1.Exploring Mechanism of Polygoni Cuspidati Rhizoma et Radix in Treating Respiratory Syncytial Virus Infection Based on Pulmonary Surfactant Lipid Homeostasis
Xiaorong WANG ; Keyu TAO ; Jianjian JI ; Yingmei DONG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(21):102-108
ObjectiveTo investigate the efficacy and mechanism of Polygoni Cuspidati Rhizoma et Radix (Huzhang) in treating respiratory syncytial virus(RSV) infection by regulating pulmonary surfactant lipid homeostasis through lipidomics. MethodsSixty BALB/c mice were randomly divided into the blank group, model group, positive group(ribavirin group, 46 mg·kg-1), and low- and high-dose Huzhang groups(0.75, 2.25 g·kg-1), with 12 mice in each group. Except for the blank group, all other groups were infected with RSV via intranasal instillation. The drug intervention groups were given corresponding doses of drug by gavage for 3 consecutive days, while normal saline was used in the blank and model groups. Hematoxylin-eosin(HE) staining was used to observe pathological changes in mouse lung tissue. Real-time fluorescence quantitative polymerase chain reaction(Real-time PCR) was employed to detect viral loads[RSV-nucleoprotein(N) and RSV-glycoprotein(G) mRNA] and inflammatory factor levels[interleukin(IL)-1β and tumor necrosis factor(TNF)-α mRNA] in the lung tissue. Mouse bronchoalveolar lavage fluid was collected to detect the levels of pulmonary surfactant lipids through ultra-high performance liquid chromatography-quadrupole-electrostatic field orbitrap high-resolution mass spectrometry(UPLC-Q-Exactive Orbitrap-MS), followed by principal component analysis and differential lipid identification. ResultsCompared with the blank group, the model group exhibited extensive inflammatory cell infiltration, congestion, and tissue damage in the lungs, and the pathological score and lung index of lung tissue significantly increased(P<0.01), along with significantly elevated mRNA expressions of RSV-N, RSV-G, IL-1β, and TNF-α(P<0.01). Compared with the model group, different doses of Huzhang and ribavirin significantly reduced the pathological scores of the lung tissue and lung index(P<0.01). In addition, the mRNA levels of RSV-N, RSV-G and TNF-α in the lungs significantly decreased in the Huzhang high dose group(P<0.01). Lipidomics analysis identified multiple significantly changed differential metabolites. Compared with the blank group, the model group showed obvious abnormal lipid metabolism, which was manifested by the elevated levels of prostaglandin(PG), ceramide(Cer), phosphatidylcholine(PC), phosphatidylethanolamine(PE), phosphatidylinositol(PI), sphingomyelin(SM), and the decreased levels of diglycerides(DG) and acylethanolamine(NAE). After the intervention of low dose of Huzhang, the above lipid metabolites showed a significant reversal trend, while the intervention of high dose of Huzhang could regulate levels of PI lipids, PG lipids and PC lipids. ConclusionHuzhang can significantly reduce the viral load of lung tissue and improve lung inflammation in RSV-infected mice. The underlying mechanism may be related to the maintenance of homeostasis in pulmonary surfactant lipids such as PI and PG.
