1.Evidence-based expert consensus on the clinical application and pharmaceutical management of antibody-based drugs for the treatment of myasthenia gravis
Rong DUAN ; Zhengxiang LI ; Xiaocong ZUO ; Rongsheng ZHAO ; Ruigang HOU ; Chunsheng YANG ; Guoyan QI
China Pharmacy 2026;37(9):1113-1121
OBJECTIVE To provide standardized guidance for the rational clinical use of antibody-based drugs for the treatment of myasthenia gravis, and to enhance the evidence-based system of guidelines and consensus in this field. METHODS The consensus expert team consisted of 71 multidisciplinary experts from 28 provinces/autonomous regions/municipalities directly under the Central Government. Evidence was systematically retrieved through multiple databases, drug package inserts, and official websites of international and national health administrative authorities, drug regulatory agencies, healthcare security departments, and related industry associations, up to April 30, 2025. Evidence was graded according to the 2014 version of JBI pre-grading system for evidence from intervention studies. Based on full consideration of the current best evidence and multidisciplinary expert experience, the expert consensus recommendations were formulated using a modified Delphi method. RESULTS The Evidence-based expert consensus on the clinical application and pharmaceutical management of antibody-based drugs for the treatment of myasthenia gravis standardized the key points of whole-process pharmaceutical management for four antibody-based drugs approved for marketing in the mainland of China for the treatment of myasthenia gravis (efgartigimod alfa, efgartigimod alfa/hyaluronidase, eculizumab, and rozanolixizumab). It formulated 37 expert consensus recommendations covering nine pharmaceutical management aspects: drug suitability selection, medication in special populations, administration methods, drug storage, therapeutic drug monitoring and pharmacogenetic testing, immunization management, drug interactions, pharmaceutical care, and off-label drug use. CONCLUSIONS Based on the current best evidence and multidisciplinary expert experience, this consensus establishes a whole-process management framework for antibody-based drugs for the treatment of myasthenia gravis, from clinical application to pharmaceutical management. It provides a scientific basis for the rational and precise use of these drugs in clinical practice, effectively promotes the enhancement of pharmaceutical management efficiency, and helps improve the overall therapeutic benefits for patients.
2.Expert consensus on perioperative nursing care for myasthenia gravis patients undergoing thymectomy
Huimin DONG ; Ting ZHOU ; Yingmei ZHONG ; Wei LI ; Xiaoyan LI ; Chunfang ZHANG ; Guoyan QI ; Yangchun LIU
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(01):1-12
Myasthenia gravis is an autoimmune disorder characterized by impaired neuromuscular transmission. Thymectomy is one of the therapeutic options for acetylcholine receptor antibody-positive myasthenia gravis patients. The quality of perioperative care is directly associated with surgical safety and patient outcomes. However, there is currently a lack of specialized nursing consensus or guidelines specifically addressing the care of these patients domestically or internationally. To promote the standardization and normalization of perioperative nursing care for myasthenia gravis patients undergoing thymectomy and to ensure treatment efficacy, a panel of 57 experts from relevant fields was convened. Based on evidence-based medicine and clinical practice experience, discussions were held on various aspects including condition assessment, nutritional support, medication management, and airway care, resulting in a consensus with 18 final recommendations by using the Delphi method through two rounds of expert consultation. This consensus aims to provide a scientific reference for the perioperative nursing care of myasthenia gravis patients undergoing thymectomy.
