1.Expert consensus on antiviral therapy of COVID-19
Fujie ZHANG ; Zhuo WANG ; Quanhong WANG ; Qing MAO ; Jinsong BAI ; Hanhui YE ; Jia TIAN ; Tianxin XIANG ; Jihong AN ; Zujiang YU ; Wenjie YANG ; Xingxiang YANG ; Xiaoju ZHANG ; Jie ZHANG ; Lina ZHANG ; Xingwang LI ; Jiabin LI ; Manxiang LI ; Zhiwei LI ; Hourong ZHOU ; Yi SHI ; Xiaoling XU ; Xiaoping TANG ; Hong TANG ; Xixin YAN ; Wenxiang HUANG ; Chaolin HUANG ; Liang DONG ; Baosong XIE ; Jiandong JIANG ; Bin XIONG ; Xuemei WEI ; Jifang SHENG ; Ronghua JIN
Chinese Journal of Clinical Infectious Diseases 2023;16(1):10-20
COVID-19 is caused by a novel coronavirus-severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), which has being spreading around the world, posing a serious threat to human health and lives. Neutralizing antibodies and small molecule inhibitors for virus replication cycle are the main antiviral treatment for novel coronavirus recommended in China. To further promote the rational use of antiviral therapy in clinical practice, the National Center for Infectious Diseases (Beijing Ditan Hospital Capital Medical University and the First Affiliated Hospital, Zhejiang University School of Medicine) invited experts in fields of infectious diseases, respiratory and intensive care to develop an Expert Consensus on Antiviral Therapy of COVID-19 based on the Diagnosis and Treatment Guideline for COVID-19 ( trial version 10) and experiences in the diagnosis and treatment of COVID-19 in China. The consensus is concise, practical and highly operable, hopefully it would improve the understanding of antiviral therapy for clinicians and provide suggestions for standardized medication in treatment of COVID-19.
2.Radiation-induced GATA3 expression in lung epithelial cells and mechanism of RNA methylation
Junxuan YI ; Xiaodan DONG ; Wenxiang XUE ; Shuying GAO ; Naiwen XUE ; Shunzi JIN
Chinese Journal of Radiological Health 2023;32(3):223-229
Objective:
To investigate GATA3 expression and the regulatory mechanism of m6A modification in the re-
sponse of alveolar epithelial cells to radiation, and to provide a new therapeutic target for radiation-induced lung injury based on its pathogenesis.
Methods:
Human lung epithelial cell line (A549) and mouse lung epithelial cell line (MLE-12) were
exposed to X-ray irradiation with a single dose of 10 Gy (dose rate 1 Gy/min) and 6 Gy (dose rate 0.75 Gy/min), respect-
ively. The expression of VIRMA gene (RNA methylase) was inhibited by lipofection of A549 cells and MLE-12 cells with shRNA-VIRMA plasmid and siRNA-VIRMA interfering fragment, respectively. Quantification of m6A RNA methylation
was performed by colorimetry. Changes in the expression of mRNAs of VIRMA, GATA3, and epithelial-mesenchymal transition (EMT) markers in irradiated A549 and MLE-12 cells were determined by qRT-PCR. Changes in the expression of
VIRMA, GATA3, and EMT marker proteins in irradiated A549 and MLE-12 cells were determined by Western blot.
Results:
Radiation up-regulated the expression of methylase VIRMA in A549 and MLE-12 cells, which in turn enhanced
the m6A of total RNA and the expression of GATA3 gene and protein, resulting in EMT. Furthermore, in A549 and MLE-12
cells, interference of the VIRMA gene significantly reduced the expression of GATA3 gene and protein and the expression of EMT-related molecules.
Conclusion
Radiation induces m6A modification in alveolar epithelial cells, which up-regu-
lates the expression of GATA3 gene and induces EMT, thus playing an important role in the process of radiation-induced lung injury.
