1.Comparison of subjective refraction based on power vectors and conventional subjective refraction in different degree of astigmatism
Recent Advances in Ophthalmology 2017;37(9):871-875
Objective To compare subjective refraction based on power vectors and conventional subjective refraction in different degrees of astigmatism.Methods A total of 143 subjects (143 right eyes) were divided into two groups according to astigmatism degree:low astigmatism group (0-1.50 D) and high astigmatism group (1.50 -3.00 D).Subjects were then examined by both methods to fetch refraction data,and then the equivalent spherical M component,J0 component,J45 component and the duration of refraction procedures were compared and analyzed.Results There was no statistically difference in age,gender,M component,J45 component and time consuming of subjective refraction between the high and low astigmatism groups (all P > 0.05),but intergroup comparison of J0 component from subjective refraction based on power vectors and conventional subjective refraction was significantly different (all P =0.00).In the low astigmatism group,the agreement of M,J0 and J45 measured by the two methods was tmified,and the mean absolute value of M,J0 and J45 difference was 0.04 D,0.02 D and 0.02 D,respectively;moreover,within the limits of consistency,the maximum absolute value of the difference was 0.37 D,0.13 D and 0.17 D,respectively,and there was no statistically difference in time consuming of the two methods (P =0.72).In the high astigmatism group,the agreement of M,J0 and J45 measured by the two methods was poor,and the mean absolute value of M,J0 and J45 difference was 0.43 D,0.21 D and 0.00 D,respectively;moreover,within the limits of consistency,the maximum absolute value of the difference was 0.75 D,0.50 D and 0.30 D,respectively,and the difference in time consuming of the two methods approached statistical significance (P =0.00),suggesting time consuming of subjective refraction based on power vectors was longer.Conclusion Subjective refraction based on power vectors has good effect on low astigmatism,and it needs to be further improved for clinical practices.
2.Factors affecting self-management behaviors among patients with gestational diabetes mellitus
JIANG Zheyi ; CHEN Gongjin ; WANG Qiaoqiao ; CHEN Chao
Journal of Preventive Medicine 2023;35(11):935-938
Objective :
To investigate the status and influencing factors of self-management behaviors among pregnant women with gestational diabetes mellitus (GDM), so as to provide insights into health management of GDM.
Methods:
GDM patients admitted to Medical Community General Hospital of Shaoxing Second Hospital were sampled from January to June 2023, and basic characteristics were collected using questionnaire surveys, including age, parity, education level and gestational age. The self-management behaviors were evaluated among GDM patients using the self-management behavior scale, and the social support level was evaluated using the social support scale, while the modes of coping with diseases were identified using the medical coping modes questionnaire (MCMQ). Factors affecting the self-management behaviors were identified among GDM patients using a multiple linear regression model.
Results:
A total of 120 GDM patients were enrolled, with a mean age of (27.58±3.73) years and gestational age of (22.16±5.82) weeks. The score for self-management behaviors was (118.19±24.86) points among GDM patients, including 15 cases with good self-management behaviors (12.50%), 61 cases with moderate behaviors (50.83%) and 44 cases with poor behaviors (36.67%). Multiple linear regression analysis showed that educational level (high school: β'=0.168; junior college and above: β'=0.187), per capita monthly household income (≥5 000 Yuan, β'=0.305), health education for GDM (β'=0.087), coping mode (avoidance: β'=0.168; acceptance: β'=0.375) and social support level (general: β'=0.184; high: β'=0.429) were factors affecting self-management behaviors among GDM patients.
Conclusion
The self-management behaviors of GDM patients are associated with educational level, per capita monthly household income, health education for GDM, coping mode and social support level.
3.Qualitative research about the influence of communication disabilities caused by dialects on the safety of ophthalmic surgery and its solution
Meina HUANG ; Zheyi CHEN ; Caifen CHEN
Chinese Journal of Practical Nursing 2018;34(25):1952-1956
Objective To explore the influence of dialect-based communication obstacle on the safety of ophthalmic operation room and to provide the basis for improving the safety of ophthalmic operation room. Methods An in-depth interview was taken on 10 medical staff by qualitative research. The information was arranged and analyzed by phenomenology method. Results The interview with the surgical doctors on the communication barriers were extracted to three themes, including lower surgical efficiency, decreased patient satisfaction, increased risk of surgical complications, the interview with the surgical nurses on the dialects leading to communication barriers were extracted three themes, including surgical verification difficult to carry out, affect the perioperative care, hinder the postoperative mission to carry out, the extracted themes about the impact on patients include increased stress and anxiety affect the surgical outcome, poor intraoperative experience reduced satisfaction, the extracted themes about solution include the organization of medical staff to learn the dialect of the common language, recruit staff diversification, to provide professional translation, standardized body language to instruct the patient. Conclusions In this study, the experience of communication disorder caused by doctors and nurses in the ophthalmic operating room reflects the shortcomings of the safety management of the ophthalmic operating room. These deficiencies can be reduced by the independent study of the medical staff.
