1.Risk Factors Analysis and Predictive Model Construction for Acute Kidney Injury Following Amphotericin B Deoxycholate Use in Hospitalized Patients
Hao XIE ; Yixun SHI ; Zhiqing XU ; Minquan LI ; Xiaoli DU ; Gang CHEN ; Bin ZHAO
Medical Journal of Peking Union Medical College Hospital 2026;17(2):429-437
To investigate the risk factors for acute kidney injury (AKI) following the use of amphotericin B deoxycholate and to develop a predictive model to guide clinical monitoring and intervention. A retrospective analysis was conducted on hospitalized patients who received amphotericin B deoxycholate between January 2014 and September 2024. Patients were divided into a training set and a validation set. Demographic data, laboratory findings, and medication orders were collected. Based on the occurrence of AKI during treatment and within 7 days after discontinuation, patients were classified into an AKI group and a non-AKI group. Univariate analysis was used to screen for potential risk factors, multivariate logistic regression was employed to construct a predictive model, and model performance was evaluated using the area under the receiver operating characteristic curve (AUC) and the Hosmer-Lemeshow test. The training set included 473 patients, comprising 255 males (53.91%) and 218 females (46.09%), with a median age of 52(35, 62) years. The AKI group consisted of 191 cases (40.38%), and the non-AKI group consisted of 282 cases (59.62%). The validation set included 114 patients, comprising 80 males (70.18%) and 34 females (29.82%), with a median age of 43.5 (31.0, 58.5) years. The AKI group consisted of 42 cases (36.84%), and the non-AKI group consisted of 72 cases (63.16%). Univariate analysis revealed statistically significant differences between the two groups in 23 factors (all Admission to the ICU, elevated serum creatinine at admission, and comorbid cardiac insufficiency as potential risk factors for AKI, while prophylactic use of diphenhydramine/promethazine or sodium bicarbonate showed a protective association. A predictive model with good discrimina-tion and calibration was developed, which may provide a basis for early identification of high-risk patients and timely adjustment of treatment strategies in clinical practice.
2.Targeting PI3K/AKT signaling pathway to treat allergic asthma: Pathogenesis, mechanism, and treatment with traditional Chinese medicine and its components
Jiamao WANG ; Qitong ZHENG ; Yiqing SHI ; Mengyao CHEN ; Xia'nan SANG ; Gang CAO
Science of Traditional Chinese Medicine 2026;4(1):10-23
Traditional Chinese medicine and its bioactive components have garnered increasing attention as potential therapeutic options for allergic asthma. By targeting the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT) signaling pathway, these natural compounds exhibit unique advantages in multilevel immunomodulation and inflammation suppression compared with single-target synthetic drugs. Accumulating pharmacological evidence supports their capacity to restore pathway homeostasis, positioning them as promising candidates for complementary strategies in asthma management. Allergic asthma, a heterogeneous respiratory disorder affecting approximately 150 million individuals worldwide, arises from a complex interplay of genetic predisposition, environmental exposures, and lifestyle factors. Its pathological progression is marked by aberrant activation of the PI3K/AKT signaling cascade, with the mechanistic target of rapamycin serving as a key downstream regulatory node. This evolutionarily conserved pathway orchestrates fundamental cellular processes that contribute to three hallmark pathological features of allergic asthma: chronic airway inflammation, structural remodeling of the bronchial architecture, and airway hyperresponsiveness. This review has 3 primary objectives: (1) to evaluate the role of the PI3K/AKT pathway in allergic asthma pathogenesis, (2) to analyze the molecular mechanisms of representative traditional Chinese medicine preparations and their active ingredients, and (3) to identify novel bioactive inhibitors derived from natural products. Collectively, these investigations provide a conceptual framework for the development of next-generation targeted therapies and for optimizing clinical management strategies for allergic asthma.
