1.Effect of Yangjing Tongluo Prescription on Oxidative Damage of Endometrium in Rats with Intrauterine Adhesion Based on Keap1/Nrf2/HO-1 Signaling Pathway
Jiaying CHEN ; Jing ZENG ; Zhaoling YOU ; Yonglian WANG ; Muya LIU ; Fang ZHOU ; Li TANG ; Sainan TIAN
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(4):100-108
ObjectiveTo explore the mechanisms of Yangjing Tongluo prescription (YJTL) in the treatment of intrauterine adhesion (IUA) from the perspective of oxidative stress mediated by the Kelch-like ECH-associated protein 1/nuclear factor erythroid 2-related factor 2/heme oxygenase-1 (Keap1/Nrf2/HO-1) signaling pathway. MethodsA total of 48 rats with normal estrous cycles were selected and randomly divided into a normal group (n=8) and a modeling group (n=40). An IUA rat model was established using a dual-injury method combining surgical curettage and infection. Eight rats were randomly selected from the modeling group for a pilot experiment to confirm successful model establishment. After successful modeling, the remaining 32 rats were randomly divided into a model group, a low-dose YJTL group (YJTL-L), a high-dose YJTL group (YJTL-H), and a Progynova group. Rats in the normal and model groups were administered purified water (15 mL·kg-1) by gavage daily, while rats in the YJTL-L, YJTL-H, and Progynova groups received YJTL at doses of 6.43 and 12.86 g·kg-1 and Progynova at 2.06 × 10-4 g·kg-1, respectively, for 14 consecutive days. The general condition, uterine morphology, and uterine index of the rats were monitored. Histopathological changes in uterine tissue were observed using hematoxylin-eosin (HE) staining. Serum levels of reactive oxygen species (ROS) and glutathione peroxidase (GSH-Px) were measured by enzyme-linked immunosorbent assay (ELISA). Protein expression levels of Keap1, Nrf2, and HO-1 in endometrial tissue were detected by Western blot. Immunofluorescence (IF) was used to assess the distribution of Nrf2 and HO-1, as well as the expression of Nrf2 in the cytoplasm and nucleus. ResultsCompared with the normal group, rats in the model group exhibited poor mental status and reduced mobility, markedly edematous and tortuous uterine morphology, decreased gland number, and inflammatory reactions in the endometrium, along with an increased uterine organ index (P<0.05). Serum ROS levels were significantly increased (P<0.05), while serum GSH-Px levels were significantly decreased (P<0.05). In endometrial tissue, Keap1 protein expression was increased (P<0.05), whereas Nrf2 and HO-1 protein expression was decreased. Mild nuclear translocation of Nrf2 was observed, accompanied by increased relative fluorescence intensity of nuclear Nrf2 and decreased relative fluorescence intensity of cytoplasmic HO-1. Compared with the model group, all treatment groups showed varying degrees of improvement in the above symptoms and pathological changes. Serum ROS levels were reduced (P<0.05), serum GSH-Px levels were increased (P<0.05), Keap1 protein expression in endometrial tissue was decreased, and Nrf2 and HO-1 protein expression was increased in a dose-dependent manner (P<0.05). Notably, significant nuclear translocation of Nrf2 was observed, with correspondingly increased relative fluorescence intensity of nuclear Nrf2 and enhanced relative fluorescence intensity of cytoplasmic HO-1. ConclusionYJTL may enhance antioxidant capacity and repair oxidative damage to the endometrial basal layer by regulating the Keap1/Nrf2/HO-1 signaling pathway.