3.Impact of thymectomy on immune function: Long-term risks and clinical management
Xiaoting LIN ; Zulin PAN ; Peng LIU ; Guoyan QI
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(02):211-217
The thymus is a key organ for T-cell development and the establishment of central immune tolerance. Research on immune function changes and long-term health risks following thymectomy is characterized by significant population heterogeneity and controversial conclusions. This article systematically reviews the key immunological alterations after thymectomy - including reduced T-cell receptor (TCR) repertoire diversity, regulatory T cell (Treg) dysfunction, accelerated immune aging, and compensatory immune responses, and clarifies population differences in postoperative risks of infection, autoimmune diseases, and tumors, as well as the impact of surgical approaches. The clinical outcome after thymectomy is not solely determined by thymus loss, but rather depends on a dynamic balance between "immune deficiency risk" and "host compensatory capacity," which is modulated by multiple factors such as age at surgery, extent of resection, and individual immune status. This review proposes a "risk-compensation balance model" framework, providing an integrated theoretical basis for explaining the heterogeneity in outcomes across different populations and surgical methods. It also holds significant implications for future efforts in individualized surgical decision-making, establishment of stratified immune monitoring systems, and exploration of targeted immune intervention strategies.
4.Analysis of survival time and influencing factors of 1411 HIV/AIDS cases in Yancheng city,Jiangsu province from 2016 to 2020
Yi CAO ; Yu YAN ; Guoyan JIANG ; Lei ZOU ; Yao QI
Chinese Journal of Experimental and Clinical Virology 2025;39(5):575-581
Objective:To analyze the survival time and influencing factors of human immunodeficiency virus(HIV)infected individuals and acquired immunodeficiency syndrome(AIDS)patients in Yancheng City from 2016 to 2020.Methods:The survival and death information of HIV/AIDS patients in Yancheng city from 2016 to 2020 was collected through the National AIDS Comprehensive Prevention and Control Information System. A retrospective cohort study was conducted,and the survival status of HIV/AIDS patients was analyzed using life tables. The Cox proportional hazards regression model was used to analyze the influencing factors of survival time.Results:A total of 1 411 HIV/AIDS patients were included in this study. By the end of the study,the cumulative survival rates of patients at 1-5 years were 93.90%,91.95%,91.24%,90.35%,and 90.12%,respectively. The multivariate Cox proportional hazards model analysis results showed that the risk of death for the age group of ≥60 years at the first diagnosis of HIV positive was 1.54 times that of the <45 years age group(95% CI:1.05-2.28);the risk of death for the CD4 +T lymphocyte(CD4)count groups of 200-349 cells/μl,350-499 cells/μl,and ≥500 cells/μl was 0.30 times(95% CI:0.19-0.47),0.21 times(95% CI:0.11-0.42),and 0.12 times(95% CI:0.04-0.37)that of the <200 cells/μl group,respectively;the risk of death for those who received antiviral treatment was 0.08 times(95% CI:0.05-0.12)that of those who did not receive antiviral treatment;and the risk of death from HIV/AIDS for cases detected through medical institution testing is 2.23 times(95% CI:1.14-3.51)that of cases detected through testing and counseling. Conclusion:The study of HIV/AIDS in Yancheng city from 2016 to 2020 shows that older age at diagnosis,lower initial CD4 +T lymphocyte count,no antiviral treatment,and detection by medical institutions are associated with higher risk of death. It is recommended to expand testing,improve treatment compliance,and promote early detection and treatment of high-risk groups to prolong survival.
