1.Prediction of primary biliary cholangitis among health check-up population with anti-mitochondrial M2 antibody positive
Haolong LI ; Song LIU ; Xu WANG ; Xinxin FENG ; Siyu WANG ; Yanli ZHANG ; Fengchun ZHANG ; Li WANG ; Tengda XU ; Yongzhe LI
Clinical and Molecular Hepatology 2025;31(2):474-488
Background:
s/Aims: Anti-mitochondrial M2 antibody (AMA-M2) is a specific marker for primary biliary cholangitis (PBC) and it could be also present in non-PBC individuals.
Methods:
A total of 72,173 Chinese health check-up individuals tested AMA-M2, of which non-PBC AMA-M2 positive individuals were performed follow-up. Baseline data of both clinical characteristics and laboratory examinations were collected in all AMA-M2-positive individuals. Least absolute shrinkage and selection operator (LASSO) regression was performed to investigate the potential variables for developing PBC.
Results:
A total of 2,333 individuals were positive with AMA-M2. Eighty-two individuals had a medical history of PBC or fulfilled the diagnostic criteria of PBC at baseline, and 2,076 individuals were non-PBC. After a median follow-up of 6.6 years, 0.6% developed PBC, with an accumulative 5-year incidence rate of 0.5%. LASSO regression showed that levels of alkaline phosphatase (ALP), gamma-glutamyl transpeptidase (GGT), immunoglobulin M (IgM), eosinophilia proportion (EOS%), gamma globulin percentage, and hemoglobin (HGB) were potential variables for developing PBC. Multivariate Cox regression is used to construct a predictive model based on 7 selected variables, and time-dependent receiver operating characteristic analysis showed that the area under the curve of the prediction model at 3, 5, and 10 years were, respectively, 1.000, 0.875, and 0.917.
Conclusions
This study offers insights into the onset of PBC among individuals who tested positive for AMA-M2 during routine health check-ups. The prediction model based on ALP, GGT, IgM, EOS%, gamma globulin percentage, HGB, and sex has a certain predictive ability for the occurrence of PBC in this population.
3.Prediction of primary biliary cholangitis among health check-up population with anti-mitochondrial M2 antibody positive
Haolong LI ; Song LIU ; Xu WANG ; Xinxin FENG ; Siyu WANG ; Yanli ZHANG ; Fengchun ZHANG ; Li WANG ; Tengda XU ; Yongzhe LI
Clinical and Molecular Hepatology 2025;31(2):474-488
Background:
s/Aims: Anti-mitochondrial M2 antibody (AMA-M2) is a specific marker for primary biliary cholangitis (PBC) and it could be also present in non-PBC individuals.
Methods:
A total of 72,173 Chinese health check-up individuals tested AMA-M2, of which non-PBC AMA-M2 positive individuals were performed follow-up. Baseline data of both clinical characteristics and laboratory examinations were collected in all AMA-M2-positive individuals. Least absolute shrinkage and selection operator (LASSO) regression was performed to investigate the potential variables for developing PBC.
Results:
A total of 2,333 individuals were positive with AMA-M2. Eighty-two individuals had a medical history of PBC or fulfilled the diagnostic criteria of PBC at baseline, and 2,076 individuals were non-PBC. After a median follow-up of 6.6 years, 0.6% developed PBC, with an accumulative 5-year incidence rate of 0.5%. LASSO regression showed that levels of alkaline phosphatase (ALP), gamma-glutamyl transpeptidase (GGT), immunoglobulin M (IgM), eosinophilia proportion (EOS%), gamma globulin percentage, and hemoglobin (HGB) were potential variables for developing PBC. Multivariate Cox regression is used to construct a predictive model based on 7 selected variables, and time-dependent receiver operating characteristic analysis showed that the area under the curve of the prediction model at 3, 5, and 10 years were, respectively, 1.000, 0.875, and 0.917.
Conclusions
This study offers insights into the onset of PBC among individuals who tested positive for AMA-M2 during routine health check-ups. The prediction model based on ALP, GGT, IgM, EOS%, gamma globulin percentage, HGB, and sex has a certain predictive ability for the occurrence of PBC in this population.
5.Prediction of primary biliary cholangitis among health check-up population with anti-mitochondrial M2 antibody positive
Haolong LI ; Song LIU ; Xu WANG ; Xinxin FENG ; Siyu WANG ; Yanli ZHANG ; Fengchun ZHANG ; Li WANG ; Tengda XU ; Yongzhe LI
Clinical and Molecular Hepatology 2025;31(2):474-488
Background:
s/Aims: Anti-mitochondrial M2 antibody (AMA-M2) is a specific marker for primary biliary cholangitis (PBC) and it could be also present in non-PBC individuals.
