1.Correlation between serum metabolomic characteristics and risk of myocardial infarction in patients with coronary atherosclerosis
Jin LIU ; Wanhua CHEN ; Yueru REN
Journal of Xi'an Jiaotong University(Medical Sciences) 2025;46(3):402-409
Objective To explore the correlation between serum metabolomics characteristics and the risk of myocardial infarction in patients with coronary atherosclerosis(CAS)so as to provide new ideas and targets for clinical prevention and treatment of myocardial infarction.Methods A total of 180 CAS patients treated in our hospital from June 2018 to June 2022 were selected as the study subjects and divided into control group(non-myocardial infarction,n=138)and observation group(myocardial infarction,n=42)according to follow-up.Propensity score matching method was used to perform 1∶1 matching,and a total of 34 pairs were successfully matched.The serum samples of patients were detected by mass spectrometry chip in metabolomics technology.Principal component analysis(PCA),partial least square discriminant analysis(PLS-DA),and orthogonal partial least square discriminant analysis(OPLS-DA)results were compared among groups to screen out different metabolites.The diagnostic value of differential metabolites was evaluated by receiver operating characteristic(ROC)curve.The samples were cluster analyzed by agglomerative hierarchical clustering,and the pathway enrichment analysis of differential metabolites was carried out.Results There were significant differences in the mass spectra of serum samples from the two groups of CAS patients.PC A results showed that there was a certain separation trend between the overall level of serum metabolism in the two groups,but the trend was not significant(R2X=0.654,Q2Y=0.719).PLS-DA analysis showed the separation trend of the two groups of samples(R2X=0.582,R2Y=0.810,Q2Y=0.675).Further OPLS-DA analysis showed that the two groups of samples had an obvious separation trend(R2X=0.595,R2Y=0.831,Q2Y=0.742).Twelve differential metabolites between groups were screened by VIP value>1 and Wilcoon-Mann-Whitney test;of them three were upregulated and nine were downregulated.Upregulated D-glucose and downregulated glycocholic acid,ursodeoxycholic acid,nicotinic acid acid,niacinamide and succinic acid were of high value as diagnostic markers for myocardial infarction.Differential metabolite pathway analysis showed that among the eight metabolic pathways that may be disturbed by differential metabolites,non-alcoholic fatty liver,niacin and niacinamide metabolism,and pathways associated with type 2 diabetes mellitus Impact ≥ 0.1 might be potential pathways in the pathogenesis of myocardial infarction in CAS patients.Conclusion Serum levels of glycinocholic acid,D-glucose,ursodeoxycholic acid,niacin,niacinamide,and succinic acid can be used as potential markers to distinguish the risk of myocardial infarction in patients with CAS.The metabolic pathways affected mainly include non-alcoholic fatty liver disease,niacin and niacinamide metabolism,and type 2 diabetes mellitus-related pathways.
