1.Effect of intermediate care on the recurrence and recurrence rate of elderly patients with cerebral infarction
Yufu WU ; Xiaohong LIU ; Haoran WANG ; Jie ZHAO ; Weicheng GUO ; Zheng CHEN
Clinical Medicine of China 2017;33(2):97-101
Objective To observe the effect of intermediate care on recurrence factors and recurrence rate of elderly patients with cerebral infarction.Methods Five Hundred and ninety-eight cases of acute cerebral stroke were divided into two groups,301 cases in the experimental group and 297 cases in the control group.After the acute stage,patients in the experimental group was included into the intermediate care unit.The experimental group was given comprehensive evaluation and multidisciplinary management,including the combination of traditional Chinese and Western medicine treatment,rehabilitation training and physical therapy,medication guidance,nursing and health education.After the acute stage of the disease,the control group patients were in the general ward.The course of treatment was 2 weeks.At baseline(t0),second weeks(t1),sixth months(t2)and twelfth months(t3),the blood pressure(SBP,DBP),fasting blood-glucose(FBG),blood lipid(TC,TG,LDL),serum homocysteine(Hcy)level and the recurrence rate of cerebral infarction in all two groups were observed.Results SBP at t1,t2 and t3 was lower than that at t0 in the experimental group,and the difference was statistically significant(P<0.05).SBP in the experimental group at t2 and t3 was lower than that in the control group.There was significant difference between the experimental group and the control group(P<0.05).DBP at t2 and t3 was lower than that at t0 in the experimental group,and the difference was statistically significant(P<0.05).DP in the experimental group at t2 and t3 was lower than that in the control group.There was significant difference between the experimental group and the control group(P<0.05).FBG at t1((5.34±0.76)mmol/L),t2(5.86±1.05)mmol/L)and t3(5.62±0.89)mmol/L)were lower than that at t0((7.27±2.34)mmol/L),and the difference was statistically significant(P<0.05).FBG in the experimental group at t2 and t3 were lower than that in the control group((6.85±0.92)mmol/L,(6.36±1.03)mmol/L).There was significant difference between two groups(P<0.05).TC at t1((4.86±0.85)mmol/L),t2((4.21±0.76)mmol/L)and t3((3.95±0.64)mmol/L)were lower than that at t0((5.56±1.06)mmol/L),and the difference was statistically significant(P<0.05).TC in the experimental group at t2 and t3 was lower than that in the control group((5.06±0.93)mmol/L,(4.84±0.76)mmol/L).There was significant difference between two groups(P<0.05).TG at t3((1.48±0.26)mmol/L)was lower than that at t0((1.86±1.31)mmol/L),and the difference was statistically significant(P<0.05).TG in the experimental group at t3 was lower than that in the control group((1.71±0.66)mmol/L).There was significant difference between two groups(P<0.05).LDL at t1((3.76±0.92)mmol/L),t2((3.09±0.62)mmol/L)and t3((2.59±0.51)mmol/L)were lower than that at t0((4.59±1.45)mmol/L),and the difference was statistically significant(P<0.05).LDL in the experimental group at t2and t3 was lower than that in the control group((4.09±0.75)mmol/L,(4.12±0.64)mmol/L).There was significant difference between two groups(P<0.05).Hcy at t1((14.16±3.17)μmol/L),t2((10.37±2.59)μmol/L)and t3((10.10±1.86)μmol/L)were lower than that at t0((23.62±5.62)μmol/L),and the difference was statistically significant(P<0.05).Hcy in the experimental group at t2and t3 was lower than that in the control group((18.52±3.64)μmol/L,(16.37±2.75)μmol/L).There was significant difference between two groups(P<0.05).The recurrence rate of cerebral infarction within 1 years was 4.7%(14/301)and 7.1%(21/297)in the experimental group and the control group.There was a decreasing tendency,but no statistical significance(P=0.208).Conclusion The intermediate care may affect the blood pressure,FBG,blood lipids,serum Hcy levels in elderly patients with cerebral infarction,so as to reduce the recurrence rate of cerebral infarction.
