1.Correlation Between Traditional Chinese Medicine Syndrome Type of Unstable Angina Pectoris and Iron Metabolism Indices
Jiye CHEN ; Min WU ; Changxin SUN ; Xiaonan ZHANG ; Zeping WANG ; Longtao LIU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(20):126-136
ObjectiveTo investigate the correlation between iron metabolism parameters and various syndrome types of unstable angina pectoris (UAP). MethodsA cross-sectional study was conducted from October 2021 to October 2023, encompassing 213 patients diagnosed with UAP at Xiyuan Hospital of Chinese Academy of Chinese Medical Sciences. Additionally, 30 healthy individuals were selected as control cases. Single-factor analysis was used to investigate the differences in clinical data among different Traditional Chinese Medicine (TCM) syndrome types of UAP and their correlation with iron metabolism indices. The study conducted a comparative analysis of the aforementioned clinical data among patients with and without heat-toxic and blood-stasis syndrome. Logistic regression was used to analyze the correlation between TCM syndrome types and related factors. The receiver operator characteristic (ROC) curve was employed to assess the predictive value of iron metabolism indices, along with their sensitivity and specificity. ResultsCompared to those in the control group, serum iron (SI) and serum ferritin (SF) levels were significantly increased in the UAP group (P<0.01), while transferrin (TRF) and total iron binding capacity (TIBC) levels were decreased (P<0.01). However, there was no significant difference in unsaturated iron binding capacity (UIBC). Multivariate binary Logistic regression analysis identified apolipoprotein A1 (ApoA1), homocysteine (HCY), high-sensitivity C-reactive protein (hs-CRP), and SF as independent influencing factors for the UAP patients (P<0.05, P<0.01). Additionally, statistically significant differences were observed in SI, SF, TRF, and TIBC among 213 patients with different TCM types (P<0.01). Patients with heat-toxic and blood-stasis syndrome had higher SI and SF values than those without the syndrome (P<0.01), while their TIBC and TRF values were lower (P<0.01). Multivariate binary logistic regression analysis showed that SI and LDL-C levels were closely associated with the differentiation of heat-toxic and blood-stasis syndrome. ConclusionUAP patients often experience iron metabolism disorders, and the heat-toxic and blood-stasis syndrome are significantly correlated with iron metabolism parameters. The SI and LDL-C levels have high specificity and sensitivity in diagnosing heat-toxic and blood-stasis syndrome.
2.Study on disease structure and optimization strategy of breast, thyroid and hernia surgery department based on DRG
Journal of Chinese Physician 2025;27(9):1388-1391
Objective:To provide guidance for department operation and discipline development by analyzing the disease structure of the Department of Breast, Thyroid and Hernia Surgery in a Class-A tertiary hospital in Shandong Province.Methods:The inpatient medical record homepages of the Liaocheng People′s Hospital from January 1 to October 31, 2024, were collated, with a total of 113 857 medical records collected. Based on the International Classification of Diseases coding (ICD-10), and utilizing the Shanghai Lianzhong version Diagnosis-Related Group (DRG) grouper and the National Healthcare Security Diagnosis-Related Group (CHS-DRG) grouper version 1.1, combined with the performance evaluation indicators for national tertiary public hospitals (hereinafter referred to as the " National Evaluation" ), a four-quadrant analysis and analogy method were applied to study the disease structure, relative weight (RW), average profit/loss per case (average effective revenue per case), and the proportion of Level IV and minimally invasive surgeries in the Department of Breast, Thyroid, and Hernia Surgery.Results:Chemotherapy was the main disease type in the department, accounting for 43.25% of the total cases, but its RW was low, so it had no advantage in discipline development. Except for chemotherapy, thyroid surgery, abdominal external hernia surgery, and breast malignant tumor surgery were the main disease types, accounting for 39.73% of the total cases. Among them, thyroid surgery and breast malignant tumor surgery had advantages in discipline development in terms of the National Assessment system and medical insurance payment; in addition, grade IV surgeries were concentrated in thyroid surgery, and minimally invasive surgeries were concentrated in abdominal external hernia surgery.Conclusions:The characteristics of the disease structure of the Department of Breast, Thyroid and Hernia Surgery are initially grasped, the development direction of the department is clarified, the cost structure is optimized, and the disciplinary competitiveness is improved.
