1.Application status of non-invasive urine biopsy in diagnosis and recurrence surveillance of bladder cancer
Hongchen SONG ; Yufeng ZHANG ; Menghua WU ; Jiaxin LIU ; Xuanhao LI ; Jian SONG ; Mingjun SHI
International Journal of Surgery 2024;51(6):423-432
Bladder cancer is one of the most common malignancy in the urinary system over the world. Urine cytology and cystoscopy are important tools for bladder cancer diagnosis and recurrence monitoring. However, due to the limited sensitivity and invasive procedure, there is an urgent need to develop new non-invasive and highly sensitive liquid biopsy approaches. Urine biopsy is a research focus in the field and has great potential. This review focused on protein-based urine markers (including NMP22, BTA and UroVysion etc.) and DNA or RNA-based urine markers (including cfDNA, AssureMDx and Xpert BC Monitor etc.), which were used for bladder cancer diagnosis and recurrence monitoring, and summarized the sensitivity and specificity of each biomarker as well as their characteristics in the diagnosis and recurrence surveillance of bladder cancer. This study provides theoretical and empirical support for further optimization and application of these biomarkers in clinical practice.
2.Predictive value of serum cathepsin S,progranulin and chemokine ligand 12 for acute exacerbation of chronic obstructive pulmonary disease
Yu LI ; Jian ZHANG ; Juanjuan ZHOU ; Yufeng DENG ; Shengkang ZHU
Journal of Xinxiang Medical College 2024;41(8):766-771
Objective To explore the predictive value of serum cathepsin S(CTSS),progranulin(PGRN)and chemo-kine ligand 12(CXCL12)for acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods A total of 202 patients with COPD who were admitted to the Tongling Municipal Hospital from January 2020 to February 2023 were selected as the research subjects.The patients were divided into an acute exacerbation group(n=64)and a non-acute exacerbation group(n=138)according to whether acute exacerbation occurred.Clinical data such as serum CTSS,PGRN and CXCL12 levels,age,gender,body mass index(BMI),disease course,smoking history,forced expiratory volume in one second/forced vital capacity ratio(FEV1%),and COPD assessment test(CAT)score in the stable period were collected.Univariate analysis was made to compare the differences in relevant indicators between the two groups,and multivariate logistic regression analysis was made to identify the independent risk factors for acute exacerbation in COPD patients.The Pearson correlation method was used to analyze the correlation between serum CTSS,PGRN,CXCL12 levels and FEV1%,CAT score.Relative risk analysis was used to evaluate the influence of different CTSS,PGRN and CXCL12 levels on acute exacerbation in COPD patients.The predictive efficacy of serum CTSS,PGRN and CXCL12 levels on acute exacerbation in COPD patients was evaluated by receiver operating characteristic(ROC)curve.Results Univariate analysis showed that there was no significant difference in age,sex,BMI and disease course of patients between the two groups(P>0.05),while there were significant differences in the propor-tion of patients with smoking history,FEV1%,CAT score,and serum CTSS,PGRN and CXCL12 levels between the two groups(P<0.05).Multivariate logistic regression analysis showed that elevated serum CTSS,PGRN and CXCL12 levels were risk factors for acute exacerbation in COPD patients(P<0.05).There were significant differences in serum CTSS,PGRN and CXCL12 levels among patients with different FEV1%and CAT scores(P<0.05).Pearson correlation analysis showed that serum CTSS,PGRN and CXCL12 levels were negatively correlated with FEV1%and positively correlated with CAT score(P<0.05).Risk analysis showed that the risk of acute exacerbation in COPD patients with high serum CTSS,PGRN and CXCL12 levels was 2.089 times[95%confidence interval(CI):1.341-3.253],2.294 times(95%CI:1.363-3.862)and 2.359 times(95%CI:1.459-3.815)of the COPD patients with low serum CTSS,PGRN and CXCL12 levels.ROC analysis indica-ted that the area under the curve for predicting the risk of acute exacerbation in COPD patients based on serum CTSS,PGRN and CXCL12 levels alone was 0.780,0.811 and 0.755,respectively;the area under the curve for predicting the risk of acute exacerbation in COPD patients based on the combination of serum CTSS,PGRN and CXCL12 levels was 0.923.Conclusion Serum CTSS,PGRN and CXCL12 levels are risk factors for acute exacerbation of COPD.Abnormal elevation of serum CTSS,PGRN and CXCL12 levels can significantly increase the risk of acute exacerbation of COPD.The combination of serum CTSS,PGRN and CXCL12 levels is more effective in predicting the risk of acute exacerbation of COPD.