2.Study of the Mechanism of Du Meridian-unblocking and Mind-regulating Acupuncture Pretreatment for Modu- lating miRNA664 and MMP9 in Cerebral Ischemia/reperfusion Rats
Shiping ZHENG ; Wei HAN ; Haoran CHU ; Ying WANG ; Ling ZHANG ; Guoqing ZHANG ; Lingling ZHU
Shanghai Journal of Acupuncture and Moxibustion 2016;(1):76-80
Objective To investigate the effect of meridian-unblocking and mind-regulating acupuncture pretreatment on neurobehavioral functions and cerebral water content and explore its mechanism for modulating miRNA664 and MMP9 expressions in cerebral ischemia/reperfusion rats.Methods One hundred and thirty Wistar rats were randomized into group A (electroacupuncture pretreatment) of 30 rats, group B (moxibustion pretreatment) of 30 rats, group C (aspirin pretreatment) of 30 rats, group D (model) of 30 rats and group E (blank control) of 10 rats. Group A received electroacupuncture; group B, suspended moxibustion with moxa sticks; group C, an oral gavage of aspirin 10 mg/kg. A model of cerebral ischemia/reperfusion was made in every group after seven days. Rat neurobehavioral functions were observed and cerebral water content and relative miRNA664 and MMP9 expressions in the cortical region were determined at 24 hours after reperfusion.Results There was a statistically significant difference in the neurobehavioral score between group A, B, C or D and group E (P<0.01), between group A or B and group C (P<0.01) and between groups A and B (P<0.01). There were statistically significant differences in cerebral water content and relative miRNA664 and MMP9 expressions between group A, B, C or D and group E (P<0.01,P<0.05), between group A, B or C and group D (P<0.01), between group A or B and group C (P<0.01,P<0.05) and between groups A and B (P<0.01,P<0.05).Conclusions Meridian-unblocking and mind-regulating acupuncture pretreatment can effectively decrease the neurobehavioral score and cerebral water content and reduce relative MMP9 expression through modulating miRNA664 expression in cerebral ischemia/reperfusion rats. One of the mechanisms of Du meridian-unblocking and mind-regulating acupuncture pretreatment for protecting the brain may be reducing relative MMP9 expression, inducing tolerance to cerebral ischemia and relieving cerebral edema by the modulation of miRNA664 expression.
3.A review of advances in biologic therapy for Beh?et uveitis
Biao LI ; Haoran LI ; Hui HUANG ; Yanlin ZHENG
Chinese Journal of Ocular Fundus Diseases 2021;37(9):737-742
Beh?et uveitis (BU), one of the common manifestations of Beh?et syndrome, has a poor prognosis, high blinding rate, and severely impairs the quality of patients' life. The current treatment principle mainly induce and maintain inflammation remission by suppressing the immune response. The glucocorticoid combined with immunosuppressive therapy for the treatment of BU has disadvantages such as long medication time, severe adverse effects, and poor long-term prognosis, whereas biologics have gradually attracted attention about the treatment of BU because of their high efficacy, low toxicity, and good long-term prognosis. The biologics used to treat BU include tumor necrosis factor-α inhibitors, interferon-α, interleukin blockers, and lymphocyte targeting preparations. It is believed that with the progress of various studies and clinical trials, the stepwise application of biologics is promising, and it is hopeful to provide more accurate and effective treatment for patients with BU in the future.
