1.Application of the combined tumor burden score and platelet-albumin-bilirubin score model for predicting postoperative tumor recurrence in liver transplant recipients with hepatocellular carcinoma
Weidong ZHU ; Junyang XIAO ; Xiaoji QIU ; Lizhi LÜ ; Jianwei CHEN ; Fang YANG
Organ Transplantation 2025;16(4):556-564
Objective To investigate the predictive value of the combined tumor burden score (TBS) and platelet-albumin-bilirubin (PALBI) score model for postoperative tumor recurrence in liver transplant recipients with hepatocellular carcinoma (HCC). Methods The general information of 158 recipients diagnosed with HCC and underwent liver transplantation at the 900th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army from 2008 to 2021 was collected. Lasso regression analysis combined with multivariate Cox regression analysis were used to identify independent risk factors for postoperative tumor recurrence after liver transplantation with HCC. A nomogram prediction model was constructed based on variables selected by Lasso regression analysis, and the predictive performance of the model was verified by calibration curve and clinical decision curve. The optimal cut-off values for postoperative tumor recurrence in liver transplant recipients with HCC were determined by receiver operating characteristic (ROC) curve, and Kaplan-Meier analysis was used to compare survival differences among different groups. Results Among the 158 liver transplant recipients with HCC, 82 experienced tumor recurrence, with a recurrence rate of 51.9% and a median tumor-free survival time of 10 (4, 25) months. Results of Lasso regression analysis and multivariate Cox regression analysis showed that alpha-fetoprotein (AFP) ≥400 ng/mL, TBS and PALBI score were all independent risk factors for postoperative tumor recurrence in liver transplant recipients with HCC (all P<0.05). The combined high TBS-high PALBI score showed the highest predictive value (hazard ratio 6.909, 95% confidence interval 3.067-15.563, P<0.001). A nomogram prediction model was constructed based on six variables selected by Lasso regression analysis. Calibration curve showed good consistency between the model's predicted results and the ideal curve. Decision curve analysis indicated that the nomogram prediction model provided the highest clinical benefit for predicting 1-year tumor-free survival after liver transplantation with HCC. Time-dependent ROC curves at 1, 3 and 5 years after surgery showed that TBS-PALBI model had good predictive performance, with no significant difference in area under the curve (AUC) compared with TBS-PALBI-AFP model. The optimal cut-off values for predicting postoperative tumor recurrence were determined by ROC curve, with a PALBI score cut-off of −2.334 and a TBS cut-off of 5.305. Recipients were divided into a low TBS-low PALBI score group (n=47) and a low/high TBS-low/high PALBI score group (at least one score was high) (n=111). Kaplan-Meier survival analysis showed that the low TBS-low PALBI score group had a higher tumor-free survival rate than the low/high TBS-low/high PALBI score group, with a significant difference (P<0.05). Conclusions TBS-PALBI model provides a novel, simple and effective tool for assessing the prognosis of liver transplant recipients with HCC. The nomogram model constructed based on this has significant advantages in predictive performance and may serve as a reference for guiding individualized treatment plans and improving clinical outcomes.
2.Textual Research on Lianggesan from Ancient Literature and Its Modern Clinical Application
Weilu NIU ; Chengqi LYU ; Mengjie YANG ; Shunxi WANG ; Jingkang QIAO ; Huangchao JIA ; Liyun WANG ; Xuewei LIU ; Mingsan MIAO ; Jianwei LI ; Gang WANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(22):223-234
Lianggesan was first recorded in Taiping Huimin Heji Jufang, which was composed of Rhei Radix et Rhizoma, Natrii Sulfas, Gardeniae Fructus, Forsythiae Fructus, Scutellariae Radix, Glycyrrhizae Radix et Rhizoma(GRR), Menthae Haplocalycis Herba, Lophatheri Herba and Mel. It was clinically applied to treat fire-heat syndrome in the upper and middle Jiao, and the curative effect was positive. In this study, the bibliometric method was used to conduct a detailed textual research on the formula name, medicinal composition, dosage evolution, origin and processing, functional indications and other aspects of Lianggesan. Research revealed that Lianggesan has six other names, such as Lianqiao Yinzi, Lianqiao Jiedusan, Jufang Lianggesan, Jiegu Lianggesan, Hejian Lianggesan and Qingji Lianggesan. Based on the edition of Taiping Huimin Heji Jufang, an analysis of the evolution of its formula composition revealed that the missing Chinese medicines were predominantly bamboo leaves and honey, while the added Chinese medicines were primarily supplements introduced to address changes in disease manifestations. After textual research, the dosage for one dose of Lianggesan from Taiping Huimin Heji Jufang was as follows:826 g of Rhei Radix et Rhizoma, 826 g of Natrii Sulfas, 826 g of GRR, 413 g of Gardeniae Fructus, 413 g of Menthae Haplocalycis Herba, 413 g of Scutellariae Radix, and 1652 g