1.Screening and diagnostic framework of vascular dementia in Chinese population
Jinzhou TIAN ; Hengge XIE ; Bin QIN ; Dongsheng FAN ; Tao LU ; Jing SHI ; Jingnian NI ; Luning WANG ; Yinhua WANG
Chinese Journal of Internal Medicine 2019;58(1):10-16
For lack of cognitive screening standard system and controversy over the value of imaging for cerebrovascular diseases in China, the research group of Alzheimer′s Disease Chinese (ADC) studied the knowledge of neuropsychology, neuroimaging and clinical neurology, systematically reviewed the diagnostic techniques such as memory, language, visuospatial, executive, function, and magnetic resonance imaging (MRI) of cerebrovascular diseases, and their optimal threshold and diagnostic value for vascular dementia. Via a consensus meeting, the diagnostic guidelines and practical screening process are combined to construct a framework in Chinese population, which is based on the objective evidence of medical history and clinical evaluation. The diagnosis of vascular dementia is supported by imaging evidence of cerebrovascular diseases and differentiates from other causes of dementia or comorbidities. This consensus is applicable to medical units in China, and is of great significance for early detection, early diagnosis and early treatment of vascular dementia.
2.The diagnostic framework for screening Alzheimer's disease in the Chinese population
Jinzhou TIAN ; Hengge XIE ; Bin QIN ; Dongsheng FAN ; Jing SHI ; Weizhong XIAO ; Jingnian NI ; Mingqing WEI ; Tao LU ; Luning WANG ; Yinhua WANG
Chinese Journal of Internal Medicine 2019;58(2):91-101
Criteria for diagnosis of Alzheimer's disease (AD) is not available in China.The international criteria is not a proper choice due to issues such as translation and lead to low diagnostic rate and high rate of missed diagnosis.The research group of Alzheimer's Disease Chinese (ADC) reviewed knowledge and techniques in neuropsychology,neuroimaging,molecular biology,and clinical neurology,and systematically studied the detection techniques such as memory,language,visuospatial,executive function,and medial temporal lobe visual scores on MRI,and their optimal threshold and diagnostic value for the diagnosis of AD.Through a systematic review and consensus meeting,a diagnostic framework for screeningAD in the Chinese population was established.Among these methods,an operational standard for clinical pathology models increased the diagnostic sensitivity by 15%.The sensitivity and specificity of screening memory impairment increased by 18.1% and 11.6%,respectively.The sensitivity of screening medialtemporal lobe atrophy increased by 24.5% and missed diagnosis was decreased by 34.5%.An operational standard for clinical biology models,incorporating the latest molecular imaging and molecular biology techniques,has enabled the early diagnosis of AD in China.The framework combines a principled diagnostic guideline with an operational screening protocol,which is applicable to all clinical settings and of great significance for the early detection,early diagnosis and early treatment of AD.
