1.Clinical application value of intracavitary PRP infusion combined with IVF-FET in patients with chronic endometritis
Xiaotong ZHANG ; Xiaoyuan HAO ; Rui FANG ; Shuyao HU ; Linkun MA ; Yaqi ZHAO ; Wei HAN
Chinese Journal of Blood Transfusion 2025;38(3):382-387
[Objective] To evaluate the clinical application value of intrauterine perfusion with platelet-rich plasma (PRP) combined with in vitro fertilization-frozen-thawed embryo transfer (IVF-FET) in patients with chronic endometritis (CE). [Methods] A randomized controlled trial (RCT) was conducted, enrolling 60 CE patients undergoing artificial cycle frozen embryo transfer at our hospital from January 2022 to January 2024. Participants were randomly divided into three groups: Group A (routine frozen embryo transfer, n=20), Group B (routine frozen embryo transfer + one PRP intrauterine perfusion, n=20), and Group C (routine frozen embryo transfer + two PRP intrauterine perfusions, n=20). Endometrial thickness during the transformation and transplantation phases, uterine artery pulsatility index (PI), resistance index (RI), systolic peak velocity/end-diastolic velocity (S/D) ratio during transplantation, serum levels of IL-2, IL-4, IL-6, IL-10, and TNF-α during transplantation, as well as biochemical pregnancy rate, clinical pregnancy rate, live birth rate, and early miscarriage rate were compared across groups. [Results] No significant differences in endometrial thickness were observed among the three groups during the transformation phase (P>0.05). During the transplantation phase, endometrial thickness in Groups C and B was significantly higher than in Group A[9.54 (8.96-10.22) and 8.90 (8.34-9.72) vs 8.37 (7.89-8.75) mm, P<0.05], with Group C showing greater thickness than Group B (Z=3.733, P<0.05). Endometrial thickness in Groups C and B during transplantation was significantly increased compared to their respective transformation phases (Z=2.191, 2.462; P<0.05). Groups C and B exhibited lower PI, RI, and S/D values than Group A[PI:1.87 (1.77-1.97), 1.94 (1.88-2.15) vs 2.43 (2.35-2.49); RI:0.75 (0.73-0.77), 0.78 (0.75-0.81) vs 0.84 (0.83-0.86); S/D:2.61 (2.33-3.42), 3.01 (2.20-3.93) vs 3.72 (3.06-4.49); P<0.05]. Group C demonstrated lower PI and RI than Group B (P<0.05). IL-2 levels in Groups C and B were higher than in Group A[3.88 (2.71-5.01), 3.59 (2.73-4.38) vs 3.16 (2.11-3.25) ng/L, P<0.05], while IL-4, IL-6, IL-10, and TNF-α levels were significantly lower (IL-4: Z=1.428, 2.421; IL-6: Z=1.754, 2.435; IL-10: Z=1.754, 2.854; TNF-α: Z=1.961, 1.765; P<0.05). Group C had lower IL-6 levels than Group B (Z=3.976, P<0.05). Biochemical pregnancy rate, clinical pregnancy rate, and live birth rate in Group C were significantly higher than in Group A (75% vs 40%, 70% vs 35%, 60% vs 20%, P<0.05). No significant differences in early miscarriage rates were observed among the groups (χ2=3.750, P>0.05). [Conclusion] Intrauterine autologous PRP perfusion in CE patients enhances pregnancy and live birth rates, improves pregnancy outcomes post-FET, and demonstrates superior efficacy in endometrial repair and receptivity with two PRP perfusions compared to a single perfusion. This provides a safe and effective therapeutic option for optimizing outcomes in CE patients with prior implantation failure.