of Forsythiae Fructus. Decocting method was as following:Grinding the Chinese medicines into coarse powder(2-4 mm), taking 8.16 g per dose, adding 300 mL of water, along with 2 g of Lophatheri Herba and 5 g of Mel, and decocting to 140 mL. The residue was removed and taken warmly 30 min after meals. It was recommended to take it three times daily until improvement was achieved. The origins of the 9 Chinese medicines were consistent with the 2020 edition of Pharmacopoeia of the People's Republic of China. Except for GRR, which required single frying(stir-frying), the remaining medicines were all raw products. The description of the function of this formula in ancient books was summarized as purging fire and promoting bowel movements, clearing heat from the upper body and purging the lower body, and the main syndromes included facial redness, tongue swelling, red eyes, etc. In modern applications, the formula is primarily used for respiratory and digestive system diseases, including acute lung injury, chronic obstructive pulmonary disease, herpetic angina and aphthous stomatitis, covering 142 types of diseases. In summary, this paper can provide a basis for further research and development of Lianggesan through the literature review and key information combing.
3.Establishment and performance evaluation of nanobody-based cat dander specific IgE antibody hypersensitivity assay
Yanyan SUN ; Desheng QI ; Furao SHEN ; Caiyue YANG ; Xiangmei SUN ; Guoning CHEN ; Jianwei WU
Chinese Journal of Immunology 2024;40(4):818-823
Objective:To prepare anti-human IgE nanobody by phage display technology,and to establish a method for hyper-sensitivity detection of cat dander specific IgE antibody.Methods:Allergen bio-information of cat was searched in WHO/IUIS Allergen Database.After synthesizing sequence,recombinant cat dander allergenic protein Fel d 1 was expressed and purified in prokaryotic ex-pression system.Human IgE was used to immunize Bactrian camel and RNA were extracted from lymphocyte to construct phage dis-play library.Library capacity,diversity and insertion rate were analyzed,anti-human IgE nanobody were obtained by screening and identification.A magnetic particle chemical method for cat dander specific IgE antibody detection was established using recombinant allergen-coupled magnetic particles and acridine ester-labeled nanobodies.Results:Capacity of phage display library was 1.88×108 cfu/ml,insertion rate was 93.6%,and purity of nanobody was>95%.Linear range of the method based on nanobody was 0.1~100 U/ml,who was consistent with ImmunoCAP detection system by clinical data.Conclusion:Nanobody-based cat dander specific IgE antibody hypersensitivity assay is successfully prepared,providing a technical basis for auxiliary diagnosis of cat allergic diseases.
4.Efficacy of high-flow nasal cannula oxygen therapy for respiratory support after tracheal extubation under general anesthesia in neonates
Menglin SUN ; Jianwei GE ; Bo YANG ; Bo LIU ; Guangchao ZHU ; Tao WANG ; Yuxia WANG ; Changsheng LI ; Lihua JIANG
Chinese Journal of Anesthesiology 2024;44(10):1217-1220
Objective:To assess the efficacy of high-flow nasal cannula oxygen therapy for the respiratory support after tracheal extubation under general anesthesia in neonates.Methods:This was a prospective randomized controlled study. Ninety-four neonates undergoing general surgery under general anesthesia with endotracheal intubation and endotracheal tube removal following surgery from December 2022 to November 2023 in the Third Affiliated Hospital of Zhengzhou University were selected and divided into 2 groups ( n=47 each) by the random number table method: conventional oxygen therapy group (group C) and high-flow nasal cannula oxygen therapy group (group H). After the endotracheal tube was removed, group H underwent high-flow nasal cannula oxygen therapy: oxygen flow was 2 L·kg -1·min -1, the concentration and humidity of oxygen were both 100%, and the temperature was 37 ℃. Group C underwent conventional mask ventilation with the oxygen flow rate 5 L/min, oxygen concentration 100%, ventilation frequency about 25-35 times/min. The outcome measures were recorded from the time after extubation to the time before discharge from the operating theatre. The main outcome measures were the minimum SpO 2 and hypoxemia (SpO 2<90%), choking, laryngospasm and asphyxia. The secondary outcome measures were respiratory rate (immediate extubation, immediate discharge), minimum HR, and time to discharge from the operating theatre. Results:Compared with group C, the lowest SpO 2 was significantly increased, the incidence of hypoxemia and respiratory rate immediately after discharge from the operating room was decreased ( P<0.05), and no significant changes were found in the incidence of choking, laryngospasm and asphyxia, the lowest heart rate, respiratory rate immediately after tracheal extubation and time to discharge from the operating theatre in group H( P>0.05). Conclusions:High-flow nasal cannula oxygen therapy can improve oxygenation and significantly reduce the risk of hypoxemia when used for the respiratory support after tracheal extubation under general anesthesia in neonates.