3.Expert consensus on the construction, evaluation and application of bone organoids (version 2024)
Jian WANG ; Long BAI ; Xiao CHEN ; Yuanyuan LIU ; Guohui LIU ; Zhongmin SHI ; Kaili LIN ; Chuanglong HE ; Jing WANG ; Zhen GENG ; Weiyang SHI ; Wencai ZHANG ; Fengjin ZHOU ; Qiang YANG ; Lili YANG ; Zhiwei WANG ; Haodong LIN ; Yunfei ZHANG ; Fuxin WEI ; Wei CHEN ; Wenguo CUI ; Fei LUO ; Jun FEI ; Hui XIE ; Jian LUO ; Chengtie WU ; Xuanyong LIU ; Yufeng ZHENG ; Changsheng LIU ; Jiacan SU
Chinese Journal of Trauma 2024;40(11):974-986
Bone organoids can simulate the complex structure and function of the bone tissues, which makes them a frontier technology in organoid researches. Bone organoids show a tremendous potential of applications in bone disease modeling, bone injury repair, and medicine screening. Although advancements have been made so far in constructing bone organoids with functional structures like mineralization, bone marrow, trabecular bone, callus, woven bone, etc, the researches in this field are confronted with numerous challenges such as lack of standardized construction strategies and unified evaluation criteria, which limits their further promotion and application. To standardize researches in bone organoids, the Orthopedic Expert Committee of Geriatric Branch of Chinese Association of Gerontology and Geriatrics, the Youth Osteoporosis Group of Orthopedic Branch of Chinese Medical Association, the Osteoporosis Group of Orthopedic Surgeon Branch of Chinese Medical Doctor Association, and the Osteoporosis Committee of Shanghai Association of Integrated Traditional Chinese and Western Medicine organized related experts to formulate Expert consensus on the construction, evaluation, and application of bone organoids ( version 2024) based on an evidence-based approach. A total of 17 recommendations were put forth, aiming to standardize researches and clinical applications of bone organoids and enhance their value in scientific research and clinical practice.
4.Expression and clinical significance of long non-coding RNA differentially expressed genes, micro RNA-181a-5p and autophagy-related protein 5 in primary gouty arthritis
Jianwei GUO ; Tianyi LEI ; Peng WANG ; Zeng ZHANG ; Guilin JIAN ; Quanbo ZHANG ; Yufeng QING
Chinese Journal of Rheumatology 2024;28(5):303-311
Objective:To explore the expression and clinical significance of long non-coding RNA colorectal neoplasia differentially expressed (lncRNA CRNDE), microRNA-181a-5p (miR-181a-5p) and autophagy related 5 (ATG5) in the peripheral blood of patients with gouty arthritis (GA) patients.Methods:The clinical data, laboratory parameters and peripheral blood samples were collected from 40 patients with acute gout (AG), 40 patients with intermittent gout (IG) and 50 healthy subjects (HC). The expression levels of lncRNA CRNDE, miR-181a-5p and ATG5 mRNA were detected by real-time fluorescence quantification (RT-qPCR) and the expression level of ATG5 protein was detected by Western-blot. The expression levels of lncRNA CRNDE, miR-181a-5p, ATG5 mRNA were compared among the three groups and correlated with clinical indices, and a subject operating characteristic curve (ROC) was constructed to assess the value of lncRNA CRNDE, miR-181a-5p, ATG5 mRNA in the diagnosis of gout. Measurements conforming to normal distribution were analyzed using t test or ANOVA, data with non-normal distribution was analyzed using Mann-Whitney U test or Kruskal-Wallis H test, correlation analysis between variables was analyzed using Spearman's analysis, and the diagnostic value of each indicator was analyzed using ROC curve. Results:① The differences in the expression of lncRNA CRNDE, miR-181a-5p, and ATG5 mRNA between the three groups were statistically significant ( H=32.12, 57.73, 68.32, all P<0.001). Among them, lncRNA CRNDE expression level in the AG group was significantly higher than that in the IG group