly 30-69 years old,accounting for 78.34%;were mainly farmers,household workers and retired people,accounting for 59.87%;and were mainly clinically mild,accounting for 87.90%.There were 51 imported cases, accounting for 32.48%. The initial confirmed case was a local case. In the early stage of the epidemic, local cases and imported cases prevalent together,which was due to the outbreak caused by the large-scale buddhist activity on January 19.This event resulted in 67 confirmed cases and 15 asymptomatic cases. There totally reported 22 clusters with 138 (87.90%)confirmed cases.
Conclusions
In the early stage of the COVID-19 epidemic in Ningbo, the imported cases and local cases prevalent at the same time. Most of the cases were female, aged from 30 to 69 years, and their occupation were farmers, household workers and retired people. With comprehensive measures taken, the epidemic of COVID-19 in Ningbo have been under control.
7.Oncologic outcomes of early stage cervical cancer performed operation by different laparoscopic surgical procedures: analysis of clinical data from mutiple centers
Kaijian LING ; Yanzhou WANG ; Hui ZHANG ; Xuyin ZHANG ; Junjun YANG ; Chengyan LUO ; Bin SONG ; Wenxi ZHANG ; Li DENG ; Gongli CHEN ; Yudi LI ; Qunying HU ; Yong CHEN ; Xin WANG ; Jun ZHANG ; Jingxin DING ; Tong REN ; Shan KANG ; Keqin HUA ; Yang XIANG ; Wenjun CHENG ; Zhiqing LIANG
Chinese Journal of Obstetrics and Gynecology 2020;55(9):617-623
Objective:To evaluate the oncologic outcomes of different laparoscopic radical hysterectomy.Methods:From January 2011 to December 2014, the laparoscopic operation cases of cervical cancer at stage Ⅰb1, Ⅰb2, Ⅱa1 and Ⅱa2, including the histologic subtypes of squamous-cell carcinoma, adenocarcinoma and adenosquamous carcinoma, were collected in five clinical centers. The data were divided into two groups according to the surgical procedures, that is, modified laparoscopic-vaginal radical hysterectomy (mLVRH) and total laparoscopic radical hysterectomy (TLRH). The overall survival rate (OS), disease-free survival rate (DFS) at 5 years were retrospectively analyzed in this study.Results:There were 674 cases in total, including 377 cases of mLVRH, 297 cases of TLRH. (1) The OS at 5 years: the mLVRH was 96.1% and the TLRH was 92.0%, and the mLVRH was higher than that of TLRH ( P=0.010). Stratify analysis, including stage of disease (Ⅰb1 and Ⅱa1), histologic subtypes (squamous-cell carcinoma, adenocarcinoma), lymph node metastasis, revealed that, ① Stage of disease: in stage Ⅰb1, the OS at five years of mLVRH was higher than that in TLRH group (98.6% vs 93.6%, P=0.012). In stage Ⅱa1, there was significant difference between the two groups, the OS at five years of mLVRH and TLRH were 93.6% and 77.6% ( P=0.007). ② Histologic subtypes: for the OS at five years of squamous-cell carcinoma, mLVRH and TLRH were 96.1% and 92.3%, and there was significant difference ( P=0.046); for adenocarcinoma, the OS at five years were 91.0% and 88.6%, and there was no difference between two groups ( P=0.230). ③ Lymph node metastasis: the mLVRH and TLRH with lymph node metastasis, the OS at five years were 98.6% and 96.4%; the mLVRH and TLRH without lymph node metastasis, the OS at five years were 89.3% and 80.8%. There were no significant differences between the two groups,respectively ( P=0.156, P=0.093). (2) The DFS at 5 years: there was no significant difference between mLVRH and TLRH (94.1% vs 90.9%, P=0.220). Stratify analysis for stage of disease, the mLVRH group was higher than that in the TLRH group in stage Ⅰb1 (97.0% vs 92.8%, P=0.039). However, for stage Ⅱa1, there was no significant difference between mLVRH and TLRH group (88.2% vs 75.8%, P=0.074). Conclusions:The results of this retrospective study indicated that different laparoscopy surgical procedures had diverse oncologic outcomes. The OS at 5 years of the mLVRH is superior to the TLRH. The DFS at 5 years in Ⅰb1 stage, the mLVRH is higher than the TLRH. Therefore, the modified laparoscopy is still an alternative surgery for early cervical cancer patients when following the principle of no-tumor-exposure.
