1.A nomogram model for predicting malnutrition after a tracheotomy
Ang CAI ; Junfeng YANG ; Ruyao LIU ; Le WANG ; Yi LI ; Liugen WANG ; Heping LI ; Xi ZENG
Chinese Journal of Physical Medicine and Rehabilitation 2024;46(3):199-204
Objective:To explore the risk factors for malnutrition after a tracheotomy and to construct a predictive model useful for its prevention through early intervention.Methods:Clinical data describing 440 tracheotomy patients were subjected to a retrospective analysis. The variables examined were age, sex, etiology, Glasgow Coma Score (GCS), activities of daily living (ADL) score, age-corrected Charlson comorbidity index (aCCI), food intake, swallowing function, incidence of infections, as well as any history of diabetes mellitus, hypertension, smoking or alcohol consumption. Patients identified as being at risk of malnutrition (NRS-2002≥3) were screened using the Nutritional Risk Screening tool (NRS-2002) and the European Society of Clinical Nutrition and Metabolism′s ESPEN2015 criteria. The subjects were thus categorized into a malnutrition group of 343 and a control group of 97. Unifactorial and multifactorial logistic regression analyses were performed, and stepwise regression was applied to include the factors found significant in the unifactorial analysis into the multifactorial logistic regression analysis, and to construct a column-line graph prediction model. The clinical utility of the model was assessed by applying the receiver operator characteristics (ROC) curves, calibration plots and decision curve analysis (DCA).Results:Of the 440 persons studied, 343 (78%) were malnourished. The multivariate logistic regression analysis showed that pulmonary infection, dysphagia, low GCS score and high aCCI score were significant risk factors for malnutrition after a tracheotomy. A prediction nomograph was constructed. After fitting and correcting, the area under the curve (AUC) of the prediction model′s ROC curve was 0.911, the specificity was 80.4%, and the sensitivity was 91.3%. That was significantly higher than the AUCs for pulmonary infection (0.809), dysphagia (0.697), aCCI (0.721) and GCS (0.802). Bootstrap self-sampling was used to verify the model internally. After 1000 samples the average absolute error between the predicted risk and the actual risk was 0.013, indicating good prediction ability. The DCA results demonstrated that the model has substantial clinical applicability across a range of nutritional interventions, particularly for threshold probability values ranging from 0 to 0.96.Conclusion:Pulmonary infection, dysphagia, low GCS score, and high aCCI score are risk factors for malnutrition among tracheotomy patients. The nomogram model constructed in this study has good predictive value for the occurrence of malnutrition among such patients.
2.Effects of targeted inhibition of deubiquitinase USP7/USP47 on proliferation and apoptosis of acute myeloid leukemia cells with or without Flt3-ITD mutation
Qianyu ZHANG ; Yu′ang GAO ; Xin LI ; Yongfeng SU ; Bo CAI ; An WANG ; Jie ZHOU ; Hongmei NING
Chinese Journal of Microbiology and Immunology 2024;44(3):217-224
Objective:To investigate the effects of ubiquitin-specific protease (USP) 7/47 inhibitor (Cat. No. 1247825-37-1) on the proliferation and apoptosis of acute myeloid leukemia (AML) cells with or without internal tandem duplications of the Flt3 gene (Flt3-ITD). Methods:ATP assay was used to detect the effects of 1247825-37-1 on the cell viability of two AML cell lines (MOLM13 and MV4-11) harboring Flt3-ITD mutation and one AML cell line (THP-1) without Flt3-ITD mutation as well as the primary Flt3-ITD-mutant and non-mutant AML cells from patient samples. Flow cytometry was used to detect the apoptosis of AML cell lines treated by different concentrations of 1247825-37-1.Results:Compared with the control group, 1247825-37-1 was able to significantly inhibit the proliferation of MOLM13, MV4-11 and THP-1 cells ( P<0.000 1). Besides, the cell viability of primary AML cells was also inhibited by 1247825-37-1, and a stronger inhibitory effect on non-mutant AML cells was observed. The USP7/USP47 inhibitor 1247825-37-1 could inhibit the proliferation of AML cells in a dose-dependent manner and a low dose (2 or 4 μmol/L) of 1247825-37-1 would be effective. Moreover, 1247825-37-1 was also able to efficiently induce the apoptosis of above AML cell lines in a dose-dependent manner. Conclusions:The USP7/USP47 inhibitor 1247825-37-1 significantly inhibits the proliferation of AML cells with or without Flt3-ITD mutation.
