1.Analysis of HPV Infection Characteristics and Influencing Factors for Lesion Grade in Patients with Cervical Squamous Intraepithelial Lesion and Cervical Cancer
Jingjing HAN ; Lijie ZHANG ; Ruyu CAI ; Haili LI ; He WANG ; Le DANG ; Hongda CHEN ; Ming'e LI ; Lan ZHU
Medical Journal of Peking Union Medical College Hospital 2026;17(1):156-165
To summarize the distribution characteristics of human papillomavirus(HPV) infection types in patients with cervical squamous intraepithelial lesion(SIL) and cervical cancer(CC), and to explore the impact of HPV vaccination, HPV infection types, and general clinical data on different grades of cervical lesions. Clinical data of women attending the gynecological colposcopy clinic of Shenzhen People's Hospital from January 2020 to December 2023 were retrospectively collected. Patients with HPV genotyping records and histopathologically diagnosed SIL or CC were included and divided into three groups based on pathological results: low-grade squamous intraepithelial lesion(LSIL) group, high-grade squamous intraepithelial lesion(HSIL) group, and CC group. The distribution of high-risk HPV subtypes was analyzed among the three groups, and multivariate Logistic regression was used to identify influencing factors for high-grade cervical lesions. A total of 4162 patients were included, comprising 4057 cervical SIL patients(3317 LSIL and 740 HSIL) and 105 CC patients. The overall mean age was(39.9±11.2) years. The HPV infection rate was 95.1%(3959/4162), and 25.0%(1040/4162) of patients had received HPV vaccination. Among high-risk HPV infections, HPV 52, HPV 16, HPV 58, and HPV 18 were the most common subtypes. HPV 52 had the highest infection rate in the LSIL group(27.6%), while HPV 16 was the most prevalent in the HSIL group(45.3%) and CC group(64.9%). Multivariate Logistic regression analysis showed that HPV vaccination( HPV infection is common in patients with SIL and CC, but the distribution of high-risk HPV subtypes varies among different grades of cervical lesions. It is recommended to strengthen cervical cancer screening and monitoring of key high-risk HPV infections in older and multiparous women in Shenzhen, and to continue promoting HPV vaccination.
2.Explainable Machine Learning Model for Predicting Prognosis in Patients with Malignant Tumors Complicated by Acute Respiratory Failure: Based on the eICU Collaborative Research Database in the United States
Zihan NAN ; Linan HAN ; Suwei LI ; Ziyi ZHU ; Qinqin ZHU ; Yan DUAN ; Xiaoting WANG ; Lixia LIU
Medical Journal of Peking Union Medical College Hospital 2026;17(1):98-108
To develop and validate a model for predicting intensive care unit (ICU) mortality risk in patients with malignant tumors complicated by acute respiratory failure (ARF) based on an explainable machine learning framework. Clinical data of patients with malignant tumors and ARF were extracted from the eICU Collaborative Research Database in the United States, including demographic characteristics, comorbidities, vital signs, laboratory test indicators, and major interventions within the first 24 hours after ICU admission.The study outcome was ICU death.Enrolled patients were randomly divided into a training set and a validation set at a ratio of 7:3.Predictor variables were selected using least absolute shrinkage and selection operator (LASSO) regression.Five machine learning algorithms-extreme gradient boosting (XGBoost), support vector machine (SVM), Logistic regression, multilayer perceptron (MLP), and C5.0 Decision Tree-were employed to construct predictive models.Model performance was evaluated based on the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, and other metrics.The optimal model was further interpreted using the Shapley additive explanations (SHAP) algorithm. A total of 3196 patients with malignant tumors complicated by ARF were included.The training set comprised 2, 261 patients and the validation set 935 patients; 683 patients died during ICU stay, while 2513 survived.LASSO regression ultimately selected 12 variables closely associated with patient ICU outcomes, including sepsis comorbidity, use of vasoactive drugs, and within the first 24 hours after ICU admission: minimum mean arterial pressure, maximum heart rate, maximum respiratory rate, minimum oxygen saturation, minimum serum bicarbonate, minimum blood urea nitrogen, maximum white blood cell count, maximum mean corpuscular volume, maximum serum potassium, and maximum blood glucose.After model evaluation, the XGBoost model demonstrated the best performance.The AUCs for predicting ICU mortality risk in the training and validation sets were 0.940 and 0.763, respectively; accuracy was 88.3% and 81.2%;sensitivity was 98.5% and 95.9%.Its predictive performance also remained optimal in sensitivity analyses.SHAP analysis indicated that the top five variables contributing to the model's predictions were minimum oxygen saturation, minimum serum bicarbonate, minimum mean arterial pressure, use of vasoactive drugs, and maximum white blood cell count. This study successfully developed a mortality risk prediction model for ICU patients with malignant tumors complicated by ARF based on a large-scale dataset and performed explainability analysis.The model aids clinicians in early identification of high-risk patients and implementing individualized interventions.