4.Production of phage-displayed anti-idiotypic antibody single chain variable fragments to MG7 monoclonal antibody directed against gastric carcinoma.
He FENGTIAN ; Nie YONGZHAN ; Chen BAOJUN ; Qiao TAIDONG ; Han ZHEYI ; Fan DAIMING
Chinese Medical Sciences Journal 2002;17(4):215-219
OBJECTIVETo generate phage-displayed anti-idiotypic antibody single chain variable fragments (anti-Id ScFv) to MG7 monoclonal antibody (McAb) directed against gastric carcinoma so as to lay a foundation for developing anti-Id ScFv vaccine of the cancer.
METHODSBalb/c mice were immunized i.p. with MG7 McAb conjugated with keyhole limpet hemocyanin (KLH), and mRNA was isolated from the spleens of the immunized mice. Heavy and light chain (VH and VL) genes of antibody were amplified separately and assembled into ScFv genes with a linker DNA by PCR. The ScFv genes were ligated into the phagemid vector pCANTAB5E and the ligated sample was transformed into competent E. coli TG1. The transformants were infected with M13K07 helper phage to yield recombinant phages displaying ScFv on the tips of M13 phage. After 4 rounds of panning with MG7, the MG7-positive clones were selected by ELISA from the enriched phages. The types of the anti-Id ScFv displayed on the selected phage clones were preliminarily identified by competition ELISA.
RESULTSThe VH, VL and ScFv DNAs were about 340 bp, 320 bp and 750 bp respectively. Twenty-four MG7-positive clones were selected from 60 enriched phage clones, among which 5 displayed beta or gamma type anti-Id ScFv.
CONCLUSIONThe anti-Id ScFv to MG7 McAb can be successfully selected by recombinant phage antibody technique, which paves a way for the study of prevention and cure of gastric carcinoma by using anti-Id ScFv.
Animals ; Antibodies, Anti-Idiotypic ; biosynthesis ; genetics ; Antibodies, Monoclonal ; genetics ; immunology ; Bacteriophages ; genetics ; Cloning, Molecular ; Immunoglobulin Fragments ; biosynthesis ; genetics ; Immunoglobulin Heavy Chains ; biosynthesis ; genetics ; Immunoglobulin Light Chains ; biosynthesis ; genetics ; Immunoglobulin Variable Region ; biosynthesis ; genetics ; Mice ; Mice, Inbred BALB C ; RNA, Messenger ; genetics ; Stomach Neoplasms ; immunology ; Vaccines, DNA ; genetics ; immunology
5.Imaging manifestations and clinical diagnosis of phosphaturic mesenchymal tumor
Fangfang YAN ; Mengyu CHEN ; Zheyi CHEN ; Mei LI ; Weiwu YAO ; Fengling SHAN ; Qiong JIAO ; Qiang ZHENG
Chinese Journal of Radiology 2018;52(11):858-863
Objective To investigate the clinical and imaging characteristics of phosphaturic mesenchymal tumor and improve the clinical diagnosis. Methods From November 2014 to September 2017, 22 patients with pathologically confirmed diagnosis as phosphaturic mesenchymal tumor (PMT) were retrospectively analyzed, including 12 males and 10 females, age ranged from 30-72 years, mean (47 ± 11) years old. The clinical data, laboratory tests [serum calcium, phosphorus, alkaline phosphatase, parathyroid hormone and 1, 25- (OH) 2 D] and imaging examinations (X-ray, CT, MRI, nuclide) were collected and explored. Sixteen patients underwent SPECT scan and seven underwent PET/CT scan. Twenty patients had X-ray, eighteen patients had CT and 12 patients had MRI with enhancement. Results All patients suffered from diffuse pain for one to fifteen years, especially in lower back and lower extremities. All patients were found with low serum phosphorus, normal serum calcium. Twenty-one patients were found with elevated alkaline phosphatase, 16 with increased parathyroid hormone and 15 with decreased 1, 25 - (OH) 2 D. Thirteen lesions were located in the medullary cavity, seven in the soft tissue and two in the sinuses. Nineteen cases showed varying degrees of trabecular bone sparse, osteoporosis and osteomalacia on X-ray;There were 15 cases of multiple pseudo-fractures, including four cases of pelvic fracture complicated with femoral fracture, six cases of single fracture of pelvis, four cases of femur and one case of fibula. And seven cases showed multiple vertebral compression fractures. Thirteen lesions showed soft-tissue density and four in the medullary cavity showed high density on CT scan. The lesions presented low signal intensity on T1WI,high or low signal intensity on T2WI FLAIR and obviously enhanced in 12 patients who underwent MRI enhancement. Conclusion For patients with decreased serum phosphorus, elevated alkaline phosphatase, bone softening and fracture, octreotide or other nuclides should be primary imaging modality for confirming the location of the lesion. CT and MRI can further evaluate the nature of the lesion and improve diagnostic accuracy.
