1.Construction of a cardiovascular disease risk prediction model for patients with rheumatic immune diseases based on echocardiography combined with clinical laboratory tests
Ting SONG ; Yilu SHI ; Shasha DUAN ; Dan ZHANG ; Ying JIANG ; Yaxi WANG ; Shurong YUN ; Xiaoshan ZHANG
Chinese Journal of Ultrasonography 2025;34(8):701-707
Objective:To investigate the incidence and high-risk pathogenic factors of cardiovascular disease(CVD)in patients with rheumatic and autoimmune diseases,and to construct and validate a predictive model for the risk of CVD occurrence in these patients.Methods:A retrospective analysis was conducted on 239 patients with rheumatic and autoimmune diseases who underwent treatment and echocardiography at the Affiliated Hospital of Inner Mongolia Medical University between June 2020 and June 2023. General patient data,laboratory test results,and echocardiographic findings were collected. Follow-up was performed via electronic medical records or telephone surveys until December 2024 to determine the incidence of CVD,starting from the date of the first echocardiographic examination. Predictive factors were screened using univariate analysis and Lasso regression,and a Logistic regression model was constructed. Internal validation was performed using the Bootstrap method. The model's accuracy and clinical utility were assessed using the Hosmer-Lemeshow test,calibration curve,and decision curve analysis.Results:Among the 239 patients,111 developed CVD. Logistic regression analysis identified age,diastolic blood pressure,use of immunosuppressants,lymphocyte count(LYM),α-hydroxybutyrate dehydrogenase(α-HBDH)level,serum cystatin C(CysC),and right ventricular fractional area change(RVFAC)as independent predictive factors for CVD in these patients(all P<0.05). The area under the ROC curve(AUC)for the prediction model was 0.895(95% CI = 0.856 - 0.935),and after Bootstrap validation,it was 0.894(95% CI = 0.861-0.925). The Hosmer-Lemeshow test,calibration curve,and decision curve analysis all indicated that the model had good accuracy and clinical utility. Conclusions:Age,diastolic blood pressure,use of immunosuppressants,LYM,α-HBDH,CysC,and RVFAC may serve as independent risk factors for CVD in patients with rheumatic and autoimmune diseases. The prediction model based on echocardiography combined with laboratory indicators can,to some extent,predict the risk of CVD occurrence in these patients.
2.Establishment of Risk Prediction Model for Cardiovascular Outcomes in Patients with Connective Tissue Disease
Yilu SHI ; Yaxi WANG ; Dan ZHANG ; Xiaoxiao LIU ; Shurong YUN ; Ting SONG ; Xiaoshan ZHANG
Chinese Journal of Medical Imaging 2025;33(10):1104-1112
Purpose To assess the utility of echocardiographic parameters in predicting adverse cardiovascular in patients with connective tissue disease.Materials and Methods A retrospective analysis was conducted on the clinical and echocardiographic records of patients with connective tissue disease from the Affiliated Hospital of Inner Mongolia Medical University(June 1st,2020 to June 1st,2023)who had complete medical data and at least twelve months of follow-up.Variables were screened based on univariate analysis,combined with clinical expertise and XGBoost feature weight analysis;this information was used to construct a Cox proportional hazards regression model designed to predict composite endpoint events of adverse cardiovascular outcomes.Internal validation was performed using the Bootstrap resampling method,and the model's performance was evaluated.Results The study included 123 participants.The incidence of positive events reached 39.02%(48/123).Mitral valve early diastolic annular velocity(reflecting left heart function)(HR=0.79,P=0.041)and tricuspid annular plane systolic excursion(reflecting right heart function)(HR=0.92,P=0.044)emerged as significant predictors for adverse cardiovascular outcomes.Compared with the clinical model,the model combined with left heart function parameters showed significant improvements in both risk classification and absolute accuracy for short-term and medium-term adverse prognosis(NRI365=0.054,IDI365=0.060,NRI730=0.064,IDI730=0.079,all P<0.05)and optimized risk classification for long-term adverse prognosis(NRI1 095=0.256,P<0.05).In contrast,the model combined with right heart function parameters improved risk classification at all time points(NRI365=0.054,NRI730=0.000,NRI1 095=0.135,all P<0.05).Conclusion Mitral valve early diastolic annular velocity and tricuspid annular plane systolic excursion,which reflect cardiac function,are factors for predicting adverse cardiovascular outcomes among individuals diagnosed with connective tissue disease.Multi-parameter combined models incorporating echocardiographic variables can provide incremental predictive value compared with clinical models.
