1.Development and validation of a multidisciplinary risk assessment scale for immune checkpoint inhibitor-associated myocarditis
Yanan DAI ; Yuan LIU ; Yuchen XU ; Qingqing CAI ; Yan WANG ; Yuhong ZHOU ; Leilei CHENG ; Junbo GE
Chinese Journal of Clinical Medicine 2025;32(4):561-567
Objective To develop a risk assessment scale for immune checkpoint inhibitor (ICI)-associated myocarditis based on multidisciplinary collaboration, and to evaluate its diagnostic performance. Methods Based on multidisciplinary cooperation, integrating clinical experience from oncology and cardiology, literature data, and patient conditions, a risk assessment scale for ICI-associated myocarditis was developed. A total of 101 patients with malignancies who received immunotherapy at Zhongshan Hospital, Fudan University, from October 2020 to October 2024 were included as the validation cohort. Patients were stratified into low-risk (0-1 point), medium-risk (2-4 points), and high-risk (≥5 points) groups based on their scale scores. The association between pretictive risk stratifications and actual assessment results was assessed using the Cox proportional hazards regression model. The predictive value of the scale for ICI-associated myocarditis was evaluated using receiver operating characteristic (ROC) curve. Agreement between the scale scores and actual assessment results was assessed using Cohen’s Kappa coefficient. Results Based on the scale pretictive results, 28(27.7%), 8(7.9%), 65(64.4%) patients were at low risk, medium risk, and high risk for ICI-related myocarditis, respectively; however, 46(45.5%), 8(7.9%), 47(46.5%) were at low risk, medium risk, and high risk actually. Kaplan-Meier survival analysis showed that the cumulative incidence of ICI-related myocarditis in the high-risk group was significantly higher than that in the medium- and low-risk groups (P<0.05). In the multivariable-adjusted Cox proportional hazards model, the ICI-related myocarditis risk in high-risk group was about 4 times that in the low-risk group. ROC curve analysis demonstrated that the average area under the curve (AUC) for predicting ICI-related myocarditis was 0.81, with an accuracy of 0.74. The Cohen’s Kappa coefficient was 0.55, indicating moderate agreement. In the actual high-risk group, no patient was predicted to be at low risk; in the actual low-risk group, 16 patients were predicted to be at high risk. Conclusions This risk assessment scale for ICI-associated myocarditis shows high predictive performance. It provides oncologists with a simple yet effective multidisciplinary diagnostic reference tool, potentially enhancing early identification of ICI-associated myocarditis.
2.Application of Micro-CT in experimental animal disease models
Shuzhen LI ; Wenjing DAI ; Qingqing YU ; Miao TIAN ; Qian ZHANG ; Bei LI
Acta Laboratorium Animalis Scientia Sinica 2024;32(5):676-682
Micro-computed tomography(Micro-CT)is a non-invasive technology that is widely used in animal experiments to assist in the detection of bone,lung,oral,metabolic,middle and inner ear diseases,as well as tumors,and in other animal disease models.The technique can provide diverse scientific and reliable imaging data for animal experiments and has accordingly become an indispensable experimental method in animal experiments.In this review,we introduce the imaging principles of Micro-CT,review its application in the study of animal disease models,summarize the limitations of Micro-CT technology,and consider its future prospects.