2.Exploring Mechanism of Polygoni Cuspidati Rhizoma et Radix in Treating Respiratory Syncytial Virus Infection Based on Pulmonary Surfactant Lipid Homeostasis
Xiaorong WANG ; Keyu TAO ; Jianjian JI ; Yingmei DONG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(21):102-108
ObjectiveTo investigate the efficacy and mechanism of Polygoni Cuspidati Rhizoma et Radix (Huzhang) in treating respiratory syncytial virus(RSV) infection by regulating pulmonary surfactant lipid homeostasis through lipidomics. MethodsSixty BALB/c mice were randomly divided into the blank group, model group, positive group(ribavirin group, 46 mg·kg-1), and low- and high-dose Huzhang groups(0.75, 2.25 g·kg-1), with 12 mice in each group. Except for the blank group, all other groups were infected with RSV via intranasal instillation. The drug intervention groups were given corresponding doses of drug by gavage for 3 consecutive days, while normal saline was used in the blank and model groups. Hematoxylin-eosin(HE) staining was used to observe pathological changes in mouse lung tissue. Real-time fluorescence quantitative polymerase chain reaction(Real-time PCR) was employed to detect viral loads[RSV-nucleoprotein(N) and RSV-glycoprotein(G) mRNA] and inflammatory factor levels[interleukin(IL)-1β and tumor necrosis factor(TNF)-α mRNA] in the lung tissue. Mouse bronchoalveolar lavage fluid was collected to detect the levels of pulmonary surfactant lipids through ultra-high performance liquid chromatography-quadrupole-electrostatic field orbitrap high-resolution mass spectrometry(UPLC-Q-Exactive Orbitrap-MS), followed by principal component analysis and differential lipid identification. ResultsCompared with the blank group, the model group exhibited extensive inflammatory cell infiltration, congestion, and tissue damage in the lungs, and the pathological score and lung index of lung tissue significantly increased(P<0.01), along with significantly elevated mRNA expressions of RSV-N, RSV-G, IL-1β, and TNF-α(P<0.01). Compared with the model group, different doses of Huzhang and ribavirin significantly reduced the pathological scores of the lung tissue and lung index(P<0.01). In addition, the mRNA levels of RSV-N, RSV-G and TNF-α in the lungs significantly decreased in the Huzhang high dose group(P<0.01). Lipidomics analysis identified multiple significantly changed differential metabolites. Compared with the blank group, the model group showed obvious abnormal lipid metabolism, which was manifested by the elevated levels of prostaglandin(PG), ceramide(Cer), phosphatidylcholine(PC), phosphatidylethanolamine(PE), phosphatidylinositol(PI), sphingomyelin(SM), and the decreased levels of diglycerides(DG) and acylethanolamine(NAE). After the intervention of low dose of Huzhang, the above lipid metabolites showed a significant reversal trend, while the intervention of high dose of Huzhang could regulate levels of PI lipids, PG lipids and PC lipids. ConclusionHuzhang can significantly reduce the viral load of lung tissue and improve lung inflammation in RSV-infected mice. The underlying mechanism may be related to the maintenance of homeostasis in pulmonary surfactant lipids such as PI and PG.
3.Genotype drug resistance in human immunodeficiency virus/acquired immunodeficiency syndrome patients with antiviral therapy failure in Yunnan Province from 2021 to 2023
Hongli FAN ; Mi ZHANG ; Jiafa LIU ; Junchuan YE ; Xia LI ; Jiali WANG ; Xuemei DENG ; Lin WANG ; Sha MA ; Jianjian LI
Chinese Journal of Infectious Diseases 2025;43(7):395-402
Objective:To investigate the overall drug resistance, drug resistance trend and distribution of drug resistance mutation sites in human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients with antiviral therapy failure in Yunnan Province.Methods:The demographic data and genotype drug resistance of HIV/AIDS population with antiviral therapy failure in Yunnan Province from January 2021 to December 2023 were collected and analyzed by cross-sectional investigation. Statistical analyses were performed using chi-square test.Results:Among 15 159 HIV/AIDS patients, 12 215 cases tested positive by amplification. The circulating recombinant form (CRF) 08_BC was the predominant genetic subtype, accounting for 54.97%(6 714/12 215), followed by CRF01_AE (16.14%(1 972/12 215)) and CRF07_BC (14.48% (1 769/12 215)). When the viral load was ≥200 to <1 000 copies/mL, the incidence of drug resistance was 21.48%(99/461). When it was ≥1 000 to <10 000 copies/mL, the incidence was 51.29%(2 867/5 590). When it was ≥10 000 to <100 000 copies/mL, the incidence was 69.39% (3 979/5 734). When it was ≥100 000 copies/mL, the incidence was 81.86%(352/430). A total of 7 297 drug resistant cases were detected, with a drug resistance rate of 59.74% (7 297/12 215), thus the estimated drug resistance incidence rate among the antiviral treated population in Yunnan Province was 2.00% (7 297/364 238). From 2021 to 2023, the annual drug resistance rates among patients were 60.71%(2 554/4 207), 60.28%(1 671/2 772), and 58.67% (3 072/5 236), respectively, with no statistically significant difference ( χ2=4.47, P=0.107). Among the population with antiviral therapy failure, the drug resistance rates of non-nucleoside reverse transcriptase inhibitor (NNRTI), nucleoside reverse transcriptase inhibitor (NRTI), and protease inhibitor (PI) were 93.70%(6 837/7 297), 44.10%(3 218/7 297) and 5.15%(376/7 297), respectively. The mutation sites with the highest frequencies among the three classes of drugs including NRTI, NNRTI and PI were M184V/I (46.13%(2 123/4 602)), K103N/S (37.14%(2 648/7 129)), L33F (15.50%(82/529)) and M46I/L (15.50%(82/529)), respectively. Analysis of the degree of drug resistance showed that among NNRTI drugs, nevirapine (49.01%(5 987/12 215)) and efavirenz (48.00%(5 863/12 215)) had the highest drug resistance rates, followed by emtricitabine (23.59%(2 882/12 215)) and lamivudine (23.58%(2 881/12 215)) among NRTI drugs. Conclusions:Among HIV/AIDS patients with antiviral therapy failure in Yunnan Province from 2021 to 2023, CRF08_BC is the main genetic subtype. The drug resistance rate of patients increases with the increase of HIV-1 viral load. There is no significant change in the drug resistance rate from 2021 to 2023. NNRTI has the highest drug resistance rate, followed by NRTI, and PI has the lowest. The main mutation sites are M184V/I for NRTI, K103N/S for NNRTI, and M46I/L and L33F for PI. The drug resistance rates of nevirapine, efavirenz, emtricitabine and lamivudine are relatively high.
