1.Effect of anti-HLA antibody detected by Luminex testing on clinical prognosis of renal transplantation ;recipients
Hua LIN ; Jiejing CHEN ; Huaizhou CHEN ; Qiuju MO ; Weiguo SUI
Organ Transplantation 2016;7(5):386-389,393
Objective To investigate the value of anti-human leukocyte antigen (HLA)antibody level detected by Luminex testing in predicting clinical prognosis of renal transplantation recipients. Methods A total of 1 105 patients scheduled to undergo renal transplantation (354 successfully undergoing renal transplantation)in the 181st Hospital of People's Liberation Army from June 2013 to November 2015 were selected. The serum samples were collected from 1 923 cases before and after renal transplantation. The positive rate and fluorescent intensity of anti-HLA antibody were detected by Luminex testing before and after renal transplantation. The renal function of recipients was also evaluated after renal transplantation. Results Prior to renal transplantation,51.0%(546/1 071)of serum samples were positive for anti-HLA antibody,including 26.0%(279/1 071)positive for anti-HLAⅠantibody,24.9%(267/1 071)positive for anti-HLAⅡantibody and 11.4% (122/1 071 )positive for both anti-HLA Ⅰ and anti-HLA Ⅱ antibodies. Among 354 patients undergoing renal transplantation,59 (17%)were positive for anti-HLA antibody after renal transplantation,including 25 (4 newly positive after surgery)positive for anti-HLAⅠantibody,15 (1 newly positive after surgery)positive for anti-HLAⅡantibody and 19 (4 newly positive after surgery)positive for both anti-HLA Ⅰ and anti-HLA Ⅱ antibodies. During subsequent follow-up,13 patients positive for anti-HLAⅠantibody,5 positive for anti-HLAⅡantibody and 1 1 positive for both anti-HLA Ⅰ and anti-HLA Ⅱ antibodies developed transplant kidney dysfunction. All patients newly positive for anti-HLA antibody after renal transplantation presented with transplant kidney dysfunction. Conclusions Luminex testing can perform dynamic detection of the positive rate of anti-HLA antibody,which is important in predicting clinical prognosis of recipients after renal transplantation.
2.Serum levels of myeloperoxidase, interleukin-1β, transforming growth factor-β1 and their correlation with uric acid in patients with gout
Tingwei LI ; Danhua LAO ; Qiuju LIU ; Yaqing MO
Chinese Journal of Postgraduates of Medicine 2024;47(10):936-940
Objective:To investigate the serum levels of myeloperoxidase (MPO), interleukin-1β (IL-1β) and transforming growth factor-β1 (TGF-β1) in patients with hyperuric acid gout, and to analyze their correlation and interaction with uric acid.Methods:A total of 120 male patients with hyperuricemia (HUA) diagnosed and treated in the Tenth Affiliated Hospital of Guangxi Medical University (Qinzhou First People′s Hospital) from December 2019 to December 2022 were selected as the study objects, including 55 patients with gout as the observation group and 65 patients without gout as the control group. Serum levels of uric acid, MPO, IL-1β and TGF-β1 were compared between the two groups, Logistic regression was used to analyze the risk factors of HUA with gout, and Pearson test was used to analyze the correlation between serum uric acid level and MPO, IL-1β and TGF-β1 levels, the interactions were calculated by the likelihood ratio test.Results:The levels of serum uric acid, MPO, IL-1β and TGF-β1 in the observation group were higher than those in the control group: (559.63 ± 70.62) μmol/L vs. (448.24 ± 50.49) μmol/L, (0.37 ± 0.10) mmol/L vs. (0.29 ± 0.07) mmol/L, (49.83 ± 5.03) ng/L vs. (42.15 ± 4.77) ng/L, (34.15 ± 6.82) μg/L vs. (28.97 ± 5.14) μg/L, there were statistical differences ( P<0.05). The results of Logistic regression showed that serum uric acid, MPO, IL-1β and TGF-β1 levels were risk factors for hyperuric acid gout ( P<0.05). The results of Pearson test showed that serum uric acid were positively correlated with the levels of MPO, IL-1β and TGF-β1( r = 0.760, 0.775, 0.759, P<0.05), and there was interaction in the pathogenesis of hyperuric acid gout ( P<0.05). Conclusions:The high levels of MPO, IL-1β and TGF-β1 at the same time can increase the risk of hyperuric acid gout.