3.Cost-effectiveness analysis of chemical treatment with drones for Oncomelania hupensis control in marshland and lake areas
Yong CHEN ; Xiaojuan XU ; Daolong WEN ; Bo DAI ; Lan GAO ; Rong ZHANG ; Qingqing HUANG ; Linlin LI ; Fan ZHA ; Liang FANG ; Ping ZHANG ; Shiqing ZHANG ; Chunli CAO
Chinese Journal of Schistosomiasis Control 2024;36(5):502-506
Objective To evaluate the molluscicidal effect and cost of spraying molluscicides with drones against Oncomelania hupensis snails in marshland and lake areas, so as to provide new insights into field snail control in China. Methods A marshland and lake setting measuring approximately 12 000 m2 was selected in Wanzhi District, Wuhu City on June 2023 as the test field, and assigned to four groups, of 3 000 m2 in each group. Environmental cleaning was not conducted in groups A or B, which were given 5% niclosamide ethanolamine salt granules sprayed with knapsack-type sprayers and drones at a dose of 40 g/m2, and environmental cleaning was conducted in groups C and D, which were given 5% niclosamide ethanolamine salt granules sprayed with drones and knapsack-type sprayers at a dose of 40 g/m2, respectively. O. hupensis snails were surveyed before chemical treatment and 1, 3, 5, 7, 14 days post-treatment. The uniformity of chemicals was determined on the day of treatment, and the snail mortality, corrected snail mortality and density of living snails were calculated and compared among groups. The cost of molluscicides, labor fees of environmental cleaning and chemical treatment and cost of equipment were calculated, and the cost for a 1% reduction in the mean density of living snails was calculated 14 days post-treatment. Results The mean densities of living snails and mortality rates of snails were 1.82 to 2.85 snails/0.1 m2 and 1.41% to 2.94% in groups A, B, C and D before chemical treatment, and the mortality and corrected mortality of snails were 55.75%, 49.32%, 85.94% and 87.50%, and 55.00%, 48.47%, 85.70% and 87.29% in groups A, B, C and D 14 days post-treatment. There was a significant difference in the mortality of snails among the four groups 14 days post-treatment (χ2 = 38.735, P < 0.005), and there was a higher snail mortality in Group D than in Group A (χ2 = 16.876, P < 0.005), and higher in Group C than in Group B (χ2 = 20.508, P < 0.005). The density of living snails reduced by 55.00%, 43.94%, 90.43% and 87.14% 14 days post-treatment relative to pre-treatment in groups A, B, C and D, respectively. The test for uniformity of chemicals showed that the mean dose of molluscicides were 57.34, 55.21, 40.19 g/m2 and 32.37 g/m2 in groups A, B, C and D, respectively, and the minimal standard deviation (7.07) and coefficient of variation (0.18) of mean doses were seen in Group C. The costs for chemical treatment were 0.33 Yuan in groups A and B and 1.53 Yuan in groups C and D, respectively. The costs for a 1% reduction in the mean density of living snails were 17.82, 22.47, 50.73 Yuan and 52.56 Yuan in groups A, B, C, and D 14 days post-treatment, respectively. Conclusions The molluscicidal effect and cost of spraying 5% niclosamide ethanolamine salt granules with drones are comparable to manual spraying, and chemical treatment with drones are high in uniformity of molluscicides, time- and labor-saving, and feasible for applications in complex environments, which deserves widespread applications in the field of snail control.
4.Pathological Diagnosis of Systemic Amyloidosis in a New Zealand White Rabbit
Qingqing LIN ; Jinlong DAI ; Zhisen CHEN ; Jianmin GUO ; Wei YANG
Laboratory Animal and Comparative Medicine 2024;44(6):695-699
ObjectiveTo provide a reference for the diagnosis of amyloidosis in experimental animals through the pathological diagnosis of systemic amyloidosis in a case of a New Zealand white rabbit. MethodsIn a 6-month repeated ocular toxicity study, an abnormal finding was noted during the routine gross anatomical examination of one New Zealand white rabbit. Its organs were prepared as paraffin sections and stained with hematoxylin-eosin (HE) staining and Congo red staining. The histopathological features were observed under optical and polarized light microscopy. ResultsGross anatomical examination of the animal revealed an enlarged spleen and changes in the color and texture of the lung. HE staining showed that the splenic tissue structure was destroyed, the white pulp of the spleen was surrounded by dense amyloid deposition in the form of nodular rings, along with pressure atrophy of the white pulp. Amyloid deposits were also observed in the submandibular lymph nodes, mesenteric lymph nodes, ileum, sacculus rotundus, vermiform appendix, jejunum, cecum, and rectum. Congo red staining showed that the amyloid deposition in the affected organs appeared salmon-pink, and exhibited characteristic apple green birefringence under polarized light microscopy.Conclusion The histo-pathological features of the New Zealand white rabbit are consistent with the diagnostic characteristics of systemic amyloidosis.