5.Analysis of survival time and influencing factors of 1411 HIV/AIDS cases in Yancheng city,Jiangsu province from 2016 to 2020
Yi CAO ; Yu YAN ; Guoyan JIANG ; Lei ZOU ; Yao QI
Chinese Journal of Experimental and Clinical Virology 2025;39(5):575-581
Objective:To analyze the survival time and influencing factors of human immunodeficiency virus(HIV)infected individuals and acquired immunodeficiency syndrome(AIDS)patients in Yancheng City from 2016 to 2020.Methods:The survival and death information of HIV/AIDS patients in Yancheng city from 2016 to 2020 was collected through the National AIDS Comprehensive Prevention and Control Information System. A retrospective cohort study was conducted,and the survival status of HIV/AIDS patients was analyzed using life tables. The Cox proportional hazards regression model was used to analyze the influencing factors of survival time.Results:A total of 1 411 HIV/AIDS patients were included in this study. By the end of the study,the cumulative survival rates of patients at 1-5 years were 93.90%,91.95%,91.24%,90.35%,and 90.12%,respectively. The multivariate Cox proportional hazards model analysis results showed that the risk of death for the age group of ≥60 years at the first diagnosis of HIV positive was 1.54 times that of the <45 years age group(95% CI:1.05-2.28);the risk of death for the CD4 +T lymphocyte(CD4)count groups of 200-349 cells/μl,350-499 cells/μl,and ≥500 cells/μl was 0.30 times(95% CI:0.19-0.47),0.21 times(95% CI:0.11-0.42),and 0.12 times(95% CI:0.04-0.37)that of the <200 cells/μl group,respectively;the risk of death for those who received antiviral treatment was 0.08 times(95% CI:0.05-0.12)that of those who did not receive antiviral treatment;and the risk of death from HIV/AIDS for cases detected through medical institution testing is 2.23 times(95% CI:1.14-3.51)that of cases detected through testing and counseling. Conclusion:The study of HIV/AIDS in Yancheng city from 2016 to 2020 shows that older age at diagnosis,lower initial CD4 +T lymphocyte count,no antiviral treatment,and detection by medical institutions are associated with higher risk of death. It is recommended to expand testing,improve treatment compliance,and promote early detection and treatment of high-risk groups to prolong survival.
6.Distribution and drug resistance of the bacterial strains isolated from urine in a tertiary Traditional Chinese Medicine hospital in Shanghai from 2010 to 2021
Lingyan PEI ; Guoyan XIE ; Jiangli WANG ; Bin LIANG ; Qi FEN ; Qingzhong LIU
Chinese Journal of Infection and Chemotherapy 2024;24(3):318-325
Objective To investigate the distribution and antibiotic resistance profiles of the bacterial strains isolated from urine samples in a tertiary Traditional Chinese Medicine hospital in Shanghai in the 12-year period from 2010 through 2021 for better empirical antibiotic use in clinical practice.Methods The clinical data of patients with urinary tract infection,including the species and antibiotic resistance of the bacterial strains isolated from urine samples from January 2010 to December 2021 were retrospectively analyzed.Results A total of 5 231 nondupliate bacterial strains were isolated,among which E.coli was the most common(52.8%),followed by Enterococcus spp(19.1%)and Klebsiella spp(11.1%).Most of the urinary isolates(76.0%)were isolated from the elderly aged 60-89,and only 3.1%of the strains were isolated from the young people aged under 44.Most of the bacterial strains were isolated from female patients(75.8%),however,more P.aeruginosa and A.baumannii were isolated from male patients compared to female patients(55.3%vs 44.7%and 67.7%vs 32.3%).About 13.7%of the strains were collected from the Department of Nephrology,more than the strains from any other clincial department.In intensive care unit(ICU),the proportion of E.coli was the lowest,while the proportion of Enterococcus spp was the highest.Enterobacterales showed lower resistance raets to carbapenems,cephamycin,amikacin,cefepime,and β-lactam/β-lactamase inhibitor combinations.P.aeruginosa showed higher susceptibility rates to carbapenems,aminoglycosides and β-lactam/β-lactamase inhibitor combinations compared to A.baumannii(≥54.6%vs≤39.8%).Gram-positive cocci were highly sensitive to glycopeptide antibiotics.No SS.aureus or E.faecalis isolates were found resistant to vancomycin.About 2.7%of the E.faecium isolates were resistant to vancomycin.The prevalence of drug-resistant bacteria was the highest in elderly patients,and in the strains isolated from ICU and emergency department.Conclusions Compared with general hospitals,a high proportion of elderly patients were treated in this hospital.It should be more cautious in the treatment of patients with urinary tract infection.The major bacterial species isolated from urine were E.coli,Enterococcus,and K.pneumoniae.Empirical treatment should be prescribed considering patient age and gender as well as the species and distribution of pathogenic bacteria.Urine culture and antibiotic susceptibility testing should be performed proactively.Appropriate antimicrobial agents should be selected according to the results of antimicrobial susceptibility testing.Antimicrobial ressitance surveillance should also be strengthened.
