1.Research progress of urea-containing PET tracers targeting prostate specific membrane antigen
Hong ZHU ; Hui WANG ; Hongwei SI ; Dan ZHANG ; Dengyun CHEN ; Pengfei DAI
Acta Universitatis Medicinalis Anhui 2026;61(2):369-375
Prostate cancer is one of the most common malignant tumors of male genitourinary system. Prostate cancer has the following characteristics: insidious onset, early asymptomatic or not obvious symptoms, complex etiology and pathogenesis, long incubation period and so on. Therefore, the realization of its early diagnosis and treatment is of great significance to the prognosis of patients. Prostate-specific membrane antigen (PSMA) is a type 2 transmembrane glycoprotein that is highly expressed on the membrane of almost all primary and metastatic prostate cancer cells, and is an ideal target for prostate cancer imaging and treatment. In recent years, with the approval of urea-containing small molecule PET (positron emission computed tomography) radiopharmaceutical based on PSMA (68Ga-PSMA-11, 18F-PSMA-1007), PET-CT (positron emission computed tomography/computed tomography) has shown new potential for early diagnosis and accurate staging of prostate cancer patients. This review mainly summarizes the research progress of urea-containing PSMA PET imaging agents and finds that they have defects such as uptake in non-target tissues like the kidneys, lacrimal glands, and salivary glands. Thus, further optimizing their structure to reduce the uptake in non-target tissues, providing provide convenience for the labeling of therapeutic radiopharmaceuticals, thereby achieving the goal of integrated diagnosis and treatment, is an important development direction in this field.
2.Ethical conflicts and codes of conduct for military physicians in battlefield settings
Qiuju ZHANG ; Dan LI ; Changyong MA ; Xiaojuan WU ; Hui JIANG
Chinese Medical Ethics 2026;39(6):724-729
In the challenging and specific military environment, medical activities are not only confined to traditional medical care but must also adapt to the special requirements of military operations. Meanwhile, when military operations employ medical interventions for treatment and research, they introduce complexities and ethical considerations inherent in the medical domain. Against this backdrop, the ethical conflicts and moral dilemmas confronted by the special identity of military doctors have become an inevitable and urgent issue requiring resolution. The identities of doctors and soldiers, typically distinct, overlap and intersect in the role of the military doctors on the battlefield, inevitably giving rise to intricate ethical predicaments that frequently place them in arduous moral choices. The special considerations in behavioral decision-making, contradictions in value judgments, and the reconciliation of moral injury among military doctors in battlefield scenarios should be comprehensively considered based on factors such as professional codes of conduct, values and emotions, international law, and humanitarian principles. Military doctors should regard respecting life as the supreme principle, while also taking into account the protection needs of special groups, and adhering to the core concept of fairness and reasonableness, all of which should serve as the fundamental guidance for their behavioral standards.
3.A Latent Class Trajectory Model Based Analysis of KCCQ Symptom Score Trajectories and Readmission Risk in Heart Failure Patients during the Vulnerable Period
Yuan XU ; Yan JIANG ; Yanan ZHANG ; Hui HU ; Dan XIAO
Journal of Sun Yat-sen University(Medical Sciences) 2026;47(5):899-912
ObjectiveThis study examined KCCQ symptom score trajectories during the vulnerable phase of heart failure and their association with readmission within 6 months. MethodsThis prospective cohort study included 1 109 patients hospitalized for chronic heart failure at a tertiary hospital in Nanchang, China, between August 2020 and July 2025. KCCQ scores were assessed at six time points: day 3 after admission, discharge, and 1, 2, 3, and 6 months after discharge. Group-based trajectory modeling was used to identify patterns of change in KCCQ scores. Multiple logistic regression was used to assess the association between trajectory membership and readmission risk. ResultsDuring follow-up, 229 patients were readmitted, accounting for 20.6% of the cohort. Four KCCQ trajectories were identified: persistently declining scores (n=228, 20.6%), persistently improving scores (n=110, 9.9%), stable intermediate scores (n=545, 49.1%), and stable high scores (n=226, 20.4%). Compared with the stable intermediate group, the persistently declining group had a higher risk of readmission in the fully adjusted model (OR=2.099, 95% CI: 1.027–4.315, P=0.043), whereas the stable high-score group had a lower risk (OR=0.260, 95% CI: 0.127–0.494, P<0.001). The association between the persistently improving trajectory and readmission was not statistically significant (OR=0.614, 95% CI: 0.306–1.154, P=0.147). ConclusionsKCCQ symptom score trajectories during the vulnerable phase of heart failure show marked heterogeneity and are associated with readmission within 6 months. A persistently declining trajectory is associated with higher readmission risk, whereas a stable high-score trajectory is associated with lower risk. Longitudinal monitoring of KCCQ score changes may help inform post-discharge risk stratification and follow-up management in patients with heart failure.
