1.Reproduction of reference method for serum glucose detection and comparison with routine glucose kits
Keke JIA ; Wenxiang CHEN ; Jie ZHANG ; Guoquan LI
Chinese Journal of Laboratory Medicine 2009;32(3):346-351
Objective To reproduce and validate the hexokinase reference method for glucose detection and compare other 5 routine glucose kits with this reference method. Methods The CDC hexokinase reference method for glucose detection was established and the performance was validated through testing a standard reference material (SRM) and participating in the IFCC ring-trial for reference laboratories for glucose evaluation. The CLSI EP 9-A2 protocol was used to compare the 5 routine glucose kits with the hexokinase reference method. Forty serum samples were analyzed by 5 routine kits and the hexokinase reference method. Results When SRM 965a was determined by the reference method,the bias of level 2 and level 3 were 0. 93%, -0. 23% respectively. The results for IFCC ring trial were within the accepted range. For the 5 routine kits, the confidence intervals of the predictive bias at the medical decision point Xc (Xc = 6. 11 mmol/L) were all within the range of defined acceptable error (10%) and the range of biological variation bias (6.9%). Conclusions The hexokinase reference method for serum glucose was reproduced in our lab. The serum glucose results measured with 5 routine kits were different from results detected with the reference method, but the bias was acceptable,and it will not affect the detection results.
2.Investigation on serum lipid levels of healthy adult population in Beijing
Shuo YANG ; Rui QIAO ; Keke JIA ; Jie ZHANG
Chinese Journal of Laboratory Medicine 2016;(1):34-39
Objective To investigate on the gender and age distribution characteristics of serum lipid levels among apparently healthy adult population in Beijing and analyse its related risk factors .Methods This is a prospective study.1 712 healthy individuals between 18 and 79 years old were recruited from medical examination center of Peking University Third Hospital .By strict exclusion criteria , 951 healthy individuals (429 males and 522 females) were included in our study.A calibrated automatic biochemical analyzer was used to measure TC, TG, HDL-C, LDL-C, ApoA1, ApoB concentrations in serum.Test results were stratified by gender , age, related risk factors, and statistically analysed.Two groups of normally disthibuted data were compared using t test;multiple groups of data were compared using variance analysis . Results Results for TC (t=4.013, P<0.050), HDL-C(t=9.162, P<0.05) and ApoA1( t=8.225, P<0.05) appear generally higher in women than in men .On the contrary, males had greater levels of TG (Z=3.119, P<0.05) compared to females.There was an obvious increasing trend in TC ( F=47.984, P<0.05), TG(Chi square =146.616, P<0.05), LDL-C(F=46.024, P <0.05), non-HDL-C(F =45.027, P<0.05) and ApoB levels(F=52.020, P<0.05), as well as peaked in the 60-69 age group, decreased in 70-70 years old.The population of beneath the bachelor-degree had greater levels of ApoB ( t=5.989, P<0.05), LDL-C(t=4.445, P<0.05), TC(t=2.885, P<0.05), non-HDL-C(t=4.332, P<0.05) and TG(Z=3.346, P<0.05) compared to the group of bachelor degree or above .Meanwhile, The levels of TC(t=8.273, P<0.05), HDL-C(t=3.346, P<0.05), LDL-C(t=5.768, P<0.05), non-HDL-C(t=7.213, P<0.05), ApoA1(t=3.683, P<0.05), ApoB(t=6.267, P<0.05), TG(Z=5.626, P<0.05) of the population lived in urban area were higher than rural areas .Interestingly, the concentration of ApoA1(t=3.238, P<0.05), HDL-C( t=6.011, P<0.05) and TC(t=2.712, P<0.05) were much higher in the population of mental worker than the manual worker .BMI and waistline positively correlated with serum TG(rs=0.379, 0.443, P<0.01), TC(rs =0.160, 0.176, P<0.01), LDL-C(rs =0.238, 0.263, P <0.01), ApoB (rs =0.326, 0.371, P <0.01) and non-HDL-C(rs =0.304, 0.336, P<0.01) respectively, but negatively correlated with HDL-C(rs =-0.358, -0.386, P<0.01) and ApoA1 ( rs =-0.203, -0.209, P <0.01 ) .Conclusions The study obtained the distribution of lipid levels among apparently healthy a dult population in Beijing .It may offer objective basis for clinical risk assessment of ASCVD , and guid the clinician to choose the optimal individualized treatment .