2.Decision-making behavior in patients with depressive disorder and its relationship with depressive and anxiety symptoms
Yuxiang WANG ; Luoya ZHANG ; Maomao ZHANG ; Juan DENG ; Yanjie PENG ; Xiaotong CHENG ; Kezhi LIU ; Wei LEI ; Jing CHEN
Sichuan Mental Health 2025;38(1):22-27
BackgroundPatients with depressive disorder often exhibit impaired decision-making functions. However, the relationship between decision-making abilities and depressive and anxiety symptoms in these patients remains unclear. ObjectiveTo explore the characteristics of decision-making behavior in patients with depressive disorder, and to analyze its relationship with clinical symptoms. MethodsA total of 48 patients diagnosed with depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) were recruited from the Department of Psychosomatic Medicine of the Affiliated Hospital of Southwest Medical University from October 2020 to May 2023. Concurrently, 52 healthy individuals matched for age and gender were recruited from Luzhou as the control group. Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were used for assessment, and decision-making behavior was evaluated using Probabilistic Reversal Learning (PRL) task. Indicators assessed included the number of trials to criterion, perseverative errors, win-stay rate and lose-shift rate. Spearman correlation analysis was used to assess the correlation between BDI and BAI scores and PRL task indicators. ResultsThe depression group showed a significantly higher lose-shift rate compared with the control group (t=3.684, P<0.01). There were no statistically significant differences between two groups in trials to criterion, perseverative errors and win-stay rate (t=0.329, 0.132, 0.609, P>0.05). In depression group, BDI and BAI scores were positively correlated with the win-stay rate(r=0.450, 0.398, P<0.01). ConclusionPatients with depressive disorder are more likely to change their decision-making strategies following negative outcomes. Furthermore, the severity of depressive and anxiety symptoms is associated with a greater propensity to maintain existing decisions after receiving positive feedback. [Funded by 2019 Joint Project of Luzhou Science and Technology Bureau-Southwest Medical University (number, 2019LZXNYDJ39]
3.Development and validation of a prediction score for subtype diagnosis of primary aldosteronism.
Ping LIU ; Wei ZHANG ; Jiao WANG ; Hongfei JI ; Haibin WANG ; Lin ZHAO ; Jinbo HU ; Hang SHEN ; Yi LI ; Chunhua SONG ; Feng GUO ; Xiaojun MA ; Qingzhu WANG ; Zhankui JIA ; Xuepei ZHANG ; Mingwei SHAO ; Yi SONG ; Xunjie FAN ; Yuanyuan LUO ; Fangyi WEI ; Xiaotong WANG ; Yanyan ZHAO ; Guijun QIN
Chinese Medical Journal 2025;138(23):3206-3208
4.Efficacy of CEA, CA125, CA199, CA724, and G-17 in diagnosing early gastric cancer
Xiaotong ZHANG ; Lansheng ZHANG ; Yaqi ZHAO ; Wei HAN
Cancer Research and Clinic 2025;37(3):206-210
Objective:To explore the clinical values of carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), carbohydrate antigen 199 (CA199), carbohydrate antigen 724 (CA724) and gastrin 17 (G-17) detections in the early diagnosis of gastric cancer patients.Methods:A retrospective case-control study was conducted. A total of 120 patients with gastric diseases who were admitted to General Hospital of Xuzhou Mining Group from January 2019 to December 2021 were selected. According to the pathological results of gastroscopy examination, the patients were divided into gastric ulcer group (23 cases), atrophic gastritis group (58 cases) and early gastric cancer