1.Evaluation of PEscore performance in predicting platelet transfusion efficacy in hematological patients
Jun LI ; Lan WANG ; Yihua XIE ; Ziqi CHEN ; Gang ZHAO
Chinese Journal of Blood Transfusion 2025;38(6):797-802
Objective: To evaluate the performance of platelet efficacy score (PEscore) in predicting platelet transfusion efficacy in hematological patients. Methods: A total of 485 patients with hematological diseases, including 298 males (62.09±15.45 years) and 187 females (59.17±16.52 years) who received platelet transfusion from January 1, 2021 to December 31, 2024 were enrolled in this study. Clinical data of the patients such as diagnosis, gender, age, number of platelet transfusion, and platelet antibody data were analyzed to investigate the incidence and influencing factors of platelet transfusion refractoriness in hematological patients at our hospital. ROC curve was used to evaluate the performance of PEscore model in predicting platelet transfusion efficacy. The predictive performance of PEscore model was validated by calculating its sensitivity, specificity, and accuracy in 115 clinical cases. Results: The incidence of platelet transfusion refractoriness in 485 cases was 29.90% (145/485). Significant differences (P<0.05) were observed between the effective and ineffective platelet transfusion groups regarding the following factors: diagnosis: lymphoma [55.32% (26/47) vs 44.68% (21/47)], the number of previous platelet transfusions [≥25: 60.78% (31/51) vs 39.22% (20/51)], platelet antibody screening result [positive: 33.76% (53/157) vs 66.24% (104/157)], and platelet transfusion volume (×10
/L) [>6: 62.71% (74/118) vs 37.29% (44/118)]. The area under the ROC curve of PEscore was 0.876. The cut-off points and corresponding sensitivity and specificity were 19.90.59% and 69.44%, respectively. The results of clinical application showed that the sensitivity, specificity and accuracy of the PEscore model for predicting platelet transfusion were 87.50%, 93.41% and 92.17%, respectively. Conclusion: The incidence of platelet transfusion refractoriness in hematological patients is relatively high. PEscore prediction model has a good performance in predicting the effect of platelet transfusion, which can provide a reliable basis for predicting the effect of platelet transfusion in hematological patients before blood transfusion.
2.Outcomes of endoscopic balloon dilation laryngoplasty for acquired subglottic stenosis in children.
Qi LI ; Pengcheng WANG ; Yihua NI ; Letian TAN ; Zhengmin XU ; Chao CHEN
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(2):124-127
Objective:To investigate the outcomes of endoscopic balloon dilation laryngoplasty (EBDL) in managing acquired subglottic stenosis in children. Methods:A retrospective analysis of clinical data from patients who underwent endoscopic balloon dilation for secondary subglottic stenosis between January 2017 and January 2024 at Department of Otorhinolaryngology Head and Neck Surgery, Children's Hospital of Fudan University, Shanghai. The study included 10 children (6 males, 4 females) aged between 13 days and 3 years at the time of their first procedure, with an average age of 7 months. Subglottic stenosis was graded according to the Myer-Cotton classification, with two cases classified as grade Ⅱ and eight cases as grade Ⅲ. All patients had a history of tracheal intubation, including seven for rescue purposes and three for operations. Eight cases were complicated by other conditions: two with atrial septal defect, patent ductus arteriosus, and patent foramen ovale; two with patent foramen ovale only; one with atrial septal defect and extreme deafness in the left ear; one with a brain tumor and hydrocephalus; one with a traumatic diaphragmatic hernia and hepatic rupture; and one case complicated by type Ⅰ laryngeal cleft. Prior to surgery, all children required respiratory support-seven needed high-flow oxygen while three required CPAP. Results:All ten cases underwent endoscopic balloon dilation under spontaneous respiration and general anesthesia, totaling fourteen dilations (an average of 1.4 dilations per person) without any complications. Post-surgery air permeability tests showed that eight cases had grade Ⅰ stenosis while two had grade Ⅱ stenosis. The follow-up period ranged from six months to six years (average duration: 46 months). Following treatment, all patients no longer required respiratory support or experienced significant mobility limitations. Conclusion:Endoscopic balloon dilation under general anesthesia is deemed safe and effective in treating secondary subglottic stenosis. Early diagnosis coupled with prompt intervention can help avoid tracheotomy procedures altogether. Standard tracheoscopy combined with breathability testing represents a crucial approach to assess normal airway diameter and effectively reduce or prevent secondary subglottic stenosis following re-intubation.