4.Classification of bilobar anterolateral thigh perforator flaps based on color Doppler ultrasound and donor site evaluation
Fuqiang YANG ; Yuxiang ZHAO ; Xuejian GAO ; Jianjian GE ; Qishen FAN ; Jianguo WANG ; Xiaodong ZHAO
Chinese Journal of Orthopaedic Trauma 2025;27(6):521-528
Objective:To explore the classification of bilobar anterolateral thigh perforator flaps assisted by color Doppler ultrasonography and its impact on their donor sites.Methods:A retrospective analysis was conducted of the data of 67 patients with large soft tissue defects who had been repaired with anterolateral thigh perforator flaps at Department of Orthopaedics, The Hospital Affiliated to The Second Medical University of Shandong, Department of Orthopaedics, The 80th Group Army Hospital of the People's Liberation Army, and Department of Orthopaedics, Weifang Traditional Chinese Medicine Hospital. The patients were divided into 2 groups according to their flaps used: a unilobar group and a bilobar group. In the unilobar group, 36 cases [25 males and 11 females with an age of (40.3±8.3) years] were repaired with a unilobar anterolateral thigh perforator flap from March 2015 to April 2019. In the bilobar group, 31 cases [22 males and 9 females with an age of (38.9±7.4) years] were repaired with a bilobar anterolateral thigh perforator flap from May 2019 to August 2023. Color Doppler ultrasonography was used to classify the bilobar flaps into 4 types according to the different distributions of perforating vessels: common trunk type, separate trunks type, fascia dependent type, and composite mixed type. The number of perforating vessels and type of perforator flap found by preoperative color Doppler ultrasound were compared with the intraoperative findings in the bilobar group. One year after operation, recovery rate of donor muscle strength, rate of skin paresthesia, scar length at the donor site, the widest scar width and motor function were compared between the 2 groups.Results:The number of perforating vessels and type of perforator flap found by preoperative color Doppler ultrasound were consistent with the intraoperative findings ( P<0.05). There was no significant difference in the preoperative general data between the 2 groups, indicating comparability ( P>0.05). One year after operation in the bilobar group, the recovery rate of donor muscle strength was 96.8% (30/31), significantly higher than that in the unilobar group [77.8% (28/36)], the rate of skin paresthesia 6.5% (2/31), significantly lower than that in the unilobar group [27.8% (10/36)], the scar length at the donor site (22.18±5.02) cm, significantly longer than that in unilobar group [(17.35±3.11) cm], the widest scar width (7.26±1.58) mm, significantly narrower than that in the unilobar group [(43.72±9.81) mm], and the scores of Vancouver Scar Assessment Scale and Fugl-Meyer lower limb motor function scale were (1.95±0.57) points and (8.39±2.17) points, respectively, significantly lower than those in the unilobar group [(6.38±1.72) points and (14.02±3.54) points] ( P<0.05). Conclusions:Preoperative classification of bilobar anterolateral thigh perforator flaps assisted by color Doppler ultrasonography may provide guidance for flap harvesting and lobe layout of the flap. Compared to traditional unilobar flaps, bilobar ones may minimize tissue damage at a donor site.