group (39 cases). The healthy control group consisted of 30 healthy individuals who underwent physical examination during the same period. All participants were detected for serum levels of CEA, CA125, CA199, CA724, and G-17. The levels of various indicators in each group were compared. Using the pathological results of gastroscopy as the gold standard, the receiver operating characteristic (ROC) curve was used to analyze the efficacy of various indicators in distinguishing early gastric cancer from healthy individuals, gastric ulcer and atrophic gastritis.Results:The serum levels of CA125 [ M ( Q1, Q3)] [19.94 (8.29, 22.99) U/ml vs. 6.03 (4.07, 10.48) U/ml, 7.49 (4.96, 12.19) U/ml, 7.54 (6.20, 11.91) U/ml], CA199 [32.09 (15.68, 41.97) U/ml vs. 19.19 (10.01, 30.05) U/ml, 21.00(16.01, 32.71) U/ml, 18.95 (13.90, 32.76) U/ml], CA724 [19.55 (3.91, 26.25) U/ml vs. 4.61 (3.06, 5.24) U/ml, 4.09 (3.37, 5.00) U/ml, 4.88 (3.92, 5.46) U/ml] and G-17 [21.01 (14.67, 24.00) pmol/L vs. 11.80 (10.07, 16.58) pmol/L, 12.74 (11.09, 14.69) pmol/L, 12.08 (8.40, 15.10) pmol/L] in the early gastric cancer group were higher than those in the gastric ulcer group, atrophic gastritis group and healthy control group, and the differences were statistically significant (all P < 0.05). The CEA level in the early gastric cancer group, gastric ulcer group and atrophic gastritis group was all higher than that in the healthy control group [4.38 (3.22, 7.56) ng/ml, 4.51 (3.37, 5.51) ng/ml, 4.49 (4.13, 5.09) ng/ml vs. 3.95 (2.16, 4.44) ng/ml], and the differences were statistically significant (all P < 0.05). ROC curve analysis showed that among all indicators, the area under the curve (AUC) of G-17 for distinguishing early gastric cancer from healthy individuals was the largest [0.825 (95% CI: 0.728-0.922)], the optimal critical value was 18.21 pmol/L, and the specificity was the highest (96.7%); the AUC of CA125 and CA724 was also relatively high, with values of 0.768 (95% CI: 0.653-0.884) and 0.744 (95% CI: 0.622-0.866), respectively, and the optimal critical values were 15.41 and 39.60 U/ml, respectively, with the corresponding sensitivities of 71.8%, which was the highest among several indicators. Among all indicators, CA125 had the largest AUC for distinguishing early gastric cancer from gastric ulcer, which was 0.829 (95% CI: 0.729-0.930), with an optimal critical value of 11.60 U/ml, and the corresponding sensitivity was also the highest (74.4%); the AUC of CEA and CA724 was 0.534 (0.391-0.677) and 0.786 (0.668-0.903), respectively; the optimal critical values were 7.20 ng/ml and 6.34 U/ml, respectively; the corresponding specificity was 100.0%. Among the various indicators, the AUC of G-17 for distinguishing early gastric cancer from atrophic gastritis was the largest [0.813 (95% CI: 0.710-0.915)]. The specificity of each indicator at the optimal critical value was relatively high (≥ 94.8%), among which the optimal critical values of CEA and CA125 were 7.170 ng/ml and 15.55 U/ml, respectively, with the corresponding specificity of 100.0%; the AUC of CA724 was 0.783 (95% CI: 0.671-0.895), the optimal critical value was 6.40 U/ml, and the corresponding sensitivity was 71.8%, which was the highest among the several indicators. Conclusions:CEA, CA125, CA199, CA724, and G-17 have high sensitivity and detection rate in the differential diagnosis of early gastric cancer, gastric ulcer and atrophic gastritis, and have certain clinical values in the diagnosis of early gastric cancer and potential for clinical auxiliary diagnosis.