3.Segmented Time Study and Optimization Strategy for Clinical Application of Ethos Online Adaptive Radiotherapy.
Dandan ZHANG ; Yuhan KOU ; Shilong ZHU ; Xiaoyu LIU ; Meng NING ; Peichao BAN ; Jinyuan WANG ; Changxin YAN ; Zhongjian JU
Chinese Journal of Medical Instrumentation 2025;49(2):134-140
OBJECTIVE:
To analyze the time characteristics of the Ethos online adaptive radiotherapy (OART) process in clinical practice and provide guidance for the comprehensive optimization of each stage of adaptive radiotherapy.
METHODS:
The study involved 61 patients with cervical, rectal, gastric, lung, esophageal, and breast cancers who underwent Ethos OART. The mean ± standard deviation of segmental time, total time, and target volume for these patients were tracked. The time characteristics for different cancer types were evaluated, and the average time for target and organ at risk (OAR) modifications was compared with the average target volume for each cancer type.
RESULTS:
Cervical cancer born the longest total treatment time, while breast cancer had the shortest. For all cancer types except breast cancer, the modification time for target and OAR was the most time-consuming segment. The average time for target and OAR modifications aligned with the trend of the average target volume.
CONCLUSION
The total treatment time for various cancers ranges from 15 to 35 minutes, indicating room for improvement.
Humans
;
Radiotherapy Planning, Computer-Assisted/methods*
;
Neoplasms/radiotherapy*
;
Female
4.Role of mitochondrial autophagy-related genes in colorectal cancer based on spatial transcriptomics and single-cell sequencing analysis
Changxin SHU ; Chen WEI ; Dong TANG
Journal of Clinical Medicine in Practice 2025;29(7):92-99
Objective To investigate the role of mitochondrial autophagy-related genes in color-ectal cancer using machine learning algorithms to analyze single-cell sequencing data and spatial tran-scriptomics data.Methods Key mitochondrial autophagy-related genes were screened using Support Vector Machine-Recursive Feature Elimination(SVM-RFE)and Random Forest algorithms.Compre-hensive assessments of cell-cell interactions,pseudo-time analysis,and gene spatial localization were conducted by integrating single-cell sequencing data and spatial transcriptomics data.Knockdown ex-periments were performed on the identified core genes to verify their effects on the proliferation,mi-gration,and invasion capabilities of colorectal cancer cells.Results RPS5 was identified as a core gene in the progression of colorectal cancer.RPS5-positive epithelial cells were primarily located in the tumor core region and interacted with fibroblasts.Immunohistochemical experiments demonstrated that RPS5 expression was significantly higher in colorectal cancer tissues compared to adjacent tis-sues.Functional experiments showed that knockdown of RPS5 significantly inhibited the proliferation,migration,and invasion capabilities of colorectal cancer cells.Conclusion RPS5 is a key molecule promoting the progression of colorectal cancer,which provides a new potential target for precision therapy in colorectal cancer.
