1.Current Research Status of Digital Technology in the Rehabilitation of Rare Neurological and Muscular Diseases
Yixuan GUO ; Yi GAO ; Yiyang YAO ; Zhuoyue QIN ; Yaofang ZHANG ; Jiaqi JING ; Jing XIE ; Jian GUO ; Shuyang ZHANG
JOURNAL OF RARE DISEASES 2025;4(1):122-131
To review the randomized controlled trials (RCTs) at home and abroad on digital intelligence (DI)-driven rehabilitation in patients of neuromuscular disease, compare the effects of DI-driven rehabilitation with traditional rehabilitation, summarize the special needs and challenges faced by patients in rehabilitation of rare neuromuscular diseases, and provide evidence for the development and quality improvement of rehabilitation for rare neuromuscular diseases. We searched PubMed, Web of Science, Embase, CNKI, VIP, and Wanfang databases for literature on neuromuscular diseases, rare diseases, digital and intelligent technologies, and rehabilitation published from the inception of the databases to June 2024. Basic and research-related information from the retrieved literature was extracted and analyzed. A total of 43 RCTs in English from 14 countries were included. The most studied diseases were Parkinson′s disease and multiple sclerosis. The application of DI-driven technologies in rehabilitation of rare neuromuscular diseases was still limited. The commonly used technologies were virtual reality (VR) games, intelligent treadmill assistance, gait training robots, hybrid assistive limb (HAL), wearable sensors and tele-rehabilitation (TR) systems. These technologies were applied in patients′ homes or rehabilitation service centers. The VR games significantly improved both static/dynamic balance functions and cognitive functions. The intelligent treadmill assistance significantly enhanced gait speed and stride length. The gait training robots significantly improved balance, gait speed and stride length of patients. The wearable exoskeletons significantly enhanced walking ability. DI-driven rehabilitation measures have great value and potential in the field of neuromuscular disease rehabilitation. Their advantages and characteristics can meet the diverse needs of rare disease patients. In the future, a hierarchical and collaborative rehabilitation service system should be established to meet the urgent needs of the rehabilitation of rare neuromuscular diseases. Combining the advantages of digitization and intelligence will provide standardized, scientific, convenient and affordable rehabilitation services to patients.
2.The Application of Digital Intelligence Technology in the Management of Non-Hospitalized Patients with Rare Diseases
Yiyang YAO ; Yi GAO ; Yixuan GUO ; Zhuoyue QIN ; Yaofang ZHANG ; Jiaqi JING ; Jing XIE ; Jian GUO ; Shuyang ZHANG
JOURNAL OF RARE DISEASES 2025;4(1):46-53
To provide references to and give suggestions to the development and optimiza-tion of Digital Intelligence (DI) technology in management of non-hospitalized patients by systematical review the application of digital technology in non-hospital settings. We designed the search strategy and used the words " rare diseases"" patient management"" non-hospitalized management"" community management"" digital intelligence"" big data"" telemedicine" as MESH terms or free words. We searched the database of PubMed, Science-Direct, Web of Science, CNKI, Wanfang and VIP from the beginning of the database to July 2024 and used computer retrieval to get the literatures on the application of DI technology in the management of patients with rare diseases in non-hospital setting. We extracted the information of the first author, country or region, publication time, research participants, DI technology application, and application effect for summary analysis. A total of 13 articles were included in this study, which were from 8 countries or regions. We found that DI technologies used were in the following forms: Internet information platform, wearable devices, telemedicine management platform and electronic database. The DI technology was used by the patients with rare diseases, patient caregivers and professional medical staffs. The application of all the forms above in different populations had good effect. The Internet information platform helped patients and their caregivers learn more about the disease and improved their self-management ability. The wearable device helped monitor the health status of patients in real time and predict the risk of emergent events. The telemedicine management platform facilitated to optimize the allocation of medical resources and strengthen doctor-patient communication. The electronic health database promoted the interconnection of data inside and outside the hospital and improved the accuracy of decision-making through data sharing. The application of DI technology in the management of patients with rare diseases in non-hospitalized settings has shown positive results. In the future, it is necessary to correct the shortcomings and to deal with the challenges in terms of accuracy, readiness, applicability, and privacy protection. Besides, the DI can be integrated into the tri-level management system of patients known as the "patient-community-hospital". It is advisable to take the advantages of digital intelligence technology to improve the efficiency and quality of management of patients in non-hospitalized settings.