5.Diagnostic value of the vesical imaging-reporting and data system in bladder urothelial carcinoma with variant histology
Linjing JIANG ; Xiao YANG ; Lingkai CAI ; Qiang CAO ; Wei TIAN ; Xiaotong LIU ; Bo LIANG ; Meihua JIANG ; Gongcheng WANG ; Qiang SHAO ; Hongliang QUE ; Xuping JIANG ; Qiang LYU
Chinese Journal of Urology 2025;46(10):751-758
Objective:To evaluate the diagnostic value of the vesical imaging-reporting and data system(VI-RADS)for determining muscle invasion in variant histology urothelial carcinoma(VUC)of the bladder.Methods:A retrospective analysis was performed on the pathological and imaging data of 518 bladder cancer patients admitted to Jiangsu Province Hospital between January 2013 and January 2023. Patients were stratified into pure urothelial carcinoma(PUC)group( n = 457)and variant urothelial carcinoma(VUC)group( n = 61)based on the presence of histological variants. In the PUC group,there were 390 males(85.3%)and 67 females(14.7%),with a mean age of(66.9 ± 11.2)years. Tumor characteristics included maximum diameter ≥ 30 mm in 149(32.6%),< 30 mm in 308(67.4%),multiple tumors in 147(32.2%),solitary in 310(67.8%),pedunculated morphology in 143(31.3%)and non-pedunculated in 314(68.7%). Histological grading identified high-grade tumors in 319 patients(69.8%)and low-grade tumors in 138(30.2%). Pathological stage distribution included 191 of T a(41.8%),127 of T 1(27.8%),76 of T 2(16.6%),47 of T 3(10.3%),and 16 of T 4(3.5%)patients. The VUC group included 61 patients,comprising 51 males(83.6%)and 10 females(16.4%),with a mean age of(65.8 ± 11.4)years. Tumor characteristics were maximum diameter ≥ 30 mm in 38(62.3%),< 30 mm in 23(37.7%),multiple tumors in 16(26.2%),solitary in 45(73.8%),pedunculated morphology in 11(18.0%)and non-pedunculated in 50(82.0%). Histological grading identified high-grade tumors in 59 patients(96.7%)and low-grade tumors in 2(3.3%). Pathological stage distribution included 3 of T a(4.9%),15 of T 1(24.6%),15 of T 2(24.6%),20 of T 3(32.8%),and 8 of T 4(13.1%)patients. No statistically significant differences were found between the two groups in gender,age,or tumor multiplicity( P > 0.05). Statistically significant differences were found in pathological grade,pathological stage,maximum tumor diameter,and pedunculated morphology( P < 0.05). Furthermore,an external validation cohort of 278 bladder cancer patients treated between February 2023 and February 2024 from multiple centers(Jiangsu Provincial People’s Hospital,The First Affiliated Hospital of Zhengzhou University,Union Hospital Tongji Medical College Huazhong University of Science and Technology,Jiangsu Provincial Hospital of Traditional Chinese Medicine,Suzhou Municipal Hospital,Huaian First People’s Hospital,Yixing People’s Hospital)was retrospectively analyzed to externally validate the performance of VI-RADS scoring in predicting muscle invasion of VUC. This cohort included a PUC subgroup of 241 patients,comprising 196 males(81.3%)and 45 females(18.7%),with a mean age of(68.0 ± 10.7)years. Tumor characteristics were maximum diameter ≥ 30 mm in 85(35.3%),< 30 mm in 156(64.7%),multiple tumors in 65(27.0%),solitary in 176(73.0%),pedunculated morphology in 76(31.5%)and non-pedunculated in 165(68.5%). Histological grading identified high-grade tumors in 175 patients(72.6%)and low-grade tumors in 66(27.4%). Pathological staging comprised 107 patients of T a(44.4%),78 of T 1(32.4%),22 of T 2(9.1%),22 of T 3(9.1%),and 12 of T 4(5.0%). The VUC subgroup consisted of 37 patients,comprising 29 males(78.4%)and 8 females(21.6%),with a mean age of(70.5 ± 9.5)years. Tumor characteristics were maximum diameter ≥ 30 mm in 23(62.2%),< 30 mm in 14(37.8%),multiple tumors in 9(24.3%),solitary in 28(75.7%),pedunculated morphology in 7(18.9%)and non-pedunculated in 30(81.1%). Histological grading identified high-grade tumors in 36 patients(97.3%)and low-grade tumors in 1(2.7%). Pathological staging comprised 1 patient of T a(2.7%),9 of T 1(24.3%),7 of T 2(18.9%),19 of T 3(51.4%),and 1 of T 4(2.7%). In this validation cohort,no significant differences were found in gender,age,tumor multiplicity,or pedunculated morphology between the PUC and VUC subgroups( P > 0.05). Significant differences were observed in pathological grade,pathological stage,and maximum tumor diameter( P < 0.05). Three radiologists independently reviewed and scored the multiparametric MRI(mp-MRI)in a blinded manner. Inter-reader agreement was assessed using the weighted kappa statistic. Differences in variables between the two groups were compared using