5.Preliminary study on the implementation of HT for segmented TMLI in adults
Haiyang WANG ; Gaoxiang CHEN ; Xiang HUANG ; Ruigang GE ; Shilei ZHANG ; Changxin YAN ; Chuanbin XIE
China Medical Equipment 2025;22(9):21-26
Objective:To investigate the feasibility of segmented total marrow and lymphoid irradiation(TMLI)using Helical TomoTherapy(HT)in adults,and to analyze the impact of positional errors in the treatment on the actually received dose.Methods:Imaging data from four adult patients with acute myeloid leukemia were treated at the First Medical Center of the Chinese PLA General Hospital between November 2022 and December 2024 were retrospectively selected.The prescribed dose was 12 Gy in 3 fractions,and the heights range of patient was from 162 to 178 cm.The planning target volume(PTV)included the entire bone marrow and lymphatic drainage regions.The mid-femur was used as the dividing landmark,and the segmented location of head-in first(upper segmentation)and foot-in first(lower segmentation)were adopted to design plan for each segmentation.The upper segmentation used helical tomotherapy,and the lower segmentation used tomo direct therapy.The dosimetric parameters of planning target volume,and organ at risk(OAR)included eye lens,testicles and lungs were analyzed.The located computed tomography(CT)images of patients were used to simulate the changes of dosimetric parameters of each planning target region and OAR when the positions of patients moved 3,5,10 and 15 mm to outside of rack aperture.The changes of dose distribution of connection region of upper and lower segmentation were further analyzed.Results:The segmented irradiation technique can better achieve the cover(95%)of whole target region of TMLI under the condition of protecting normal organs.Under the condition with different position errors,the cover rate of the most of target region significant decreased.The largest dose of right lens increased 9.272%than primary under the 5 mm position error,and that of left and right lens increased respectively 40.199%and 67.898%under the 10 mm position error,and the max dose and mean dose of testicles increased respectively 5.847%and 5.240%under the 3mm position error.The mean dose of whole lung increased all under the error at different grades,which increased 3.021%under the 10mm position error.The non-uniformity of dose distribution of connection region increased after the position error was introduced,and the largest variation range reached to 4 Gy.Conclusion:The technique of segmented radiotherapy of Helical Tomotherapy has feasibility for TMLI of adult.But the error of the position of patients can reduce the cover of target region,and decrease the control rate for target region,and can lead to the occurrences of excessive doses on eye lens,testicles,lung and other OAR at the same time,which can increase the probability of occurring OAR injury.It should be high pay attention in treatment and implementation.
6.Short-term effects and safety outcomes of the combination of tislelizumab and neoadjuvant chemotherapy in the perioperative treatment of locally advanced gastric cancer
Yawen CHEN ; Yunhe GAO ; Yunshan ZHAO ; Xudong ZHAO ; Li LI ; Hao CUI ; Huan ZHANG ; Changxin LONG ; Zhi QIAO
Chinese Journal of Gastrointestinal Surgery 2025;28(5):536-543
Objective:In this study, we aimed to investigate the short-term efficacy and safety of perioperative administration of the PD-1 inhibitor tislelizumab combined with the SOX regimen (oxaliplatin plus S-1) in patients with locally advanced gastric cancer, and to identify factors influencing therapeutic outcomes.Methods:In this retrospective cohort study, we analyzed clinical data of 166 patients who had undergone perioperative therapy and D2 radical gastrectomy in the Department of General Surgery, First Medical Center of Chinese PLA General Hospital between September 2021 and September 2023. The cohort comprised 140 men and 26 women, of median age 62 years (range: 30-75). The patients were allocated to two groups: 62 receiving tislelizumab plus SOX (combination therapy group), and 104 SOX alone (chemotherapy-only group). Primary outcomes included pathological complete response rate, treatment-related adverse events, and complications of surgery. Secondary outcomes comprised major pathological response rate, tumor regression grade (Grades 1-2 denoting favorable response, Grade 3 moderate, and Grades 4-5 poor response), R0 resection rate, and short-term survival outcomes (1-year disease-free and overall survivals). Risk factors associated with pCR in the combination group were also analyzed.Results:The combination therapy group exhibited significantly higher rates of pCR (25.8% vs. 8.7%, χ 2=8.93, P=0.003) and Grade 1 tumor regression (25.8% vs. 16.3%, χ 2=15.32, P=0.001) than the chemotherapy-only group. There were no statistically significant differences in major pathological response rates (41.9% vs. 39.4%), R0 resection rates (96.8% vs. 97.1%,), treatment- related adverse events (48.4% vs. 42.3%,), surgical complications (9.7% vs. 12.5%), 1-year disease-free survival (82.3% vs. 78.8%), or 1-year overall survival (93.5% vs. 91.3%), There were no statistically significant differences (all P>0.05). Multivariate logistic analysis identified neural invasion as an independent risk factor for reduced pCR in the combination group (OR=0.10, 95%CI:0.01-0.85, P=0.035). Conclusions:Perioperative tislelizumab combined with SOX chemotherapy improves pathological response rates in patients with locally advanced gastric cancer and has favorable short-term efficacy and safety profiles. Neural invasion may diminish the therapeutic efficacy of immunotherapy.
