1.A random forest model to predict acute kidney injury after acute myocardial infarction
Luhang LAN ; Xuandong JIANG ; Maofeng WANG ; Weimin ZHANG ; Liang LU ; Weimin LI
Chinese Journal of Emergency Medicine 2021;30(4):491-495
Objective:Our study aims to predict acute kidney injury (AKI) in acute myocardial infarction (AMI) by establishing a random forest model.Methods:By using the clinical database from affiliated Dongyang Hospital of Wenzhou Medical University, a total of 1 363 AMI cases were included. Then, 75% of participants were analyzed as training subsets and the remaining 25% were testing subsets. The CARET package in R was used to filter variables and build random forest. The prediction ability of established model was evaluated by specificity, sensitivity, accuracy, relative operating characteristic curve (ROC curve) in testing subsets. In addition, the performance of random forest was compared with other 3 commonly used machine learning algorithms (Artificial Neural Network, Naive Bayes, and Support Vector Machine).Results:In this study, 30 variables including the demographic information, risk factors of cardiovascular disease, vital signs at admission, laboratory tests were identified and used to establish our random forest prediction model. The area under the curve of the testing subsets ROC was 0.893. The specificity and sensitivity of prediction model was 0.791 and 0.866, respectively. And the first creatinine, first blood urea nitrogen, and D-dimer after admission, age, mechanical ventilation were the top-five factors in this model. After comparing various machine learning algorithms, random forest model had a better performance.Conclusion:The random forest model would be used to predict the occurrence of AMI with AKI.
2.Analysis on pathogenesis of 50 cases of bladder proliferative lesions.
Zhiqiang, CHEN ; Ruzhu, LAN ; Zhangqun, YE ; Weimin, YANG
Journal of Huazhong University of Science and Technology (Medical Sciences) 2003;23(3):294-6
In order to study the pathogenesis, clinical and pathological characteristics of proliferative lesions of the bladder, 50 cases of proliferative lesions of the bladder from 150 patients with complaints of frequency, urgency, hematuria and dysuria were subjected to cystoscopic biopsy of the suspicious foci in the bladder. In combination with the symptoms, urine and urodynamics, the relationship of proliferative lesions of the bladder to the inflammation and obstruction of the lower urinary tract was analyzed. Of the 50 cases of proliferative bladder lesions, 44 cases (88%) had lower urinary tract infection and 29 (58%) lower urinary tract obstruction. The patients with lower urinary tract obstruction were all complicated with infection. Three cases were associated with transitional cell carcinoma. Malignant cells were detected in 1 case by urinary cytologic examination. Proliferative lesions of the bladder, especially those without other obvious mucosa changes under cystoscopy, are common histological variants of urothelium in the patients with chronic inflammation and obstruction of the lower urinary tract. Chronic inflammation and obstruction of the lower urinary tract might be the causes for proliferative lesions of the bladder. It is suggested that different treatments should be applied according to the scope and histological type of the proliferative lesions.
Cystitis/*complications
;
Hyperplasia
;
Mucous Membrane/pathology
;
Precancerous Conditions/*pathology
;
Urinary Bladder/*pathology
;
Urinary Bladder Diseases/*etiology
;
Urinary Bladder Diseases/pathology
;
Urinary Bladder Neck Obstruction/*complications
;
Urination Disorders/complications
;
Urodynamics/physiology
3.Advances in the study of structural modifications and biological activities of betulinic acids.
Ping LAN ; Dongmei ZHANG ; Weimin CHEN ; Wencai YE
Acta Pharmaceutica Sinica 2010;45(11):1339-45
Betulinic acids are lupine-type pentacyclic triterpenoid saponins commonly found in some plants of Betulaceae family, especially in the bark of betula alba (birch). The potent anti-HIV and anti-tumor activities of betulinic acids have been greatly concerned. The natural betulinic acids include betulinic acid, 23-hydroxy betulinic acid, betulin and so on. Some investigations on the structural modifications of betulinic acids were carried out, and many derivatives with excellent biological activity have been obtained nowadays. In this paper, the research advances of the structural modification of betulinic acids, as well as their anti-HIV and anti-tumor activities are reviewed.