2.Correlation between serum metabolomic characteristics and risk of myocardial infarction in patients with coronary atherosclerosis
Jin LIU ; Wanhua CHEN ; Yueru REN
Journal of Xi'an Jiaotong University(Medical Sciences) 2025;46(3):402-409
Objective To explore the correlation between serum metabolomics characteristics and the risk of myocardial infarction in patients with coronary atherosclerosis(CAS)so as to provide new ideas and targets for clinical prevention and treatment of myocardial infarction.Methods A total of 180 CAS patients treated in our hospital from June 2018 to June 2022 were selected as the study subjects and divided into control group(non-myocardial infarction,n=138)and observation group(myocardial infarction,n=42)according to follow-up.Propensity score matching method was used to perform 1∶1 matching,and a total of 34 pairs were successfully matched.The serum samples of patients were detected by mass spectrometry chip in metabolomics technology.Principal component analysis(PCA),partial least square discriminant analysis(PLS-DA),and orthogonal partial least square discriminant analysis(OPLS-DA)results were compared among groups to screen out different metabolites.The diagnostic value of differential metabolites was evaluated by receiver operating characteristic(ROC)curve.The samples were cluster analyzed by agglomerative hierarchical clustering,and the pathway enrichment analysis of differential metabolites was carried out.Results There were significant differences in the mass spectra of serum samples from the two groups of CAS patients.PC A results showed that there was a certain separation trend between the overall level of serum metabolism in the two groups,but the trend was not significant(R2X=0.654,Q2Y=0.719).PLS-DA analysis showed the separation trend of the two groups of samples(R2X=0.582,R2Y=0.810,Q2Y=0.675).Further OPLS-DA analysis showed that the two groups of samples had an obvious separation trend(R2X=0.595,R2Y=0.831,Q2Y=0.742).Twelve differential metabolites between groups were screened by VIP value>1 and Wilcoon-Mann-Whitney test;of them three were upregulated and nine were downregulated.Upregulated D-glucose and downregulated glycocholic acid,ursodeoxycholic acid,nicotinic acid acid,niacinamide and succinic acid were of high value as diagnostic markers for myocardial infarction.Differential metabolite pathway analysis showed that among the eight metabolic pathways that may be disturbed by differential metabolites,non-alcoholic fatty liver,niacin and niacinamide metabolism,and pathways associated with type 2 diabetes mellitus Impact ≥ 0.1 might be potential pathways in the pathogenesis of myocardial infarction in CAS patients.Conclusion Serum levels of glycinocholic acid,D-glucose,ursodeoxycholic acid,niacin,niacinamide,and succinic acid can be used as potential markers to distinguish the risk of myocardial infarction in patients with CAS.The metabolic pathways affected mainly include non-alcoholic fatty liver disease,niacin and niacinamide metabolism,and type 2 diabetes mellitus-related pathways.
3.Research progress of fibroblast growth factor in nervous system diseases.
Wenting HUANG ; Wanhua QIU ; Kun CHEN ; Shasha YE ; Dongxue WANG ; Jian HU ; Huiqin XU ; Li LIN ; Xiaokun LI
Journal of Zhejiang University. Medical sciences 2023;51(6):738-749
Fibroblast growth factors (FGF) are a group of structurally related polypeptides which constitute an elaborate signaling system with their receptors. Evidence accumulated in the years suggests that the FGF family plays a key role in the repair of central nervous system injury. The main protective mechanisms include activating the expression of PI3K-Akt, peroxisome proliferator-activated receptor (PPARγ) and other signals; inhibiting NF-κB-mediated inflammatory response, oxidative stress and apoptosis; regulating neuronal differentiation and neuronal excitability as well as participating in protection of neurovascular units and nerve function repair. This paper comprehensively summarizes the latest research progress in FGF signaling related to diseases of the central nervous system such as cerebral infarction, cerebral hemorrhage, traumatic brain injury, Alzheimer's disease, Parkinson's disease, epilepsy and depression, aiming to provide scientific basis and reference for the development of innovative FGF drugs for the prevention and treatment of neurological diseases.