5.Isolation and protection of organs at risk by crosslinked sodium hyaluronate gel during brachytherapy
Jianjian LIU ; Yan ZHANG ; Zhiwei CUI ; Dongfang WANG ; Xu LIU ; Shenglin YANG ; Qian CHAI ; Fenglin LIU
Chinese Journal of Tissue Engineering Research 2025;29(4):700-706
BACKGROUND:Crosslinked sodium hyaluronate gel has good mechanical property,biocompatibility,and biodegradability,and can be used as an isolated protective material in tumor radiation therapy to protect endangered organs from damage caused by excess radiation dose. OBJECTIVE:To investigate the safety and efficacy of crosslinked sodium hyaluronate gel in reducing the dose of radiation to dangerous organs during brachytherapy. METHODS:A total of 16 specific pathogen-free Kunming mice of the same age and similar body weight were selected as experimental subjects and divided into experimental group and control group by the random number table method,with 8 mice in each group.125I seeds were implanted subcutaneously in the back of mice in the experimental group,and then crosslinked sodium hyaluronate gel was injected around the radioactive particles.Only 125I seeds were implanted subcutaneously in the back of mice in the control group.After injection,the distance between the radioactive particles and the epidermis was measured by spiral CT scan,and the surface radiation dose was measured by radiation dosimeter.Within 10 weeks after injection,the growth state,survival rate,skin radiation damage,and gel retention of mice were observed. RESULTS AND CONCLUSION:(1)Spiral CT scan showed that the implanted gel was relatively concentrated and created an effective distance between the radioactive seeds and the epidermis.The body surface radiation dose of the experimental group was significantly lower than that of the control group(P<0.01).(2)During the experimental observation period,mice in both groups survived;mice in the control group showed obvious irritability and other unstable behavior in the late experimental period,and some mice in the experimental group showed similar behavior.The daily food intake of mice in the two groups had no significant change,and the body mass showed the same increasing trend.After implantation of radioactive seeds,the two groups of mice showed different degrees of radioactive skin injury.From day 23 after injection to the end of the experiment,the skin radiation injury score of the experimental group was lower than that of the control group(P<0.01).At week 10 after implantation,6 mice in the experimental group had no obvious gel residue under their skin,and 2 mice had a very small amount of scattered gel-like samples under their skin.(3)Therefore,the crosslinked sodium hyaluronate injection technique can increase the space between the radioactive target area of 125I seeds and the organ at risk outside the target through physical space occupying,which can effectively reduce the dose of the organ at risk,and play a role in the isolation and protection of the organ at risk.
6.Genotype drug resistance in human immunodeficiency virus/acquired immunodeficiency syndrome patients with antiviral therapy failure in Yunnan Province from 2021 to 2023
Hongli FAN ; Mi ZHANG ; Jiafa LIU ; Junchuan YE ; Xia LI ; Jiali WANG ; Xuemei DENG ; Lin WANG ; Sha MA ; Jianjian LI
Chinese Journal of Infectious Diseases 2025;43(7):395-402
Objective:To investigate the overall drug resistance, drug resistance trend and distribution of drug resistance mutation sites in human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients with antiviral therapy failure in Yunnan Province.Methods:The demographic data and genotype drug resistance of HIV/AIDS population with antiviral therapy failure in Yunnan Province from January 2021 to December 2023 were collected and analyzed by cross-sectional investigation. Statistical analyses were performed using chi-square test.Results:Among 15 159 HIV/AIDS patients, 12 215 cases tested positive by amplification. The circulating recombinant form (CRF) 08_BC was the predominant genetic subtype, accounting for 54.97%(6 714/12 215), followed by CRF01_AE (16.14%(1 972/12 215)) and CRF07_BC (14.48% (1 769/12 215)). When the viral load was ≥200 to <1 000 copies/mL, the incidence of drug resistance was 21.48%(99/461). When it was ≥1 000 to <10 000 copies/mL, the incidence was 51.29%(2 867/5 590). When it was ≥10 000 to <100 000 copies/mL, the incidence was 69.39% (3 979/5 734). When it was ≥100 000 copies/mL, the incidence was 81.86%(352/430). A total of 7 297 drug resistant cases were detected, with a drug resistance rate of 59.74% (7 297/12 215), thus the estimated drug resistance incidence rate among the antiviral treated population in Yunnan Province was 2.00% (7 297/364 238). From 2021 to 2023, the annual drug resistance rates among patients were 60.71%(2 554/4 207), 60.28%(1 671/2 772), and 58.67% (3 