4.Study on the Diagnosis Model of Phlegm-Dampness Obstruction Syndrome in Patients with Stable Angina Pectoris Due to Coronary Heart Disease Based on Machine Learning
Haoran CHEN ; Tong JIANG ; Yi ZHENG ; Weiwei WANG ; Ying LIU ; Kejun WANG
Chinese Journal of Information on Traditional Chinese Medicine 2024;31(12):142-150
Objective To construct a diagnostic model for the phlegm-dampness obstruction syndrome in patients with coronary heart disease stable angina pectoris(CSAP);To provide a reference for clinical syndrome differentiation.Methods Totally 305 patients'clinical data were collected from the Department of Cardiology,Dongying Hospital Affiliated to Shandong University of Traditional Chinese Medicine,from May 2022 to January 2024.The least absolute shrinkage and selection operator(LASSO)was used to select features,and multiple models were constructed and compared using machine learning(ML)algorithms.The optimal ML model was selected for training,validation,and testing.Finally,the operational logic of the optimal model was explained using Shapley Additive Explanations(SHAP),and two typical examples were provided to help users understand the model's operational logic.Results LASSO regression identified chest pain,body mass index(BMI),limb heaviness,drinking history,age,triglycerides(TG),total cholesterol(TC),and low-density lipoprotein cholesterol(LDL-C)as features included in the model.After comparing multiple models,the Gaussian Naive Bayes(GNB)model demonstrated the best performance.The final constructed GNB model achieved an average AUC of 0.938(95%CI:0.903-0.972)in the training set,an average AUC of 0.927(95%CI:0.851-0.992)in the validation set,and an AUC of 0.856(95%CI:0.751-0.961)in the test set.The learning curve showed that the error between the training and validation sets in the model converged as the number of training samples increased.The calibration curve showed that the model had good consistency in predicting the probability of observed phlegm-dampness obstruction syndrome patients.The clinical decision curve(DCA)showed that the model could provide clinical benefits for patients at a decision threshold below 0.7.The features ranked by SHAP importance in order were chest pain,BMI,LDL-C,TG,limb heaviness,TC,drinking history and age.Conclusion The diagnostic model for CSAP phlegm-dampness obstruction syndrome constructed in this study can assist physicians in the syndrome differentiation of patients,thereby enabling the formulation of integrated clinical treatment plans combining traditional Chinese and Western medicine,and aiding patients in achieving better clinical therapeutic outcomes.
5.Clinical effects of minimally invasive negative pressure curettage combined with InMode diamond carving on axillary osmidrosis and axillary hyperhidrosis
Teng LONG ; Ran XU ; Yanli ZHENG ; Haoran CHEN
Chinese Journal of Medical Aesthetics and Cosmetology 2024;30(6):593-597
Objective:To explore the efficacy of negative pressure suction curettage combined with InMode diamond carving in the treatment of axillary osmidrosis.Methods:A total of 200 patients with bromhidrosis, 89 males and 111 females, aged (27.85±7.98) years, were prospectively included in the study from February 2022 to February 2023 in Huamei Zixin Medical Cosmetology Hospital in Sichuan Province. According to different treatment methods, the patients were divided into 2 groups with 100 cases in each group by random number table method. The control group received negative pressure suction curettage, and the experimental group received combination with InMode diamond carving. After follow-up for one year, the efficacy, recurrence rate and incidence of adverse reactions were compared between the two groups.Results:In the experimental group, 94 cases were cured, 6 cases were effective, 0 cases were ineffective; the effective rate was 100% (100/100). In the control group, 90 cases were cured, 5 cases were effective and 5 cases were ineffective; the effective rate was 95% (95/100). The effective rate of experimental group was higher than that of control group, and the difference was statistically significant (χ 2=5.128, P=0.024). In the experimental group, no cases relapsed, and the recurrence rate was 0. In the control group, 5 cases relapsed, and the recurrence rate was 5.3% (5/95). The recurrence rate of experimental group was lower than that of control group, and the difference was statistically significant (χ 2=5.390, P=0.020) In control group, 5 cases of subcutaneous hematoma, 1 case of scar contracture, 7 cases of scar hyperplasia, and 1 case of skin necrosis occurred; the incidence of adverse reactions was 14.0% (14/100). In the experimental group, 2 cases of subcutaneous hematoma, 5 cases of scar contracture and 5 cases of scar hyperplasia occurred; the incidence of adverse reactions was 12.0% (12/100). There was no significant difference in the incidence of postoperative adverse reactions between the two groups (χ 2 = 0.177, P=0.674). Conclusions:Negative pressure suction curettage combined with InMode diamond carving has better curative effect and lower recurrence rate in the treatment of axillary osmidrosis.
