1.Construction and validation of a risk prediction model for 28-day mortality in patients with sepsis-associated acute kidney injury
Jiang-Ming ZHANG ; Ze-Qian WANG ; Cun-Lian XU ; Pai DENG ; Yang WU ; Min-Jun QI ; Lu-Mei MA ; Wei-Qing YAO ; Dong LIU ; Dong-Mei LIU
Medical Journal of Chinese People's Liberation Army 2025;50(8):935-942
Objective To explore the risk factors for 28-day mortality of sepsis-associated acute kidney injury(SA-AKI)patients and to develop a nomogram risk prediction model.Methods A retrospective cohort study was conducted,involving 184 patients with SA-AKI admitted to the intensive care unit(ICU)of the 940th Hospital of Joint Logistic Support Force of PLA between January 2017 and December 2022.Patients were categorized into survival(n=135)and non-survival(n=49)groups based on 28-day mortality.Clinical data were collected,and statistically significant risk factors were preliminarily screened.Multivariate stepwise logistic regression analysis was performed to identify independent risk factors for 28-day mortality of SA-AKI patients.A nomogram predictive model was constructed using these factors,and internally validated with the Bootstrap method.The receiver operating characteristic curve(ROC curve)was drawn,and the area under the ROC curve(AUC)was calculated to verify the predictive value and accuracy of the model.Results The 28-day mortality rate among 184 SA-AKI patients was 26.6%(49/184).Multivariate stepwise logistic regression analysis identified multiple organ dysfunction syndrome(MODS)(OR=16.393,95%CI 4.317-62.254,P<0.001),high acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score(OR=1.097,95%CI 1.036-1.161,P=0.002),low oxygenation index(OR=0.992,95%CI 0.986-0.998,P=0.015),low neutrophil count(OR=0.912,95%CI 0.860-0.968,P=0.002)and low fibrinogen concentration(OR=0.733,95%CI 0.549-0.978,P=0.034)as independent risk factors.The prediction model equation was P=1/1+e-logit(P),logit(P)=-1.626+2.797×MODS+0.092×AP ACHE Ⅱ+(-0.311)×fibrinogen+(-0.092)×neutrophil count+(-0.008)×oxygenation index.Internal validation with 1000 Bootstrap resamples showed high consistency between predicted and actual values.ROC analysis showed an AUC of 0.911(95%CI 0.868-0.955,P<0.05)for the model,with 93.9%sensitivity and 78.5%specificity at a cut-off of 0.194.The Hosmer-Lemeshow test confirmed good calibration(P=0.62),and decision-making curve analysis demonstrated clinical utility within the high-risk threshold range(0.1-0.9).Conclusions MODS,high APACHE Ⅱ score,low oxygenation index,low neutrophil count,and low fibrinogen concentration are independent risk factors for 28-day mortality in SA-AKI patients.The developed nomogram risk prediction model may provide important guidance for predicting 28-day mortality in SA-AKI patients.
2.Based on PI3K/Akt/mTOR Signaling Pathway to Explore Mechanism of Zhigancao Tang Against MIRI-induced Ventricular Tachycardia and Ventricular Fibrillation in Rats
Xu-ying ZHENG ; Chun-jie MA ; Yong-zhen CHEN ; Cun-xia REN ; Ren-xiu NIU ; Hua LIAN ; Kun CHEN ; Xiao-hui TAN ; Qing-zhi YAN ; Xing ZHANG ; Hao WU
Chinese Journal of Experimental Traditional Medical Formulae 2020;26(17):1-8
Objective:Through phosphatidylinositol 3-kinase(PI3K)/protein kinase B (Akt)/mammalian rapamycin target protein (mTOR) signaling pathway, explore the effect of Zhigancao Tang on myocardial ischemia-reperfusion injury(MIRI)The role and mechanism of arrhythmia(ventricular tachycardia and ventricular fibrillation). Method:The 72 SD rats were randomly divided into sham operation group,model group, Zhigancao Tang low,medium and high dose group(11.43,22.86,45.72 g·kg-1),Wenxin granule group(2.43 g·kg-1),continuous drug intervention for 10 days. Two hours after the last administration,the MIRI model of rat was prepared by ligating the left anterior descending coronary artery,and the changes of electrocardiogram were recorded. After successful modeling,blood and heart tissue were collected to detect the content of creatine creatine(CK),lactate dehydrogenase(LDH)and aspartate aminotransferase(AST)in the serum, the enzyme-linked immunoassay(ELISA) method was used to detect cardiac troponin(CtnI)content, immunohistochemical detection of myocardial PI3K,Akt,mTOR expression. Western blot was used to detect the myocardial autophagy-related protein microtubule-associated protein 1 light chain 3(LC-3),autophagy markers Beclin1 and PI3K/Akt/mTOR signaling pathway related protein expression and phosphorylated p-PI3K,p-Akt,p-mTOR levels. Result:In model group, 100% of ventricular tachycardia and 91.67% of ventricular fibrillation occurred. Compared with sham operation group, the serum levels of CK,LDH,AST,and CtnI in the model group were significantly increased(
3.Expressions and prognostic significance of PTEN and PD-1 protein in patients with classical Hodgkin's lymphoma.