3.Ameliorative effect and mechanism of Forsythia suspensa-Lonicera japonica herb pair on acute lung injury via regulating serum exosomal miRNA
Zhaohua CHEN ; Shumin XIE ; Wanshun CHANG ; Yuqing HAN ; Yanwen CHEN ; Yanhui ZHU ; Mingzhuo CAO ; Haiying HUANG
China Pharmacy 2026;37(3):305-310
OBJECTIVE To study the ameliorative effect and mechanism of Forsythia suspensa-Lonicera japonica herb pair on acute lung injury (ALI) based on serum exosomal microRNA (miRNA). METHODS The rats were randomly divided into a blank group (normal saline), model group (nomal saline), and F. suspensa-L. japonica herb pair group (2.55 g/kg), with 10 rats in each group. Except for the blank group, the other groups were used to establish an ALI model by intratracheal dripping of 5 mg/ mL lipopolysaccharides. After modeling, each group was given relevant medicine/normal saline intragastrically, once a day, for 3 consecutive days. After the last medication, the pathological status of lung tissue was observed; lung wet-to-dry weight ratio and leukocyte counts in bronchoalveolar lavage fluid (BALF) were determined. The levels of inflammatory factors [tumor necrosis factor-α(TNF-α), interleukin-1β (IL-1β), IL-10] in BALF were determined. Exosomes were isolated from rat serum, and high- throughput sequencing technology was employed to screen differentially expressed miRNA within the exosomes, followed by Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. Based on the screened differentially expressed miRNA and the enriched KEGG pathways, in vitro cellular experiments were conducted for validation. RESULTS The animal experimental results demonstrated that after intervention with the F. suspensa-L. japonica herb pair, the wet-to-dry weight ratio, the number of leukocytes in BALF, as well as the levels of TNF-α and IL-1β in BALF of ALI rats were all significantly reduced (P<0.01), while the level of IL-10 was significantly increased (P<0.01). The results of high-throughput sequencing experiments revealed that the F. suspensa-L. japonica herb pair could significantly up-regulate the expressions of miR-345-3p, miR-194-5p, miR-653-5p, and others in exosomes. Among them, the KEGG pathways involved in the target genes of differentially expressed miRNA included the hypoxia-inducible factor-1(HIF-1) signaling pathway, among others. The results of cellular E-mail:huang.haiying@126.com validation experiments showed that overexpressed miR-345-3p could significantly elevate the level of IL-10 in the cell supernatant (P<0.01), while significantly reducing the levels of TNF-α and IL-1β in the cell supernatant, as well as the mRNA and protein expression levels of protein kinase B1, phosphatidylinositol 3- kinase, and HIF-1α (P<0.01). CONCLUSIONS F. suspensa-L. japonica herb pair can alleviate inflammatory responses and thereby exert a therapeutic effect in improving ALI by up-regulating the expression of miR-345-3p in serum exosomes and inhibiting the activity of the HIF-1 signaling pathway.
