1.Construction of a high-efficiency risk-prediction model for urinary tract infection after BPH surgery based on machine learning algorithm
Guiping FU ; Xiao LIU ; Zhengdong HONG ; Dongping ZHOU
National Journal of Andrology 2025;31(10):874-880
Objective To explore the risk factors for urinary tract infection(UTI)after benign prostatic hyperpla-sia(BPH)surgery,and construct a high-efficiency risk-prediction model based on machine learning algorithms(MLA).Methods This retrospective study included 200 cases of BPH surgically treated in Xinyu Hospital of Traditional Chinese Medicine from May 2020 to April 2023.Twenty-three cases were included in the UTI group,and 177 were enrolled into the non-UTI group.The relevant data were collected and analyzed for the statistically significant factors by univariate logistic analysis by using the SPSS software,MLA-based logistic regression,back-propagation(BP)neural networks and decision classification and regression tree(CRT).And the predictive values of the models established via different algorithms using the area under the receiver operating characteristic curve(AUC)were compared.We assessed the prediction accuracy of the models and identified one with the best prediction efficiency based on the mean absolute error(MAE).Results Univariate analysis indicated statisti-cally significant differences between the UTI and non-UTI groups in age,comorbid diabetes mellitus(DM),urinary catheter-in-dwelling time,prostate volume,preoperative catheterization,preoperative IPSS(P<0.05).The independent predictive varia-bles for UTI after BPH surgery were shown to be age,IPSS,comorbid DM and prostate volume by the method of multivariate lo-gistic regression model(P<0.05).Age,urinary catheter-indwelling time,prostate volume and IPSS were assessed as the influ-ence factors by the CRT model(P<0.05),and prostate volume,IPSS,age and urinary catheter-indwelling time were assessed as the influence factors by the BP neural network model(P<0.05).Among the 3 risk-prediction models,the one constructed with the BP neural networks exhibited the best prediction efficiency(AUC:0.992,the optimal truncation value:0.912,corre-sponding sensitivity and specificity:0.957 and 0.955).Conclusion The risk-prediction model constructed by MLA and BP neural networks based on the characteristic factors of age,preoperative urinary retention catheterization,urinary catheter-indwell-ing time,IPSS and comorbid DM has a high predictive value for UTI after BPH surgery which can be applied to the identification and management of such high-risk population.
2.Carrier screening and prenatal diagnosis analysis of high-risk cases in 3 044 preconception and early pregnancy couples
Xiaolin FU ; Wei HOU ; Manli ZHANG ; Xiaoxiao XIE ; Yan MENG ; Honghui ZHOU ; Qingdong ZHAO ; Jialin HU ; Guiping MO ; Yanping LU
Chinese Journal of Obstetrics and Gynecology 2025;60(3):161-170
Objective:To carry out carrier screening among people of childbearing age, detect the pathogenic genes of monogenic genetic diseases and analyze the carrier status of pathogenic variants, so as to provide fertility guidance and intervention measures for high-risk families.Methods:From August 2022 to August 2023, 1 533 families of childbearing age who met the criteria were recruited in the Chinese PLA General Hospital, including a total of 3 044 subjects. According to the standard enrollment procedure, 223 genes (197 autosomal recessive genes and 26 X-linked genes) of the subjects were tested. According to the screening results, genetic counseling and fertility guidance were provided to the subjects. Invasive prenatal diagnosis was performed for high-risk couples (both couples being carriers of the same autosomal recessive disease gene or the woman was a carrier of X-linked disease gene), and their pregnancy pattern, outcome and offspring phenotype were followed up.Results:(1) A total of 3 044 cases from 1 511 couples and women of childbearing age from 22 families were included for carrier screening. Totally 1 503 families chose simultaneous screening and 30 families chose sequential screening out of the 1 533 families. Among the 3 044 subjects, 1 603 individuals carried at least one pathogenic or likely pathogenic variant, and the overall carrier rate was 52.66% (1 603/3 044). A total of 2 292 pathogenic or likely pathogenic variants were detected, and 0.75 variants (2 292/3 044) were detected per capita. (2) The three genes with the highest carrier rates were GJB2 (8.67%, 264/3 044), CYP21A2 (3.19%, 97/3 044) and PAH (3.09%, 94/3 044). There were 32 genes with a carrier rate ≥1/200, 17 genes with a carrier rate ≥1/100, and 7 genes with a carrier rate ≥1/50. (3) Thirty-eight high-risk families were identified. After excluding G6PD gene mutation, there were 33 high-risk families, of which 25 couples were carriers of the same autosomal recessive gene, 9 women were carriers of X-linked gene, and 1 family was double high-risk couple with both autosomal recessive and X-linked gene. After further excluding the GJB2 c.109G>A mutation, 21 high-risk families were identified. Preimplantation genetic testing for monogenic disease was performed in 12 families after genetic counseling. Prenatal diagnosis was completed in 4 out of 5 high-risk families who conceived naturally. Two fetuses carried the parental variants and terminated the pregnancy, one fetus did not carry the parental variants but was induced due to trisomy 21 syndrome, and one fetus was a carrier of congenital disorders of glycosylation type 1a.Conclusions:Carrier screening effectively identifies high-risk genetic disease families and provides reproductive guidance to prevent the birth of affected children. However, establishing multidisciplinary team is essential for managing complex cases. Implementation should prioritize prenatal institutions with genetic counseling or diagnostic expertise for monogenic disorders or established referral networks.
