1.The effect of patient's body shape and image acquisition mode on the radiation dose and image quality in percutaneous coronary angiography
Hai QIAN ; Yuqin ZHANG ; Yan XU ; Dexing HU ; Zemin CEN ; Kenan LOU
Journal of Interventional Radiology 2024;33(6):599-603
Objective To investigate the effect of patient's body shape and image acquisition mode on the radiation dose and image quality in percutaneous coronary angiography.Methods A total of 40 patients,who received selective percutaneous coronary angiography at the Ningbo Medical Center Lihuili Hospital of China between January 2022 and June 2023,were selected for this study.The patients were randomly divided into conventional group(including 11 males and 9 females,using coronary angiography mode to make image acquisition)and low-dose group(including 14 males and 6 females,using electrophysiological mode to make image acquisition).The patient's basic information,body size data,and the various radiation dose data were collected.The image quality rating scale for assessing the image quality was formulated.The independent sample t-test and Mann-Whitney U test were used for the comparison between the two groups.Pearson correlation analysis method was used to make correlation analysis.Results The larger the patient's chest circumference was,the higher the radiation dose would be,there was a positive linear relationship between the patient's chest circumference and the radiation dose.All the radiation dose parameters in the low-dose group were significantly lower than those in the conventional group(P<0.01),and its reduction percentage was 48.51%-60.74%.No statistically significant difference in image quality score existed between the two groups(P>0.0l),and in both groups the image quality was rated as good or better,meeting the requirements of intervention procedures.Conclusion In percutaneous coronary angiography the radiation dose is influenced by multiple factors including patient's body shape,image acquisition mode,exposure time,etc.Optimizing the image acquisition mode can remarkably reduce the radiation dose while maintaining the image quality and protecting the health of patients and operators.(J Intervent Radiol,2024,33:599-603)
2.DUS testing guidelines for new varieties of Chinese medicinal plants.
Cheng-Cai ZHANG ; Chao FANG ; Ming QIN ; Hong-Yang WANG ; Xiu-Zhi GUO ; Yue-Feng WANG ; Bin-Bin YAN ; Zi-Hua ZHANG ; Sheng WANG ; Lan-Ping GUO
China Journal of Chinese Materia Medica 2023;48(11):2896-2903
A rich diversity of wild medicinal plant resources is distributed in China, but the breeding of new plant varieties of Chinese medicinal plants started late and the breeding level is relatively weak. Chinese medicinal plant resources are the foundation for new varieties breeding, and the plant variety rights(PVP) are of great significance for the protection and development of germplasm resources. However, most Chinese medicinal plants do not have a distinctness, uniformity, and stability(DUS) testing guideline. The Ministry of Agriculture and Rural Affairs has put 191 plant species(genera) on protection lists, of which only 30 are medicinal species(genera). At the same time, only 29 of 293 species(genera) plants in the Protection List of New Plant Varieties of the People's Republic of China(Forest and Grass) belong to Chinese medicinal plants. The number of PVP applications and authorization of Chinese medicinal plants is rare, and the composition of variety is unreasonable. Up to now, 29 species(genera) of DUS test guidelines for Chinese medicinal plants have been developed. Some basic problems in the breeding of new varieties of Chinese medicinal plants have appeared, such as the small number of new varieties and insufficient utilization of Chinese medicinal plant resources. This paper reviewed the current situation of breeding of new varieties of Chinese medicinal plants and the research progress of DUS test guidelines in China and discussed the application of biotechnology in the field of Chinese medicinal plant breeding and the existing problems in DUS testing. This paper guides the further application of DUS to protect and utilize the germplasm resources of Chinese medicinal plants.
Agriculture
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Biotechnology
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Plant Breeding
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Plants, Medicinal/genetics*
3.Individualized red-cell transfusion strategy for non-cardiac surgery in adults: a randomized controlled trial.
Ren LIAO ; Jin LIU ; Wei ZHANG ; Hong ZHENG ; Zhaoqiong ZHU ; Haorui SUN ; Zhangsheng YU ; Huiqun JIA ; Yanyuan SUN ; Li QIN ; Wenli YU ; Zhen LUO ; Yanqing CHEN ; Kexian ZHANG ; Lulu MA ; Hui YANG ; Hong WU ; Limin LIU ; Fang YUAN ; Hongwei XU ; Jianwen ZHANG ; Lei ZHANG ; Dexing LIU ; Han HUANG
Chinese Medical Journal 2023;136(23):2857-2866
BACKGROUND:
Red-cell transfusion is critical for surgery during the peri-operative period; however, the transfusion threshold remains controversial mainly owing to the diversity among patients. The patient's medical status should be evaluated before making a transfusion decision. Herein, we developed an individualized transfusion strategy using the West-China-Liu's Score based on the physiology of oxygen delivery/consumption balance and designed an open-label, multicenter, randomized clinical trial to verify whether it reduced red cell requirement as compared with that associated with restrictive and liberal strategies safely and effectively, providing valid evidence for peri-operative transfusion.