3.Analyzing the prevention strategies of accidental puncture in traditional Chinese medicine acupuncture based on occupational exposure data
Li CAI ; Huichao CHEN ; Yafei LI ; Ding LUO ; Jingwei CHEN ; Honglian OUY-ANG
The Journal of Practical Medicine 2024;40(18):2635-2639
Objectives To enhance occupational safety for medical practitioners involved in acupuncture procedures within the field of Chinese medicine,it is imperative to thoroughly investigate and analyze the current incidence of accidental punctures.Subsequently,effective strategies can be proposed to prevent such occurrences.Methods Through retrospective analysis,this study investigates the occupational exposure data of a tertiary hospital specializing in traditional Chinese medicine from 2020 to 2022.The demographic characteristics(age and gender),professional experience,occupational category,pre-service training,type of acupuncture tools used,puncture session details,and exposure sources of the individuals involved are collected and organized for analyzing the risk factors asso-ciated with accidental needlestick injuries.Corresponding preventive measures are proposed accordingly.Results In this survey,a total of 5 069 medical staff from 12 clinical departments were included,among whom 63 experienced accidental puncture with an incidence rate of 1.24%(63/5 069).The likelihood of puncture was found to be signifi-cantly higher in individuals aged between 25~30 years compared to those under the age of 25(OR=18.556,P<0.05).Similarly,the probability of puncture was also higher in individuals aged over 30 years compared to those under the age of 25(OR=14.311,P<0.05).Conversely,individuals with at least three years of experience had a lower probability of experiencing punctures compared to those with less than three years(OR=0.025,P<0.05).Furthermore,interns exhibited a higher likelihood of puncture incidents compared to physicians(OR=2.212,P<0.05).Regarding the puncture session,the highest probability of occurrence is 58.73%at the time of needle removal(χ2=106.222,P<0.05).Regarding the type of acupuncture tools,acupuncture needles have the highest probability of occurrence at 41.27%(χ2=45.095,P<0.05).Concerning the exposure source,"unknown exposure source"has the highest preva-lence at 42.86%(χ2=57.476,P<0.05),while"exposure source is hepatitis B patient"accounts for 20.63%(χ2=57.476,P<0.05).Regarding pre-service training,individuals who have received pre-service training exhibit a higher likelihood of puncture incidents(69.84%)(χ2=38.000,P<0.05).Conclusions The serological status of patients should be obtained in advance,and strict adherence to infection prevention control measures such as"standard precau-tions"and"contact isolation"is necessary.Effective pre-service training must be implemented,with particular atten-tion given to the risk of puncture when using specialized acupuncture tools for occupational safety.
4.Multicenter epidemiological characteristics of Mycoplasma pneumoniae infection in children in Hainan Province, 2012-2020
LIAO Shang-qiu ; TAN Hui ; ZHANG Xue-mei ; WAN Ke-cheng ; LU Xiong-fu ; ZHU Hou-cai ; YANG Zi-jiang ; ZHANG Yu-qing ; LIU Jia-yu ; TAN Xiao-yu ; DU Yu-ang ; BAI En-xu ; CAI Si-ming ; HUO Kai-ming
China Tropical Medicine 2023;23(5):511-
Abstract: Objective To analyze the epidemiological characteristics (season, age, gender, mixed infection and clinical manifestations, etc.) of Mycoplasma pneumoniae (MP) infection in children in Hainan Province, so as to provide epidemiological evidence-based medical basis for the prevention and control of MP infection in children in Hainan Province. Methods The serum IgM antibodies of MP, Legionella pneumophila, Chlamydia pneumoniae, adenovirus, respiratory syncytial virus (RSV), Q fever Rickettsia, parainfluenza virus, influenza A virus and influenza B virus in children with respiratory tract infections (RTIs) who were hospitalized in pediatrics of many hospitals in Hainan Province from March 2012 to February 2020 were detected by indirect immunofluorescence method. The positive serum MP-IgM antibody was defined as MP infection. The epidemiological and clinical data of MP infected cases were analyzed retrospectively. Results From March, 2012 to February, 2020, a total of 35 731 qualified pediatric inpatients with RTIs in many hospitals in Hainan Province were tested for serum MP-IgM with the total positive rate of 39.12% (13 978/35 731). The yearly positive rates of MP-IgM from 2012 to 2020 were 48.39%, 56.23%, 56.62%, 47.04%, 29.71%, 24.14%, 47.55%, 36.84% and 24.46% respectively. The positive rates of MP-IgM in 2013 and 2014 were significantly higher than those in other years (P<0.05). The positive rate of MP-IgM in summer in Hainan Province was the highest (41.34%) and the lowest in winter (35.77%) (P<0.05). MP infection occurred in all age groups, the positive rate of MP-IgM in children of preschool (51.80%) was significantly higher than that in other age groups (P<0.01), and the positive rate of MP IgM in children of infancy (15.36%) was lower than that in other age groups (P<0.01). The positive rate of MP-IgM in female was 44.77%, which was significantly higher than that in male (35.83%) (P<0.05). MP infection combined with positive IgM of another pathogen accounted for 32.63% (4 561 cases), positive IgM of another two pathogens accounted for 1.26% (176 cases). MP infection was mostly found in pneumonia (68.73%), and the main clinical symptoms were cough (84.72%), fever (51.01%) and wheezing (3.16%). Conclusions MP is an important pathogen of respiratory tract infection in children in Hainan Province, and infection is more common in children in early school age and early childhood. Mp-specific tests should be performed to identify the pathogen in children suspected of MP infection. In the high incidence season, health education should be strengthened in kindergartens, schools and other places to prevent respiratory tract infection.