3.Carrier screening and prenatal diagnosis analysis of high-risk cases in 3 044 preconception and early pregnancy couples
Xiaolin FU ; Wei HOU ; Manli ZHANG ; Xiaoxiao XIE ; Yan MENG ; Honghui ZHOU ; Qingdong ZHAO ; Jialin HU ; Guiping MO ; Yanping LU
Chinese Journal of Obstetrics and Gynecology 2025;60(3):161-170
Objective:To carry out carrier screening among people of childbearing age, detect the pathogenic genes of monogenic genetic diseases and analyze the carrier status of pathogenic variants, so as to provide fertility guidance and intervention measures for high-risk families.Methods:From August 2022 to August 2023, 1 533 families of childbearing age who met the criteria were recruited in the Chinese PLA General Hospital, including a total of 3 044 subjects. According to the standard enrollment procedure, 223 genes (197 autosomal recessive genes and 26 X-linked genes) of the subjects were tested. According to the screening results, genetic counseling and fertility guidance were provided to the subjects. Invasive prenatal diagnosis was performed for high-risk couples (both couples being carriers of the same autosomal recessive disease gene or the woman was a carrier of X-linked disease gene), and their pregnancy pattern, outcome and offspring phenotype were followed up.Results:(1) A total of 3 044 cases from 1 511 couples and women of childbearing age from 22 families were included for carrier screening. Totally 1 503 families chose simultaneous screening and 30 families chose sequential screening out of the 1 533 families. Among the 3 044 subjects, 1 603 individuals carried at least one pathogenic or likely pathogenic variant, and the overall carrier rate was 52.66% (1 603/3 044). A total of 2 292 pathogenic or likely pathogenic variants were detected, and 0.75 variants (2 292/3 044) were detected per capita. (2) The three genes with the highest carrier rates were GJB2 (8.67%, 264/3 044), CYP21A2 (3.19%, 97/3 044) and PAH (3.09%, 94/3 044). There were 32 genes with a carrier rate ≥1/200, 17 genes with a carrier rate ≥1/100, and 7 genes with a carrier rate ≥1/50. (3) Thirty-eight high-risk families were identified. After excluding G6PD gene mutation, there were 33 high-risk families, of which 25 couples were carriers of the same autosomal recessive gene, 9 women were carriers of X-linked gene, and 1 family was double high-risk couple with both autosomal recessive and X-linked gene. After further excluding the GJB2 c.109G>A mutation, 21 high-risk families were identified. Preimplantation genetic testing for monogenic disease was performed in 12 families after genetic counseling. Prenatal diagnosis was completed in 4 out of 5 high-risk families who conceived naturally. Two fetuses carried the parental variants and terminated the pregnancy, one fetus did not carry the parental variants but was induced due to trisomy 21 syndrome, and one fetus was a carrier of congenital disorders of glycosylation type 1a.Conclusions:Carrier screening effectively identifies high-risk genetic disease families and provides reproductive guidance to prevent the birth of affected children. However, establishing multidisciplinary team is essential for managing complex cases. Implementation should prioritize prenatal institutions with genetic counseling or diagnostic expertise for monogenic disorders or established referral networks.