3.Assessment of different size tumor stiffness characteristic with shear wave elastography in a triple-negative human breast cancer implantation model
Wenxiang ZHI ; Jin ZHOU ; Chaoxu LIU ; Shichong ZHOU ; Cai CHANG
Chinese Journal of Ultrasonography 2021;30(4):346-350
Objective:To investigate the stiffness characteristic of triple-negative human breast cancer at different size in a implantation nude female mice model using shear wave elastography(SWE) and to compare the clinical pathologic features of tumors with elasticity variables.Methods:Human breast cancer MDA-MB-231 cells were injected into 30 nude female mice and 27 transplanted tumors were successfully found in nude female mice. Ultrasound and SWE were longitudinally performed on maximum diameter plane of 21 tumours in 21 nude mice. The elastic parameters of maximal elasticity(Emax), mean elasticity (Emean) and standard deviation of elasticity(Esd) were recorded. The mice were divided into 3 groups according to the tumor size. They were group A with tumor size less than or equal to 5 mm, group B with tumor size greater than 5 mm and less than or equal to 10 mm, group C with tumor size larger than 10 mm and smaller than or equal to 15 mm. Compared with pathology, the relationships between Ki67 of transplanted tumor and elastic parameters were analyzed.Results:As the transplanted tumors increased, the values of Emax, Esd, Ki67 all increased. The lesions maximal size, Emax, Esd, Ki67 were significant higher in group B ( P<0.001, P=0.006, P=0.002, P=0.026) and group C ( P<0.001, P<0.001, P<0.001, P=0.028) than group A. The other parameters were not significantly different among the groups(all P>0.05). The size of transplanted tumors was significantly and positively correlated with Emax ( rs=0.673, P=0.001), Esd ( rs=0.661, P=0.001), and Ki67 ( rs=0.509, P=0.018). Conclusions:SWE Emax and Esd can reflect the tumor tissue stiffness change and biological activity during the tumor growth.
4.Application of convolutional neural networks in the diagnosis of schizophrenia
Jin LIU ; Yong HE ; Jiuju WANG ; Wenxiang QUAN ; Ju TIAN ; Chaonan FENG ; Haokui YU ; Cai NAN ; Jun JI
Chinese Journal of Behavioral Medicine and Brain Science 2019;28(7):622-626
Objective To explore the program of convolutional neural networks for the diagnosis of schizophrenia and evaluate its effects. Methods Using the convolutional neural network,the training model was trained in the lead data of 138 normal people and 183 schizophrenic patients,and the model was valida-ted by 20-fold cross-validation. Results The true positive rate of schizophrenia prediction using the convolu-tional neural network training model was 0. 749, the false positive rate was 0. 275, and the accuracy was 0. 738. Conclusion This model can achieve a strong diagnostic ability for patients with schizophrenia. Therefore,convolutional neural network for the diagnosis of schizophrenia will become an important research direction in the future.
5. Risk factors of predicting lateral neck lymph node metastasis following solitary papillary thyroid carcinoma
Jin ZHOU ; Shichong ZHOU ; Jiawei LI ; Yu WANG ; Yaling CHEN ; Fen WANG ; Wenxiang ZHI ; Min CHEN ; Cai CHANG
Chinese Journal of Ultrasonography 2019;28(11):971-975
Objective:
To evaluate the risk factors in terms of clinical characteristics and sonographic features regarding solitairy thyroid papillary carcinoma (PTC) for the lateral cervical lymph node metastasis(LLNM) and then to establish nomogram model.
Methods:
All patients were confirmed to be solitary PTC in paraffin wax pathology after thyroidectomy in Fudan University Shanghai Cancer Center from January to September 2016. Meanwhile, the status of lateral cervical lymph node metastasis was determined referring to postoperative pathology. Clinical characteristics including gender, age, preoperative thyroid stimulating hormone (TSH), thyroglobulin (Tg), thyroglobulin antibody (TGAb), thyroid peroxidase antibody (TPOAb), central lymph node metastasis (CLNM) and sonographic features of the PTC lesion including maximum tumor diameter, location, aspect ratio, relation with thyroid capsule, echo, margin, acoustic halo, microcalcification were evaluated for the association with lateral cervical lymph node metastasis using univariate and multivariate logistic regression analyses. Then the nomogram model was established and its application value was evaluated using ROC.