Bing XIA ; Dong Wei WU ; Teng Teng WANG ; Shan Qi GUO ; Yi WANG ; Hong Liang YANG ; Wen XU ; Chen TIAN ; Lian Yu ZHANG ; Bao Cun SUN ; E M SOTOMAYOR ; Yi Zhuo ZHANG
Chinese Journal of Hematology 2018;39(10):839-844
Objective: To elucidate the expression levels of key immune biomarkers, phosphate and tension homology deleted on chromosome ten (PTEN) and programmed cell death protein1(PD-1),of different immune tolerance pathway in classic Hodgkin's lymphoma (CHL) to further determine their clinical role and prognostic significance. Methods: The clinical features and prognostic factors of 56 CHL patients, who were admitted to the TianJin Medical University Cancer Institute from February 2003 to August 2013, were retrospectively analyzed. PTEN and PD-1 protein expression levels were analyzed by immunohistochemistry, Epstein-Barr virus encoded RNA (EBER) was performed by in situ hybridization assay. Correlations between the expression of biomarkers and clinicopathologic parameters were examined and survival analyses were performed. Results: This cohort of 56 CHL patients included 34 males and 22 females with a median age of 25 years (ranged from 7 to 71 years). In a univariate analysis, age≥45, IPS score >2, EBER positive, high expression of PTEN protein conferred inferior 5-year OS and 5-year PFS; In a multivariate model, age≥45, IPS score >2, EBER positive, high expression of PTEN protein were identified as the independent adverse prognostic factors for CHL. Conclusions: This study suggested for the first time that PTEN was independent prognostic immune biomarkers in CHL, which provided the novel therapeutic strategy of immune therapy for CHL.
Adolescent
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Adult
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Aged
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Child
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Female
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Hodgkin Disease
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Humans
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Male
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Middle Aged
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PTEN Phosphohydrolase/analysis*
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Prognosis
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Programmed Cell Death 1 Receptor/analysis*
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Retrospective Studies
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Young Adult
4.Current status and sustainable development countermeasures of Anoectochilus roxburghii.
Lin HONG ; Qing-Song SHAO ; Ai-Cun ZHOU ; Hong-Zhen WANG ; Ai-Lian ZHANG ; Jian-Wei XU ; Yu-Qiu HUANG
China Journal of Chinese Materia Medica 2016;41(3):553-558
The current status of the domestic manufacturing and sales markets of Anoectochilus roxburghii were investigated and analyzed in the study. Some problems in the A. roxburghii industry were revealed and a variety of sustainable development countermeasures were also proposed. The main problems of A. roxburghii industry are the lack of protection for wild resources, the lag in the speed of variety breeding, the insufficient research on the quality systems, the low level of industry and product innovation capability, as well as the relatively low market cognition and brand competence. Therefore, strengthening the protection for breeding resources, establishing a dynamic monitoring system, promoting the variety breeding, constructing a propagation system for improved varieties, enhancing the quality of medicinal herbs, accelerating the adjustment of product structure, upgrading the industry technology, strengthening brand competence and expanding the market, will be the effective methods to realize the sustainable development of A. roxburghii industry.
5.Current researches and prospects of seedling propagation and cultivation modes of Jinxianlian.
Qing-Song SHAO ; Shen-Yi YE ; Ai-Cun ZHOU ; Hong-Zhen WANG ; Ai-Lian ZHANG ; Jian-Wei XU
China Journal of Chinese Materia Medica 2016;41(2):160-166
In the wake of on-the-spot investigation into Chinese major production bases in Fujian, Zhejiang, Jiangxi, Taiwan, Guangxi and Yunnan provinces, and based on relevant literature, the paper systematically elaborates the current researches of botanical origin, major cultivation type, seedling propagation technique as well as cultivation mode of Jinxianlian. The way of seedling breeding mainly includes aseptic seed culture, in vitro propagation, artificial seed and bioreactor propagation, etc. And the planting model mainly includes protected cultivation modes, bionic wild cultivation modes and pot cultivation modes, etc. Further discussions have also been conducted to tackle significant problems existing in the production process of Jinxianlian, based on personal studies of the authors. It has made considerable contributions for the betterment of Jinxianlian's development and improvement.