Humans
;
Laryngostenosis/surgery*
;
Male
;
Female
;
Retrospective Studies
;
Laryngoplasty/methods*
;
Child, Preschool
;
Infant
;
Dilatation/methods*
;
Laryngoscopy/methods*
;
Treatment Outcome
;
Endoscopy
3.A novel anti-ischemic stroke candidate drug AAPB with dual effects of neuroprotection and cerebral blood flow improvement.
Jianbing WU ; Duorui JI ; Weijie JIAO ; Jian JIA ; Jiayi ZHU ; Taijun HANG ; Xijing CHEN ; Yang DING ; Yuwen XU ; Xinglong CHANG ; Liang LI ; Qiu LIU ; Yumei CAO ; Yan ZHONG ; Xia SUN ; Qingming GUO ; Tuanjie WANG ; Zhenzhong WANG ; Ya LING ; Wei XIAO ; Zhangjian HUANG ; Yihua ZHANG
Acta Pharmaceutica Sinica B 2025;15(2):1070-1083
Ischemic stroke (IS) is a globally life-threatening disease. Presently, few therapeutic medicines are available for treating IS, and rt-PA is the only drug approved by the US Food and Drug Administration (FDA) in the US. In fact, many agents showing excellent neuroprotection but no blood flow-improving activity in animals have not achieved ideal clinical efficacy, while thrombolytic drugs only improving blood flow without neuroprotection have limited their wider application. To address these challenges and meet the huge unmet clinical need, we have designed and identified a novel compound AAPB with dual effects of neuroprotection and cerebral blood flow improvement. AAPB significantly reduced cerebral infarction and neural function deficit in tMCAO rats, pMCAO rats, and IS rhesus monkeys, as well as displayed exceptional safety profiles and excellent pharmacokinetic properties in rats and dogs. AAPB has now entered phase I of clinical trials fighting IS in China.
5.Astrocytic dopamine D1 receptor modulates glutamatergic transmission and synaptic plasticity in the prefrontal cortex through d-serine.
Yanan YIN ; Jian HU ; Haipeng WU ; Xinyu YANG ; Jingwen QI ; Lang HUANG ; Zhengyi LUO ; Shiyang JIN ; Nengyuan HU ; Zhoucai LUO ; Tong LUO ; Hao CHEN ; Xiaowen LI ; Chunhua YUAN ; Shuji LI ; Jianming YANG ; Yihua CHEN ; Tianming GAO
Acta Pharmaceutica Sinica B 2025;15(9):4692-4710
The prefrontal cortex (PFC) plays a pivotal role in orchestrating higher-order emotional and cognitive processes, a function that depends on the precise modulation of synaptic activity. Although pharmacological studies have demonstrated that dopamine signaling through dopamine D1 receptor (DRD1) in the PFC is essential for these functions, the cell-type-specific and molecular mechanisms underlying the neuromodulatory effects remain elusive. Using cell-type-specific knockout mice and patch-clamp recordings, we investigated the regulatory role of DRD1 on neurons and astrocytes in synaptic transmission and plasticity. Furthermore, we explored the mechanisms by which DRD1 on astrocytes regulate synaptic transmission and plasticity at the cellular level, as well as emotional and cognitive functions at the behavioral level, through two-photon imaging, microdialysis, high-performance liquid chromatography, transcriptome sequencing, and behavioral testing. We found that conditional knockout of the Drd1 in astrocytes (CKOAST) increased glutamatergic synaptic transmission and long-term potentiation (LTP) in the medial prefrontal cortex (mPFC), whereas Drd1 deletion in pyramidal neurons did not affect synaptic transmission. The elevated level of d-serine in the mPFC of CKOAST mice increased glutamatergic transmission and LTP through NMDA receptors. In addition, CKOAST mice exhibited abnormal emotional and cognitive function. Notably, these behavioral changes in CKOAST mice could be reversed through the administration of d-serine degrease to the mPFC. These results highlight the critical role of the astrocytic DRD1 in modulating mPFC synaptic transmission and plasticity, as well as higher brain functions through d-serine, and may shed light on the treatment of mental disorders.
6.Thymosin α1 alleviates pulpitis by inhibiting ferroptosis of dental pulp cells.