2.Traditional Chinese Medicine Alleviates Dry Eye Disease by Regulating Tear Film Homeostasis: A Review
Sainan TIAN ; Bin'an WANG ; Yao CHEN ; Guicheng LIU ; Li TANG ; Pei LIU ; Genyan QIN ; Jun PENG ; Qinghua PENG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(7):172-181
Dry eye (DE) is a prevalent multifactorial disease of the ocular surface, clinically characterized by tear film homeostasis imbalance accompanied by related ocular surface symptoms. Specifically, the tear film is a thin liquid layer of tears covering the cornea and conjunctiva through blinking, while tear film homeostasis serves as the foundation for maintaining normal ocular surface structure and function. Insufficient tear secretion and excessive tear film evaporation lead to tear hyperosmolarity and the production of inflammatory mediators, disrupting tear film homeostasis and subsequently forming DE. Additionally, cascade reactions are triggered, resulting in a "vicious cycle of DE" that exacerbates the disease severity and prolongs its duration. Therefore, for DE treatment, it is crucial to restore tear film homeostasis and terminate this vicious cycle. Traditional Chinese medicine (TCM), which differentiates and treats DE based on systemic conditions, often achieves favorable therapeutic outcomes, offering additional treatment options for DE. Studies have demonstrated that TCM can alleviate DE by regulating tear film homeostasis and terminating the vicious cycle. This review systematically summarizes recent basic experimental research in China and abroad on TCM in alleviating DE by regulating tear film homeostasis, aiming to provide a theoretical basis for clinical treatment and an insight for research design.
3.Zhuluan Decoction Ameliorates Premature Ovarian Insufficiency by Inhibiting Excessive Autophagy of KGN Through Regulation of PI3K/Akt/mTOR Pathway
Yao CHEN ; Sainan TIAN ; Jing ZENG ; Xingxing YI ; Wen'e LIU ; Lei LEI ; Li TANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):89-98
ObjectiveTo elucidate the underlying mechanism through which Zhuluan decoction suppresses excessive autophagy in human ovarian granulosa cells (KGN) and ameliorates premature ovarian insufficiency (POI) via the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt)/mammalian target of rapamycin (mTOR) signaling pathway. MethodsThe optimal concentration of cyclophosphamide for inducing a POI model in KGN cells was identified via the cell counting kit-8 (CCK-8) assay. Subsequently, the impacts of varying concentrations of Zhuluan decoction-containing serum on the viability of the KGN cell model were assessed. After the optimal drug concentration was determined, KGN cells were categorized into the following groups: blank control (20% blank serum), model (20% blank serum + 5 μmol·L-1 cyclophosphamide), Zhuluan decoction-containing serum (20% Zhuluan decoction-containing serum + 5 μmol·L-1 cyclophosphamide), autophagy inhibitor (20% blank serum + 5 μmol·L-1 cyclophosphamide + 20 μmol·L-1 chloroquine phosphate), autophagy inhibitor + Zhuluan decoction-containing serum (20% Zhuluan decoction-containing serum + 5 μmol·L-1 cyclophosphamide + 20 μmol·L-1 chloroquine phosphate), and estradiol valerate (20% estradiol valerate-containing serum + 5 μmol·L-1 cyclophosphamide). Following 48 hours of incubation, flow cytometry was utilized to measure the apoptosis rate of KGN cells in each group. Western blotting was employed to quantify the protein levels of PI3K, phosphorylated (p)-Akt, Akt, p-mTOR, and mTOR, along with the expression levels of autophagy-related proteins such as Beclin1, autophagy-related 5 homolog (ATG5), and microtubule-associated protein 1 light chain 3 (LC3), in each group. Additionally, monodansylcadaverine (MDC) staining was performed to evaluate the extent of autophagy in each group. ResultsIncubation of KGN cells with 5 μmol·L-1 cyclophosphamide for 48 h successfully established a POI model, marked by a significant inhibition of KGN cell proliferation. Notably, the inhibitory effect of cyclophosphamide on KGN cell proliferation exhibited a positive correlation with its concentration. Zhuluan decoction-containing serum at 20% and 30% promoted cell proliferation and mitigated the inhibitory effect of cyclophosphamide on KGN cell proliferation, with comparable therapeutic efficacy observed at both concentrations. Compared with the blank control group, the model group displayed an elevated apoptosis rate (P<0.01), reduced protein levels of PI3K, p-Akt, and p-mTOR (P<0.01), increased protein levels of Beclin1, LC3, and ATG5 (P<0.01), no significant alterations in the protein levels of Akt and mTOR, and an enhanced MDC autophagy fluorescence intensity (P<0.01). In comparison to that the model group, the apoptosis rates in the blank control group, model group, Zhuluan decoction-containing serum group, autophagy inhibitor group, autophagy inhibitor + Zhuluan decoction-containing serum group, and estradiol valerate group all reduced (P<0.05, P<0.01), with the most pronounced reduction observed in the autophagy inhibitor + Zhuluan decoction-containing serum group. The protein levels of PI3K, p-Akt, and p-mTOR were higher in other groups than in the model group (P<0.05, P<0.01), being the highest in the autophagy inhibitor + Zhuluan decoctio-containing serum group (P<0.01). The protein levels of Beclin1 and ATG5 were lower in other groups than in the model group (P<0.05, P<0.01). The expression level of LC3 declined in the Zhuluan decoction-containing serum group and the estradiol valerate group (P<0.05, P<0.01), while it decreased without statistical significance in the autophagy inhibitor group and the autophagy inhibitor + Zhuluan decoction-containing serum group. ConclusionZhuluan decoction may activate the PI3K/Akt/mTOR pathway to inhibit excessive autophagy and counteract the detrimental effects of cyclophosphamide on the KGN cell model, thus managing POI.