METHODS:
Patients aged >14 years undergoing elective non-cardiac surgery with estimated blood loss > 1000 mL or 20% blood volume and hemoglobin concentration <10 g/dL were randomly assigned to an individualized strategy, a restrictive strategy following China's guideline or a liberal strategy with a transfusion threshold of hemoglobin concentration <9.5 g/dL. We evaluated two primary outcomes: the proportion of patients who received red blood cells (superiority test) and a composite of in-hospital complications and all-cause mortality by day 30 (non-inferiority test).
RESULTS:
We enrolled 1182 patients: 379, 419, and 384 received individualized, restrictive, and liberal strategies, respectively. Approximately 30.6% (116/379) of patients in the individualized strategy received a red-cell transfusion, less than 62.5% (262/419) in the restrictive strategy (absolute risk difference, 31.92%; 97.5% confidence interval [CI]: 24.42-39.42%; odds ratio, 3.78%; 97.5% CI: 2.70-5.30%; P <0.001), and 89.8% (345/384) in the liberal strategy (absolute risk difference, 59.24%; 97.5% CI: 52.91-65.57%; odds ratio, 20.06; 97.5% CI: 12.74-31.57; P <0.001). No statistically significant differences were found in the composite of in-hospital complications and mortality by day 30 among the three strategies.
CONCLUSION:
The individualized red-cell transfusion strategy using the West-China-Liu's Score reduced red-cell transfusion without increasing in-hospital complications and mortality by day 30 when compared with restrictive and liberal strategies in elective non-cardiac surgeries.
TRIAL REGISTRATION
ClinicalTrials.gov, NCT01597232.
Humans
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Adult
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Postoperative Complications
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Erythrocyte Transfusion/adverse effects*
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Blood Transfusion
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Hospitals
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Hemoglobins/analysis*
4.Application of tissue culture technology of medicinal plants in sustainable development of Chinese medicinal resources.
Cheng-Cai ZHANG ; Sheng WANG ; Yue-Feng WANG ; Hong-Yang WANG ; Ming QIN ; Xiao-Yu DAI ; Bin-Bin YAN ; Xiu-Zhi GUO ; Li ZHOU ; Huai-Bin LIN ; Lan-Ping GUO
China Journal of Chinese Materia Medica 2023;48(5):1186-1193
Chinese medicinal resources are the cornerstone of the sustainable development of traditional Chinese medicine industry. However, due to the fecundity of species, over-exploitation, and limitations of artificial cultivation, some medicinal plants are depleted and even endangered. Tissue culture, a breakthrough technology in the breeding of traditional Chinese medicinal materials, is not limited by time and space, and can allow the production on an annual basis, which plays an important role in the protection of Chinese medicinal resources. The present study reviewed the applications of tissue culture of medicinal plants in the field of Chinese medicinal resources, including rapid propagation of medicinal plant seedlings, breeding of novel high-yield and high-quality cultivars, construction of a genetic transformation system, and production of secondary metabolites. Meanwhile, the current challenges and suggestions for the future development of this field were also proposed.
Sustainable Development
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Plants, Medicinal/genetics*
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Plant Breeding
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Medicine, Chinese Traditional
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Technology
5.Associations between adverse childhood experiences and diabetes among middle-aged and older Chinese: a social-ecological perspective
Siyu ZHU ; Leying HOU ; Jiaying MA ; Shuting LI ; Weidi SUN ; Wen LIU ; Jiajun HAO ; Wenhan XIAO ; Siqing CHENG ; Dexing ZHANG ; Dong ZHAO ; Peige SONG
Epidemiology and Health 2023;45(1):e2023071-
OBJECTIVES:
This study examined the associations between adverse childhood experiences (ACEs) and diabetes within a social-ecological framework, incorporating personal and environmental unfavorable conditions during childhood from family, school, and community contexts.
METHODS:
Data were obtained from the China Health and Retirement Longitudinal Study (2014 life history survey and 2015 survey), including 9,179 participants aged ≥45 years. ACEs were collected through self-report questionnaires, and participants were categorized based on the number of distinct ACEs experienced (0, 1, 2, 3, or ≥4 ACEs). Diabetes was defined by biomarkers, self-reported diagnosis, and treatment status. Logistic regression was conducted to explore the associations between ACEs and diabetes. Subgroup analyses were conducted by gender, age, and obesity status.