3.Opportunities and challenges in controlling metabolic dysfunction-associated steatotic liver disease: Editorial on “Downregulation of the MARC1 p.A165 risk allele reduces hepatocyte lipid content by increasing beta-oxidation”
Jian XU ; Gang SHI ; Tao SHENG ; Jingdong LI
Clinical and Molecular Hepatology 2026;32(2):919-920
4.Genetic differentiation of Anopheles sinensis (Diptera: Culicidae) based on COⅠ and ITS2 sequences
Gang WANG ; Chun-juan SHI ; Dan KONG ; Xuan ZHU ; Ji HE ; Ming-hui ZHAO ; Chong-cai WANG
Acta Parasitologica et Medica Entomologica Sinica 2026;33(2):90-95
Objective Exploring genetic differences among geographic strains of Anopheles sinensis in China. Methods Based on the mitochondrial cytochrome oxidase subunit I(COⅠ )and ribosomal the second internal transcribed spacer(ITS2), genetic distance analyses were conducted on An. sinensis samples collected nationwide. Results Genetic differentiation was observed within An. sinensis geographic strains, primarily reflected in the genetic distances of COⅠ sequences, with some distances between samples exceeding those between closely related species. However, ITS2 sequences showed relatively low levels of differentiation within geographic strains. No significant separation was observed, and gene exchange exhibited a random pattern among geographic strains. Conclusions Significant differences in genetic distance were observed among An. sinensis samples, along with evidence of interspecific continuity among sibling species. For the identification of closely related species using wild-collected Anopheles mosquitoes samples, reliance solely on commonly used barcodes such as COⅠ and ITS2 may be insufficient. Additional molecular markers, including COⅡ and D3 gene fragments, should also be considered. Caution should be exercised when using COⅠ genes to identify cryptic species, especially within Anopheles mosquitoes.
5.Literature analysis of euglycemic diabetic ketoacidosis induced by empagliflozin
Zhenzhen LEI ; Wei RUI ; Yanling SHI ; Jiayue ZHU ; Ying GANG ; Xiaodi SUN ; Hao ZHAN ; Junnan WANG ; Yukun NIU ; Wenxiang ZHANG
China Pharmacy 2026;37(14):1874-1879
OBJECTIVE To investigate the clinical characteristics of euglycemic diabetic ketoacidosis (euDKA) induced by empagliflozin, and provide references for safe medication. METHODS Case reports of euDKA induced by empagliflozin were retrieved and analyzed from PubMed, Web of Science, CNKI, and Wanfang Data. The Naranjo’s scale was adopted to assess the causal relationship between empagliflozin and euDKA. RESULTS A total of 29 patients were enrolled, including 16 males and 13 females,with a median age of 58 years. All patients were diagnosed with type 2 diabetes mellitus; 22 patients had at least one comorbidity. The median time to euDKA onset was 60 days after administration, and 7 cases occurred within 2 weeks of treatment. Perioperative periods,fasting,and low-carbohydrate or ketogenic diets were the main predisposing factors. Common presentations included nausea,vomiting, fatigue, tachypnea,and tachycardia. The causal relationship between empagliflozin and euDKA was assessed as “probable” in all cases. According to adverse reaction severity grading, 13 cases were grade 3 (severe) and 16 cases were grade 4 (life-threatening). All patients discontinued empagliflozin and recovered after corresponding treatment. CONCLUSIONS euDKA is a serious adverse reaction to empagliflozin, which mostly occurs early in treatment. Perioperative periods, fasting, and ketogenic diets are prone to induce euDKA. Elderly patients and those with comorbidities are at higher risk. Risk assessment should be conducted before clinical administration; blood ketones and acid-base monitoring should be strengthened in the early medication period; withhold the drug before elective surgery, avoid prolonged fasting;upon diagnosis, discontinue empagliflozin and initiate intravenous insulin, provide fluid resuscitation promptly, and use other treatments to improve patient prognosis.
6.Effects of hemolysis, chylemia and repeated freeze-thawing of human serum immunized with pneumococcal vaccine on ELISA clinical evaluation method
Chinese Journal of Biologicals 2025;38(06):705-712
Objective To confirm the effects of hemolysis,chylemia and repeated freeze-thawing of human serum immunized with pneumococcal vaccine on ELISA for the detection of specific IgG antibody against pneumococcal capsular polysaccharide,and to promote the continuous development and improvement of the evaluation methods for clinical serum IgG antibody content of pneumococcal vaccine.Methods The same batch of reconstituted laboratory internal quality control serum 09CS was aliquoted into different volumes and subjected to 1 to 12 freeze-thaw cycles.The IgG antibodies of 24 types were detected respectively with the serum after single freeze-thaw and the repeated freeze-thaw serum.The ELISA test for detecting the content of IgG antibodies specific to pneumococcal capsular polysaccharides was carried out,and the test results were systematically analyzed.The laboratory internal quality control serum 09CS was respectively mixed with hemolyzed and chylous serum after immunization in different volume fractions to prepare hemolyzed and chylous serum,and the IgG antibodies of 24 types were detected respectively.The test was repeated three times,and the recovery rate was calculated.Results The repeated freeze-thaw serum and single freeze-thaw serum were detected for 24 types respectively,and the detection results showed good linear relationship with R~2> 0.99.The detection results were analyzed by Lin's concordance correlation coefficient(r_c),and the r_c was 0.992 3(95% CI:0.990 2-0.993 9),indicating that the test results of single freeze-thaw serum and repeated freeze-thaw serum were highly consistent.The accuracy of serum recovery rate was74.65% for hemolyzed serum and 70.48% for chylous serum,both in line with the acceptance range of accuracy±40%.Conclusion During the ELISA test for the specific IgG antibody content against pneumococcal capsular polysaccharide,hemolyzed and chylous serum and repeated freeze-thawing of serum for 12 times have no effect on the detection,which can satisfy the detection requirements for clinical serum antibody evaluation of pneumococcal vaccine.