Humans
;
Fibroblast Growth Factors
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Phosphatidylinositol 3-Kinases/metabolism*
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Central Nervous System/metabolism*
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Signal Transduction/physiology*
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Alzheimer Disease
4.High resolution CT findings and clinical features of the novel coronavirus B.1.617.2 variant
Chengcheng YU ; Yanhong YANG ; Tianli HU ; Lieguang ZHANG ; Songfeng JIANG ; Bihua CHEN ; Lin LIN ; Wanhua GUAN ; Jinxin LIU
Chinese Journal of Radiology 2021;55(10):1054-1058
Objective:To investigate high resolution CT (HRCT) manifestations and clinical features of patients infected with the novel coronavirus B.1.617.2 variant.Methods:A total of 125 patients with the novel coronavirus B.1.617.2 variant in Guangzhou Eighth People′s Hospital from May 21 to June 9, 2021 was enrolled. There were 52 males and 73 females, aged from 1 to 92 years old with a median age of 47 year. The clinical features and HRCT characteristics were analyzed retrospectively.Results:Of the 125 patients, the main clinical manifestations were fever in 54 patients, cough in 50 patients, pharyngeal discomfort in 39 patients, and diarrhea in 5 patients. HRCT showed pneumonia in 96 cases, which predominantly had ground-glass opacities in 92 cases, ground-glass opacities combined with local consolidation in 22 cases, consolidation in 11 cases, intralobular interstitial thickening in 51 cases, centrilobular structural thickening in 23 cases, and cord-like lesions in 33 cases. One patient had pleural effusion, and no enlarged lymph nodes were observed in all patients. The lesions were distributed in the subpleural and/or peripheral lung in 96 cases and along the bronchovascular bundle (middle and inner zone) in 24 cases. The time interval from onset to positive HRCT was 3 (1, 4) days in 96 patients with pneumonia on HRCT. HRCT showed absorption after the imaging findings reaching the peak in 20 patients, and the time interval between the first positive HRCT findings and the peak imaging was 6 (3, 7) days in these 20 patients.Conclusions:The novel coronavirus B.1.617.2 variant has a strong infectivity, short viral latency. Lung injury is decreaseel. People of all ages are susceptible and the diseasemay have rapid pnegression. HRCT mainly shows ground glass opacities, which are more common in subpleural and/or in the lung periphery, with interlobular thickening.
5.High resolution CT findings and clinical features of COVID-19 in Guangzhou
Chengcheng YU ; Jing QU ; Lieguang ZHANG ; Songfeng JIANG ; Bihua CHEN ; Wanhua GUAN ; Qingxin GAN ; Deyang HUANG ; Zhoukun LING ; Rui JIANG ; Lin LIN ; Jinxin LIU
Chinese Journal of Radiology 2020;54(4):314-317
Objective:To investigate the initial high resolution CT (HRCT) manifestations and clinical features of imported COVID-19 in Guangzhou.Methods:A retrospective analysis of 91 COVID-19 patients admitted to the Guangzhou Eighth People's Hospital from January 22 to 30, 2020 was performed including 39 males and 52 females, with a median age of 50 (33-62) years,then their clinical features and HRCT characteristics were analyzed.Results:The main clinical presentations included fever in 70 cases and cough in 57 cases(mainly dry cough in 39 cases). The first time HRCT showed that 24 cases with COVID-19 were normal, however other 67 cases were abnormal. The ground glass opacity in the lung on HRCT was found in 65 cases, including 64 cases with dilated blood vessel crossing the lesion, 50 cases with thickened adjacent pleura, and 47 cases with thickening of interstitial septum. The patchy opacity was seen in 42 cases, and no enlarged lymph nodes were observed in all patients. As for the lesion distribution, there were two cases with bilateral diffuse changes, 57 cases with multiple lesions, 8 cases with the lesion in only one lobe. The lesions were mainly located under the pleura area in 46 cases, including 39 cases in the lower lobe and other 7 cases in the upper lobe. And there were 13 cases without characteristic distribution in the lung.Conclusion:The initial images of COVID-19 in Guangzhou mainly showed multiple ground glass opacity, which were mostly seen in the subpleural and lower lung fields, most of them with thickened pulmonary interstitium. Guangzhou has a higher proportion of COVID-19 patients with mild and general patients, and some confirmed patients show negative HRCT for the first time. Patients without HRCT changes should be reviewed in a timely manner.