5.Analysis of risk factors and a predictive model of malnutrition in disabled stroke patients
Ang CAI ; Yi LI ; Liugen WANG ; Heping LI ; Xi ZENG
Chinese Journal of Physical Medicine and Rehabilitation 2023;45(1):24-28
Objective:To analyze the risk factors for malnutrition among disabled stroke survivors and devise a prediction model.Methods:A total of 373 disabled stroke survivors treated in the Department of Rehabilitation Medicine, the First Affiliated Hospital of Zhengzhou University in 2021 formed a control group ( n=102) and a malnutrition group ( n=271) according to their nutritional status. Univariate correlation analysis and multivariate logistic regression were used to analyze the risk factors for malnutrition and their predictive value. Results:Age, dysphagia, pulmonary infection, disability score and feeding style were found to be related significantly to the occurrence of malnutrition. Multivariate logistic regression confirmed that age, pulmonary infection, dysphagia, low total intake and a low Barthel index were useful predictors of malnutrition in such persons. Moreover, patients who had received nasogastric tube feeding were at much higher risk of malnutrition than those with intermittent oroesophageal tube feeding. The area under the receiver operating characteristics curve of the Barthel index combined with dysphagia to predict malnutrition was 0.84. The critical value was 0.67 with a sensitivity of 88% and a specificity of 72.5%.Conclusions:Age, pulmonary infection, dysphagia, feeding method, total intake and disability score are risk factors for malnutrition in disabled stroke survivors. The Barthel index combined with dysphagia has good predictive power for the occurrence of malnutrition in such persons.
6. Qualitative and quantitative analysis of Arnebiae Radix and Dictamni Cortex and efficacy study of herbal extracts on allergic contact dermatitis using 3D human reconstructed epidermis
Huan LI ; Esther LIM ; Gladys ANG ; Zhi-qing LIM ; Martin Hui CAI ; Jo-anne LOH ; Celine NG ; Peijia SEETOH ; Edmund TIAN ; Lay Beng GOH ; Jo-anne LOH ; Lay Beng GOH
Chinese Herbal Medicines 2021;13(4):556-564
Objective: To evaluate the quality of Arnebiae Radix (AR) and Dictamni Cortex (DC) and study the efficacy of herbal extracts of these two herbs on the treatment of allergic contact dermatitis (ACD). Methods: Qualitative and quantitative analysis of effective components was performed using High Performance Thin Layer Chromatography (HPTLC), High Performance Liquid Chromatography (HPLC), and HPLC-Quadrupole Time of Flight-Mass Spectrometry (HPLC-QTOF-MS). In vitro allergic ACD 3D model was established by incubating 3D reconstructed human epidermis (RHE) with skin sensitizer, potassium dichromate. A total of 65 gene expression that were associated with ACD, which included 24 antioxidant responsive element (ARE) and 41 SENS-IS genes were quantified by qRT-PCR. More than or equal to 10 ARE genes and 18 SENN-IS genes were induced by 1.3-fold, demonstrating the successful establishment of in vitro ACD model. Oil extracts of AR and DC were applied on the in vitro ACD model to study the efficacy. Results: Batch 3 of AR and batch 2 of DC showed presence of all active ingredients with the highest concentrations. Active ingredients of the herbs were extracted using a special oil and formulated into herbal oil extracts. The herbal oil extracts were able to down regulate the induced genes in the in-vitro ACD skin model, bringing the tissue back to homeostatic status. Conclusion: The oil extracts showed the potent efficacy of using AR and DC in ACD treatment. The combination study will be done to optimize the formulation ratio which will be developed into a topical cream.