3.Value of 68 Ga-DOTANOC PET/CT imaging in primary diagnosis and staging of pancreatic neuroen-docrine neoplasms
Qingju ZHANG ; Weidong YANG ; Shengjun WANG ; Xiaohu ZHAO ; Ni WANG ; Shuailiang WANG ; Jing WANG
Chinese Journal of Nuclear Medicine and Molecular Imaging 2019;39(8):453-457
Objective To evaluate the value of 68 Ga-1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid-1-Nal3-octreotide ( DOTANOC) PET/CT imaging in the diagnosis and staging of pancreatic neuroendocrine neoplasms ( pNENs) . Methods Data of 48 patients ( 18 males, 30 females, age: 23-86 (50.0±14.7) years) who underwent 68Ga-DOTANOC PET/CT imaging from June 2016 to June 2018 were retrospectively analyzed. The histopathological results were considered as the gold standard. The diagnostic efficacies of 68 Ga-DOTANOC PET/CT imaging and conventional imaging ( CI) for pNENs were analyzed and compared ( McNemar test) . Imaging characteristics of true positive lesions in 68 Ga-DOTANOC PET/CT ima-ging were analyzed. The maximum standardized uptake value ( SUVmax ) in different pathological grades of pNENs lesions were compared (Kruskal-Wallis rank sum test). Accuracy for TNM staging by 68Ga-DOTANOC PET/CT imaging and the correlations between the staging results and clinical TNM stages were analyzed (R× C contingency table). Results (1) The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of 68Ga-DOTANOC PET/CT imaging were 93.8%(30/32), 14/16, 93.8%(30/32), 14/16 and 91.7%(44/48). All true positive lesions detected by PET/CT showed focal up-take of 68 Ga-DOTANOC with SUVmax of 30. 52 ± 23. 57. There were 26 patients with confirmed pathological grades of G1 (n=10;SUVmax:28.20 (17.60, 49.22)), G2 (n=13; SUVmax: 27.60 (13.05, 56.08)) and G3 (n=3;SUVmax:13.68(10.02, 27.80)), with no significant difference in SUVmax among 3 groups (H=0.495, P>0.05). (2)Of the 48 patients, 95.8%(46/48) also underwent CI concurrent with PET/CT. The sensitivity, specificity, PPV, NPV and accuracy of CI were 60.0%(18/30), 9/16, 72.0%(18/25), 9/21 and 58.7%(27/46). The diagnostic efficacy of 68Ga-DOTANOC PET/CT imaging was significantly higher than that of CI ( P=0.041) . ( 3) The accuracies of 68 Ga-DOTANOC PET/CT imaging for T, N, M staging were 93.3%(28/30), 6/6, 9/10, respectively, and the staging results were significantly correlated with clinical TNM stages (r=0.880, P<0.05). Conclusion 68Ga-DOTANOC PET/CT imaging has great values in the diagnosis and staging of pNENs.
4.Comparison of different serological methods in screening early gastric cancer
Dongqiong NI ; Bin LYU ; Haibiao BAO ; Haifeng JIN ; Jing ZHAO ; Yi XU ; Xuan HUANG
Chinese Journal of Internal Medicine 2019;58(4):294-300
Objective To compare the consistency and detection rate of early gastric cancer (EGC) of three different methods including anti-Helicobacter pylori (Hp) antibody combined with pepsinogen (PG) (ABC method),serum PG combined with gastrin-17 (G-17) (new ABC method) and the new scoring system.Methods Serological tests were performed in Zhejiang population,which divided the subjects into low risk,intermediate risk and high risk groups.High risk subjects were examined by endoscopic and pathological examination.SPSS19.0 were used to evaluate the consistency of three methods.According to the receiver operating characteristic (ROC) curve,the ratio of G-17 to PG (PGR) was calculated for the optimal diagnostic cut-off value of EGC.Results A total of 30 126 subjects were recruited.Based on the data of ABC method,the proportions of low risk,intermediate risk and high risk group were 15 368 (51.01%),13 246 (43.97%),and 1 512 (5.02%),respectively.These proportions by the new ABC method were 20 584 (68.32%),8 990 (29.84%),552 cases (1.83%),respectively.By new scoring system,these were 20 810 (69.08%),8 059 (26.75%),and 1 257 (4.17%),respectively.Among them,1 263 subjects underwent endoscopy and 22 cases (1.74%) were finally diagnosed as gastric cancer including 19 EGC (86.4%).There were 1 case (0.35%),14 cases (1.84%),and 7 cases (3.21%) with gastric cancer in low risk,intermediate risk,and high risk groups by ABC methods,respectively.Gastric cancer patients were 7 (1.68%),10 (1.38%),and 5 (4.10%) in three groups respectively by new ABC methods.Via new scoring system,gastric cancer were detected in 5 (0.66%),9 (2.22%),and 8 (7.84%) patients of three risk groups respectively.The consistency of three screening methods was poor.The detection rate of gastric cancer in high risk group was higher than that in the other two (P<0.05).The area under the curve (AUC) for diagnosis of gastric cancer by G-17 and PGR was 0.588 and 0.729,respectively.According to the PGR cut-off value determined by the fitted model,the incidence of gastric cancer in the low,intermediate and high risk groups was 0.94%,1.97%,and 6.31%,respectively.When the cut-off value is PGR<4.135,the sensitivity is 0.855 and the specificity is 0.545.Conclusion The new scoring system has a better predictive value in EGC screening.The detection rate of EGC in high risk group is higher than that in low and intermediate risk groups.