4.Establishment of an inactivated viral particle-based ELISA for the detection of anti-MERS-CoV anti-bodies
Huijuan WANG ; Wenling WANG ; Jiaming LAN ; Tie SONG ; Wei ZHEN ; Weimin ZHOU ; Changwen KE ; Guizhen WU ; Wenjie TAN
Chinese Journal of Microbiology and Immunology 2016;36(2):93-97
Objective To establish an inactivated viral particle-based ELISA for the detection of antibodies against Middle East respiratory syndrome coronavirus (MERS-CoV) in serum samples collected from a MERS-CoV associated case. Methods Serum samples were collected from 10 newborns and 40 healthy adults. A viral particle-based ELISA was established by using the inactivated MERS-CoV virions as antigen. The levels of IgM and IgG antibodies in the serum samples were detected by the established ELISA and the cut-off values for positive detection were determined. Then the inactivated MERS-CoV virion-based ELISA was used to detect the antibodies against MERS-CoV in 5 serum samples collected from the first im-ported MERS case in China. Results The cut-off values of IgM and IgG antibodies in serum samples for ELISA were determined to be A450 readings of 0. 32 and 0. 42, respectively. The titers of IgM and IgG anti-bodies in serum samples collected at early admission to hospital from the first imported MERS case in China were both 1 ︰ 40. Seroconversion occurred 2 weeks after his admission to hospital with the titers of IgM and IgG reaching to 1 ︰ 320. Conclusion The inactivated MERS-CoV virion-based ELISA was established successfully and could be used for the detection of serum antibodies (IgG and IgM) in MERS associated cases.
5.Effect of IL-12 on IFN-gamma and IL-10 produced by peripheral blood mononuclear cells in patients with chronic hepatitis B virus infection during IFN-alpha treatment.
Shaoyang WANG ; Yumei LIN ; Weimin MA ; Baohua ZHANG ; Shaoran QI ; Fenghua LAN
Chinese Journal of Hepatology 2002;10(2):116-119
OBJECTIVETo investigate the effect of IL-12 on IFN-gamma and IL-10 production of peripheral blood mononuclear cells (PBMC) in chronic hepatitis B virus infection patients during IFN-alpha treatment.
METHODSBefore and after IFN-alpha treatment of 3 months and 6 months, PBMC of 20 patients with chronic hepatitis B virus infection were collected and cultured in vitro in the culture fluid containing PHA (100 microg/ml), HBcAg (1 microg/ml), or HBeAg (1 microg/ml) for 48 h under the condition of the presence or absence of IL-12 (10 ng/ml). Then the levels of IFN-gamma and IL-10 were determined by ELISA.
RESULTSThere were 12 responders and 8 nonresponders to IFN-alpha treatment. In the responders, the enhancing effect of IL-12 on IFN-gamma production was significantly greater after IFN-alpha treatment than before the treatment. The production of IL-10 was suppressed in the presence of IL-12 after 3 months and 6 months of IFN-alpha treatment. In the same treatment time, the level of IFN-gamma in the presence of IL-12 was significantly higher than that in the absence of IL-12. To the nonresponders, the enhancing effect of IL-12 on IFN-gamma production was also significantly increased after IFN-alpha treatment. Moreover, in the same treatment time, the level of IFN-gamma in the presence of IL-12 was significantly higher than that in the absence of IL-12.
CONCLUSIONSThe enhancing effect of IL-12 on IFN-gamma production of PBMC in patients with chronic hepatitis B virus infection is increased during IFN-alpha treatment. IFN-alpha and IL-12 may enhance the efficacy for the treatment of chronic hepatitis B virus infection.
Adolescent ; Adult ; Antiviral Agents ; therapeutic use ; Enzyme-Linked Immunosorbent Assay ; Female ; Hepatitis B, Chronic ; blood ; drug therapy ; Humans ; Interferon-alpha ; therapeutic use ; Interferon-gamma ; metabolism ; Interleukin-10 ; metabolism ; Interleukin-12 ; pharmacology ; Leukocytes, Mononuclear ; cytology ; drug effects ; metabolism ; Male ; Middle Aged ; Time Factors
6.Analysis on pathogenesis of 50 cases of bladder proliferative lesions.