Results:
Out of 1 174 patients, 125 patients (10.6%) presented lateral neck lymph node metastasis and 10 patients presented skipping metastasis.Univariate analysis showed gender, preoperative Tg and TGAb, CLNM, maximum tumor diameter, location, close to the thyroid tumor capsule, echo, aspect ratio, acoustic halo, microcalcification were associated with LLNM(
6.Risk factors of central neck lymph node metastasis following solitary papillary thyroid carcinoma
Jin ZHOU ; Shichong ZHOU ; Jiawei LI ; Yu WANG ; Yaling CHEN ; Fen WANG ; Wenxiang ZHI ; Min CHEN ; Cai CHANG
Chinese Journal of Ultrasonography 2019;28(3):235-240
Objective To evaluate the risk factors in terms of clinical characteristics ,serological indicators and sonographic features regarding thyroid papillary carcinoma ( PTC) for the central neck lymph node metastasis . Methods One thousand one hundred and seventy‐four patients accepted thyroid cancer surgery at Fudan University Shanghai Cancer Center from January to September 2016 were enrolled . All patients were confirmed to be solitary PTC in paraffin wax pathology after thyroidectomy .M eanwhile ,the status of central neck lymph node metastasis was determined referring to postoperative pathology . All features of the PTC lesion in terms of clinical ,serological and sonographic features were evaluated for the association with central neck lymph node metastasis using univariate and multivariate logistic regression analysis . Meanwhile ,a nomogram model was established for the determined risk factors . Results Out of 1 174 patients ,469 patients ( 39 .9% ) presented central neck lymph node metastasis ,univariate analysis showed that age , gender , preoperative thyroglobulin ( Tg ) and thyroid peroxidase antibody ( T POAb ) , maximum diameter ,location ,close to the thyroid capsule ,AP/T R ,echo ,acoustic halo ,and presence of microcalcification were related with CLNM ( P < 0 .05 ) . M ultivariate logistic regression analysis demonstrated that less than 55 years‐old , male , Tg higher than 20 eg/L , T POAb less than 1 kU/L , maximum diameter larger than 10 mm ,and presence of microcalcification were independent risk factors for CLNM . T he nomogram was established based on independent risk factors determined by the logistic regression with the AUC 0 .714 ,specificity 73 .1% ,and sensitivity 59 .7% . Conclusions For patients with single focal PTC lesion , younger age , male , higher Tg , lower T POAb , and larger lesions containing microcalcificatin on ultrasound are associated with central neck lymph node metastasis .
7.The effect of age on the center of plantar pressure
Wenxiang FAN ; Chaomin NI ; Meng LIU ; Jin CHEN ; Jing-Song MU ; Zheng LIU ; Liling LIU ; Dongqing QI
Chinese Journal of Physical Medicine and Rehabilitation 2018;40(3):174-178
Objective To study the effect of age on the trajectory of the center of plantar pressure.Methods Twenty-five healthy young people constituted a youth group,while another 25 elderly counterparts formed an aged group.Descriptors of everyone's gait were collected using an AL-600 gait and balance training and evaluation apparatus.The length of the total trajectory of the center of plantar pressure (COPD) was recorded along with the average left and right deviation of the center of plantar pressure (COPD-X) and its average anterior-posterior deviation (COPD-Y) in the heel strike (LR),single plantar stance (SPS) and push-off (PS) phases of striding.Results The average COPD of the aged group was significantly longer than that of the youths.For both groups,the average COPD-X and COPD-Y deviations in SPS were significantly less than those in the LR and PS phases,with no significant difference between them.Compared with the youth group,the average COPD-X in the LR and PS phases and the average COPD-Y in the PS were significantly greater among the aged,but there was no significant difference between the two groups in the average COPD-X in SPS or in the average COPD-Y in the LR and SPS phases.Conclusions The average COPD,COPD-X and COPD-Y increase with age,indicating the higher risk of falling.The changes in each sub-phase of gait are different,but those in the LR and PS phases more reliably reflect stability.
8.Ultrasound-guided diffuse optical tomography(DOT) differences and clinical characteristics of T1-T3 breast carcinoma
Wenxiang ZHI ; Min CHEN ; Yu WANG ; Shichong ZHOU ; Na HU ; Wei ZENG ; Xun ZHANG ; Jin ZHOU ; Jian LE ; Cai CHANG
Chinese Journal of Ultrasonography 2018;27(1):31-35
Objective To explore the ultrasound-guided diffuse optical tomography (DOT) distribution difference and clinical characteristics of T 1-T3 breast carcinoma. Methods Four hundred and forty-seven breast cancer patients with 455 breast lesions were enrolled.The lesion maximal diameter and total hemoglobin concentration(THC) were obtained by ultrasound-guided DOT before breast surgery biopsy.The patients age,body mass index(BMI),and the distances from lesion to skin and nipple were measured,lymph node status were also assessed.According to the 7th Edition of the AJCC Cancer Staging, all tumors were divided into T1( ≤ 2 cm),T2(2 cm < lesion ≤ 5 cm),and T3( > 5 cm) three groups according to maximum diameter on ultrasound.Results Out of 455 breast cancer lesions,148 lesions were stage T1,251 lesions were stage T2,56 lesions were T3.The age,lesion size,lesion THC and the distances between lesions and nipples of breast cancer patients were found that there were significant differences among T1,T2 and T3(all P = 0.000). With T stages increasing,the age of breast cancers patients decreased,the distance between lesions and nipples decreased,the THC increased.THC of breast cancer T 2 [(221.0 ± 56.0)μmol/L] and T3[(233.1 ± 54.0)μmol/L] were significant higher than that of T1 [(181.6 ± 70.4)μmol/L](all P = 0.000).There were all no significant difference for BMI and the distancefrom lesion to skin among different stages T( P > 0.05).With T stages increasing,the ratio of lymph node metastasis increased(T1 26.4%,T2 49.8%,T3 55.4%; P =0.000).Conclusions With breast cancer T stages increasing,T HC increases,the age of the patients decreases,lymph node metastasis rate increases.