6.Effect of antiarrhythmic peptide on ventricular arrhythmia induced by lysophosphatidic acid.
Qing ZHOU ; Tian-jie WANG ; Cun-tai ZHANG ; Lei RUAN ; Lian-dong LI ; Ren-de XU ; Xiao-qing QUAN ; Ming-ke NI
Chinese Journal of Cardiology 2011;39(4):301-304
OBJECTIVETo investigate the effect and potential mechanism of lysophosphatidic acid (LPA) and antiarrhythmic peptide (AAP10) on rabbit ventricular arrhythmia.
METHODSTwenty-four rabbits were randomly divided into three groups (n = 8 each): control group, LPA group and AAP10 + LPA group. Using arterially perfused rabbit ventricular wedge preparations, transmural ECG and action potentials from both endocardium and epicardium were simultaneously recorded in the whole process of all experiments with two separate floating microeletrodes. The incidence of ventricular arrhythmia post S1S2 stimulation was recorded. Protein levels of nonphosphorylated Cx43 and total Cx43 were evaluated by Western blot. The distribution of nonphosphorylated Cx43 was observed by confocal immunofluorescence microscopy.
RESULTSCompared with the control group, the QT interval, endocardial action potential duration, transmural repolarization dispersion (TDR) and incidence of ventricular arrhythmia were significantly increased and nonphosphorylated Cx43 expression was significantly upregulated in the LPA group. Compared with the LPA group, cotreatment with AAP10 can reduce the QT interval, endocardial action potential duration, TDR and incidence of ventricular arrhythmia (25.0% vs 62.5%, P < 0.01) and downregulate nonphosphorylated Cx43.
CONCLUSIONSLPA could promote the arrhythmia possibly by upregulating nonphosphorylated Cx43 and subsequent gap junction transmission inhibition. Gap junction enhancer AAP10 could attenuate the pro-arrhythmic effect of LPA probably by downregulating myocardial nonphosphorylated Cx43 expression.
Animals ; Anti-Arrhythmia Agents ; pharmacology ; Arrhythmias, Cardiac ; chemically induced ; metabolism ; physiopathology ; Connexin 43 ; metabolism ; Lysophospholipids ; adverse effects ; Oligopeptides ; pharmacology ; Rabbits
7.Kv1.3 potassium channel expression changes after CD4+ and subsets CD28null/CD28+ T cells activation in peripheral blood of patients with acute coronary syndrome
Da-Ying FENG ; Cun-Tai ZHANG ; Ye-Xin MA ; Hong-Lian ZHOU ; Ren-De XU ; Xin-Wei YANG ; Shen HUANG ; Jin MA ; Xiao-Qing QUAN
Chinese Journal of Cardiology 2009;37(7):599-604
Objective To study the Kv1.3 channel expression changes after CD4 + and subsets CD28null/CD28+T cells activation in peripheral blood of patients with acute coronary syndrome (ACS).Methods CD4+ T cell in 27 ACS patients and CD4+ CD28null/CD4+ CD28 + T cells in 12 out of these 27 ACS patients were isolated from peripheral blood with magnetic cell sorting.The whole-cell Kv1.3 currents for three T cells were recorded with patch-clamp technique before and 72 hours after activation by purified anti-human CD3 Interferon gamma,tumor necrosis factor alpha(TNF-α),granzyme B mRNA expression were determined by reverse transcription-PCR before and 72 hours after activation by purified anti-human CD3 in the presence or absence of recombinant Margstoxin (rMgTX,0.1,1,10 nmol/L),a specific Kv1.3 channel blocker.Results Peak Kv1.3 channel currents of CD4 + ,CD4+ CD28null,CD4+ CD28 + T cells were significantly increased and the mean Kv1.3 channel numbers per cell of these cells were increased by about 90%,60%,80% (402 ± 88 vs.752 ± 275,553 ± 328 vs.874 ± 400,392 ± 133 vs.716 ± 251,all P <0.05) after activation compared to baseline values.Baseline CD4+ CD28nullT cell numbers were about 40% more than those of CD4+ CD28+ T cell (P < 0.05) and were similar after activation (P = 0.102).The mRNA expression of interferon gamma,TNF-α and granzyme B were dose-dependently down-regulated by rMgTX.Conclusions Kv1.3 channels of peripheral CD4 + T cell and CD28null/CD28 + T cells from ACS patients significantly increased after activation and Kv1.3-specific channel blocker rMgTX could effectively abolish this effect suggesting a potential role of Kv1.3 channel blocker on plaque stabilization in ACS patients.

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