4.Zhuluan Decoction Ameliorates Premature Ovarian Insufficiency by Inhibiting Excessive Autophagy of KGN Through Regulation of PI3K/Akt/mTOR Pathway
Yao CHEN ; Sainan TIAN ; Jing ZENG ; Xingxing YI ; Wen'e LIU ; Lei LEI ; Li TANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):89-98
ObjectiveTo elucidate the underlying mechanism through which Zhuluan decoction suppresses excessive autophagy in human ovarian granulosa cells (KGN) and ameliorates premature ovarian insufficiency (POI) via the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt)/mammalian target of rapamycin (mTOR) signaling pathway. MethodsThe optimal concentration of cyclophosphamide for inducing a POI model in KGN cells was identified via the cell counting kit-8 (CCK-8) assay. Subsequently, the impacts of varying concentrations of Zhuluan decoction-containing serum on the viability of the KGN cell model were assessed. After the optimal drug concentration was determined, KGN cells were categorized into the following groups: blank control (20% blank serum), model (20% blank serum + 5 μmol·L-1 cyclophosphamide), Zhuluan decoction-containing serum (20% Zhuluan decoction-containing serum + 5 μmol·L-1 cyclophosphamide), autophagy inhibitor (20% blank serum + 5 μmol·L-1 cyclophosphamide + 20 μmol·L-1 chloroquine phosphate), autophagy inhibitor + Zhuluan decoction-containing serum (20% Zhuluan decoction-containing serum + 5 μmol·L-1 cyclophosphamide + 20 μmol·L-1 chloroquine phosphate), and estradiol valerate (20% estradiol valerate-containing serum + 5 μmol·L-1 cyclophosphamide). Following 48 hours of incubation, flow cytometry was utilized to measure the apoptosis rate of KGN cells in each group. Western blotting was employed to quantify the protein levels of PI3K, phosphorylated (p)-Akt, Akt, p-mTOR, and mTOR, along with the expression levels of autophagy-related proteins such as Beclin1, autophagy-related 5 homolog (ATG5), and microtubule-associated protein 1 light chain 3 (LC3), in each group. Additionally, monodansylcadaverine (MDC) staining was performed to evaluate the extent of autophagy in each group. ResultsIncubation of KGN cells with 5 μmol·L-1 cyclophosphamide for 48 h successfully established a POI model, marked by a significant inhibition of KGN cell proliferation. Notably, the inhibitory effect of cyclophosphamide on KGN cell proliferation exhibited a positive correlation with its concentration. Zhuluan decoction-containing serum at 20% and 30% promoted cell proliferation and mitigated the inhibitory effect of cyclophosphamide on KGN cell proliferation, with comparable therapeutic efficacy observed at both concentrations. Compared with the blank control group, the model group displayed an elevated apoptosis rate (P<0.01), reduced protein levels of PI3K, p-Akt, and p-mTOR (P<0.01), increased protein levels of Beclin1, LC3, and ATG5 (P<0.01), no significant alterations in the protein levels of Akt and mTOR, and an enhanced MDC autophagy fluorescence intensity (P<0.01). In comparison to that the model group, the apoptosis rates in the blank control group, model group, Zhuluan decoction-containing serum group, autophagy inhibitor group, autophagy inhibitor + Zhuluan decoction-containing serum group, and estradiol valerate group all reduced (P<0.05, P<0.01), with the most pronounced reduction observed in the autophagy inhibitor + Zhuluan decoction-containing serum group. The protein levels of PI3K, p-Akt, and p-mTOR were higher in other groups than in the model group (P<0.05, P<0.01), being the highest in the autophagy inhibitor + Zhuluan decoctio-containing serum group (P<0.01). The protein levels of Beclin1 and ATG5 were lower in other groups than in the model group (P<0.05, P<0.01). The expression level of LC3 declined in the Zhuluan decoction-containing serum group and the estradiol valerate group (P<0.05, P<0.01), while it decreased without statistical significance in the autophagy inhibitor group and the autophagy inhibitor + Zhuluan decoction-containing serum group. ConclusionZhuluan decoction may activate the PI3K/Akt/mTOR pathway to inhibit excessive autophagy and counteract the detrimental effects of cyclophosphamide on the KGN cell model, thus managing POI.