3.Study on Medication Rules of TCM Treatment for Primary Hepatic Carcinoma in Recent ;Ten Years
Minghao LIU ; Keke LI ; Lihui ZHANG ; Hanting JIA ; Wenxia ZHAO
Chinese Journal of Information on Traditional Chinese Medicine 2016;23(9):45-47
Objective To analyze medication rules of TCM treatment for primary hepatic carcinoma in recent ten years;To provide references for clinical medication. Methods Literature about primary hepatic carcinoma in CNKI, VIP and Wanfang database from January 2005 to September 2015 was searched by computers to carry out statistical analysis of medicine classification and frequency of usage. Results Through screening, 131 articles were included, covering 131 compound TCM prescriptions, 228 kinds of medicine, and 1416 times of frequency of usage. Medicines with relatively high frequency were tonifying deficiency medicine 430 times (30.37%), damp-clearing medicine 233 times (16.45%), medicine for invigorating blood circulation and eliminating stasis (12.99%). Medicines with relatively high frequency were Atractylodis Macrocephalae Rhizoma 64 times (4.52%), Poria 62 times (4.38%), Glycyrrhizae Radix et Rhizoma 52 times (3.67%), Bupleuri Radix 49 times (3.46%), Paeoniae Radix Alba 45 times (3.18%), Astragali Radix 44 times (3.22%), Curcumae Rhizoma 43 times (3.04%), and Artemisiae Scopariae Herba 41 times (2.90%). Conclusion This study summarizes the medicine classification and frequency of usage of TCM treatment for primary hepatic carcinoma in recent ten years, which can provide data support for clinical treatment.
4.The predictive value for serum levels of N-terminal pro-brain natriuretic peptide and high sensitivity C-reactive protein in left ventricular remodeling after acute myocardial infarction
Jie ZHANG ; Xiaozhou HU ; Keke JIA ; Liyan CUI
Chinese Journal of Clinical Laboratory Science 2006;0(02):-
Objectives This study was designed to observe the correlation of the levels of serum N-terminal pro-brain natriuretic peptide(NT-proBNP) and high sensitivity C-reactive protein(hs-CRP) between the 3rd day after acute myocardial infarction(AMI) and after 3 months of left ventricular remodeling(LV remodeling) and to establish the predictive levels of NT-proBNP,hs-CRP for LV remodeling after AMI.Methods The blood samples from 106 patients with the first AMI and echocardiography were examined on the 3rd day and after 3 month.LV remodeling was estimated by the changes of left ventricular end-diastolic volume(LVEDV) during the 3rd day and after 3 month.Based on the change of LV remodeling,the 106 patients were divided into two groups:LV remodeling group(defined as the change rate of LVEDV more than 20%) and non-LV remodeling group.Results The correlation coefficients of the change of LVEDV were 0.706 for serum NT-pro BNP and 0.596 for hs-CRP.With a cutoff value of 0.20,the area under the ROC curve(AUCs) was(0.892) for NT-proBNP and 0.825 for hs-CRP.There was no statistically difference between NT-proBNP and hs-CRP.The ROC plot indicated that NT-proBNP was superior to hs-CRP for predicting LV remodeling.Conclusion The level of serum NT-proBNP appropriately reflects LV remodeling after AMI and shows more efficacious than the level of serum hs-CRP.The level of serum NT-proBNP on the 3rd day after AMI and LV remodeling were positively correlated with the level after 3 months.