3.Efficacy and safety of tislelizumab in the treatment of advanced non-small cell lung cancer:a meta-analysis
Yanxue WANG ; Xiaotong LIAN ; Ziying LIANG ; Xinyi GUO ; Qiuyi YUAN ; Jinni WANG ; Yixuan QIN ; Xiaolian DING ; Gang LIANG
China Pharmacy 2025;36(19):2454-2459
OBJECTIVE To systematically evaluate the efficacy and safety of tislelizumab in the treatment of advanced non- small cell lung cancer (NSCLC). METHODS Computerized searches were conducted in PubMed, Embase, the Cochrane Library, CNKI, Wanfang and other Chinese and English databases to collect randomized controlled trials (RCTs) on tislelizumab for advanced NSCLC. The search period was from the establishment of the databases to December 2024. After strictly screening the literature, extracting data and conducting quality evaluations in accordance with the inclusion and exclusion criteria, a meta-analysis was performed using RevMan 5.3 and Stata 16.0 software. RESULTS A total of 18 RCTs involving 2 337 patients were included, with 1 283 in the experimental group and 1 054 in the control group. The meta-analysis results showed that the objective response rate [RR=1.61, 95%CI (1.48, 1.75), P<0.000 01], disease control rate [RR=1.21, 95%CI (1.13, 1.29), P<0.000 01], progression free survival [HR=0.55, 95%CI (0.45, 0.66), P<0.000 01], and overall survival [HR=0.78, 95%CI(0.62, 0.97), P=0.03] were significantly better in the experimental group than in the control group. There was no statistically significant difference in the incidence of adverse reactions between the two groups [RR=1.00, 95%CI (0.73, 1.37), P=1.00]; among the common adverse reactions, only the incidence of liver function impairment was significantly higher in the experimental group than in the control group [RR=1.30, 95%CI (1.10, 1.54), P<0.01]. CONCLUSIONS Tislelizumab in combination with chemotherapy or targeted drugs significantly improves the efficacy in patients with advanced NSCLC without increasing the risk of adverse reactions overall. However, liver function should be closely monitored during treatment.
4.Augmentation of PRDX1-DOK3 interaction alleviates rheumatoid arthritis progression by suppressing plasma cell differentiation.
Wenzhen DANG ; Xiaomin WANG ; Huaying LI ; Yixuan XU ; Xinyu LI ; Siqi HUANG ; Hongru TAO ; Xiao LI ; Yulin YANG ; Lijiang XUAN ; Weilie XIAO ; Dean GUO ; Hao ZHANG ; Qiong WU ; Jie ZHENG ; Xiaoyan SHEN ; Kaixian CHEN ; Heng XU ; Yuanyuan ZHANG ; Cheng LUO
Acta Pharmaceutica Sinica B 2025;15(8):3997-4013
Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by persistent inflammation and joint damage, accompanied by the accumulation of plasma cells, which contributes to its pathogenesis. Understanding the genetic alterations occurring during plasma cell differentiation in RA can deepen our comprehension of its pathogenesis and guide the development of targeted therapeutic interventions. Here, our study elucidates the intricate molecular mechanisms underlying plasma cell differentiation by demonstrating that PRDX1 interacts with DOK3 and modulates its degradation by the autophagy-lysosome pathway. This interaction results in the inhibition of plasma cell differentiation, thereby alleviating the progression of collagen-induced arthritis. Additionally, our investigation identifies Salvianolic acid B (SAB) as a potent small molecular glue-like compound that enhances the interaction between PRDX1 and DOK3, consequently impeding the progression of collagen-induced arthritis by inhibiting plasma cell differentiation. Collectively, these findings underscore the therapeutic potential of developing chemical stabilizers for the PRDX1-DOK3 complex in suppressing plasma cell differentiation for RA treatment and establish a theoretical basis for targeting PRDX1-protein interactions as specific therapeutic targets in various diseases.
5.RRS1 regulates proliferation, migration, and invasion of HTR-8/SVneo human trophoblasts.
