1.Serum cystatin C level and risk of hypertensive cerebral hemorrhage
Ran XU ; Jing CHEN ; Jie LI ; Huaping DU ; Huihui LIU ; Shoujiang YOU ; Chunfeng LIU
International Journal of Cerebrovascular Diseases 2015;(2):97-100,101
ObjectiveToinvestigatetherelationshipbetweenserumcystatinC(CysC)leveland hypertensive intracerebral hemorrhage (HICH). Methods The patients w ith HICH and healthy controls w ere enroled. The demographic and clinical data were colected. Immunoturbidimetric assay was used to detect serum CysC level. Results A total of 94 consecutive patients w ith HICH and 131 healthy controls w ere enroled. The baseline systolic blood pressure ( 168.57 ±28.64 mmHg vs.128.13 ±16.23 mmHg; t=-13.442, P<0.001;1 mmHg=0.133 kPa), diastolic blood pressure ( 95.56 ±14.68 mmHg vs.76.80 ± 8.76 mmHg; t= -11.965, P<0.001 ), fasting plasma glucose ( 6.24 ±1.83 mmol/L vs.5.22 ± 1.13 mmol/L; t= -4.234, P<0.001), and serum CysC level (1.02 ±0.26 mg/L vs.0.91 ±0.13 mg/L, P<0.001) in the HICH group w ere significantly higher than those in the control group. Multivariable logistic regression analysis show ed that baseline systolic blood pressure≥140 mmHg ( odds ratio [ OR] 12.523, 95% confidence interval [CI] 5.353-29.299; P<0.01), diastolic blood pressure ≥90 mmHg (OR 3.968, 95%CI 1.792-8.784; P<0.01 ) and serum CysC level≥1.09 mg/L ( OR 3.279, 95%CI 1.336-8.050; P<0.05) w ere the independent risk factors for HICH. In patients w ith HICH, the CysC serum level (1.13 ±0.26 mg/L) in the bleeding ≥30 ml group w as higher than that in the bleeding <30 ml group (0.99 ±0.25 mg/L; P<0.001) and the control group ( 0.91 ±0.13 mg/L; P<0.001). The serum CysC level in the bleeding volume <30 ml w as higher than that in the control group ( P=0.004). There w ere positive correlations betw een serum CysC and age, creatinine, urea, and uric acid (al P<0.01);there w ere negative correlations betw een serum CysC level and the estimated glomerular filtration rate ( P<0.01). Multivariable linear regression analysis show ed that age, creatinine, urea and uric acid w ere independent associated w ith the serum CysC level ( al P<0.05 ). Conclusions The increased serum CysC level is correlated w ith the amount of bleeding in patients w ith HICH. The increased serum CysC level is an independent risk factor for HICH.
2.Ethical issues in clinical application of neuroprosthetics
Chinese Journal of Neuromedicine 2020;19(6):632-638
Neuroprosthetics is to cure an existing motor or sensory neural dysfunction. It can electrically stimulate myogenic regions, peripheral and central nervous systems to restore or replace damaged nervous systems, sensory organs or limb loss that helps patients who fail to respond to other treatments to cure diseases and improve quality of life. However, the uncertainty of this new technology and difficulty of risk/benefit assessment result in many ethical issues in the effectiveness of informed consent, safety, personal identity, responsibility confirmation and social fairness. In order to ensure the best interests of patients, approaches to solve these ethical issues must be proposed. The vulnerability of patients in informed consent should be considered, and substantive information should be paid attention and ability to consent of the patients needs to be evaluated; an acceptable risk-benefit ratio should be obtained to evaluate the long-term security of the technology and protect the patient's privacy; changes in personality identity should be assessed and patient's autonomy should be respected and responsibility of behavior should be assumed; the development of technology should be strictly supervised and standardized to avoid abuse in the aspect of social fairness.
3.Expression of serum exosomal miRNA-21 and its clinical significance in gastric cancer
Huihui YOU ; Yan DING ; Yanlan ZHOU
Chinese Journal of General Surgery 2020;35(3):223-227
Objective:To explore the relationship of serum exosomal miRNA-21 expression and clinical pathological parameters and prognosis in gastric cancer (GC) patients.Methods:Exosomes from serum samples of 52 GC patients and 10 healthy controls were extracted using the ExoQuick Exosome Precipitation Solution, and were further validated by immunoblotting for exosome markers and characterization of nanoparticle using NanoSight. The expression levels of exosomal miRNA-21 in exosomes was detected by RT-qPCR, and its relationship with clinicopathological features and prognosis was further analyzed.Results:The expression level of miRNA-21 in serum exosomes of patients with GC was significantly higher than that of normal subjects (2.59±0.12 vs. 1.16±0.10, t=5.168, P<0.05), and its high expression was significantly related to tumor grade, depth of invasion, lymph node metastasis, distant metastasis, vascular invasion, nerve invasion and TNM stage (all P<0.05). Patients in exosomal miRNA-21 high expression group had lower overall survival than that of exosomal miRNA-21 low expression group (χ 2=14.573, P<0.05). Multivariate analysis using the COX regression test identified that higher serum exosomal miRNA-21 was an independent predictor of mortality for GC patients ( HR=2.863, 95% CI: 1.063-7.712, P=0.038). Conclusion:The expression of miRNA-21 in serum exosomes of GC patients is up-regulated, and its high expression is associated with multiple unfavorable clinicopathological factors and poor prognosis of patients.