7.Effect of Qiangjing Tablets on the MAPK signaling pathway in SD rats with asthenospermia.
Guang-Sen LI ; Pei-Hai ZHANG ; Jian CAI ; Xiao-Peng HUANG ; Xu-Jun YU ; Liang DONG ; Yao-Dong YOU ; Di-Ang CHEN ; Lei ZHANG ; De-Gui CHANG
National Journal of Andrology 2018;24(5):436-441
ObjectiveTo investigate the effects of Qiangjing Tablets (QJT) on sperm quality and the MAPK signaling pathway in the SD rat model of asthenospermia (AS).
METHODSA total of 100 male SD rats were randomly divided into five groups of equal number, blank control, AS model control, high-dose QJT, medium-dose QJT, and low-dose QJT. All the rats were intragastrically administered ORN at 200 mg/kg/d for establishment of the AS model except those in the blank control group, which were given 1% CMC sodium solution at 1 ml/100 g by gavage. Meanwhile the animals of the high-, medium-, and low-dose QJT groups were gavaged with QJT at 6700, 3300 and 1700 mg/kg/d, respectively, qd 6 days a week for 20 days. Then the testis issue and the apoptosis of the testicular cells were observed under the electron microscope, the expression of vimentin in the testis was determined with the immunohistochemical SP method, that of ERK1/2 detected by Western blot, and the concentration of TGF-β1 in the semen measured by ELISA.
RESULTSThe AS model controls showed round nuclei of spermatocytes, homogeneously distributed chromatins, broken or lost mitochondria, and expanded rough endoplasmic reticulum in the testis tissue. In comparison, the rats of the high-, medium-, and low-dose QJT groups exhibited round nuclei of spermatocytes, homogeneously distributed chromatins, and well-structured mitochondria, rough endoplasmic reticulum and ribosome, which were all similar those of the blank controls. Compared with the blank controls, the AS model rats manifested significantly increased expressions of ERK1/2 (1.00 ± 0.00 vs 1.26 ± 0.10, P<0.01) and vimentin (0.16 ± 0.01 vs 0.17 ± 0.01, P<0.01) and apoptosis rate of cells in the testis tissue ([9.20 ± 3.07] vs [42.20 ± 9.17] %, P<0.01), but decreased level of TGF-β1 in the semen ([627.67 ± 26.07] vs [566.73 ± 68.44] ng/ml, P<0.05). In comparison with the model controls, the rats of the high- and medium- -dose QJT groups presented remarkably down-regulated expressions of ERK1/2 (1.26 ± 0.10 vs 1.14 ± 0.08, P<0.01; 1.26 ± 0.10 vs 1.18 ± 0.05, P<0.05) and vimentin (0.17 ± 0.01 vs 0.16 ± 0.01, P<0.01; 0.17 ± 0.01 vs 0.17 ± 0.09, P<0.05) and decreased rate of cell apoptosis ([42.20 ± 9.17] vs [21.60 ± 5.94] %, P<0.01; [42.20 ± 9.17] vs [33.95 ± 6.39] %, P<0.05). The concentration of TGF-β1 in the semen was markedly lower in the high-dose QJT than in the AS model control group ([621.78 ± 30.80] vs [566.73 ± 68.44] ng/ml, P < 0.05).
CONCLUSIONSQiangjing Tablets could improve semen quality in asthenospermia rats by acting against oxidative stress.