7.Epidemiological characteristics of latent syphilis in Yancheng Cityfrom 2016 to 2020
Zhongyang GUAN ; Lixin SUN ; Yi CAO ; Guoyan JIANG ; Haiyang YAN ; Yao QI
Journal of Preventive Medicine 2022;34(8):826-830
Objective:
To analyze the epidemiological characteristics of latent syphilis in Yancheng City from 2016 to 2020, so as to provide insights into syphilis control.
Methods:
All reported cases with latent syphilis in Yancheng City from 2016 to 2020 was collected from the Communicable Disease Report System of China Disease Prevention and Control Information System, and the prevalence of latent syphilis was estimated and standardized by the seventh population census data in Yancheng City. The trends in the incidence of latent syphilis were evaluated using annual percent change (APC), and the temporal, regional and human distributions of latent syphilis patients were descriptively analyzed. In addition, the spatial clusters of latent syphilis incidence were identified using spatial autocorrelation analysis.
Results:
A total of 7 790 cases with latent syphilis were reported in Yancheng City from 2016 to 2020, and the standardized incidence of latent syphilis increased from 15.35/105 in 2016 to 28.70/105 in 2020 (APC=17.54%, t=5.357, P=0.013). Latent syphilis cases were reported in each month, and no obvious seasonable characteristics were seen. During the period from 2017 to 2020, the highest incidence of latent syphilis was seen in residents at ages of 70 to 79 years, with incidence rates of 41.71/105, 43.04/105, 75.79/105 and 72.94/105, respectively, and most cases were farmers (4 711 cases, 60.47%). The three highest incidence of latent syphilis was reported in Funing County (191.40/105), Tinghu District (137.13/105) and Yandu District (126.23/105). There was a positive spatial correlation of latent syphilis incidence in Yancheng City from 2016 to 2020 (Moran's I=0.23, Z=4.457, P=0.001), and two high-high clusters were identified in 14 townships (streets) of Funing County, Binhai County, Tinghu District, Sheyang County and Yandu District and 3 low-low clusters in 7 townships (streets) in Jianhu County, Tinghu District, Dongtai City and Sheyang County.
Conclusions
The incidence of latent syphilis appeared a tendency towards a rise, and there were remarkable spatial clusters identified in latent syphilis incidence in Yancheng City from 2016 to 2020. The elderly people and farmers are at high risk of latent syphilis.
8.Analysis of malaria epidemic situation before and after malaria elimination in Qiandongnan Prefecture of Guizhou
Deliang TANG ; Tao LUO ; Maoming DENG ; Jing DI ; Yu GUO ; Xinghua HOU ; Bin YANG ; Dehui SHI ; Zhangping YANG ; Yunwei LIU ; Yuanfang QI ; Qiong LI ; Xiaoyan PAN ; Guoyan WU
Chinese Journal of Endemiology 2020;39(5):362-366
Objective:To analyze the characteristics of malaria epidemic situation before and after malaria elimination in Qiandongnan Prefecture, and to provide the basis for establishment of effective strategies and measures to consolidate the achievements of malaria prevention and control.Methods:The data of malaria cases in 16 counties (cities) of Qiandongnan Prefecture from 2005 to 2018 were collected, and descriptive epidemiological method was used to analyze the infection rate of Plasmodium among local residents and floating population before (2005-2011) and after (2012-2018) elimination of malaria, and the characteristics of population distribution, seasonal distribution, species of Plasmodium and types of malaria vectors were analyzed. Results:Before elimination of malaria, total of 1 412 cases of malaria were reported, among those cases, 1 361 cases were local cases, accounting for 96.39% of the total cases. After elimination of malaria, total of 17 cases were reported, all of them were imported cases. After comparison of malaria cases before and after the elimination, the proportion of people aged from 18 to 60 was 70.54% (996/1 412) before the elimination, all 17 imported cases were 18-60 years old after the elimination, and the proportion of children/students decreased from 24.65% (348/1 412) before the elimination to 0 after the elimination. The peak incidence of malaria cases before the elimination was from June to October, and cases occurred every month. After the elimination, the imported cases were sporadic. Plasmodium vivax was the main species of Plasmodium before the elimination (98.58%, 1 392/1 412), and Plasmodium falciparum was mainly imported after the elimination (70.59%, 12/17). Before and after the elimination, Anopheles sinensis, the malaria vector, was the dominant population, but no distribution of Anopheles minimus and Anopheles anthropophagus was found after 2015. Conclusions:After the elimination of malaria in Qiandongnan Prefecture, there is a risk of local malaria cases caused by imported cases. It is suggested that local authorities should focus on the treatment of suspected malaria cases and vector surveillance of overseas returnees in the future.