072/5 236), respectively, with no statistically significant difference ( χ2=4.47, P=0.107). Among the population with antiviral therapy failure, the drug resistance rates of non-nucleoside reverse transcriptase inhibitor (NNRTI), nucleoside reverse transcriptase inhibitor (NRTI), and protease inhibitor (PI) were 93.70%(6 837/7 297), 44.10%(3 218/7 297) and 5.15%(376/7 297), respectively. The mutation sites with the highest frequencies among the three classes of drugs including NRTI, NNRTI and PI were M184V/I (46.13%(2 123/4 602)), K103N/S (37.14%(2 648/7 129)), L33F (15.50%(82/529)) and M46I/L (15.50%(82/529)), respectively. Analysis of the degree of drug resistance showed that among NNRTI drugs, nevirapine (49.01%(5 987/12 215)) and efavirenz (48.00%(5 863/12 215)) had the highest drug resistance rates, followed by emtricitabine (23.59%(2 882/12 215)) and lamivudine (23.58%(2 881/12 215)) among NRTI drugs. Conclusions:Among HIV/AIDS patients with antiviral therapy failure in Yunnan Province from 2021 to 2023, CRF08_BC is the main genetic subtype. The drug resistance rate of patients increases with the increase of HIV-1 viral load. There is no significant change in the drug resistance rate from 2021 to 2023. NNRTI has the highest drug resistance rate, followed by NRTI, and PI has the lowest. The main mutation sites are M184V/I for NRTI, K103N/S for NNRTI, and M46I/L and L33F for PI. The drug resistance rates of nevirapine, efavirenz, emtricitabine and lamivudine are relatively high.
7.Classification of bilobar anterolateral thigh perforator flaps based on color Doppler ultrasound and donor site evaluation
Fuqiang YANG ; Yuxiang ZHAO ; Xuejian GAO ; Jianjian GE ; Qishen FAN ; Jianguo WANG ; Xiaodong ZHAO
Chinese Journal of Orthopaedic Trauma 2025;27(6):521-528
Objective:To explore the classification of bilobar anterolateral thigh perforator flaps assisted by color Doppler ultrasonography and its impact on their donor sites.Methods:A retrospective analysis was conducted of the data of 67 patients with large soft tissue defects who had been repaired with anterolateral thigh perforator flaps at Department of Orthopaedics, The Hospital Affiliated to The Second Medical University of Shandong, Department of Orthopaedics, The 80th Group Army Hospital of the People's Liberation Army, and Department of Orthopaedics, Weifang Traditional Chinese Medicine Hospital. The patients were divided into 2 groups according to their flaps used: a unilobar group and a bilobar group. In the unilobar group, 36 cases [25 males and 11 females with an age of (40.3±8.3) years] were repaired with a unilobar anterolateral thigh perforator flap from March 2015 to April 2019. In the bilobar group, 31 cases [22 males and 9 females with an age of (38.9±7.4) years] were repaired with a bilobar anterolateral thigh perforator flap from May 2019 to August 2023. Color Doppler ultrasonography was used to classify the bilobar flaps into 4 types according to the different distributions of perforating vessels: common trunk type, separate trunks type, fascia dependent type, and composite mixed type. The number of perforating vessels and type of perforator flap found by preoperative color Doppler ultrasound were compared with the intraoperative findings in the bilobar group. One year after operation, recovery rate of donor muscle strength, rate of skin paresthesia, scar length at the donor site, the widest scar width and motor function were compared between the 2 groups.Results:The number of perforating vessels and type of perforator flap found by preoperative color Doppler ultrasound were consistent with the intraoperative findings ( P<0.05). There was no significant difference in the preoperative general data between the 2 groups, indicating comparability ( P>0.05). One year after operation in the bilobar group, the recovery rate of donor muscle strength was 96.8% (30/31), significantly higher than that in the unilobar group [77.8% (28/36)], the rate of skin paresthesia 6.5% (2/31), significantly lower than that in the unilobar group [27.8% (10/36)], the scar length at the donor site (22.18±5.02) cm, significantly longer than that in unilobar group [(17.35±3.11) cm], the widest scar width (7.26±1.58) mm, significantly narrower than that in the unilobar group [(43.72±9.81) mm], and the scores of Vancouver Scar Assessment Scale and Fugl-Meyer lower limb motor function scale were (1.95±0.57) points and (8.39±2.17) points, respectively, significantly lower than those in the unilobar group [(6.38±1.72) points and (14.02±3.54) points] ( P<0.05). Conclusions:Preoperative classification of bilobar anterolateral thigh perforator flaps assisted by color Doppler ultrasonography may provide guidance for flap harvesting and lobe layout of the flap. Compared to traditional unilobar flaps, bilobar ones may minimize tissue damage at a donor site.