5.Mechanism of Action of Guishenwan in Treatment of Ovarian Insufficiency Diseases: A Review
Yao CHEN ; Sainan TIAN ; Bin'an WANG ; Shengyu WANG ; Wen'e LIU ; Lei LEI ; Li TANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(2):317-324
Guishenwan (GSW), originating from Jingyue Quanshu (Zhang Jingyue's Complete Works), is a classic traditional Chinese medicine (TCM) formula with a history of over 400 years. Designed for kidney essence deficiency syndrome, it is clinically applied to treat diseases associated with essence-blood deficiency, such as ovarian insufficiency diseases in women, oligospermia-induced infertility in men, and lumbar disc herniation. Numerous studies have confirmed its significant efficacy and advantages in managing ovarian insufficiency diseases, including diminished ovarian reserve (DOR), premature ovarian insufficiency (POI), and premature ovarian failure (POF). According to recent literature, the therapeutic mechanisms of GSW in treating ovarian insufficiency diseases involve regulating the hypothalamic-pituitary-ovarian axis (HPOA) function, ameliorating reproductive endocrine disorders, improving ovarian function, modulating relevant signaling pathways, and exerting immunoregulatory and anti-inflammatory effects. A review of GSW in clinical treatment revealed that clinical applications of GSW, particularly in combination with Western medicine, not only alleviate symptoms but also compensate for the limitations of hormone replacement therapy, thereby reducing recurrence, minimizing adverse reactions, and enhancing safety. This review aims to provide a scientific basis for the rational clinical use of GSW in ovarian insufficiency diseases, offer innovative TCM strategies for developing novel ovarian-protective drugs, promote the integration of TCM and Western medicine in reproductive medicine, and ultimately contribute a Chinese approach to global management of ovarian insufficiency diseases.
6.Investigation on the current status of information systems in CSSD of hospitals in China
Ying ZHANG ; Yuhua GAO ; Sainan QIAO ; Jian SHEN ; Baohua LI
China Medical Equipment 2025;22(5):142-146
Objective:To investigate the status of development and application of information system of central sterile supply department(CSSD)in hospitals of China,so as to provide references for the promotion of CSSD information system in hospital.Methods:Hierarchical sampling method was adopted to combine with CSSD Professional Committee of Chinese Nursing Association to design questionnaire for Questionnaire Star Network Survey about basic information,CSSD information system,whether the CSSD information system connected with equipment,tracing links and tracing levels,identification method of apparatuses,automation of equipment in 3,074 hospitals of 22 provinces,4 municipalities directly under the central government,and 5 autonomous regions.Results:In 3,074 hospitals,1,811 hospitals(accounting for 58.91%)adopted the CSSD information system.The utilization rate of tertiary hospitals was 81.90%for the information system,which was higher than that(34.51%)in secondary hospitals,and the difference was statistically significant(x2=636.65,P<0.05).The proportion of hospitals that included the recycling,cleaning,disinfection,inspection and packaging,sterilization,storage,and distribution links of CSSD internal management into information management was all>88%,while the utilization link only accounted for 15.18%.The proportion that surgical apparatuses and the apparatuses of clinical diagnosis and treatment were included in management was higher in 1811 hospitals that used CSSD information system,which were respectively 88.02%and 84.70%,while the proportion of surgical soft endoscope was lower,which only was 49.20%.A total of 84.37%of hospitals conducted informatization management for using extracorporeal apparatuses and implants.The connection rates of the main CSSD equipment,which included the washing and disinfection machine,the pressure steam sterilizer and the low-temperature sterilizer,were connected with information system were respectively 56.60%,63.06%and 43.95%.The full compatibility between the information system and all monitoring methods did not be realized in these hospitals.Barcode was the main identification form(69.91%)of the CSSD information system,and personnel management was the most common management module(53.62%)of the information system.The utilization rate(2.93%-5.14%)of automated equipment was low,and 35.45%of the CSSD information systems had the function of automatic emergency handling.Conclusion:The CSSD informatization management of China has achieved remarkable results,but there are still problems such as insufficient connection of equipment,inclusion of monitoring data,and insufficient automation and intelligence.It is necessary to increase the promotion efforts to promote the high-quality development of hospitals.