3.Establishment of Risk Prediction Model for Cardiovascular Outcomes in Patients with Connective Tissue Disease
Yilu SHI ; Yaxi WANG ; Dan ZHANG ; Xiaoxiao LIU ; Shurong YUN ; Ting SONG ; Xiaoshan ZHANG
Chinese Journal of Medical Imaging 2025;33(10):1104-1112
Purpose To assess the utility of echocardiographic parameters in predicting adverse cardiovascular in patients with connective tissue disease.Materials and Methods A retrospective analysis was conducted on the clinical and echocardiographic records of patients with connective tissue disease from the Affiliated Hospital of Inner Mongolia Medical University(June 1st,2020 to June 1st,2023)who had complete medical data and at least twelve months of follow-up.Variables were screened based on univariate analysis,combined with clinical expertise and XGBoost feature weight analysis;this information was used to construct a Cox proportional hazards regression model designed to predict composite endpoint events of adverse cardiovascular outcomes.Internal validation was performed using the Bootstrap resampling method,and the model's performance was evaluated.Results The study included 123 participants.The incidence of positive events reached 39.02%(48/123).Mitral valve early diastolic annular velocity(reflecting left heart function)(HR=0.79,P=0.041)and tricuspid annular plane systolic excursion(reflecting right heart function)(HR=0.92,P=0.044)emerged as significant predictors for adverse cardiovascular outcomes.Compared with the clinical model,the model combined with left heart function parameters showed significant improvements in both risk classification and absolute accuracy for short-term and medium-term adverse prognosis(NRI365=0.054,IDI365=0.060,NRI730=0.064,IDI730=0.079,all P<0.05)and optimized risk classification for long-term adverse prognosis(NRI1 095=0.256,P<0.05).In contrast,the model combined with right heart function parameters improved risk classification at all time points(NRI365=0.054,NRI730=0.000,NRI1 095=0.135,all P<0.05).Conclusion Mitral valve early diastolic annular velocity and tricuspid annular plane systolic excursion,which reflect cardiac function,are factors for predicting adverse cardiovascular outcomes among individuals diagnosed with connective tissue disease.Multi-parameter combined models incorporating echocardiographic variables can provide incremental predictive value compared with clinical models.
4.Construction of a cardiovascular disease risk prediction model for patients with rheumatic immune diseases based on echocardiography combined with clinical laboratory tests
Ting SONG ; Yilu SHI ; Shasha DUAN ; Dan ZHANG ; Ying JIANG ; Yaxi WANG ; Shurong YUN ; Xiaoshan ZHANG
Chinese Journal of Ultrasonography 2025;34(8):701-707
Objective:To investigate the incidence and high-risk pathogenic factors of cardiovascular disease(CVD)in patients with rheumatic and autoimmune diseases,and to construct and validate a predictive model for the risk of CVD occurrence in these patients.Methods:A retrospective analysis was conducted on 239 patients with rheumatic and autoimmune diseases who underwent treatment and echocardiography at the Affiliated Hospital of Inner Mongolia Medical University between June 2020 and June 2023. General patient data,laboratory test results,and echocardiographic findings were collected. Follow-up was performed via electronic medical records or telephone surveys until December 2024 to determine the incidence of CVD,starting from the date of the first echocardiographic examination. Predictive factors were screened using univariate analysis and Lasso regression,and a Logistic regression model was constructed. Internal validation was performed using the Bootstrap method. The model's accuracy and clinical utility were assessed using the Hosmer-Lemeshow test,calibration curve,and decision curve analysis.Results:Among the 239 patients,111 developed CVD. Logistic regression analysis identified age,diastolic blood pressure,use of immunosuppressants,lymphocyte count(LYM),α-hydroxybutyrate dehydrogenase(α-HBDH)level,serum cystatin C(CysC),and right ventricular fractional area change(RVFAC)as independent predictive factors for CVD in these patients(all P<0.05). The area under the ROC curve(AUC)for the prediction model was 0.895(95% CI = 0.856 - 0.935),and after Bootstrap validation,it was 0.894(95% CI = 0.861-0.925). The Hosmer-Lemeshow test,calibration curve,and decision curve analysis all indicated that the model had good accuracy and clinical utility. Conclusions:Age,diastolic blood pressure,use of immunosuppressants,LYM,α-HBDH,CysC,and RVFAC may serve as independent risk factors for CVD in patients with rheumatic and autoimmune diseases. The prediction model based on echocardiography combined with laboratory indicators can,to some extent,predict the risk of CVD occurrence in these patients.
5.Logic-gated tumor-microenvironment nanoamplifier enables targeted delivery of CRISPR/Cas9 for multimodal cancer therapy.
