1.Analysis of HPV Infection Characteristics and Influencing Factors for Lesion Grade in Patients with Cervical Squamous Intraepithelial Lesion and Cervical Cancer
Jingjing HAN ; Lijie ZHANG ; Ruyu CAI ; Haili LI ; He WANG ; Le DANG ; Hongda CHEN ; Ming'e LI ; Lan ZHU
Medical Journal of Peking Union Medical College Hospital 2026;17(1):156-165
To summarize the distribution characteristics of human papillomavirus(HPV) infection types in patients with cervical squamous intraepithelial lesion(SIL) and cervical cancer(CC), and to explore the impact of HPV vaccination, HPV infection types, and general clinical data on different grades of cervical lesions. Clinical data of women attending the gynecological colposcopy clinic of Shenzhen People's Hospital from January 2020 to December 2023 were retrospectively collected. Patients with HPV genotyping records and histopathologically diagnosed SIL or CC were included and divided into three groups based on pathological results: low-grade squamous intraepithelial lesion(LSIL) group, high-grade squamous intraepithelial lesion(HSIL) group, and CC group. The distribution of high-risk HPV subtypes was analyzed among the three groups, and multivariate Logistic regression was used to identify influencing factors for high-grade cervical lesions. A total of 4162 patients were included, comprising 4057 cervical SIL patients(3317 LSIL and 740 HSIL) and 105 CC patients. The overall mean age was(39.9±11.2) years. The HPV infection rate was 95.1%(3959/4162), and 25.0%(1040/4162) of patients had received HPV vaccination. Among high-risk HPV infections, HPV 52, HPV 16, HPV 58, and HPV 18 were the most common subtypes. HPV 52 had the highest infection rate in the LSIL group(27.6%), while HPV 16 was the most prevalent in the HSIL group(45.3%) and CC group(64.9%). Multivariate Logistic regression analysis showed that HPV vaccination( HPV infection is common in patients with SIL and CC, but the distribution of high-risk HPV subtypes varies among different grades of cervical lesions. It is recommended to strengthen cervical cancer screening and monitoring of key high-risk HPV infections in older and multiparous women in Shenzhen, and to continue promoting HPV vaccination.
2.Latent tuberculosis infection among cattle farming and slaughterhouse workers in Hubei Province,China
Da XU ; Zhixiong SHU ; Xue LI ; Ni NI ; Feifei TIAN ; Yanlin ZHAO ; Lijie ZHANG ; Wei CHEN ; Liping ZHOU
Chinese Journal of Zoonoses 2025;41(10):1061-1068
This study was aimed at preliminarily assessing the prevalence of latent tuberculosis infection(LTBI)among cattle farming and slaughterhouse workers across Wuxue,Xianning,and Yichang Cities in Hubei Province,and exploring associated risk factors.Data on cattle farming and slaughterhouse workers were gathered via a questionnaire.LTBI detection was performed with a tu-berculin skin test and interferon-gamma release assay,and influencing factors were subsequently analyzed.The LTBI prevalence among cattle farming and slaughterhouse personnel in the three cities was 30.50%,and a higher rate was observed in slaughterhouse workers(39.01%)than cattle farmers(21.63%)(P<0.01).Multifactor analysis indicated that working in slaughterhouses(95%CI:1.582-3.878),having a history of tuberculosis(95%CI:1.377-25.057)or BCG vaccination(95%CI:1.229-3.285),and having a college education or above(95%CI:0.303-0.859)were significant factors influencing LTBI positivity in these personnel.Having more than 30 years of work experience(95%CI:1.303-18.782)was a risk factor for personnel at cattle breeding farms.Among slaugh-terhouse personnel,having a college education or above(95%CI:0.164-0.894),11-20 years of work experience(95%CI:0.122-0.994),or a history of tuberculosis(95%CI:1.661-64.397);performing logistics work(95%CI:3.234-126.424);and working in slaughter-related positions(95%CI:1.209-19.639)were associated with LTBI positivity.Therefore,the slaughterhouse workers in the three cities had higher LTBI rates than the cattle farming workers,thus underscoring the need for increased attention to personnel in logistics and slaughter-related positions.