4.Effectiveness Evaluation of Exhalation-Inhalation Exercise on Early Pulmonary Rehabilitation for Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Jiaojiao WANG ; Lin HAN ; Pengcheng ZHOU
Journal of Traditional Chinese Medicine 2026;67(4):432-438
ObjectiveTo evaluate the effectiveness of exhalation-inhalation exercise on early pulmonary rehabi-litation for patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). MethodsA total of 120 participants with AECOPD were randomly divided into a treatment group and a control group, with 60 participants in each group. The control group treated with conventional western medicine, while the treatment group received exhalation-inhalation exercise training on the basis of conventional western medicine treatment, with 30 minutes per session and 5 sessions per week. The course of treatment for both groups was 12 weeks. The primary outcome was the 6-minute walking distance (6MWD). The secondary outcomes included pulmonary function indexes including forced expiratory volume in one second/forced vital capacity (FEV1/FVC), percentage of predicted forced expiratory volume in one second (FEV1%) and percentage of predicted forced vital capacity (FVC%), St.George's Respiratory Questionnaire (SGRQ) score, modified Medical Research Council (mMRC) dyspnea scale score, COPD assessment test (CAT) score, hospital anxiety and depression scale-anxiety subscale [HADS(A)] score, and hospital anxiety and depression scale-depression subscale [HADS(D)] score. Meanwhile, safety of all participants was recorded and assessed. ResultsDuring the treatment, 12 participants dropped out from both the treatment group and the control group, with 48 participants in each group finally included in the analysis. The 6MWD of both groups after treatment was higher than that before treatment, and the 6MWD of the treatment group was higher than that of the control group (P<0.05 or P<0.01). After treatment, the SGRQ score, mMRC score and CAT score of the treatment group were lower than those before treatment, while FEV1%, FVC% and FEV1/FVC were higher than those before treatment (P<0.05). Moreover, after treatment, the FEV1/FVC of the treatment group was higher than that of the control group, while the SGRQ score, mMRC score and CAT score were lower than those of the control group (P<0.05 or P<0.01). There was no statistically significant difference in pulmonary function indexes, SGRQ score, mMRC score and CAT score after treatment in the control group (P>0.05). No statistically significant difference was observed in HADS(A) score and HADS(D) score after treatment within and between groups (P>0.05). The incidence of adverse reactions in the treatment group was 6.25% (3/48), and 0 in the control group, with no statistically significant difference between groups (P>0.05). ConclusionExhalation-inhalation exercise for patients with AECOPD in early pulmonary rehabilitation can improve patients' exercise tole-rance, quality of life, clinical symptoms and pulmonary function, with good safety.
5.Application of visual perception training in ophthalmic clinical practice
Yang GU ; Qionglei ZHONG ; Han REN
International Eye Science 2026;26(3):473-476
Vision is the primary perceptual mode through which humans and higher animals acquire external information. Visual perception encompasses various aspects of visual processing and has been widely applied in ophthalmic clinical practice. Based on the principle of neural plasticity, visual perception training relies on the visual signal processing mechanism. After receiving external visual signals, the retina transmits them via the optic nerve to the brain, where the cerebral cortex decodes, extracts, and processes the information. By stimulating specific visual information, visual perception training activates visual processing pathways, strengthens synaptic connections among neurons within these pathways, and ultimately enhances the cerebral cortex's ability to integrate and process information, thereby improving patients' visual function and experience. This article explores the application of visual perception training in conditions such as amblyopia, myopia, presbyopia, strabismus, glaucoma, macular degeneration, and optic pathway lesions, discussing its value in improving visual function. It provides theoretical references for the intervention and treatment of related diseases. Visual perception training has been widely applied in various ophthalmic diseases with confirmed clinical efficacy, and it may play a broader role in neurologically related systemic diseases, demonstrating certain clinical application value.
6.Mortality and years of life lost of residents with viral hepatitis among in Pudong New Area of Shanghai in 2003 - 2023
Sen WANG ; Lianghong SUN ; Caixia HU ; Hua CHEN ; Xiaobin QU ; Jiayi SHENG ; Siyue HAN ; Caoyi XUE ; Yichen CHEN
Journal of Public Health and Preventive Medicine 2026;37(1):53-57
Objective To analyze the characteristics of viral hepatitis mortality and life loss among residents in Pudong New Area from 2003 to 2023, and to provide a basis for related prevention and control work. Methods Viral hepatitis mortality data were obtained from the Pudong New Area mortality monitoring system. The crude mortality rate (CMR), standardized mortality rate (SMR), potential years of life lost (PYLL), average years of life lost (AYLL), and standardized potential years of life lost (SPYLL) were calculated to analyze viral hepatitis deaths. The average annual change (AAPC) and annual percentage change (APC) of the mortality rate were calculated by Joinpoint regression analysis to analyze the trend of mortality. Results The CMR and SMR of viral hepatitis among residents in Pudong New Area from 2003 to 2023 were 3.89/100000 and 1.98/100000, respectively. Both CMR and SMR of viral hepatitis showed a decreasing trend over time (CMR:APC=-5.476, t=-13.581, P<0.001; SMR:APC=- 7.624, t= -21.253, P<0.001). The CMR for males was 4.75/100000 and the SMR for males was 2.65/100000; the CMR for females was 3.04/100000 and the SMR for females was 1.32/100000, with a higher mortality rate for males than for females(ZCME=12.094,P<0.001; ZSMR=-14.718,P<0.001). Deaths were concentrated in the age groups of 45-64 years old and 65 years old and above, accounting for 91.62% of the total deaths. The PYLL of deaths due to viral hepatitis among residents in Pudong New Area from 2003 to 2023 was 26912 person-years, with a PYLLR of 0.45% and an AYLL of 8.88 years per person. Conclusion The mortality rate of viral hepatitis among the residents of Pudong New Area in 2003-2023 shows a decreasing trend over time. The mortality rate of males is higher than that of females, and the deaths of middle-aged and elderly people account for a large proportion of the total deaths. Chronic hepatitis B is the main cause of death.
