1.Research status of risk prediction model of post-endoscopic retrograde cholangiopancreatography pancreatitis
Zhe-Yu ZHU ; Yi-Yu HU ; Peng CHEN ; Fei-Fan WU ; Si-Yu WANG ; Wei-Min WANG ; Chun-Mu MIAO ; Yun-Bing WANG ; Xiong DING
Journal of Regional Anatomy and Operative Surgery 2024;33(12):1105-1109
Post-endoscopic retrograde cholangiopancreatography pancreatitis(PEP)is one of the most common complications after endoscopic retrograde cholangiopancreatography(ERCP).Numerous PEP prediction models have been established based on different statistical methods at home and abroad.The PEP prediction model,as a tool for evaluating and screening high-risk populations,can provide a basis for medical staff to find high-risk PEP patients early and take effective preventive measures.In recent years,new PEP prediction models have appeared one after another,but there is still a lack of recognized reliable prediction models in clinic.This article reviews the research status of PEP risk prediction models,aim to provide a direction for establishing a more reliable,accurate,and practical PEP risk prediction model in the later period.
2.Analysis of Therapeutic Efficacy and Adverse Prognostic Factors of Secondary Central Nervous System Lymphoma
Ning WANG ; Fei-Li CHEN ; Yi-Lan HUANG ; Xin-Miao JIANG ; Xiao-Juan WEI ; Si-Chu LIU ; Yan TENG ; Lu PAN ; Ling HUANG ; Han-Guo GUO ; Zhan-Li LIANG ; Wen-Yu LI
Journal of Experimental Hematology 2024;32(5):1420-1426
Objective:To explore the therapeutic efficacy and prognostic factors of induction therapy for secondary central nervous system lymphoma(SCNSL).Methods:Clinical data of patients diagnosed with SCNSL from 2010 to 2021 at Guangdong Provincial People's Hospital were retrospectively collected.A retrospective cohort study was performed on all and grouped patients to analyze the efficacy and survival.Multivariate logistic regression analysis was used to explore the adverse prognostic factors.Results:Thirty-seven diffuse large B-cell lymphoma patients with secondary central involvement were included in the research.Their 2-year overall survival(OS)rate was 46.01%and median survival time was 18.1 months.The 2-year OS rates of HD-MTX group and TMZ group were 34.3%and 61%,median survival time were 8.7 and 38.3 months,and median progression-free survival time were 8.1 and 47 months,respectively.Multivariate logistic regression analysis showed that age,sex,IPI,Ann Arbor stage were correlated with patient survival time.The median survival time of patients with CD79B,KMT2D,CXCR4.ERBB2,TBL1XR1,BTG2,MYC,MYD88,and PIM1 mutations was 8.2 months,which was lower than the overall level.Conclusion:HD-MTX combined with TMZ as the first-line strategy may improve patient prognosis,and early application of gene sequencing is beneficial for evaluating prognosis.
3.Analysis of RhC Antigen Weak Expression Combined with Mimicking Autoanti-Ce and Homologous Anti-Jkb Causing Mismatch
Hong-Mei YANG ; Xi YU ; Xin ZOU ; Si-Fei MA ; Jin CHEN ; Jian-Wei ZHANG
Journal of Experimental Hematology 2024;32(5):1539-1544
Objective:To investigate the reasons for the weak expression of RHCE gene in a patient whose mimicking anti-Ce combined with anti-Jkb caused cross-matching non-combination.Methods:ABO,Rh,and Kidd blood group antigens were identified by test tube method and capillary centrifugation.Antibody screening and antibody specificity identification were performed using saline,polybrene and antiglobulin in tri-media association with multispectral cells.RHCE gene sequencing and haploid analysis were performed by multiplex PCR technique and RHCE protein modeling was performed using Swiss-Model.Results:The serum of the patient contained anti-Ce mimicking autoantibodies along with anti-Jkb antibodies.c.48G>C,c.150C>T,c.178C>A,c.201A>G,c.203A>G,and c.307C>T mutations were detected in the RHCE triple-molecule sequencing.A 109 bp insertion sequence was found in intron 2,with fragment loss from intron 5-8.The Rh-group genotype was DCe/DCe,and phenotype was CCDee.Conclusion:Genotyping techniques can assist in deducing the molecular mechanisms of some weakly expressed RhC,c,E,and e in patients'sera to aid in the identification of difficult antibodies and thus ensure the safety of patients'blood transfusion.