5.Screening and analysis of differentially expressed genes in basal cell carcino-ma of the eyelid
Jianwei YANG ; Lihua SONG ; Juan WANG ; Lulu ZHANG ; Li XIAO ; Hongbin ZHANG ; Limin LIU ; Yandong LIU
Recent Advances in Ophthalmology 2024;44(6):454-457
Objective To screen and analyze the differentially expressed genes(DEGs)in basal cell carcinoma(BCC)of the eyelid using RNA sequencing technology.Methods Six patients who underwent extended resection and primary eyelid reconstruction for BCC of the eyelid in Hebei Eye Hospital from July to November 2021 were selected.Part of the excised cancer tissues and the adjacent normal tissues trimmed during the repair of the defect were sampled for the study.The library construction for sequencing was performed using RNA sequencing technology.The threshold for DEGs was set using the DESeq2 software:P<0.05 and|log2(foldchange)|>1,to identify DEGs.Gene Ontology(GO)and Kyo-to Encyclopedia of Genes and Genomes(KEGG)enrichment analyses were performed using the clusterProfiler software,and the biological significance of these DEGs was further analyzed.Results DESeq2 software was used to analyze the differential expression between cancer tissues and adjacent tissues,and 1 317 DEGs were screened out.In the cancer tis-sues of the 6 patients,906 DEGs were up-regulated,and 411 DEGs were down-regulated.GO enrichment analysis showed that the top 30 up-regulated DEGs were mainly concentrated in humoral immune response,immunoglobulin complex,B cell receptor signaling pathway,extracellular matrix,antigen binding,and receptor modulator activity,and the top 10 down-regulated genes were mainly related to epidermal development in biological process,cell composition,and molecular func-tion.KEGG pathway analysis revealed that DEGs were mainly enriched in the melanogenesis signaling pathway,WNT sig-naling pathway,and immune-related signaling pathway,and there were 8 related gene pathways.According to the signifi-cance of gene up-regulation,the core genes identified finally were FZD2,PTCH1,WNT7B,TCF3,MMP-9,and TEAD2.Conclusion The occurrence of BCC is closely related to the interaction and synergy of various pathways.Among the highly expressed genes,the up-regulation of FZD2,PTCH1,WNT7B,TCF3,MMP-9,and TEAD2 expression in the tissues of patients with BCC of the eyelid is the most significant,which is closely related to the occurrence and development of BCC of the eyelid.
6.Malaria re-importation risk and control needs in the border region, Yunnan
ZHOU Yaowu ; DING Chunli ; YANG Zhongping ; LIN Zurui ; TIAN Peng ; SUN Xiaodong ; DUAN Kaixia ; CHEN Qiyan ; ZHAO Yulong ; XU Jianwei ; ZHOU Hongning
China Tropical Medicine 2024;24(4):394-
Recently, malaria incidence has sharply resurgence in the border area of northern Myanmar, with the parasite incidence rate in 2023 being 21.47 times (95% CI: 18.84-24.48) that of 2019 in Kachin State's Razan and nearby areas. This resurgence caused the number of imported malaria cases to increase from 188 in 2019 to 398 in 2023 in Yunnan Province. In addition to the impact of military conflict, the border malaria joint prevention and control cooperation mechanism and malaria control measures established between China and Myanmar have failed to be implemented effectively due to the impact of the international COVID-19 epidemic. Hence, it is recommended that relevant departments evaluate the quality and effectiveness of the current cross-border transmission measures for malaria in the China-Myanmar border area from a technical perspective, and provide a large demand for primaquine, which can block the spread of malaria and cure vivax malaria, in response to the current prevalent characteristics of vivax malaria predominating in northern Myanmar. Moreover, to effectively reduce the mortality of imported malaria patients and prevent re-importation and transmission, it is necessary to enhance clinical physicians' knowledge, awareness, and vigilance regarding malaria diagnosis and treatment in the Yunnan border region, as well as China's ability and quality of appropriate response to imported malaria.