7.Drug Delivery Systems for Pancreatic Cancers Treatment
Wan-Rui SHI ; Li-Gang CUI ; Xiao-Long LIANG
Progress in Biochemistry and Biophysics 2025;52(7):1745-1756
Pancreatic cancers (PCs) is a common malignant tumor with poor prognosis in the digestive system. Its main treatment methods include surgery, radiotherapy, chemotherapy, and targeted therapy. The early diagnosis rate of hidden onset of PCs is low, and most patients have already lost the opportunity to undergo surgery when diagnosed with PCs. Chemotherapy is still the main treatment for advanced PCs, but the use of chemotherapy drugs in PCs can easily lead to drug resistance. The most significant feature that distinguishes PCs from other tumors is its rich and dense matrix, which not only hinders drug penetration but also impedes the infiltration of immune cells. The above reasons have led to a very low survival rate of PCs patients. Therefore, drug delivery systems are very important in the diagnosis and treatment of PCs. They can improve drug delivery, enhance biological barrier penetration, reduce side effects, and combine multiple treatment methods. Therefore, the treatment prospects of PCs are very broad. Currently, drug delivery systems widely applied in PCs primarily include nanodrug delivery systems, tumor microenvironment-targeted drug delivery system, immunotherapy drug delivery system, gene therapy drug delivery system, and combination therapy drug delivery system that synergize multiple therapeutic modalities. Emerging drug delivery systems (DDSs) have revolutionized PCs treatment by addressing these challenges through multiple mechanisms. Nanoformulations improve drug solubility, prolong circulation time, and reduce systemic toxicity via passive/active targeting. Smart DDSs responsive to PCs-specific stimuli enable extracellular matrix degradation, tumor-associated fibroblasts reprogramming, and vascular normalization to enhance drug accessibility. Last but not least, carrier systems loaded with myeloid-derived suppressor cell inhibitors or T cell activators can reverse immunosuppression and potentiate immunotherapy efficacy. Advanced platforms co-deliver chemotherapeutics with immunomodulators, gene-editing tools, or sonodynamic agents to achieve synergistic antitumor effects. These platforms aim to address critical challenges in PCs treatment, such as enhancing drug bioavailability, overcoming stromal barriers, reprogramming immunosuppressive niches, and achieving multi-mechanistic antitumor effects. This article provides a systematic summary and prospective analysis of the current development status, latest cutting-edge advances, opportunities, and challenges of the above-mentioned drug delivery systems in the field of PCs therapy.
8.Evaluation of postoperative recurrence and treatment efficacy of glioma using 3.0 T functional magnetic resonance imaging
Yang SHI ; Cuixia XU ; Junming WEI ; Gang CUI
Chinese Journal of Radiological Health 2025;34(4):553-558
Objective To investigate the clinical value of 3.0 T functional magnetic resonance imaging in evaluating postoperative recurrence and treatment efficacy of glioma. Methods A retrospective analysis was conducted on the general clinical data of 67 patients who underwent glioma surgery at the Second Affiliated Hospital of Xingtai Medical University. All patients received chemotherapy for more than one month post-surgery. Recurrence of glioma was diagnosed based on secondary surgery or pathological biopsy results as the gold standard. From 3 to 6 months post-surgery, computerized tomography was used to measure cerebral blood volume (CBV), three-dimensional arterial spin labeling was used to measure cerebral blood flow (CBF) and relative CBF (rCBF), and diffusion-weighted imaging with and without contrast enhancement was used to measure apparent diffusion coefficient (ADC). Data were analyzed using SPSS 26.0 statistical software, and the t test or χ2 test was used for inter-group comparisons based on data type. The receiver operating characteristic (ROC) curve was applied to evaluate the value of CBV, rCBF, and ADC in assessing postoperative recurrence and treatment efficacy of glioma. Results Patients with high-grade gliomas showed significantly higher CBV and rCBF and significantly lower ADC compared to those with low-grade gliomas (P < 0.05). The area under the ROC curve (AUC) of CBV, rCBF, and ADC in combination for grading glioma was 0.960, which was higher than those of individual indicators (0.790, 0.955, and 0.795, P < 0.05). The recurrence group had significantly higher CBV and rCBF and lower ADC compared to the non-recurrence group (P < 0.05). The AUC of CBV, rCBF, and ADC in combination for predicting postoperative glioma recurrence was 0.965, which was significantly higher than those of individual indicators (0.729, 0.929, and 0.941, P < 0.05). CBV and rCBF were lower and ADC was higher in the effective treatment group than in the ineffective treatment group (P < 0.05). The AUC of CBV, rCBF, and ADC in combination for evaluating glioma treatment efficacy was 0.985, which was higher than those of individual indicators (0.842, 0.898, and 0.961, P < 0.05). Conclusion The CBV, rCBF, and ADC in combination has shown high diagnostic accuracy and predictive efficacy in the evaluation of postoperative recurrence and treatment efficacy of glioma, which has important clinical application value.