7.Epidemiological characteristics and disease burden of liver cancer in Guangdong Province
Ying ZHANG ; Yixuan CHEN ; Rong CAO ; Yue GAO ; Yutong HAN ; Ye WANG ; Ruilin MENG ; Xueyan ZHENG ; Yu LIAO ; Zhuanping ZENG
Journal of Public Health and Preventive Medicine 2026;37(1):68-72
Objective To analyze the epidemiological characteristics and disease burden of liver cancer in Guangdong Province in 2020, and to provide a scientific foundation for the development of regionalized prevention and control strategies for liver cancer. Methods According to the cancer registry data of Guangdong Province, the incidence, mortality and age-standardized rate by Chinese standard population in 2020 were calculated to analyze the epidemiological characteristics of liver cancer. The disability adjusted life years (DALYs), year of life loss (YLL), year of lived with disability (YLD), and cause-eliminated life expectancy were used to assess the disease burden of liver cancer. Results In 2020, the crude incidence rate and the age-standardized incidence rate of liver cancer in Guangdong Province were 27.79/100 000 and 20.84/100 000,respectively, and the crude mortality rate and the age-standardized mortality rate of liver cancer were 25.49/100,000 and 17.64/100 000, respectively. The total DALY and DALY rate of liver cancer in Guangdong Province were 515 311 person-years and 513.83/100 000, respectively. After eliminating the causes of death from liver cancer, the life expectancy in Guangdong Province increased from 84.60 years to 84.99 years. All indicators consistently demonstrated that the burden of liver cancer was higher in males than that in females, and the burden of liver cancer was higher in rural areas than that in urban areas. Conclusion Liver cancer in Guangdong Province exhibits a high incidence, mortality and disease burden level in 2020. There are obvious differences of gender, age and region in cancer burden. It is necessary to strengthen liver cancer screening and diagnosis and treatment in men, the elderly and those in rural areas to reduce the burden of liver cancer gradually in Guangdong Province.
8.Epidemiological characteristics and spatial clustering analysis of varicella in Changzhou
Yao ZHANG ; Changlei HAN ; Jie TAN
Journal of Public Health and Preventive Medicine 2026;37(1):73-77
Objective To analyze the epidemiological and spatial clustering characteristics of varicella in Changzhou from 2018 to 2024, and to provide a theoretical support for the formulation of prevention and control measures. Methods The reported case information of varicella in Changzhou from 2018 to 2024 was collected through the China Information System for Disease Control and Prevention, and the three-dimensional distribution characteristics were analyzed. The incidence trend was analyzed by Joinpoint regression, and the spatial autocorrelation analysis was performed by Arc GIS 10.5 software. The spatiotemporal scanning analysis was carried out with SaTScan 10.1.2 software. Results From 2018 to 2024, a total of 42,132 cases of varicella were reported in Changzhou, with an average annual incidence of 116.25/100,000. The reported incidence showed a downward trend, with an annual percentage change (APC) of -21.96% (95%C1: -32.63%~-9.33%, P<0.01). The incidence showed a “bimodal distribution”, and the age group was mainly under 15 years old (29,086 cases, accounting for 69.04%). The difference in incidence between men and women was statistically significant (χ2= 92.83, P<0.001), and the incidence gradually decreased with age ( χ2trend=112771.44, P<0.001). Global autocorrelation analysis showed that there was spatial aggregation in the six years (P<0.05), and local autocorrelation analysis showed that most of the towns (streets) in the three central urban areas of Tianning District, Zhonglou District, and Xinbei District, as well as some towns (streets) in Liyang City, Wujin District, and Economic Development Zone were high-high aggregation areas. Spatiotemporal scanning analysis showed that the first type of aggregation area was most of the towns (streets) in Tianning District, Zhonglou District and Xinbei District (23, accounting for 92%), and some towns (streets) in Wujin District and Economic Development Zone (RR=3.76, P<0.001), and the second type of aggregation area was most of the towns (streets) in Liyang City (7, accounting for 70%) (RR=3.66, P<0.001). Conclusion The reported incidence of varicella in Changzhou City shows a downward trend, with multiple spatial and temporal clusters. The prevention and control of varicella in high-risk clustering areas, peak hours and high-risk populations should be strengthened, and intervention measures should be taken as soon as possible.