t-tests,chi-square tests,or Fisher’s exact test. The diagnostic performance of VI-RADS for muscle invasion in VUC and PUC was comprehensively evaluated using receiver operating characteristic(ROC)curves,the area under the curve(AUC),and cut-off values determined by the Youden’s index. The DeLong test was used to assess whether the diagnostic performance of VI-RADS differed between VUC and PUC. Results:In the retrospective single-center cohort,the AUC of VI-RADS for assessing muscle invasion was 0.895(95% CI 0.864?0.922)in the PUC group,with a cut-off value of > 3,and the AUC was 0.896(95% CI 0.791-0.960)in the VUC group,with a cut-off value of > 3. The difference between the two groups was not statistically significant( P = 0.986). Using a VI-RADS score > 3 as the cut-off value,the accuracy,sensitivity,specificity,positive predictive value(PPV),and negative predictive value(NPV)for diagnosing muscle invasion status in the PUC group were 85.8%(392/457),70.5%(98/139),92.5%(294/318),80.3%(98/122),and 87.8%(294/335),respectively. The corresponding values for the VUC group were 82.0%(50/61),76.7%(33/43),94.4%(17/18),97.1%(33/34),and 63.0%(17/27).In the retrospective multicenter cohort,the AUC of VI-RADS for assessing muscle invasion was 0.891(95% CI 0.845?0.927)in the PUC group,with a cut-off value of > 2,and the AUC was 0.898(95% CI 0.754?0.973)in the VUC group,with a cut-off value of > 3. The difference between the two groups was not statistically significant( P = 0.897). Using a VI-RADS score > 3 as the cut-off value,the accuracy,sensitivity,specificity,PPV,and NPV for diagnosing muscle invasion status in the PUC group were 85.9%(207/241),58.9%(33/56),94.1%(174/185),75.0%(33/44),and 88.3%(174/197),respectively. The corresponding values for the VUC group were 81.1%(30/37),77.8%(21/27),90.0%(9/10),95.5%(21/22),and 60.0%(9/15).In the single-center cohort,the Kappa values for inter-reader agreement in assessing muscle invasion status using VI-RADS were 0.881( P < 0.01)for the PUC group and 0.941( P < 0.01)for the VUC group among the three readers. In the multicenter cohort,the Kappa values were 0.858( P < 0.01)for the PUC group and 0.838( P < 0.01)for the VUC group. Conclusions:VI-RADS demonstrates similarly high diagnostic performance for assessing muscle invasion in both PUC and VUC,which is applicable for diagnosing muscle invasion status in VUC,and shows good inter-reader agreement.
6.Expression of miR-340-5p and miR-155-5p in chronic hepatitis B patients and their relationship with Th1/Th2 factor levels
Huifang ZHOU ; Minrong KANG ; Xue'e DAI ; Tingxi YAN ; Xiaotong WANG ; Wei YAN
International Journal of Laboratory Medicine 2025;46(2):205-209
Objective To investigate the expression of serum microRNA(miR)-340-5p,miR-155-5p and their relationship with Th1/Th2 cytokines in patients with chronic hepatitis B.Methods A total of 128 pa-tients with chronic hepatitis B in this hospital from October 2021 to October 2023 were selected as the study group,and 96 healthy subjects from the hospital during the same period were selected as the control group.The expression levels of serum miR-340-5p and miR-155-5p were detected by fluorescence quantitative PCR(qPCR),and the expression levels of serum Th1/Th2 cytokines were detected by enzyme-linked immunosor-bent assay(ELISA).The relationship between miR-340-5p,miR-155-5p and Th1/Th2 cytokines was analyzed by Pearson method,and the influence of serum miR-340-5p and miR-155-5p on the occurrence of chronic HPV infection was analyzed by Logistic regression.Results Compared with the reference group,the serum levels of miR-340-5p,miR-155-5p,IL-4,and IL-13 in the study group decreased(P<0.05),while the levels of IFN-γand IL-12 increased(P<0.05).Serum miR-340-5p was negatively correlated with IFN-γ and IL-12(r=-0.315,-0.293,both P<0.05),and positively correlated with IL-4 and IL-13(r=0.413,0.412,both P<0.05).Serum miR-155-5p was negatively correlated with IFN-γ and IL-12(r=-0.406,-0.375,both P<0.05),and positively correlated with IL-4 and IL-13(r=0.343,0.407,both P<0.05).Serum miR-340-5p(OR=0.735,95%CI:Increased expression levels of 0.590-0.915)and miR-155-5p(OR=0.612,95%CI:0.416-0.900)were protective factors for the occurrence of chronic hepatitis B.IFN-γ(OR=1.652,95%CI:1.170-2.333)and IL-12(OR=1.063,95%CI:1.012-1.116)were risk factors for chronic hepatitis B(P<0.05).Conclusion Serum miR-340-5p and miR-155-5p are usually low expressed in chronic hepatitis B patients,and they are negatively correlated with Th1 cytokine level and positively correlated with Th2 cytokine level.