RESULTS:
Compared with participants without ACEs, those exposed to any ACE (odds ratio [OR], 1.19; 95% confidence interval [CI], 1.01 to 1.40), 3 ACEs (OR, 1.32; 95% CI, 1.07 to 1.62) and ≥4 ACEs (OR, 1.29; 95% CI, 1.07 to 1.56) had an increased risk of diabetes. For each additional ACE, the risk of diabetes increased by about 5%. Regarding the source of ACEs, those originating from the family (OR, 1.23; 95% CI, 1.08 to 1.41) were associated with diabetes. In terms of specific ACE types, family members with substance abuse (OR, 1.23; 95% CI, 1.01 to 1.52), emotional abuse (OR, 1.28; 95% CI, 1.12 to 1.46), and poor parental relationship (OR, 1.25; 95% CI, 1.09 to 1.43) were associated with diabetes.
CONCLUSIONS
ACEs, particularly those originating from the family, were associated with diabetes. Interventions aimed at preventing and mitigating ACEs are essential for the early prevention of diabetes.
6.Ecological Suitability and Quality Zoning of Panax ginseng Cultivated Under Forest in Liaoning Province
Miao YU ; Jiankui ZHANG ; Zhi SUN ; Jiaying LI ; Yinlei LIU ; Zhixian JING
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(20):149-159
ObjectiveTo identify potential distribution areas for wild Panax ginseng cultivated under forest in Liaoning province, China, and analyze the ecological factors of spatial stratified heterogeneity affecting its ecological suitability and quality suitability. MethodWild Panax ginseng samples cultivated under forest were collected from 33 cultivation bases in Liaoning province. The Maxent maximum entropy model and ArcGIS were used to delineate the ecological suitability zones. Correlation analysis was performed on seven indicators and 110 ecological factors. Variables with significant correlation (P<0.05) were used to build partial least squares regression analysis models. A comprehensive quality zoning was conducted using the analytic hierarchy process (AHP). The geographic detector was employed to analyze the interactions among dominant ecological factors of spatial stratified heterogeneity affecting habitat suitability, quality suitability, and the ecological driving factors. ResultVegetation type was the most influential ecological factor for delineating the ecological suitability zones for wild Panax ginseng in Liaoning province. The main ecological suitability areas for wild Panax ginseng cultivated under forest were located in the northeast, east, and southeast regions along the line from Xifeng County to Gaizhou City. The comprehensive quality suitability of wild Panax ginseng cultivated under forest was highest in Kuandian County and Huanren County and gradually decreased to the northwest and southwest. Within the delineated regions, the suitability conditions and comprehensive quality of wild Panax ginseng cultivated under forest were primarily influenced by the interactions between radiation and precipitation factors. The content of the measured samples was significantly higher than the standards in the 2020 edition of the Chinese Pharmacopoeia, indicating the high overall quality of wild Panax ginseng in Liaoning Province. ConclusionAccording to the zoning and prediction results, areas in Fengcheng City, Xiuyan County, Zhuanghe City, Liaoyang County, Tieling County, Xifeng County, Gaizhou City, Haicheng City, and Dashiqiao City showed large potential distribution areas with high quality, making them highly promising for wild Panax ginseng cultivation. However, further experimental verification is required. The zoning results can provide insights for research on habitat suitability and comprehensive quality accumulation of wild Panax ginseng cultivated under forest, as well as guidance for the search for potential cultivation areas and industrial development of wild Panax ginseng in Liaoning Province.
7.Research progress in microevolutionary process of excellent traits and quality of Dao-di herbs.
Cheng-Cai ZHANG ; Jia-Hui SUN ; Yi-Heng WANG ; Hong-Yang WANG ; Xiu-Zhi GUO ; Bin-Bin YAN ; Zhi SUN ; Sheng WANG ; Lan-Ping GUO
China Journal of Chinese Materia Medica 2023;48(22):6021-6029
Dao-di herbs are the treasure of Chinese materia medica and one of the characteristic research objects of traditional Chinese medicine(TCM). Probing into the microevolution of Dao-di herbs can help to reveal their biological essence and quality formation mechanisms. The progress in molecular biology and omics provides the possibility to elucidate the phylogenetic and quality forming characteristics of Dao-di herbs at the molecular level. In particular, genomics serves as a powerful tool to decipher the genetic origins of Dao-di herbs, and molecular markers have been widely used in the research on the genetic diversity and population structure of Dao-di herbs. Focusing on the excellent traits and quality of Dao-di herbs, this paper reviews the studies about the microevolution process of quality formation mechanisms of Dao-di herbs with the application of molecular markers and omics, aiming to underpin the protection and utilization of TCM resources.