4.Construction of a high-efficiency risk-prediction model for urinary tract infection after BPH surgery based on machine learning algorithm
Guiping FU ; Xiao LIU ; Zhengdong HONG ; Dongping ZHOU
National Journal of Andrology 2025;31(10):874-880
Objective To explore the risk factors for urinary tract infection(UTI)after benign prostatic hyperpla-sia(BPH)surgery,and construct a high-efficiency risk-prediction model based on machine learning algorithms(MLA).Methods This retrospective study included 200 cases of BPH surgically treated in Xinyu Hospital of Traditional Chinese Medicine from May 2020 to April 2023.Twenty-three cases were included in the UTI group,and 177 were enrolled into the non-UTI group.The relevant data were collected and analyzed for the statistically significant factors by univariate logistic analysis by using the SPSS software,MLA-based logistic regression,back-propagation(BP)neural networks and decision classification and regression tree(CRT).And the predictive values of the models established via different algorithms using the area under the receiver operating characteristic curve(AUC)were compared.We assessed the prediction accuracy of the models and identified one with the best prediction efficiency based on the mean absolute error(MAE).Results Univariate analysis indicated statisti-cally significant differences between the UTI and non-UTI groups in age,comorbid diabetes mellitus(DM),urinary catheter-in-dwelling time,prostate volume,preoperative catheterization,preoperative IPSS(P<0.05).The independent predictive varia-bles for UTI after BPH surgery were shown to be age,IPSS,comorbid DM and prostate volume by the method of multivariate lo-gistic regression model(P<0.05).Age,urinary catheter-indwelling time,prostate volume and IPSS were assessed as the influ-ence factors by the CRT model(P<0.05),and prostate volume,IPSS,age and urinary catheter-indwelling time were assessed as the influence factors by the BP neural network model(P<0.05).Among the 3 risk-prediction models,the one constructed with the BP neural networks exhibited the best prediction efficiency(AUC:0.992,the optimal truncation value:0.912,corre-sponding sensitivity and specificity:0.957 and 0.955).Conclusion The risk-prediction model constructed by MLA and BP neural networks based on the characteristic factors of age,preoperative urinary retention catheterization,urinary catheter-indwell-ing time,IPSS and comorbid DM has a high predictive value for UTI after BPH surgery which can be applied to the identification and management of such high-risk population.
5.Effect of sevoflurane inhalation anesthesia on postoperative extubation time and major adverse cardiovascular events incidence in patients undergoing mitral valve replacement
Shuangqin WANG ; Yuguang XU ; Wenlong GUO ; Xianhui TAN ; Donglin FU ; Guiping XING ; Gui LI ; Shuangyi LIU
Journal of Chinese Physician 2020;22(4):535-538,543
Objective:To explore the application value of sevoflurane inhalation anesthesia in mitral valve replacement.Methods:A total of 94 patients who underwent mitral valve replacement in our hospital (October 2016-October 2018) were randomly divided into the control group ( n=47) and the observation group ( n=47). The control group received target-controlled infusion of propofol, and the observation group inhaled sevoflurane.The postoperative conditions [intensive care unit (ICU) stay time, extubation time of tracheal tube, spontaneous cardiac rebound], hemodynamic indexes [mean arterial pressure (MAP), heart rate (HR)], serum creatine phosphokinase isoenzyme (CK-MB), cardiac troponin I (cTnI), malondialdehyde (MDA) and superoxide dismutase (SOD) in the two groups were analyzed. The patients were followed up for one month. The incidence of major adverse cardiovascular events (MACE) was calculated. Results:⑴ Postoperative situation: the time of stay in ICU and extubation of tracheal tube in the observation group was shorter than that in the control group, and the rate of spontaneous cardiac rebound (93.62%) was higher than that in the control group (72.34%) ( P<0.05); ⑵ Hemodynamic index level: there was no statistically significant difference in MAP and HR levels between two groups before operation, before cardiopulmonary bypass, after cardiopulmonary bypass, and after operation ( P>0.05); ⑶ CK-MB and cTnI: the levels of serum CK-MB and cTnI in the two groups were higher at 2, 6, 24, and 48 h after aortic cross-clamp release than before anesthesia induction, but the indicators of the observation group were lower than those in the control group; ⑷ MDA and SOD: the serum SOD level in the two groups at 2, 6, 24, and 48 h after aortic cross-clamp release were lower than before anesthesia induction, and the MDA level in the two groups at 2, 6, 24, and 48 h after aortic cross-clamp release were higher than before anesthesia induction. The level of SOD in the observation group was higher than that in the control group, and the level of MDA was lower than that in the control group ( P<0.05); ⑸ MACE: the incidence of MACE in the observation group (12.77%) was lower than that of the control group (29.79%) ( P<0.05). Conclusions:During mitral valve replacement, sevoflurane inhalation anesthesia can maintain hemodynamic stability. The duration of ICU stay and tracheal tube extubation time is shorter, and the fluctuation of serum CK-MB, cTnI, MDA and SOD is small, and it can reduce the risk of MACE.