6.Correlation between serum C3 and glomerular microthrombosis in patients with lupus nephritis
Yang LIU ; Haofei HU ; Jianyu CHEN ; Zheyi CHANG ; Changchun CAO ; Qijun WAN
Chinese Journal of Nephrology 2020;36(10):750-757
Objective:To investigate the correlation between serum C3 and glomerular microthrombosis in patients with lupus nephritis (LN).Methods:Patients who were diagnosed as LN by renal biopsy hospitalized in Department of Nephrology, the First Affiliated Hospital of Shenzhen University from January 2010 to February 2019 were retrospectively analyzed and they were divided into glomerular microthrombosis group (GMT group) and non-glomerular microthrombosis group (non-GMT group). The demographic data, clinical characteristics, pathology and prognosis of the two groups were compared. Logistic regression and smooth curve fitting of generalized additive mixed model analysis were used to explore the correlation between serum C3 and glomerular microthrombosis. Renal prognosis of the two groups were compared by the Kaplan-Meier survival curve.Results:A total of 116 patients were enrolled, aged (32.79±11.43) years old, in which 108 cases (93.10%) were female. Thirty-seven patients (31.90%) were confirmed to be combined with GMT (GMT group) and 79 cases were not (non-GMT group). Compared with the non-GMT group, patients in the GMT group were relatively older ( t=-2.876, P=0.002), with higher proportion of hypertension ( χ2=7.492, P=0.006), higher urine protein quantitation ( Z=-2.115, P=0.003), lower levels of eGFR and serum complement C3 ( Z=3.469, P<0.001; t=1.744, P<0.001), higher systemic lupus erythematosus disease activity index ( t=-2.758, P=0.007). As to the pathological characteristics, type IV LN patients were the majority (72.97%). Proportion of crescents and pathological activity indicators of the GMT group were higher ( Z=-1.866, P=0.002; t=-5.005, P<0.001), nuclear fragmentation, endothelial hyperplasia and renal tubular atrophy were more serious ( χ2=14.987, P<0.001; χ2=15.695, P<0.001; χ2=4.130, P=0.042). Multivariate logistic regression analysis indicated that serum complement C3 was a relational factor of the formation of GMT in LN patients ( OR=0.966, 95% CI 0.938-0.995, P=0.023). Smooth curve fitting of generalized additive mixed model analysis indicated that level of complement C3 had a linear relationship with the changing trend of GMT. The Kaplan-Meier curve showed that there were statistical differences between the two groups in terms of complete remission of urine protein (Log-rank χ2=5.858, P=0.016) and doubled serum creatinine/end-stage renal disease (Log-rank χ2=3.945, P=0.047). Conclusions:Serum C3 is closely related to the formation of GMT in LN patients, and statistical differences were demonstrated in the renal prognosis of GMT group and non-GMT group.