5.Flavonoid compounds improve hippocampal neuro-genesis and cognitive dysfunction in mice
Guixiang WANG ; Qingqing ZHANG ; Jiahui LIANG ; Manli ZHANG ; Xiaoying GOU ; Binbin DAI ; Yongxiang LIU ; Jingyu YANG ; Yuting LI
Chinese Journal of Pharmacology and Toxicology 2023;37(7):511-511
OBJECTIVE To investigate the improve-ment functions of flavonoid compounds on temozolomide(TMZ)-,aging-or AD model-induced dysregulation of hip-pocampal NSC lineage progression,retardancy of den-dritic spine maturation in new-born neurons,as well as impairment of hippocampal-related learning and memory.METHODS We applied 30-week-old neural stem cell(NSC)specific promoter Nestin-GFP and NestinCreERT2:Rosa26-LSL-tdTomato transgenic mice and 16-week-old AD model 5XFAD transgenic mice,together with hippo-campal microinjection(ih),endogenous fluorescence trac-ing and immunofluorescent staining.RESULTS Both fla-vonoid compound A and its functional derivative flavo-noid compound B dose-dependently improved TMZ-,aging-or AD-induced defects of hippocampal NSC lin-eage progression and the maturation of dendritic spines of newborn neurons,thereby improving hippocampus related learning and memory.CONCLUSION This paper provides a new idea and treatment strategy for the devel-opment of new flavonoids that can promote neurogene-sis for neurodegenerative diseases and aging.
6.Diagnostic utility of electromagnetic navigation bronchoscopy combined with radial endobronchial ultrasound in peripheral pulmonary lesions
Min YU ; Shenyun SHI ; Yan LI ; Yanzhe YU ; Tingting ZHAO ; Qingqing XU ; Qi ZHAO ; Jingjing DING ; Anning FENG ; Jinghong DAI ; Yonglong XIAO
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2022;29(01):44-49
Objective To investigate the diagnostic value and safety of electromagnetic navigation bronchoscopy combined with radial endobronchial ultrasound in peripheral pulmonary nodules. Methods The clinical imaging, surgical and pathological data of 60 patients with 76 peripheral pulmonary nodules who underwent electromagnetic navigation bronchoscopy combined with radial endobronchial ultrasound guided biopsy in the Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School from June 2020 to June 2021 were retrospectively analyzed. The diagnosis rate and complications were analyzed and summarized. The 76 pulmonary nodules were divided into a small pulmonary nodules group (10 nodules, diameter≤1 cm) and a pulmonary nodules group (1 cm
7.Application of multiple post labeling delay time arterial spin labeling imaging in the quantitative blood flow analysis of brain subregions in healthy adults
Qingqing LI ; Fei CHEN ; Jianguo ZHONG ; Yuan SHEN ; Congsong DONG ; Lizheng YAO ; Jianbin HU ; Shu WANG ; Xiaochen NIU ; Zhenyu DAI
Chinese Journal of Internal Medicine 2022;61(8):908-915
Objective:To explore the normal ranges of perfusion parameters between cerebral hemisphere, cerebellar hemisphere and brain anatomical subregions (56 pairs) in different gender and age groups with multiple post labeling delay time (Multi-PLD) arterial spin labeling (ASL) imaging.Methods:From November 2020 to December 2020, 42 healthy adult volunteers (Male 25, Female 17) were recruited to perform 7 PLD ASL imaging, including 21 young adults (15 males and 6 females, aged 23—35 years) and 21 seniors (10 males and 11 females, aged 36—74 years). The data was processed offline by Cereflow software to obtain arterial arrival time (ATT) and corrected cerebral blood flow (CBF) and cerebral blood volume (CBV) perfusion parameters. SimpleITK standardization function was used to standardize the calculated perfusion image according to the anatomical automatic labeling (AAL) template. Therefore, CBF, ATT, CBV perfusion values of brain subregions were obtained. Paired samples t test, Wilcoxon rank sum test, independent samples t test and Mann-Whitney U test were used to compare