and healthy control group [61.95(11.39, 108.30)×10 -3, 25.71(15.40, 38.40)×10 -3, 13.80(3.97, 23.99)×10 -3; Z=-3.24, P=0.001; Z=-5.03, P<0.001], and the expression level of IG group was higher than that of healthy control group( Z=-3.56, P<0.001); miR-181a-5p and ATG5 mRNA expression levels in AG group were significantly lower than those in IG group and healthy control group [miR-181a-5p: 39.81(31.22, 69.38)×10 -3, 60.74(44.19, 90.35)×10 -3, 121.30(101.50, 316.90)×10 -3; Z=-3.01, P=0.030; Z=-6.93, P<0.001. ATG5 mRNA: 4.52(2.31, 26.63)×10 -3, 43.63(13.72, 102.70)×10 -3, 153.90(66.62, 365.80)×10 -3; Z=-5.47, -7.36, all P<0.001)], which were expressed at lower levels in the IG group than in the healthy controls ( Z=-5.25, -4.47, all P<0.001). The difference of ATG5 protein expression level among the three groups expressed was statistically significant ( F=6.24, P=0.030), and the AG group was higher than the healthy control group, and the difference was statistically significant [(0.96±0.13) vs.(0.61±0.04), t=4.25, P=0.013], but the difference between the IG group (0.78±0.15) and the AG group and the HC group was not statistically significant ( t=1.51, P=0.206; t=1.85, P=0138). ② Spearman correlation analysis showed that lncRNA CRNDE was negatively correlated with the expression levels of miR-181a-5p and ATG5 mRNA in gout patients ( r=-0.49, P<0.001; r=-0.35, P=0.002); miR-181a-5p was positively correlated with ATG5 mRNA expression levels ( r=0.64, P<0.001); lncRNA CRNDE expression level was positively correlated with ESR and WBC ( r=0.49, P<0.001; r=0.43, P=0.001); miR-181a-5p expression level was negatively correlated with ESR and WBC ( r=-0.29, P=0.009; r=-0.35, P=0.002), and ATG5 mRNA expression levels were negatively correlated with ESR, WBC, and GR ( r=-0.26, P=0.021; r=-0.26, P=0.024; r=-0.27, P=0.021). In the AG group lncRNA CRNDE was positively correlated with ESR and WBC ( r=0.36, P=0.022; r=0.36, P=0.026) and miR-181a-5p was negatively correlated with WBC ( r=-0.34, P=0.038) ③ ROC curve showed that the areas under ROC curve of lncRNA CRNDE, miR-181a-5p and ATG5 mRNA expression levels to predict gout were 0.764, 0.875 and 0.864, respectively. The area under ROC curve of gout predicted by the three combined was 0.928. Conclusion:lncRNA CRNDE, miR-181a-5p, and ATG5 may be involved in the pathoge-nesis of primary gouty arthritis, and are potential biological parameters for studying the pathogenesis of gout.
5.Exploration on the Application of Partially Nested Design in Effectiveness Assessment of Different Treatment for the Same Disease in TCM and Its Methodology
Shuo FENG ; Jizheng MA ; Yufeng GUO ; Jian CAO ; Jing HU ; Xing LIAO
Chinese Journal of Information on Traditional Chinese Medicine 2024;31(4):26-30
Objective To introduce a partially nested design based on the characteristics of TCM in treating the same disease with different treatments and syndrome differentiation and treatment.Methods Partially nested design was used for standardized treatment of complex interventions.The TCM group was divided into multiple subsets according to"syndrome type-treatment method-prescription"(with nested structure),while the control group was treated with standardized Western medicine(without nested structure);taking a case study of"different treatments for the same disease"data for ulcerative colitis,this design type was applied and analyzed using a multi-level model.Results The partially nested design was consistent with the feature of TCM of"different treatments for the same disease"and met the methodological requirements for evidence-based evaluation.Multilevel models allowed analyses with this type of data.Conclusion The use of partially nested design enables the evaluation of the comprehensive effectiveness of"different treatments for the same disease",which can provide a methodological reference for the assessment of clinical effectiveness of TCM.