8.Correlations of STAT3 and STAT4 gene polymorphisms with myasthenia gravis susceptibility
Hui DENG ; Jianjian WANG ; Xiaotong KONG ; Yuan YAN
Chinese Journal of Neuromedicine 2024;23(10):1012-1020
Objective:To investigate the correlations of myasthenia gravis (MG) susceptibility with STAT3 (rs744166 and rs1053005) and STAT4 (rs7574865) gene polymorphisms. Methods:A total of 149 MG patients admitted to Department of Neurology, Second Affiliated Hospital of Harbin Medical University from September 2019 to June 2022 were selected as MG group, and 148 subjects accepted physical examination in our hospital at the same period were selected as control group. Peripheral venous blood of all subjects was collected. Improved multiplex ligation detection reaction (imLDR) assay was used to detect the STAT3 (rs744166 and rs1053005) and STAT4 (rs7574865) gene polymorphisms. Differences in polymorphisms of various gene loci were compared between the MG group and control group, among subjects with different gender or age, between MG patients with and without thymoma, between AChR-Ab positive and AChR-Ab negative MG patients, and between patients with eye muscle MG and systemic MG. Results:(1) Compared with the control group, the MG group had significantly increased GT and TT genotype and T allele frequencies (37.2% vs. 57.0%; 10.1% vs. 11.4%; 28.7% vs. 39.9%), and decreased GG genotype and G allele frequencies (52.7% vs. 31.5%; 71.3% vs. 60.1%) at rs7574865 locus in STAT4 gene ( P<0.05). (2) Compared with male subjects in the control group, the male patients in MG group had significantly increased GT and TT genotype and T allele frequencies, and decreased GG genotype and G allele frequencies at rs7574865 locus in STAT4 gene ( P<0.05); compared with female subjects in the control group, the female patients in MG group had significantly increased GT and TT genotype frequencies and decreased GG genotype frequency at rs7574865 locus in STAT4 gene ( P<0.05). Compared with subjects≤50 years old in the control group, patients≤50 years old in the MG group had significantly increased GT and TT genotype and T allele frequencies, and decreased GG genotype and G allele frequencies at rs7574865 locus in STAT4 gene ( P<0.05); compared with subjects>50 years old in the control group, patients>50 years old in the MG group had significantly increased GT genotype frequency and decreased GG and TT genotype frequencies at rs7574865 locus in STAT4 gene ( P<0.05). (3) No significant differences in genotype and allele frequencies were noted between MG patients with and without thymoma, between AChR-Ab positive and AChR-Ab negative MG patients, or between patients with eye muscle MG and systemic MG ( P>0.05). Conclusion:MG susceptibility is associated with rs7574865 polymorphism of STAT4 gene; the male subjects or subjects≤50 years old with GT/TT genotype or T allele are susceptible to MG.