7.A study on the preference of elderly cancer patients in a certain specialized cancer hospital for online hospital services based on discrete choice experiments
Quanbo HUO ; Xiaotong YANG ; Wei ZHANG ; Xuanyue YAN ; Yaxin FU ; Junqing LIU ; Ling YAN
Modern Hospital 2025;25(6):930-935
Objective To analyze the preferences of elderly cancer patients for internet hospital diagnosis and treatment services,providing a reference for the sustainable development of internet hospitals.Methods This study was based on the method of discrete choice experiments.By combining literature review and expert consultation,10 relevant attributes affecting the choice of internet hospitals by elderly cancer patients were determined.Through KANO questionnaires,6 key attributes were se-lected to form the final DCE questionnaire,consisting of 11 choice sets and 1"quality control"set.Using the convenience sam-pling method,elderly cancer patients visiting a certain tertiary hospital in Tianjin were selected to collect 318 valid question-naires.The obtained data were analyzed using mixed Logit regression.Results Patients visiting a certain specialized cancer hos-pital in Tianjin tend to prefer hospitals with a grade of Grade Ⅲ-A(β=0.661 6,P<0.05)and those offering out-of-hospital rehabilitation guidance for cancer patients(β=0.559 9,P<0.05).The page operation process(β=0.352 2,P<0.05)and the accessibility mode for the elderly(β=0.357 5,P<0.05)are the attributes with lower attention.In the subgroup analysis,for patients of different genders and different family incomes,hospital grade and out-of-hospital rehabilitation guidance for cancer patients remain the most influential factors,but male patients pay more attention to the page operation process(β=0.378 3,P<0.05)and the accessibility mode for the elderly(β=0.373 7,P<0.05),while female patients pay more attention to the cover-age of medical insurance reimbursement(β=0.435 9,P<0.05),which has a greater impact than that of male patients(β=0.394 7,P<0.05);patients with a monthly per capita income of less than 5 000 yuan pay more attention to the coverage of medical insurance reimbursement(β=0.423 0,P<0.05)and the self-appointment check function(β=0.467 0,P<0.05);while patients with a monthly per capita income of more than 5 000 yuan pay more attention to the page operation process(β=0.364 7,P<0.05)and the accessibility mode for the elderly(β=0.359 1,P<0.05).Conclusion Hospitals should en-hance elderly patients' awareness and trust in internet hospitals by providing comprehensive health education and support,simpli-fying operational processes,strengthening age-friendly design,and highlighting medical insurance coverage to address the diverse needs across genders and income levels.