4.Construction of risk factors and risk prediction model of complications after laparoscopic cholecystectomy for acute cholecystitis
Fei HE ; Ming ZHOU ; Si-Qiang GUAN
Chinese Journal of Current Advances in General Surgery 2024;27(9):709-713
Objective:To investigate the construction and empirical study of the risk predic-tion model of postoperative complications in patients with acute cholecystitis undergoing laparo-scopic cholecystectomy(LC).Method:The clinical data of 101 patients with acute cholecystitis treated by LC from January 2021 to January 2023 were retrospectively analyzed.According to the occurrence of postoperative complications(the following symptoms occurred within 30 days after surgery,such as abdominal hemorrhage,bile leakage,biliary tract injury and wound infection),pa-tients were divided into complication group(26 cases)and non-complication group(75 cases).Uni-variate analysis and multivariate Logistic regression were used to analyze the affecting factors of complications after LC in patients with acute cholecystitis,and the risk prediction model was con-structed,and the predictive value of the model was analyzed by receiver operating characteristic curve(ROC curve).Result:Univariate analysis showed that gender,BMI,cirrhosis,gallstone,gall-bladder atrophy and CCI grade were not correlated with postoperative complications in patients with acute cholecystitis after LC treatment(P>0.05).Age,gallbladder wall thickness,triangular ana-tomic variation,ASA-PS grade,TG13/TG18 grade were associated with postoperative complica-tions of LC in patients with acute cholecystitis(P<0.05).Multivariate Logistic regression analysis showed that age>70 years old,gallbladder wall thickness ≥5mm,triangular anatomical variation,ASA-PS grade Ⅲ~Ⅵ,TG13/TG18 grade Ⅲ were all independent risk factors for postoperative complications(P<0.05).ROC analysis showed that the AUC of the risk prediction model constructed based on the above five indicators was 0.836,and the sensitivity and specificity were 80.8%and 82.7%,which were all higher than the single indicators in the model,and the degree of fit of the risk prediction model was good(Hosmer-Lemeshow x2=0.998,P=0.986).Conclusion:Age>70 years old,gallbladder wall thickness ≥5mm,triangular anatomic variation,ASA-PS grade Ⅲ~Ⅵand TG13/TG18 grade Ⅲ were independent risk factors for postoperative complications in patients with acute cholecystitis undergoing LC treatment.The risk prediction model constructed based on the above five indicators has high predictive value for postoperative complications in patients with acute cholecystitis undergoing LC treatment.
5.Simultaneous content determination of eleven ginsenosides in Fukang Tablets by UPLC-MS/MS
Si-Min XIE ; Jun-Fei CHEN ; Hao-Yu HUANG ; Li-Hong GU ; Jian-Ming LI
Chinese Traditional Patent Medicine 2024;46(9):2858-2863
AIM To establish a UPLC-MS/MS method for the simultaneous content determination of pseudoginsenoside F11 and ginsenosides Rf,Rg1,Re,Rb1,Rb2,Rb3,Rg2,Rg3,Rc,Rd.METHODS The analysis was performed on a 40℃ thermostatic Phenomenex Kinetex F5 column(2.1 mm×100 mm,1.7 μm),with the mobile phase comprising of acetonitrile-2 mmol/L ammonium formate flowing at 0.3 mL/min in a gradient elution manner,and electron spray ionization source was adopted in negative ion scanning with multiple reaction monitoring mode.RESULTS Eleven ginsenosides showed good linear relationships within their own ranges(r>0.9900),whose average recoveries were 97.40%-103.74%with the RSDs of 1.76%-3.48%.CONCLUSION This sensitive,practical and reproducible method can be used for the quality control of Ginseng Radix et Rhizoma in Fukang Tablets.