5.High expression of Axl promotes clinical progression of nasopharyngeal carcinoma
Yanan JIA ; Rujia LI ; Keke WANG ; Hong LEI ; Yanping HA ; Sisi WANG ; Xiaomin LIAO ; Wei JIE ; Zhihua SHEN
Chinese Journal of Pathophysiology 2017;33(8):1386-1392
AIM: To explore the expression and significance of receptor tyrosine kinase anexelekto (Axl) in nasopharyngeal carcinoma (NPC).METHODS: Immunohistochemistry was used to detect the Axl protein expression of 78 patients with NPC and 32 patients with nasopharyngeal chronic inflammation (NPI).The correlations between the Axl protein levels and the clinical parameters of NPC patients were analyzed.NPC cells were cultured in vitro, and the expression of Axl in well differentiated CNE1 cells, poorly-differentiated CNE2Z cells and undifferentiated C666-1 cells was detected by immunofluorescence staining.After treatment of the CNE1and C666-1 cells with Axl specific inhibitor TP-0903, CCK-8 assay was used to detect cell viability, flow cytometry was adopted to analyze the cell cycle distribution, qPCR was used to examine the mRNA levels of Axl and proliferating cell nuclear antigen (PCNA), and Western blot was used to examine the protein expression of Axl and p-Axl.RESULTS: Axl protein was localized in the cell membrane and cytoplasm.The rate of high expression of Axl in NPC was significantly higher than that in NPI (P<0.01).High Axl expression showed no correlations with NPC patients'' age, gender and M stage, while positively correlated with the clinical stage, T stage and N stage (P<0.05).Axl protein showed a low level in the CNE1 cells, but showed a high level in CNE2Z and C666-1 cells.TP-0903 inhibited cell viability in concentration and time dependent manners.TP-0903 at 2 nmol/L showed significant inhibitory effects, as evidenced by arresting the cell cycle at G0 phase and reducing Axl activity and PCNA expression.CONCLUSION: High expression of Axl promotes the clinical progress of NPC.TP-0903 significantly inhibits the viability of NPC cells, suggesting that Axl may be a valuable target in the NPC treatment.
6.Clinical application evaluation of serum C1q and other complement factors in the diagnosis and prediction of preeclampsia
Keke JIA ; Lijuan MA ; Siyi WU ; Shufang LI ; Yan WANG
Chinese Journal of Laboratory Medicine 2018;41(12):934-942
Objective To observe the levels of serum complement C 1q, C3, C4 and factor B in different phases during normal pregnancy;To evaluate the diagnostic value and the predictive value of serum complement C1q, C3, C4 and factor B in preeclampsia (PE).Methods Three groups of subjectes were enrolled from January 2017 to March 2018 in Department of Obstetrics and Gynecology , Peking University Third Hospital.(1) 30 pregnant women in each group at 8-14 weeks, 20-26 weeks and 28-36 weeks were retrospectively selected , and the serum levels of complement C 1q, C3, C4 and B factors were measured and compared.(2)Selecting 17 cases of early-onset mild PE, 47 cases of early-onset severe PE, 24 cases of late-onset mild PE, 27 cases of late-onset severe PE, and 30 normal pregnant cases of the same gestational stage as early-onset /late-onset controls , through ANOVA analysis and comparison between two groups , this study evaluated the diagnostic value of serum complement C 1q, C3, C4 and factor B in PE.(3)To evaluate the predictive effect in PE, it analyzed serum C1q and factor B levels of pregnant women at 20-26 gestation weeks through prospective nested case-control study of 214 cases.Results The levels of serum C1q remained stable in the whole pregnancy .The levels of C3 and factor B increased at the early stage of pregnancy and remained stable after the middle stage .C4 increased early in pregnancy and then remained stable.Compared with the control group , the levels of serum C1q in all four types of PE patients were significantly decreased ( median: 169 mg/L, 161 mg/L, 165 mg/L, 163 mg/L;early-onset, late-onset control group:187 mg/L, 194 mg/L;U=130.500, 426.500, 159.500, 130.500, all P<0.05).Serum C3 levels of all the other three types of PE patients were significantly lower than those of the control groups (median:1170 mg/L, 1323 mg/L, 1223 mg/L;early-onset, late-onset control groups: 1438 mg/L, 1434 mg/L;U =379.000, 246.000, 160.000, all P <0.05 ), except for the early-onset mild PE (1275 mg/L).Serum C4 levels of patients with early/late