3.Predictive Value of Baseline Total Bilirubin Levels on the Efficacy of Immunotherapy in Advanced Non-Small Cell Lung Cancer
Lijie MA ; Wanling ZHU ; Hao CHEN
Journal of Medical Research 2025;54(5):136-140,173
Objective To investigate the correlation between peripheral blood total bilirubin(TBIL)levels and the efficacy and prognosis of immunotherapy in advanced non-small cell lung cancer(NSCLC),as well as its relationship with immune inflammation.Methods A retrospective analysis was conducted on 246 patients with advanced NSCLC who received immunotherapy from June 2019 to June 2022.Pre-treatment TBIL levels were collected,and the optimal cutoff value for TBIL was determined using the"X-tile"software and the ROC curve.The impact of pre-treatment TBIL on the short-term efficacy and long-term prognosis of advanced NSCLC was an-alyzed.Results The optimal cutoff value for TBIL was identified as 10.5μmol/L using the"X-tile"software and the ROC curve.A-nalysis of short-term efficacy indicated that patients with higher TBIL levels had a significantly better objective response rate(ORR)compared to those with lower levels(51.3%vs 33.8%,P=0.006).The disease control rate(DCR)was also higher in the higher TBIL level group compared to the low level group(92.9%vs 81.2%,P=0.007).Kaplan-Meier survival analysis revealed that patients with elevated TBIL levels had a longer median progression-free survival(PFS)compared to those with lower TBIL levels,with 13.0 vs 7.0 months,respectively(P<0.001).Similarly,the median overall survival(OS)was greater in the higher TBIL level group than in the lower TBIL level group,with 16.0 vs 12.0months,respectively(P<0.001).Additionally,there were significant differences in neutro-phil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),and systemic immune-inflammation index(SII)between two groups of different TBIL levels(P<0.05).Conclusion In immunotherapy for advanced non-small cell lung cancer,patients with higher baseline levels of TBIL exhibit a positive correlation with the efficacy and prognosis of immunotherapy.TBIL might be served as an important predictive marker for immunotherapy in patients with advanced NSCLC.
4.Effect Analysis of the Informatization of the Prescription Review Center and the Homogeneity of Pharmacist Service in Promoting the Rationality of Outpatient and Emergency Department Prescriptions
Congxin LI ; Xuejing LI ; Lijie GAO ; Jia CHEN ; Leilei DONG ; Xizhe LIU ; Ying PAN ; Suhui QIE
Herald of Medicine 2025;44(1):140-145
Objective To discusse the application effects of the informatization of the review center and the homogeneity of pharmacists on the rationality of emergency department prescriptions.Methods Based on the system rules of the rational drug use management system and manually set custom rules,the changes in pharmacist's review quality,efficiency homogeneity,and prescription rationality were compared before(February 2023 to July 2023)and after(August 2023 to January 2024)the construction of the review center,according to the informatization and process standardization management.Results After the establishment of the review center,analysis of variance showed that the approval rate of pharmacist's review significantly increased compared to before the establishment of the review center(P<0.05),while the average time consumption increased significantly(P<0.01).The average review time,average approval time,and average review return time have been extended from(4.50±0.58),(4.50±0.58),and(4.75±0.96)s to(11.67±1.03),(8.50±0.55)and(13.17±0.98)s,respectively.The trend chi-square test showed that the irrationality rate of emergency department prescriptions decreased monthly from 6.27%in August 2023 to 0.93%in January 2024(P<0.01).Correlation analysis between the number of intervention system rules since the establishment of the review center and the irrationality rate of emergency department prescriptions revealed a significant correlation(P=0.004 4).Conclusions By utilizing the platform of the review center,establishing dedicated review pharmacists and an information pharmacist team,and implementing informatization and standardized management processes,it can contribute to improving the quality and efficiency of prescription review,increasing the qualification rate of prescriptions,ensuring rational drug use,and enhancing the management level and medical quality of hospitals.