6. Role of PI3K/Akt/Nrf2 signaling pathway in resveratrol preconditioning-induced cardioprotection in diabetic rats
Guiping XU ; Juan FU ; Xuan ZHAO ; Xiaoli WANG
Chinese Journal of Anesthesiology 2019;39(10):1189-1193
Objective:
To evaluate the role of phosphatidylinositol-3-kinase/protein kinase B/nuclear factor erythroid 2-related factor 2 (PI3K/Akt/Nrf2) signaling pathway in resveratrol preconditioning-induced cardioprotection in diabetic rats.
Methods:
Clean-grade healthy male Sprague-Dawley rats, aged 2-3 months, weighing 240-280 g, were used in the study.The diabetes model was established by intraperitoneal injection of streptozotocin 30 mg/kg once a day for 7 consecutive days.Forty diabetic rats were selected and divided into 4 groups (
7.Role of PI3K/Akt/Nrf2 signaling pathway in resveratrol preconditioning-induced cardioprotection in diabetic rats
Guiping XU ; Juan FU ; Xuan ZHAO ; Xiaoli WANG
Chinese Journal of Anesthesiology 2019;39(10):1189-1193
Objective To evaluate the role of phosphatidylinositol-3-kinase/protein kinase B/nucle-ar factor erythroid 2-related factor 2(PI3K/Akt/Nrf2)signaling pathway in resveratrol preconditioning-in-duced cardioprotection in diabetic rats.Methods Clean-grade healthy male Sprague-Dawley rats,aged 2-3 months,weighing 240-280 g,were used in the study.The diabetes model was established by intraper-itoneal injection of streptozotocin 30 mg/kg once a day for 7 consecutive days.Forty diabetic rats were se-lected and divided into 4 groups(n=10 each)according to the random number table method: sham opera-tion group(S group),myocardial ischemia-reperfusion(I/R)group(I/R group),resveratrol plus myo-cardial I/R group(Res+I/R group),and PI3K inhibitor LY294002 plus resveratrol plus myocardial I/R group(LY+Res+I/R group).The myocardial I/R injury model was established by ligating the left anterior descending coronary artery for 30 min followed by 120-min reperfusion in anesthetized rats.Resveratrol 20 mg/kg was intraperitoneally injected once a day for 7 consecutive days at one week before surgery in Res+I/R and LY+Res+I/R groups.LY294002 1.5 mg/kg was intraperitoneally injected at 30 min before operation in LY+Res+I/R group.After 120 min of reperfusion,blood samples were taken for determination of serum creatine kinase-MB(CK-MB)and lactic dehydrogenase(LDH)concentrations(by enzyme-linked immu-nosorbent assay),and myocardial tissues at the ischemic area were obtained for determination of superoxide dismutase(SOD),glutathione(GSH)and malondialdehyde(MDA)levels(by enzyme-linked immu-nosorbent assay)and expression of Akt,phosphorylated Akt(p-Akt),glycogen synthase kinase 3β(GSK3β),phosphorylated GSK3β(p-GSK3β)and Nrf2(by Western blot).Results Compared with group S,serum CK-MB and LDH concentrations were significantly increased,the SOD and GSH levels were decreased,the MDA level was increased,and the expression of p-Akt and p-GSK3β was down-regu-lated in I/R group(P<0.05).Compared with I/R group,serum CK-MB and LDH concentrations were sig-nificantly decreased,the SOD and GSH levels were increased,the MDA level was decreased,and the ex-pression of p-Akt,p-GSK3β and Nrf2 was up-regulated in Res+I/R group(P<0.05).Compared with Res+I/R group,serum CK-MB and LDH concentrations were significantly increased,the SOD and GSH levels were decreased,the MDA level was increased,and the expression of p-Akt,p-GSK3β and Nrf2 was down-regulated in LY+Res+I/R group(P<0.05).Conclusion The mechanism of resveratrol precondi-tioning-induced cardioprotection is related to activating PI3K/Akt/Nrf2 signaling pathway and inhibiting oxi-dative stress responses in diabetic rats.