6.Background, design, and preliminary implementation of China prospective multicenter birth cohort
Si ZHOU ; Liping GUAN ; Hanbo ZHANG ; Wenzhi YANG ; Qiaoling GENG ; Niya ZHOU ; Wenrui ZHAO ; Jia LI ; Zhiguang ZHAO ; Xi PU ; Dan ZHENG ; Hua JIN ; Fei HOU ; Jie GAO ; Wendi WANG ; Xiaohua WANG ; Aiju LIU ; Luming SUN ; Jing YI ; Zhang MAO ; Zhixu QIU ; Shuzhen WU ; Dongqun HUANG ; Xiaohang CHEN ; Fengxiang WEI ; Lianshuai ZHENG ; Xiao YANG ; Jianguo ZHANG ; Zhongjun LI ; Qingsong LIU ; Leilei WANG ; Lijian ZHAO ; Hongbo QI
Chinese Journal of Perinatal Medicine 2024;27(9):750-755
China prospective multicenter birth cohort (Prospective Omics Health Atlas birth cohort, POHA birth cohort) study was officially launched in 2022. This study, in collaboration with 12 participating units, aims to establish a high-quality, multidimensional cohort comprising 20 000 naturally conceived families and assisted reproductive families. The study involves long-term follow-up of parents and offspring, with corresponding biological samples collected at key time points. Through multi-omics testing and analysis, the study aims to conduct multi-omics big data research across the entire maternal and infant life cycle. The goal is to identify new biomarkers for maternal and infant diseases and provide scientific evidence for risk prediction related to maternal diseases and neonatal health.
7.How Traditional Chinese Medicine Treats Autism in Children:Based on Classical Theory"God Comes from the Heart and Gives to the Kidney"
Journal of Zhejiang Chinese Medical University 2024;48(9):1186-1190
[Objective]To analyze the traditional Chinese medicine(TCM)treatment of autism spectrum disorder(ASD)based on the theoretical perspective of"spirit originating from the heart and connecting with the kidneys".[Methods]By studying the chapters"Shen Jing"and"Jing Yi"in HUANG Yuanyu's Sisheng Xinyuan and combining these with the clinical symptoms of childhood autism,this paper analyzes the key pathogenesis of autism from the physiological and pathological perspectives of the heart and kidneys,and the related theories of heart-kidney interactions.Corresponding treatment methods and medications are proposed,accompanied by clinical cases for discussion.[Results]The syndrome analysis of childhood autism indicates that the disease primarily affects the heart and kidneys.The key pathogenesis involves insufficient development of the Shen(spirit)and deficiency of kidney essence.Based on HUANG Yuanyu's theory that"Shen originates from the heart and communicates with the kidneys...essence is stored in the kidneys and communicates with the heart,"the functionality of the Shen and essence depends not only on the normal functioning of the heart and kidneys but also on the proper relationship between them.Specifically,this is reflected in the mutual use of spirit and essence,the generation of essence and blood,the stability of the monarch(heart)and minister(kidneys),and the harmony of water and fire.Therefore,TCM treatment should focus on benefiting kidney essence and controlling heart fire to achieve mutual use of spirit and essence,and harmony of water and fire;strengthening kidney willpower and calming the spirit to stabilize the monarch and minister;regulating the middle earth to ascend and descend,and soothing liver and gallbladder Qi to ensure the proper movement of Qi and heart-kidney harmony.The case study presented involved a diagnosis of insufficient kidney essence and virtual fire disturbing the heart.The treatment focused on nourishing the kidneys,replenishing essence,clearing the heart and calming the spirit,with adjustments to strengthen the spleen,boost Qi,and clear liver fire,achieving satisfactory clinical efficacy.[Conclusion]TCM treatment of childhood autism from the perspective of regulating the heart-kidney relationship shows that proper heart-kidney coordination leads to sufficient essence and vigorous spirit,improving social,language and behavioral abnormalities in children.This provides broader ideas and methods for the clinical treatment of childhood autism in the future.
8.The prognostic value of colonoscopy grading for acute graft-versus-host disease in patients with malignant hematological disorders after unrelated cord blood transplantation
Senlin WANG ; Guangyu SUN ; Xiaoyu ZHU ; Xuemei XU ; Fei YE ; Shilan LI ; Si CHEN
Chinese Journal of Hematology 2024;45(5):462-467
Objective:To investigate the prognostic value of enteroscopic grading for the prognostic assessment of patients with malignant hematological diseases who developed intestinal acute graft-versus-host disease (IT-aGVHD) after unrelated cord blood transplantation (UCBT) .Methods:Fifty patients with IT-aGVHD who developed hormone resistance after UCBT from June 2016 to June 2023 at Anhui Provincial Hospital were collected to compare the effective and survival rates of IT-aGVHD treatment in the group with milder enteroscopic mucosal injury (27 cases, enteroscopic grading of Ⅰ and Ⅱ) and the group with more severe injury (23 cases, enteroscopic grading of Ⅲ and Ⅳ) and to retrospectively analyze the factors affecting patients’ prognosis.Results:Patients in the mild and severe groups had an effective rate of 92.6% and 47.8% at 28 days after colonoscopy ( P<0.001), 81.5% and 39.1% at 56 days after colonoscopy ( P=0.002), with optimal effective rate of 92.6% and 65.2% ( P=0.040), respectively, and the differences were statistically significant. The multifactorial analysis found that enteroscopic grading was an independent risk factor affecting the effective rate of IT-aGVHD treatment. The overall survival rate at 2 years after colonoscopy was 70.4% (95% CI 52.0% -88.8% ) and 34.8% (95% CI 14.8% -54.8% ) for patients in the mild and severe groups, respectively, and the difference was statistically significant ( P=0.003). Multifactorial analysis revealed that enteroscopic grading, cytomegalovirus infection status, second-line treatment regimen, and patients’ age were independent risk factors for survival. Conclusion:The treatment efficacy and prognosis of patients in the group with less severe enteroscopic injury (grades Ⅰ and Ⅱ) were better than those in the group with more severe injury (grades Ⅲ and Ⅳ) .