7.The effect of OSTA index on baPWV in menopausal women and its predictive value for peripheral atherosclerosis
Fangyuan CHENG ; Xiaoqin ZHANG ; Junxiang LI ; Yun LI ; Bihua WU ; Jianwei GU ; Yunfeng YANG ; Juhua LIU
Tianjin Medical Journal 2024;52(10):1079-1083
Objective To investigate the effect of Osteoporosis Self-Assessment Tool for Asia(OSTA)index on brachial ankle pulse wave velocity(baPWV)and its predictive value for peripheral atherosclerosis in menopausal women.Methods A total of 1 138 menopausal women who underwent physical examination at our hospital from January 2022 to December 2022 were enrolled in the study.General clinical data were collected,the OSTA index was calculated,and baPWV was measured.Patients were divided into the control group(n=539)and the peripheral atherosclerosis group(n=599)according to the baPWV values(peripheral atherosclerosis occurs with baPWV≥1 400 cm/s).Linear regression and Logistic regression were used to analyze the effect of OSTA index on baPWV in menopausal women.The predictive value of peripheral atherosclerosis was evaluated using the receiver operating characteristic(ROC)curve.Results The OSTA index was lower in the peripheral atherosclerosis group than that in the control group[-0.40(-2.20,1.00)vs.0.40(-0.60,1.40),P<0.05].Univariate linear regression analysis was used to conclude that the OSTA index was an influencing factor of baPWV,and after correcting for risk factors,multivariate linear regression analysis indicated that OSTA index still affected the value of baPWV(P<0.05).The linear regression equation was baPWV=-27.911-39.752×OSTA+6.444×SBP+7.008×DBP+11.506×HCY+27.942×Hs-CRP.Logistic regression analysis suggested that increased OSTA index was a protective factor for peripheral atherosclerosis(OR=0.664,95%CI:0.535-0.823,P<0.001).ROC curve analysis suggested that OSTA index was-1.25 as the optimal cutoff point,which predicted peripheral atherosclerosis with an area under the curve of 0.619,a sensitivity of 36.2%and a specificity of 86.3%.Conclusion In menopausal women,OSTA index is an influential factor for baPWV,and increased OSTA index is a protective factor against peripheral atherosclerosis,which can be used to predict baPWV value.
8.Exploring the implementation of licensed assistant pharmacist system in retail pharmacies
Long XU ; Hua YE ; Jianwei YANG ; Ruirui WEN ; Wenjing ZHU
China Pharmacist 2024;27(7):1240-1247
Objective To rationally allocate pharmaceutical and healthcare human resources,and to explore the feasibility of implementing the system of licensed assistant pharmacists in retail pharmacies.Methods Through literature review,questionnaire surveys,and statistical analysis of exam scores,the training status of pharmacy technicians with secondary vocational education,the employment situation in retail pharmacies,and the results of the licensed pharmacist qualification examination were deeply understood.Results Every year,a certain number of graduates with a secondary vocational education in pharmacy entered society,and retail pharmacies were willing to recruit pharmacy technicians with this educational background,their professional competence were recognized.Pharmacy technicians with secondary vocational education can obtain the professional qualification of practicing pharmacists through hard work,and demonstrated the basic competency for working as licensed assistant pharmacists.Conclusion The implementation of the licensed assistant pharmacist system among pharmacy technicians with secondary vocational education in retail pharmacies is feasible.This system can fully leverage the role of pharmacy technicians with secondary vocational education,make up for the shortage of professional personnel in certain regions,promote the construction of the pharmaceutical care system in retail pharmacies,and ensure drug quality and medication safety.