5.Construction of a predictive model for efficacy of neoadjuvant immunotherapy combined with chemotherapy in gastric cancer based on CT radiomics
Huo JUNJIE ; Chen FENGJU ; Duan YINGXIN ; Li MAN ; Shen LIJIE ; Wu YONGCUN ; Wang LIJUN
Chinese Journal of Clinical Oncology 2025;52(1):16-23
Objective:To investigate the value of a computed tomography(CT)radiomics-based model for predicting the efficacy of neoad-juvant immunotherapy combined with chemotherapy for locally advanced gastric cancer(LAGC).Methods:Data on 114 patients with LAGC who underwent radical surgery after neoadjuvant immunotherapy combined with chemotherapy at The Second Affiliated Hospital of Xingtai Medical College between June 2019 and June 2021 were retrospectively collected.These patients'data were divided into a training set(n=67)and a validation set(n=47)based on the time of admission.High-throughput features were extracted from baseline portal phase CT images of all patients,and the selected features were used to construct the radiomics prediction model.The predictive performance of the model was evaluated using receiver operating characteristic(ROC)and calibration curves.The prognostic ability of the model was assessed using Kaplan-Meier curves.Results:Based on the maximum relevancy min-redundancy(mRMR)algorithm and least absolute shrinkage and selection operator(LASSO)regression model,5 out of 584 assessed features were incorporated into the radiomics(Rad)score.The respect-ive areas under the curve for predicting pathological complete response(pCR)in the training and validation sets were 0.865 and 0.830,re-spectively,and good fits were obtained(Hosmer-Lemeshow test:P>0.05).The optimal cut-off value for the Rad score was determined based on the Youden index.Patients with high Rad scores had significantly higher 3-year recurrence-free survival rates(82.7%vs.60.4%in the training set and 78.9%vs.53.8%in the validation set)and 3-year overall survival rates(78.9%vs.60.2%in the training set and 79.3%vs.50.0%in the validation set)than those with low Rad scores(P<0.05).Conclusions:The CT radiomics prediction model effectively predicted the pathological response and prognosis of patients with LAGC after neoadjuvant immunotherapy combined with chemotherapy and is ex-pected to serve as a practical clinical tool.
6.Predictive Value of Baseline Total Bilirubin Levels on the Efficacy of Immunotherapy in Advanced Non-Small Cell Lung Cancer
Lijie MA ; Wanling ZHU ; Hao CHEN
Journal of Medical Research 2025;54(5):136-140,173
Objective To investigate the correlation between peripheral blood total bilirubin(TBIL)levels and the efficacy and prognosis of immunotherapy in advanced non-small cell lung cancer(NSCLC),as well as its relationship with immune inflammation.Methods A retrospective analysis was conducted on 246 patients with advanced NSCLC who received immunotherapy from June 2019 to June 2022.Pre-treatment TBIL levels were collected,and the optimal cutoff value for TBIL was determined using the"X-tile"software and the ROC curve.The impact of pre-treatment TBIL on the short-term efficacy and long-term prognosis of advanced NSCLC was an-alyzed.Results The optimal cutoff value for TBIL was identified as 10.5μmol/L using the"X-tile"software and the ROC curve.A-nalysis of short-term efficacy indicated that patients with higher TBIL levels had a significantly better objective response rate(ORR)compared to those with lower levels(51.3%vs 33.8%,P=0.006).The disease control rate(DCR)was also higher in the higher TBIL level group compared to the low level group(92.9%vs 81.2%,P=0.007).Kaplan-Meier survival analysis revealed that patients with elevated TBIL levels had a longer median progression-free survival(PFS)compared to those with lower TBIL levels,with 13.0 vs 7.0 months,respectively(P<0.001).Similarly,the median overall survival(OS)was greater in the higher TBIL level group than in the lower TBIL level group,with 16.0 vs 12.0months,respectively(P<0.001).Additionally,there were significant differences in neutro-phil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),and systemic immune-inflammation index(SII)between two groups of different TBIL levels(P<0.05).Conclusion In immunotherapy for advanced non-small cell lung cancer,patients with higher baseline levels of TBIL exhibit a positive correlation with the efficacy and prognosis of immunotherapy.TBIL might be served as an important predictive marker for immunotherapy in patients with advanced NSCLC.