9.Small bowel capsule endoscopy image classification method based on Swin Transformer network and Adapt-RandAugment data augmentation approach
Rui NIE ; Xue-Si LIU ; Fei TONG ; Yuan-Yang DENG ; Xiang-Hua LIU ; Li YANG ; He-Hua ZHANG ; Ao-Wen DUAN
Chinese Medical Equipment Journal 2024;45(6):9-16
Objective To propose a method for classifying small bowel capsule endoscopy images by combining the Swin Transformer network with an improved Adapt-RandAugment data augmentation approach,aiming to enhance the accuracy and efficiency of small bowel lesion classification and recognition.Methods An Adapt-RandAugment data augmentation approach was formulated based on the RandAugment data enhancement sub-strategy and the principles of no feature loss and no distortion when enhancing small bowel capsule endoscopy images.In the publicly available Kvasir-Capsule dataset of small bowel capsule endoscopic images,the Adapt-RandAugment data augmentation approach was trained based on the Swin Transformer network,and the convolutional neural networks ResNet152 and DenseNet161 were used as the benchmarks to validate the combined Swin Transformer network and Adapt-RandAugment data augmentation approach for small bowel capsule endoscopy image classification.Results The proposed algorithm gained advantages over ResNet152 and DenseNet161 networks in the indicators,which had the macro average precision(MAC-PRE),macro average recall(MAC-REC),macro average F1 score(MAC-Fi-S)being 0.383 2,0.314 8 and 0.290 5 respectively,the micro average precision(MIC-PRE),micro average recall(MIC-REC)and micro average F1 score(MIC-Fi-S)all being 0.755 3,and the Matthews correlation coe-fficient(MCC)being 0.452 3.Conclusion The proposed small bowel capsule endoscopy image classification method based on Swin Transformer network and Adapt-RandAugment data augmentation approach behaves well in classified recognition efficiency and accuracy.[Chinese Medical Equipment Journal,2024,45(6):9-16]
10.Application research of R language-based autoregressive integrated moving average model for predicting short-term consumption of medical consumables
Ze-Hua LIU ; Hong-Tao LU ; Wei LI ; Fei WEI ; Si-Si WANG ; Xiao-Ning FU ; Xin-Ming DONG
Chinese Medical Equipment Journal 2024;45(10):84-87
Objective To explore the effect of a R language-based autoregressive integrated moving average(ARIMA)model for predicting the consumption of medical consumables.Methods The monthly consumption data of a certain type of pre-filled flush syringe from July 2018 to June 2023 was selected as the sample data,which underwent smoothness test and difference operation with R language.An ARIMA model was established and the optimal model was determined according to the Akaike and Bayesian information criteria.The corresponding data of the third quarter of 2023 was used as the validation set to predict the consumption,and the prediction result was compared with the actual values to evaluate the prediction effect of the ARIMA model.Results The ARIMA model with the best fitting was ARIMA(0,1,1)(1,0,0)12,all the predicted data were within 95%confidence interval,and its mean absolute percentage error MAPE was 9.92%.P-value proved to be higher than 0.05 when the residual series were tested using the Ljung-Box statistics,which meant the prediction result was satisfactory.Conclusion The R language-based ARIMA model behaves well in predicting the consumption of medical consumables,and provides references for demand planning,budgeting,purchasing and management of medical consumables.[Chinese Medical Equipment Journal,2024,45(10):84-87]

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