6.Analysis on knowledge mapping of edema treated with TCM: a bibliometrics based quantitative study
Haoran ZHENG ; Bingxuan ZHANG ; Qingqiao SONG ; Shuqing SHI ; Huaqin WU ; Yumeng LI ; Xia XU ; Jiayu LYU ; Yajiao WANG ; Xinxin MAO
International Journal of Traditional Chinese Medicine 2023;45(7):884-891
Objective:Applying bibliometrics to analyze the research history, hotspots and trends of Traditional Chinese Medicine (TCM) interventions in edema-related diseases, and to provide reference for the revision of diagnostic and therapeutic criteria for edema in TCM.Methods:The literature about edema treated with TCM was retrieved from CNKI, Wanfang, VIP, CBM from 1 st. Jan 1995 to 25 th. May 2022. CiteSpace and VOSviewer softwares were used to draw the knowledge map, and analyze the co-occurrence relationship and clustering characteristics of the institution, author, keywords and mechanism hotspots. Results:Totally 3 198 articles were included. The annual number of documents issued generally shows a spiral rise trend. Liaoning University of Chinese Medicine published the most articles. Core authors published the most articles were Sun Wei (13 articles); the team with the highest cooperation intensity was Yang Hongtao's team; keywords formed 7 clusters. Hotspot mechanisms included metabolic disorders, immune balance, anti-inflammation, calcium and phosphorus metabolism. Keywords in the past 7 years were membranous nephropathy, chronic heart failure, diabetes, lymphedema etc.Conclusions:The attention paid to the intervention of TCM in the field of edema is generally on the rise, and has decreased in the past two years. The research categories focus on the experience of famous doctors, clinical trials, and mechanistic studies, and nephropathy-related edema has been the focus of research; diabetic nephropathy, chronic heart failure, metabolomics, and immunotherapy are expected to be the focus of attention in the next stage.
7.Association between skin advanced glycation end products and carotid atherosclerosis in population with normal glucose regulation
Yixin GONG ; Haiou HONG ; Bei YAO ; Yuanzhi ZHANG ; Yang ZHANG ; Xinji LIU ; Haoran ZHENG ; Yikun WANG
Chinese Journal of Health Management 2022;16(2):99-104
Objective:To investigate the association between skin advanced glycation end products (AGEs) and carotid atherosclerosis (AS) in subjects with normal glucose regulation (NGR).Methods:This was a cross-sectional study. Data from the Health Management Center of the First Affiliated Hospital of University of Science and Technology between January 2019 to June 2019 were collected. A total of 902 NGR subjects aged 40-79 were enrolled and categorized into control group (530 cases), carotid intima-media thickness (IMT) thickening group (150 cases), and carotid atherosclerosis plaque group (222 cases) based on the carotid ultrasound results. Data as follows were collected, gender, age, blood pressure, body mass index (BMI), triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), fasting blood glucose (FPG), glycosylated hemoglobin (HbA 1c) and skin AGEs. Comparison via ANOVA analysis were carried out among the 3 groups. Logistic regression analysis was used to screen the independent influencing factors of carotid atherosclerosis plaque. Spearman correlation analysis was used to evaluate the correlation between AGEs and other parameters, and receiver operating characteristic (ROC) curve was used to evaluate the efficiency of skin AGEs in predicting carotid atherosclerosis plaque in NGR subjects. Results:Among the control group, IMT thickening group and carotid atherosclerosis plaque group, gender, age, systolic blood pressure (SBP), diastolic blood pressure (DBP), TC, LDL-C, FPG, HbA 1c, AGEs were significantly different (all P<0.05). Compared with IMT thickening group, the age, SBP and AGEs of carotid atherosclerotic plaque group were higher [55 (50, 60) vs 53 (49, 56) year; 132 (122, 141) vs 126 (115, 142) mmHg(1 mmHg=0.133 kPa); 74 (67, 81) vs 72 (67, 78) AU] (all P<0.001); compared with the control group, age, LDL-C, HbA 1c and AGEs of IMT thickening group were higher [53 (49, 56) vs 48 (45, 52) year; (2.8±0.7) vs (2.7±0.7) mmol/L; 5.4% (5.2, 5.6)% vs 5.4% (5.1, 5.6)%; 72 (67, 78) vs 70 (66, 76)] (all P<0.05). Age ( OR=1.179, 95% CI: 1.107-1.255), SBP ( OR=1.045, 95% CI: 1.013-1.077), LDL-C ( OR=2.028, 95% CI: 1.036-3.969), AGEs ( OR=1.049, 95% CI: 1.000-1.100) were independent influencing factors of carotid atherosclerotic plaque in population with normal glucose regulated (all P<0.05). AGEs was positively correlated with age, HbA 1c and carotid atherosclerosis plaque ( r=0.407, 0.092, 0.172) (all P<0.01). The area under the ROC curve of skin AGEs for identifying carotid atherosclerotic plaque in NGR population was 0.650 (95% CI 0.601-0.698), the best cutoff value was 70.5, the sensitivity was 65.8%, and the specificity was 56.9%. Conclusion:Skin AGEs level is closely associated with the occurrence of carotid atherosclerosis in NGR subjects.