Yongchun PAN ; Xiaowei LUAN ; Fei ZENG ; Xuyuan WANG ; Shurong QIN ; Qianglan LU ; Guanzhong HE ; Yanfeng GAO ; Xiaolian SUN ; Xin HAN ; Bangshun HE ; Yujun SONG
Acta Pharmaceutica Sinica B 2024;14(2):795-807
Recent innovations in nanomaterials inspire abundant novel tumor-targeting CRISPR-based gene therapies. However, the therapeutic efficiency of traditional targeted nanotherapeutic strategies is limited by that the biomarkers vary in a spatiotemporal-dependent manner with tumor progression. Here, we propose a self-amplifying logic-gated gene editing strategy for gene/H2O2-mediated/starvation multimodal cancer therapy. In this approach, a hypoxia-degradable covalent-organic framework (COF) is synthesized to coat a-ZIF-8 in which glucose oxidase (GOx) and CRISPR system are packaged. To intensify intracellular redox dyshomeostasis, DNAzymes which can cleave catalase mRNA are loaded as well. When the nanosystem gets into the tumor, the weakly acidic and hypoxic microenvironment degrades the ZIF-8@COF to activate GOx, which amplifies intracellular H+ and hypoxia, accelerating the nanocarrier degradation to guarantee available CRISPR plasmid and GOx release in target cells. These tandem reactions deplete glucose and oxygen, leading to logic-gated-triggered gene editing as well as synergistic gene/H2O2-mediated/starvation therapy. Overall, this approach highlights the biocomputing-based CRISPR delivery and underscores the great potential of precise cancer therapy.
6.The role of plasma exchange in treatment of postpartum HELLP syndrome
Qing WEI ; Shurong SONG ; Ni LI ; Qian LIANG
Chongqing Medicine 2017;46(34):4799-4801
Objective To explore the clinical effect of plasma exchange on postpartum HELLP syndrome.Methods From January 2014 to December 2015,44 patients with postpartum HELLP syndrome were chosen as the treatment group which received conventional treatment combined with plasma exchange.And we selected 47 patients with postpartum HELLP syndrome as the control group from January 2012 to December 2013.Serum hemoglobin(Hb),platelet(PLT),prothrombin time(PT),serum aspartate aminotransferase (AST),alanine aminotransferase (ALT),serum total bilirubin (TBIL),conjugated bilirubin(DBIL) and serum lactic dehydrogenase(LDH),blood urea nitrogen(BUN) and creatinine(Cr) level in patients with postpartum HELLP syndrome were detected before and after the treatment.The ICU stay,recovery time of PLT,ALT,AST,and LDH were compared between two group.Results After treatment,the levels of PLT,AST,ALT and LDH in the treatment group were significantly higher than those in the control group (P<0.05).The ICU stays and the recovery time of PLU,ALT,AST and LDH in the treatment group were significantly lower than the control group (P<0.05).Conclusion Plasma replacement can significantly improve the clinical symptoms of postpartum HELLP syndrome patients,improve the cure rate.
7.Research progress of antiviral treatment in preventing mother-to-infant transmission of hepatitis B virus
Qian LIANG ; Ni LI ; Yanyan SUN ; Shurong SONG
Tianjin Medical Journal 2016;44(3):381-384
Hepatitis B virus (HBV) infection is a worldwide health problem and vertical transmission is the main source of chronic infection in Asian countries. Breakthrough perinatal HBV transmission occurs in 10%-15% of infants born to pregnatal women with high viral load even with appropriate postexposure immunoprophylaxis. Management of chronic hepati?tis B (CHB) during pregnancy remains a challenge, with unique issues that involve prevention of mother-to-child transmis?sion (MTCT) and safe use of antiviral therapy. Previous studies indicate that antiviral therapy with analogs (Lamivudine, Tel?bivudine or Tenofovir) may prevent vertical transmission during late pregnancy in highly viremic mothers. This article sum?marized relevant studies that antiviral therapy in preventing MTCT of hepatitis B virus.