the differences of perfusion parameters in the cerebral hemisphere, the cerebellar hemisphere, brain subregions depending on side, gender and age. Pearson correlation analysis was used to compare the correlations of perfusion parameters with age. Results:CBF in 62.5% (35/56) subregions and CBV in 44.6% (25/56) subregions were higher in right side than those in left side. ATT in most brain anatomical subregions (16/56) were higher in left side. The CBF [(35.30±8.31) vs. (34.34±7.53) ml·100g -1·min -1, P=0.021], CBV [(0.47±0.11) vs. (0.45±0.09) ml/100g, P<0.001], ATT [(1.30±0.10) vs. (1.24±0.11) s, P<0.001] in left cerebellar hemisphere were higher than that of right side. The CBF (28/56) of cerebral hemisphere, cerebellar hemisphere and brain subregions was higher in females than that in males, while ATT in 83.9% (47/56) subregions was lower than that in males (all P<0.05). CBV in female subjects was higher only in 5 brain regions (superior occipital gyrus, middle occipital gyrus, inferior occipital gyrus, superior parietal gyrus and cerebelum_7b) (all P<0.05). In young subjects, CBF in 44.6% (25/56) subregions and CBV in 33.9% (19/56) subregions were higher than those in the senior group (all P<0.05). The ATT in most subregions in young group were lower than those in senior group, but the difference was statistically significant only in rectus gyrus ( P=0.026) and paracentral lobule ( P=0.006). The CBF ( r=-0.430, P=0.005) and CBV ( r=-0.327, P=0.035) of cerebral hemisphere were negatively correlated with age. The CBF (24/25, r range:-0.497 —-0.343, all P<0.05) and CBV (16/19, r range:-0.474 —-0.322, all P<0.05) in most subregions were negatively correlated with age, while ATT was positively correlated (gyrus rectus: r=0.311, P=0.045; paracentral lobule: r=0.392, P=0.010). Conclusions:Multi-PLD ASL imaging could be applied for quantitative analysis of brain perfusion. The perfusion parameters of anatomical subregions are different depending on side, gender, and age.
8.A comparative study of dose distribution of prostate IMRT between IMRT and VMAT models using knowledge-based planning
Suyan BI ; Zhitao DAI ; Zhen DING ; Xingru SUN ; Qingqing YUAN ; Zhijian CHEN ; Hua REN
Chinese Journal of Radiation Oncology 2021;30(2):164-169
Objective:To compare the dosimetric difference between knowledge-based planning (KBP) volumetric modulated arc therapy (VMAT) and intensity-modulated radiotherapy (IMRT) models for predicting the dose distribution during IMRT, aiming to investigate the feasibility of VMAT model to predict the IMRT plans.Methods:Fifty prostate cancer patients who had completed radiotherapy were selected. Manual planning was performed on each selected patient to generate the corresponding IMRT and VMAT plans. The IMRT and VMAT manual plans of the 40 randomly-selected patients were adopted to generate the KBP VMAT and IMRT models. The remaining 10 patients were utilized to predict IMRT plans. VMAT library-derived IMRT model (V-IMRT) and IMRT library-derived IMRT model (I-IMRT) were generated. Dosimetric parameters related to organ-at-risks (OARs) and planning target volume (PTV) were statistically compared among the manual IMRT (mIMRT), V-IMRT and I-IMRT plans.Results:Compared with the mIMRT plan, I-IMRT could significantly better control D max of the PTV ( P=0.039), whereas V-IMRT and I-IMRT plans could better protect the bladder and bilateral femoral heads (both P<0.05). V-IMRT plan could better protect the D max of bilateral femoral heads and the D 15% of the right femoral head (both P<0.05), whereas no significant difference was observed in other OARs and PTV (all P>0.05). Conclusions:Compared with the manual plans, KBP IMRT plan has significant advantages in protecting the OARs. KBP VMAT and IMRT models are both feasible in clinical practice, which yield equivalent accuracy for predicting IMRT plan.