6.Interpretation and Elaboration for the ARRIVE Guidelines 2.0—Animal Research: Reporting In Vivo Experiments (V)
Zhengwen MA ; Xiaying LI ; Xiaoyu LIU ; Yao LI ; Jian WANG ; Jin LU ; Guoyuan CHEN ; Xiao LU ; Yu BAI ; Xuancheng LU ; Yonggang LIU ; Yufeng TAO ; Wanyong PANG
Laboratory Animal and Comparative Medicine 2024;44(1):105-114
Improving the reproducibility of biomedical research results is a major challenge. Transparent and accurate reporting of the research process enables readers to evaluate the reliability of the research results and further explore the experiment by repeating it or building upon its findings. The ARRIVE 2.0 guidelines, released in 2019 by the UK National Centre for the Replacement, Refinement and Reduction of Animals in Research (NC3Rs), provide a checklist that is applicable to any in vivo animal research report. These guidelines aim to improve the standardization of experimental design, implementation, and reporting, as well as enhance the reliability, repeatability, and clinical translation of animal experimental results. The use of the ARRIVE 2.0 guidelines not only enriches the details of animal experimental research reports, ensuring that information on animal experimental results is fully evaluated and utilized, but also enables readers to understand the content expressed by the author accurately and clearly, promoting the transparency and completeness of the fundamental research review process. At present, the ARRIVE 2.0 guidelines have been widely adopted by international biomedical journals. This article is based on the best practices following the ARRIVE 2.0 guidelines in international journals, and it interprets, explains, and elaborates in Chinese the fifth part of the comprehensive version of the ARRIVE 2.0 guidelines published in PLoS Biology in 2020 (the original text can be found at
7.Network pharmacology analysis and molecular docking verification of the mechanism of Zhenqi Fuzheng Capsule in the adjuvant treatment treatment of AIDS
Shengxing CAI ; Kaining WANG ; Yifang LOU ; Xiaonan HU ; Yanhong WANG ; Pei ZHOU ; Hao GU ; Xiaoping ZHANG ; Jian WANG ; Guojian GAO ; Yufeng ZHAO
International Journal of Traditional Chinese Medicine 2023;45(6):736-742
Objective:To analyze the molecular mechanism of Zhenqi Fuzheng Capsules in the adjuvant treatment of AIDS by network pharmacology method and molecular docking technology.Methods:The active components and targets of Zhenqi Fuzheng Capsules were obtained through TCMSP, and the AIDS-related targets were obtained through GeneCards, OMIM and DrugBank databases. The intersection target PPI network was constructed through STRING 11.5 database, and Cytoscape 3.9.1 software was used for network topology analysis; Metascape database was used for GO function and KEGG pathway enrichment analysis of core targets; Cytoscape 3.9.1 was used to construct Zhenqi Fuzheng Capsules component-target-pathway network; Autodock Tools software was used to carry out molecular docking of core targets and active components.Results:Totally 31 active components and 180 targets of Zhenqi Fuzheng Capsules were screened out. TNF, IL6, AKT1, IL1B, TP53, VEGFA, RELA, EGFR and CASP3 were identified as the core targets. GO functional enrichment analysis obtained 1 436 biological processes, 53 cellular components, and 117 molecular functions. KEGG pathway enrichment analysis obtained 167 pathways, which were related to pathways in cancer, AGE-RAGE signaling pathway in diabetic complications, and IL-17 signaling pathway was closely related. Molecular docking results showed that core targets such as AKT1 and TNF had good binding activity to quercetin, kaempferol, and luteolin.Conclusion:The main active components of Zhenqi Fuzheng Capsules in the adjuvant treatment of AIDS are quercetin, kaempferol and luteolin, which may treat AIDS through the IL-17 signaling pathway.
8.Development and construction of comprehensive examination database for periodontology based on curriculum integration
Yiwei WANG ; Lizhen WANG ; Xi CHEN ; Ling ZHU ; Jian JIN ; Chaolun LI ; Rong SHU ; Yufeng XIE
Chinese Journal of Medical Education Research 2023;22(1):38-41
Periodontology is one of the important disciplines in oral clinical medicine, which covers a wide range of subjects and intersects with many basic disciplines. Under the environment of the implementation of modular teaching in Shanghai Jiao Tong University School of Medicine, the assessment method with separate propositions for the teaching and research section is still adopted. There is a mismatch between the assessment mode and the curriculum setting; the basic subject propositions are difficult to be combined with clinical cases; the knowledge point assessment is single, and the students' ability to integrate the knowledge points cannot be assessed. The development and construction of the comprehensive examination database for periodontology was based on curriculum integration, gathering the teaching backbones of various disciplines, focusing on periodontology, radiating all related disciplines, unifying the proposition outline, proposition type, proposition principle, combining with relevant knowledge points of various disciplines based on clinical cases, and tried to apply to clinical students majoring in stomatology. The use of the examination database promotes students' ability to flexibly apply theoretical knowledge to clinical case analysis, further promotes the reform of modular teaching, lays a solid foundation for future clinical work, and meanwhile provides an important basis for directions of the teaching and research section.