Yixuan WU ; Yao LI ; Jing WANG ; Qianying GUO ; Wei CHEN ; Jie QIAO ; Liying YAN ; Peng YUAN
Frontiers of Medicine 2025;19(5):831-841
Trophoblast cells serve as the foundation for placental development. We analyzed published multiomics sequencing data and found that trophoblast cells highly expressed RRS1 compared to primitive endoderm and epiblast. We used HTR-8/SVneo cells for further investigation, and Western blot and immunofluorescence staining confirmed that HTR-8/SVneo cells highly expressed RRS1. RRS1 was successfully knocked down in HTR-8/SVneo cells using siRNA. Using IncuCyte S3 live-cell analysis system based on continuous live-cell imaging and real-time data, we observed that proliferation, migration, and invasion abilities were all significantly decreased in RRS1-knockdown cells. RNA-seq revealed that knockdown of RRS1 affected the gene transcription, and upregulated pathways in extracellular matrix organization, DNA damage response, and intrinsic apoptotic signaling, downregulated pathways in embryo implantation, trophoblast cell migration, and wound healing. Differentially expressed genes were enriched in diseases related to placental development. Consistent with these findings, human chorionic villus samples collected from spontaneous abortion cases exhibited significantly reduced RRS1 expression compared to normal controls. Our results highlight the functional importance of RRS1 in human trophoblasts and suggest that its deficiency contributes to early pregnancy loss.
Humans
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Trophoblasts/physiology*
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Cell Movement/genetics*
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Cell Proliferation/genetics*
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Female
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Pregnancy
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Abortion, Spontaneous/metabolism*
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Cell Line
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Placentation/genetics*
6.Latent class analysis of the behavioral lifestyle of diabetic patients in community diabetes based on the perspective of lifestyle medicine
Yixuan ZHANG ; Tianyuan FENG ; Yifei GAO ; Meixiang HUANG ; Luyi GUO
Journal of Public Health and Preventive Medicine 2024;35(5):28-32
Objective To explore the latent class and influencing factors between different behavioral lifestyles in community patients with diabetes, to classify the population and reveal the behavioral lifestyle characteristics of different types of diabetes, and to provide a scientific basis for active health management of diabetes, the identification of high-risk groups and maximization of the effect of intervention measures. Methods From June to August 2022, a behavioral and lifestyle follow-up survey was conducted on 1 179 diabetes patients with electronic health records from 18 community health service centers in Pingshan District, Shenzhen. The latent class analysis (LCA) method was used to cluster the life and behavior style of the study subjects, and the disordered multi-classification logistic regression was used to analyze the influencing factors of each class. Results The LCA results showed that there were three latent classes of community diabetes patients: “overweight and obese group” (28.4%), “balanced diet group” (30.8%), and “vegetarian but persistent exercise group” (40.8%). Logistic regression analysis results showed that age, total cholesterol , LDL , fasting blood glucose, comorbidities, and hypertension history affected the latent classes of behavioral lifestyle in diabetic patients in the community (P<0.05). Conclusion The behavioral lifestyle of community diabetes patients has obvious classification characteristics and obvious differentiation in terms of eating behavior. Doctors and health managers can issue corresponding lifestyle medicine prescriptions and formulate corresponding active health management measures to prevent the occurrence of risk factors related to diabetes patients in advance and formulate personalized intervention measures.
7.Association between sedentary behaviors with cardiorespiratory fitness and executive function among adolescents
SHANG Wenjin, YIN Xiaojian, WANG Jinxian, HONG Jun, SHI Lijuan, GUO Junfeng, WANG Tianyi, LIU Yixuan
Chinese Journal of School Health 2024;45(3):330-334
Objective:
To explore the relationship between sedentary behavior with cardiorespiratory fitness and executive function in adolescents, and to provide some references for sedentary behavior prevention and executive function improvement.
Methods:
From September to December 2022, a total of 5 018 adolescents aged 13 to 18 years were selected by stratified random sampling method in Shanghai, Suzhou, Taiyuan,Wuyuan, Xingyi, and Urumqi to conduct physical activity survey, as well as cardiorespiratory fitness and executive function assessment. Pearson s correlation was used to analyze the relationship between sedentary behavior, cardiorespiratory fitness and executive function. The mediation effect model was fitted by the bootstrap mediation procedure in the PROCESS (version 3.3 ) SPSS macro compiled by Haves, and the mediation effect of adolescents cardiorespiratory fitness in the relationship between static behavior and executive function was examined using model 4 in the PROCESS SPSS macro, where Boosrap method was used to compute the mediation effect of adolescents cardiorespiratory fitness. where the Boosrap method was used to calculate confidence intervals for the mediating effects.