Drugs, Chinese Herbal
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Phylogeny
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Plants, Medicinal/chemistry*
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Medicine, Chinese Traditional
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Phenotype
8.Radiological protection detection and dose assessment of selective internal radiotherapy with 90Y resin microspheres
Dexing LIAN ; Shanshan KOU ; Jianfei LU ; Qingzhao ZHANG ; Weiguo ZHU ; Chuanjian WANG ; Changsong HOU
Chinese Journal of Radiological Medicine and Protection 2022;42(5):385-390
Objective:To conduct radiation detection and dose assessment in selective internal radiotherapy with 90Y resin microspheres for the purpose of providing a reference for radiological protection. Methods:The dose rates from radiotherapy with 90Y resin microspheres were detected in the process of each operation at different distances from the body surface of patients the levels of dose to the persons concerned were compared with the relevant national regulations and standards. Results:The estimated dose rates were 1.12-454 μSv/h during 90Y resin microspheres dispensing and 2.06-58.2 μSv/h during surgical procedure. The dose rates at 0.5 h after surgery were 22.7-64.1 μSv/h at 5 cm and 0.82-2.55 μSv/h at 1 m from three patient′s body surface. Assuming treating 200 patients a year, the annual individual effective dose to the radiation workers was 0.12-1.03 mSv/year. The annual individual effective dose to the public, comforters and carers of patients was 0.02-0.24 mSv/year after release of a patient. Conclusions:During the treatment, nursing and release of patients, the radiation doses to workers, carers and the public are lower than the individual dose limit given in the GB18871-2002 basic standards for protection against ionizing radiation and for the safety of radiation sources and the management target value set by of the relevant medical institutions.
9.Measurement and analysis of 90Y radioactivity in urine of patients treated with 90Y resin microspheres
Dexing LIAN ; Shanshan KOU ; Jianfei LU ; Jun CHAO ; Zaiyun ZHU ; Qingzhao ZHANG ; Changsong HOU
Chinese Journal of Radiological Medicine and Protection 2022;42(6):460-463
Objective:To evaluate 90Y activity concentration in renal excretions during the first 48 hours after being treated with 90Y resin microspheres seleceive internal radiation therapy(SIRI) and to provide advice on the management of patient excreta after surgery. Methods:After surgery, urine excreted from 3 patients during 0-24 h and 24-48 h was collected respectively, and the 90Y activity concentration in urine was tested and analyzed. Results:90Y radioctivity in the urine excreted from 3 patients after surgery was (1 266±258)kBq/GBq during 0-24 h and (140±106) kBq/GBq during 24-48 h, respectively, and 90Y activity concentration were (640±113) kBq/L during 0-24 h and (53±12) kBq/L during 24-48 h. Conclusions:90Y radioactivity in patient′s urine excreted at 1 d was about 10 times higher than that at 2 d. After surgery, patients can accelerate the reduction of free 90Y activity by increasing excretion. Urine excreted by the patients during hospitalization should be handled in accordance with the requirements of the national standard HJ 1188-2021 Radiation protection and safety requirements for nuclear medicine.
10.Analysis of external exposure dose during 131I treatment for thyroid cancer patient
Qingzhao ZHANG ; Wenliang LI ; Weiguo ZHU ; Jing LIANG ; Dexing LIAN ; Changsong HOU
Chinese Journal of Radiological Medicine and Protection 2021;41(5):353-357
Objective:To explore the existing issues in radiation protection during the treatment of 131I by means of measuring the ambient dose equivalent rate to patients with thyroid cancer and the dose equivalent to the surface of chest of patients during hospitalization. Methods:The ambient dose equivalent rate (peer) was measured by using gamma ray detector for selected 78 patients who received 131I treatment in a hospital 10 min, 1 d, 2 d, 3 d and 5 d after administration with 131I. The measurements were made at distances of 5 cm, 0.5 m and 1 m from the body surface in front, rear, left and right directions. The photoluminescence dosimeter on the chest of the patients was used to measure the effective dose during hospitalization period (6 d). Results:The ambient dose equivalent rate on the surface of chest of patients was up to 4.81 mSv/h 10 min after administration of medicine. The dose equivalent on the surface of chest of patients before discharge ranged 2.6-64.1 μSv/h. The cumulative dose on chest surface during hospitalization was 15.9-58.8 mGy. There was a significant difference in the dose rate at 5 cm from the body surface between 3.7 GBq group and 5.55 GBq group 10 min after medication ( t=-6.11, P<0.05). There was a significant difference in the dose rate at 5 cm from the body surface between male and female groups 10 min after medication ( t=4.52, P < 0.05). There was no significant difference in other groups ( P > 0.05). Conclusions:During the 131I treatment, patients had high level of radiation around them, so it is necessary to strengthen the protection and management of patients and reduce unnecessary exposure to the public.

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