8.Effects of self-efficacy intervention on activities of daily living and outcomes in patients with acute ischemic stroke complicated with white matter lesions
Guiping JIANG ; Yanbin WU ; Yunyun LIU ; Min LI ; Bing FU ; Juan DU
International Journal of Cerebrovascular Diseases 2019;27(1):17-20
Objective To investigate the effects of self-efficacy intervention on activities of daily living and outcomes in patients with acute ischemic stroke complicated with white matter lesions (WML).Methods From March 2016 to June 2017,patients with acute ischemic stroke complicated with WML admitted to the Departments of Neurology,the Second People's Hospital of Lianyungang were enrolled prospectively.They were randomly divided into intervention group and control group.The control group received routine treatment and nursing,and the intervention group implemented self-efficacy intervention on the basis of the control group.They were followed up until 90 d after onset.Stroke Self-Efficiency Questionnaire (SSEQ) was used to assess the stroke self-efficacy level.The Barthel Index (BI) was used to assess the activities of daily living (ADL) of the patients.The National Institutes of Health Stroke Scale (NIHSS) and the modified Rankin Scale (mRS) were used to assess the outcomes of the patients.Results The SSEQ scores in the intervention group were significantly higher than those at the time of admission and in the control group at 90 d (all P <0.01).The BI in the intervention group was significantly higher than that in the control group (66.51 ±22.35 vs.58.41 ±23.17;t =3.473,P =0.001),and the NIHSS score was significantly lower than the control group (5.51 ±2.98 vs.6.95 ±2.94;t =-2.094,P=0.040),and the proportion of patients with good outcomes (mRS score 0-2) was significantly higher than that of the control group (73.7% vs.56.6%;x2 =4.896,P =0.027).Conclusion For patients with acute ischemic stroke complicated with WML,active self-efficacy intervention could improve the ADL and it was helpful to improve the outcomes of patients.
9.Establishment of a novel cell model targeted on FGF-21 receptor for screening anti-diabetic drug candidates.
Hongmei GAO ; Wenfei WANG ; Qiao ZHANG ; Yang HAN ; Qi WANG ; Guiping REN ; Yunwei FU ; Deshan LI
Acta Pharmaceutica Sinica 2011;46(8):904-9
The aim of this project is to establish a fibroblast growth factor-21 (FGF-21) signaling pathway targeted cell model, for screening a class of FGF-21 receptor agonists as anti-diabetic candidates. FGF-21 requires beta klotho transmembrane proteins as co-receptor for the activation of tyrosine kinase FGF receptor (FGFR) signaling, thereby activating a series of intracellular signaling pathways and regulating gene transcription for glucose metabolism. Firstly a recombinant plasmid expressing co-receptor beta klotho and EGFP reporter genes was constructed. After introducing the recombinant plasmid into package cells, the cell culture supernatant was used to infect 3T3-L1 cells, which were then screened for stably expressing beta klotho gene. Administration of FGF-21 increased the expression of GLUT1 and stimulated GLUT1-mediated glucose uptake. This novel cell model can be conveniently used in high-throughput drug screening of FGF-21 or FGF-21 analogues.
10.Expression and characterization of soluble recombinant Ulp1p with glutathione S-transferase tag in Escherichia coli.
Junhua FU ; Qi WANG ; Jiechao YIN ; Mingyao LIU ; Ning LI ; Wenbin YAO ; Guiping REN ; Lu LI ; Deshan LI
Chinese Journal of Biotechnology 2010;26(6):837-842
The aim of the study is to obtain an efficient expression of recombinant ubiquitin-like specific protease 1 (Ulp1) by gene engineering. We cloned the Ulp1p, active fragment (403 aa-621 aa) of Ulp1, from Saccharomyces cerevisia, and subcloned into pGEX/Rosetta (DE3) to form an expression plasmid, pGEX-Ulp1p-His6. In order to enhance the solubility of GST-Ulp1p-His6, we purified the fusion protein GST-Ulp1p-His6 by either glutathione S-transferase agarose or Ni-NTA resin chromatography, the purity was up to 98%. We utilized the protein to cleave the SUMO fusions, and the specific activity of GST-Ulp1p-His6 was 1.375 x 10(4) U/mg. This study showed that the recombinant protein GST-Ulp1p-His6 displayed high specificity and activity.
Cloning, Molecular
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Cysteine Endopeptidases
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biosynthesis
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genetics
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Escherichia coli
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genetics
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metabolism
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Fungal Proteins
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biosynthesis
;
genetics
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Glutathione Transferase
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biosynthesis
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genetics
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Recombinant Fusion Proteins
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biosynthesis
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genetics
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Saccharomyces cerevisiae
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enzymology
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Solubility

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