4.A Latent Class Trajectory Model Based Analysis of KCCQ Symptom Score Trajectories and Readmission Risk in Heart Failure Patients during the Vulnerable Period
Yuan XU ; Yan JIANG ; Yanan ZHANG ; Hui HU ; Dan XIAO
Journal of Sun Yat-sen University(Medical Sciences) 2026;47(5):899-912
ObjectiveThis study examined KCCQ symptom score trajectories during the vulnerable phase of heart failure and their association with readmission within 6 months. MethodsThis prospective cohort study included 1 109 patients hospitalized for chronic heart failure at a tertiary hospital in Nanchang, China, between August 2020 and July 2025. KCCQ scores were assessed at six time points: day 3 after admission, discharge, and 1, 2, 3, and 6 months after discharge. Group-based trajectory modeling was used to identify patterns of change in KCCQ scores. Multiple logistic regression was used to assess the association between trajectory membership and readmission risk. ResultsDuring follow-up, 229 patients were readmitted, accounting for 20.6% of the cohort. Four KCCQ trajectories were identified: persistently declining scores (n=228, 20.6%), persistently improving scores (n=110, 9.9%), stable intermediate scores (n=545, 49.1%), and stable high scores (n=226, 20.4%). Compared with the stable intermediate group, the persistently declining group had a higher risk of readmission in the fully adjusted model (OR=2.099, 95% CI: 1.027–4.315, P=0.043), whereas the stable high-score group had a lower risk (OR=0.260, 95% CI: 0.127–0.494, P<0.001). The association between the persistently improving trajectory and readmission was not statistically significant (OR=0.614, 95% CI: 0.306–1.154, P=0.147). ConclusionsKCCQ symptom score trajectories during the vulnerable phase of heart failure show marked heterogeneity and are associated with readmission within 6 months. A persistently declining trajectory is associated with higher readmission risk, whereas a stable high-score trajectory is associated with lower risk. Longitudinal monitoring of KCCQ score changes may help inform post-discharge risk stratification and follow-up management in patients with heart failure.
5.Proficiency testing for 11 clinical biobanks in Beijing City: simulation study and result analysis
Qian ZHANG ; Yun ZHANG ; Lu HAN ; Min LIU ; Yongbo YU ; Yan WANG ; Ying HU ; Hui ZHONG ; Dan GUO ; Shipeng SUN ; Jinxi LIN ; Siyuan XU ; Xiaokun TANG ; Gaoyuan SUN ; Chuanbao ZHANG ; Hexin LI
Chinese Journal of Preventive Medicine 2025;59(9):1590-1596
Objective:To evaluate the sample preparation proficiency and storage proficiency of 11 clinical biobanks in Beijing through simulated experiments, and to establish an assessment method for the quality comparability of biological samples.Methods:An exploratory research design was adopted. In November 2023, artificial composite serum quality control materials containing six recombinant human protein markers—recombinant human alanine aminotransferase (rhALT), recombinant human aspartate aminotransferase (rhAST), recombinant human creatine kinase (rhCK), recombinant human creatine kinase-MB (rhCK-MB), recombinant human B-type natriuretic peptide (rhBNP), and recombinant human troponin I (rhTNI)—were distributed to 11 clinical biobanks in Beijing City. Sample preparation and storage followed the standardized operating procedures. Proficiency differences were assessed through statistical analysis.Results:Three-way repeated measures ANOVA revealed all six protein markers showed a declining trend over storage time in ultra-low-temperature environments ( F values 11.68-4 179.66, all P<0.01). However, neither long-term/temporary refrigerator types ( F values 0.01-1.23, all P>0.05)nor placement locations within refrigerators significantly affected the stability of these six proteins ( F valus 0.03-1.47, all P>0.05). The biases in detection results for rhALT, rhAST, rhTNI, and rhBNP at different storage time points were within the allowable bias limits for each item, supporting their use as markers for protein stability in biobank samples. All 11 institutions passed the storage proficiency assessment. In the preparation proficiency assessment, deviations were observed in post-preparation sample results, with a notably high out-of-control rate for rhCK (36.36%). Conclusion:Sample preparation proficiency can serve as a quality control metric for clinical biobanks. Future external quality assessment systems for biobanks should focus on sample preparation rather than storage processes.