6.Characteristics of urinary microflora in women with type 2 diabetic peripheral neuropathy without lower urinary tract symptoms
Ying LI ; Fang GAO ; Jiawei CHEN ; Xinzhao FAN ; Wanhua ZHAN ; Peng WU ; Yaoming XUE ; Ying CAO
Chinese Journal of Urology 2020;41(3):219-224
Objective:To investigate the characteristics of urinary microflora in women with type 2 diabetic peripheral neuropathy without lower urinary tract symptoms.Methods:By completing nerve conduction function and the American Urological Association Symptom Index questionnaire (AUA-SI), a total of 30 cases of women hospitalized with type 2 diabetes and no symptoms of lower urinary tract from May 2017 to August 2018 were included. 17 patients with diabetic peripheral neuropathy were assigned to the DPN group, and 13 patients without diabetic peripheral neuropathy were assigned to the nDPN group. Urine specimens were collected from clean catch midstream urine and processed for extracting DNA. Microbial diversity and composition were analyzed using the Illumina sequencing platform targeting to 16S rDNA gene. Sequencing reads were processed by QIIME. LEfSe algorithm was used to analyze the flora with significant differences between the two groups.Results:The duration of diabetes in the DPN group was lower than that in the nDPN group [(4.12 ± 3.28)years vs.(8.03 ± 6.11)years, P = 0.03], and the retinopathy cases were more in the DPN group than those in the nDPN group (6 vs. 0, P=0.03). Except for above two indicators, there was no significant difference in demographic characteristics between DPN group and nDPN group( P>0.05). The urinary microenvironment of DPN was characterized by increased bacterial richness(sobs index, chao index and aec index, 67.24±40.25 vs.108.69±57.18; 81.36±47.99 vs.122.55±55.70; 88.58±55.03 vs.125.78±53.03, all P<0.05) and by the enrichment of Mycoplasmataceae(Metastats value: 0.52±0.01vs.0.01±0.00001, P=0.02). Beta diversity showed that no significant difference of bacterial composition was found between these two group( P>0.05). LEfSe analysis showed that at the genus level, the relative abundance of eight genera(e.g., Bacillus, Duganella, Leptotrichia, Proteus, Propionibacterium, Pseudoxanthomonas, Bdellovibrio and uncultured_soil_bacterium) in DPN group decreased at the level of genus( P<0.05). Conclusions:Female patients with type 2 diabetes without lower urinary tract symptoms of peripheral neuropathy exhibit a different microbial community compared to nDPN controls. Mycoplasmataceae may be a potential biomarker for patients with DPN.
7. High resolution CT findings and clinical features of novel coronavirus pneumonia in Guangzhou
Chengcheng YU ; Jing QU ; Lieguang ZHANG ; Songfeng JIANG ; Bihua CHEN ; Wanhua GUAN ; Qingxin GAN ; Deyang HUANG ; Zhoukun LING ; Rui JIANG ; Lin LIN ; Jinxin LIU
Chinese Journal of Radiology 2020;54(0):E010-E010
Objective:
To investigate the initial HRCT manifestations and clinical features of imported novel coronavirus pneumonia (NCP) in Guangzhou.
Methods:
A retrospective analysis of 91 NCP patients admitted to the Guangzhou Eighth People’s Hospital from January 22 to 30, 2020 was performed including 39 males and 52 females, with a median age of 50 (33-62) years, then their clinical features and HRCT characteristics were analyzed.
Results:
The main clinical presentations included fever in 70 cases and cough in 57 cases(mainly dry coughin39 cases). The first time HRCT showed that 24 cases with NCP were normal, however other 67 cases were abnormal. The ground glass opacity in the lung on HRCT was found in 65 cases, including 64 cases with dilated blood vessel crossing the lesion, 50 cases with thickened adjacent pleura, and 47 cases with thickening of interstitial septum. The patchy opacity was seen in 42 cases, and no enlarged lymph nodes were observed in all patients. As for the lesion distribution, there were two cases with bilateral diffuse changes, 57 cases with multiple lesions, 8 cases with the lesion in only one lobe. The lesions were mainly located under the pleura area in 46 cases, including 39 cases in the lower lobe and other 7 cases in the upper lobe. And there were 13 cases without characteristic distribution in the lung.
Conclusions
The initial images of NCP in Guangzhou mainly showed multiple ground glass opacity, which were mostly seen in the subpleural and lower lung fields, most of them with thickened pulmonary interstitium. Guangzhou has a higher proportion of NCP patients with mild and general patients, and some confirmed patients show negative HRCT for the first time. Patients without HRCT changes should be reviewed in a timely manner.