8.Efficacy and safety of mifepristone combined with misoprostol for termination of pregnancy ;between 8 and 16 weeks of gestation
Jinfeng QIAN ; Xiaoping JING ; Shuying WU ; Shurong ZHENG ; Yi LI ; Mulan REN ; Wen DI ; Huan SHEN ; Baihua DONG ; Qing CHANG ; Huirong SHI ; Chen YAO ; Wei SONG ; Zirong HUANG
Chinese Journal of Obstetrics and Gynecology 2015;(7):505-509
Objective To assess the efficacy and safety of mifepristone combined with oral or vaginal misoprostol for termination of pregnancy between 8 and 16 weeks of gestation. Methods This was a randomized, multi-center, open clinical trial. A total of 625 women at 8-16 weeks of gestation were randomized to receive 200 mg oral mifepristone followed by either oral misoprostol 400 μg every 3 hours or vaginal misoprostol 400μg every 6 hours for a maximum of 4 doses 36-48 hours later. There were 417 women in oral group with 198 at 8-9 weeks and 219 at 10-16 weeks, while 208 women in vaginal group with 99 at 8-9 weeks and 109 at 10-16 weeks. The outcome measures were the success abortion rate, induction to abortion interval, the amount of bleeding, reoccurrence of menstruation and adverse events. Results Abortion rate was significantly higher in vaginal group [98.1% (202/206)] than that in oral group [94.0%(390/415), P=0.023]; concerning termination of pregnancy at 8-9 weeks and 10-16 weeks respectively, there were no significant differences between oral and vaginal groups (P=0.156, P=0.073). The induction to abortion interval was no significant difference in oral and vaginal group in different gestational weeks ( P=0.238, P=0.273). The average induction to abortion interval was (4.1 ± 6.6) hours and (6.0 ± 4.5) hours respectively in terminating 8-9 weeks and 10-16 weeks of gestation. Concerning the amount of bleeding within 2 hours of placenta expulsion, there was significant difference between oral group [(63±46) ml] and vaginal group [(55 ± 45) ml] in terminating 8-9 weeks of gestation (P=0.047), while there was no significant difference between groups in terminating 10-16 weeks of gestation [oral group (76 ± 52) ml versus vaginal group (76 ± 61) ml, P=0.507]. The reoccurrence of menstruation was about 37 days in both oral and vaginal groups. Two cases of incomplete abortion were serious adverse events (SAE) relating to treatment. The common adverse events (AE) of nausea and vomiting were significantly higher in oral group [57.2% (239/417), 36.3% (151/417)] than those in vaginal group [45.4% (94/208), 26.1% (54/208); P=0.005, 0.011]. Conclusion Oral or vaginal misoprostol combined with mifepristone, is effective and safe for termination of pregnancy between 8 and 16 weeks of gestation.
9.Spinal Decompression System for Patients with Lumbar Disc Herniation
Xin CHEN ; Shurong CHEN ; Lin SONG ; Huiping LU ; Shu JIANG
Chinese Journal of Rehabilitation Theory and Practice 2013;19(12):1177-1179
Objective To explore the effect of spinal decompression system on lumbar disc herniation. Methods 83 patients of lumbar disc herniation were divided into observation group (n=42) and control group (n=41). Both groups received massage therapy, while the observation group was treated with spinal decompression system in addition. The effect was evaluated with Visual Analogue Scale (VAS) and Japanese Orthopedic Association (JOA) assessment of low back pain. Results The VAS score decreased and the JOA score increased in both groups after treatment (P<0.05), and it was better in the observation group than in the control group (P<0.01). Conclusion Spinal decompression system could improve the therapeutic effect on lumbar disc herniation.
10.Analysis of risk factors of acute renal failure after surgery for simple abdominal trauma
Xiaohang LI ; Jialin ZHANG ; Fengshan WANG ; Shurong LIU ; Shaowei SONG ; Yongfeng LIU
Chinese Journal of Trauma 2010;26(6):507-510
Objective To investigate the risk factors associated with acute renal failure (ARF)after surgery in patients with simple abdominal trauma. Methods A retrospective case-control study was carried out in patients with simple abdominal trauma after surgery from January 2003 through May 2008 in our hospital. Twenty patients with ARF were set as study group and 68 patients without ARF as control group. Clinical data including age, gender, injury type, number of injured organs, blood transfusion volume, intra-abdominal pressure, abdominal infection, shock and related factors were analyzed by using univariate and Logistic regression to identify the independent risk factors of ARF after surgery in patients with simple abdominal trauma. Results Univariate analysis revealed statistical difference in aspects of blood transfusion volume ( > 1 600 ml), operation timing ( interval between trauma and operation >12 h), preoperative shock duration ( >6 h), postoperative abdominal infection and intra-abdominal hypertension ( > 12 mm Hg) between two groups ( P < 0. 05 ). Logistic regression analysis showed that these five indices were the independent risk factors of ARF after surgery in patients with simple abdominal trauma ( P < 0. 05 ). Conclusions Massive blood transfusion, delayed operation, long preoperative duration of shock, postoperative abdominal infection or intra-abdominal hypertension are the risk factors of ARF after surgery in patients with simple abdominal trauma. We should pay attention to these factors and take effective measures to prevent occurrence of ARF.


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