9.Bottlenecks and modification strategies of 1,3-propanediol biosynthesis from glycerol.
Miaomiao YANG ; Junhua YUN ; Huanhuan ZHANG ; Guoyan ZHANG ; Hossain ZABED ; Xianghui QI
Chinese Journal of Biotechnology 2018;34(7):1069-1080
Crude glycerol is the main by-product of biodiesel production. A few microorganisms can transfer crude glycerol to 1,3-propanediol (1,3-PD) that is an important chemical material. There exist many limitations such as substrate inhibition, product inhibition when wild strains are used in 1,3-PD biosynthesis. In this review, based on the microbial transformation of 1,3-propanediol from glycerol and its limitations, some strategies using genetic engineering such as knockout or gene overexpression were summarized. The latest research progresses in biosynthesis of 1,3-propanediol from glycerol by genetically engineered strains are discussed.
10.A Study on the Traditional Chinese Medical (TCM) Syndrome Screening of Myasthenia Gravis Based on Expert Consensus
Zhiguo LYU ; Jian WANG ; Peng XU ; Xiaodong LUO ; Guoyan QI ; Qing SHI ; Wenjun QIAO ; Zhigang CHEN ; Shixiang KUANG ; Guangwen LI ; Han WANG ; Junyong HU
World Science and Technology-Modernization of Traditional Chinese Medicine 2017;19(1):1-6
This study preliminarily discussed the TCM syndrome types of myasthenia gravis (or flaccidity) and its treatments and prescriptions through consensus method,providing evidence and level revision of the recommended expert consensus of myasthenia gravis in TCM clinical practice guideline.Literatures over TCM syndrome types,symptoms,therapeutic regime,medication and acupuncture were involved in the syndrome analysis of myasthenia gravis through literature retrieval.The common clinical syndromes were outputted by mentioned rate.Ten first-rate hospitals were finally included,such as The Affiliated Hospital of Changchun University of Traditional Chinese Medicine,Dongfang Hospital of Beijing University of Chinese Medicine,Guangdong Province Traditional Chinese Medical Hospital and Affiliated Hospital of Anhui University of Traditional Chinese Medicine.Twelve experts in aggregate were confirmed to participate in the discussion for the identification of the TCM syndrome types,treatments and prescriptions of myasthenia gravis.As a result,five TCM syndrome types,such as syndrome of spleen and stomach qi deficiency,syndrome of spleen-kidney deficiency,deficiency syndrome of both qi and yin,syndrome of deficiency and sinking of qi,were confirmed;while five therapeutic regimes were approved,including reinforcement of qi,tonification of spleen and stomach,tonification of spleen and kidney qi,tonification of qi and yin,the supplement of qi and restoration of yang for ascending qi collapse.In addition,five prescriptions were supported by the experts,such as Bu Zhong Yi Qi (BZYQ) decoction,BZYQ decoction combined with You Gui pills,BZYQ decoction combined with Sheng Mai powders and Sheng Xian decoction.In conclusion,the expert consensus method for the screen of TCM syndrome types of myasthenia gravis embodied the conception of literature research based on the clinical practice combined with the scientific methods in conformity with the current research approaches to TCM syndrome types.


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