1.Mental health disparities in people living with human immunodeficiency virus: A cross-sectional study on physician-patient concordance and treatment regimens
Jinchuan SHI ; Zhongdong ZHANG ; Junyan ZHANG ; Yishu ZHANG ; Jiating QIU ; Fang LIU ; Daoyuan SONG ; Yanfang MA ; Lianmei ZHONG ; Hongxing WANG ; Xiaolei LIU
Chinese Medical Journal 2024;137(18):2223-2232
Background::Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) can profoundly affect the mental health of the people living with HIV (PLWH), with higher rates of anxiety, depression, and sleep disturbances. The disparities in neuropsychological problems evaluated by physicians and self-assessed by patients are still unknown.Methods::A total of 5000 PLWH and 500 physicians from 167 hospitals were enrolled in this cross-sectional study from September 2022 to February 2023. 4-Item Patient Health Questionnaire (PHQ-4) was used for the evaluation of depressive issues and anxiety issues by PLWH. Each physician assessed 10 PLWH under their care for the presence of depressive or anxiety issues. The primary outcomes of this study are the concordance rates on the depressive issues and anxiety issues evaluation between physicians and PLWH. The Cohen’s kappa test was used to assess the agreement between physicians and PLWH.Results::The concordance rate for the evaluation of depressive issues is 73.84% (95% confidence interval [CI]: 72.60-75.04%), and it is significantly different from the expected rate of 80% ( P <0.001). Similarly, the concordance rate for the evaluation of anxiety issues is 71.74% (95% CI: 70.47-72.97%), which is significantly different from the expected rate of 80% as per the null hypothesis ( P <0.001). The overestimation rate by physicians on depressive issues is 12.20% (95% CI: 11.32-13.14%), and for anxiety issues is 12.76% (95% CI: 11.86-13.71%). The mismatch rate for depressive issues is 26.16% (95% CI: 24.96-27.40%), and for anxiety issues is 28.26% (95% CI: 27.02-29.53%). The underestimation rate by physicians on depressive issues is 13.96% (95% CI: 13.03-14.95%), and for anxiety issues is 15.50% (95% CI: 14.52-16.53%). For the treatment regiments, PLWH sustained on innovative treatment regimen (IR) related to a lower prevalence of depressive issues (odds ratio [OR] = 0.71, 95% CI: 0.59-0.87, P = 0.003) and a lower prevalence of anxiety issues (OR = 0.63, 95% CI: 0.52-0.76, P <0.001). PLWH switch from conventional treatment regimen (CR) to IR also related to a lower prevalence of depressive issues (OR = 0.79, 95% CI: 0.64-0.98) and a lower prevalence of anxiety issues (OR = 0.81, 95% CI: 0.67-0.99). Conclusion::Nearly one in three PLWH had their condition misjudged by their physicians. The findings underscore the need for improved communication and standardized assessment protocols in the care of PLWH, especially during the acute phase of HIV infection.