Results:
Adolescents daily sedentary time was positively correlated with both the refreshing function (1-back and 2-back) and the switch function reaction time ( r =0.05, 0.07, 0.05, P <0.01). Adolescent VO 2max was negatively correlated with both the refreshing function (1-back,2-back) and the switching function ( r =-0.09, -0.14 , -0.11, P <0.01). Adolescents daily sedentary time was negatively correlated with VO 2max ( r =-0.04, P <0.01); cardiorespiratory fitness mediated effect values between sedentary behavior and refreshing function (1-back and 2-back) and converted function were 0.20(95% CI =0.06-0.36), 0.43(95% CI =0.14-0.74) and 0.13 (95% CI =0.04-0.22), with mediating effect shares of 6.87%, 8.33% and 8.59%, respectively.
Conclusion
The duration of sedentary behavior in adolescents is related to executive function performance, and cardiorespiratory fitness may serve as a mediator to mediate the association between sedentary behavior and executive function in adolescents.
8.Correlation Analysis Between Ultrasound Ossification Ratio and Exercise Intensity in Adolescents
Li ZHANG ; Hanze DU ; Yixuan ZHANG ; Yamei YANG ; Zeqing ZHAO ; Xiaoyuan GUO ; Shi CHEN ; Hui PAN ; Xiao YANG ; Jianchu LI
Medical Journal of Peking Union Medical College Hospital 2024;15(5):1198-1203
To evaluate the correlation between ultrasound ossification ratio(OR) and exercise intensity among adolescents. This cross-sectional study used stratified sampling to select adolescents aged 11-15 years from a sports school and some ordinary middle schools in Shandong Province in June 2023. The participants were divided into two groups: competitive sports group (high exercise intensity), and general sports group (moderate exercise intensity), based on their exercise intensity. Ultrasound images of long bones from nine body regions (including 3 upper limb bones and 6 lower limb bones) were collected for both groups. Two sonographers interpreted the images and calculated the ultrasound OR values (the ratio of ossification center length to epiphyseal length on the standard ultrasound section). The intraclass correlation coefficient (ICC) was used to assess the consistency of image interpretation between the observers. Differences in ultrasound OR values between the two groups were compared, and multivariate Logistic regression analysis was performed to assess the correlation between ultrasound OR values and exercise intensity. A total of 252 adolescents who met the inclusion and exclusion criteria were included, with 154 in the competitive sports group (97 males and 57 females) and 98 in the general sports group (52 males and 46 females). The median height and average daily exercise duration were significantly higher in the competitive sports group than in the general sports group (all The medial femoral ultrasound OR value was correlated with exercise intensity among adolescents. This indicator may serve as an objective imaging parameter for assessing whether adolescent exercise meets recommended standards.
9.Effect of three-dimensional spatial distribution of necrotic and support areas on outcomes of fibular support for hip preservation
Xinwei YUAN ; Yixuan HUANG ; Hongzhong XI ; Mingbin GUO ; Jianbin MAI ; Guangquan SUN ; Xin LIU ; Bin DU
Chinese Journal of Tissue Engineering Research 2024;28(18):2789-2794
BACKGROUND:The distribution of the necrotic area plays an important role in hip preservation treatment.At present,there are few studies on whether the difference in the three-dimensional spatial distribution of osteonecrosis of the femoral head affects the clinical outcome of fibular support. OBJECTIVE:To explore the relationship between the spatial distribution and clinical outcome at the sites of osteonecrosis of the femoral head and fibular support using CT three-dimensional reconstruction so as to provide a basis for optimizing the applicable conditions of fibular support and improving the hip preservation effect of fibular support. METHODS:Eighty patients with osteonecrosis of the femoral head who were treated with fibular support for hip preservation from January 2010 to January 2021 were selected as the study subjects according to the inclusion criteria.They were followed up for at least 2 years.According to the clinical outcome,the patients were divided into the successful hip preservation group(n=55)and the failure hip preservation group(n=25).3D reconstruction was performed according to the preoperative and postoperative CT images of the patients.According to the three-column theory,the femoral head was divided into outer nine areas,middle nine areas and inner nine areas(L1-9,C1-9,and M1-9)to explore the spatial distribution of necrotic area of the femoral head and fibular support area and its relationship with clinical outcome. RESULTS AND CONCLUSION:(1)Before operation,the necrotic area of the femoral head was mainly distributed in L1,L2,L4,L5,C1,C2,C4,and C5(the upper and middle part of the anterior part of the outer ninth area and the middle part of the middle ninth area).After operation,the fibular support area was mainly distributed in L5,L6,C5,and C6(the middle and lower part of the outer ninth area and the middle and lower part of the middle ninth area).