Zhiqiang CHEN ; Ruzhu LAN ; Zhangqun YE ; Weimin YANG
Journal of Huazhong University of Science and Technology (Medical Sciences) 2003;23(3):294-296
In order to study the pathogenesis, clinical and pathological characteristics of proliferative lesions of the bladder, 50 cases of proliferative lesions of the bladder from 150 patients with complaints of frequency, urgency, hematuria and dysuria were subjected to cystoscopic biopsy of the suspicious foci in the bladder. In combination with the symptoms, urine and urodynamics, the relationship of proliferative lesions of the bladder to the inflammation and obstruction of the lower urinary tract was analyzed. Of the 50 cases of proliferative bladder lesions, 44 cases (88%) had lower urinary tract infection and 29 (58%) lower urinary tract obstruction. The patients with lower urinary tract obstruction were all complicated with infection. Three cases were associated with transitional cell carcinoma. Malignant cells were detected in 1 case by urinary cytologic examination. Proliferative lesions of the bladder, especially those without other obvious mucosa changes under cystoscopy, are common histological variants of urothelium in the patients with chronic inflammation and obstruction of the lower urinary tract. Chronic inflammation and obstruction of the lower urinary tract might be the causes for proliferative lesions of the bladder. It is suggested that different treatments should be applied according to the scope and histological type of the proliferative lesions.
Adult
;
Aged
;
Cystitis
;
complications
;
Female
;
Humans
;
Hyperplasia
;
Male
;
Middle Aged
;
Mucous Membrane
;
pathology
;
Precancerous Conditions
;
pathology
;
Urinary Bladder
;
pathology
;
Urinary Bladder Diseases
;
etiology
;
pathology
;
Urinary Bladder Neck Obstruction
;
complications
;
Urination Disorders
;
complications
;
Urodynamics
;
physiology
7.Clinical study on the comprehensive treatment of diet and Chinese medicine on type 2 diabetes mellitus based on pattern differentiation
Hua CHENG ; Yanan SONG ; Jinguo ZHOU ; Ye LU ; Tonghua LIU ; Lili WU ; Weimin LAN
International Journal of Traditional Chinese Medicine 2023;45(4):404-409
Objective:To explore the effectiveness and safety of comprehensive treatment of type 2 diabetes mellitus (T2DM) based on syndrome differentiation and diet.Methods:Prospective clinical study. A total of 147 patients with T2DM from September 2021 to August 2022 who met the inclusion criteria were included in the self-controlled trial. On the basis of diet and exercise intervention, the subjects were treated and observed with comprehensive treatment based on syndrome differentiation for 120 days. The main outcome indicators including TCM symptom score, fasting blood glucose (FPG), 2 hPG, HbA1c , Fasting insulin (FINS), C-peptide(C-PR), and the secondary outcome indicators including blood lipid (TC, TG, HDL-C, LDL-C), blood pressure, and safety indicators were performed before and after treatment.Results:After treatment, the FPG of subjects decreased from (8.75±2.26) mmol/L to (7.05±1.23) mmol/L, 2 hPG decreased from (10.75±3.01) mmol/L to (7.07±0.78) mmol/L, HbA1c decreased from (6.82±1.47)% to (5.49±0.63)%, and FINS decreased from (15.4±9.33) μIU/ml to (8.82±7.28) μIU/ml, C-PR decreases from (1.95±0.91) nmol/L to (1.72±1.53) nmol/L, SBP decreased from (137.51±17.94) mmHg to (125.79±7.57) mmHg, DBP decreased from (82.85±9.65) mmHg to (77.54±6.21) mmHg,TG decreased from (1.57±1.04) mmol/L to (1.25±1.24) mmol/L, HDL-C increased from (1.48±0.41) mmol/L to (1.66±0.46)mmol/L. The above differences were statistically significant ( P<0.05). Conclusion:The comprehensive treatment of T2DM based on syndrome differentiation and diet can significantly reduce the blood glucose indicators including FPG, 2 hPG, HbA1c, FINS and C-PR, and benefit blood pressure and blood lipids with no adverse reactions.
8.Management of patients with chronic kidney disease in the community
Zheng QI ; Shuai LIU ; Hongmei HUAN ; Xia CHEN ; Weimin YE ; Ping ZHANG ; Lan SUN ; Qi SHEN ; Weiying GU ; Xianya WEI
Chinese Journal of General Practitioners 2018;17(2):94-98
Huacao Community Health Service Center has established an integrated chronic kidney disease (CKD) management system since 2015,which greatly improved CKD management in the community.From September 2016 to August 2017,4084 residents were screened by the family doctor team,975 were suspected to have CKD (23.87%),among whom 202 (20.72%) were referred to district CKD treatment center,and 197 (97.52%) were confirmed as CKD.The detection rate of suspected CKD among patients with hypertension and diabetes mellitus was the highest,which was much higher than that among outpatients and those with routine health check up.It is suggested that the integrated management of CKD should be widely implemented to cope with the prevalence of CKD,particularly for those with hypertension and diabetes.