Methods:
A total of 72,173 Chinese health check-up individuals tested AMA-M2, of which non-PBC AMA-M2 positive individuals were performed follow-up. Baseline data of both clinical characteristics and laboratory examinations were collected in all AMA-M2-positive individuals. Least absolute shrinkage and selection operator (LASSO) regression was performed to investigate the potential variables for developing PBC.
Results:
A total of 2,333 individuals were positive with AMA-M2. Eighty-two individuals had a medical history of PBC or fulfilled the diagnostic criteria of PBC at baseline, and 2,076 individuals were non-PBC. After a median follow-up of 6.6 years, 0.6% developed PBC, with an accumulative 5-year incidence rate of 0.5%. LASSO regression showed that levels of alkaline phosphatase (ALP), gamma-glutamyl transpeptidase (GGT), immunoglobulin M (IgM), eosinophilia proportion (EOS%), gamma globulin percentage, and hemoglobin (HGB) were potential variables for developing PBC. Multivariate Cox regression is used to construct a predictive model based on 7 selected variables, and time-dependent receiver operating characteristic analysis showed that the area under the curve of the prediction model at 3, 5, and 10 years were, respectively, 1.000, 0.875, and 0.917.
Conclusions
This study offers insights into the onset of PBC among individuals who tested positive for AMA-M2 during routine health check-ups. The prediction model based on ALP, GGT, IgM, EOS%, gamma globulin percentage, HGB, and sex has a certain predictive ability for the occurrence of PBC in this population.
7.Effect of the staging comprehensive treatment with acupuncture-moxibustion on Bell's facial palsy in the acute stage.
Jiajie CHEN ; Haiping SHI ; Wanli GAO ; Xiaowei LI ; Yuling SHU ; Yongzhe WANG ; Binjian JIANG ; Jun YANG ; Pin WANG
Chinese Acupuncture & Moxibustion 2024;44(1):51-56
OBJECTIVES:
To compare the clinical effect on Bell's facial palsy in the acute stage between the staging comprehensive treatment with acupuncture-moxibustion and western medication.
METHODS:
Sixty patients with Bell's facial palsy in the acute stage were randomly divided into an observation group and a control group, with 30 cases in each one. The patients in the control group were administered orally with prednisone acetate tablets and methylcobalamin tablets until the 28th day of illness. In the observation group, the staging comprehensive treatment with acupuncture-moxibustion was adopted. On the affected side, Qianzheng (EX-HN 16), Yifeng (TE 17), Sibai (ST 2), Yangbai (GB 14), Jiache (ST 6), Dicang (ST 4) and Touwei (ST 8), etc. were stimulated. In the acute stage (Day 1 to 7 of illness), the routine acupuncture and the point-toward-point needle insertion were delivered, no any manipulation was exerted at acupoints, and the needles were retained for 30 min. In the subacute stage (Day 8 to 14 of illness), on the base of the treatment as the acute stage, the depth of needle insertion was adjusted at a part of acupoints and the even needling technique was operated by twisting needle. Besides, electroacupuncture (EA) was attached to Qianzheng (EX-HN 16) and Dicang (ST 4), with continuous wave of low intensity and high frequency, 100 Hz, for 20 min. In the recovery stage (Day 15 to 28 of illness), on the base of the treatment as the subacute stage, the heavy stimulation of acupuncture was given, in which, the sticking and lifting needle techniques were delivered after the needles were inserted from Sibai (ST 2) toward Dicang (ST 4), and from Dicang (ST 4) toward Jiache (ST 6), separately; warm needling was operated at Yifeng (TE 17), and EA changed to stimulate the acupoints with the intermittent wave of high intensity and low frequency, 2 Hz, for 30 min. Acupuncture-moxibustion was given once every other day until the end of the 28th day of illness. The level of House-Brackmann facial nerve function rating scale (H-B grade),the score of Sunnybrook facial nerve grading system (Sunnybrook), the score of facial disability index (FDI), the temperature difference in the infrared thermal imaging facial area and electromyogram (EMG) situation of the affected muscle group were observed before and after treatment in the two groups. Using musculoskeletal ultrasound,the facial nerve diameter was detected and the clinical effect was compared between the two groups.