8.Cerebrovascular reserve in patients with acute atherosclerotic cerebral infarction and its application value in the short-term prognosis
Yan CHEN ; Youling ZHU ; Bin DONG ; Ya CHEN ; Wanhua HU ; Yuhao PENG
Chinese Journal of Neurology 2018;51(8):606-611
Objective To assess the cerebrovascular reserve (CVR)and the relationship of CVR with the short-term prognosis in patients with acute atherosclerotic cerebral infarction.Methods A total of 106 patients with unilateral acute (within 72 h) atherosclerotic cerebral infarction (trial group) were selected from December 2016 to December 2017 in the Department of Neurology of the First People's Hospital of Hefei,which were divided into two groups including the lesion group (106 cases) and the nonlesion group (106 cases).The median score of NIHSS in patients was 4(2,5).The control group included 40 healthy controls.The cerebral blood flow reserve and pulsatility index were measured by transcranial Doppler combined with CO2 inhalation test in both the trial group and the control group.According to the rate of change of cerebral blood flow velocity (CBFV),all subjects were divided into two groups including the normal group and the impaired cerebral blood flow reserve group.The changes of CBFV were compared in the control group and the trial group,which was divided into two groups including the group with lesion side and the group with non-lesion side.To evaluate the brain structure reserve the circle of Willis in the trial group was assessed by MRA.According to the integrity of the circle of Willis anterior and posterior circulation all subjects were divided into four groups (type Ⅰ,type Ⅱ,type Ⅲ and type Ⅳ).The effect of the factors,such as diabetes,hypertension,low density lipoprotein (LDL),high density lipoprotein (HDL),smoking,and drinking history,on cerebral blood flow reserve was measured by single-factor analysis.The correlation of NIHSS scores,infarct size and volume with CVR was also measured.All patients in the trial group were treated with drugs and were followed-up for three months.The modified Rankin Scale (Mrs) was used to evaluate the prognosis of the patients.It means poor prognosis if the value of Mrs was more than three.The effects of factors,such as sex,HDL,LDL,diabetes,hypertension,smoking history,drinking history,cerebral blood flow reserve,NIHSS scores,brain structure reserve,infarct location,age,on the prognosis were measured by multivariate Logistic regression.Results The increase rate of CBFV in the lesion-side of patients with atherosclerotic cerebral infarction was 5.94% (2.18%,10.49%),and the increase rate of pulsatility index was 10.77% (2.21%,22.62%),which were both lower than the control group (CBFV:11.54% (5.01%,17.96%),Z =2.547,P<0.05);pulsatility index:48.36% (33.93%,64.51%),Z =6.604,P < 0.01).There was significant difference (x2 =4.328,P < 0.05) in the distribution of diabetes,which was 2/14 in the normal group and 43.48% (40/92) in the impaired cerebral blood flow reserve group.And in the trial group the brain structural reserve was positively correlated to the infarct volume and the NIHSS score,and the rank correlation coefficient was 0.219 and 0.238 respectively (P < 0.05).The prognosis of cerebral blood flow reserve in the normal group was better than the impaired group (x2 =4.155,P < 0.05),for example,the proportion of patients with good prognosis and normal CBFV was 18.84% (13/69),the proportion of patients with good prognosis but decreased CBFV was 81.16% (56/69),the proportion of patients with poor prognosis but normal CBFV was 2.70% (1/37),the proportion of patients with poor prognosis and decreased CBFV was 97.30% (36/37).The proportion of patients with type Ⅰ and type Ⅲ of the brain structure reserve was 37.68% (26/69) and 5.80% (4/69) respectively,whose prognosis was better (x2 =8.456,P < 0.05) than patients with type Ⅱ and type Ⅳ,whose proportion was 43.48% (30/69) and 13.04% (9/69).Multivariate Logistic regression analysis showed that NIHSS score,age,and brain structural reserve were risk factors for poor prognosis in the trial group.Normal cerebral blood flow reserve was a protective factor for good prognosis.Conclusions CVR in patients with acute atherosclerotic cerebral infarction is significantly reduced.CVR can be used as an index to evaluate the prognosis of patients who were followed-up for three months.