(2)There were significant differences in the distribution of osteonecrosis of the femoral head between the successful hip preservation group and the failure hip preservation group in L8(the posterior middle part of the outer ninth area),C3(the anterior lower part of the middle ninth area),C6(the lower middle part of the middle part of the inner ninth area)and M2(the anterior middle part of the inner ninth area)(P<0.05).There was a significant difference in the distribution of fibular support in L5 and L6(middle and lower part of outer nine)(P<0.05).Among them,the L8 region could be used as an independent predictor of hip preservation failure in fibular support surgery.The area under the curve of the L8 single factor prediction model was 0.698[95%CI(0.575,0.822)];the sensitivity was 76%,and the specificity was 63.6%.(3)It turns out,when the necrotic area involves L8,C3,C6,and M2,especially L8,the failure of fibular support may increase,and when the fibular support involves L5 and L6,the effect of hip preservation is often not ideal.
10.Application of bioelectric effect materials in design of bone tissue engineering scaffolds
Hongzhong XI ; Xin LIU ; Guangquan SUN ; Bin DU ; Xinwei YUAN ; Yixuan HUANG ; Mingbin GUO ; Jianbin MAI
Chinese Journal of Tissue Engineering Research 2024;28(22):3569-3575
BACKGROUND:Bone has bioelectric effects.However,bone defects can lead to loss of endogenous bioelectricity in bone.The implantation of bone tissue engineering scaffolds with bioelectric effect into bone defects will replenish the missing electrical signals and accelerate the repair of bone defects. OBJECTIVE:To introduce the bioelectric effect of bone tissue and expound the repair effect of electrical stimulation on bone defects,summarize the research progress of bioelectric effect applied to bone tissue engineering,in order to provide new ideas for the research of bone tissue engineering. METHODS:Relevant articles were searched on CNKI,WanFang,PubMed,Web of Science and ScienceDirect databases,using"bioelectrical effect,bioelectrical materials,electrical stimulation,bone tissue engineering,bone scaffold,bone defect,bone repair,osteogenesis"as the English and Chinese search terms.Finally,87 articles were included for analysis. RESULTS AND CONCLUSION:(1)Bioelectrical effect combined with ex vivo electrical stimulation to design bone tissue engineering scaffolds is an ideal and feasible approach,and the main materials involved include metallic materials,graphene materials,natural bio-derived materials,and synthetic biomaterial.At present,the most widely used conductive material is graphene material,which benefits from its super conductivity,large specific surface area,good biocompatibility with cells and bones,and excellent mechanical properties.(2)Graphene materials are mainly introduced into the scaffold as modified materials to enhance the conductivity of the overall scaffold,while its large surface area and rich functional groups can promote the loading and release of bioactive substances.(3)However,there are still some major challenges to overcome for bioelectrically effective bone tissue engineering scaffolds:not only electrical conductivity but also the overall performance of the bracket needs to be considered;lack of uniform,standardized preparation of bioelectrically effective bone tissue engineering scaffolds;extracorporeal electrical stimulation intervention systems are not yet mature enough;lack of individualized guidance on stent selection to enable the selection and design of the most appropriate stent for patients with different pathologies.(4)When designing conductive scaffolds,researchers have to deeply consider the comprehensive effects of the scaffolds,such as biocompatibility,mechanical properties,and biodegradability.This combination of properties can be achieved by combining multiple materials.(5)Beyond that,clinical translation should be the ultimate consideration for conductive stent design.On the basis of evaluating the safe current threshold for electrical stimulation to act on the human body and facilitate the repair of bone defects,animal experiments as well as basic experiments are designed and then applied to the clinic to achieve the ultimate goal of applying bioelectrical effect bone tissue engineering scaffolds in the clinic.


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