8.Study on occurrence and influencing factors of potentially inappropriate medication in hospitalized elderly patients with bacterial pneumonia
Xiaotong ZHANG ; Biqing LIU ; Xiaoxuan XING ; Zhizhou WANG ; Ke WANG ; Wei ZHUANG ; Lan ZHANG ; Xianzhe DONG
Adverse Drug Reactions Journal 2025;27(8):465-471
Objective:To evaluate potentially inappropriate medication (PIM) in hospitalized elderly patients with bacterial pneumonia, and explore its influencing factors.Methods:It was a single-center cross-sectional study. The study focused on elderly patients with bacterial pneumonia who were admitted to Xuanwu Hospital, Capital Medical University from January 2018 to November 2022. Patients′ gender, age, weight, length of hospital stay, diagnosis at admission, physical examination, diagnosis at discharge, comorbidities, medications, and laboratory test results were extracted from hospital information system and electronic medical records. Medication use of patients included in the analysis during their hospitalization were evaluated according to the classification of PIMs in the 5 lists of the Beer′s criteria of American Geriatrics Society. Based on whether PIM occurred, the patients were divided into with PIM group and without PIM group. The clinical features between the 2 groups were compared and the influencing factors of PIM were analyzed using multivariable logistic regression.Results:A total of 2 720 patients were included, in which 1 734 (63.75%) were male. The median age was 78 (70, 85) years and their ages ranged from 65 to 103 years. The number of drugs used per patient was 14 (10, 18) kinds, ranging from 1 to 57 kinds. The length of hospital stay was 12 (9, 17) days, ranging from 1 to 162 days. Charlson comorbidity index (CCI) was 6 (5, 8) points. Among the 2 720 patients, 1 894 (69.63%) experienced PIM, with a total of 6 166 cases of PIM. The top 3 drugs ranked by the number of PIM occurrence were antiplatelet agents (1 357 cases), benzodiazapine receptor agonists (956 cases), and antipsychotics (884 cases). The comparison of clinical characteristics between the 2 groups showed that differences in age, CCI, length of hospital stay, and number of medications between with PIM and without PIM patients were statistically significant (all P<0.001). Multivariable logistic regression results showed that CCI, length of hospital stay, and number of medications were independent influencing factors for PIM. The risk increased by 8% and 1% with one point increase in CCI and one day extension in length of hospital stay [odds ratio ( OR)=1.08, 95% confidence interval ( CI): 1.04-1.13, P<0.001; OR=1.01, 95% CI: 1.00-1.03, P=0.03]. PIM risk of patients with more than 15 concurrent medications had a 22.16 times higher PIM risk than those with less than 5 concurrent medications ( OR=22.16, 95% CI: 14.15-34.72, P<0.001). Conclusions:Hospitalized eldery patients with bacterial pneumonia who have more severe comorbidities, longer hospital stay, and multiple concomitant medications are at a higher risk of PIM occurrence. Rational medication use among these patients should be paid attention to in clinical practice.
9.Effects of silver nanoparticles (AgNPs) on lunginjury and fibrosis in chickens
Yangyong DONG ; Xiaotong WANG ; Zhaomei LIU ; Ran WANG ; Yuxuan ZHANG ; Jingyi CHEN ; Tongyao WANG ; Wei WANG ; Xiaoyan QIU ; Xiong XIAO
Chinese Journal of Veterinary Science 2025;45(9):2008-2016
Silver nanoparticles(AgNPs)are employed as disinfectants due to their extensive antimi-crobial properties,but their biosafety in the livestock industry has not been comprehensively as-sessed.In this study,16 Black-skin Red-crowned chickens aged 32 weeks were randomly divided in-to four groups and sprayed with AgNP solution at the concentration of 0,0.064,0.128 or 0.256 g/L,respectively,every 72 h in their coops for 30 d.The effects of AgNPs as the disinfectant on lung tissue in chicken were investigated through calculation of organ coefficients,observation of lung tissue sections,analysis of bronchoalveolar lavage fluid,measurement of inflammatory factors,de-tection of silver residue in lung tissue,and exploration of signaling pathways in pulmonary fibrosis.The results indicated that chickens in the 0.128 and 0.256 g/L AgNPs treatment groups showed the blurred pulmonary lobule boundaries,the destroyed alveolar structure,and the significant in-crease in pulmonary fibrosis.These pathological changes were accompanied by the decrease in lung organ coefficient,the reduced SP-C content,the increased total protein concentration in lavage flu-id,and the elevated LDH and silver content in lung tissue.The levels of IL-6 and TNF-α in the 0.128 and 0.256 g/L AgNPs treatment groups were significantly higher than the control group,which suggested that AgNPs exposure could induce the pulmonary inflammatory responses.High concentrations of AgNPs can trigger pulmonary tissue fibrosis,damaging the structure and func-tions of lungs.The relative mRNA expression levels of NF-κB in all AgNPs treatment groups,TGF-β in the 0.128 g/L AgNPs treatment group,and Smad3 in the 0.128 and 0.256 g/L AgNPs treatment groups were significantly higher than these in the control group,respectively.Spraying chickens with 0.128 or 0.256 g/L AgNPs for disinfection led to pulmonary deposition of AgNPs,causing direct structural and functional damages to the lungs.It could also induce the chronic pul-monary inflammation through the NF-κB pathway and promote the TGF-β/Smad3 pathway to in-crease collagen synthesis,leading to pulmonary fibrosis.Therefore,the application of high concen-trations of AgNPs in livestock farming requires careful consideration of their potential biological safety issues.