RESULTS:
After treatment, the level of H-B grade, Sunnybrook score, the scores of physical function and social life function in FDI were improved when compared with those before treatment in the patients of either group (P<0.01, P<0.05), and the results of these evaluations in the observation group were better than those of the control group (P<0.05). After treatment, the temperature difference of the frontal area, the eye area, the zygomatic area and the mouth corner was declined in comparison with that before treatment in the two groups (P<0.05), and the temperature difference in each area in the observation group was lower than that of the control group (P<0.05).The root mean square (RMS) of the frontal muscle group, the zygomatic muscle group and the orbicularis muscle group on the affected side increased in comparison with that before treatment in the two groups (P<0.01), and RMS of the observation group was higher than that of the control group (P<0.05) after treatment. Before treatment, the diameter of the facial nerve on the affected side was larger than that on the healthy side (P<0.01), and after treatment, the diameter on the affected side was reduced when compared with that before treatment in the two groups (P<0.01); the diameter of the facial nerve on the affected side in the observation group was smaller than that of the control group (P<0.05), while, the diameter on the affected side was larger when compared with the healthy side in the control group (P<0.05). The total effective rate of the observation group was 93.3% (28/30), higher than that of the control group (83.3% [25/30], P<0.05).
CONCLUSIONS
The staging comprehensive treatment with acupuncture-moxibustion is clearly effective on Bell's facial palsy in the acute stage, which affirms the effectiveness of acupuncture-moxibustion for the acute stage of Bell's facial palsy in comparison with conventional western medication.
Humans
;
Facial Paralysis/therapy*
;
Moxibustion
;
Acupuncture Therapy
;
Bell Palsy/therapy*
;
Face
8.Emphasis on the laboratory testing of biomarkers for autoimmune nephropathies and lung diseases and the clinical promotion of their application
Chinese Journal of Laboratory Medicine 2024;47(9):981-986
Autoimmune nephropathies and lung dieases are conditions arised from the mistaken attacks of the immune system to the kidneys and lungs. Due to the complex pathogenesis and the variability and lack of specificity of clinical manifestations, there are many challenges on accurate diagnosis. While markers such as anti-MPO antibody, anti-PR3 antibody, and anti-PLA2R antibody have been widely used in clinical practise which obviously improved diagnostic precision and efficiency, there remains a deficiency in specific diagnostic indicators for conditions like seronegative membranous nephropathies, IgA nephropathies, alveolar protein deposition, interstitial lung disease, and pulmonary nodular disease. Thus, there is an urgent need to discover more sensitive and specific markers to provide basis for early diagnosis and personalized treatment guidance. For further quality improvment of diagnosis and treatment, we will focus on promoting normalization and standardization of testing methods to ensure quality control during analytical processes. This will bolster the laboratory analysis of the markers for autoimmune nephropathies and lung diseases markers, and will facilitate their clinical applications, so as to improve clinical diagnosis and treatment, and to elevate patients′ clinical outcomes as well as their quality of life.
9.Research progress of biomarkers in Behcet′s disease
Chinese Journal of Laboratory Medicine 2024;47(9):1106-1114
Behcet′s disease is a variable vasculitis characterized by oral aphthous ulcers, ocular lesions and genital ulcers with involvement of arteries, veins, joints, gastrointestinal tract and nerves, resulting in reduced quality of life and even death. The lack of laboratory diagnostic markers for Behcet′s disease, necessitates the identification of biomarkers that correlate with disease phenotype, activity and severity. These biomarkers are crucial for advanced warning, treatment response, monitoring and prognosis assessment. This article reviews recent advances in clinical research on biomarkers for Behcet′s disease, clarifies the role of each biomarker in the pathogenesis of Behcet′s disease, and provides corresponding prospects for future research directions.
10.A case of iatrogenic hypernatremia caused by multiple myeloma-associated pseudohyponatremia
Yuan HUANG ; Lu ZHANG ; Liangyu XIA ; Jinyan LEI ; Chong WEI ; Yongzhe LI
Chinese Journal of Laboratory Medicine 2024;47(10):1212-1214
The patient was a 55-year-old man. On February 16, 2024, he was admitted to Peking Union Medical College Hospital complaining of "weakness and poor appetite for more than half a year, and found creatinine increase for 1 week". The patient was diagnosed with multiple myeloma. During the treatment in our hospital, the patient sustained"hyponatremia"(Na 124-136 mmol/L measured by indirect ion selective electrode method), and combined with the patient′s clinical symptoms and serum osmotic pressure results (327 mOsm/kg H 2O), it was considered that hyperglobulinemia led to pseudohyponatremia. So no intervention was given. Subsequent failure to recognize pseudohyponatremia during treatment in other hospitals and the administration of hypertonic saline resulted in severe iatrogenic hypernatremia. By reviewing similar cases in our hospital, we found that hyperglobulinemia/hyperlipidemia associated pseudohyponatremia was not uncommon. This case reminds us that for patients whose serum solid phase ratio is higher than normal due to various reasons, the use of indirect ion selective electrode method to determine serum sodium is prone to false low, and direct ion selective electrode method can be used to re-test blood sodium to determine whether it is true, so as to avoid iatrogenic injury to patients.

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