6.Investigation on awareness of the adjusted DTaP immunization schedule and its influencing factors among immunization service personnel in China in 2025
Hongwei LIU ; Mingshuang LI ; Qian ZHANG ; Dan WU ; Tingting YAN ; Zhijie AN ; Hui ZHENG
Chinese Journal of Preventive Medicine 2025;59(11):1828-1833
Objective:To analyze the awareness of and factors influencing the adjusted national immunization schedule for the diphtheria-tetanus-acellular pertussis (DTaP) vaccine among grassroots immunization service personnel in China.Methods:Based on the snowball sampling method from January to February 2025, immunization service personnel from all provinces of China were selected from the "Tingting Experts Talk" WeChat platform, with concurrent dissemination through the "National Vaccine-Preventable Diseases Communication Group" WeChat group. The questionnaire included basic demographic characteristics and knowledge of the DTaP vaccine immunization policy (13 questions in total). Respondents who answered ≥10 questions correctly were defined as being aware of the policy adjustment. The multivariable logistic regression analysis was performed to identify factors influencing awareness.Results:A total of 8 030 valid questionnaires were collected from 29 provinces, with a valid response rate of 92.91%. The overall awareness accuracy rates among the Centers for Disease Control and Prevention (CDC) personnel and the point of vaccination (POV) staff were 74.1% and 62.5%, respectively. The awareness rate of the core points of policy adjustment among the research subjects exceeded 90%. Among the questions regarding the operational details of policy implementation, the correct rate of answering questions related to the catch-up vaccination principles was relatively low (37.1%-74.0%). The multivariate logistic regression analysis showed that, compared with those with primary titles, CDC personnel with senior titles had higher mastery of the policy adjustment, with an OR (95% CI) value of 2.238 (1.343-3.730). Compared with those engaged in disease surveillance and immunization strategy research, CDC personnel with other work types had lower awareness of the policy adjustment, with an OR (95% CI) value of 0.404 (0.195-0.833). Compared with those in western regions, with primary titles, and without relevant training, POV staff in central regions, eastern regions, with intermediate titles, with senior titles, with one relevant training session, and with ≥2 relevant training sessions had better awareness of the program adjustment, with OR (95% CI) values of 1.214 (1.085-1.358), 1.412 (1.246-1.600), 1.606 (1.446-1.784), 1.737 (1.443-2.091), 2.254 (1.509-3.366), and 2.674 (1.769-3.981), respectively. Compared with those engaged in information registration/recipient notification, POV staff with vaccination services and other work types had lower awareness of the program adjustment, with OR (95% CI) values of 0.713 (0.633-0.803) and 0.508 (0.427-0.604), respectively. Conclusion:Although grassroots immunization service personnel show an insufficient mastery of certain catch-up vaccination knowledge, they demonstrate a good understanding of overall principles and routine immunization schedules shortly after the policy adjustment, which can effectively ensure an orderly transition between old and new immunization strategies.