9.Ultra-fast scanning scheme based on deep learning reconstruction for cervical MR examination
Xianfeng RAO ; Shuwen YANG ; Jing CHEN ; Zhengwen KANG ; Jianwei CHEN ; Zetao WU ; Tong WANG ; Bo WANG ; Qiusheng ZHANG
Chinese Journal of Medical Imaging Technology 2024;40(6):843-847
Objective To explore the feasibility and diagnostic value of ultra-fast scanning scheme based on deep learning-based reconstruction(DLR)for cervical MR examination.Methods Thirty-six subjects were prospectively enrolled and underwent both conventional scheme(scan time:6 min 14 s)and ultra-fast scheme(2 min)cervical spine MR scanning to acquire encompassing sagittal T1WI,sagittal adipose suppression T2WI and axial T2WI.The ultra-fast MRI were reconstructed using DLR method.The subjective and objective evaluations on imaging qualities of different MRIs were compared,along with the inter-observer agreement for diagnosing intervertebral disc degeneration and herniation.Results Compared with conventional MRI,artifacts in ultra-fast DLR images significantly reduced(P<0.05).The subjective evaluation results of MRI had good agreement(all Kappa≥0.60).Compared with conventional MRI,the sagittal T1WI,T2WI and axial T2WI obtained with ultra-fast DLR showed significantly improved signal-to-noise ratio(SNR)of the spinal cord,cerebrospinal fluid(CSF)and vertebral body,as well as the spinal cord/CSF contrast(all P<0.001).The Kappa value of 2 physicians for diagnosing intervertebral disc degeneration based on ultra-fast DLR and conventional scheme images was 0.94 and 1.00,respectively,of intervertebral disc herniation was 0.96 and 0.98,respectively.Conclusion Compared with conventional scanning scheme,using ultra-fast DLR scheme in cervical MR examination could shorten scanning time while achieve similar image quality and diagnostic accuracy.
10.Yiqi Wenyang Huwei Decoction in Treatment of Bronchial Asthma in Rats by Regulating TGF-β1/Smad3 Signaling Pathway
Xiaopu SU ; Wei TANG ; Chao YE ; Qiangqiang YU ; Peng SUN ; Yuping YANG ; Jianwei YU
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(19):98-105
ObjectiveTo investigate the effect and mechanism of Yiqi Wenyang Huwei decoction (YWHD) on airway inflammation in bronchial asthma (BA) rats based on transforming growth factor-β1 (TGF-β1)/SMAD family member 3 (Smad3) signaling pathway. MethodSixty male SD rats were randomly divided into a normal group, a model group, a dexamethasone (DEX) group, and low-, medium-, and high-dose YWHD groups, with 10 rats in each group. The BA model was induced by intraperitoneal injection of 1 mL of ovalbumin (OVA)-aluminum hydroxide suspension for sensitization, followed by nebulization with 2% OVA. One hour before daily OVA nebulization, the control group was treated with saline, the DEX group with DEX solution at 0.2 g·L-1, and the low-, medium-, and high-dose YWHD groups with YWHD at 1, 2, 4 g·mL-1, respectively. General conditions and lung function were observed. Bronchoalveolar lavage fluid (BALF) and serum were collected to count inflammatory cells in BALF and measure immunoglobulin E (IgE) levels in serum and inflammatory cytokines in BALF using enzyme-linked immunosorbent assay (ELISA). Pathological changes in lung tissues, collagen deposition, and airway mucus secretion were observed by hematoxylin-eosin (HE), Masson, and periodic acid-Schiff (PAS) staining. TGF-β1/Smad3-related mRNA and protein levels in lung tissues were determined by Real-time fluorescent quantitative polymerase chain translation (Real-time PCR) and Western blot analysis. ResultCompared with the normal group, the model group showed increased total airway resistance (RL) and decreased dynamic compliance (Cdyn) (P<0.05, P<0.01), elevated serum IgE levels, increased inflammatory cell counts, and higher inflammatory cytokine levels in BALF (P<0.01). Additionally, there was significant inflammatory cell infiltration, collagen deposition, and mucus secretion in lung tissues. The levels of TGF-β1, α-smooth muscle actin (α-SMA), and Smad3 phosphorylation in lung tissues were significantly increased (P<0.01). Compared with the model group, the DEX group and high-dose YWHD group exhibited significantly reduced RL (P<0.01), improved lung dynamic compliance (P<0.05), and lower serum IgE levels, inflammatory cell counts, and inflammatory cytokine levels in BALF (P<0.05). Moreover, these treatments alleviated pathological damage in lung tissues and reduced the levels of TGF-β1, α-SMA, and Smad3 phosphorylation (P<0.01). ConclusionYWHD reduces airway inflammation, improves pathological damage, and mitigates airway remodeling in bronchial asthma rats, possibly by downregulating TGF-β1, α-SMA protein levels, and Smad3 phosphorylation.

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