10.Effect of LINC01355 on the proliferation,apoptosis,and invasion of oral squamous cell carcinoma cells through miR-545-5p/FOXD1 signaling pathway
Jing GAO ; Xiaotong WEI ; Xingchen LI ; Wei YAN ; Hao WANG
Journal of China Medical University 2025;54(3):238-245
Objective To investigate the effects of LINC01355 on the proliferation,apoptosis,and invasion of oral squamous cell car-cinoma(OSCC)cells via the miR-545-5p/forkhead box D1(FOXD1)signaling pathway.Methods Cal-27 cells were cultured in vitro and randomly separated into the control group,si-LINC01355(transfected with LINC01355 siRNA)group,pc-LINC01355(transfected with LINC01355 overexpression plasmid)group,si-NC+miR-545-5p-NC+pc-NC(transfected with LINC01355 siRNA negative control,miR-545-5p negative control and empty plasmid)group,and si-LINC01355+miR-545-5p inhibitor(transfected with LINC01355 siRNA and miR-545-5p inhibitor)group.After transfection,quantitative real-time PCR was applied to detect the expression of LINC01355,miR-545-5p,and FOXD1 in cells.The Cal-27 cells transfected into groups were then subcutaneously inoculated to construct nude mouse models of transplanted tumors in each group,and the growth of the transplanted tumors was measured.The CCK-8 method,flow cytom-etry,and Transwell assay were applied in order to detect cell proliferation,apoptosis,and invasion,respectively.Immunohistochemical staining was applied to detect the expression of epithelial-mesenchymal transition(EMT)related proteins Vimentin and E-cadherin in cells.Western blotting was applied to detect the expression of cell proliferation related proteins(proliferating cell nuclear antigen[PCNA],C-myc),apoptosis related proteins(cleaved cysteinyl aspartate-specific proteases-3[cleaved caspase-3],BCL-2-associated X protein[Bax]),and FOXD1 protein.A dual-luciferase reporter assay was used to identify the relationship between LINC01355 and the miR-545-5p/FOXD1 signaling pathway.Results Compared with the control group,the expression of LINC01355 and FOXD1 mRN A,proliferation activity,number of invasions,positive expression of Vimentin protein,expression of PCNA,C-myc and FOXD1 protein,and transplanted tumor volume reduced(All P<0.05);the expression of miR-545-5p,apoptosis rate,cleaved caspase-3 and Bax protein expression,and positive expression of E-cadherin protein increased(All P<0.05)in the si-LINC01355 group.The trend of changes in the various indica-tors of the pc-LINC01355 group was opposite to that of the si-LINC01355 group.Compared with the si-LINC01355 group,the expression of LINC01355 and FOXD1 mRNA,prolife ration activity,number of invasions,positive expression of Vimentin protein,expression of PCNA,C-myc and FOXD1 proteins,and the transplanted tumor volume in the si-LINC01355+miR-545-5p inhibitor group increased(All P<0.05),whereas the expression of miR-545-5p,apoptosis rate,cleaved caspase-3 and Bax protein expression,and positive expression of E-cadherin protein decreased(All P<0.05).LINC01355 was able to downregulate miR-545-5p expression in Cal-27 cells and miR-545-5p was able to downregulate FOXD1 expression.Conclusion LINC01355 promotes OSCC cell proliferation and invasion,and inhibits apoptosis by targeting the miR-545-5p/FOXD1 signaling pathway.

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