9.Short-term efficacy of atrial septostomy in the treatment of idiopathic pulmonary arterial hypertension patients complicating with right heart failure.
Xin PAN ; Email: PANXIN805@163.COM. ; Cheng WANG ; Youjun ZHANG ; Weihua WU ; Lan MA ; Weimin SU ; Weiyi FANG
Chinese Journal of Cardiology 2015;43(4):319-322
OBJECTIVETo evaluate the efficacy of atrial septostomy in idiopathic pulmonary arterial hypertension (IPAH) patients complicating right ventricular failure.
METHODSThis retrospective analysis included 5 IPAH patients (3 males, (29.3±15.2) years old) with right ventricular failure which were refractory to conventional and target-specific medication in Shanghai Chest Hospital from March to July 2014. Graded balloon dilation septostomy procedures were performed in all 5 patients.
RESULTSSuccessful atrial septostomy was achieved in 5 attempts with no procedure-related complications. Immediately post procedure, the mean systemic oxygen saturation decreased from (98.0±1.8)% to (86.4±3.2)% (P = 0.002), while the mean right atrial pressure decreased from (18.9±1.7) mmHg (1 mmHg = 0.133 kPa) to (16.0±1.3) mmHg (P = 0.039) and the mean cardiac index increased from (2.1±0.3) L · min(-1) · m(-2) to (2.7±0.5) L · min(-1) · m(-2) (P = 0.029). Mean follow-up was (6.2 ±1.8) months. Cardiac functional class (WHO) was 3 in 3 patients and 4 in 2 patients before the procedure, and increased 1 class in all patients during follow-up (P = 0.062). Exercise endurance (6-min walk test) also improved from (289.2±16.9) m to (320.4±19.6) m (P = 0.019), while B-type natriuretic peptide (BNP) level declined from (550.0±35.7) ng/L to (218.0±36.2) ng/L (P < 0.001). Except one patient developed spontaneous closure of created defect, right to left shunt at atrial septal level was evidenced by echocardiography during follow-up in the rest 4 patients.
CONCLUSIONSAtrial septostomy is safe and can improve hemodynamics and heart function in selected IPAH patients with right heart failure. Atrial septostomy can be used as a palliative treatment for IPAH and further study is warranted to evaluate the long-term efficacy of this procedure.
Adult ; Catheterization ; Familial Primary Pulmonary Hypertension ; surgery ; Female ; Heart Failure ; Heart Septum ; surgery ; Hemodynamics ; Humans ; Male ; Palliative Care ; Retrospective Studies ; Ventricular Dysfunction, Right ; surgery ; Young Adult
10.A placebo-controlled clinical trial to evaluate the efficacy and safety of domestic palonosetron hydrochloride injection on the prevention of postoperative nausea and vomiting
Nan XU ; Weixiu YUAN ; Ming TIAN ; Buwei YU ; Yuanchang XIONG ; Jin ZHOU ; Hong MA ; Weimin CHEN ; Jun LUO ; Zhixun LAN ; Hailong DONG ; Rongliang XUE ; Xiongqing HUANG ; Nuoer SANG ; Yuguang HUANG
The Journal of Clinical Anesthesiology 2014;(7):651-655
Objective To evaluate the efficacy and safety of domestic palonosetron hydrochlo-ride injection on its prevention of postoperative nausea and vomiting.Methods A multi-centered,ran-domized,double-blinded and placebo-controlled clinical trial was carried out.A total of 281 patients were enrolled,with 141 of patients in study group and 140 of patients in control group respectively. 0.075 mg of intravenous palonosetron hydrochloride injection was delivered in the study group before anesthesia induction.The drug was substituted by 1.5 ml of NS in the control group.All anesthesia inductions were conducted by the intravenous injection of propofol,fentanyl and rocuronium,and were maintained with sevoflurane and fentanyl.Complete remission rate and treatment failure cut-off time of vomiting were evaluated at 0-6 h,6-72 h,0-72 h postoperatively.Results In the study group CR% 0-6 h,6-72 h and 0-72 h were 107 (75.89%),104 (73.76%)and 92 (65.25%),the control group was 81 (57.86%),70 (50%)and 62 (42.86%),CR% of the study group was significantly higher than that of the control group (P <0.01).Insignificant statistical difference but significant clin-ical difference exists in their treatment failure cut-off time,386.5 min and 300.0 min,respectively be-tween the groups.Conclusion Domestic palonosetron hydrochloride injection is safe and effective in the prevention of postoperative nausea and vomiting.