Animals ; Apoptosis ; Asthenozoospermia ; enzymology ; Drugs, Chinese Herbal ; pharmacology ; Male ; Mitogen-Activated Protein Kinase 3 ; metabolism ; Mitogen-Activated Protein Kinases ; drug effects ; metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Semen ; Semen Analysis ; Signal Transduction ; Spermatozoa ; Testis ; metabolism ; ultrastructure ; Transforming Growth Factor beta1 ; metabolism ; Vimentin ; metabolism
8.Daily calorie restriction and alternate day fasting for type 2 diabetes prevention
Ang ZHENG ; Guofang CHEN ; Keying CAI ; Chao LIU
Chinese Journal of Endocrinology and Metabolism 2016;32(5):433-436
[Summary] Lifestyle intervention is one of the important strategies for the prevention of type 2 diabetes. Recently, caloric restriction regimen has become a hot topic as one of the cornerstone of lifestyle intervention. The alternate day fasting regimen is simple, and increases the patient compliance. Both daily calorie restriction and alternate day fasting regimen can reduce body-weight significantly in pre-diabetes subjects, and reduce the visceral fat mass and the fasting insulin levels, and improve the insulin sensitivity, as well as maintain the lean mass, though the effect on fasting blood glucose was not significant. Nevertheless, the most recent studies have demonstrated that daily calorie restriction,in particular, alternate day fasting regimens can be effective in individuals with pre-diebates in order to prevent type 2 diabetes.
9.Evaluation of Storage Performance of Preserving Bags for Manually Separated Platelets.
Min-Xia LIU ; Lan DUAN ; Jie-Xi WANG ; Yan WANG ; Hai-Long ZHUO ; Li-Na CAI ; Xiao-Yang YI ; Jian-Wei ZHOU ; Jian-Wei ANG ; Ying HAN
Journal of Experimental Hematology 2015;23(4):1152-1155
OBJECTIVETo evaluate the storage performance of the domestically made platelet storage bags (experimental group) and the United States Trima set platelet storage bags (control group).
METHODSThe manually separated platelets were divided in two equal parts, which was added to control blood bags and experimental blood bags respectively, all samples were stored at a 22 °C ± 2 °C. The platelet count, mean volume, aggregation activity (ADP, THR), pH, glucose, lactate concentration, lactate dehydrogenase concentration, hypotonic shock reaction, CD62P and phosphatidic acid serine content were detected at day 0, 3, 5 and 7 of storage.
RESULTSThere was no significant difference of platelet quality at day 5 after storage between the experimental group and the control group (T-test, P > 0.05).
CONCLUSIONTwo kinds of platelet storage bags have the similar storage performance.
Blood Platelets ; Blood Preservation ; Cell Separation ; Glucose ; Humans ; Platelet Count
10.Creation of Consistent Burn Wounds: A Rat Model.
Elijah Zhengyang CAI ; Chuan Han ANG ; Ashvin RAJU ; Kong Bing TAN ; Eileen Chor Hoong HING ; Yihua LOO ; Yong Chiat WONG ; Hanjing LEE ; Jane LIM ; Shabbir M MOOCHHALA ; Charlotte A E HAUSER ; Thiam Chye LIM
Archives of Plastic Surgery 2014;41(4):317-324
BACKGROUND: Burn infliction techniques are poorly described in rat models. An accurate study can only be achieved with wounds that are uniform in size and depth. We describe a simple reproducible method for creating consistent burn wounds in rats. METHODS: Ten male Sprague-Dawley rats were anesthetized and dorsum shaved. A 100 g cylindrical stainless-steel rod (1 cm diameter) was heated to 100degrees C in boiling water. Temperature was monitored using a thermocouple. We performed two consecutive toe-pinch tests on different limbs to assess the depth of sedation. Burn infliction was limited to the loin. The skin was pulled upwards, away from the underlying viscera, creating a flat surface. The rod rested on its own weight for 5, 10, and 20 seconds at three different sites on each rat. Wounds were evaluated for size, morphology and depth. RESULTS: Average wound size was 0.9957 cm2 (standard deviation [SD] 0.1845) (n=30). Wounds created with duration of 5 seconds were pale, with an indistinct margin of erythema. Wounds of 10 and 20 seconds were well-defined, uniformly brown with a rim of erythema. Average depths of tissue damage were 1.30 mm (SD 0.424), 2.35 mm (SD 0.071), and 2.60 mm (SD 0.283) for duration of 5, 10, 20 seconds respectively. Burn duration of 5 seconds resulted in full-thickness damage. Burn duration of 10 seconds and 20 seconds resulted in full-thickness damage, involving subjacent skeletal muscle. CONCLUSIONS: This is a simple reproducible method for creating burn wounds consistent in size and depth in a rat burn model.
Animals
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Burns*
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Erythema
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Extremities
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Hot Temperature
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Humans
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Male
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Models, Animal*
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Muscle, Skeletal
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Rats
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Rats, Sprague-Dawley
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Skin
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Viscera
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Water
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Wounds and Injuries*

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