onset severe PE were significantly lower than those of the control groups ( median: 140 mg/L, 142 mg/L;early-onset, late-onset control groups:223 mg/L, 235 mg/L;U =329.500, 136.500, both P <0.001 ) .Serum factor B levels showed no statistical difference among 3 early on-set groups or among 3 late on-set groups ( early-onset group median:332 mg/L,318 mg/L,early-onset control group 312 mg/L;late-onset group median:316 mg/L,314 mg/L, late-onset group 303 mg/L;χ2 =5.990, 1.77, all P>0.05).33 (15.4%) cases developed PE out of 214 pregnant women with PE risk factors .Compared to those who didn′t develop PE , it showed no statistical difference of serum C1q, C3, C4, and factor B levels at 20-26 gestational weeks of the women who subsequently developed PE ( C1q:175 mg/L vs.184 mg/L; C3:1523 mg/L vs.1467 mg/L; C4:230 mg/L vs.229 mg/L;FB:344 mg/L vs.320 mg/L;U=2090.000, 1575.000, 2058.500, 1362.000, all P>0.05).Compared to those of the healthy pregnant controls , it showed no statistical difference of serum C1q, C3 and C4 levels of 20-26 gestational weeks of the women who subsequently developed PE (C1q:175 mg/L vs.190 mg/L; C3:1523 mg/L vs.1428 mg/L; C4:230 mg/L vs.227 mg/L; U=353.000, 395.000, 493.500, all P >0.05),while it showed statistical difference (344 mg/L vs.306 mg/L;U=233.500, P=0.007) for factor B.Conclusions Serum C1q level of PE patients significantly decreased, which can be used as potential indicators of PE diagnosis , but serum C1q, C3, C4 level of 20-26 gestational weeks cannot predict risk of PE .Factor B cannot serve as serum index of PE diagnosis , but its serum levels at 20-26 gestational weeks werer higher than those of normal pregnant controls , factor B may be a potential predictor , but need further verification .
7.Association between body mass index trajectories in children and adolescents of Hanzhong city of Shanxi province and subclinical renal damage in adulthood: a 30-year longitudinal follow-up study
Yang WANG ; Ruichen YAN ; Guilin HU ; Mingfei DU ; Ting ZOU ; Xiaoyu ZHANG ; Chao CHU ; Hao JIA ; Haowei ZHOU ; Chen CHEN ; Yueyuan LIAO ; Qiong MA ; Yu YAN ; Keke WANG ; Yue SUN ; Jiawen HU ; Dan WANG ; Xi ZHANG ; Zejiaxin NIU ; Ke GAO ; Weihua GAO ; Jianjun MU
Chinese Journal of Nephrology 2022;38(3):189-195
Objective:To investigate the association between body mass index (BMI) trajectories in children and adolescents and subclinical renal damage (SRD) in adulthood.Methods:4 623 participants aged 6-18 years old were recruited from the ongoing cohort of Hanzhong adolescent hypertension study in 1987, and the subjects were followed up in 1989, 1992, 1995, 2005, 2013 and 2017, respectively. Group-based trajectory modeling was used to identify distinct BMI trajectories in longitudinal analysis. Generalized linear model was applied to examine the association between different BMI trajectories and SRD incidence in adulthood.Results:A total of 2 678 subjects from childhood to adulthood were enrolled in this study. All subjects were divided into three groups according to three distinct BMI trajectories: low-increasing BMI group ( n=1 017), moderate-increasing BMI group ( n=1 353), and high-increasing BMI group ( n=308). Over follow up for 30 years, a total of 248 participants (9.3%) developed SRD. Urinary albumin-to-creatinine ratio (uACR) in low to high-increasing BMI group was 0.9(0.6, 1.4), 1.0(0.7, 1.7), 1.6(0.8, 3.2), respectively ( P trend<0.001), and estimated glomerular filtration rate was 98.5(87.6, 111.6) , 96.2(86.4, 109.7), 95.3 (87.5, 125.0) ml·min -1·(1.73 m 2) -1, respectively ( P trend=0.025). The generalized linear model analysis showed that uACR was increased linearly from low to high-increasing BMI group [ β=3.16(95% CI 1.02-5.31), Ptrend=0.004]. There was no correlation or linear trend between BMI trajectory and estimated glomerular filtration rate [ β=-2.30(95% CI-5.18-0.57), Ptrend=0.117]. Compared with the low-increasing BMI group, the high-increasing BMI group had greater odds of experiencing SRD in adulthood after adjusting for multiple confounders such as age, gender, medical history and lifestyle ( OR=2.83, 95% CI 1.84-4.36, Ptrend<0.001). Conclusions:Higher BMI trajectorie is correlated with higher level of uACR and risk of SRD in middle age. Identifying long-term BMI trajectorie from early age may assist in predicting individuals′ renal function in later life.