7.Establishment of a short-term prognosis model for patients with refractory cardiogenic shock induced by fulminant myocarditis treated with veno-arterial extracorporeal membrane oxygenation based on early indicators
Hang DU ; Rui WANG ; Nan WANG ; Mingkai ZHOU ; Gen LI ; Sainan WANG ; Huijie DING ; Shaojie QIN
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care 2025;32(2):177-183
Objective To explore the short-term prognosis and risk factors for in-hospital mortality in patients with fulminant myocarditis induced refractory cardiogenic shock(FM-RCS)receiving veno-arterial extracorporeal membrane oxygenation(VA-ECMO)treatment,and to construct an early prognosis prediction model using relevant indicators.Methods A total of 61 FM-RCS patients treatment by VA-ECMO in the department of intensive care unit of the Second Affiliated Hospital of Zhengzhou University from January 2017 to February 2024,excluding 15 cases with age less than 18 years and 3 cases with ECMO treatment duration less than 24 hours,a total of 43 patients were finally included.Participants were stratified into survival(n=19)and mortality(n=24)groups according to discharge outcomes.Demographic data,chronic disease history,early laboratory indicators,left ventricular function indicators,and basic reference values of hemodynamics were systematically compared between the two groups.Variable selection was performed using LASSO regression,followed by multivariate COX regression analysis to screen independent risk factors for in-hospital mortality in ECMO-treatment FM-RCS patients.A nomogram prediction model was subsequently developed using R software and validated through calibration curves,concordance index(C-index),and receiver operator characteristic curve(ROC curve)analysis.Results The overall survival rate of the 43 enrolled patients was 44.2%,with 19 cases in the survival group and 24 cases in the mortality group.In early laboratory indicators,the survival group exhibited significantly lower levels of initial lactic acid(Lac),24-hour Lac(Lac 24 h),24-hour MB isoenzyme of creatine kinase(CK-MB 24 h),24-hour cardiac troponin T(cTnT 24 h),24-hour total bilirubin(TBil 24 h),24-hour serum creatinine(SCr 24 h),and lactate albumin ratio(LAR)compared to the mortality group[initial Lac(mmol/L):2.7(1.3,7.6)vs.9.2(5.9,14.0),Lac 24 h(mmol/L):2.4(2.0,3.6)vs.5.4(3.3,9.2),CK-MB 24 h(U/L):58.0(28.0,115.0)vs.167.7(68.5,280.3),cTnT 24 h(μg/L):0.53(0.37,2.41)vs.3.92(3.10,8.86),TBil 24h(μmol/L):18.3(9.9,37.8)vs.40.2(24.6,67.0),SCr 24 h(μmol/L):90.63±42.49 vs.177.76±70.76,LAR:0.09(0.04,0.23)vs.0.31(0.20,0.38),all P<0.05],serum albumin(Alb)levels were significantly higher in the survival group[g/L:36.0(31.9,39.2)vs.31.7(26.4,34.4),P<0.05].The mortality group had a higher incidence of malignant arrhythmias[66.7%(16/24)vs.31.6%(6/19),P<0.05].The LASSO regression model identified four non-zero coefficient variables-Lac 24 h,CK-MB 24 h,cTnT 24 h,and SCr 24 h-which were included in the subsequent multivariate COX regression analysis.The results demonstrated that Lac 24 h[hazard ratio(HR)and 95%confidence interval(95%CI)was 1.186(1.074-1.310),P<0.001]and cTnT 