9.Comparison of ultrasonography and ultrasound-guided diffuse optical tomography in assessing treatment response of breast cancer to neoadjuvant chemotherapy
Wenxiang ZHI ; Yiwu FAN ; Yi GAO ; Yu WANG ; Fen WANG ; Yaling CHEN ; Aiyu MIAO ; Shichong ZHOU ; Zhaoting SHI ; Jin ZHOU ; Cai CHANG
Chinese Journal of Ultrasonography 2018;27(5):406-410
Objective To investigate the clinical value of conventional ultrasonographic ( US),US-guided diffuse optical tomography ( US-guided DOT ) and both combined to assess treatment response of breast cancer to neoadjuvant chemotherapy( NAC). Methods Eighty-eight breast cancer patients,totally 93 lesions were included in the study. Pre-and post-last chemotherapy,size,and total hemoglobin concentration ( THC) of each lesion were measured by conventional US and US-guided DOT before biopsy,the change of lesion Size( ΔSize) and the change of THC( ΔTHC) were calculated respectively.Based on the guidelines to evaluate the response to treatment in solid tumors,the responses to NAC were classified into complete response, partial response, static disease, progressive disease groups. The histological response to chemotherapy were categorised as partial pathological response and complete pathological response using Miller and Payne system. Results Of 93 breast cancers,the overall response rate was 81.7%,the cPR rate was 24.7%. According to ROC curve analysis,when ΔSize 42.6% and ΔTHC 23.9% as cutoff values to evaluate the complete response and partial response,the area under the curve ( AUC ) were 0.666 and 0.751,respectively,the AUC of US and US-guided DOT combined in parallel and in series were 0.680 and 0.737 respectively.When ΔSize 64.5% and ΔTHC 27.2% as cutoff values to evaluate complete pathologial response,the AUC were 0.690 and 0.728 respectively,the AUC of US and US-guided DOT combined in parallel and in series were 0.693 and 0.726 respectively. Conclusions US-guided DOT and US can be used to predict breast cancers response to NAC,US and US-guided DOT combined in parallel and in series can not improve response prediction comparing with US or US-guided DOT alone.
10.Safety and efficacy of transurethral Thulium laser resection of high-risk stage bladder tumor in anticoagulant state
Baochun CHEN ; Kewei ZHANG ; Longjiang TIAN ; Lifeng LIU ; Qingfeng SUN ; Feng SUN ; Yuzhang QU ; Hao WANG ; Wenxiang JIN
Chinese Journal of Geriatrics 2017;36(5):560-562
Objective To study safety and efficacy of transurethral Thulium laser resection of high-risk stage bladder tumor in anticoagulant state.Methods A total of 26 non-muscle invasive bladder cancer patients receiving long-term anticoagulant therapy,including 16 cases with cerebral infarction,7 cases with coronary heart disease,3 patients with coronary stenting,were retrospectively analyzed in our hospital from July 2012 to July 2014.In condition not stopping anticoagulants,Thulium laser transurethral resection of bladder tumor was performed,and hemoglobin,thrombin time,the operative time,intraoperative blood loss,postoperative bladder irrigation duration,postoperative hospital stay,bladder tumor recurrence within two years,the postoperative complications were recorded before and after surgery.Results All patients were successfully treated.The operative time was(29.1 ± 12.8) min,int raoperative blood loss was (29.4 ± 16.9) ml portions,postoperative bladder irrigation time was (1.25 ± 0.55) d,postoperative hospital stay was(5.51 ± 1.06) d.Hemoglobin before and after operation were (131.35 ± 6.57) g/L and (129.75 ± 11.05) g/L respectively,there was no statistically significant differences (t =1.014,P > 0.05) between them.Prothrombin time before and after operation were (12.50 ± 0.25) s and(12.44 ± 0.27) s,with no statistically significant difference (t =0.908,P>0.05)between them.During the followed-up of 48 months,tumor recurred at heterotopia in 2 patients.Conclusions Thulium laser transurethral resection of bladder tumor is safe and effective for patients undergoing long-term oral anticoagulation drugs,without a needto stop taking anticoagulant drugs.

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