8.Hypoxia-stressed cardiomyocytes promote early cardiac differentiation of cardiac stem cells through HIF-1/Jagged1/Notch1 signaling.
Keke WANG ; Ranran DING ; Yanping HA ; Yanan JIA ; Xiaomin LIAO ; Sisi WANG ; Rujia LI ; Zhihua SHEN ; Hui XIONG ; Junli GUO ; Wei JIE
Acta Pharmaceutica Sinica B 2018;8(5):795-804
Hypoxia is beneficial for the differentiation of stem cells transplanted for myocardial injury, but mechanisms underlying this benefit remain unsolved. Here, we report the impact of hypoxia-induced Jagged1 expression in cardiomyocytes (CMs) for driving the differentiation of cardiac stem cells (CSCs). Forced hypoxia-inducible factor 1 (HIF-1) expression and physical hypoxia (5% O) treatment could induce Jagged1 expression in neonatal rat CMs. Pharmacological inhibition of HIF-1 by YC-1 attenuated hypoxia-promoted Jagged1 expression in CMs. An ERK inhibitor (PD98059), but not inhibitors of JNK (SP600125), Notch (DAPT), NF-B (PTDC), JAK (AG490), or STAT3 (Stattic) suppressed hypoxia-induced Jagged1 protein expression in CMs. c-Kit CSCs isolated from neonatal rat hearts using a magnetic-activated cell sorting method expressed GATA4, SM22 or vWF, but not Nkx2.5 and cTnI. Moreover, 87.3% of freshly isolated CSCs displayed Notch1 receptor expression. Direct co-culture of CMs with BrdU-labeled CSCs enhanced CSCs differentiation, as evidenced by an increased number of BrdU/Nkx2.5 cells, while intermittent hypoxia for 21 days promoted co-culture-triggered differentiation of CSCs into CM-like cells. Notably, YC-1 and DAPT attenuated hypoxia-induced differentiation. Our results suggest that hypoxia induces Jagged1 expression in CMs primarily through ERK signaling, and facilitates early cardiac lineage differentiation of CSCs in CM/CSC co-cultures HIF-1/Jagged1/Notch signaling.
9.Feasibility and safety of bipolar-plasmakinetic transurethral enucleation and resection of the prostate in day surgery mode.
Zhihui ZOU ; Ligang ZHANG ; Keke CAI ; Yongtao HU ; Shuchen LIU ; Jia CHEN ; Qintao GE ; Xiaohu ZHAO ; Zongyao HAO ; Chaozhao LIANG
Journal of Zhejiang University. Medical sciences 2023;52(2):148-155
OBJECTIVES:
To evaluate the feasibility and safety of bipolar-plasmakinetic transurethral enucleation and resection of the prostate (B-TUERP) in day surgery.