9.Application of language intervention in the regulation of psychological stress during endoscopic retrograde cholangiopancreatography examination
Xiaoyan LUO ; Xiaozhen CHEN ; Wanhua YANG
Chinese Journal of Modern Nursing 2018;24(12):1437-1440
Objective To investigate the application effect of language intervention in the regulation of psychological stress of patients during endoscopic retrograde cholangiopancreatography (ERCP) examination. Methods A total of 70 ERCP patients in Yiwu Central Hospital from April 2013 to May 2017 were included in the study using simple stratified sampling method. A number of 35 cases from April 2013 to April 2015 were recruited as the control group and received routine health education. Another 35 cases from May 2015 to May 2017 were included in the observation group who received additional language intervention. The heart rate, blood pressure, Self-Rating Anxiety Scale (SAS) score, Self-Rating Depression Scale (SDS) score, blood glucose and cortisol levels of patients at different time points were compared between two groups. Results The time factor and between group factor of heart rate, blood pressure, blood glucose and cortisol levels of patients had interaction effect (P< 0.05). The scores of SAS and SDS in the observation group were lower than the scores before the examination,and the differences were statistically significant (P< 0.05). After the examination, there were statistically significant differences in the SAS and SDS scores between two groups (P< 0.05). Conclusions The application of language intervention during the ERCP examination can significantly improve the psychological stress state of patients and the safety of ERCP.
10.Efficacy and Safety Observation of Infliximab in the Treatment of Crohn's Disease and Analysis of Influen-tial Factors
Hefeng CHEN ; Wanhua YANG ; Weiyan YAO
China Pharmacy 2017;28(35):4947-4951
OBJECTIVE:To observe therapeutic efficacy and safety of infliximab (IFX) in the treatment of Crohn's disease (CD),and to investigate its influential factors. METHODS:In retrospective study,a total of 120 CD patients received IFX treat-ment in our hospital during Jan.-Dec. 2015 were selected as research objects. All patients were given IFX for injection 5 mg/kg intra-venously at 0,2nd,6th week and later every 8 weeks continously. Therapeutic efficacy indexes(body weight,CRP,ESR,WBC, mucosal healing under endoscope),liver and renal indexes (ALT,AST,AKP,γ-GT,TB,DB,Cr),the occurrence time of ADR,organs/systems involved,clinical manifestations and outcomes were compared before and after treatment. Influential factors were analyzed. RESULTS:Compared with before medication,body weight of patients were increased significantly,while ESR were decreased significantly,with statistical significance (P<0.05). There was positively correlation between above two indexes (r=0.275,P=0.016). Mucosal healing was found in 78.57% of patients by colonoscopy. There was statistical significance in the levels of AST,AKP and Cr before and after treatment(P<0.05),but those indexes were increased slightly. AKP exceeded 2 times the upper limit of normal value in only 1 case,but AST did not exceed 2 times the upper limit of normal limit,Cr did not exceed the upper limit of normal value. There was no statistical significance in CRP,WBC or other liver and renal function indexes before and af-ter treatment(P>0.05). There were 24 cases of ADR with incidence of 20.00%. Respiratory system,digestive system,skin mucous membrane,body defense and other organs/systems were involved,mainly manifestating as uper respiratory tract infetion,liver func-tion indexes order etc. Ten patients(41.67%)delayed the treatment,and 6 cases(25.00%)discontinued. Standard rate of ESR in pa-tients with regular/primary medication (78.21%) was higher than those with intermittent medication history (57.14%),but without statistical significance(P>0.05). Combined use of mesalazine had no significant effect on the increase of AST and AKP(P=0.002). CONCLUSIONS:IFX significantly increases body weight of CD patients,decreases ESR and improves mucosal healing. It shows def-inite therapeutic efficacy. It is suggested that CD patients should use IFX regularly. The overall safety of IFX is good,but it may cause transfusion reaction and transient increase of liver function index. So,the patient's condition should be closely monitored during the in-fusion.

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