5.Expression and role of Hippo signaling pathway in non-small cell lung cancer
Zhao WANG ; Yingnan WANG ; Jixiang NI ; Jing ZHU
Journal of International Oncology 2019;46(4):239-242
Hippo signaling pathway plays an important role in the growth and regeneration of animal organs. Studies have shown that the misexpression of Hippo signaling pathway composed of yes-associated protein and trascriptional co-activator with PDZ-binding motif is involved in the development of non-small cell lung cancer(NSCLC)and has synergistic effect with mutant p53. In addition,its overexpression leads to drug resistance in lung cancer treatment and inhibition of its expression may benefit cancer patients. The expression and role of Hippo signaling pathway in NSCLC are described in detail,which is expected to provide a new direction for targeted therapy of lung cancer.
6.TCM chemical biology--emerging interdiscipline of "TCM chemistry" and "biology".
Ke-Wu ZENG ; Yong JIANG ; Jing WANG ; Min YE ; Jun LI ; Xiao-Ni AI ; Yue-Lin SONG ; Li-Wen HAN ; Ke-Chun LIU ; Peng-Fei TU
China Journal of Chinese Materia Medica 2019;44(5):849-860
Traditional Chinese medicine(TCM) is a research area with highly original innovation features,and is also a Chinese name card to the world. However,TCM owns a unique theoretical system which is quite different from western modern medicine,leading to an awkward situation of deficient modern social identity as well as poor international spread. Therefore,how to establish a research strategy in line with the characteristics of TCM itself to systematically interpret the unique scientific connotation of TCM is always a public hot topic. Based on persistent practical exploration and scientific consideration in TCM,our group firstly promoted the concept of traditional Chinese medicine chemical biology(TCM chemical biology,TCMCB). The major idea of TCMCB is to clarify the nature of TCM regulating life progress to link TCM to modern medicine by using TCM components as chemical tools. Notably,TCMCB mainly focuses on TCM target identification and TCM-guided disease molecular mechanism exploration,further to clarify the basic law of TCM mediating disease process. Finally,TCMCB-guided scientific studies can help explain TCM theory and promote the developmentof modern innovative drugs based on identified targets using TCM active components. Moreover,TCMCB is of vital importance for investigating the scientific nature of biological progress and the pattern of disease occurrence and development,indicating a key significance for modern life science and medicine. This review introduces the definition of TCMCB as well as its academic thought,research method,technology system and scientific significance,for providing new research ideas and scientific thoughts for TCM development.
Biology
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Chemistry
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Interdisciplinary Research
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Medicine
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Medicine, Chinese Traditional
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Research Design
7.Identification of active components in Longxue Tongluo Capsules against ischemic brain injury based on component-activity relationship.