7.Predictive value of serum IL-17 combined with eotaxin-3 for poor prognosis in patients with acute exacerbation of chronic obstructive pulmonary disease
Na WANG ; Li ZHAI ; Lin ZHANG ; Jungang LYU ; Tiantian CAO ; Qing DAN ; Hui LIU
International Journal of Laboratory Medicine 2025;46(6):752-756
Objective To investigate the predictive value of serum interleukin-17(IL-17)combined with eotaxin-3 for poor prognosis in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 213 patients with AECOPD admitted to Beijing Municipal Armed Police Force Hospital from May 2018 to July 2023 were selected as the disease group.According to the prognosis of patients,they were divided into good prognosis group(133 cases)and poor prognosis group(80 cases).At the same time,205 physical examination healthy people in Beijing Municipal Armed Police Force Hospital were selected as the healthy group.The serum levels of IL-17 and eotaxin-3 were detected by enzyme-linked immu-nosorbent assay.The clinical data of poor prognosis group and good prognosis group were compared.Pearson correlation analysis was used to analyze the correlation between serum IL-17 level and eotaxin-3 in AECOPD patients.Multivariate Logistic regression analysis was used to analyze the related factors affecting the progno-sis of AECOPD patients.The receiver operating characteristic(ROC)curve was used to evaluate the predic-tive value of serum IL-17 and eotaxin-3 levels for the prognosis of AECOPD patients.Results Compared with the healthy group,the serum levels of IL-17 and eotaxin-3 were increased in the disease group(P<0.05).Compared with the good prognosis group,the poor prognosis group had significant increases in serum IL-17 and eotaxin-3 levels(P<0.05).Serum IL-17 level was positively correlated with eotaxin-3 in AECOPD pa-tients(r=0.537,P<0.001).There were significant differences in Global Initiative for Chronic Obstructive Lung Disease(GOLD)grade,blood oxygen partial pressure(PaO2)and carbon dioxide partial pressure(PaCO2)between the poor prognosis group and the good prognosis group(P<0.05).GOLD grade,PaCO2,serum IL-17 and eotaxin-3 levels were risk factors for poor prognosis in patients with AECOPD(P<0.05),and PaO2 was a protective factor for poor prognosis in patients with AECOPD(P<0.05).The area under the curve of serum IL-17 and eotaxin-3 combined to predict the prognosis of AECOPD patients was 0.885,the sensitivity was 80.00%,and the specificity was 83.46%,which was better than that of IL-17 and eotaxin-3 a-lone(Zcombiation-IL-17=4.045,P<0.001,Zcombiation-eotaxin-3=3.254,P=0.001).Conclusion The serum levels of IL-17 and eotaxin-3 are increased in AECOPD patients.The combination of IL-17 and eotaxin-3 has predictive value for the prognosis of AECOPD patients.
8.Role of PPAR signaling pathway related genes in acute gouty arthritis
Yuqin LI ; Hui ZHANG ; Dan WANG ; Jing LIU ; Chengxiu YU ; Guohua YUAN
Chinese Journal of Immunology 2025;41(1):163-168
Objective:To investigate the role of mRNA expression in the pathogenesis of gout by analyzing the difference of gene expression in peripheral blood mononuclear cells(PBMCs)among acute gouty(AG),intermittent gouty(IG)and health con-trols(HC).Methods:AG patients,IG patients and HC were enrolled in this study.RNA-seq and bioinformatics techniques were used to observe the differences of mRNA expression in PBMCs of different groups,and to explore the genes and signaling pathways as-sociated with gout attack.GO and KEGG databases were used to investigate the biological functions of differentially expressed genes and the relationship between genes and signaling pathways.Genes involved in the KEGG enriched PPAR signaling pathway(CYP27A1,ACSL1,CD36,PPARG,ANGPTL4,PLIN2)were validated in PBMCs from 35 patients with AG,35 patients with IG,and 35 normal healthy subjects using real-time PCR.Results:Compared with HC group,there were 222 significant differential genes in AG group,including 193 up-regulated genes and 29 down-regulated genes.GO analysis showed that the genes differentially ex-pressed in AG group were mainly enriched in the regulation of multicellular biological processes such as inflammation,trauma,and stress response and immune response regulation compared with HC group.However,KEGG analysis showed that the up-regulated genes in AG group were enriched in"Toll-like receptor signaling pathway""complement and coagulation cascades""PPAR signaling pathway""lipid and atherosclerosis""osteoclast differentiation""cytokine-cytokine receptor interaction""chemokine signaling path-way""IL-17 signaling pathway",and"cholesterol metabolism"compared with HC group.The results of PCR validation of related genes in the PPAR signaling pathway showed that the expression levels of ACSL1,CD36,PPARG,and PLIN2 in the AG group were higher than those in the control group(P<0.05),and the expression levels of CYP27A1 and ANGPTL4 in the AG group were not dif-ferent from those in the HC group(P>0.05).Conclusion:PPAR signaling pathway may be involved in the pathogenesis of AG,of which ACSL1,CD36,PPARG,and PLIN2 may be used as potential therapeutic targets for acute gouty arthritis;CYP27A1 and ANG-PTL4 may not be associated with the pathogenesis of AG.