2.Effect of PCSK9 Gene Knockout on Myocardial Function in Obese Mice via Ultrasound Strain
Qin WANG ; Yishu JING ; Xin MA ; Lu PAN ; Ru YAN ; Xueping MA
Chinese Journal of Medical Imaging 2024;32(9):873-877,907
Purpose To evaluate the effect of PCSK9 gene knockout on myocardial function in obese mice via ultrasound strain technology,and to discuss the related mechanisms.Materials and Methods Twenty six-week-old wild-type C57BL/6 male mice were selected and randomly divided into a normal group(n=10)and an obese group(n=10).Additionally,ten six-week-old PCSK9-/-C57BL/6 male mice were selected as the PCSK9-/-group.Mice in the obese group and PCSK9-/-group were fed with high-fat feed to create models,while those in the normal group were fed with regular feed.After 12 weeks,mice that were successfully modeled were selected from the obese group and PCSK9-/-group.Then,the three groups of mice were subjected to cardiac ultrasound,transmission electron microscopy and immunofluorescence staining to observe relevant indicators.Results The interventricular septal end-diastolic thickness of mice in obese group,normal group,and PCSK9-/-group were(0.98±0.13)mm,(0.77±0.07)mm,(0.78±0.13)mm,respectively,with statistically significant difference(F=5.10,P=0.02).The obese group was thicker than the normal group(t=2.73,P<0.05),while the PCSK9-/-group was thinner than the obese group(t=-2.92,P<0.05).There were statistically significant differences in global longitudinal strain and global circumferential strain of the left ventricle among the three groups(F=7.44,15.40,P<0.05),with the obese group showing a decrease in global longitudinal strain and global circumferential strain compared to the normal group(t=3.79,5.50,P<0.05).The PCSK9-/-group showed an increase in global longitudinal strain and global circumferential strain compared to the obese group(t=-2.53,-3.37,P<0.05).Electron microscopy and immunofluorescence results showed that the myocardial ultrastructure of the obese group was damaged,and the expression of NLRP3 and Caspase-1 were higher than that of the normal group(t=12.53,-4.73,P<0.05),the myocardial ultrastructure damage in the PCSK9-/-group was significantly improved,the expression of NLRP3 and Caspase-1 were lower than that in the obese group(t=-6.23,2.05,P<0.05).Conclusion Ultrasound strain can more sensitively detect changes in myocardial function in obese mice with PCSK9 gene knockout compared with conventional cardiac ultrasound parameters.Knockout of the PCSK9 gene may improve myocardial function in obese mice by inhibiting the expression of NLRP3 and Caspase-1.
3.Research progress in lymph node targeted drug delivery system for transplantation rejection
Jiani QIU ; Yishu SONG ; Qiaofeng JIN ; Ying BAI ; Mingxing XIE ; Jing WANG
Chinese Journal of Organ Transplantation 2024;45(7):481-485
Immunosuppressants are the most commonly used therapeutic means to reduce organ transplantation rejection and improve short-term clinical outcomes of patients after transplantation. However, systemic use of immunosuppressants increases the risk of opportunistic infections and the incidence of malignancies. Therefore, the efficient targeted delivery of immunosuppressants to target organs is particularly important. Lymph nodes are the main sites of transplant rejection activation. In recent years, drug delivery systems targeting lymph nodes have played an increasingly important role in the treatment of organ transplant rejection. This review briefly introduces the mechanism of action of lymph nodes in transplant rejection, and focuses on the construction of lymph node targeted drug delivery system and its application in transplant rejection, aiming to apply it in the treatment of transplant rejection toimprove patient outcomes.
4.Advances on the target antigens and immunosuppressive treatment in membranous nephropathy
Yishu WANG ; Yi WANG ; Xiaoyan MA ; Jun WANG ; Shuchen MA ; Na LIU
Chinese Journal of Nephrology 2024;40(5):418-425
Membranous nephropathy (MN) is a type of glomerular disease characterized by diffuse thickening of glomerular basement membrane with subepithelial immune complex deposition, and traditional diagnosis of MN mainly relies on the pathological results of renal biopsy. In recent years, the emergence of biomarkers related to MN such as phospholipase A2 receptor and thrombospondin type-1 domain-containing 7A has changed the diagnosis and treatment mode of MN, providing a new basis for the diagnosis, treatment and prognosis of MN. MN patients with positive specific target antigens exhibit different clinical manifestations and prognoses. Specific target antigens can not only guide diagnosis, but also has predictive value for prognosis. Immunosuppressive therapy is a common treatment for idiopathic MN patients, and the emergence of novel medications such as biologics represents a advance in the treatment of MN, providing a broader array of options for managing the condition. Conversely, the treatment approach for secondary MN primarily targets the management of the primary disease. Based on multiple and new literature, we reviewed the researches progress of target antigens and immunosuppressive therapy related to MN, so as to provide references for clinical diagnosis and treatment of MN.