Jie WU ; Qimei GONG ; Wenxuan LIU ; Aijia CHEN ; Zekai LIAO ; Yihua HUANG ; Wenkai JIANG ; Zhongchun TONG
International Journal of Oral Science 2025;17(1):68-68
Tooth pulpitis is a prevalent oral disorder. Understanding the underlying mechanisms of pulpitis and developing effective treatment strategies hold great significance. Ferroptosis has recently emerged as a new form of cell death, but the role of ferroptosis in pulpitis remains largely unknown. In our study, single-cell RNA sequencing (scRNA-seq) was used to identify cellular heterogeneity between 3 pulpitis tissue and 3 healthy pulp tissue, and explored ferroptosis occurrence in pulpitis tissue and inflamed dental pulp cells (DPCs). In scRNA-seq, 40 231 cells (Pulpitis: 17 814; Healthy pulp: 22 417) were captured, and visualized into 12 distinct cell clusters. Differentially expressed ferroptosis-related genes (DE-FRGs) were almost presented in each cluster in pulpitis vs healthy pulp. ROS and Fe2+ levels significantly rose, and immunohistochemistry showed low expression of GPX4 and high expression of PTGS2 in pulpitis. In LPS-stimulated DPCs, thymosin α1 increased the expression of GPX4 and FTL, and decreased expression of TNF-α, IL-1β, IL-6, and Fe2+ levels. In rat pulpitis models, both prothymosin α (PTMA, precursor of thymosin α1) gelatin sponge placed at the hole of pulp (LPS-P(gs)) and PTMA injection in pulp (LPS-P(i)) significantly reduced infiltration of inflammatory cells and expression of PTGS2, and increased the expression of GPX4. In RNA sequencing, the expression of DE-FRGs were reversed when thymosin α1 were added in LPS-stimulated DPCs. Collectively, single-cell atlas reveals cellular heterogeneity between pulpitis and healthy pulp, and ferroptosis occurrence in pulpitis. Thymosin α1 may reduce ferroptosis in DPCs to alleviate pulpitis and thus potentially has the ability to treat pulpitis.
Ferroptosis/drug effects*
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Dental Pulp/drug effects*
;
Animals
;
Pulpitis/pathology*
;
Rats
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Thymalfasin/pharmacology*
;
Humans
;
Male
;
Thymosin/pharmacology*
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Disease Models, Animal
;
Rats, Sprague-Dawley
7.Pseudocarcinomatous hyperplasia of the fallopian tube: a clinicopathological analysis of sixteen cases
Yihua SUN ; Xiaochen CHEN ; Yinping XIAO ; Xiang TAO ; Weiyong GU
Chinese Journal of Pathology 2024;53(6):541-545
Objective:To investigate the clinicopathological features, diagnosis and differential diagnosis of pseudocarcinomatous hyperplasia of the fallopian tubes.Methods:Sixteen cases of pseudocarcinomatous hyperplasia of the fallopian tubes diagnosed at Obstetrics and Gynecology Hospital of Fudan University from January 2011 to January 2024 were collected.The pathological sections were reviewed, the clinical and pathological data were consulted, and immunohistochemical examination was conducted along with follow-up.Results:The patients were aged from 19 to 57 years, with an average age of 41 and a median age of 38. Among the 16 cases, 4 were located in the right fallopian tubes, 6 in the left fallopian tubes, while the remaining cases presented bilaterally. The general manifestations were tubal edema, crispness and purulent secretion in the lumen. Morphologically, the fallopian tube mucosa exhibited a significant infiltration of neutrophils, lymphocytes and plasma cells. The epithelial cells of the fallopian tube displayed evident proliferation, stratification and disorganized arrangement leading to formation of small glandular cavity with back-to-back, fissure-like and sieve-like structures. Immunohistochemical analysis revealed positivity for CK7 and WT1, along with wild-type p53 expression, Ki-67 index ranged from 5% to 20%. During the follow-up period ranging from 1 to 156 months, all the patients remained free of disease.Conclusions:Pseudocarcinomatous hyperplasia of the fallopian tube is a rare non-neoplastic lesion, which can lead to epithelial hyperplasia and atypical hyperplasia. The most important significance of recognizing this lesion lies in avoiding misdiagnosis of fallopian tube cancer during intraoperative and postoperative pathological examination. This ensures that clinicians can administer correct clinical interventions.