7.Exploration on the influence of continuous infusion with long time on infusion precision of infusion pump
Changxin ZHANG ; Yu WANG ; Wenbo ZHOU ; Huiqing LIU ; Jing ZHAO
China Medical Equipment 2025;22(7):177-179,187
Objective:To investigate the influence of continuous infusion with long time on infusion precision of infusion pump,and establish a predictive model for flow velocity to predict the change of flow velocity of infusion pump after infusion with long time,so as to provide reference for the use of infusion pump in clinical treatment.Methods:Six infusion sets of different models,numbered A to F,were selected.A 24-hour continuous infusion experiment was conducted using an infusion pump with the above six infusion sets.The flow rate of the infusion pump was set to 100 mL/h,and real-time data of the infusion speed was recorded to evaluate the performance changes of the infusion pump under long-term continuous infusion.A flow rate prediction model for the infusion pump was established based on the research data,and the accuracy of the model was verified.Results:After 24 hours of continuous infusion,the infusion accuracy of infusion sets A to F showed varying degrees of decline over time.The final infusion accuracies were 96.47%,97.95%,92.56%,88.41%,89.26%,93.93%,respectively,with corresponding flow rate errors of 3.53%,2.05%,7.44%,11.59%,10.74%,6.07%.The prediction model established in this study was used to predict the flow rate of the infusion pump during 24-36 hours of continuous infusion.Compared with the actual flow rate under the same conditions,the difference was not statistically significant(P>0.05).Conclusion:Long-term continuous infusion affects the infusion accuracy of the infusion pump,resulting in a decrease in infusion speed.The established flow rate prediction model can accurately predict the flow rate of the infusion pump after long-term continuous infusion,providing a useful reference for the clinical application of infusion pumps.
8.Study on Mechanism of Modified Guizhi Fuling Pills in Treating Diabetic Kidney Disease through Autophagy Regulation
Ziying LIU ; Jinhong LENG ; Xiaochen WEN ; Aihua LIU ; Xinyu SUN ; Changxin MIAO ; Yongming LIU
Chinese Journal of Information on Traditional Chinese Medicine 2025;32(8):46-55
Objective To investigate the mechanism of modified Guizhi Fuling Pills in treating diabetic kidney disease(DKD)through autophagy regulation based on network pharmacology and experimental validation.Methods Active components and action targets of modified Guizhi Fuling Pills were screened via the TCMSP database.DKD-related autophagy targets were obtained from GeneCards,TTD,DrugBank and PharmGKB.A protein-protein interaction network was constructed using STRING,followed by GO functional and KEGG pathway enrichment analyses via DAVID.Molecular docking of key components and core targets was performed using AutoDock Tools 1.5.7.DKD model rats were prepared.The rats were randomly divided into normal group,model group,valsartan group(50 mg/kg),and modified Guizhi Fuling Pills low-,medium-and high-dosage group(9.9,19.8 and 39.6 g/kg).After 8-week interventions,body mass and water intake were recorded;fasting blood glucose,24 h urinary total protein(24 hUTP),urinary albumin-to-creatinine ratio(UACR)were monitored.Renal histopathology was evaluated via HE and Masson staining.Western blot was used to detect protein expressions of AMPK/FOXO1 pathway(p-AMPK,AMPK,FOXO1)and autophagy markers(Beclin-1,p62),while quantitative real-time PCR was used to assess AMPK and FOXO1 mRNA expressions.Results A total of 146 active components of Guizhi Fuling Pills and 33 main targets for treating DKD were screened,with the core targets including FOXO1,BCL2,TP53 and PTEN.KEGG pathway enrichment analysis suggested that AMPK/FOXO1 signaling pathway,AGE-RAGE and insulin signaling pathways may play a core regulatory role.Guizhi Fuling Pills could significantly reduce the body mass of DKD rats,reduce water intake,decrease renal index,decrease fasting blood glucose,24 hUTP and UACR(P<0.05,P<0.01),improve renal tissue pathology,increase AMPK,FOXO1,Beclin-1 protein expressions and AMPK,FOXO1 mRNA expressions(P<0.05),and reduce p62 protein expression(P<0.05).Conclusion Modified Guizhi Fuling Pills may exert therapeutic effects on DKD by regulating the AMPK-FOXO1-autophagy axis.