24 h(HR=1.230,95%CIwas 1.078-1.404,P=0.002)were independent risk factors for in-hospital mortality in VA-ECMO treatment FM-RCS patients.A predictive model constructed using these two indicators showed a C-index of 0.812,area under the curve(AUC)=0.941,with 91.7%sensitivity and 94.7%specificity.Furthermore,compared to the survival group,the mortality group exhibited significantly higher incidences of acute kidney injury[91.7%(22/24)vs.36.8%(7/19)]and hypoxic-ischemic encephalopathy[62.5%(15/24)vs.10.5%(2/19),both P<0.05].The mortality group also required greater transfusion volumes[mL:3 800(1 420,8 515)vs.1 200(400,3 020),P<0.05],but had shorter total hospitalization durations[days:7(3,13)vs.23(20,44),P<0.05].Conclusion For FM-RCS patients receiving VA-ECMO treatment,Lac 24 h and cTnT 24 h after ECMO initiation are independent predictors of in-hospital mortality.Clinicians should be vigilant about poor prognosis in FM-RCS patients with high Lac 24 h hours(>2.5 mmol/L)and cTnT 24 hours(>3.01 μg/L)after ECMO treatment.
8.Detection and clinical significance of serum FGF23 and 25-OH-VD levels in children with osteoporosis
Nuan HAN ; Wenke CHEN ; Sainan WANG ; Tao LI ; Tixue WANG ; Jinsong SUN
Chinese Journal of Endocrine Surgery 2025;19(4):579-583
Objective:To analyze the relationship among serum levels of fibroblast growth factor 23 (FGF23), 25-hydroxyvitamin D (25-OH-VD) and osteoporosis in children.Methods:Eighty children with osteoporosis admitted to Affiliated Hosptial of Jining Medieal University from Jun. 2019 to Jun. 2024 were included as the observation group, and 60 healthy children who underwent physical examination during the same period were included as the control group. Serum FGF23 and 25-OH-VD levels were compared between the two groups, and bone mineral density and bone metabolism indexes [CTX-1, osteocalcin (OC) and N-terminal propeptide of type I precollagen (PINP) ] were detected. Pearson correlation was used to analyze the correlation among serum FGF23, 25-OH-VD, bone metabolism indexes and bone mineral density. Logistic regression model was used to analyze the risk factors of osteoporosis in children.Results:Serum FGF23 and CTX-1 levels in the observation group were significantly higher than those in the control group ( t=15.77, 7.56, P < 0.05), while serum 25-OH-VD, OC, PINP and BMD levels were significantly lower ( t=14.09, 2.70, 13.25, 3.63, P < 0.05) ; Pearson correlation analysis showed that BMD was not correlated with age, BMI and OC ( r=-0.07, -0.02, 0.01, P > 0.05), BMD was negatively correlated with FGF23 and CTX-1, and positively correlated with 25-OH-VD and PINP ( r=-0.35, -0.34, 0.41, 0.40, P < 0.05). The stepwise regression model showed that FGF23 and 25-OH-VD were the main factors affecting BMD ( t=-2.40, 9.02, P<0.05). Multifactor Logistic regression model showed that FGF23 and 25-OH-VD were related factors of osteoporosis in children ( OR=3.01,1.16, P<0.05) . Conclusion:Serum FGF23 level is higher and 25-OH-VD level is lower in children with osteoporosis, which is significantly correlated with bone mineral density and is a related factor for osteoporosis in children.