7.Establishment of a diagnostic model for glomerular micro thrombosis in patients with lupus nephritis based on machine learning
Haofei HU ; Ricong XU ; Yang LIU ; Jianyu CHEN ; Zheyi CHANG ; Qijun WAN
Chinese Journal of Rheumatology 2022;26(11):721-729,C11-1
Objective:To establish a diagnostic model for glomerular micro thrombosis (GMT) in lupus nephritis through clinical indicators.Methods:A continuous collection of patients diagnosed with lupus nephritis (LN) by renal biopsy in the Department of Nephrology, Shenzhen Second People's Hospital, from January 2010 to March 2021. All patients were admitted and discharged through the inclusion and exclusion criteria. Demographic data, clinical characteristics, biochemical indicators, and immune indicators were collected. A GMT diagnosis model was established from the most important variables among the abovementioned variables through machine learning and Logistic stepwise regression analysis. The model was presented through a nomogram. The receiver operating characteristic curve (ROC), the clinical decision curve and the calibration curve were used to evaluate the model discrimination, clinical use and accuracy, respectively. The internal verification of the model was carried out by repeated sampling 500 times by the Bootstrap method.Results:There were a total of 129 patients with lupus nephritis including the study, including 117 females (90.7%); the average age was (34±11) years. There were 39 patients with GMT (30.2%). Using machine learning to screen out the top 10 important variables from 47 candidate variables, then through logistic stepwise regression analysis, five variables were further screened to establish the diagnostic model of GMT, namely hemoglobin [ OR(95% CI)=0.966(0.943, 0.990), P=0.005], serum C3 [ OR(95% CI)=0.133(0.022, 0.819), P=0.030], systolic blood pressure [ OR(95% CI)=1.027(1.005, 1.049), P=0.017], lymphocyte count [ OR(95% CI)=0.462(0.213, 0.999), P=0.049], and TT [ OR(95% CI)=1.260(0.993, 1.597), P=0.057]. Draw up the equation of the GMT diagnosis model of lupus nephritis and establish a nomogram to present the model. The area under curve (AUC) of the diagnostic model was 0.823, 95% CI(0.753, 0.893), indicating that the model had a reasonable degree of discrimin-ation. The Hosmer-Lemeshow test showed a perfect fit between the predicted GMT risk and the observed GMT risk ( χ2= 14.62, P=0.067). The clinical decision curve and clinical impact curve reflect that the model had a good clinical application value, especially when the threshold probability is between 0.4 and 0.6, the application value is more significant. In addition, after 500 repeated samplings by the Bootstrap method, the average AUC was 0.825, 95% CI(0.753, 0.893), which is basically the same as the AUC obtained by the original model. Conclusion:We established a diagnostic model of GMT inLN based on clinical indicators through machine learning and logistic stepwise regression analysis. It is used for early diagnosis of the risk of GMT before the renal biopsy.
8.The role of intravoxel incoherent motion diffusion-weighted imaging in distinguishing diabetic nephropathy from non-diabetic renal disease in diabetic patients
Shaopeng ZHOU ; Qian WANG ; Xue ZHAI ; Pu CHEN ; Jian ZHAO ; Xu BAI ; Xiaojing ZHANG ; Lin LI ; Huiyi YE ; Zheyi DONG ; Xiangmei CHEN ; Haiyi WANG
Chinese Journal of Internal Medicine 2023;62(11):1288-1294
Objective:To investigate the intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) in the differential diagnosis of diabetic nephropathy (DN) and non-diabetic renal disease (NDRD) among patients with type 2 diabetes mellitus (T2DM).Methods:A diagnostic test. In this prospective study, patients with T2DM who underwent both IVIM-DWI and renal biopsy at the First Medical Center of Chinese PLA General Hospital between October 2017 and September 2021 were consecutively enrolled. IVIM-DWI parameters including perfusion fraction (f), pure diffusion coefficient (D), and pseudo-diffusion coefficient (D*) were measured in the renal cortex, medulla, and parenchyma. Patients were divided into the DN group and NDRD group based on the renal biopsy results. IVIM-DWI parameters, clinical information, and diabetes-related biochemical indicators between the two groups were compared using Student′s t-test or Mann-Whitney U test. The correlation of IVIM-DWI parameters with diabetic nephropathy histological scores were analyzed using Spearman′s correlation analyzes. The diagnostic efficiency of IVIM-DWI parameters for distinguishing between DN and NDRD were assessed using the receiver operating characteristic (ROC) curves. Results:A total of 27 DN patients and 23 NDRD patients were included in this study. The DN group comprised 19 male and 8 female patients, with an average age of 52±9 years. The NDRD group comprised 16 male and 7 female patients, with an average age of 49±10 years. The DN group had a higher D* value in the renal cortex and a lower f value in the renal medulla than the NDRD group (9.84×10 -3 mm 2/s vs. 7.35×10 -3 mm 2/s, Z=-3.65; 41.01% vs. 46.74%, Z=-2.29; all P<0.05). The renal medulla D* value was negatively correlated with DN grades, interstitial lesion score, and interstitial fibrosis and tubular atrophy (IFTA) score ( r=-0.571, -0.409, -0.409; all P<0.05) while the renal cortex f value was positively correlated with vascular sclerosis score ( r=0.413, P=0.032). The renal cortex D* value had the highest area under the curve (AUC) for discriminating between the DN and NDRD groups (AUC=0.802, sensitivity 91.3%, specificity 55.6%). Conclusion:IVIM-derived renal cortex D* value can be used non-invasively to differentiate DN from NDRD in patients with T2DM that can potentially facilitate individualized treatment planning for diabetic patients.