9.Report of 6 cases of lymphoproliferative disorders after liver transplantation
Hui ZHANG ; Yandong SUN ; Feng WANG ; Dan LIU ; Bin ZHUANG ; Jianhong WANG ; Dahong TENG ; Jinzhen CAI
Chinese Journal of Organ Transplantation 2025;46(2):161-165
This study reports the diagnosis and treatment of six cases of post-transplant lymphoproliferative disorder (PTLD) in liver transplant recipients, confirmed at the Affiliated Hospital of Qingdao University between August 2017 and May 2023. The report includes details on anti-rejection therapy, Epstein-Barr virus (EBV) and cytomegalovirus (CMV) infections, imaging findings, histopathological results, treatment courses, and prognoses. By summarizing the clinical experience in the diagnosis and management of PTLD following liver transplantation, this study aims to provide valuable insights and references for the clinical diagnosis and treatment of this condition.
10.Proficiency testing for 11 clinical biobanks in Beijing City: simulation study and result analysis
Qian ZHANG ; Yun ZHANG ; Lu HAN ; Min LIU ; Yongbo YU ; Yan WANG ; Ying HU ; Hui ZHONG ; Dan GUO ; Shipeng SUN ; Jinxi LIN ; Siyuan XU ; Xiaokun TANG ; Gaoyuan SUN ; Chuanbao ZHANG ; Hexin LI
Chinese Journal of Preventive Medicine 2025;59(9):1590-1596
Objective:To evaluate the sample preparation proficiency and storage proficiency of 11 clinical biobanks in Beijing through simulated experiments, and to establish an assessment method for the quality comparability of biological samples.Methods:An exploratory research design was adopted. In November 2023, artificial composite serum quality control materials containing six recombinant human protein markers—recombinant human alanine aminotransferase (rhALT), recombinant human aspartate aminotransferase (rhAST), recombinant human creatine kinase (rhCK), recombinant human creatine kinase-MB (rhCK-MB), recombinant human B-type natriuretic peptide (rhBNP), and recombinant human troponin I (rhTNI)—were distributed to 11 clinical biobanks in Beijing City. Sample preparation and storage followed the standardized operating procedures. Proficiency differences were assessed through statistical analysis.Results:Three-way repeated measures ANOVA revealed all six protein markers showed a declining trend over storage time in ultra-low-temperature environments ( F values 11.68-4 179.66, all P<0.01). However, neither long-term/temporary refrigerator types ( F values 0.01-1.23, all P>0.05)nor placement locations within refrigerators significantly affected the stability of these six proteins ( F valus 0.03-1.47, all P>0.05). The biases in detection results for rhALT, rhAST, rhTNI, and rhBNP at different storage time points were within the allowable bias limits for each item, supporting their use as markers for protein stability in biobank samples. All 11 institutions passed the storage proficiency assessment. In the preparation proficiency assessment, deviations were observed in post-preparation sample results, with a notably high out-of-control rate for rhCK (36.36%). Conclusion:Sample preparation proficiency can serve as a quality control metric for clinical biobanks. Future external quality assessment systems for biobanks should focus on sample preparation rather than storage processes.

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