5.Association analysis of serum complement C3 level with blood pressure and estimated glomerular filtration rate in patients with idiopathic membranous nephropathy
Daofang JIANG ; Xiaoyan MA ; Yi WANG ; Xinyu YANG ; Yishu WANG ; Shuchen MA ; Jun WANG ; Chao YU ; Lu FANG ; Na LIU
Chinese Journal of Nephrology 2024;40(6):475-480
It was a single-center cross-sectional study to investigate the association of serum C3 level with blood pressure and estimated glomerular filtration rate (eGFR) in patients with idiopathic membranous nephropathy (IMN). The clinical and pathological data of 98 patients with IMN diagnosed by renal biopsy in the Department of Nephrology of East Hospital Affiliated to Tongji University from August 1, 2018 to October 31, 2023 were retrospectively analyzed. The demographic characteristics, serum complement C3 and other clinical data were compared between the non-hypertension group ( n=37) and hypertension group ( n=61). Pearson or Spearman correlation analysis method was used to analyze the correlation between serum C3 and eGFR in IMN patients and IMN patients with hypertension. Multiple linear regression analysis was used to analyze the related factors of eGFR in IMN patients with chronic kidney disease stage 1-3 in hypertension group. The results showed that compared with the non-hypertension group, the patients in hypertension group were older, and had higher levels of serum creatinine, cystatin C, urinary microalbumin to creatinine ratio, serum C3 and C4, and lower eGFR (all P<0.05). The correlation analysis showed that there was no correlation between serum C3 level and eGFR in IMN patients ( r=0.118, P=0.247). However, serum C3 level was positively correlated with eGFR in IMN patients with hypertension ( r=0.325, P=0.011). Multiple linear regression analysis showed that eGFR was negatively correlated with age ( β=-0.328, P=0.013), and positively correlated with serum C3 level ( β=0.228, P=0.048). The study shows that serum C3 level in hypertension group is higher than that in non-hypertension group in IMN patients. Moreover, serum C3 is positively correlated with eGFR.
6.Research progress in decision-making aids for breast cancer patients.
Juan LI ; Bo YUAN ; Yishu WANG ; Jie ZHANG ; Silan YANG ; Yuchen WU ; Jingping ZHANG ; Yao XIAO
Journal of Central South University(Medical Sciences) 2021;46(2):176-182
Decision-making aid for cancer patients is of great significance in the diagnosis and treatment for diseases. Breast cancer is one of the most common malignant tumors in women all over the world, and breast cancer patients have become the main target population for decision-aided research. Application of decision-making assistance for patients in Western countries has developed to a certain extent, while relevant research in China is still at the early stage. There are kinds of intervention forms for patients' decision aids, including traditional brochures and videos, decision aids systems, decision coaching, multidisciplinary breast cancer teams, etc. The tools for decision-making quality evaluation include the patients' awareness for decision-making, participation, decision-making conflict, decision-making satisfaction, decision-making regret, which can provide important guidance for the application of decision-making aid treatment in breast cancer patients in the future.
Breast Neoplasms/therapy*
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China
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Decision Making
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Emotions
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Female
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Humans
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Personal Satisfaction
7.Congenital hemangioma: genetic pathogenesis and potential targeted therapy
Yishu WANG ; Chen HUA ; Xiaoxi LIN
Chinese Journal of Plastic Surgery 2021;37(9):1057-1062
Congenital hemangioma (CH), a benign vascular tumor, is divided into rapidly involuting congenital hemangioma (RICH), noninvoluting congenital hemangioma (NICH) and partially involuting congenital hemangioma (PICH). Similarities and differences of clinical manifestation and histopathology exist in the three major subgroups, in which genetic variations probably play a part. This article focuses on genetic pathogenesis and provides potential targeted therapies. Somatic activating mutations in GNAQ or GNA11 and damaging de novo germline mutations in MYH9 were identified. GNAQ/GNA11 mutation that alters glutamine at amino acid 209 contributes to the formation of CH via RAS/MAPK/ERK and Hippo/YAP signaling pathways. Thus, ERK/MEK or Hippo/YAP, the critical components of aforementioned pathways, might become the potential target of CH therapy to develop a more specific treatment.