7.Effect Analysis of the Informatization of the Prescription Review Center and the Homogeneity of Pharmacist Service in Promoting the Rationality of Outpatient and Emergency Department Prescriptions
Congxin LI ; Xuejing LI ; Lijie GAO ; Jia CHEN ; Leilei DONG ; Xizhe LIU ; Ying PAN ; Suhui QIE
Herald of Medicine 2025;44(1):140-145
Objective To discusse the application effects of the informatization of the review center and the homogeneity of pharmacists on the rationality of emergency department prescriptions.Methods Based on the system rules of the rational drug use management system and manually set custom rules,the changes in pharmacist's review quality,efficiency homogeneity,and prescription rationality were compared before(February 2023 to July 2023)and after(August 2023 to January 2024)the construction of the review center,according to the informatization and process standardization management.Results After the establishment of the review center,analysis of variance showed that the approval rate of pharmacist's review significantly increased compared to before the establishment of the review center(P<0.05),while the average time consumption increased significantly(P<0.01).The average review time,average approval time,and average review return time have been extended from(4.50±0.58),(4.50±0.58),and(4.75±0.96)s to(11.67±1.03),(8.50±0.55)and(13.17±0.98)s,respectively.The trend chi-square test showed that the irrationality rate of emergency department prescriptions decreased monthly from 6.27%in August 2023 to 0.93%in January 2024(P<0.01).Correlation analysis between the number of intervention system rules since the establishment of the review center and the irrationality rate of emergency department prescriptions revealed a significant correlation(P=0.004 4).Conclusions By utilizing the platform of the review center,establishing dedicated review pharmacists and an information pharmacist team,and implementing informatization and standardized management processes,it can contribute to improving the quality and efficiency of prescription review,increasing the qualification rate of prescriptions,ensuring rational drug use,and enhancing the management level and medical quality of hospitals.
8.Relationship between Dynamic Changes of NLR,PLR,and SII and Short-term Efficacy and Long-term Prognosis of Patients with Ad-vanced Non-small Cell Lung Cancer
Wanling ZHU ; Lijie MA ; Hao CHEN
Journal of Medical Research 2025;54(10):99-104
Objective To analyze the correlation of neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),and systemic immune-inflammatory index(SII)with short-term outcome and long-term prognosis in patients with advanced non-small cell lung cancer(NSCLC).Methods A retrospective study was conducted.A total of 215NSCLC patients who received a complete 4-cycle chemotherapy combined with immunotherapy or chemotherapy alone in the Department of Respiratory and Critical Care Medicine,Affiliated Hospital of Xuzhou Medical University from January 2021 to January 2023 were selected as the research subjects.The patients were divided into remission group(n=97)and non-remission group(n=118)based on the efficacy of the treatments,and the differences in NLR,PLR,SII,and decline rate of each index were compared between the two groups.NLR,PLR,SII and decline rate before and after treatment were grouped by the best cut-off value or median,and the differences in progression-free survival and overall survival were analyzed by each index group.Results NLR and PLR in the remission group before each cycle of treatment were signifi-cantly lower than those in the non-remission group,and SII in the remission group before cycles 2nd,3rd,and 4th of treatment were sig-nificantly lower than those in the non-remission group(P<0.05);From initial treatment to before the fourth treatment cycle,NLR and SII decline rates in the remission group were significantly higher than those in the non-remission group(P<0.05);the tumor stage,NLR before cycle 4th of treatment were independent influencing factors of short-term efficacy in patients with advanced NSCLC(P<0.05);patients with low NLR,PLR,SII and higher rates of decline in NLR and SII before cycle 4th treatment had longer progression-free survival and overall survival(P<0.05).Conclusion Tumor stage and post-treatment NLR are significantly correlated with the short-term outcomes of patients with advanced NSCLC,and high post-treatment NLR often suggests a poorer response to treatment.The prognosis of advanced NSCLC patients with higher NLR decline rate and higher SII decline rate after treatment is better.
9.Relationship between Dynamic Changes of NLR,PLR,and SII and Short-term Efficacy and Long-term Prognosis of Patients with Ad-vanced Non-small Cell Lung Cancer
Wanling ZHU ; Lijie MA ; Hao CHEN
Journal of Medical Research 2025;54(10):99-104
Objective To analyze the correlation of neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),and systemic immune-inflammatory index(SII)with short-term outcome and long-term prognosis in patients with advanced non-small cell lung cancer(NSCLC).Methods A retrospective study was conducted.A total of 215NSCLC patients who received a complete 4-cycle chemotherapy combined with immunotherapy or chemotherapy alone in the Department of Respiratory and Critical Care Medicine,Affiliated Hospital of Xuzhou Medical University from January 2021 to January 2023 were selected as the research subjects.The patients were divided into remission group(n=97)and non-remission group(n=118)based on the efficacy of the treatments,and the differences in NLR,PLR,SII,and decline rate of each index were compared between the two groups.NLR,PLR,SII and decline rate before and after treatment were grouped by the best cut-off value or median,and the differences in progression-free survival and overall survival were analyzed by each index group.Results NLR and PLR in the remission group before each cycle of treatment were signifi-cantly lower than those in the non-remission group,and SII in the remission group before cycles 2nd,3rd,and 4th of treatment were sig-nificantly lower than those in the non-remission group(P<0.05);From initial treatment to before the fourth treatment cycle,NLR and SII decline rates in the remission group were significantly higher than those in the non-remission group(P<0.05);the tumor stage,NLR before cycle 4th of treatment were independent influencing factors of short-term efficacy in patients with advanced NSCLC(P<0.05);patients with low NLR,PLR,SII and higher rates of decline in NLR and SII before cycle 4th treatment had longer progression-free survival and overall survival(P<0.05).Conclusion Tumor stage and post-treatment NLR are significantly correlated with the short-term outcomes of patients with advanced NSCLC,and high post-treatment NLR often suggests a poorer response to treatment.The prognosis of advanced NSCLC patients with higher NLR decline rate and higher SII decline rate after treatment is better.