Jing SUN ; Xiao-Nan CHEN ; Jia-Ni LIU ; Peng-Wei GUAN ; Chao-Chao WANG ; Bo PAN ; Dao-Ran PANG ; Shan-Shan LI ; Jiao ZHENG ; Wen-Zhe HUANG ; Peng-Fei TU ; Jun LI
China Journal of Chinese Materia Medica 2019;44(1):150-157
Ten fractions(A-J) were prepared by separation of Longxue Tongluo Capsules(LTC) by using silica gel column chromatography and orthogonal experimental design,showing similar chemical profiles with different abundances of peaks.These ten samples were assessed with UHPLC-QE OrbitrapHRMS for 97 common peaks.For the pharmacological activity experiment,three kinds of in vitro cell models including lipopolysaccharide(LPS)-induced BV-2 microglial cells NO release model,oxygen-glucose deprivation/reoxygenation(OGD/R)-treated HUVEC vascular endothelial cells injury model,and OGD/R-treated PC-12 nerve cells injury model were employed to evaluated the bioactivity of each fraction.Based on the contribution of each identified component,grey relation analysis and partial least squares(PLS) analysis were performed to establish component-activity relationship of LTC,identify the potential active components.After that,validation of the potential active components in LTC was carried out by using the same models.The results indicated that 4 phenolic compounds including 7,4'-dihydroxyhomoisoflavanone,loureirin C,4,4'-dihydroxy-2,6-dimethoxydihydrochalcone,and homoisosocotrin-4'-ol,might be the active components for anti-neuroinflammation effect;five phenolic compounds such as 3,5,7,4'-tetrahydroxyhomoisoflavanone,loureirin D,7,4'-dihydroxyhomoisoflavane,and 5,7-dihydroxy-4'-methoxy-8-methyflavane,might have positive effects on the vascular endothelial injury;three phenolic compounds including 5,7,4'-trihydroxyflavanone,7,4'-dihydroxy-5-methoxyhomoisoflavane,and loureirin D,might be the active components in LTC against neuronal injury.
Brain Ischemia
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drug therapy
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Capsules
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Cell Line
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Drugs, Chinese Herbal
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pharmacology
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Glucose
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Human Umbilical Vein Endothelial Cells
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drug effects
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Humans
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Microglia
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drug effects
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Oxygen
8.Management System of Implantable Medical Device in Accordance with JCI Standard Based on HRP System.
Jiasheng NI ; Qilin TAO ; Hongmin ZHU ; Jing GENG
Chinese Journal of Medical Instrumentation 2019;43(4):310-312
JCI standard is the most professional and authoritative certification standard of medical quality and safety system in the world. HRP information system is a systematic hospital resource management platform which integrates the existing hospital information resources and establishes a set of unified, efficient, interconnected and information sharing operation and management of the hospital. In order to meet the requirements of closed-loop management of implantable medical devices in the JCI standard, our hospital has established a set of standards which based on the HRP system platform, including access permission, purchase application, entering and leaving the warehouse, bookkeeping charge, cost accounting and postoperative traceability of implanted medical device management system. HRP system improves the management level of implantable medical devices, and realizes the closed-loop management of the whole process of implantable medical devices.
Hospitals
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Humans
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Information Dissemination
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methods
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Management Information Systems
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standards
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Prostheses and Implants
9.E-cadherin Expression in Children with Acute Leukemia and Its Clinical Significance.
Bin-Xia BAO ; Xi-Zhou AN ; Peng-Fei LI ; Yong-Jing LI ; Ying-Hui CUI ; Xue TANG ; Qi-Hui LIU ; Yan-Ni HU ; Wei LIU ; Shao-Yan LIANG ; Jie YU
Journal of Experimental Hematology 2019;27(2):339-347
OBJECTIVE:
To investigate the correlation of E-cadherin expression level with the clinical characterastics in children with acute leukemia (AL), and to explore the possible regulatory mechanism.
METHODS:
Real-time quantitative RT-PCR was applied to detect the expression level of E-cadherin in bone marrow samples from 135 child patients diagnosed as AL, and its relevance with clinical indicators was statistically analyzed. The expression levels of E-cadherin, β-catenin, and Akt/p-Akt were detected by using Western blot. The bone marrow samples from 22 children with non-malignant hematological diseases were used as controls.