9.Effect of 2-year resistance exercises on cardiovascular disease risk in prediabetes patients
Ying WANG ; Xiaodan YUAN ; Xia DAI ; Fan LI ; Hong JI ; Qingqing LOU
Chinese Journal of Internal Medicine 2021;60(1):22-28
Objective:To investigate the effect of a 2-year resistance and aerobic training on reducing the risk of cardiovascular disease in patients with prediabetes.Methods:A total of 248 patients with prediabetes were enrolled from Chinese and Western Medicine Hospital Affiliated to Nanjing University of Chinese Medicine from January to April 2014, and Danyang People′s Hospital and The First Affiliated Hospital of Guangxi Medical University from May to December 2014.Based on random number table method, the patients were divided into 3 groups: the resistance training group (RT group, 82 cases), the aerobic training group (AT group, 83 cases) and control group (83 cases). Participants in the RT group and the AT group underwent a total of 24 months of exercise training. Changes in indicators (blood glucose,blood lipid, etc.) at baseline and the end of 12 and 24 months among the groups were compared.Results:After intervention, glycosylated hemoglobin (HbA1c), low density lipoprotein cholesterol (LDL-C), blood pressure and homeostasis model 2 insulin resistance index (HOMA2-IR) in the RT and AT groups tended to decrease, and the steady state model 2 β cell function index (HOMA2-β) tended to increase. At the end of 24 months, HbA1c [5.80 (5.43, 6.20) %, 5.70 (5.50, 6.00)% vs. 6.20 (5.70, 6.60) %, all P≤ 0.01], LDL-C [3.07 (2.69, 3.58) mmol/L, 2.97 (2.62, 3.95) mmol/L vs. 3.21(2.54, 3.78) mmol/L, all P<0.05] and HOMA2-IR [0.96 (0.82, 1.47), 1.20 (0.99, 1.43) vs. 1.34 (1.09, 1.51), all P<0.05] were significantly decreased in the RT and AT groups than in the control group. In addition, HOMA2-β [84.50 (60.55, 107.33), 93.00 (78.60, 119.75) vs. 53.40 (37.70, 80.40), all P = 0.001] was significantly increased in the AT and RT groups compared with that in the control group. There were no significant differences in triglyceride (TG) and high-density lipoproteincholesterol (HDL-C) levels between the training groups and the control group (all P>0.05). After adjusting for age, sex and blood pressure, the cardiovascular risk of prediabetes was significantly reduced in RT ( P =0.017) and AT groups ( P =0.018). The Cox regression analyses showed that both the resistance training (HR=0.419, 95 %CI =0.415-0.942, P=0.037) and the aerobic training ( HR=0.310, 95 %CI=0.447-0.866, P=0.026) were protective factors for cardiovascular disease in prediabetic patients after adjustment of age, sex, statins, body mass index and waist-to-hip ratio, which reduced the risks of cardiovascular disease in prediabetic patients by 58.1% and 69.0%, respectively. Conclusions:Two years of aerobic and resistance training interventions have obvious advantages on glycemic and insulin resistance control in prediabetes patients. The resistance training can reduce the risk of cardiovascular disease, and it is, thus, recommended for prediabetic patients without obvious exercise contraindications.
10.AncPhore: A versatile tool for anchor pharmacophore steered drug discovery with applications in discovery of new inhibitors targeting metallo-
Qingqing DAI ; Yuhang YAN ; Xiangli NING ; Gen LI ; Junlin YU ; Ji DENG ; Lingling YANG ; Guo-Bo LI
Acta Pharmaceutica Sinica B 2021;11(7):1931-1946
We herein describe AncPhore, a versatile tool for drug discovery, which is characterized by pharmacophore feature analysis and anchor pharmacophore (

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