3.Construction and validation of a nomogram model to predict abnormal female factors in in vitro fertilization
Chao ZHOU ; Huan LI ; Guangyu YU ; Chunmei YU ; Di CHEN ; Chengmin TANG ; Qiuju MO ; Renli QIN ; Xinmei HUANG
Chinese Journal of Tissue Engineering Research 2024;28(11):1696-1703
BACKGROUND:Reducing the rate of abnormal fertilization is an effective approach to improving the efficacy of in vitro fertilization and reducing patients'financial strain.However,the current research on abnormal fertilization has focused on exploring the types of prokaryotic nuclei and their generation mechanisms,as well as analyzing embryos formed by abnormal fertilization,chromosomal ploidy and utilization value.There is a lack of clinical prediction models for abnormal fertilization based on retrospective studies. OBJECTIVE:To construct a nomogram model to predict abnormal female factors in in vitro fertilization. METHODS:A total of 5 075 patients undergoing treatment for conventional in vitro fertilization at Nanxishan Hospital of Guangxi Zhuang Autonomous Region from March 2017 to March 2022 were retrospectively analyzed.The male confounders were calibrated on a 1:1 propensity score with a match tolerance of 0.02,and 1 672 cases were successfully matched.According to the Vienna Consensus,patients with≥60%normal fertilization capacity were included in the normal fertilization group(n=836)and those with<60%normal fertilization capacity were included in the abnormal fertilization group(n=836).The model and validation groups were obtained by random sampling at a ratio of 7:3.Factors related to the occurrence of abnormal fertilization following conventional in vitro fertilization in the model group were screened using univariate analysis and the best matching factors were selected using the Least Absolute Shrinkage and Selection Operator(LASSO)and included in a multifactorial forward stepwise Logistic regression to identify their independent influencing factors and plot a nomogram.Finally,the prediction model was validated for discrimination,accuracy and clinical application efficacy using receiver operating characteristic curves,calibration curves,clinical decision curves and clinical impact curves. RESULTS AND CONCLUSION:The univariate analysis indicated the factors influencing the occurrence of abnormal fertilization were age,controlled ovarian hyperstimulation protocol,number of assisted pregnancies,years of infertility,infertility factors,anti-mullerian hormone,sinus follicle count,basal luteinizing hormone,luteinizing hormone concentration on the human chorionic gonadotropin day,and estradiol level on human chorionic gonadotropin injection day(P<0.05).LASSO regression further identified the best matching factors,including age,microstimulation protocol,number of assisted pregnancies,years of infertility,anti-mullerian hormone,luteinizing hormone level on human chorionic gonadotropin injection day,and estradiol level on human chorionic gonadotropin injection day(P<0.05).Multifactorial forward stepwise Logistic regression results showed that age,microstimulation protocol,number of assisted conceptions,years of infertility,anti-mullerian hormone,and estradiol level on human chorionic gonadotropin injection day were independent influencing factors for the occurrence of abnormal fertilization following conventional in vitro fertilization.The receiver operating characteristic curves showed an area under the curve of 0.761(0.746,0.777)for the model group and 0.767(0.733,0.801)for the validation group,indicating that the model has good discrimination.The mean absolute error of the calibration curve was 0.044,and the Hosmer-Lemeshow test indicated that there was no significant difference between the predicted probability of abnormal fertilization and the actual probability of abnormal fertilization(P>0.05),indicating the prediction model has good consistency and accuracy.The clinical decision curves and clinical impact curves showed that the model and validation groups had the maximum net clinical benefit at valve probability values of 0.00-0.52 and 0.00-0.48,respectively,and there was a good clinical application efficacy in this valve probability range.To conclude,the nomogram model has good discrimination and accuracy as well as clinical application efficacy for predicting the occurrence of abnormal fertilization in women undergoing conventional in vitro fertilization based on age,microstimulation protocol,number of assisted conceptions,years of infertility,anti-mullerian hormone,and estradiol level on human chorionic gonadotropin injection day.
4.Evaluation of the safety of radial artery puncture in neurointerventional surgery in elderly patients aged 75 years and older
Qiuju LI ; Ke PANG ; Hanlin CHEN ; Yue YIN ; Feng GAO ; Xuan SUN ; Ligang SONG ; Ning MA ; Dapeng MO ; Yiming DENG ; Zhongrong MIAO
Chinese Journal of Geriatrics 2024;43(10):1255-1259
Objective:To compare the safety of radial artery puncture in elderly patients aged 75 years and older who are undergoing neurointerventional procedures.Methods:A single-center retrospective study was conducted, involving 350 elderly patients aged 75 years and older who received neurointerventional treatment at Beijing Tiantan Hospital, Capital Medical University, from June to December 2022.The participants were divided into two groups based on the puncture site: femoral artery puncture and radial artery puncture.The safety indicators compared between the two groups included puncture failure, changes in puncture site, general puncture complications(such as subcutaneous bleeding, puncture site hematoma, and vasospasm), severe puncture complications(including distal limb ischemia and pseudoaneurysm), and lower limb venous thrombosis.Multivariate Logistic regression analysis was conducted to evaluate the impact of different puncture methods on the occurrence of complications.Results:Among the 350 patients, 280 underwent femoral artery puncture, while 70 underwent radial artery puncture.There were no statistically significant differences in baseline characteristics between the two groups(all P>0.05).The proportions of patients using antiplatelet drugs prior to surgery, puncture failure rates, rates of change in puncture sites, and the incidence of severe complications-including distal limb ischemia and pseudoaneurysm-were not significantly different between the two groups( χ2=2.051, 0.075, 0.588, 3.175; P=0.152, 0.784, 0.443, 0.075).In the femoral artery puncture group, 20.4%(57 cases)of patients experienced general puncture complications(including subcutaneous bleeding, puncture site hematoma, and vasospasm), whereas only 8.6%(6 cases)in the radial artery puncture group experienced such complications, revealing a statistically significant difference between the two groups( χ2=5.720, P=0.022).Multivariate Logistic regression analysis indicated that, compared to femoral artery puncture, radial artery puncture was associated with a reduced risk of all complications( OR=0.272, 95% CI: 0.139-0.532, P<0.001), general puncture complications( OR=0.375, 95% CI: 0.153-0.919, P=0.032)and lower limb venous thrombosis( OR=0.219, 95% CI: 0.050-0.954, P=0.043). Conclusions:In elderly patients aged 75 years and older who are undergoing neurointerventional procedures, radial artery puncture is associated with a reduced incidence of general puncture complications and lower limb venous thrombosis when compared to femoral artery puncture, indicating a superior safety profile.