8.Epidemiological characteristics of infection in COVID-19 close contacts in Ningbo city
Yi CHEN ; Aihong WANG ; Bo YI ; Keqin DING ; Haibo WANG ; Jianmei WANG ; Hongbo SHI ; Sijia WANG ; Guozhang XU
Chinese Journal of Epidemiology 2020;41(5):667-671
Objective:To estimate the infection rate of close contacts of COVID-19 cases, and to evaluate the risk of COVID-19 under different exposure conditions.Methods:A prospective study was used to conduct continuous quarantine medical observations of close contacts of people infected with COVID-19, collect epidemiological, clinical manifestations, and laboratory test data to estimate the infection rate of close contacts under different exposures.Results:The epidemiological curve of COVID-19 in Ningbo showed persistent human-to-human characteristics. A total of 2 147 close contacts were tracked and investigated. The total infection rate was 6.15%. The infection rates of confirmed cases and positive contacts were 6.30% and 4.11%, respectively. The difference was not statistically significant ( P>0.05). Among close contacts of different relationships, friends/pilgrims (22.31%), family members (18.01%), and relatives (4.73%) have a higher infection rate, and close contacts of medical staff were not infected. Differences in infection rates among the close contacts were statistically significant ( P<0.005). Living with the case (13.26%), taking the same transportation (11.91%), and dining together (7.18%) are high risk factors for infection. Cross-infection in the hospital should not be ignored (1.94%). The median of incubation period is 5 days. Conclusion:The infection rate of close contacts of COVID-19 cases is high, and isolation medical observation measures should be implemented in strict accordance with the close contact management plan.
9.Epidemiological characteristics of infection in COVID-19 close contacts in Ningbo city
Yi CHEN ; Aihong WANG ; Bo YI ; Keqin DING ; Haibo WANG ; Jianmei WANG ; Hongbo SHI ; Sijia WANG ; Guozhang XU
Chinese Journal of Epidemiology 2020;41(5):667-671
Objective:To estimate the infection rate of close contacts of COVID-19 cases, and to evaluate the risk of COVID-19 under different exposure conditions.Methods:A prospective study was used to conduct continuous quarantine medical observations of close contacts of people infected with COVID-19, collect epidemiological, clinical manifestations, and laboratory test data to estimate the infection rate of close contacts under different exposures.Results:The epidemiological curve of COVID-19 in Ningbo showed persistent human-to-human characteristics. A total of 2 147 close contacts were tracked and investigated. The total infection rate was 6.15%. The infection rates of confirmed cases and positive contacts were 6.30% and 4.11%, respectively. The difference was not statistically significant ( P>0.05). Among close contacts of different relationships, friends/pilgrims (22.31%), family members (18.01%), and relatives (4.73%) have a higher infection rate, and close contacts of medical staff were not infected. Differences in infection rates among the close contacts were statistically significant ( P<0.005). Living with the case (13.26%), taking the same transportation (11.91%), and dining together (7.18%) are high risk factors for infection. Cross-infection in the hospital should not be ignored (1.94%). The median of incubation period is 5 days. Conclusion:The infection rate of close contacts of COVID-19 cases is high, and isolation medical observation measures should be implemented in strict accordance with the close contact management plan.
10.Epidemic dynamic model based evaluation of effectiveness of prevention and control strategies for COVID-19 in Ningbo
Hang HONG ; Hongbo SHI ; Haibo JIANG ; Xiaomin GU ; Yi CHEN ; Keqin DING ; Guozhang XU
Chinese Journal of Epidemiology 2020;41(10):1606-1610
Objective:To evaluate effectiveness of prevention and control strategies for COVID-19 in Ningbo by using an epidemic dynamic model.Methods:The incidence data and epidemic information of COVID-19 reported in Ningbo as of 9 March, 2020 were collected, and based on the implementation of prevention and control strategies, we developed a SEIR epidemic dynamics model. The basic and real-time reproduction numbers were calculated to evaluate effectiveness of prevention and control.Results:A total of 157 cases of COVID-19 were confirmed, without death, in Ningbo. The proportion of severe cases was 12.1 %. The mean incubation period was estimated to be (5.7±2.9) days. The mean interval from illness onset to diagnosis was (5.4±3.7) days. The mean duration from diagnosis to hospital discharge was (16.6±6.5) days. A total of 105 339 contacts had been under medical observation. The infection rates in contacts with home quarantine and centralized quarantine were 0.1 % and 0.3 %, respectively. In the confirmed cases, those who had been under medical observation before diagnoses accounted for 63.1 %. The basic reproduction number was estimated to be 4.8. With the strengthening of prevention and control measures, real-time reproduction number showed a gradual downward trend, dropping to below 1.0 on 4 February, and then continued to drop to 0.2 in mid-February. Conclusion:The effectiveness of the prevention and control measures for COVID-19 in Ningbo can be evaluated by using epidemic dynamic model to provide scientific evidence for the development of the prevention and control strategies.


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