8.Congenital hemangioma: genetic pathogenesis and potential targeted therapy
Yishu WANG ; Chen HUA ; Xiaoxi LIN
Chinese Journal of Plastic Surgery 2021;37(9):1057-1062
Congenital hemangioma (CH), a benign vascular tumor, is divided into rapidly involuting congenital hemangioma (RICH), noninvoluting congenital hemangioma (NICH) and partially involuting congenital hemangioma (PICH). Similarities and differences of clinical manifestation and histopathology exist in the three major subgroups, in which genetic variations probably play a part. This article focuses on genetic pathogenesis and provides potential targeted therapies. Somatic activating mutations in GNAQ or GNA11 and damaging de novo germline mutations in MYH9 were identified. GNAQ/GNA11 mutation that alters glutamine at amino acid 209 contributes to the formation of CH via RAS/MAPK/ERK and Hippo/YAP signaling pathways. Thus, ERK/MEK or Hippo/YAP, the critical components of aforementioned pathways, might become the potential target of CH therapy to develop a more specific treatment.
9.Molecular markers derived from ovarian cancer and its correlation with the types of oviductal epithelial lesions.
Yishu YUAN ; Wei ZHU ; Guanghui GONG ; Jing JIANG ; Yixuan WANG ; Xiaoying WU
Journal of Central South University(Medical Sciences) 2019;44(5):528-534
To explore the role of P53, pairing box gene 8 antibody (PAX8), and calcium omentum protein (Calretinin) in the origin of epithelial ovarian cancer.
Methods: A total of 63 tissue samples of ovarian tumor and fallopian tubes were collected. Immunohistochemistry methods were used to analyze the expression of P53, PAX8, and Calretinin. The relationship between these protein levels and the classification of ovarian tumors was evaluated.
Results: In epithelial ovarian cancer, the P53 or PAX8 was correlated with the occurrence of high-grade carcinoma, while the calretinin was correlated with the occurrence of low-grade carcinoma (P<0.05). The combination of PAX8 with Calretinin was correlated with the grade of ovarian tumor (P<0.05). The combination of P53 with Calretinin was correlated with the grade of tumor (P<0.05). The combination of P53 with PAX8 was correlated with the grade of tumor (P<0.05). The expression of P53 in fallopian tubes was correlated with the malignant degree of epithelial ovarian cancer (P<0.05). The degree of fallopian tube lesions in patients with ovarian cancer was correlated with epithelial ovarian cancer. The malignant lesions of tubal epithelium was correlated with high-grade carcinoma, while the normal or atypical hyperplasia of tubal epithelium was correlated with low-grade carcinoma (P<0.05).
Conclusion: P53 and Calretinin combined with PAX8 show a synergistic effect on the differentiation of epithelial ovarian cancer grade. The morphology of HE and the expression of TP53 in the fallopian tube epithelium play an auxiliary role in the diagnosis of epithelial ovarian cancer.
Carcinoma, Ovarian Epithelial
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Epithelium
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Fallopian Tubes
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Female
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Humans
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Ovarian Neoplasms
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PAX8 Transcription Factor
10.Tat-based cell-cell fusion method for screening HIV-1 fusion inhibitors.
Xiaoli WANG ; Yishu YANG ; Sisi SHEN ; Xianliang WANG ; Tian FENG ; Qin HU ; Yi ZENG
Chinese Journal of Biotechnology 2018;34(3):429-439
An HIV-1 cell-cell fusion system was developed to screen HIV-1 entry inhibitors that block cell-cell fusion. In this system, the pEGFP-Tat plasmid was constructed and cotransfected into effector cells (HEK-293T) with HIV-1 envelope plasmid. TZM-bl cell, a genetically engineered cell line that expresses CD4, CXCR4, CCR5 as well as Tat-inducible β-galactosidase and luciferase reporter gene, was used as target cell. Thus, the co-culture of target cells and effector cells allows the cell fusion via Env and the activity of the fusion inhibitor can be quantified by measuring the reporter protein expression. The experimental parameters were optimized and 11 anti-HIV-1 agents including CCR5 antagonist maraviroc, reverse transcription inhibitor zidovudine (AZT) and integrase inhibitor raltegravir were tested. The result showed that the system exhibited high specificity and sensitivity. Two of eight tested anti-HIV-1 agents were found to block the cell-cell fusion. The system is suitable for efficient screening of HIV-1 cell-cell fusion inhibitors.

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