10.PEG-rhG-CSF for primary prevention of granulocytopenia in breast cancer chemotherapy
Puchao PENG ; Haojun XUAN ; Jing ZHU ; Weiliang FENG ; Min YAO ; Xingfei YU ; Lijie CHEN
Chinese Journal of Endocrine Surgery 2025;19(2):153-158
Objective:To explore the effect of Pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) with chemotherapy on breast cancer patients who got agranulocytosis of 3 to 4 degree, agranulocytosis with fever (FN) and the influential factors of relative dose intensity (RDI) chemotherapy scheme. Meantime, the value of CD34 + and CD45 in peripheral blood on predicting agranulocytosis of 3-4 degree were investigated.Methods:A total of 104 women with breast cancer were treated at Huzhou Maternal and Child Health Hospital and Cancer Hospital of Zhejiang Province from Jan. 2022 to Sep. 2023. All subjects received primary prevention with PEG-rhG-CSF during chemotherapy. The clinical risk factors of agranulocytosis, FN and RDI were analyzed. The levels of CD34 + and CD45 in peripheral blood samples were analyzed by flow cytometry. Then the predictive value of the receiver characteristic curve (ROC) for Grade 3 to 4 agranulocytosis after primary prophylaxis with PEG-rhG-CSF for breast cancer chemotherapy was evaluated.Results:Among 104 breast cancer patients who received primary prevention of PEG-rhG-CSF during chemotherapy, 28 patients had agranulocytosis of 3 to 4 grade, 10 patients got FN, and 12 patients developed RDI<85%. The results of single factor analysis showed that CD34 +, CD45 and chemotherapy scheme were the influential factors of agranulocytosis of 3 to 4 degree, and low RDI of chemotherapy scheme ( OR=0.584, OR=0.999, OR=2.299, OR=0.100, OR=0.999, OR=3.088, P<0.05) . It also showed that CD34 + and chemotherapy scheme were the influential factors of FN ( OR=0.099, OR=2.667, P<0.05) . Multivariate Logistic regression analysis showed that CD34 +, CD45 and intensive chemotherapy were the independent risk factors of agranulocytosis of 3 to 4 degree after primary prevention with PEG-rhG-CSF ( OR=0.602, OR=0.999, OR=20.174, P<0.05) . CD34 + and intensive chemotherapy scheme were the independent influential factors of FN and RDI of chemotherapy scheme after primary prevention with PEG-RHG-CSF ( OR=0.072, OR=33.934, OR=0.086, OR=54.788, P<0.05) . The area under the curve (AUC) of CD34 + were 0.767 (95% CI:0.659-0.876) , AUC of CD45 were 0.743 (95% CI:0.644-0.842) , and the AUC of combined two indexes was 0.825 (95% CI:0.730-0.920) , which was higher than that of single index. So AUC of CD34 + and CD45 can be used for predicting agranulocytosis of grade 3 to 4 in breast cancer patients receiving primary prophylaxis with PEG-rhG-CSF. Conclusions:The levels of CD34 + and CD45 in peripheral blood of breast cancer patients with agranulocytosis of grade 3 to 4 receiving primary prevention with PEG-rhG-CSF during chemotherapy are lower. Combined detection of CD34 + and CD45 in peripheral blood can predict the occurrence of agranulocytosis of grade 3 to 4 in breast cancer patients after primary prevention with PEG-rhG-CSF. Also it can provide a reliable basis for assessing the risk of grade 3 to 4 agranulocytosis.

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