9.Regional molecular transmission characteristics of newly reported HIV-infected students aged ≥18 years in Nanjing City from 2016 to 2022
Hongjie SHI ; Sainan WANG ; Xin LI ; Sushu WU ; Rong WU ; Xin YUAN ; Jingwen WANG ; Xiaoyong SHENG ; Yuanyuan XU ; Zhengping ZHU
Chinese Journal of Preventive Medicine 2025;59(1):82-89
To analyze the transmission characteristics of newly reported HIV-infected students aged ≥18 years in Nanjing City from 2016 to 2022 and provide evidence for AIDS publicity and intervention among young students. The pol region sequences of newly reported HIV-infected students and non-student HIV-infected individuals in Nanjing City from 2016 to 2022 were collected, and the BLAST tool was used to search the published global non-Nanjing reported HIV infection sequences in the LANL HIV database. The basic molecular transmission network and regional molecular transmission network were constructed using the HIV-TRACE in a pairwise genetic distance threshold of 1.0%. 332 sequences of infected students aged≥18 years in Nanjing City, 1 904 sequences of non-student-infected individuals in Nanjing City and 1 698 non-Nanjing-infected individuals were obtained. Among the 332 infected students, the main route of infection was homosexual (96.39%), and the subtypes were CRF01_AE (37.95%), CRF07_BC (37.65%) and CRF105_0107 (10.24%). There were 890 sequences in the regional molecular transmission network, of which 21.80% were infected students in Nanjing City, 39.89% were non-student-infected individuals in Nanjing City, and 38.31% were non-Nanjing-infected individuals. In the CRF105_0107 transmission cluster, non-student-infected individuals from Nanjing accounted for 66.95% (81/121), while in the CRF07_BC transmission cluster, non-Nanjing-infected individuals accounted for 56.66% (200/353). There were 1 644 edges connected to infected students within the regional molecular transmission network, with local transmission accounting for 64.72% and regional transmission accounting for 35.28%. Regional transmission was mainly in Guangdong Province (19.83%) and other cities in Jiangsu Province (4.50%). The HIV-1 subtypes of newly reported HIV-infected students aged≥18 years in Nanjing City are mainly CRF01_AE, CRF07_BC and CRF105_0107, with local transmission as the main transmission characteristics. There is transmission between students and non-students.
10.Clinical application value of the detection of blood routine parameters and C-reactive protein in children with influenza A vi-rus infection
Jinghua ZHANG ; Sainan WANG ; Runpeng ZHAO ; Li CHEN
Chinese Journal of Clinical Laboratory Science 2025;43(1):30-34
Objective To investigate the clinical application value of blood routine parameters such as white blood cells(WBC),neu-trophils(NEU),lymphocytes(LYM),monocytes(MON),platelets(PLT),neutrophil to lymphocyte ratio(NLR),and platelet to lymphocyte ratio(PLR)and C-reactive protein(CRP)in children with influenza A(Flu A)virus infection.Methods 317 children with upper respiratory tract symptoms visited Department of Pediatrics,Affiliated Jiangning Hospital of Nanjing Medical University from September 2023 to May 2024 were retrospectively analyzed.According to the six kinds of nucleic acid test results of upper respiratory tract,the children were divided into the Flu A group(n=150)and disease control group(n=167).In addition,97 healthy children who underwent physical examination in our hospital during the same period were selected as the healthy control group.The finger blood of the children was collected for the detection of blood routine parameters and CRP.The Kruskal-Wallis H non-parametric test was used to compare the differences of these parameters among the three groups.The receiver operating characteristic(ROC)curve was drawn,and the area under the ROC curve(AUCROC)was used to evaluate the diagnostic value of each indicator for influenza A virus infection.Results The NLR and PLR in the Flu A group were significantly higher than those in the disease control group and healthy control group,while the levels of WBC and LYM were significantly lower than those in the disease control group and healthy control group(P<0.05).The level of CRP in the Flu A group was higher than that in the healthy control group but lower than that in the disease control group(P<0.05).The indicator with the best diagnostic efficacy for influenza A virus infection was LYM,whose AUCROC was 0.79.When the optimal diagnostic threshold was 1.55×109/L,its sensitivity and specificity were 0.620 and 0.837,respectively.Next were PLR and NLR,with AUCROC of 0.735 and 0.723,specificity of 0.754 and 0.826,and sensitivity of 0.693 and 0.553,respectively.The diagnostic efficacy of MON,PLT,and CRP was relatively low.The AUCROC of the combined detection of LYM,NLR,PLR,MON,PLT,and CRP for the diagnosis of influenza A virus infection could increase to 0.838.Conclusion The blood routine parameters of children with influenza A virus infection show a decrease in the level of LYM and an increase in NLR and PLR.The combined detection of LYM,NLR,PLR,MON,PLT,and CRP can improve the accuracy of early diagnosis of influenza A virus infection in children.

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