9.New era in the development of wound healing discipline in China: standardization, integration, and translation
Ting XIE ; Pengwen NI ; Chunmao HAN ; Bing WEN ; Jian XIAO ; Ling WANG ; Yufeng JIANG ; Qixia JIANG ; Man LUO
Chinese Journal of Burns 2023;39(11):1001-1005
In line with the significant changes in disease spectrum, the wound healing discipline in China has shown a good momentum of development from budding to rapid growth. At present, improving the connotation of disciplinary development determines the speed and quality of disciplinary development in the future. The characteristics of wound diseases determine that the wound healing discipline must have the following property: standardization, integration, and translation. Here is the initial introduction on the connotation of standardization, collaboration, and translation in clinical practice of wound healing discipline. Besides, the discussions on standardization, integration, and translation in the 13 th National Conference of Wound Repair (Healing) and Tissue Regeneration were summarized. It is expected that these achievements can be reflected and improved in the construction of the wound healing discipline in China.
10.Efficacy and safety of Tofacitinib in treating the elderly rheumatoid arthritis
Keqin ZENG ; Erye ZHOU ; Tian REN ; Yufeng YIN ; Michun HE ; Xianming LONG ; Mingjun WANG ; Yufan GUO ; Jian WU
Chinese Journal of Geriatrics 2023;42(1):40-45
Objective:To observe the efficacy and safety of Tofacitinib in treating elderly rheumatoid arthritis(RA), in order to provide clinical evidence.Methods:In the randomized control trial, a total of 90 elderly RA patients admitted to the Department of Rheumatology of the First Affiliated Hospital of Soochow University from January 2019 to January 2021 were selected and divided into Methotrexate group(MTX group, MTX 10mg, qw, n=45)and Tofacitinib group(TOF group, oral 5mg, bid, n=45). The efficacy and safety of the two groups were evaluated at week 12.The primary endpoint was the proportion of patients meeting the American College of Rheumatology 50%(ACR50)improvement response criteria at week 12.Secondary endpoints included ACR20/70 improvement response, proportion of patients who met treat-to-target(T2T)criteria, including Disease Activity Score in 28 joints using erythrocyte sedimentation rate(DAS28-ESR), Disease Activity Score in 28 joints using C-reactive protein level(DAS28-CRP), clinical disease activity index(CDAI), and simplified disease activity index(SDAI), and patient-reported outcomes(PROs)which included changes compared to baseline in pain visual analog scale(VAS)and Health Assessment Questionnaire Disability Index(HAQ-DI)score, at week 12.Safety outcomes including drug-related adverse events, serious adverse events, dropping out due to adverse events, and deaths were assessed throughout.Results:Five patients in each group withdrew from the trial due to adverse events, and the number of patients who finally completed the observation was 40 in each group.At week 12, the ACR50 response rate was higher in TOF group than in MTX group[35%(14/40) vs.12.5%(5/40), χ2=5.591, P=0.018)], achieving the primary endpoint.When comparing TOF vs.MTX group, the ACR20 response rate[55%(22/40) vs.25%(10/40), χ2=7.500, P=0.006]and ACR70 response rate[25%(10/40) vs.7.5%(3/40), χ2=4.501, P=0.034], and proportions of indexes of disease remission including DAS28-ESR<2.6[25%(11/40) vs.7.5%(3/40), χ2=4.501, P=0.034], or DAS28-CRP<2.6[27.5%(11/40) vs.7.5%(3/40), χ2=5.541, P=0.019], or CDAI≤2.8[30%(12/40) vs.10%(4/40), χ2=5.000, P=0.025], or SDAI≤3.3[27.5%(11/40) vs.7.5%(3/40), χ2=5.541, P=0.019], and the proportions of patients with low disease activity including DAS28-ESR≤3.2[32.5%(14/40) vs.12.5%(5/40), χ2=5.591, P=0.018], or DAS28-CRP≤3.2[32.5%(14/40) vs.12.5%(5/40), χ2=5.591, P=0.018], or CDAI≤10[37.5%(15/40) vs.17.5%(7/40), χ2=4.013, P=0.045], or SDAI≤11[37.5%(15/40) vs.15%(6/40), χ2=5.230, P=0.022], as well as changes compared to baseline data in pain VAS[(26.51±8.32)scores vs.(14.16±4.39)scores, t=8.371, P<0.001]and in HAQ-DI score(0.65±0.24 vs.0.32±0.06, t=9.387, P<0.001)were all better in the TOF group than in the MTX group at week 12.During the 12-week observation period, the number of patients with infection and hyperlipidemia was higher in TOF group than in MTX group, while the number of patients with abnormal blood cell count and liver function was lower than that in MTX group, but the differences were not statistically significant(all P<0.05). Conclusions:Tofacitinib has good efficacy and safety in the elderly RA.In patients over 70 years of age who are at high risk of infection, tofacitinib should be used with caution.

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