9.Detection method for the performance of ultrasound probes based on pulse echo
Yu WANG ; Changxin ZHANG ; Jing ZHAO ; Guanghan LI ; Wenbo ZHOU ; Xinyuan DONG
China Medical Equipment 2025;22(3):157-159
The ultrasound probe is the most important accessory in ultrasound equipment,which adopted the piezoelectric vibrator as its core component,and it can complete ultrasonic emission and receiving echoes.A deep understanding for the operational characteristics of the probe's array elements is important premise that user can accurately judge the running situation of the probe.This study employed pulse-echo technique to detect sensitivity and capacitance of the array elements of ultrasonic probe.The detected data of 60 probes at China-Japan Friendship Hospital were collected,and 75%of the 60 probes existed residual couplant,and 80%of them existed indentation or damage to the outer skin.The tested results of leakage current indicated that 1 probe(1.7%)existed excessively high leakage current.In test for array elements,2 probes(3.4%)displayed partial damage at array elements,and 6 probes(10.2%)were irreparably damaged.The preventive test for the diagnostic equipment with ultrasound is helpful to establish a quality control system for ultrasound,and to provide analysis materials with reliability in using diagnostic equipment with ultrasound,and to also provide decision-making basis for equipment departments and clinical department of using equipment in hospital.
10.Analysis of dentofacial characteristics in Han Chinese adults with facial harmony
Siyue CHEN ; Sitong LI ; Kaijun GU ; Changxin DU ; Yanfei ZHU ; Chao ZHENG ; Jing ZHOU ; Ying HE ; Min ZHU
Journal of Shanghai Jiaotong University(Medical Science) 2025;45(3):317-323
Objective·To establish Downs cephalometric norms for the Han Chinese aged 18-25 with harmonious faces,and to analyze gender and regional characteristics.Methods·A stratified sampling approach was used to recruit participants from seven geographic regions across China.Over 30 000 volunteers were screened,and 883 participants with harmonious faces were ultimately included.Basic demographic data were collected,and lateral cephalometric radiographs were taken.Hard tissue measurements were performed with Downs analysis(using anatomical porion).The data were then statistically analyzed to compare gender and regional differences in dentofacial structures.Results·The gender differences in the four hard tissue measurements,the angle of convexity,A-B plane angle,mandibular plane angle,and occlusal plane angle,were statistically significant(P<0.001).Females showed larger values for the angle of convexity,mandibular plane angle,and occlusal plane angle,but smaller values for the A-B plane angle,compared to males.The gender differences in the interincisal angle,L1 to occlusal plane,L1 to mandibular plane,and U1 to AP plane were not statistically significant.There were regional differences in all 10 measurements of Downs analysis,though some regions shared common features.Specifically,the northeastern,eastern,and southern coastal regions exhibited a smaller facial angle,and larger mandibular plane angle,angle of convexity,occlusal plane angle,and U1 to AP plane.It suggested that,compared to inland regions,individuals from coastal regions tended to have more retrusive chins,steeper mandibular planes,more prominent upper incisors,and more convex hard tissue profiles.Conclusion·Gender differences exist in the dentofacial hard tissue structures of Han Chinese adults with harmonious faces,primarily in skeletal measurements.Each region has its unique dentofacial characteristics,along with some common features.These differences should be taken into account in clinical diagnosis and treatment for the development of personalized and precise therapeutic strategies.

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