9.Epidemiology and trends of major respiratory infectious diseases in Beijing in 2014-2023
Xiao HU ; Yanlin GAO ; Yunping SHI ; Yang LIU ; Chao WANG ; Ying ZHOU ; Wei LI ; Jiaze LI ; Gang LI
Military Medical Sciences 2025;49(2):101-109
Objective To analyze the epidemiology and trends of measles,tuberculosis,pertussis,scarlet fever,influenza,mumps and rubella in Beijing between 2014 and 2023 in order to provide data for prevention and control of related diseases.Methods Data on the incidences of seven respiratory infectious diseases in Beijing between 2014 and 2023 was collected.Descriptive epidemiological methods were employed to analyze their demographic,temporal and spatial distribution.Joinpoint regression analysis was used to assess temporal trends in incidence.Results A total of 1 406 777 cases of seven respiratory infectious diseases were reported in Beijing between 2014 and 2023,which corresponded to an average crude rate of 649.76/100 000 reported annually.The crude rate of incidencewas higher among females than among males,with the most vulnerable age groups being 0-4 years and 5-19 years,and was higher in the six districts than on the outskirts.Most of the respiratory infectious diseases peaked in winter and spring.The annual increase in the incidence of respiratory infectious diseases in Beijing in this period averaged 27.27%,with no statistically significant differences in trends.The incidence rates of measles,tuberculosis,scarlet fever,mumps and rubella decreased significantly while those of pertussis and influenza increased,but with no statistically significant difference.Conclusion The overall incidence of major respiratory infectious diseases in Beijing is increasing.It is recommended that more people get vaccinated,surveillance of such diseases as pertussis and influenza be enhanced,and regional health resources be allocated more effectively,all of which will be critical to subsequent prevention and control of respiratory infectious diseases in Beijing.
10.Application of cross bar technique in repair of pectus excavatum
Tianjun ZHOU ; Dan TIAN ; Ruiqing SHI ; Zihao ZHOU ; Jiming TANG ; Dongkun ZHANG ; Xiaosong BEN ; Guibin QIAO ; Gang CHEN ; Liang XIE
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(11):1572-1578
Objective To explore the indication, surgical technique, and clinical efficacy of the cross bar based on the Nuss procedure in pectus excavatum. Methods The clinical data of patients who underwent cross bar based on the Nuss procedure from August 2023 to August 2024 in Guangdong Provincial People's Hospital were retrospectively analyzed. Results A total of 88 patients including 85 males and 3 females with a mean age of (17.56±5.20) years were enrolled. All operations were performed successfully without intraoperative cardiac injury, pericardial injury or diaphragmatic injury. The mean operation time was (147.65±47.75) min. The mean blood loss was (13.30±9.06) mL. The mean postoperative hospitalization stay was (4.81±1.55) days, without perioperative death. Six (6.82%) patients developed early postoperative complications, including 3 patients of pleural effusion, 1 patient of subcutaneous hematoma, 1 patient of suffocation and 1 patient of bar rotation. The postoperative outcomes were excellent in 71 (80.68%) patients, good in 16 (18.18%) patients and moderate in 1 (1.13%) patient. The excellent and good rate was 98.86%. Conclusion The cross bar technique is safe and convenient, with satisfactory results. It is worth promoting in clinical application.


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