9.Predictive study of serum 25-hydroxyvitamin D and blood lipid metabolism indexes in occurrence of osteoporosis in type 2 diabetes mellitus
Jiajia SONG ; Xiaofang HAN ; Ting HU ; Xiaohuan ZHU
Journal of Public Health and Preventive Medicine 2026;37(1):154-157
Objective To explore the predictive effect of serum 25-hydroxyvitamin D3 [25(OH)D3] and blood lipid metabolism indexes on the occurrence of osteoporosis in type 2 diabetes mellitus (T2DM). Methods Totally 98 patients with T2DM in the hospital from January 2022 to January 2024 were classified into osteoporosis group (38 cases) and non-osteoporosis group (60 cases) by means of concurrent osteoporosis status. The levels of serum 25(OH)D3 and blood lipid metabolism indexes [high density lipoprotein (HDL), total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL), VLDL] were measured in study subjects. The association of serum 25(OH)D3 and blood lipid metabolism indexes with osteoporosis was explored by Logistic regression analysis. The predictive value of serum 25(OH)D3 and blood lipid metabolism indexes on osteoporosis was analyzed by receiver operating characteristic curve (ROC). Results Serum 25(OH)D3 and HDL levels in the osteoporosis group were lower while TG and LDL levels were higher than those in the non-osteoporosis group (P<0.05). The differences in the levels of TC and VLDL were insignificant between groups (P>0.05). After logistic regression analysis, the levels of serum 25(OH)D3, HDL, TG and LDL were closely related to the occurrence of osteoporosis (P<0.05). ROC curve indicated that the area under the curve (AUC), sensitivity and specificity of combined prediction of osteoporosis by serum 25(OH)D3, HDL, TG, and LDL were 0.943, 92.11% and 85.00%, and the efficiency of combined prediction was better than that of each index alone (P<0.05). Conclusion The levels of serum 25(OH)D3, HDL, TG and LDL in T2DM are closely related to osteoporosis. Early combined monitoring of the indicators can provide reference value for clinical prediction of osteoporosis occurrence in patients with T2DM.
10.Research on the in vitro cytotoxic effects of CAR-T cells targeting CD117 on acute myeloid leukemia Kasumi-1 cells
HAN Panpan1 ; CHEN Xujing2 ; CHEN Hanyi2 ; WANG Shuyan1 ; ZHAN Sijian2 ; MO Shengshui3 ; CHEN Lili3 ; FENG Yaru3 ; LIN Wei1 ; WANG Jianxun1
Chinese Journal of Cancer Biotherapy 2026;33(1):45-50
[摘 要] 目的:制备低亲和力的CD117 CAR-T细胞,探讨其对急性髓系白血病(AML)细胞Kasumi-1的体外杀伤效应。方法:调取CD117低亲和力抗体巴佐利单抗(barzolvolimab)和Fab-79D VH和VL序列,设计VH-(G4S)3-VL结构的单链抗体,分别构建带4-1BB共刺激分子的经典二代CAR分子,经基因合成后分别亚克隆至pMFG逆转录病毒载体,获得CD117-79D CAR和CD117-0159 CAR质粒。将两种CAR质粒分别包装制备逆转录病毒,检测其滴度合格后转导活化后的T细胞,构建CD117-79D CAR-T和CD117-0159 CAR-T细胞,采用流式细胞术检测两种CAR-T细胞的阳性率。将未转导T细胞与两种CAR-T细胞分别与CD117+ Kasumi-1细胞共培养,通过流式细胞术检测Kasumi-1细胞凋亡率,以评估两种CAR-T细胞的抗肿瘤活性。结果:成功构建CD117-79D CAR-T和CD117-0159 CAR-T细胞,其阳性率分别为(59.4 ± 2.6)%、(62.5 ± 1.2)%。未转导T细胞、CD117-79D CAR-T和CD117-0159 CAR-T细胞体外培养均能稳定增殖,且三者的增殖能力均无显著差异(均P > 0.05)。体外杀伤Kasumi-1细胞结果显示,不同效靶比条件下,CD117-79D CAR-T和 CD117-0159 CAR-T细胞较未转导T细胞展现出显著增强的杀伤能力(P < 0.05或P < 0.01),但两种CAR-T细胞的杀伤效率无显著差异(P > 0.05)。结论:成功构建低亲和力的CD117-79 CAR-T和CD117-0159 CAR-T细胞,体外实验证实其可有效杀伤CD117+ Kasumi-1细胞,为AML的靶向治疗提供了实验依据。


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