RESULTS:
The expression level of E-cadherin significantly decreased in newly diagnosed patients with all 3 types of AL as compared with bone marrow samples from control group (P<0.01). In B-ALL group, compared with standard risk group, E-cadherin expression level significantly decreased in intermediate risk group (P<0.05). Moreover,the expression level of E-cadherin mRNA was also reduced in splenomegaly group (P<0.01). However, the correlation of E-cadherin level with clinical characteristics was not found in T-ALL and AML (P>0.05). The expression level of E-cadherin in the patients from Common-B-ALL group was higher than B-ALL patients with other immunophenotypes (P<0.01), while no significant difference was found among patients grouped by FAB classification. By the correlation analysis of measured data, lower E-cadherin expression level was found to be related with high WBC count and serum lactic dehydrogenase level (LDH) (r=-0.419, r=-0.269), but with low blood platelet count in B-ALL (r=0.335). In T-ALL, expression of E-cadherin was found to be negatively correlated with LDH and percentage of immature cells in the bone marrow (r=-0.567, r=-0.557). In addition, the lower expression of E-cadherin was also found to be related with WBC count and percentage of immature cells in the bone marrow in newly diagnosed AML patients (r=-0.368, r=-0.391). Compared with control group, the expression of E-cadherin was down-regulated significantly (P<0.01), while β-catenin, Akt significantly was up-regulated in 3 types of AL patients (P<0.01). The expression of p-Akt and p-Akt/Akt was up-regulated significantly in T-ALL (P<0.01).
CONCLUSION
Lower expression of E-cadherin is related factor of unfavourable prognosis in children with acute leukemia. The expression deficiency or down-regulation of E-cadherin may activate Wnt/β-catenin and PI3K/ Akt signaling pathways to promote the genesis and progress of haematological malignancies, thus resulting in a series of malignant biological behaviors in cells. E-cadherin may be a new prognostic indicator for pediatric acute leukemia, thus to guide individualized hemotherapy.
Acute Disease
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Bone Marrow
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Cadherins
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Child
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Humans
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Leukemia, Myeloid, Acute
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Precursor Cell Lymphoblastic Leukemia-Lymphoma
10.Correlation between Mycoplasma pneumoniae DNA replication level and disease severity in children with severe Mycoplasma pneumoniae pneumonia.
Ke-Nan FANG ; Jing WANG ; Jing-Wen NI
Chinese Journal of Contemporary Pediatrics 2019;21(9):876-880
OBJECTIVE:
To study the correlation of Mycoplasma pneumoniae DNA (MP-DNA) replication level in throat swab and bronchoalveolar lavage fluid (BALF) with disease severity in children with severe Mycoplasma pneumoniae pneumonia (SMPP).
METHODS:
A total of 44 children with SMPP who underwent bronchoalveolar lavage were enrolled as subjects. The serum levels of cytokines and MP-DNA replication times in throat swab were measured in the acute stage and the recovery stage, and the levels of interleukin (IL)-8 and MP-DNA replication times in BALF were measured in the acute stage. According to whether mechanical ventilation was needed for respiratory failure, the children were divided into a mechanical ventilation group (n=19) and a non-mechanical ventilation group (n=25), and the two groups were compared in MP-DNA replication times in BALF.
RESULTS:
For the children with SMPP, serum levels of C-reactive protein, erythrocyte sedimentation rate, lactate dehydrogenase, IL-1, IL-6, IL-8, and IL-18 in the acute stage were significantly higher than those in the recovery stage (P<0.05). In the acute stage, MP-DNA replication times in throat swab were positively correlated with those in BALF (r=0.613, P<0.05), and MP-DNA replication times in BALF were positively correlated with IL-18 levels in peripheral blood and BALF (r=0.613 and 0.41 respectively, P<0.05). Compared with the non-mechanical ventilation group, the mechanical ventilation group had significantly higher MP-DNA replication times in BALF, a significantly longer duration of systemic hormone treatment, significantly higher serum levels of lactate dehydrogenase and IL-18, and significantly higher white blood cell count and IL-18 level in BALF (P<0.05).
CONCLUSIONS
In children with SMPP, MP-DNA replication level in throat swab and BALF can be used as a reference index for the assessment of disease severity.
Bronchoalveolar Lavage Fluid
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Child
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Cytokines
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DNA Replication
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DNA, Bacterial
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Humans
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Mycoplasma pneumoniae
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Pneumonia, Mycoplasma

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