8.Revision of the curative effect evaluation part of Criteria for Diagnosis and Treatment of Diseases in Traditional Chinese Medicine - Edema based on delphi method
Xinxin MAO ; Qingqiao SONG ; Yumeng LI ; Huaqin WU ; Haoran ZHENG ; Bingxuan ZHANG
International Journal of Traditional Chinese Medicine 2024;46(10):1264-1270
Based on literature research and Delphi method, the curative effect evaluation criteria of Traditional Chinese Medicine (TCM) edema were revised, in order to promote the standardization construction of the curative effect evaluation of edema and strengthen the research on the revision technology of TCM standards. From January 1, 1994 to July 1, 2021, the China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (Chongqing VIP), Chinese Academic Periodical Database (Wanfang Data) and Chinese Biomedical Literature Service System (SinoMed) were searched, and 221 articles were included. Then the questionnaire item pool was constructed after extracting the contents of the articles. Delphi method was used to conduct two rounds of expert questionnaire survey. And then the concentration degree and coordination degree of expert opinions were counted and analyzed to screen out the content to be revised and the indicators to be included in the revised version, so as to form the revised version of curative effect evaluation criteria of edema. A total of 32 experts participated in this study, and the positive coefficient of experts in the first round was 84.21%, and the positive coefficient of experts in the second round was 78.13%. The mean value ( Xˉ), full score ratio, rank sum, coefficient of variation ( CV), Kendall's coefficient of concordace (Kendall's W) were used to select the questionnaire items. Kendall's W of the second round of expert questionnaire survey was 0.368, P=0.000, higher than that of the first round, and 11 items were finally included in the curative effect evaluation. The CV of the included items in the second round of the questionnaire is lower than that in the first round, and Kendall's W was higher than that in the first round, and the expert opinions tend to be unified. Consensus was reached after the expert discussion meeting, and the revised version of curative effect evaluation criteria of edema has been preliminarily formed.
9.Target prediction approach to inhibit SARS-CoV-2 replication based on metabolic difference analysis
Yupeng QI ; Yanlong ZHAO ; Haoran ZHENG
Chinese Journal of Medical Physics 2023;40(12):1577-1584
A target prediction approach to inhibit SARS-CoV-2 replication through metabolic difference analysis is presented.The approach is based on gene expression data from lung host cells,reconstructs a network model of the parts of the host cell metabolic system that are reprogrammed after viral invasion,and identifies candidate targets using single-gene knockout and cytotoxicity test.The robustness of antiviral targets against multiple currently known variants of SARS-CoV-2 is also analyzed.The results indicate that D-alanine is a key metabolite affecting SARS-CoV-2 replication and is applicable to all current SARS-CoV-2 variants.The gene regulating D-alanine(PLPBP)is the main gene target.The proposed approach is applicable to the existing viruses and host cells,providing new ideas for viral disease management.
10.Review on beam monitoring for particle radiotherapy
Xin LI ; Haoran LI ; Qibin ZHENG
Chinese Journal of Medical Physics 2024;41(3):273-281
Particle radiotherapy is a new type of radiotherapy with superior targeting and precision for more accurate radiotherapy.Considering the complexity of the particle beams and the different lesion sites and physique of patients,a high-precision beam monitoring system which enables the monitoring of the spatial and energy distributions of the beams,such as position,dose and other important parameters,is needed to ensure the efficacy of particle radiotherapy.The beam monitoring system plays a crucial role in the safety and accuracy of particle therapy.By monitoring vital parameters such as the position and dose of the beams,the treatment plan can be adjusted in real-time,thus ensuring accurate lesion irradiation while minimizing the effects on the surrounding healthy tissues.Consequently,the development and validation of such a beam monitoring system are essential in particle radiotherapy.Herein the advances in beam monitoring for quality assurance for particle therapy are summarized.It gives a brief description of particle radiotherapy,emphasizing the significance of beam monitoring systems for particle radiotherapy,focuses on the development of particle beam monitoring and introduces different types of detectors,along with their applications and research advancements,and explores the future development trend of beam monitoring system and potential challenges it may face.