8.Low BMI is Associated with Poor OI-IUI Outcomes in Patients with Unexplained Primary Infertility
Yihua LIANG ; Xuedan JIAO ; Qingxue ZHANG ; Hui CHEN ; Yu LI
Journal of Sun Yat-sen University(Medical Sciences) 2024;45(2):283-289
ObjectiveTo evaluate the effect of women's body mass index (BMI) on pregnancy outcomes of ovulation induction intrauterine insemination (OI-IUI) in patients with unexplained primary infertility. MethodsThe study included 764 OI-IUI cycles from January 2016 to December 2022 in reproductive center of Sun Yat-sen Memorial Hospital. According to BMI,patients were divided into three groups:low BMI (BMI<18.5 kg/m2), normal BMI (18.5 kg/m2 ≤BMI<23.0 kg/m2), and high BMI (BMI≥23.0 kg/m2). Comparison of clinical data and pregnancy outcomes was performed between the groups. Logistic regression was used to analyze the association between BMI and live birth rate. ResultsFrom the low BMI group to the high BMI group, the HCG positive rate (7.08%,9.74%, 13.19%), clinical pregnancy rate(5.51%, 7.91%, 13.19%), and live birth rate (4.72%, 6.90%, 12.50%) increased. Among them, the live birth rate of the high BMI group was significantly higher than that of the low BMI group and the normal BMI group, with a statistically significant difference (P=0.034). While the early miscarriage rate (14.28%, 10.26%, 5.26%) decreased from the low BMI group to the high BMI group. The binary logistic regression analysis revealed that BMI was an independent factor in live birth, and high BMI resulted in a better live birth rate than low BMI (OR=3.15,95%CI=1.191-8.329,P=0.021). ConclusionLow BMI is associated with poor OI-IUI outcomes in patients with unexplained primary infertility. These patients are encouraged to gain weight in a healthy manner.
9.Validity and reliability of the Chinese version of the Social Fat Perception Scale in female college students
Yihua CHEN ; Tonglin JIN ; Wuyuntena
Chinese Mental Health Journal 2024;38(7):636-640
Objective:To revise the Social Fat Perception Scale(SI-FAT)and test its validity and reliability in female college students.Methods:A total of 564 female college students(sample 1)were recruited for explora-tory factor analysis.In addition,557 female college students(sample 2)were recruited to conduct confirmatory fac-tor analysis,validity of correlation and convergence validity of targets,and internal consistency reliability testing.Fifty-nine female college students(sample 3)were recruited for retesting 1 week apart The Social Physical Anxiety Scale(SPA)and Brief Fear of Negative Evaluation Scale(BFNES)were used as benchmarking tools.Results:The Chinese version of SI-FAT had a 4-factor(parent,peer,partner,media)structure,a total of 16 i-tems,the cumulative amount of explanatory variance was 76.64%,and the item load was between 0.65-0.94,and the confirmatory factor analysis showed that the model fit was good(x2/df=4.48,CFI=0.94,TLI=0.92,SRMR=0.06,RMSEA=0.08).The SI-FAT scores were positively correlated with the scores of SPA and BFNES(ICC=0.40,0.43,P<0.001).The Cronbach α coefficients of the SI-FAT scale and its 4 factors were 0.83-0.94,and the retest reliabilities(ICC)were 0.61-0.68.Conclusion:The Chinese version of the Social Fat Perception Scale has a good validity and reliability in assessing the perception of social fat in female college students.
10.Evolutionary characteristics of HA and NA genes of B Victoria influenza virus in Tongling city from 2019 to 2022
Yihua ZHANG ; Meng YE ; Mayun ZHOU ; Chengbao LI ; Lingjuan JIN ; Juan CHEN ; Yihong CAI
Chinese Journal of Experimental and Clinical Virology 2024;38(2):162-168
Objective:To analyze the genetic evolution characteristics of hemagglutinin (HA) and neuraminidase (NA) of influenza B virus in Tongling during 2019-2022 surveillance years.Methods:Twenty-two strains of Victoria influenza B virus isolated from our laboratory during 2019-2022 were selected for whole genome sequencing. The sequence comparison and phylogenetic analysis were conducted by using bioinformatic analysis software.Results:During 2019-2022, seasonal influenza in Tongling City was predominantly caused by influenza B Victoria lineage viruses, which fell within the V1A.3 branch. Among these, 14 strains isolated in the 2021-2022 season were further classified into the V1A.3a.2 sub-branch. Compared with vaccine strains, multiple amino acid mutation sites were detected in both HA and NA proteins of the 22 influenza B Victoria lineage viruses. Notably, all four major antigenic sites (120-loop, 150-loop, 160-helix, and 190-helix regions) in the HA protein exhibited variations. Although no mutations were detected at resistance sites on the NA protein, a change occurred in the glycosylation site at position 197 NETQ in the HA protein.Conclusions:The main amino acid sites of the HA protein of the influenza B Victoria lineage viruses in Tongling City from 2019 to 2022 have undergone significant variation, which may lead to antigenic drift. Therefore, it is essential to strengthen the monitoring of influenza virus mutations.

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