4.The theory of emphasizing both muscles and bones in the treatment of lumbar intervertebral disc herniation
Xiangfu WANG ; Wanqian ZHANG ; Huihui ZHENG ; Weiguo CHEN ; Heng ZHAO ; Xiangyu YOU ; Huanying YANG ; Gang ZHENG
International Journal of Traditional Chinese Medicine 2022;44(5):485-488
The theory of "equal stress on bones and muscles" emphasizes that "the tendons bind to the bones, the bones are stretched, the bones are connected, and the bones are fractured. The relationship between bone and soft tissues are important, which is the law of Traditional Chinese Medicine in the treatment of orthopedic diseases. For patients with lumbar disc herniation, the percutaneous intervertebral foraminal technology remodels the disordered internal biological balance of the spine under pathological conditions. Among them, two common clinical minimally invasive approaches under endoscopy are paid attention to soft tissue protection, and active and appropriate functional exercises after surgery, which have become a typical manifestation of the theory of "equal stress on bones and muscles" in modern spinal orthopedic surgery.
5.Prognostic value of Deauville criteria and IHP criteria in 18F-FDG PET/CT for clinical evaluation at the end of treatment in diffuse large B-cell lymphoma
Huihui HE ; Xiaohong WU ; Xiaoqing DU ; Baoming MI ; Liping CHEN ; Yu ZHANG ; Qiaoling XU ; Najing WU ; Xuyang YOU ; Chunjing YU
Chinese Journal of Nuclear Medicine and Molecular Imaging 2019;39(5):266-271
Objective To evaluate the diagnostic efficiency and prognostic value of 18F-fluorodeoxyglucose (FDG) PET/CT for response assessment after treatment in patients with diffuse large B-cell lymphoma (DLBCL) when using the Deauville criteria and International Harmonization Project (IHP) criteria.Methods A total of 212 patients (119 males,93 males,average age:59.6(10-88) years) with DLBCL from February 2010 to June 2018 were analyzed.All subjects underwent restaging PET/CT after treatment.Images were evaluated with the IHP criteria,Deauville score of 3-5 (DC3) and Deauville score of 4-5 (DC4).The diagnostic efficiency of the 3 criteria for treatment effect was assessed and follow-up results were used as the gold standard.Spearman rank correlation analysis was used.Progression-free survival (PFS) and overall survival (OS) were analyzed by Kaplan-Meier analysis and Cox proportional hazards model.Results The positive predictive value and accuracy of DC4 for treatment effect evaluation were 96.8%(61/63) and 94.3%(200/212),those of IHP criteria were 75.3%(67/89) and 87.7%(186/212)respectively,and those of DC3 were 82.9% (68/82) and 92.0% (195/212) respectively.IHP criteria results and Deauville scores were correlated(rs =0.926,P<0.05).The 2-year PFS rates in IHP-,DC3-and CD4-positive groups were 78.7%,76.5% and 69.8%,respectively,and those in IHP-,DC3-and CD4-negative groups were significantly higher (95.6%,94.7%,97.2%;x2=14.415,18.293 and 26.920,all P<0.05).The similar results were found for OS rates (x2 =9.597,11.149 and 17.416,all P<0.05).The 2-year PFS rates in Deauville score of 1,2,3,4,5 groups were 95.3%,91.7%,93.3%,88.9% and 55.6% respectively (x2 =48.199,P<0.05).Cox-regression analysis showed significant correlation between Deauville criteria and 2-year PFS rate (P<0.05).Conclusions PET/CT with DC4,DC3 and IHP criteria have high predictive values for treatment outcome,and DC4 is the best.Cox regression analysis shows significant risk of progression by Deauville criteria.
6. Prevalence and influential factors of stroke in Jiangxi Province in 2014
Wei ZHOU ; Bing ZHANG ; Xiao HUANG ; Chunjiao YOU ; Biming ZHAN ; Renqiang YANG ; Yifei DONG ; Juxiang LI ; Ping LI ; Kui HONG ; Yanqing WU ; Qinghua WU ; Hai SU ; Huihui BAO ; Xiaoshu CHENG
Chinese Journal of Preventive Medicine 2018;52(1):79-84
Objective:
To discuss the prevalence and influential factors of stroke among population in Jiangxi Province.
Methods:
Four cities in urban areas and four counties in rural areas were selected firstly, in which two districts or townships were selected; and then three communities or villages were chosen from each district and township, respectively, using the simple random sampling (SRS) method. Finally 15 269 subjects aging 15 years old or above, living in Jiangxi Province ≥6 months were randomly selected to participate in this survey from November 2013 to August 2014. Information of population characteristics, life behavior way, individual disease history were collected through questionnaire survey, and height, weight, waist circumference, blood pressure, body fat rate, visceral fat index and so on were measured by instruments. Risk factors of stroke prevalence were analyzed by the unconditioned logistic regression analysis.
Results:
A total of 15 269 participants (6 267 males) from 15 364 eligible participants were included in the statistical analysis. Out of which, 7 793 participants came from urban areas, and their average age was (53.04±17.91) years old. In this study, 226 stroke patients (117 males) were found among15 269 participants, including 122 urban participants and 104 rural participants, whose average age was (67.76±9.74) years old. The prevalence of stroke was 1 480.12/100 000 in 2014, which was separately 1 866.92/100 000 and 1 210.84/100 000 among males and females. The prevalence of people aging (45-49) years old was 413.79/100 000 (6/1 450) , while which among people aging 75 years old and above was 3 311.62/100 000 (61/1 842) . The prevalence of stroke among residents in Jiangxi presented an uprising tendency with age increasing (linear-by-linear association χ2=62.23,