9.Prediction of Triple-Negative Breast Cancer Based on Digital Mammography Radiomics Nomogram:A Multicenter Study
Yuhai XIE ; Peiqi MA ; Jianjian HAN ; Xiaole WANG ; Dong HU ; Wenjun MA ; Tianxian WEI ; Yang YANG
Chinese Journal of Medical Imaging 2024;32(11):1140-1146
Purpose To investigate the clinical value of multi-center digital mammography radiomics nomogram model in predicting triple-negative breast cancer(TNBC).Materials and Methods The digital mammograms of 462 patients with pathologically confirmed breast cancer from November 2016 to March 2022 were retrospectively analyzed,including 243 cases from Yijishan Hospital of Wannan Medical College(institution 1),106 cases from Fuyang People's Hospital(institution 2)and 113 cases from Taihe People's Hospital(institution 3).According to the results of immunohistochemistry,a total of 349 breast cancer patients in institution 1 and institution 2 were randomly divided into the training group(244 cases,including 41 TNBC and 203 non-TNBC)and the validation group(105 cases,including 18 TNBC and 87 non-TNBC)according to the ratio of 7∶3,113 breast cancer patients(24 TNBC and 89 non-TNBC)from institution 3 were included in the external validation group.Comparing the mediolateral oblique and cranial cauda digital mammography images,the mammography imaging with larger lesion areas were selected,and the image segmentation and radiomics feature extraction were performed.The radiomics model was constructed by using Logistic regression.The clinicopathological parameters and radiomics scores were used to construct a nomogram.Receiver operating characteristic and decision curve analysis were used to evaluate the model performance.To compare The predictive performance between the models was compared.Results Finally,four radiomics features closely related to TNBC were selected to construct an radiomics model.The area under the curve,sensitivity and specificity of TNBC predicted by the radiomics model in training group,validation group and external test group were 0.868,90.24%and 72.91%,0.827,72.22%and 75.86%,0.837,70.83%and 78.65%,respectively.The area under the curve,sensitivity and specificity of TNBC predicted by the combined model in the training group,validation group and external test group were 0.903,80.49%and 86.70%,0.890,77.78%and 88.51%,0.870,62.50%and 85.39%,respectively.The combined model was better than the single image omics model in predicting TNBC,and the difference was statistically significant between the training group and the verification group(Z=2.061,2.064,both P<0.05),but not between the external test group(Z=1.223,P=0.221).In three group,decision curve analysis showed that the nomogram predicted a higher net benefit than the radiomics model for triple-negative breast cancer.Conclusion The radiomics model has high diagnostic efficiency in predicting TNBC,and the nomogram model combined with the radiomics score and histological grading can further improve the prediction efficiency.
10.Consensus statement on research and application of Chinese herbal medicine derived extracellular vesicles-like particles (2023 edition).
Qing ZHAO ; Tong WANG ; Hongbin WANG ; Peng CAO ; Chengyu JIANG ; Hongzhi QIAO ; Lihua PENG ; Xingdong LIN ; Yunyao JIANG ; Honglei JIN ; Huantian ZHANG ; Shengpeng WANG ; Yang WANG ; Ying WANG ; Xi CHEN ; Junbing FAN ; Bo LI ; Geng LI ; Bifeng LIU ; Zhiyang LI ; Suhua QI ; Mingzhen ZHANG ; Jianjian ZHENG ; Jiuyao ZHOU ; Lei ZHENG ; Kewei ZHAO
Chinese Herbal Medicines 2024;16(1):3-12
To promote the development of extracellular vesicles of herbal medicine especially the establishment of standardization, led by the National Expert Committee on Research and Application of Chinese Herbal Vesicles, research experts in the field of herbal medicine and extracellular vesicles were invited nationwide with the support of the Expert Committee on Research and Application of Chinese Herbal Vesicles, Professional Committee on Extracellular Vesicle Research and Application, Chinese Society of Research Hospitals and the Guangdong Engineering Research Center of Chinese Herbal Vesicles. Based on the collation of relevant literature, we have adopted the Delphi method, the consensus meeting method combined with the nominal group method to form a discussion draft of "Consensus statement on research and application of Chinese herbal medicine derived extracellular vesicles-like particles (2023)". The first draft was discussed in online and offline meetings on October 12, 14, November 2, 2022 and April and May 2023 on the current status of research, nomenclature, isolation methods, quality standards and research applications of extracellular vesicles of Chinese herbal medicines, and 13 consensus opinions were finally formed. At the Third Academic Conference on Research and Application of Chinese Herbal Vesicles, held on May 26, 2023, Kewei Zhao, convenor of the consensus, presented and read the consensus to the experts of the Expert Committee on Research and Application of Chinese Herbal Vesicles. The consensus highlights the characteristics and advantages of Chinese medicine, inherits the essence, and keeps the righteousness and innovation, aiming to provide a reference for colleagues engaged in research and application of Chinese herbal vesicles at home and abroad, decode the mystery behind Chinese herbal vesicles together, establish a safe, effective and controllable accurate Chinese herbal vesicle prevention and treatment system, and build a bridge for Chinese medicine to the world.

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