METHODS:
From January 2021 to August 2022, 34 patients with benign prostatic hyperplasia (BPH) underwent B-TUERP in day surgery in the First Affiliated Hospital of Anhui Medical University. Patients completed the screening and anesthesia evaluation before admission and received the standard surgery which implements "anatomical enucleation of the prostate" and "absolute bleeding control" on the same day of admission, and by the same doctor. Bladder irrigation was stopped, catheter was removed and the discharge evaluation was performed on the first day after operation. The baseline data, perioperative conditions, time of recovery, treatment outcomes, hospitalization costs, and postoperative complications were analyzed.
RESULTS:
All operations were successfully conducted. The average age of the patients was (62.2±7.8) years, average prostate volume was (50.2±29.3) mL. The average operation time was (36.5±19.1) min, the average hemoglobin and blood sodium were decreased by (16.2±7.1) g/L and (2.2±2.0) mmol/L, respectively. The average postoperative length of hospital stay, and total length of hospital stay were (17.7±2.2) and (20.8±2.1) h, respectively, and the average hospitalization cost was (13 558±2320) CNY. All patients were discharged on the day after surgery except for one patient who was transferred to a general ward. Three patients received indwelling catheterization after catheter removal. The 3-month follow-up results showed a substantial improvement in the International Prostate Symptom Score, quality of life score and maximum urinary flow rate (all P<0.01). Three patients experienced temporary urinary incontinence, 1 patient experienced urinary tract infection, 4 patients were diagnosed with urethral stricture and 2 patients experienced bladder neck contracture. No complications above Clavien grade Ⅱ occurred.
CONCLUSIONS
The preliminary results showed that B-TUERP ambulatory surgery is a safe, feasible, economical and effective treatment for appropriately selected patients with BPH.
Male
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Humans
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Middle Aged
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Aged
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Prostate/surgery*
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Prostatic Hyperplasia/surgery*
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Ambulatory Surgical Procedures
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Quality of Life
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Feasibility Studies
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Retrospective Studies
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Treatment Outcome
10.Association between residual cholesterol and the risk of subclinical renal damage
Xi ZHANG ; Zejiaxin NIU ; Guilin HU ; Mingfei DU ; Ting ZOU ; Xiaoyu ZHANG ; Lan WANG ; Chao CHU ; Yueyuan LIAO ; Qiong MA ; Dan WANG ; Keke WANG ; Hao JIA ; Chen CHEN ; Yu YAN ; Yue SUN ; Tongshuai GUO ; Jie ZHANG ; Weihua GAO ; Ziyue MAN ; Ke GAO ; Wenjing LUO ; Jianjun MU ; Yang WANG
Journal of Xi'an Jiaotong University(Medical Sciences) 2023;44(1):6-13
【Objective】 Dyslipidemia has shown to be associated with cardiovascular, metabolic and renal diseases. This study aimed to investigate the association between residual cholesterol and the risk of subclinical renal damage (SRD). 【Methods】 A total of 2 342 participants were recruited from the previously established Hanzhong Adolescent Hypertension Study cohort. According to estimated glomerular filtration rate(eGFR) and urinary albumin-to-creatine ratio(uACR), the subjects were divided into SRD group and non-SRD group. The associations of residual cholesterol with eGFR, uACR, and the risk of SRD were analyzed by multiple linear and Logistic regression analyses. 【Results】 Residual cholesterol was positively correlated with uACR(r=0.081, P<0.001) but negatively correlated with eGFR (r=-0.091, P<0.001). Multiple linear regression analysis revealed that residual cholesterol was an influencing factor of uACR (β=0.075, P<0.001) and eGFR (β=-0.027, P<0.001) after adjustment for gender, age, smoke, alcohol, exercise, BMI, hypertension, diabetes and serum uric acid. In addition, Logistic regression analysis revealed that residual cholesterol was significantly associated with the risk of SRD independently of potential confounders [OR(95% CI)=1.387 (1.113-1.728), P<0.001]. Further subgroup analysis showed that residual cholesterol was significantly associated with the risk of SRD in women but not in men. 【Conclusion】 Residual cholesterol is a contributing factor in the risk of subclinical renal damage with gender-specific association.